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<1>
Accession Number
2013511667
Title
Efficacy of high-dose atorvastatin or rosuvastatin loading in patients
with acute coronary syndrome undergoing percutaneous coronary
intervention: a meta-analysis of randomized controlled trials with GRADE
qualification of available evidence.
Source
European Journal of Clinical Pharmacology. 78(1) (pp 111-126), 2022. Date
of Publication: January 2022.
Author
Borovac J.A.; Leth-Olsen M.; Kumric M.; D'Amario D.; Schwarz K.; Glavas
D.; Bozic J.
Institution
(Borovac, Leth-Olsen, Kumric, Bozic) Department of Pathophysiology, School
of Medicine, University of Split, Split, Croatia
(Borovac, Glavas) Clinic for Heart and Cardiovascular Diseases, University
Hospital of Split (KBC Split), Split, Croatia
(D'Amario) Department of Cardiovascular and Thoracic Sciences, IRCCS
Fondazione Policlinico A. Gemelli, Universita Cattolica Sacro Cuore, Rome,
Italy
(Schwarz) Department of Internal Medicine 3, Karl Landsteiner University
of Health Sciences, University Hospital St, Polten, Krems, Austria
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: We aimed to summarize current evidence regarding the impact of a
high-dose statin loading before percutaneous coronary intervention (PCI)
on short-term outcomes in patients presenting with the acute coronary
syndrome (ACS). Method(s): This meta-analysis was based on a search
of the MEDLINE, Cochrane Central Register of Controlled Trials, Ovid
Journals, and SCOPUS for randomized controlled trials that compared
high-dose atorvastatin or rosuvastatin with no or low-dose statin
administered before planned PCI in statin-naive patients with ACS. The
primary endpoints were major adverse cardiovascular and cerebrovascular
events (MACCE), myocardial infarction (MI), and all-cause mortality at 30
days. Prespecified subanalyses were performed with respect to statin and
ACS type. Result(s): A total of eleven trials enrolling 6291 patients
were included, of which 75.4% received PCI. High-dose statin loading was
associated with an overall 43% relative risk (RR) reduction in MACCE at 30
days (RR 0.57, 95% CI 0.41-0.77) in whole ACS population. This effect was
primarily driven by the 39% reduction in the occurrence of MI (RR 0.61,
95% CI 0.46-0.80). No significant effect on all-cause mortality reduction
was observed (RR 0.92, 95% CI 0.67-1.26). In the setting of ST-elevation
myocardial infarction (STEMI), atorvastatin loading was associated with a
33% reduction in MACCE (RR 0.67, 95% CI 0.48-0.94), while in
non-ST-elevation myocardial infarction ACS (NSTE-ACS), rosuvastatin
loading was associated with 52% reduction in MACCE at 30 days (RR 0.48,
95% CI 0.34-0.66). The level of evidence as qualified with GRADE was low
to high, depending on the outcome. Conclusion(s): A high-dose loading
of statins before PCI in patients with ACS reduces MACCE and reduces the
risk of MI with no impact on mortality at 30 days. Atorvastatin reduces
MACCE in STEMI while rosuvastatin reduces MACCE in NSTE-ACS at 30 days.
Graphical abstract: [Figure not available: see fulltext.]. Copyright
© 2021, The Author(s), under exclusive licence to Springer-Verlag
GmbH Germany, part of Springer Nature.

<2>
Accession Number
2015375929
Title
Quantitating Mitral Regurgitation in Clinical Trials: The Need for a
Uniform Approach.
Source
Annals of Thoracic Surgery. 114(2) (pp 573-580), 2022. Date of
Publication: August 2022.
Author
Gammie J.S.; Grayburn P.A.; Quinn R.W.; Hung J.; Holmes S.D.
Institution
(Gammie, Quinn, Holmes) Division of Cardiac Surgery, University of
Maryland School of Medicine, Baltimore, Maryland
(Grayburn) Division of Cardiology, Department of Internal Medicine, Baylor
Scott & White Heart and Vascular Hospital, Baylor University Medical
Center, Dallas, Texas, United States
(Hung) Division of Cardiology, Massachusetts General Hospital, Boston,
Massachusetts, United States
Publisher
Elsevier Inc.
Abstract
Background: There is an established relationship between the degree of
mitral regurgitation (MR) and prognosis. Quantitation of MR severity
guides therapeutic approaches. Inconsistent definitions and categorization
of MR severity in clinical studies limit meaningful comparisons among
trials and compromise development of an effective evidence base. The
purpose of this study was to quantify heterogeneity in grading systems for
MR severity in the contemporary literature. Method(s): This was a
systematic review of randomized controlled trials and propensity
score-adjusted clinical studies of mitral valve interventions (surgical or
percutaneous). A total of 35 articles from 2015 to 2020 were included (15
randomized controlled trials and 20 propensity score-adjusted clinical
studies). Result(s): There were 22 studies that reported MR severity
in numeric categories, either values from the historical "plus" system or
numeric MR grades, whereas 9 studies reported MR severity using text-only
descriptive categories. Among the studies that used numeric categories, 2+
MR was defined as moderate in 64% of studies, mild in 27%, and
mild-moderate in 9%, and 3+ MR was defined as moderate in 14%,
moderate-severe in 52%, and severe in 14%. Conclusion(s): There was
substantial variability in MR severity definition and reporting in
contemporary clinical studies of mitral valve interventions. We recommend
that the historical plus numeric grading system be abandoned and that
inclusion and outcome criteria in MR clinical trials be based on US and
European guideline-recommended categories as none or trace, mild,
moderate, and severe. Adoption of these simple recommendations will
improve the consistency and quality of MR clinical trial design and
reporting. Copyright © 2022 The Society of Thoracic Surgeons

<3>
Accession Number
2019330317
Title
Coenzyme Q<inf>10</inf>as Adjunctive Therapy for Cardiovascular Disease
and Hypertension: A Systematic Review.
Source
Journal of Nutrition. 152(7) (pp 1666-1674), 2022. Date of Publication: 01
Jul 2022.
Author
Sue-Ling C.B.; Abel W.M.; Sue-Ling K.
Institution
(Sue-Ling) School of Nursing, University of South Carolina Aiken, Aiken,
SC, United States
(Abel) School of Nursing, The University of North Carolina at Charlotte,
Charlotte, NC, United States
(Sue-Ling) Department of Cardiology, University Hospital, Augusta, GA,
United States
Publisher
Oxford University Press
Abstract
Background: Mitochondrial ATP production requires a small electron
carrier, coenzyme Q10 (CoQ10), which has been used as adjunctive therapy
in patients with cardiovascular disease (CVD) and hypertension (HTN)
because of its bioenergetics and antioxidant properties. Randomized
controlled trials (RCTs) beyond the last 2 decades evaluating CoQ10 added
to conventional therapy resulted in mixed results and were underpowered to
address major clinical endpoints. Objective(s): The objective of this
systematic review was to examine the impact of CoQ10 supplementation on
older adults with CVD or HTN in the last 2 decades (2000-2020).
 Method(s): PubMed/Medline, Cochrane Database, CINAHL, and Google
Scholar databases were searched systematically, and references from
selected studies were manually reviewed, to identify RCTs or crossover
studies evaluating the efficacy of CoQ10 supplementation. Data extracted
from selected studies included trial design and duration, treatment, dose,
participant characteristics, study variables, and important findings.
 Result(s): A total of 14 studies (1067 participants) met the
inclusion criteria. The effect of CoQ10 supplementation was examined among
predominantly older adult males with heart failure (HF) (n = 6), HTN (n =
4), and ischemic heart disease (n = 3), and preoperatively in patients
scheduled for cardiac surgery (n = 1). CoQ10 supplementation in patients
with HF improved functional capacity, increased serum CoQ10
concentrations, and led to fewer major adverse cardiovascular events.
CoQ10 had positive quantifiable effects on inflammatory markers in
patients with ischemic heart disease. Myocardial hemodynamics improved in
patients who received CoQ10 supplementation before cardiac surgery.
Effects on HTN were inconclusive. Conclusion(s): In predominantly
older adult males with CVD or HTN, CoQ10 supplementation added to
conventional therapy is safe and offers benefits clinically and at the
cellular level. However, results of the trials need to be viewed with
caution, and further studies are indicated before widespread usage of
CoQ10 is recommended in all older adults. Copyright © 2022
Published by Oxford University Press on behalf of the American Society for
Nutrition.

