Abstracts from the 8th International Conference on cGMP Generators, Effectors and Therapeutic Implications

This work was supported by a restricted research grant of Bayer AG

Early outcomes following transatrial transcatheter mitral valve replacement in patients with severe mitral annular calcification

Objective: Implantation of a transcatheter valve-in-mitral annular calcification (ViMAC) has emerged as an alternative to traditional surgical mitral valve (MV) replacement. Previous studies evaluating ViMAC aggregated transseptal, transapical, and transatrial forms of the procedure, leaving uncertainty about each technique's advantages and disadvantages. Thus, we sought to evaluate clinical outcomes specifically for transatrial ViMAC from the largest multicenter registry to-date. Methods: Patients with symptomatic MV dysfunction and severe MAC who underwent ViMAC were enrolled from 12 centers across the United States and Europe. Clinical characteristics, procedural details, and clinical outcomes were abstracted from the electronic record. The primary end point was all-cause mortality. Results: We analyzed 126 patients who underwent ViMAC (median age 76 years [interquartile range {IQR}, 70-82 years], 28.6% female, median Society of Thoracic Surgeons score 6.8% [IQR, 4.0-11.4], and median follow-up 89 days [IQR, 16-383.5]). Sixty-one (48.4%) had isolated mitral stenosis, 25 (19.8%) had isolated mitral regurgitation (MR), and 40 (31.7%) had mixed MV disease. Technical success was achieved in 119 (94.4%) patients. Thirty (23.8%) patients underwent concurrent septal myectomy, and 8 (6.3%) patients experienced left ventricular outflow tract obstruction (7/8 did not undergo myectomy). Five (4.2%) patients of 118 with postprocedure echocardiograms had greater than mild paravalvular leak. Thirty-day and 1-year all-cause mortality occurred in 16 and 33 patients, respectively. In multivariable models, moderate or greater MR at baseline was associated with increased risk of 1-year mortality (hazard ratio, 2.31; 95% confidence interval, 1.07-4.99, P = .03). Conclusions: Transatrial ViMAC is safe and feasible in this selected, male-predominant cohort. Patients with significant MR may derive less benefit from ViMAC than patients with mitral stenosis only

Comparison of methods for collecting and modeling dissimilarity data: applications to complex sound stimuli

Sorting procedures are frequently adopted as an alternative to dissimilarity ratings to measure the dissimilarity of large sets of stimuli in a comparatively short time. However, systematic empirical research on the consequences of this experiment-design choice is lacking. We carried out a behavioral experiment to assess the extent to which sorting procedures compare to dissimilarity ratings in terms of efficiency, reliability, and accuracy, and the extent to which data from different data-collection methods are redundant and are better fit by different distance models. Participants estimated the dissimilarity of either semantically charged environmental sounds or semantically neutral synthetic sounds. We considered free and hierarchical sorting and derived indications concerning the properties of constrained and truncated hierarchical sorting methods from hierarchical sorting data. Results show that the higher efficiency of sorting methods comes at a considerable cost in terms of data reliability and accuracy. This loss appears to be minimized with truncated hierarchical sorting methods that start from a relatively low number of groups of stimuli. Finally, variations in data-collection method differentially affect the fit of various distance models at the group-average and individual levels. On the basis of these results, we suggest adopting sorting as an alternative to dissimilarity-rating methods only when strictly necessary. We also suggest analyzing the raw behavioral dissimilarities, and avoiding modeling them with one single distance model

Aortic atherosclerosis as an embolic source

Stroke is the third leading cause of death in several industrial countries and cardiogenic embolism accounts for 15\u201330 % of ischaemic strokes [1\u20135]. The diagnosis of a cardioembolic source of stroke is frequently uncertain and relies on the identification of a potential cardiac source of embolism in the absence of significant autochthonous cerebrovascular occlusive disease. In this regard, echocardiography (either transthoracic \u2013 TTE or Transoesophageal \u2013 TEE) serves as a cornerstone in the evaluation and diagnosis of these patients [6, 7]