Role of Echocardiography Before Transcatheter Aortic Valve Implantation (TAVI)

Aortic stenosis (AS) is the most common primary valve disorder in the elderly with an increasing prevalence; transcatheter aortic valve implantation (TAVI) has become an accepted alternative to surgical aortic valve replacement (AVR) in the high risk or inoperable patient. Appropriate selection of patients for TAVI is crucial and requires a multidisciplinary approach including cardiothoracic surgeons, interventional cardiologists, anaesthetists, imaging experts and specialist nurses. Multimodality imaging including echocardiography, CT and MRI plays a pivotal role in the selection and planning process; however, echocardiography remains the primary imaging modality used for patient selection, intra-procedural guidance, post-procedural assessment and long-term follow-up. The contribution that contemporary transthoracic and transoesophageal echocardiography make to the selection and planning of TAVI is described in this article

Multimodality Imaging Markers of Adverse Myocardial Remodeling in Aortic Stenosis

Aortic stenosis (AS) causes left ventricular remodeling (hypertrophy, remodeling, fibrosis) and other cardiac changes (left atrial dilatation, pulmonary artery and right ventricular changes). These changes, and whether they are reversible (reverse remodeling), are major determinants of timing and outcome from transcatheter or surgical aortic valve replacement. Cardiac changes in response to AS afterload can either be adaptive and reversible, or maladaptive and irreversible, when they may convey residual risk after intervention. Structural and hemodynamic assessment of AS therefore needs to evaluate more than the valve, and, in particular, the myocardial remodeling response. Imaging plays a key role in this. This review assesses how multimodality imaging evaluates AS myocardial hypertrophy and its components (cellular hypertrophy, fibrosis, microvascular changes, and additional features such as cardiac amyloid) both before and after intervention, and seeks to highlight how care and outcomes in AS could be improved

Moderate Aortic Stenosis: What is it and When Should We Intervene?

Current guidelines recommend aortic valve replacement in patients with severe aortic stenosis in the presence of symptoms or a left ventricular ejection fraction <50%. However, patients with less than severe aortic stenosis may also experience symptoms and recent literature suggests that the prognosis is not as benign as previously reported. There are no recommendations for patients with moderate aortic stenosis and left ventricular dysfunction, despite the high associated morbidity and mortality. There is also some evidence that these patients may benefit from early aortic valve intervention. It is recognised that aortic stenosis not only affects the valve but also has a complex myocardial response. This review discusses the natural history of moderate aortic stenosis along with the role of multimodality imaging in risk stratification in these patients

Bacterial susceptibility and resistance to modelin-5.

Modelin-5 (M5-NH ) killed with a minimum lethal concentration (MLC) of 5.86 μM and strongly bound its cytoplasmic membrane (CM) with a of 23.5 μM. The peptide adopted high levels of amphiphilic α-helical structure (75.0%) and penetrated the CM hydrophobic core (8.0 mN m ). This insertion destabilised CM structure increased lipid packing and decreased fluidity (Δ 0) and promoted only low levels of lysis (24.3%). The insertion and lysis of the CM by M5-NH showed a strong negative correlation with its lysyl phosphatidylglycerol (Lys-PG) content ( > 0.98). In combination, these data suggested that Lys-PG mediated mechanisms inhibited the membranolytic action of M5-NH against , thereby rendering the organism resistant to the peptide. These results are discussed in relation to structure/function relationships of M5-NH and CM lipids that underpin bacterial susceptibility and resistance to the peptide

Aortic Stenosis, a Left Ventricular Disease: Insights from Advanced Imaging

Aortic stenosis (AS) is the most common primary valve disorder in the elderly with an increasing prevalence. It is increasingly clear that it is also a disease of the left ventricle (LV) rather than purely the aortic valve. The transition from left ventricular hypertrophy to fibrosis results in the eventual adverse effects on systolic and diastolic function. Appropriate selection of patients for aortic valve intervention is crucial, and current guidelines recommend aortic valve replacement in severe AS with symptoms or in asymptomatic patients with left ventricular ejection fraction (LVEF) <50 %. LVEF is not a sensitive marker and there are other parameters used in multimodality imaging techniques, including longitudinal strain, exercise stress echo and cardiac MRI that may assist in detecting subclinical and subtle LV dysfunction. These findings offer potentially better ways to evaluate patients, time surgery, predict recovery and potentially offer targets for specific therapies. This article outlines the pathophysiology behind the LV response to aortic stenosis and the role of advanced multimodality imaging in describing it

Growth response and body composition of sharpsnout sea bream (Diplodus puntazzo) fed a high energy diet with different protein levels.