<4>
Accession Number
2018719690
Title
White Cord Syndrome After Cervical or Thoracic Spinal Cord Decompression.
Hemodynamic Complication or Mechanical Damage? An Underestimated
Nosographic Entity.
Source
World Neurosurgery. 164 (pp 243-250), 2022. Date of Publication: August
2022.
Author
Gerardi R.M.; Giammalva G.R.; Basile L.; Guli C.; Pino M.A.; Messina D.;
Umana G.E.; Graziano F.; di Bonaventura R.; Sturiale C.L.; Visocchi M.;
Iacopino D.G.; Maugeri R.
Institution
(Gerardi, Giammalva, Basile, Guli, Pino, Messina, Iacopino, Maugeri)
Neurosurgical Clinic, AOUP "Paolo Giaccone", Post Graduate Residency
Program in Neurologic Surgery, Department of Biomedicine Neurosciences and
Advanced Diagnostics, School of Medicine, University of Palermo, Palermo,
Italy
(Umana) Department of Neurosurgery, Cannizzaro Hospital, Trauma Center,
Gamma Knife Center, Catania, Italy
(Graziano) Department of Neurosurgery, Garibaldi Hospital, Catania, Italy
(di Bonaventura, Sturiale, Visocchi) Fondazione Policlinico Universitario
A. Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy
Publisher
Elsevier Inc.
Abstract
The ischemia/reperfusion mechanism is believed to be responsible for
parenchymal damage caused by temporary hypoperfusion and worsened by the
subsequent attempt of reperfusion. This represents a true challenge for
physicians of several fields, including neurosurgeons. A limited number of
papers have shed the light on a rare pathologic condition that affects
patients experiencing an unexplained neurologic deficit after spine
surgery, the so-called "white cord syndrome." This entity is believed to
be caused by an "ischemia/reperfusion" injury on the spinal cord,
documented by a postoperative intramedullary hyperintensity on T2-weighted
magnetic resonance imaging sequences. To date, the cases of white cord
syndrome reported in literature mostly refer to cervical spine surgery.
However, the analysis of several reviews focusing on spine surgery outcome
suggests postoperative neurologic deficits of new onset could be charged
to a mechanism of ischemia/reperfusion, even if the physiopathology of
this event is seldom explored or at least discussed. The same
neuroradiologic finding can suggest mechanical damage due to inappropriate
surgical manipulation. On this purpose, we performed a systematic review
of the literature with the aim to identify and analyze all the factors
potentially contributing to ischemic/reperfusion damage of the spinal cord
that may potentially complicate any spinal surgery, without distinction
between cervical or thoracic segments. Finally, we believe that
postoperative neurologic deficit after spinal surgery constituting the
"white cord syndrome" could be under-reported; both neurosurgeons and
patients should be fully aware of this rare but potentially devasting
complication burdening cervical and thoracic spine surgery. Copyright
© 2022 Elsevier Inc.

<5>
Accession Number
2017870716
Title
Measuring the Systemic Inflammatory Response to On- and Off-Pump Coronary
Artery Bypass Graft (CABG) Surgeries Using the Tryptophan/Kynurenine
Pathway.
Source
Journal of Investigative Surgery. 35(8) (pp 1621-1625), 2022. Date of
Publication: 2022.
Author
Farouk A.; Hamed R.A.; Elsawy S.; Abd El Hafez N.F.; Moftah F.M.; Nassar
M.A.Y.; Gabra F.A.; Saleem T.H.
Institution
(Farouk) Cardiothoracic Surgery Department, Faculty of medicine, Assiut
University, Egypt
(Hamed) Anesthesia and Intensive Care Department, Faculty of medicine,
Assiut University, Egypt
(Elsawy) Anesthesia and Pain management, Faculty of medicine, Assiut
University, Egypt
(Abd El Hafez) Anesthesia and Intensive Care Department, Faculty of
medicine, South Valley, Egypt
(Moftah) Community Medicine and Medical Statistics, Faculty of medicine,
Assiut University, Egypt
(Nassar) Biochemistry Department, Faculty of Medicine, Dongola, Sudan
(Gabra) Microbiology Department, Faculty of Science, Assiut University,
Assiut, Egypt
(Saleem) Biochemistry, Faculty of medicine, Assiut University, Egypt
(Gabra, Saleem) Metabolic and Genetic Disorders Unit, Faculty of medicine,
Assiut University, Egypt
Publisher
Taylor and Francis Ltd.
Abstract
Background: Cardiac surgeries induce many inflammatory responses with
remarkable clinical implications. Tryptophan (Trp) is a precursor for
serotonin, melatonin and kynurenine (Kyn). Plasma kynurenic acid (Kyna)
and Kyn concentrations are thought to be related to the severity of
inflammation. Plasma Trp/Kyn ratio is used to measure inflammatory
cytokine activity. Method(s): We performed the current longitudinal
study in a tertiary care center and included 62 patients divided into two
groups; group A (on-pump CABG patients) and group B (off-pump CABG
patients). Plasma Trp and Kyn were measured using the high-performance
liquid chromatography (HPLC) technique. Serum interlukin-6 (IL-6) and
white blood cells (WBCs) were measured using ELISA and routine blood
count, respectively. Result(s): The present study revealed that the
intraoperative levels of plasma Kyn, IL-6 and WBCs were significantly
increased while the plasma Trp/Kyn ratio was significantly decreased in
both the groups; however, the changes were more significant in the on-pump
CABG group. Moreover, the levels in both the groups returned to
preoperative levels 72 h postoperative. Our study has shown that WBCs is
positively correlated with IL-6, but has negative correlation with Trp/Kyn
ratio. Conclusion(s): Kyn and Trp/Kyn ratio might be utilized as
markers of the severity of inflammation in major surgery. In addition,
off-pump CABG might be more preferable than on-pump CABG regarding stress
and release of inflammatory markers. Copyright © 2022 Taylor &
Francis Group, LLC.

<6>
Accession Number
2017314545
Title
Effects of pharmacist interventions on pain intensity: Systematic review
and meta-analysis of randomized controlled trials.
Source
Journal of the American Pharmacists Association. 62(4) (pp 1313-1320.e6),
2022. Date of Publication: 01 Jul 2022.
Author
Veettil S.K.; Darouiche G.; Sawangjit R.; Cox N.; Lai N.M.; Chaiyakunapruk
N.
Publisher
Elsevier B.V.
Abstract
Background: Pharmacists can play an important role in pain management.
Objective(s): This review aims to summarize the effects of any type of
pharmacist intervention, whether led by a pharmacist or in a supportive
role, on pain intensity over time in individuals with pain of any
etiology. Method(s): Three electronic databases (MEDLINE, Embase, and
Cochrane Central Register of Controlled Trials) were searched from
inception to the end of May 2021 to identify randomized controlled trials
(RCTs) that reported the effect of pharmacist interventions on pain
intensity. Two reviewers independently extracted data and evaluated study
quality. The analyses used a random-effects models and the Grading of
Recommendations, Assessment, Development and Evaluation to rate the
certainty of the evidence. The primary outcome was reduction in pain
intensity and presented as standardized mean differences (SMD).
 Result(s): Twelve RCTs including 1710 participants were included.
Pooled estimate of 12 studies demonstrated a statistically significant
reduction in pain intensity compared with control (SMD -0.22 [95% CI -0.31
to -0.12], I2 = 0%, low certainty). The intervention was more
effective when a pharmacist delivered a combination of services comprising
educational interventions, medication review, and pharmaceutical care
services (SMD -0.24 [95% CI -0.35 to -0.13], I2 = 0%, moderate
certainty). For educational interventions alone, no statistically
significant difference was observed (SMD -0.15 [95% CI -0.45 to 0.15],
I2 = 47.6%, low certainty). Pharmacist intervention was also
effective in reducing pain intensity for patients with cancer-related pain
(SMD -0.76 [95% CI -1.17 to -0.36], I2 = 0%, moderate
certainty). Conclusion(s): There is some promising evidence to
suggest that multicomponent pharmacist interventions including medication
review or any other pharmaceutical care services, rather than merely
educational interventions, are beneficial in reducing pain intensity,
particularly in patients with chronic pain. High-quality RCTs are required
to confirm the clinical significance of this findings before advocating
for its widespread implication in clinical practice. Copyright ©
2022 American Pharmacists Association

