Canadian Stroke Best Practice Recommendations: Vascular cognitive impairment, 7th edition practice guidelines update, 2024.

The Canadian Stroke Best Practice Recommendations (CSPR) 7th edition includes this new module on the diagnosis and management of vascular cognitive impairment (VCI) with or without neurodegenerative disease. An expert writing group and people with VCI lived experience (PWLE) reviewed current evidence. Existing recommendations were reviewed and revised, and new recommendations added.

Recommendations for mitochondria transfer and transplantation nomenclature and characterization.

Intercellular mitochondria transfer is an evolutionarily conserved process in which one cell delivers some of their mitochondria to another cell in the absence of cell division. This process has diverse functions depending on the cell types involved and physiological or disease context. Although mitochondria transfer was first shown to provide metabolic support to acceptor cells, recent studies have revealed diverse functions of mitochondria transfer, including, but not limited to, the maintenance of mitochondria quality of the donor cell and the regulation of tissue homeostasis and remodelling.

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.

Distinct peripheral pro-inflammatory profile associated with tuberous sclerosis complex and epilepsy.

Objective: Tuberous sclerosis complex (TSC) is a monogenetic disorder associated with sustained mechanistic target of rapamycin (mTOR) activation, leading to heterogeneous clinical manifestations. Epilepsy and renal angiomyolipoma are the most important causes of morbidity in adult people with TSC (pwTSC). mTOR is a key player in inflammation, which in turn could influence TSC-related clinical manifestations.

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.

Atrial FDG Uptake: Etiologies, Clinical Significance, and Implications.

Purpose Of Review: This review aims to explore the clinical significance of atrial fluorodeoxyglucose (FDG) uptake observed in positron emission tomography (PET) scans, focusing on its association with atrial fibrillation (AF), cardiac sarcoidosis, and myocarditis. We discuss the implications of atrial uptake for patient management and prognosis.

Recent Findings: Recent studies have demonstrated that atrial FDG uptake is frequently present in patients with AF, particularly those with persistent AF, and is linked to increased risks of stroke and poorer outcomes after ablation.

Cardiovascular diseases, prevention and management of complications in older adults and frail patients treated for elective or post-traumatic hip orthopaedic interventions.

Due to the aging population, focusing on healthy aging has become a global priority. Cardiovascular diseases (CVDs) and frailty, characterized by increased vulnerability to adverse stress and health events, interact synergistically in advanced age. In older adults, hip fractures are a frequent dramatic "life-transition" event.

Masking in Active Comparator Designs in Pharmacovigilance: A Retrospective Bias Analysis on the Spontaneous Reporting of Thiazolidinediones and Cardiovascular Events.

Introduction: Masking is a reporting bias where drug safety signals are muffled by elevated reporting of other medications in spontaneous reporting databases. While the impact of masking is often limited, its effect when using restricted designs, such as active comparators, can be consequential.

Methods: We used data from the US Food and Drugs Administration Adverse Event Reporting System (1999Q3-2013Q3) to study masking in a real-world example.

Cardiovascular Risk in Prostate Cancer: State-of-the-Art Review.

Cardiovascular disease is common in patients with prostate cancer and is a significant cause of death. Cardiovascular risk factors are frequent in this population and are often not addressed to thresholds recommended by cardiovascular practice guidelines. Androgen deprivation therapy reduces muscle strength and increases adiposity, increasing the risk for diabetes and hypertension, although its relationship with adverse cardiovascular events requires confirmation.

Transformation and articulation of clinical data to understand students' clinical reasoning: a scoping review.

Background: Despite the importance of effective educational strategies to promote the transformation and articulation of clinical data while teaching and learning clinical reasoning, unanswered questions remain. Understanding how these cognitive operations can be observed and assessed is crucial, particularly considering the rapid growth of artificial intelligence and its integration into health education. A scoping review was conducted to map the literature regarding educational strategies to support transformation and articulation of clinical data, the learning tasks expected of students when exposed to these strategies and methods used to assess individuals' proficiency METHODS: Based on the Joanna Briggs Institute methodology, the authors searched 5 databases (CINAHL, MEDLINE, EMBASE, PsycINFO and Web of Science), ProQuest Dissertations & Theses electronic database and Google Scholar.

Sacubitril/valsartan versus valsartan initiation in patients naïve to renin-angiotensin system inhibitors: Insights from PARAGLIDE-HF.

Aims: Whether prior treatment with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) modifies efficacy and safety of sacubitril/valsartan (Sac/Val) in patients with heart failure (HF) and ejection fraction (EF) >40% is unclear, thus Sac/Val according to ACEi/ARB status at baseline was assessed.

Methods And Results: This was a pre-specified analysis of Prospective comparison of ARNI with ARB Given following stabiLization In DEcompensated HFpEF (PARAGLIDE-HF), a double-blind, randomized controlled trial of Sac/Val versus valsartan, categorizing patients according to baseline ACEi/ARB status. The primary endpoint was time-averaged proportional change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) from baseline through weeks 4 and 8.

