Persistent Left Superior Vena Cava and Partial Anomalous Pulmonary Venous Return in an Old Asymptomatic Female Patient

Persistent left superior vena cava is a rare congenital venous anomaly. It results from failure of closure of the left anterior cardinal vein during cardiac development. It is usually asymptomatic but can be associated with other congenital cardiac defects including atrial septal defects, ventricular septal defects, endocardial cushion defects, tetralogy of Fallot and rhythm disturbances. PLSVC should be considered in the presence of a dilated coronary sinus on transthoracic echocardiography. The diagnosis can be made when injection of contrast in left antecubital vein results in enhancement of the dilated coronary sinus before right atrium. MRI, CT-scan and catheterisation can be used to confirm the diagnosis

Soluble CD40 Ligand Levels in Otherwise Healthy Subjects With Impaired Fasting Glucose

Unlike diabetes mellitus and impaired glucose tolerance, it is not clear whether the subjects with impaired fasting glucose (IFG) are at increased risk of atherosclerosis and cardiovascular diseases. The CD40-CD40 ligand interaction is involved in the mechanism of atherosclerosis. We investigated whether soluble CD40L (sCD40L) as well as high sensitive C-reactive protein (hsCRP) levels are increased in subjects with IFG having no confounding factors for inflammation or atherosclerosis. Twenty four IFG subjects with no additional disorders and 40 appropriate healthy controls were studied. sCD40L and hsCRP levels in the IFG and control groups were similar. Blood pressures, total and LDL-cholesterol, and triglyceride levels were also similar, whereas HDL-cholesterol was lower and HOMA-IR indexes were higher in the IFG group. Though the sample size was small, the present data show that sCD40L seems not to alter in subjects with IFG suggesting that it might not be an independent risk factor for atherosclerosis

An Experimental Study on Construction and Demolition Waste Usage as Secondary Raw Material for Cement Production

In the present study, an investigation was conducted to evaluation of tile, brick, fire brick, plaster and concrete wastes derived from construction and demolition (CampD) wastes in Portland cement raw meal production as secondary raw material. Clinker test results showed that using of these wastes in cement was suitable. Then, cement production was performed with using 1, 2.1 and 3.9 wt. % mix CampD waste addition ratios in the cement factory. Desired phases like belite and alite, which are essential for the cement products, were observed at the micrographs. Also, obtained cement products supplied required and standard properties however, strength and hydration heat values were lower. Finally, optimum CampD waste addition ratio was determined and results were found as practicable. It was shown that mix CampD waste materials can be utilized as secondary raw material in cement production

One-year results of the first-in-man study investigating the Atrial Flow Regulator for left atrial shunting in symptomatic heart failure patients: the PRELIEVE study

Zoghi, Mehdi/0000-0002-8156-2675WOS:000625565600001PubMed: 33555114Aims Attenuating exercise-induced elevated left atrial pressure with an atrial shunt device is under clinical investigation for treatment of symptomatic heart failure (HF). Methods and results PRELIEVE was a prospective, non-randomised, multicentre, first-in-man study in symptomatic HF patients with reduced (HFrEF) or preserved (HFpEF) ejection fraction and pulmonary capillary wedge pressure (PCWP) >= 15 mmHg at rest or >= 25 mmHg during exercise. Here, we provide follow-up data up to 1 year after implantation of the Atrial Flow Regulator (AFR) device. The AFR was successfully implanted in 53 patients (HFrEF n = 24 and HFpEF n = 29). Two patients were not enrolled due to an unsuccessful transseptal puncture. There was one device embolisation into the left atrium, which required surgical removal. One patient experienced a serious procedure-related adverse event (post-procedural bleeding and syncope). All patients with sufficient echocardiography readout confirmed device patency with left-right shunt both at 3 (n = 47/51, 92%) and 12 (n = 45/49, 92%) months. At 3 months, rest PCWP decreased by 5 (-12, 0) mmHg (P = 0.0003, median Q1, Q3). No patient developed a stroke, worsening of right heart function or significant increase of pulmonary artery pressure. Six (6/53, 11%) patients were hospitalised for worsening of HF and three (3/53, 6%) patients died. We observed improvements in New York Heart Association functional class, 6-min walking distance and quality of life (Kansas City Cardiomyopathy Questionnaire) in certain patients. Conclusions Implantation of the AFR device in HF patients was feasible. No shunt occlusion, stroke or new right HF was observed during the 1-year follow-up, with clinical improvements in certain patients.Occlutech International ABThe study was supported by Occlutech International AB

The AFR-PRELIEVE trial: a prospective, non-randomised, pilot study to assess the Atrial Flow Regulator (AFR) in heart failure patients with either preserved or reduced ejection fraction

Zoghi, Mehdi/0000-0002-8156-2675;WOS: 000490322500006PubMed: 31130524Aims: Reducing elevated left atrial pressure with an atrial septum shunt device is a possible treatment option in symptomatic heart failure patients. This study aimed to investigate the safety and feasibility of the Atrial Flow Regulator (AFR) in heart failure patients. Methods and results: AFR-PRELIEVE is a prospective, non-randomised, open-label, multicentre study in patients with symptomatic heart failure NYHA Class III or IV and pulmonary capillary wedge pressure (PCWP) >= 15 mmHg at rest or >= 25 mmHg at exercise irrespective of left ventricular ejection fraction (EF >= 15%). Here we report on procedural and three-month follow-up data for a total of thirty-six enrolled patients. Sixteen (44.5%) patients with reduced EF (HFrEF: EF 15-39%) and twenty (55.5%) patients with preserved EF (HFpEF: EF >= 40%) were enrolled. Implantation success rate and device patency with left-right shunt was 100% (post procedure and at three months) in both patient groups, with one SADE in the HFpEF group which completely resolved. Three (3/36, 8.3%) patients were hospitalised for worsening of heart failure (two HFrEF patients, one HFpEF patient). Individual patients from both the HFrEF and HFpEF groups showed improvement in symptoms and surrogate parameters of heart failure (NYHA class, six-minute walking distance, Kansas City Cardiomyopathy Questionnaire, PCWP, NT-proBNP). Conclusions: Implantation of the AFR device in heart failure patients is feasible and safe; shunt patency at three months was confirmed in the study. the atrial shunt improved symptoms and surrogate parameters of heart failure in some but not all patients in both the HFpEF and HFrEF groups.Occlutech S.A.The study was funded by Occlutech S.A