<7>
Accession Number
2016980520
Title
Revascularization or Optimal Medical Therapy for Stable Ischemic Heart
Disease: A Bayesian Meta-Analysis of Contemporary Trials.
Source
Cardiovascular Revascularization Medicine. 40 (pp 42-47), 2022. Date of
Publication: July 2022.
Author
Kumar A.; Doshi R.; Khan S.U.; Shariff M.; Baby J.; Majmundar M.; Kanaa'N
A.; Hedrick D.P.; Puri R.; Reed G.; Mehran R.; Kapadia S.; Khot U.N.;
Kalra A.
Institution
(Kumar) Department of Internal Medicine, Cleveland Clinic Akron General,
Akron, OH, United States
(Doshi) Department of Cardiology, St. Joseph's Medical Centre, Paterson,
NJ, United States
(Khan) Department of Internal Medicine, West Virginia University,
Morgantown, WV, United States
(Shariff) Department of General Surgery, Mayo Clinic, Rochester, MN,
United States
(Baby) Division of Epidemiology and Biostatistics, St John's Research
Institute, Bangalore, India
(Baby) Department of Statistical Sciences, Kannur University, Kerala,
India
(Majmundar) Department of Internal Medicine, New York Medical College,
Metropolitan Hospital Center, NYC, United States
(Kanaa'N, Hedrick, Kalra) Heart, Vascular and Thoracic Department,
Cleveland Clinic Akron General, Akron, OH, United States
(Hedrick, Puri, Reed, Kapadia, Khot, Kalra) Department of Cardiovascular
Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Mehran) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
Elsevier Inc.
Abstract
Background: The role of revascularization in patients with stable ischemic
heart disease (SIHD) has been controversial, more so in the present era of
drug-eluting stents. Aim(s): To examine the absolute risk difference
(ARD) between revascularization plus optimal medical therapy (OMT) versus
OMT alone among patients with SIHD using Bayesian approach.
 Method(s): PubMed/MEDLINE and Cochrane citation indices were utilized
to identify randomized controlled trials (RCTs) through March 31, 2020.
Among trials comparing initial revascularization plus OMT with initial OMT
alone, revascularization arm must have comprised >50% of patients
receiving either percutaneous or surgical revascularization, and >50% of
patients must have received aspirin and statin as OMT in both arms.
 Result(s): Seven RCTs (12,494) were included in the final analysis.
The ARD of all-cause mortality for revascularization with respect to OMT
was centred at -0.002 (95% CrI: -0.01; 0.01, Tau: 0.01, 67% probability of
ARD of revascularization vs. OMT < 0). The ARD for cardiac mortality was
centred at -0.0025 (95%CrI: -0.01; 0.01, Tau: 0.01, 77% probability of ARD
of revascularization vs. OMT < 0). The ARD for MI was -0.02 (95% CrI:
-0.06; 0.00, Tau: 0.02, 97% probability of ARD for revascularization vs.
OMT < 0). There was 96% probability of ARD for unstable angina with
revascularization vs. OMT < 0, 4.5% probability of ARD for freedom from
angina with revascularization vs. OMT < 0, and 6% probability of ARD for
stroke with revascularization vs. OMT < 0. Conclusion(s): Bayesian
analysis demonstrated minimal probability of difference in all-cause
mortality and cardiac mortality in patients with SIHD who underwent
revascularization compared with OMT alone. However, revascularization was
associated with lower probability of MI, unstable angina, and increased
freedom from angina, but a higher risk of stroke compared with OMT alone.
PROSPERO: The protocol of this systematic review and meta-analysis was
registered in PROSPERO [CRD42020160540]. Copyright © 2021
Elsevier Inc.

<8>
Accession Number
636726796
Title
Transcutaneous Electrical Acupoint Stimulation for the Prevention of
Postoperative Cognitive Dysfunction: A Systematic Review and
Meta-Analysis.
Source
Frontiers in Medicine. 8 (no pagination), 2021. Article Number: 756366.
Date of Publication: 06 Dec 2021.
Author
Zhang T.; Ou L.; Chen Z.; Li J.; Shang Y.; Hu G.
Institution
(Zhang, Hu) Department of Neurology, The First Hospital of Hunan
University of Chinese Medicine, Changsha, China
(Zhang, Li, Shang) The Graduate School, Hunan University of Chinese
Medicine, Changsha, China
(Ou) Department of Orthopedics, The Second Affiliated Hospital of Guizhou
University of Traditional Chinese Medicine, Guiyang, China
(Chen) The Fifth Clinical Medical College, Guangzhou University of Chinese
Medicine, Guangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: No specific treatment is available for postoperative cognitive
dysfunction (POCD). Recently, interest in the prevention of POCD during
the perioperative period has increased. Although some studies suggest that
transcutaneous electrical acupoint stimulation (TEAS) may be beneficial,
the relevant evidence remains uncertain. Objective(s): To evaluate
the preventive effects of TEAS on POCD. Method(s): Seven databases
including PubMed, EMBASE, CENTRAL, China National Knowledge Infrastructure
(CNKI), Chinese Scientific Journal Database (VIP), Wanfang Database, and
Chinese Biomedical Literature Database (CBM) were electronically searched
up to April 2021. Two reviewers independently selected the studies,
collected data, and assessed the risks of bias and grading of
recommendations, assessment, development, and evaluations certainty of the
evidence. A meta-analysis of the incidence of POCD, cognitive function
score, pain, adverse reactions, and length of hospital stay after surgery
was also performed. Result(s): Twenty-nine randomized controlled
trials with 1,994 participants were included. The results of the
meta-analysis showed that the TEAS group has a significantly lower
incidence of POCD compared with the control group on postoperative days 1
[OR = 0.33 (95%CI: 0.23, 0.47); p < 0.001, I2 = 0%, moderate
certainty], 3 [OR = 0.38 (95%CI: 0.29, 0.50); p < 0.001, I2 =
0%, low certainty], and 7 [OR = 0.51 (95%CI: 0.32, 0.81); p = 0.005,
I2 = 0%, low certainty] but not on day 5 (p > 0.05, low
certainty). Moreover, TEAS improved the Mini-Mental State Examination
scores on postoperative days 1, 3, and 7 [MD = 2.44 (95%CI: 1.61, 3.27); p
< 0.001, I2 = 93%, low certainty]; [MD = 2.07 (95%CI: 1.53,
2.62); p < 0.001, I2 = 87%, low certainty]; and [MD = 0.49
(95%CI: 0.18, 0.79); p = 0.002, I2 = 21%, low certainty],
respectively, but not on day 5 (p > 0.05, very low certainty). TEAS
promoted a postoperative analgesic effect within 24 h after surgery.
Furthermore, patients receiving TEAS showed a lower incidence of
postoperative nausea and vomiting and a shorter hospital stay.
 Conclusion(s): Limited evidence suggests that the application of TEAS
in the perioperative period is associated with a reduced POCD rate and a
protected early postoperative cognitive function. Copyright ©
2021 Zhang, Ou, Chen, Li, Shang and Hu.

