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Prince Johnsen posted an update 1 week, 5 days ago
The incidence of AKI was also significantly lower with IOCM in younger patients, without diabetes, anemia, coronary artery disease history, CKD, chronic or persistent atrial fibrillation, left ventricular ejection fraction ≤35%, and in patients with low operative mortality risk scores, receiving lower amounts of dye (p<0.05 for all). Importantly, multivariate analysis identified LOCM administration as an independent risk factor for both AKI (p=0.006) and 1-year mortality (p=0.001).
The use of IOCM have a favorable impact on renal function with respect to LOCM, but it should be considered especially for TAVI patients at lower AKI risk.
The use of IOCM have a favorable impact on renal function with respect to LOCM, but it should be considered especially for TAVI patients at lower AKI risk.
Cardiac Magnetic Resonance (CMR) data regarding myocarditis presentation and disease course is still lacking in pediatric patients. We evaluate baseline CMR and evolution of functional and tissue abnormalities in children with acute myocarditis.
CMR was performed in 125 patients with clinical diagnosis of acute myocarditis. Clinical follow-up was performed for a median of 498 (214-923) days.
LVEF was depressed (<55%) in 56 cases (45%) upon baseline CMR. LGE was found in 93 patients (77%) of cases. LGE was exclusively subepicardial in 29 patients (23%), while other LGE patterns (midwall/mixed) were present in 64 (51%). CMR was repeated in 92 (74%) patients. 67% presented recover of function at a median of 170 (70-746) days after onset of symptoms. Midwall/mixed LGE pattern had a statistically significant correlation with absent recover of function (OR 0.20 p 0.036). Thirteen patients (16%) had recovery from LV dysfunction but with persistence of LGE. Sub-epicardial pattern of LGE (OR 3.33, 95% CI 1.08-10.2, p=0.036) and the presence of fever at admission (OR 4.67, 95% CI 1.16-18.7, p=0.03) were associated with a significantly higher likelihood of complete normalization while midwall/mixed LGE pattern was associated with non-recovery.
In pediatric myocarditis, midwall/mixed LGE pattern is associated with absent recover of function. Patients with recover of function may still have persistence of LGE, while a complete recovery from functional and tissue abnormalities is found only in a third of patients. Midwall/mixed pattern of LGE at first MRI was associated to worse outcome.
In pediatric myocarditis, midwall/mixed LGE pattern is associated with absent recover of function. PIK-III cost Patients with recover of function may still have persistence of LGE, while a complete recovery from functional and tissue abnormalities is found only in a third of patients. Midwall/mixed pattern of LGE at first MRI was associated to worse outcome.
To assess the feasibility of using comprehensive serial cardiovascular MR (CMR) to evaluate bilateral ventricle mechanical changes and myocardial tissue characteristics, as well as correlations between the serial CMR and histology in a beagle model of anthracycline-induced cardiotoxicity.
This animal study was approved by the institutional review board. Serial CMR imaging was performed in a total of fifteen beagles at baseline (n=15), at week 16 (n=10) and week 24 (n=7) post-anthracycline. Feature-tracking CMR (FT-CMR) was applied to measure bilateral ventricular (left ventricle (LV) and right ventricle (RV)) global peak strain including radial (GRS), circumferential (GCS) and longitudinal (GLS) strain. The changes in strain, LV/RV functional parameters, native T1, extracellular volume fraction (ECV) and collagen volume fraction (CVF) were calculated.
Compared to baseline at weeks 16 and 24, significantly decreases to LV-GLS and native T1 were observed, while ECV significantly increased (all P<0.05). LVEF significantly decreased and LV-EDV/ESV significantly increased at week 16 compared to baseline (all P<0.05), but no further progression was seen at week 24. RV-GLS significantly decreased at week 16, but no further progression was seen at week 24, while RVEF was different until week 24. CVF increased significantly during modeling. Native T1 and ECV showed positive correlation with CVF (r=0.645, P<0.001), while LV-GLS showed negative correlation with CVF (r=-0.736, P<0.05).
Cardiotoxicity affects the RV slightly and less progressively than the LV. FT-CMR-based GLS, native T1 and ECV may potentially be used as imaging biomarkers for early monitoring of anthracycline-induced myocardial Injury.
Cardiotoxicity affects the RV slightly and less progressively than the LV. FT-CMR-based GLS, native T1 and ECV may potentially be used as imaging biomarkers for early monitoring of anthracycline-induced myocardial Injury.
Concern exists about durability of stent grafts used to bridge aortic grafts to visceral and renal arteries during fenestrated and branched endovascular aneurysm repair (F/B-EVAR). There are no guidelines regarding the ideal technique for joining target vessels (TVs).
We systematically reviewed data published from 2014 to 2019 using PRISMA guidelines and PICO models. Keywords were searched in MEDLINE, EMBASE, and Cochrane Library. All articles were screened by two authors (a third author in case of discrepancies). Only original articles regarding F/B-EVAR in complex aortic aneurysm, reporting the number and type of TVs mated, the onset of bridging stent complications, and reinterventions on TVs were included. Analysis included quality assessment scoring, types of stent grafts, and complications related to bridging stents.
19 studies were included with 2,796 patients and 9556TV; 4,797 renal arteries (50.2%), 4,174 visceral arteries (43.6%), and undefined TV (n=585; 6.1%) were bridged. Balloon-expandable ng detailed data of bridging stents in F/B-EVAR. Renal TVs were more prone to complications, with an equivalent reintervention rate to visceral TVs. As to B-EVAR, the choice of B-EXP over S-EXP is still uncertain.
We aimed to evaluate the results of the combined use of rotational atherectomy (RA) followed by drug-coated balloon (DCB) treatment against DCB angioplasty alone in patients who had significantly calcified and symptomatic femoropopliteal peripheral arterial disease.
Patients presented to the clinic with symptoms of chronic limb ischemia of femoropopliteal segment such as moderate or severe claudication and rest pain, who received endovascular therapy between January 2016 and January 2018 in our hospital comprised the study cohort and investigated, retrospectively. Patients with minor or major tissue loss were excluded from the study. We evaluated the effect of RA system followed by DCB with DCB alone in 121 patients and a total of 226 significantly calcified and symptomatic femoropopliteal lesions. Fifty-eight patients and 112 (49.5%) lesions were treated with RA+DCB, whereas 63 patients and 114 (50.5%) lesions were treated with DCB only. The mean age was 61.2±9.7years. Primary patency is evaluated with duplex ultrasound/angiography at 6, 12, and 24months and with angiography on 12 and 24months.