Dataset on the use of 3D speckle tracking echocardiography in light-chain amyloidosis

The dataset presented in this article is related to the research article entitled “Biventricular assessment of light-chain amyloidosis using 3D speckle tracking echocardiography: Differentiation from other forms of myocardial hypertrophy” (Vitarelli et al.,2018) [1], which examined the potential utility of left ventricular (LV) and right ventricular (RV) deformation and rotational parameters derived from three-dimensional speckle-tracking echocardiography (3DSTE) to diagnose cardiac amyloidosis(CA) and differentiate this disease from other forms of myocardial hypertrophy. The combined assessment of LV basal longitudinal strain, LV basal rotation and RV basal longitudinal strain had a high discriminative power for detecting CA. The data of this study provides more understanding on the value of LV 3DSTE deformation parameters as well as RV parameters in this particular cardiomyopathy

How to predict conduction disturbances after transcatheter aortic valve replacement?

Transcatheter aortic valve replacement (TAVI) has evolved into the gold standard management option for high-risk patients with severe aortic stenosis. Despite procedural, electrocardiographic and clinical predictors of important post-procedural conduction disturbances (left bundle branch block [LBBB] and high-degree atrioventricular block [HAVB]) being identified, and continuous technological refinement of transcatheter aortic valves, the rate of post-procedural conduction disturbance remains high, and challenging to manage. New strategies are required to reduce the overall rate of post-procedural PPI. In this article, we will review the incidence, predictive factors, and clinical implications of conduction disturbances after TAVI

TAVI and Post Procedural Cardiac Conduction Abnormalities

Transcatheter aortic valve implantation (TAVI) is a worldwide accepted alternative for treating patients at intermediate or high risk for surgery. In recent years, the rate of complications has markedly decreased except for new-onset atrioventricular and intraventricular conduction block that remains the most common complication after TAVI. Although procedural, clinical, and electrocardiographic predisposing factors have been identified as predictors of conduction disturbances, new strategies are needed to avoid such complications, particularly in the current TAVI era that is moving quickly toward the percutaneous treatment of low-risk patients. In this article, we will review the incidence, predictive factors, and clinical implications of conduction disturbances after TAVI

Long Stent Implantation on the Left Anterior Descending Coronary Artery at a Follow-Up of More Than Five Years

Background: Stent implantation represents the standard of care in coronary intervention. While a short stent implanted on a focal lesion located on the left anterior descending artery (LAD) seems a reasonable alternative to an internal mammary implant, the same for long stents is still debated. Methods: We reported the long-term data of 531 consecutive patients who underwent Percutaneous Coronary Intervention (PCI) with long stents in two highly specialized centres. The main inclusion criteria were the implantation of stents longer than 30 mm on the LAD and a minimum follow-up (FU) of five years. The primary endpoint was mortality, and the secondary endpoints were any myocardial infarction (MI), target vessel and lesion revascularization (TVR and TLR, respectively), and stent thrombosis (ST) observed as definite, probable, or possible. Results: In this selected population with characteristics of complex PCI (99.1%), the long-term follow-up (mean 92.18 ± 35.5 months) estimates of all-cause death, cardiovascular death, and any myocardial infarction were 18.3%, 10.5%, and 9.3%, respectively. Both all-cause and cardiovascular deaths are significantly associated with three-vessel disease (HR 6.8; confidence of interval (CI) 95% 3.844–11.934; p &lt; 0.001, and HR 4.7; CI 95% 2.265–9.835; p &lt; 0.001, respectively). Target lesion (TLR) and target vessel revascularization (TVR) are associated with the presence of three-lesion disease on the LAD (HR 3.4; CI 95% 1.984–5.781; p &lt; 0.001; HR 3.9 CI 95% 2.323–6.442; p &lt; 0.001, respectively). Re-PCI for any cause occurred in 31.5% of patients and shows an increased risk for three-lesion stenting (HR 4.3; CI 95% 2.873–6.376; p &lt; 0.001) and the treatment of bifurcation with two stents (HR 1.6; 95% CI 1.051–2.414; p = 0.028). Stent thrombosis rate at the 5-year FU was 4.4% (1.3% definite; 0.9% probable; 2.1% possible), including a 1.7% rate of very-late thrombosis. The stent length superior to 40 mm was not associated with poor outcomes (all-cause death p = 0.349; cardiovascular death p = 0.855; MI p = 0.691; re-PCI p = 0.234; TLR p = 0.805; TVR p = 0.087; ST p = 0.189). Conclusion: At an FU of longer than five years, patients treated with stents longer than 30 mm in their LAD showed acceptable procedural results but poor outcomes.</p