<9>
[Use Link to view the full text]
Accession Number
2019315146
Title
Cost-Effectiveness of Percutaneous Coronary Intervention Versus Bypass
Surgery for Patients with Left Main Disease: Results from the EXCEL Trial.
Source
Circulation: Cardiovascular Interventions. 15(7) (pp E011981), 2022. Date
of Publication: 01 Jul 2022.
Author
Magnuson E.A.; Chinnakondepalli K.; Vilain K.; Serruys P.W.; Sabik J.F.;
Kappetein A.P.; Stone G.W.; Cohen D.J.
Institution
(Magnuson, Chinnakondepalli, Vilain) Saint Luke's Mid America Heart
Institute, Kansas City, MO, United States
(Magnuson) University of Missouri, Kansas City, United States
(Serruys) National Heart and Lung Institute, Imperial College London,
United Kingdom
(Sabik) Department of Surgery, University Hospitals, Cleveland Medical
Center, OH, United States
(Kappetein) Department of Cardiothoracic Surgery, Erasmus University,
Medical Center, Rotterdam, Netherlands
(Kappetein) Medtronic, Maastricht, Netherlands
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Stone, Cohen) Cardiovascular Research Foundation, New York, NY, United
States
(Cohen) Saint Francis Hospital, Heart Center, Roslyn, NY, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The EXCEL trial (Evaluation of XIENCE Versus Coronary Artery
Bypass Surgery for Effectiveness of Left Main Revascularization)
demonstrated in patients with left main coronary artery disease, no
significant difference between coronary artery bypass graft surgery (CABG)
and percutaneous coronary intervention (PCI) with everolimus-eluting
stents for the composite end point of death, stroke, or myocardial
infarction at 5 years. However, all-cause mortality at 5 years was higher
with PCI. Long-term cost-effectiveness of these 2 strategies has
heretofore not been evaluated. Method(s): From 2010 to 2014, 1905
patients with left main coronary artery disease were randomized to CABG
(n=957) or PCI (n=948). Costs ($2019) were assessed over 5 years using
resource-based costing and Medicare reimbursement rates. Health utilities
were assessed using the EuroQOL 5-dimension questionnaire. Five-year EXCEL
data in combination with US lifetables were used to develop a Markov model
to evaluate lifetime cost-effectiveness. An incremental cost-effectiveness
ratio <$50 000 per quality-adjusted life year (QALY) gained was considered
highly cost-effective. Result(s): Index revascularization procedure
costs were $4,850/patient higher with CABG, and total costs for the index
hospitalization were $17 610/patient higher with CABG ($32 297 versus $19
687, P<0.001). Cumulative 5-year costs were $20 449/patient higher with
CABG. CABG was projected to increase lifetime costs by $21 551 while
increasing quality-adjusted life expectancy by 0.49 QALYs, yielding an
incremental cost-effectiveness ratio of $44 235/QALY. In a post hoc
sensitivity analysis using mortality hazard ratios from a meta-analysis of
all randomized CABG versus PCI in left main disease trials, the gain
associated with CABG was 0.08 to 0.14 QALYs, resulting in an incremental
cost-effectiveness ratio of $139 775 to $232 710/QALY gained.
 Conclusion(s): Based on data from the EXCEL trial, CABG is an
economically attractive revascularization strategy compared with PCI over
a lifetime horizon for patients with significant left main coronary artery
disease. However, this conclusion is sensitive to the long-term mortality
rates with the 2 strategies, and CABG is no longer highly cost-effective
when substituting the pooled treatment effect from the 4 major PCI versus
CABG trials for left main disease. Registration: URL:
https://www.clinicaltrials.gov; Unique identifier:
NCT01205776. Copyright © 2022 Lippincott Williams and Wilkins.
All rights reserved.

<10>
Accession Number
2017997068
Title
Examination of the most cited studies on transcatheter aortic valve
replacement with bibliometric analysis.
Source
Echocardiography. 39(7) (pp 960-974), 2022. Date of Publication: July
2022.
Author
Guzel T.; Arslan B.
Institution
(Guzel) Department of Cardiology, Health Science University, Gazi Yasargil
Training and Research Hospital, Diyarbakir, Turkey
(Arslan) Department of Cardiology, Ergani State Hospital, Diyarbakir,
Turkey
Publisher
John Wiley and Sons Inc
Abstract
Aim: The aim of this study is to analyze the studies on TAVI with the
bibliometric method and to perform a scientiometric analysis of the top
100 most cited articles for researchers. Method(s): The Thomson
Reuters Web of Science database was searched for all relevant articles
using the terms "TAVR" and "TAVI". The results were ordered according to
the number of citations. We also analyzed the 100 most cited articles
(T100) by annual average citation count (ACpY), years, research methods,
author, institution, journal, funding agencies, and keywords. Analyses
were also performed between the total number of citations, ACpY, impact
factors, and publication time. Result(s): The article titled
"Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients
Who Cannot Undergo Surgery" was the most cited article (n = 4616). The
article titled "Transcatheter Aortic-Valve Replacement with a
Balloon-Expandable Valve in Low-Risk Patients" had the highest ACpY count
(n = 497). The United States was the country that contributed the most to
the T100 list. While the journal that contributed the most with 32
articles was "Journal of the American College Of Cardiology", the journal
in which the top 10 most cited articles were published most frequently was
the "New England Journal of Medicine". In addition, the most publications
were made in 2012. Conclusion(s): Although this bibliometric analysis
study has some limitations, it allows the most cited publications on TAVI
to be analyzed systematically and provides scientific
contributions. Copyright © 2022 Wiley Periodicals LLC.

<11>
Accession Number
638531772
Title
Effect of 4% Albumin Solution vs Ringer Acetate on Major Adverse Events in
Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass: A
Randomized Clinical Trial.
Source
JAMA. 328(3) (pp 251-258), 2022. Date of Publication: 19 Jul 2022.
Author
Pesonen E.; Vlasov H.; Suojaranta R.; Hiippala S.; Schramko A.; Wilkman
E.; Eranen T.; Arvonen K.; Mazanikov M.; Salminen U.-S.; Meinberg M.;
Vahasilta T.; Petaja L.; Raivio P.; Juvonen T.; Pettila V.
Institution
(Pesonen, Vlasov, Suojaranta, Hiippala, Schramko, Wilkman, Arvonen,
Mazanikov, Meinberg, Petaja, Pettila) Department of Anesthesiology,
Intensive Care and Pain Medicine, University of Helsinki and Helsinki
University Hospital, Helsinki, Finland
(Eranen) HUS Pharmacy, University of Helsinki and Helsinki University
Hospital, Helsinki, Finland
(Salminen, Vahasilta, Raivio, Juvonen) Department of Cardiac Surgery,
Heart and Lung Center, University of Helsinki and Helsinki University
Hospital, Helsinki, Finland
Publisher
NLM (Medline)
Abstract
Importance: In cardiac surgery, albumin solution may maintain hemodynamics
better than crystalloids and reduce the decrease in platelet count and
excessive fluid balance, but randomized trials are needed to compare the
effectiveness of these approaches in reducing surgical complications.
 Objective(s): To assess whether 4% albumin solution compared with
Ringer acetate as cardiopulmonary bypass prime and perioperative
intravenous volume replacement solution reduces the incidence of major
perioperative and postoperative complications in patients undergoing
cardiac surgery. Design, Setting, and Participant(s): A randomized,
double-blind, single-center clinical trial in a tertiary university
hospital during 2017-2020 with 90-day follow-up postoperatively involving
patients undergoing on-pump coronary artery bypass grafting; aortic,
mitral, or tricuspid valve surgery; ascending aorta surgery without
hypothermic circulatory arrest; and/or the maze procedure were randomly
assigned to 2 study groups (last follow-up was April 13, 2020).
 Intervention(s): The patients received in a 1:1 ratio either 4%
albumin solution (n=693) or Ringer acetate solution (n=693) as
cardiopulmonary bypass priming and intravenous volume replacement
intraoperatively and up to 24 hours postoperatively. Main Outcomes
and Measures: The primary outcome was the number of patients with at least
1 major adverse event: death, myocardial injury, acute heart failure,
resternotomy, stroke, arrhythmia, bleeding, infection, or acute kidney
injury. Result(s): Among 1407 patients randomized, 1386 (99%; mean
age, 65.4 [SD, 9.9] years; 1091 men [79%]; 295 women [21%]) completed the
trial. Patients received a median of 2150 mL (IQR, 1598-2700 mL) of study
fluid in the albumin group and 3298 mL (IQR, 2669-3500 mL) in the Ringer
group. The number of patients with at least 1 major adverse event was 257
of 693 patients (37.1%) in the albumin group and 234 of 693 patients
(33.8%) in the Ringer group (relative risk albumin/Ringer, 1.10; 95% CI,
0.95-1.27; P=.20), an absolute difference of 3.3 percentage points (95%
CI, -1.7 to 8.4). The most common serious adverse events were pulmonary
embolus (11 [1.6%] in the albumin group vs 8 [1.2%] in the Ringer group),
postpericardiotomy syndrome (9 [1.3%] in both groups), and pleural
effusion with intensive care unit or hospital readmission (7 [1.0%] in the
albumin group vs 9 [1.3%] in the Ringer group). Conclusions and
Relevance: Among patients undergoing cardiac surgery with cardiopulmonary
bypass, treatment with 4% albumin solution for priming and perioperative
intravenous volume replacement solution compared with Ringer acetate did
not significantly reduce the risk of major adverse events over the
following 90 days. These findings do not support the use of 4% albumin
solution in this setting. Trial Registration: ClinicalTrials.gov
Identifier: NCT02560519.