A study was undertaken to determine the effect of a high energy diet with two different protein levels on growth, feed efficiency and whole body composition of sharpsnout sea bream (Diplodus puntazzo). Two isoenergetic diets (24.1-24.7 MJ Kg-1 dry weight) with two different protein levels (46.7 and 52.5 % dry weight) were fed to satiety to duplicate groups of 300 fish (initial body weight 27.7 \ub1 0.2 g) for 94 days. At the end of the experiment, the fish fed 52.5 % protein showed a statistically higher (P < 0.05) daily intake rate (DIR) of feed. Feed conversion rate (FCR) was similar among groups. Whole body composition was similar among treatments while the high enrgy level of the diets significantly modified lipid and moisture content in comparison with fish at the beginning of the experiment. Protein efficiency ratio (PER), gross protein efficiency (GPE) of fish fed 46.7 % protein diet were statistically higher than those for the other diet. It may be concluded that the diet with a lower protein level has given better protein utilization and a protein sparing effect but tended to result in reduced weight gain and feed intake, when compared with diet containing higher protein levels

Authentication of European sea bass according to production method and geographical origin by light stable isotope ratio and rare earth elements analyses combined with chemometrics

In this work, stable isotope ratio (SIR) and rare earth elements (REEs) analyses, combined with multivariate data elaboration, were used to explore the possibility to authenticate European sea bass (Dicentrarchus labrax L.) according to: i) production method (wild or farmed specimens); ii) geographical origin (Western, Central or Eastern Mediterranean Sea). The dataset under investigation included a total of 144 wild and farmed specimens coming from 17 different European areas located in the Mediterranean Sea basin. Samples were subjected to SIR analysis (carbon and nitrogen) and REEs analysis (lanthanum, europium, holmium, erbium, lutetium, and terbium). Then, Analytical data were handled by Principal Component Analysis (PCA) and then by Orthogonal Partial Last Square Discriminant Analysis (OPLS-DA), to obtain functional classification models to qualitatively discriminate sea bass according to the conditions under study. OPLSDA models provided good correct classification rate both for production method and geographical origin. It was confirmed that chemometric elaboration of data obtained from SIR and REEs analyses can be a suitable tool for an accurate authentication of European sea bass

Effect of dietary antioxidant supplementation on rabbit performance, meat quality and oxidative stability of muscles

[EN] The aim of this study was to cast light on the effects of EconomasE™ (EcoE), a patented pre-mixture of nutritional additives consisting mainly of organic selenium (0.15 or 0.30 mg/kg feed; Se) combined with vitamin C (5 and 10 mg/kg feed; VC), compared to DL-α-tocopherol acetate (100 or 200 mg/kg feed; VE) dietary supplementation on rabbit performance and meat quality. In fact, the role of Se supplementation in the rabbit diet has not yet been elucidated in the literature and, more specifically, there are no studies on the possible synergistic action between organic Se compared with VE on lipids, fatty acids (FA) and the oxidative stability of two glycolytic muscles, longissimus lumborum (LL) and biceps femoris (BF). Two hundred and seventy New Zealand White rabbits were divided into five dietary groups of 54 rabbits each: 1) control (basal diet = BD; CTRL); 2) VE100 (BD + VE100 mg/kg); 3) VE200 (BD + VE200 mg/kg); 4) EcoE100 (BD + EcoE100 mg/kg); and 5) EcoE200 (BD + EcoE200 mg/kg). Neither of the antioxidant treatments affected growth performance, carcass traits or meat characteristics. Lipid and fatty acid contents were similar in LL and BF and not influenced by the dietary treatment. Meat oxidative stability was strongly improved by both antioxidants. These findings indicate that both EcoE and VE greatly improved the oxidative stability of LL and BF muscles at the dosage rates which, from an economic point of view, would normally be included in the formulation of feeds for rabbits.This study is part of a multidisciplinary research project funded by the Department of Veterinary Medical Science (University of Bologna, Italy). 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Metabolomics as a Powerful Tool for Molecular Quality Assessment of the Fish Sparus aurata

The molecular profiles of perchloric acid solutions extracted from the flesh of Sparus aurata fish specimens, produced according to different aquaculture systems, have been investigated. The 1H-NMR spectra of aqueous extracts are indicative of differences in the metabolite content of fish reared under different conditions that are already distinguishable at their capture, and substantially maintain the same differences in their molecular profiles after sixteen days of storage under ice. The fish metabolic profiles are studied by top-down chemometric analysis. The results of this exploratory investigation show that the fish metabolome accurately reflects the rearing conditions. The level of many metabolites co-vary with the rearing conditions and a few metabolites are quantified including glycogen (stress indicator), histidine, alanine and glycine which all display significant changes dependent on the aquaculture system and on the storage times