Long Stent Implantation on the Left Anterior Descending Coronary Artery at a Follow-Up of More Than Five Years

Background: Stent implantation represents the standard of care in coronary intervention. While a short stent implanted on a focal lesion located on the left anterior descending artery (LAD) seems a reasonable alternative to an internal mammary implant, the same for long stents is still debated. Methods: We reported the long-term data of 531 consecutive patients who underwent Percutaneous Coronary Intervention (PCI) with long stents in two highly specialized centres. The main inclusion criteria were the implantation of stents longer than 30 mm on the LAD and a minimum follow-up (FU) of five years. The primary endpoint was mortality, and the secondary endpoints were any myocardial infarction (MI), target vessel and lesion revascularization (TVR and TLR, respectively), and stent thrombosis (ST) observed as definite, probable, or possible. Results: In this selected population with characteristics of complex PCI (99.1%), the long-term follow-up (mean 92.18 ± 35.5 months) estimates of all-cause death, cardiovascular death, and any myocardial infarction were 18.3%, 10.5%, and 9.3%, respectively. Both all-cause and cardiovascular deaths are significantly associated with three-vessel disease (HR 6.8; confidence of interval (CI) 95% 3.844–11.934; p &lt; 0.001, and HR 4.7; CI 95% 2.265–9.835; p &lt; 0.001, respectively). Target lesion (TLR) and target vessel revascularization (TVR) are associated with the presence of three-lesion disease on the LAD (HR 3.4; CI 95% 1.984–5.781; p &lt; 0.001; HR 3.9 CI 95% 2.323–6.442; p &lt; 0.001, respectively). Re-PCI for any cause occurred in 31.5% of patients and shows an increased risk for three-lesion stenting (HR 4.3; CI 95% 2.873–6.376; p &lt; 0.001) and the treatment of bifurcation with two stents (HR 1.6; 95% CI 1.051–2.414; p = 0.028). Stent thrombosis rate at the 5-year FU was 4.4% (1.3% definite; 0.9% probable; 2.1% possible), including a 1.7% rate of very-late thrombosis. The stent length superior to 40 mm was not associated with poor outcomes (all-cause death p = 0.349; cardiovascular death p = 0.855; MI p = 0.691; re-PCI p = 0.234; TLR p = 0.805; TVR p = 0.087; ST p = 0.189). Conclusion: At an FU of longer than five years, patients treated with stents longer than 30 mm in their LAD showed acceptable procedural results but poor outcomes.</p

Update on the Current Landscape of Transcatheter Options for Tricuspid Regurgitation Treatment

Most patients with severe tricuspid regurgitation lack treatment options because of prohibitive surgical risk. New transcatheter treatments under development and investigation might be able to address this unmet clinical need. This article gives an update on the landscape of devices for transcatheter tricuspid regurgitation treatment including different approaches (i.e. repair with leaflet approximation or annuloplasty and replacement using orthotopic or heterotopic valves) at different stages of development, from experimental to clinical trial. Repair devices such as the Cardioband or the MitraClip are leading the field with promising preliminary data and further trials are ongoing. However, with implantations of the Gate bioprosthesis, replacement devices are catching up. Potential advantages of different approaches and most recent data are discussed

The Role of Cerebral Embolic Protection Devices During Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement is the therapy of choice for patients with severe aortic stenosis who have prohibitive or high surgical risk. However, the benefit of TAVR is attenuated by the occurrence of major disabling stroke which is associated with increased mortality and early-reduced quality of life. Despite advances in TAVR technology, stroke remains a serious complication that is associated with significant negative outcomes. The majority of these occur in the acute phase following TAVR where cerebral embolic events are frequent. Cerebral embolic protection devices (CEPD) have been developed to minimize the risk of peri-procedural ischemic stroke during TAVR. CEPD have the potential to reduce intraprocedural burden of new silent ischemic injury. In this review we outline the etiology and incidence of stroke in TAVR population, and systematically review current evidence for cerebral embolic protection devices

In vitro ovicidna aktivnost smeše linaloola i estragola protiv gastrointestinalnih nematoda ovaca