<12>
[Use Link to view the full text]
Accession Number
2014921656
Title
Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and
Ischemia Severity.
Source
Circulation. (pp 1024-1038), 2021. Date of Publication: 2021.
Author
Reynolds H.R.; Shaw L.J.; Min J.K.; Page C.B.; Berman D.S.; Chaitman B.R.;
Picard M.H.; Kwong R.Y.; O'Brien S.M.; Huang Z.; Mark D.B.; Nath R.K.;
Dwivedi S.K.; Smanio P.E.P.; Stone P.H.; Held C.; Keltai M.; Bangalore S.;
Newman J.D.; Spertus J.A.; Stone G.W.; Maron D.J.; Hochman J.S.
Institution
(Reynolds, Bangalore, Newman, Hochman) Leon H. Charney Division of
Cardiology, Department of Medicine, New York University, Grossman School
of Medicine, 30 First Ave, SKI-9R, New York, NY 10016, United States
(Shaw) Weill Cornell Medicine, New York Presbyterian Hospital, United
States
(Min) Cleerly Inc, New York, NY, United States
(Page, O'Brien, Huang, Mark) Duke Clinical Research Institute, Durham, NC,
United States
(Berman) Cedars-Sinai Medical Centerc, Los Angeles, CA, United States
(Chaitman) St. Louis University, School of Medicine, Center for
Comprehensive Cardiovascular Care, MO, United States
(Picard) Massachusetts General Hospital, Harvard Medical School, Boston,
United States
(Kwong, Stone) Brigham and Women's Hospital, Boston, MA, United States
(Nath) Dr. Ram Manohar Lohia Hospital, New Delhi, India
(Dwivedi) King George's Medical University, Lucknow, India
(Smanio) Instituto Dante Pazzanese de Cardiologia e Fleury Medicina e
Saude, Sao Paulo, Brazil
(Held) Department of Medical Sciences, Cardiology, Uppsala University,
Uppsala Clinical Research Center, Sweden
(Keltai) Semmelweis University, Budapest, Hungary
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri, Kansas City, United States
(Stone) Icahn School of Medicine at Mount Sinai, Cardiovascular Research
Foundation, New York, United States
(Maron) Department of Medicine, Stanford University, CA, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: The ISCHEMIA trial (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches) postulated that
patients with stable coronary artery disease (CAD) and moderate or severe
ischemia would benefit from revascularization. We investigated the
relationship between severity of CAD and ischemia and trial outcomes,
overall and by management strategy. Method(s): In total, 5179
patients with moderate or severe ischemia were randomized to an initial
invasive or conservative management strategy. Blinded, core
laboratory-interpreted coronary computed tomographic angiography was used
to assess anatomic eligibility for randomization. Extent and severity of
CAD were classified with the modified Duke Prognostic Index (n=2475, 48%).
Ischemia severity was interpreted by independent core laboratories
(nuclear, echocardiography, magnetic resonance imaging, exercise tolerance
testing, n=5105, 99%). We compared 4-year event rates across subgroups
defined by severity of ischemia and CAD. The primary end point for this
analysis was all-cause mortality. Secondary end points were myocardial
infarction (MI), cardiovascular death or MI, and the trial primary end
point (cardiovascular death, MI, or hospitalization for unstable angina,
heart failure, or resuscitated cardiac arrest). Result(s): Relative
to mild/no ischemia, neither moderate ischemia nor severe ischemia was
associated with increased mortality (moderate ischemia hazard ratio [HR],
0.89 [95% CI, 0.61-1.30]; severe ischemia HR, 0.83 [95% CI, 0.57-1.21];
P=0.33). Nonfatal MI rates increased with worsening ischemia severity (HR
for moderate ischemia, 1.20 [95% CI, 0.86-1.69] versus mild/no ischemia;
HR for severe ischemia, 1.37 [95% CI, 0.98-1.91]; P=0.04 for trend, P=NS
after adjustment for CAD). Increasing CAD severity was associated with
death (HR, 2.72 [95% CI, 1.06-6.98]) and MI (HR, 3.78 [95% CI, 1.63-8.78])
for the most versus least severe CAD subgroup. Ischemia severity did not
identify a subgroup with treatment benefit on mortality, MI, the trial
primary end point, or cardiovascular death or MI. In the most severe CAD
subgroup (n=659), the 4-year rate of cardiovascular death or MI was lower
in the invasive strategy group (difference, 6.3% [95% CI, 0.2%-12.4%]),
but 4-year all-cause mortality was similar. Conclusion(s): Ischemia
severity was not associated with increased risk after adjustment for CAD
severity. More severe CAD was associated with increased risk. Invasive
management did not lower all-cause mortality at 4 years in any ischemia or
CAD subgroup. Registration: URL: https://www.clinicaltrials.gov. Unique
identifier: NCT01471522. Copyright © 2021 Lippincott Williams and
Wilkins. All rights reserved.

<13>
Accession Number
2018830609
Title
COMPARATIVE EVALUATION OF ENDOSCOPIC VARICEAL BAND LIGATION AND CARVEDILOL
FOR PREVENTION OF FIRST VARICEAL BLEED IN HIGH-RISK CIRRHOTICS.
Source
Gastroenterology. Conference: DDW 2022. San Diego United States. 162(7
Supplement) (pp S-1179-S-1180), 2022. Date of Publication: May 2022.
Author
Ahuja D.; Karna R.; Panda G.; Kar P.
Publisher
W.B. Saunders
Abstract
Introduction: Endoscopic variceal ligation (EVL) and non-selective
beta-blockers (NSBBs) are the favorable options for primary prophylaxis of
variceal bleed. Carvedilol causes higher reduction in portal pressure in
comparison to other NSBBs. Our aim was to compare the outcomes of variceal
bleed prevention by EVL and carvedilol in high-risk cirrhosis patients.
Methodology: We conducted a two-arm, open-label, randomized trial
evaluating the efficacy of carvedilol and EVL in cirrhotics at high risk
of bleeding from esophageal varices (EVs). Adult cirrhosis patients
between the age of 18-70 years without any prior bleeding from varices or
beta-blocker therapy were included in the study. Exclusion criteria:
malignancy, kidney injury, refractory ascites, hepatic encephalopathy $
grade 2, bilirubin > 10 mg/dl, sepsis, prior liver or endoscopic
procedures, lung disease, heart failure, hypotension, heart block, and
pregnancy. Patients underwent screening endoscopy, and those having
high-risk varices (grade III/IV) and/or showing red wale signs were
randomized (1:1 ratio) using chit method to receive either EVL or
carvedilol. EVL group received procedure performed every 3 weeks until
eradication. Eradication of varices was defined as no varices and grade I
varices. Upon eradication, endoscopy was done initially at 3 months, and
thereafter every 6 months to assess recurrence. To the other group,
carvedilol was initially introduced at 6.25 mg per day and titrated as
tolerated clinically. Both arms were then assessed via clinical and
laboratory parameters at 3, 6, 12 weeks, 6 months, and 1 year. Primary
endpoint was first variceal bleed (identified endoscopically after the
clinical presentation as hematemesis, melena, or drop in Hb >2 gm/dl
within 24 hours), and secondary endpoints included allcause mortality.
Patients were analyzed as per intention to treat analysis. Result(s):
96 patients were enrolled in the study, from which 44 were excluded based
on eligibility criteria. 52 patients were included with 26 patients in
each group with similar baseline characteristics. Table 1 shows
characteristics and outcomes of patients in both groups. 1 patient crossed
over from carvedilol group due to hypotension; none lost to follow-up.
Carvedilol group had lower variceal bleeding than EVL group {7.6% vs
19.2%, P=0.41}. The median survival of patients of EVL arm was 44.19 weeks
and carvedilol arm was 40.03 weeks. Overall mortality in EVL arm was
15.38% (n=4), and Carvedilol arm was 11.53% (n=3) [p=0.99]. Kaplan Meier
curve for survival is shown in Figure 1. Conclusion(s): We concluded
similar efficacy of carvedilol as primary prophylaxis of variceal
bleeding. Limitation of our study includes lack of blinding, central
randomization and allocation concealment, smaller sample size, and
single-center study. Further larger clinical trials across multiple
centers are required. (Table Presented) Copyright © 2022, AGA
Institute.

