Spontaneous course of aortic valve disease

The fate of patients with aortic valve disease of varying degrees of severity and the relationship between symptoms and haemodynamic status have been studied in 190 adults undergoing cardiac catheterization during the last two decades. During the follow-up period, 41 patients died and 86 underwent aortic valve replacement; these two events were the endpointsfor the calculation of ‘event-free' cumulative survival. First-year survival in haemodynamically severe disease was 60% in aortic stenosis and 96% in aortic regurgitation; in moderate and mild disease (in the absence of coronary artery disease) first-year survival was 100% in both groups. After 10 years, 9% of those with haemodynamically severe aortic stenosis and 17% of those with severe regurgitation were event-free, in contrast to 35% and 22%, respectively, of those with moderate changes and 85% and 75%, respectively, of those with mild abnormalities. In the presence of haemodynamically severe disease, 66% of the patients with stenosis and 14% of those with regurgitation were severely symptomatic (history of hear (failure, syncope or New York Heart Association class HI and IV); 23% of patients with moderate stenosis and 14% with moderate regurgitation were also severely symptomatic. Only 40% of those with disease that was severe both haemodynamically and symptomatically with either stenosis or regurgitation survived the first two years; only 12% in the stenosis group and none in the regurgitation group were event-free at 5 years. Patients with haemodynamically severe aortic stenosis who had few or no symptoms had a 100% survival at 2 years; the comparable figure for the aortic regurgitation group was 94%; 75% of the patients in the stenosis group and 65% in the regurgitation group were event-free at 5 years. In the moderate or mild stenosis and regurgitation groups there was no mortality within the first 2 years in the absence of coronary artery disease, regardless of symptomatic status. Haemodynamically and symptomatically severe aortic stenosis and regurgitation have a very poor prognosis and require immediate valve surgery. Asymptomatic and mildly symptomatic patients with haemodynamically severe aortic stenosis are at low risk and surgical treatment can be postponed until marked symptoms appear without a significant risk of sudden death. In severe aortic regurgitation, the decision for surgery should depend not only on symptoms but should be considered in patients with few or no symptoms because of risk of sudden death. In the absence of coronary artery disease, moderate aortic valve disease does not require valve operation for prognostic reason

NMR Spectroscopy: A Useful Tool in the Determination of the Electrophilic Character of Benzofuroxans - Case Examples of the Reactions of Nitrobenzofuroxans with Dienes and Nucleophiles

International audienc

Meat quality of Italian Simmental young bulls as affected by the genes frequency of Montbéliarde origin

The aim of the research was the evaluation of carcass and meat quality traits of Italian Simmental young bulls, and their relationship with the degree of inclusion of genes of Montbéliarde origin

Radiomics for the detection of diffusely impaired myocardial perfusion: A proof-of-concept study using 13N-ammonia positron emission tomography

AIM The current proof-of-concept study investigates the value of radiomic features from normal 13N-ammonia positron emission tomography (PET) myocardial retention images to identify patients with reduced global myocardial flow reserve (MFR). METHODS Data from 100 patients with normal retention 13N-ammonia PET scans were divided into two groups, according to global MFR (i.e., < 2 and ≥ 2), as derived from quantitative PET analysis. We extracted radiomic features from retention images at each of five different gray-level (GL) discretization (8, 16, 32, 64, and 128 bins). Outcome independent and dependent feature selection and subsequent univariate and multivariate analyses was performed to identify image features predicting reduced global MFR. RESULTS A total of 475 radiomic features were extracted per patient. Outcome independent and dependent feature selection resulted in a remainder of 35 features. Discretization at 16 bins (GL16) yielded the highest number of significant predictors of reduced MFR and was chosen for the final analysis. GLRLM_GLNU was the most robust parameter and at a cut-off of 948 yielded an accuracy, sensitivity, specificity, negative and positive predictive value of 67%, 74%, 58%, 64%, and 69%, respectively, to detect diffusely impaired myocardial perfusion. CONCLUSION A single radiomic feature (GLRLM_GLNU) extracted from visually normal 13N-ammonia PET retention images independently predicts reduced global MFR with moderate accuracy. This concept could potentially be applied to other myocardial perfusion imaging modalities based purely on relative distribution patterns to allow for better detection of diffuse disease

Novel Harmonization Method for Multi-Centric Radiomic Studies in Non-Small Cell Lung Cancer

The purpose of this multi-centric work was to investigate the relationship between radiomic features extracted from pre-treatment computed tomography (CT), positron emission tomography (PET) imaging, and clinical outcomes for stereotactic body radiation therapy (SBRT) in early-stage non-small cell lung cancer (NSCLC). One-hundred and seventeen patients who received SBRT for early-stage NSCLC were retrospectively identified from seven Italian centers. The tumor was identified on pre-treatment free-breathing CT and PET images, from which we extracted 3004 quantitative radiomic features. The primary outcome was 24-month progression-free-survival (PFS) based on cancer recurrence (local/non-local) following SBRT. A harmonization technique was proposed for CT features considering lesion and contralateral healthy lung tissues using the LASSO algorithm as a feature selector. Models with harmonized CT features (B models) demonstrated better performances compared to the ones using only original CT features (C models). A linear support vector machine (SVM) with harmonized CT and PET features (A1 model) showed an area under the curve (AUC) of 0.77 (0.63-0.85) for predicting the primary outcome in an external validation cohort. The addition of clinical features did not enhance the model performance. This study provided the basis for validating our novel CT data harmonization strategy, involving delta radiomics. The harmonized radiomic models demonstrated the capability to properly predict patient prognosis

Corrigendum: A Real-World, Multicenter, Observational Retrospective Study of Durvalumab After Concomitant or Sequential Chemoradiation for Unresectable Stage III Non-Small Cell Lung Cancer (Front. Oncol., (2021), 11, (744956), 10.3389/fonc.2021.744956)

In the original article there was an error. The survival numbers were incorrect. A correction has been made to Abstract: “1-year PFS and OS were 83.5% (95%CI: 77.6-89.7) and 97.2% (95%CI: 94.6-99.9), respectively.” “1-year PFS and OS were 65.5% (95%CI: 57.6-74.4) and 87.9% (95%CI: 82.26.6-93.9), respectively” In the original article, there was an error. The survival numbers were incorrect. A correction has been made to Results, Survival: “PFS at 12, 18, and 24 months was 83.5% (95%CI: 77.6– 89.7), 65.5 (95%CI: 57.6–74.4), and 53.1% (95%CI: 43.8–64.3), respectively. (Figure 1). OS at 12, 18, and 24 months was 97.2% (95%CI: 94.6– 99.9), 87.9% (95%CI: 82.26–93.9), and 79.3% (95%CI: 71.1–88.4), respectively (Figure 1).” “PFS at 6, 12, and 18 months was 83.5% (95%CI: 77.6– 89.7), 65.5% (95%CI: 57.6–74.4), and 53.1% (95%CI: 43.8– 64.3), respectively. (Figure 1). OS at 6, 12, and 18 months was 97.2% (95%CI: 94.6– 99.9), 87.9% (95%CI: 82.26–93.9), and 79.3% (95%CI: 71.1–88.4), respectively (Figure 1)” In the original article, there was an error. The survival numbers were incorrect. A correction has been made to Discussion: “12-month PFS was 83.5%, and OS 97.2%” “12-month PFS was 65.5%, and OS 87.9%” The authors apologize for these errors and state that this does not change the scientific conclusions of the article in any way. The original article has been updated