Assessment of CardiOvascular Remodelling following Endovascular aortic repair through imaging and computation: the CORE prospective observational cohort study protocol

Thoracic aortic stent grafts are orders of magnitude stiffer than the native aorta. These devices have been associated with acute hypertension, elevated pulse pressure, cardiac remodelling and reduced coronary perfusion. However, a systematic assessment of such cardiovascular effects of thoracic endovascular aortic repair (TEVAR) is missing. The CardiOvascular Remodelling following Endovascular aortic repair (CORE) study aims to (1) quantify cardiovascular remodelling following TEVAR and compare echocardiography against MRI, the reference method; (2) validate computational modelling of cardiovascular haemodynamics following TEVAR using clinical measurements, and virtually assess the impact of more compliant stent grafts on cardiovascular haemodynamics; and (3) investigate diagnostic accuracy of ECG and serum biomarkers for cardiac remodelling compared to MRI

A preferred time for onset of Tako-Tsubo cardiomyopathy?

Recent studies have investigated the possibility of a temporal organization of onset of Tako-Tsubo cardiomyopathy (TTC). A computer-assisted search of the literature (from 2000 to January 2010) was done. Criteria for publication inclusion were: a) reporting of original data, b) inclusion of at least 5 or more cases, c) adherence to the requested diagnostic criteria for TTC. A particular attention was given to studies including in their purposes the time of occurrence of events. Ouf of the 43 studies found, 7 addressed this topic. A circadian (morning) and a seasonal (summer) higher frequency of events was found. Moreover, one study showed a Monday preference. Stress and catecholamines, according also to their temporal organization, might play a role

Malperfusion syndromes in type A aortic dissection: what we have learned from IRAD

Patients presenting with type A acute aortic dissection (TAAD) complicated by malperfusion syndromes represent one of the highest surgical risk cohorts for cardiovascular surgeons. In the setting of aortic dissection, end-organ ischemia may involve any of the major arterial side branches resulting in myocardial, cerebral, spinal cord, visceral and/or limb ischemia. In TAAD patients with malperfusion, notwithstanding continuous improvement in diagnostic and management strategies, surgical and clinical outcomes remain poor and the optimal therapy is controversial. The present review aimed to assess current evidence on TAAD patients with the complication of malperfusion, as enunciated by the International Registry of Acute Aortic Dissection (IRAD) investigators