Integrated anatomical and functional approach for tailored renal interventions-in patients with resistant arterial hypertension

resistant arterial hypertensio

Quality of Life after Transcatheter Aortic Valve Replacement in Sarcopenic Patients Using the Toronto Aortic Stenosis Quality of Life Questionnaire

Background: Sarcopenia is the core component of frailty; however, its role in patients undergoing transcatheter aortic valve replacement (TAVR) is a matter of debate. The Toronto Aortic Stenosis Quality of Life Questionnaire (TASQ) is a validated instrument for assessing quality of life (QoL) in patients with severe aortic stenosis (AS). Aims: We aim to evaluate the QoL of sarcopenic and non-sarcopenic patients with severe AS undergoing TAVR. Methods: TASQ was prospectively administered to patients undergoing TAVR. All patients completed the TASQ before TAVR and at a 3-month follow-up. The study population was divided in two groups according to sarcopenic status. The primary endpoint was the TASQ score in the sarcopenic and non-sarcopenic cohorts. Results: In total, 99 patients were eligible for the analysis. In both sarcopenic (n = 56) and non-sarcopenic (n = 43) cohorts, significant changes were observed in the overall TASQ score and in all but one (i.e., health expectations) of the individual domains (p < 0.01). Sarcopenic and non-sarcopenic patients showed substantial improvements across TASQ subscores. The mean change in overall TASQ score at three months revealed a significant improvement in both cohorts (p < 0.01). Health expectations worsened in sarcopenic patients at the 3-month follow-up (p = 0.06). Conclusions: The TASQ questionnaire revealed changes in QoL after TAVR, regardless of patients' sarcopenic status. Health status improved substantially in both sarcopenic and non-sarcopenic patients following TAVR. Lack of improvement in health expectations seems to depend on patients' expectations regarding the procedure and specific aspects in the evaluation of the outcome

NUV-HD SiPMs with metal-filled trenches

In this paper we present the performance of a new SiPM that is sensitive to blue light and features narrow metal-filled trenches placed in the area around the single-photon avalanche diodes (SPADs) that allow an almost complete suppression the internal optical crosstalk. In particular, we show the benefits of this technological upgrade in terms of electro-optical SiPM performance when compared to the previous technology which had only a partial optical screening between the SPADs. The most relevant effect is the much higher bias voltage that can be applied to the new device before the noise diverges. This allows to optimize and improve both the photon-detection efficiency and the single-photon time resolution. We also coupled the SiPMs to LYSO scintillators to verify the performance for possible application in Positron-Emission Tomography. Thanks to the better electro-optical features we were able to measure an improved coincidence time resolution. Furthermore, the optimal voltage operation region is substantially larger, making this SiPM more suitable for real system application where thousands of channels have to provide stable and reproducible performance

Reliability and failure analysis in power GaN-HEMTs: An overview

ower GaN transistors have recently demonstrated to be excellent devices for application in power electronics. The high breakdown field and the superior mobility of the 2-dimensional electron gas allow to fabricate transistors with low resistive and switching losses, that permit to increase the efficiency of switching mode power converters beyond 99 %. GaN-based transistors are currently supposed to be adopted in KW-range power converters; 650 V transistors are already available on the market, and 1200 V devices are currently under development. During operation, GaN power transistors can reach critical conditions, especially in the off-state (with a high VDS, in excess of 650 V), during hard-switching (where high current and voltage can be simultaneously present), and for high positive gate voltages (in the case of normally-off devices). This paper reports our most recent results on the gradual and catastrophic degradation of GaN-based power HEMTs. We present the results of three different case studies, on: (i) the time-dependent breakdown of power HEMTs submitted to high off-state stress; (ii) the degradation of HEMTs with p-GaN gate submitted to high gate stress; (iii) the hot electron effects in GaN-MISHEMTs submitted to high-Temperature source current stres

Optimal timing for percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation

The best timing to perform percutaneous coronary interventions (PCI) in patients undergoing TAVI is unknown. Most PCI are performed before TAVI, because of concerns about potential ischemic complications during valve implantation. In this study we aimed to compare short-and long-term outcomes of patients undergoing PCI before or after TAVI

Supplemental Material - Impact of Contrast-Associated Acute Kidney Injury on One-Year Outcomes in Very Elderly STEMI Patients: Insights From a Multicenter Registry in Northern Italy

Supplemental Material for Impact of Contrast-Associated Acute Kidney Injury on One-Year Outcomes in Very Elderly STEMI Patients: Insights From a Multicenter Registry in Northern Italy by Alessandro Ruzzarin, Simone Muraglia, Enrico Fabris, Giorgio Caretta, Filippo Zilio, Andrea Pezzato, Gianluca Campo, Matthias Unterhuber, and Luca Donazzan in Angiology.</p

Angiography-Derived and Sensor-Wire Methods to Assess Coronary Microvascular Dysfunction in Patients With Acute Myocardial Infarction

: ST-segment elevation myocardial infarction (STEMI) treatment with primary percutaneous coronary intervention has dramatically impacted prognosis. However, despite satisfactory angiographic result, occurrence or persistence of coronary microvascular dysfunction after revascularization still affects long-term outcomes. The diagnostic and therapeutic value of understanding the status of coronary microcirculation is gaining attention in the cardiology community. However, current methods to assess microvascular function (namely, cardiac magnetic resonance and invasive wire-based coronary physiology) remain, at least in part, limited by technical and logistic aspects. On the other hand, angiography-based indices of microcirculatory resistance are emerging as valid and user-friendly tools with potential impact on prognostic stratification of patients with STEMI. This review provides an overview about conventional and novel methods to assess coronary microvascular dysfunction in patients with STEMI. The authors also provide a proposed procedural algorithm to facilitate optimal use of wire-based and angiography-based indices in the acute setting of STEMI