<14>
[Use Link to view the full text]
Accession Number
2019435179
Title
Transcatheter edge-to-edge repair in patients with mitral regurgitation
and cardiogenic shock: A new therapeutic target.
Source
Current Opinion in Critical Care. 28(4) (pp 426-433), 2022. Date of
Publication: 01 Aug 2022.
Author
Jung R.G.; Simard T.; Di Santo P.; Hibbert B.
Institution
(Jung, Di Santo, Hibbert) CAPITAL Research Group, University of Ottawa
Heart Institute, Ottawa, ON, Canada
(Jung, Hibbert) Vascular Biology and Experimental Medicine Laboratory,
University of Ottawa Heart Institute, University of Ottawa, Ottawa, ON,
Canada
(Jung, Hibbert) Department of Cellular and Molecular Medicine, Ottawa, ON,
Canada
(Jung) Division of Internal Medicine, The Ottawa Hospital, Faculty of
Medicine, University of Ottawa, Ottawa, ON, Canada
(Simard) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Di Santo, Hibbert) Division of Cardiology, University of Ottawa Heart
Institute, Ottawa, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewCardiogenic shock with significant mitral regurgitation
portends a poor prognosis with limited therapeutic options. Herein, we
review the available evidence regarding the patient characteristics,
management, impact of transcatheter edge-to-edge repair (TEER) on
hemodynamics, and clinical outcomes of patients with cardiogenic shock and
mitral regurgitation.Recent findingsSeveral observational studies and
systematic reviews have demonstrated the feasibility and safety of TEER in
cardiogenic shock complicated by degenerative or functional mitral
regurgitation. Surgical interventions for mitral regurgitation remain
limited owing to the risk profile of patients in cardiogenic shock. TEER
has been studied in both degenerative and functional mitral regurgitation
and remains feasible in the critically ill population. Moreover, TEER is
associated with reduction in mitral regurgitation and improvement
in-hospital and long-term mortality.SummaryTEER remains a promising
therapeutic option in cardiogenic shock complicated by significant mitral
regurgitation, but additional research is required to identify patient and
procedural characteristics, hemodynamic parameters, and the optimal time
for intervention. Moreover, future randomized controlled trials are in
progress to evaluate the potential benefit of TEER against medical
management in cardiogenic shock and mitral regurgitation. Copyright
© 2022 Lippincott Williams and Wilkins. All rights reserved.

<15>
Accession Number
2019427222
Title
Infarct Size and Long-Term Clinical Outcomes of Prasugrel versus
Clopidogrel in Patients with Acute Coronary Syndrome Undergoing Coronary
Artery Stenting: A Prospective Randomized Study.
Source
International Journal of Angiology. (no pagination), 2022. Date of
Publication: 2022.
Author
Yabe T.; Noike R.; Okubo R.; Amano H.; Ikeda T.
Institution
(Yabe, Noike, Okubo, Amano, Ikeda) Department of Cardiovascular Medicine,
Toho University, Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo
143-8541, Japan
Publisher
Thieme Medical Publishers, Inc.
Abstract
Objective The antiplatelet drug prasugrel inhibits platelet aggregation
early after oral administration. This study examined whether prasugrel is
effective in inhibiting infarct size and can reduce the incidence of major
adverse cardiovascular events (MACE) in patients with acute coronary
syndrome (ACS). Methods This study was a single-center, prospective,
randomized pilot study. Among 80 ACS patients treated at our institution
between August 2014 and September 2015, 76 ACS patients who underwent
stenting and achieved thrombolysis in myocardial infarction flow grade 3
were assigned to receive aspirin plus prasugrel (prasugrel group; n = 37)
or aspirin plus clopidogrel (clopidogrel group; n = 39). The primary
endpoint was survival free of MACE. The secondary endpoint was the
evaluation of infarct size defined as the area under the curve (AUC) of
troponin I, calculated using the linear trapezoidal method. Results During
follow-up (mean, 1262.4 +/- 599.6 days), 14 patients showed MACE. No
significant differences in CYP2C19 genotype were seen between groups. AUC
of troponin I up to 72 hours after intervention tended to be smaller in
the prasugrel group (1,927.1 +/- 2,189.3 ng/mL) than in the clopidogrel
group (3,186.0 +/- 3,760.1 ng/mL, p = 0.08). Cumulative incidence of MACE
was significantly higher in the clopidogrel group (log-rank test; p =
0.02). Conclusions Compared with clopidogrel, prasugrel was associated
with reduced infarct size and lower frequency of long-term outcomes among
ACS patients undergoing stenting. Copyright © 2022 Thieme Medical
Publishers, Inc.. All rights reserved.

<16>
Accession Number
2019418739
Title
Transcatheter edge-to-edge repair for acute mitral regurgitation with
cardiogenic shock secondary to mechanical complication.
Source
Cardiovascular Revascularization Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
So C.-Y.; Kang G.; Lee J.C.; Frisoli T.M.; O'Neill B.; Wang D.D.; Eng
M.H.; O'Neill W.; Villablanca P.A.
Institution
(So, Kang, Lee, Frisoli, O'Neill, Wang, Eng, O'Neill, Villablanca) Center
for Structural Heart Disease, Henry Ford Hospital, Detroit, MI, United
States
(So) Divison of Cardiology, Department of Medicine and Therapeutics,
Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, SAR,
Hong Kong
Publisher
Elsevier Inc.
Abstract
Introduction: Acute MR due to mechanical mitral valve (MV) complications
frequently results in cardiogenic shock and requires emergency surgical
intervention. There was limited evidence for alternative treatment like
MitraClip for patients at prohibitive surgical risk. We aimed to study the
technical features and outcomes of emergency transcatheter edge-to-edge
repair (TEER) using the MitraClip system for patients with cardiogenic
shock (CS) secondary to acute mitral regurgitation (MR) and mechanical MV
complication. Material(s) and Method(s): We performed institutional
review and systemic literature review to identify all TEER for CS patients
due to acute mitral regurgitation and mechanical MV complication. Clinical
endpoints included device success rate assessed at the end of procedure,
ability to wean off MCS, all-cause and cardiovascular mortality at 30-day.
 Result(s): Eight patients were identified from institutional review.
Detail anatomical analysis found that patients with mechanical MV
complications related to myocardial infarction had a lower transseptal
height achieved during MitraClip (3.6 +/- 0.1 cm vs 4.3 +/- 0.3 cm, p =
0.03) than those not related. Pooled analysis for cases from institutional
review (n = 8) and systemic literature review (n = 16) was performed. The
device success rate was 68.8 %. Seventy-five percent (n = 18) cases
required mechanical circulatory support (MCS), and 94.4 % were able to
wean off MCS. At 30-day, the cardiovascular mortality was 4.5 % and the
all-cause mortality was 9.1 %. Conclusion(s): In CS patients due to
acute MR and mechanical MV complications, TEER with/without MCS was
feasible with a reasonable device success rate. Copyright © 2022
Elsevier Inc.

<17>
Accession Number
638548037
Title
The physiological insight of Coenzyme-Q10 administration in preventing the
incidence of reperfusion arrhythmia among patients undergoing coronary
artery bypass grafting surgery.
Source
Journal of basic and clinical physiology and pharmacology. (no
pagination), 2022. Date of Publication: 20 Jul 2022.
Author
Wardhani L.F.K.; Dewi I.P.; Putra K.N.S.; Andrianto A.; Soemantri D.
Institution
(Wardhani, Dewi, Putra, Andrianto, Soemantri) Faculty of Medicine,
Airlangga University, Surabaya, Indonesia
(Wardhani, Dewi, Putra, Andrianto, Soemantri) Department of Cardiology and
Vascular Medicine, Dr. Soetomo General Hospital, Surabaya, Indonesia
(Dewi) Faculty of Medicine, Duta Wacana Christian University, Yogyakarta,
Indonesia
Publisher
NLM (Medline)
Abstract
Reperfusion arrhythmia following cardiac surgery has long been studied as
part of myocardial damage. Reperfusion injury is thought to be exacerbated
by oxygen-free radicals, whereas arrhythmogenic oscillations in membrane
potential are mediated by reactive oxygen. Coenzyme Q10 is a lipid-soluble
antioxidant that inhibits lipid peroxidation in biological membranes and
supplies ATP cell synthesis, required as the organism's primary energy
source. This process explains how Coenzyme Q10 helps stabilize membranes
and avoids critical metabolite depletion that may relate to reperfusion
arrhythmia. There is a reduction of iatrogenic Coenzyme Q10 after coronary
artery bypass surgery (CABG). On the other hand, there is an increased
inflammatory process and cellular demand post CABG procedure. It leads to
ischemia that can be manifested as arrhythmia. Reperfusion arrhythmia was
less common in patients who took Coenzyme Q10. These findings suggest that
Coenzyme Q10 supplementation might help patients with heart surgery avoid
reperfusion arrhythmia. However, a higher-quality randomized controlled
study is needed to determine the effect of Coenzyme Q10 in preventing
reperfusion arrhythmia in cardiac surgery patients. Copyright ©
2022 Walter de Gruyter GmbH, Berlin/Boston.

