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Journal and News Scan
Bicuspid aortic valve (BAV) has been considered as a relative contraindication for transcatheter aortic valve implantation (TAVI) in aortic valve stenosis. In this retrospective study of the German TAVI registry, the authors have compared outcomes in patients with bicuspid and tricuspid aortic valves (TAV). Out of the 1424 patients included in the registry, 38 had bicuspid aortic valves. After TAVI, the incidence of significant aortic regurgitation (≥II) was significantly higher in patients with BAV (25 vs 15%). Interestingly, the need for pacemaker implantation was higher in patients with TAV (35 vs 17%). There was no difference in 30 day mortality and BAV was not found to be associated with 1-year mortality in the univariate and Cox regression analysis. Although the findings are interesting, they should be interpreted with caution because of the nature of the study.
This prospective study evaluated changes in diaphragm thickness during weaning trials in ventilated patients as a predictor of successful weaning. An increase in thickness of more than 30% between end-expiration and end-inspiration had a positive predictive value of 91% and an area under the ROC curve of 0.79.
In this study the authors evaluate the results of intramyocardial injection of human resident cardiac stem cells and blood derived circulatory angiogenic cells in a mouse myocardial infarction model, comparing the effect on ventricular function and myocardial repair of combined and individual administration of the cells. Better post-infarct ventricular function and myocardial repair were observed with combination therapy than when either type of cell was given alone.
Percutaneous edge to edge repair with MitraClip is typically used in situations of central mitral insufficiency (MI). In this study, the authors evaluate the applicability of this technique in non-central MI. They have carried out a retrospective analysis of their own results in a group of 79 patients. Although patients with non-central MI had higher pulmonary pressures and wider basal vena contracta, there were no significant differences in procedural success or complications. In addition, there were no significant differences in all-cause mortality, readmission for heart failure, residual MI and NYHA status at 1 and 6 months. Although the study is probably too small in size as to provide strong evidence, the results suggest that non-central MI could be amenable to treatment with percutaneous edge to edge repair techniques.
This excellent video and accompanying text provide a nice description of Swan-Ganz catheter insertion.
The issue of this single center experience was to analyze whether the concomitant cardiac surgery had a negative impact during the implantation and the follow up in patients with long term LVAD. The results are encouraging.
Pro–surfactant protein B (pro-SFTPB) has been previously identified as a possible blood bio-marker for NSCLC. This study assessed whether it is an independent predictory of lung cancer development. Blood levels were measured in nearly 2500 individuals in a Candadian lung cancer screening study. The adjusted OR for pro-SFTPB was 2.22 and the area under the ROC curve (predictive accuracy) was 0.74.
A case-control study within a large screening trial was performed to evaluate the relationship of serum inflammation markers and lung cancer. Of 68 evaluable markers, 11 were found to have a significant association with lung cancer. Increasing marker levels were associated with increasing cancer risk. The findings were unrelated to cell type and smoking status.
In this manuscript the authors evaluate the data from an Italian multicentre registry looking at the effect of diabetes mellitus (DM) on outcomes following transcatheter aortic valve implantations. At 30 days, patients with orally treated and insulin-treated DM demonstrated non-significant higher rates of all cause and cardiovascular death than non-diabetic patients. There was no difference with regards to safety outcomes such as acute kidney injury, vascular complications, stroke or life-threatening bleeding, between diabetic and non-diabetic patients.
Ad midterm follow up (median 400 days), and after multivariable analysis, insulin-treated DM was independently correlated with death and myocardial infarction.