Based on the results in different studies conducted so far, plant essential oils (EOs) are recently been marked as a possible solution for the problem of anthelmintic resistance (AR). However, their efficacy against a wide range of livestock parasites is due to active ingredients. In that context, the aim of this study was to evaluate the in vitro ovicidal effect of a mixture of linalool and estragole (14% : 86%, respectively) against sheep gastrointestinal nematodes (GINs) using the egg hatch test (EHT). The study was conducted using faecal samples of naturally infected sheep by GINs from two different farms located in Southern Italy. Coproculture of tested faecal samples was performed, as well as chemical analyses of the tested mixture. The egg hatch test (EHT) was performed at six different concentrations (50, 12.5, 3.125, 0.781, 0.195 and 0.049 mg/mL) and the obtained values were compared to the positive control (thiabendazole, 0.025 mg/mL) and the negative control (3% Tween 80, v/v). The tested binary combination showed high and dose-dependent ovicidal activity varied from 29.5% to 100%. The inhibitory effect on egg hatchability was similar (p>0.05) to the positive control (98.0%) at concentrations of 50 mg/mL (100%), 12.5 mg/mL (100%) and 3.125 (99.8%). Moreover, all tested concentrations showed significantly higher (p<0.001) activity compared to the negative control. The obtained results suggest that the combination of linalool:estragole has the potential to be used against sheep GINs. These also highlight the possible role of different combinations of certain constituents of essential oils in combating AR. However, these findings need confirmation in further in vivo studies.Na osnovu rezultata do sada sprovedenih istraživanja, etarska ulja biljaka su označena kao jedna od mogućih opcija za rešenje problemarezistencije na antihelmintike. Pri tome, za njihovu efikasnost protiv različitih parazita domaćih životinja odgovorni su njihovi aktivni sastojci. U tom kontekstu, cilj ovog istraživanja je bio ispitati ovicidnu efikasnost smeše linaloola i estragola (14% i 86%, tim redom) protiv gastrointestinalnih nematoda (GIN) ovaca koristeći test izleganja jaja (egg hatch test (EHT)). U studiji su korišćeni uzorci fecesa ovaca prirodno inficiranih GIN sa dve različite farme u južnoj Italiji. Koprokultura testiranih uzoraka je sprovedena, kao i hemijske analize testirane smeše. EHT je sproveden za šest različitih koncentracija (50; 12,5; 3,125; 0,781; 0,195 i 0,049 mg/mL), pri čemu su dobijeni rezultati upoređeni sa pozitivnom (tiabendazol, 0.025 mg/mL) i negativnom (3% Tween 80) kontrolom. Testirana binarna kombinacija je pokazala snažnu, dozno-zavisnu ovicidnu aktivnost koja je varirala između 29,5% i 100%. Inhibitorni efekat na izleganje larvi je bio sličan (p<0,05) pozitivnoj kontroli (98,0%) pri koncentracijama od 50 mg/mL (100%), 12,5 mg/mL (100%) i 3,125 mg/mL (99,8%). Pri tome, kod svih testiranih koncentracija efekat je bio značajno veći (p<0,001) u poređenju sa negativnom kontrolom. Dobijeni rezultati ukazuju na to da ispitana smeša linaloola i estragola ima potencijal da se koristi protiv GIN ovaca. Takođe, ova studija ukazuje na moguću ulogu različitih sastojaka biljnih etarskih ulja u borbi protiv rezistencije na antihelmintike. Međutim, ovi nalazi zahtevaju dodatnu potvrdu u budućim in vivo ispitivanjima

Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real-world multicentre experience.

AIMS Transcatheter mitral valve implantation (TMVI) is a new treatment option for patients with symptomatic mitral valve (MV) disease. Real-world data have not yet been reported. This study aimed to assess procedural and 30-day outcomes of TMVI in a real-world patient cohort. METHOD AND RESULTS All consecutive patients undergoing implantation of a transapically delivered self-expanding valve at 26 European centres from January 2020 to April 2021 were included in this retrospective observational registry. Among 108 surgical high-risk patients included (43% female, mean age 75 ± 7 years, mean STS-PROM 7.2 ± 5.3%), 25% was treated for an off-label indication (e.g. previous MV intervention or surgery, mitral stenosis, mitral annular calcification). Patients were highly symptomatic (New York Heart Association [NYHA] functional class III/IV in 86%) and mitral regurgitation (MR) was graded 3+/4+ in 95% (38% primary, 37% secondary, and 25% mixed aetiology). Technical success rate was 96%, and MR reduction to ≤1+ was achieved in all patients with successful implantation. There were two procedural deaths and 30-day all-cause mortality was 12%. At early clinical follow-up, MR reduction was sustained and there were significant reductions of pulmonary pressure (systolic pulmonary artery pressure 52 vs. 42 mmHg, p < 0.001), and tricuspid regurgitation severity (p = 0.013). Heart failure symptoms improved significantly (73% in NYHA class I/II, p < 0.001). Procedural success rate according to MVARC criteria was 80% and was not different in patients treated for an off-label indication (74% vs. 81% for off- vs. on-label, p = 0.41). CONCLUSION In a real-world patient population, TMVI has a high technical and procedural success rate with efficient and durable MR reduction and symptomatic improvement