<18>
Accession Number
2017904327
Title
Validity Evidence for Procedure-Specific Competency Assessment Tools in
Cardiovascular and Thoracic Surgery: A Scoping Review: Procedure-specific
competence assessment in CVT surgery.
Source
Journal of Surgical Education. 79(4) (pp 1016-1023), 2022. Date of
Publication: 01 Jul 2022.
Author
White A.; Muller Moran H.R.; Ryan J.; Mador B.; Campbell S.; Turner S.R.
Institution
(White, Ryan, Mador, Turner) Department of Surgery, University of Alberta,
Edmonton, AB, Canada
(Muller Moran) Department of Surgery, University of Manitoba, Winnipeg,
MB, Canada
(Campbell) University of Alberta Library, Edmonton, AB, Canada
Publisher
Elsevier Inc.
Abstract
OBJECTIVE: Surgical education has shifted from a time-based approach to
the achievement and demonstration of procedural competency. High quality,
objective assessment instruments are required to support this new
approach. This study comprehensively reviewed the literature to identify
and evaluate available procedure-specific assessment instruments in
cardiothoracic and vascular surgery. DESIGN: A systematic search of 8
databases identified studies containing procedure-specific operative
assessment instruments in cardiothoracic and vascular surgery. Generic
global rating scales were excluded, unless modified to be
procedure-specific. Two reviewers independently evaluated the validity
evidence, methodological rigour and educational utility of each instrument
using objective scoring criteria. Validity evidence was evaluated with a
scoring tool aligned with the contemporary framework of validity.
Methodological rigour was evaluated using the Medical Education Research
Study Quality Instrument. Educational utility was evaluated according to
the Accreditation Council for Graduate Medical Education (ACGME)
framework. RESULT(S): There were 2130 unique studies describing
procedure-specific assessment in surgery. Of these, 9 studies evaluating 8
procedure-specific assessment instruments met inclusion criteria for
cardiothoracic and vascular surgery. Four instruments were identified in
thoracic surgery, 2 in cardiac surgery, and 2 in vascular surgery. Only 1
instrument was designed to evaluate surgeon performance, with the
remainder designed to evaluate residents. No single instrument scored the
maximum score of 15 for validity evidence. The highest score was 11, with
62.5% (n = 5) of instruments scoring greater than 10. All tools attained
high scores in content validity, with minimal evidence generally presented
regarding the consequences of assessment using a particular instrument.
All but 1 instrument scored greater than 11 out of a maximum 16.5 points
for methodological rigour. Very few studies reported on the ACGME domains
of educational utility. CONCLUSION(S): In an era where surgical
education is shifting towards the demonstration of procedural competency,
objective procedure-specific assessment is critical. This review
identified that few procedure-specific assessment instruments in
cardiothoracic and vascular surgery exist, emphasizing the need for such
instruments to ensure the success of competency-based education
models. Copyright © 2022

<19>
Accession Number
2017520997
Title
Off-Pump Coronary Artery Bypass Graft Surgery with Bilateral Internal
Mammary Arteries in Left Main Coronary Artery Disease. Is There Any
Benefit in 10-Year Mortality?.
Source
Revista Argentina de Cardiologia. 90(3) (pp 173-178), 2022. Date of
Publication: 2022.
Author
Espinoza J.; Piccinini F.; Vrancic M.; Camporrotondo M.; Navia D.
Institution
(Espinoza, Piccinini, Vrancic, Camporrotondo, Navia) Instituto
Cardiovascular de Buenos Aires, Ciudad de Buenos Aires, Argentina
(Navia) Instituto de Cardiologia "Juana F. Cabral", Corrientes, Argentina
(Navia) Centro de Educacion Medica e Investigaciones Clinicas "Norberto
Quirno" (CEMIC), Ciudad de Buenos Aires, Argentina
Publisher
Sociedad Argentina de Cardiologia
Abstract
Background: The randomized controlled trials comparing coronary artery
bypass graft (CABG) surgery versus percutaneous coronary intervention
(PCI) included all types of surgical techniques (on-pump and off-pump) and
different conduits (arterial and venous). Is it reasonable to assume that
all surgical techniques are equal in terms of late mortality? Objectives:
The aim of this study was to evaluate whether off-pump CABG surgery using
both mammary arteries provides additional benefit over conventional
revascularization using single mammary artery in terms of long-term
survival for left main coronary artery (LMCA) disease. Method(s): We
conducted a retrospective, observational and comparative study (n = 723)
adjusted for risk. A stratified analysis was performed according to the
use of single internal thoracic artery (SITA, n = 144) or bilateral
internal thoracic arteries (BITA, n = 579) analyzing survival at 10 years
after the intervention. Result(s): Survival at 10 years was
significantly higher in BITA group (79.0% +/- 3.4% vs 67.0% +/- 4.9%,
log-rank test, p <0.01). This advantage was also observed in the
risk-adjusted analysis (93.0% +/- 4.6 vs 69.0% +/- 5.7 respectively, p =
0.03). The use of BITA was an independent predictor of 10-year survival
(HR 0.57, 95% CI 0.37-0.87, p = 0.01). Conclusion(s): The use of
bilateral internal mammary arteries in patients with left main coronary
artery disease undergoing off-pump coronary artery bypass grafting was
associated with higher survival at 10 years. Copyright © 2022,
Sociedad Argentina de Cardiologia. All rights reserved.

<20>
Accession Number
2017520982
Title
High Lipoprotein(a) Levels and Risk of Aortic Valve Stenosis Related
Clinical Events: A Systematic Review.
Source
Revista Argentina de Cardiologia. 90(3) (pp 215-221), 2022. Date of
Publication: 2022.
Author
Masson W.; Lobo M.; Barbagelata L.; Bagnati R.; Oberti P.; Falconi M.;
Krauss J.; Parcerisa F.; Pizarro R.
Institution
(Masson, Barbagelata, Bagnati, Oberti, Falconi, Krauss, Parcerisa)
Department of Cardiology, Hospital Italiano de Buenos Aires, Peron 4190,
Buenos Aires C1199ABB, Argentina
(Lobo, Pizarro) Department of Cardiology, Hospital Militar Campo de Mayo,
Tte. Gral. Ricchieri S/N, Buenos Aires B1659AMA, Argentina
Publisher
Sociedad Argentina de Cardiologia
Abstract
Background: Several studies have evaluated the association between
lipoprotein(a) plasma levels [Lp(a)] and the occurrence of aortic valve
stenosis related events, with contradictory results. Objective(s):
The main objective of this systematic review was to analyze the predictive
capacity of elevated Lp(a) levels on major clinical events associated with
aortic valve stenosis. Method(s): This systematic review was
conducted in accordance with PRISMA and STROBE recommendations. A search
was carried out in order to identify studies with a cohort design
evaluating the association between Lp(a) levels and the events of
interest. The primary endpoint was the incidence of clinical events
related with aortic valve stenosis (aortic valve replacement, death or
hospita-lization). This review was registered in PROSPERO. Result(s):
Seven observational studies with a total of 58 783 patients were eligible
for analysis. Our findings showed that the presence of elevated Lp(a)
levels was associated with an increased risk of events related with aortic
valve stenosis in most of the studies evaluated (between 70% and
approximately 3-fold higher risk), despite adjusting for other risk
factors. Conclusion(s): This review suggests that elevated Lp(a)
levels are associated with a higher incidence of aortic valve stenosis
related clinical events. However, considering the limitations of this
study, the clinical usefulness of Lp(a) as a prognostic marker in aortic
valve disease should be confirmed in future investigations. Copyright
© 2022, Sociedad Argentina de Cardiologia. All rights reserved.