Patterns of Cerebellar-Cortical Structural Covariance Mirror Anatomical Connectivity of Sensorimotor and Cognitive Networks.

The cortex and cerebellum are densely connected through reciprocal input/output projections that form segregated circuits. These circuits are shown to differentially connect anterior lobules of the cerebellum to sensorimotor regions, and lobules Crus I and II to prefrontal regions. This differential connectivity pattern leads to the hypothesis that individual differences in structure should be related, especially for connected regions.

Acute Effect of High-Intensity Interval Exercise on Blood Pressure in Females Living with Type 2 Diabetes and Hypertension.

Background : The acute effects of high-intensity interval training (HIIT) on blood pressure (BP) may depend on the exercise protocol performed. Purpose: To compare the acute effect of high and low-volume HIIT on post-exercise and ambulatory BP in untrained older females diagnosed with both type 2 diabetes (T2D) and hypertension (HTN). Methods: Fifteen females (69 [65 ─ 74] years) completed a crossover study with three experimental conditions: 1) REST (35 min in sitting position); 2) HIIT10 (10 × 1 min at 90% heart rate max [HRmax]), and 3) HIIT4 (4 × 4 min at 90% HRmax).

Covert Vascular Brain Injury and Cognitive Dysfunction Among Chinese Adults Living in Canada and China: The CAHHM and PURE-MIND Studies.

Background And Objective: It is unclear whether variation in covert cerebrovascular disease prevalence is attributable to ethnic differences or to other factors. We aimed to examine the associations of country of residence with covert vascular brain injury (VBI) and cognitive dysfunction among Chinese adults residing in Canada and China.

Methods: This was a multisite cross-sectional study of Chinese adults aged 40-80 years in the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM; January 1, 2014, to December 31, 2018) and Prospective Urban Rural Epidemiological-Mind (PURE-MIND; November 1, 2010, to July 31, 2015) cohorts living in Canada and China.

Cardiorespiratory fitness in COPD and HF from the Fitness Registry and the Importance of Exercise: a National Database.

Aims: To better characterize functional consequences of the presence of COPD on cardiorespiratory fitness in patients with HF.

Methods And Results: Patients with any clinical indication for cardiopulmonary exercise testing (CPET) were included in the international FRIEND registry. Diagnosis of COPD was confirmed by a ratio of forced expiratory volume in 1 s and forced vital capacity (FEV/FVC) < 0.

Five-year comparison of clinical and echocardiographic outcomes of pure aortic stenosis with pure aortic regurgitation or mixed aortic valve disease in the COMMENCE trial.

Objective: To compare outcomes of aortic valve replacement (AVR) in patients with pure aortic stenosis (Pure AS) and those with pure aortic regurgitation (Pure AR) or mixed AS and AR (MAVD) in the COMMENCE trial.

Methods: Of 689 patients who underwent AVR in the COMMENCE trial, patients with moderate or severe AR with or without AS (Pure AR + MAVD; n = 135) or Pure AS (n = 323) were included. Inverse probability of treatment weighting Kaplan-Meier survival curves were used for time-to-event endpoints, and longitudinal changes in hemodynamics were evaluated using mixed-effects models.

Modifiable Health Behaviours in Children with HCM: Lessons from the Heart Health Survey.

Obesity factors into hypertrophic cardiomyopathy (HCM)-related risk as a disease modifying environmental factor. Behaviours such as diet and sleep are seldom reported upon in children with HCM. It was our aim to report on these factors in this population.

Sugar-sweetened or artificially sweetened beverage consumption, physical activity and risk of type 2 diabetes in US adults.

Aims/hypothesis: A positive association between sugar-sweetened beverages (SSBs) and diabetes risk has been shown, with inconsistent evidence between artificially sweetened beverages (ASBs) and diabetes. Moreover, it is uncertain if physical activity can mitigate the negative effects of these beverages on diabetes development. Therefore, we aimed to evaluate the independent and joint associations between SSB or ASB consumption and physical activity on the risk of type 2 diabetes.

Bias Mitigation in Primary Health Care Artificial Intelligence Models: Scoping Review.

Background: Artificial intelligence (AI) predictive models in primary health care have the potential to enhance population health by rapidly and accurately identifying individuals who should receive care and health services. However, these models also carry the risk of perpetuating or amplifying existing biases toward diverse groups. We identified a gap in the current understanding of strategies used to assess and mitigate bias in primary health care algorithms related to individuals' personal or protected attributes.

Usefulness of Aortic Valve Calcification in Patients With Low-Flow Aortic Stenosis.

Background: Aortic valve calcification (AVC) has been shown to be a powerful assessment of aortic stenosis (AS) severity and a predictor of adverse outcomes. However, its accuracy in patients with low-flow AS has not yet been proven. The objective of the study was to assess the predictive value of AVC in patients with classical low-flow (CLF, that is, low-flow reduced left ventricular ejection fraction) or paradoxical low-flow (PLF, that is, low-flow preserved left ventricular ejection fraction) AS.