<21>
[Use Link to view the full text]
Accession Number
2019315156
Title
Neo-Commissural Alignment Technique for Transcatheter Aortic Valve
Replacement Using the ACURATE Neo Valve.
Source
Circulation: Cardiovascular Interventions. 15(7) (pp e011993), 2022. Date
of Publication: 01 Jul 2022.
Author
Abdel-Wahab M.; Kitamura M.; Fitzgerald S.J.; Dumpies O.; Wilde J.;
Gohmann R.F.; Majunke N.; Gutberlet M.; Kiefer P.; Noack T.; Lurz P.;
Desch S.; Frawley C.; Ward K.; Borger M.A.; Holzhey D.; Thiele H.
Institution
(Abdel-Wahab, Kitamura, Fitzgerald, Dumpies, Wilde, Majunke, Lurz, Desch,
Thiele) Department of Structural Heart Disease/Cardiology, Heart Center
Leipzig at University of Leipzig, Strumpellstrase 39, Leipzig 04289,
Germany
(Gohmann, Gutberlet) Department of Diagnostic and Interventional
Radiology, Heart Center Leipzig at University of Leipzig, Germany
(Kiefer, Noack, Borger, Holzhey) Department of Structural Heart
Disease/Cardiac Surgery, Heart Center Leipzig at University of Leipzig,
Germany
(Kitamura) Department of Cardiology, Sakakibara Heart Institute, Tokyo,
Japan
(Frawley, Ward) Structural Heart Valve Research and Development Campus,
Boston Scientific Corporation, Ballybrit, Galway, Ireland
Publisher
Lippincott Williams and Wilkins

<22>
Accession Number
2010392950
Title
Recruitment maneuvers to reduce pulmonary atelectasis after cardiac
surgery: A meta-analysis of randomized trials.
Source
Journal of Thoracic and Cardiovascular Surgery. 164(1) (pp 171-181.e4),
2022. Date of Publication: July 2022.
Author
Hu M.-C.; Yang Y.-L.; Chen T.-T.; Lee C.-I.; Tam K.-W.
Institution
(Hu, Chen) Graduate Institute of Clinical Medicine, College of Medicine,
Taipei Medical University, Taipei, Taiwan (Republic of China)
(Yang) School of Respiratory Therapy, College of Medicine, Taipei Medical
University, Taipei, Taiwan (Republic of China)
(Yang) Department of Respiratory Therapy, Landseed International Hospital,
Taoyuan, Taiwan (Republic of China)
(Chen) Division of Pulmonary Medicine, Department of Internal Medicine,
Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
(Republic of China)
(Lee) Division of Cardiovascular Surgery, Department of Surgery, Shuang Ho
Hospital, Taipei Medical University, New Taipei City, Taiwan (Republic of
China)
(Tam) Division of General Surgery, Department of Surgery, Shuang Ho
Hospital, Taipei Medical University, New Taipei City, Taiwan (Republic of
China)
(Tam) Division of General Surgery, Department of Surgery, School of
Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
(Republic of China)
(Tam) Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan (Republic
of China)
Publisher
Elsevier Inc.
Abstract
Background: Pulmonary atelectasis is a common postoperative complication
that may lead to intrapulmonary shunt, refractory hypoxemia, and
respiratory distress. Recruitment maneuvers may relieve pulmonary
atelectasis in patients undergoing cardiac surgery. We conducted a
meta-analysis of randomized controlled trials to evaluate the
effectiveness of recruitment maneuvers in these patients. Method(s):
We conducted a search in PubMed, Embase, Cochrane Library, and the
ClinicalTrials.gov registry for trials published before March 2020.
Individual effect sizes were standardized, and a meta-analysis was
performed to calculate a pooled effect size by using random-effects
models. Pulmonary atelectasis was assessed postoperatively. Secondary
outcomes included hypoxic events, arterial oxygen tension
(PaO<inf>2</inf>)/inspired oxygen fraction (FIO<inf>2</inf>) ratio,
cardiac index, mean arterial pressure, and postoperative complications
including pneumothorax and pneumonia. Result(s): We reviewed 16
trials involving 1455 patients. Patients receiving recruitment maneuvers
had a reduced incidence of pulmonary atelectasis (group with recruited
pressure >40 cmH<inf>2</inf>O: risk ratio [RR], 0.20; 95% confidence
interval [CI], 0.07-0.57; group with recruited pressure <40
cmH<inf>2</inf>O: RR, 0.54; 95% CI, 0.33-0.89), reduced incidence of
hypoxic events (RR, 0.23; 95% CI, 0.14-0.37), reduced incidence of
pneumonia (RR, 0.42; 95% CI, 0.18-0.95), and improved
PaO<inf>2</inf>/FIO<inf>2</inf> ratio (weighted mean difference [WMD];
58.87, 95% CI, 31.24-86.50) without disturbing the cardiac index (WMD,
0.22; 95% CI, -0.18 to 0.61) or mean arterial pressure (WMD, -0.30, 95%
CI, -3.19 to 2.59) as compared with those who received conventional
mechanical ventilation. The incidence of pneumothorax was nonsignificant
between the groups. Conclusion(s): Recruitment maneuvers may reduce
postoperative pulmonary atelectasis, hypoxic events, and pneumonia and
improve PaO<inf>2</inf>/FIO<inf>2</inf> ratios without hemodynamic
disturbance in patients undergoing cardiac surgery. Copyright ©
2020 The American Association for Thoracic Surgery

<23>
Accession Number
2015656918
Title
Left Atrial Appendage Closure During Cardiac Surgery for Atrial
Fibrillation: A Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 40 (pp 26-36), 2022. Date of
Publication: July 2022.
Author
Prasad R.M.; Saleh Y.; Al-Abcha A.; Abdelkarim O.; Abdelfattah O.M.;
Abdelnabi M.; Almaghraby A.; Elwany M.; DeBruyn E.; Abela G.S.
Institution
(Prasad, Al-Abcha) Department of Internal Medicine, Michigan State
University, East Lansing, MI, United States
(Saleh, Abdelkarim) Department of Cardiology, Houston Methodist DeBakey
Heart & Vascular Center, Houston, TX, United States
(Saleh, Abdelkarim, Almaghraby, Elwany) Department of Cardiology,
Alexandria University, Alexandria, Egypt
(Abdelfattah) Department of Internal Medicine, Morristown Medical Center,
Atlantic Health System, Morristown, NJ, United States
(DeBruyn) College of Medicine, University of Illinois, Chicago, IL, United
States
(Abela) Department of Cardiology, Michigan State University, East Lansing,
MI, United States
(Abdelnabi) Internal Medicine Department, Texas Tech University Health
Science Center, Lubbock, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Left atrial appendage closure (LAAC) during cardiac surgery in
atrial fibrillation (AF) patients has been investigated in multiple
studies with variable safety and efficacy results. Method(s): A
comprehensive review was performed of all studies comparing LAAC and
placebo arm during cardiac surgery in AF patients. A random-effect model
was used to calculate risk ratios, mean differences, and 95% confidence
intervals. Result(s): Five randomized controlled trials and 22
observational studies were included with a total of 540,111 patients. The
LAAC group had significantly decreased postoperative stroke/embolic events
as compared to the no LAAC group with all cardiac surgeries (3.74% vs
4.88%, p = 0.0002), isolated valvular surgery (1.95% vs 4.48%, p = 0.002).
However, CABG insignificantly favored the LAAC group for stroke/embolic
events (6.72% vs 8.30%, p = 0.07). There was no difference between both
groups in all-cause mortality in the perioperative period (p = 0.42), but
was significantly lower in the LAAC arm after two years (14.1% vs 18.3%, p
= 0.02). There was no difference in major bleeding, all-cause
rehospitalizations, or cross-clamp time between both groups (p = 0.53 and
p = 0.45). The bypass and the cross-clamp time were longer in the LAAC
group (4 and 9 min, respectively). Conclusion(s): In AF patients,
LAAC during cardiac surgery had a decreased risk of stroke and long-term
all-cause mortality. Additionally, there was no difference in major
bleeding, all-cause rehospitalizations, or cross-clamp time. Copyright
© 2021

<24>
Accession Number
2015583993
Title
High-dose preoperative glucocorticoid for prevention of emergence and
postoperative delirium in liver resection: A double-blinded randomized
clinical trial substudy.
Source
Acta Anaesthesiologica Scandinavica. 66(6) (pp 696-703), 2022. Date of
Publication: July 2022.
Author
Awada H.N.; Steinthorsdottir K.J.; Schultz N.A.; Hillingso J.G.; Larsen
P.N.; Jans O.; Kehlet H.; Aasvang E.K.
Institution
(Awada, Steinthorsdottir, Jans, Aasvang) Department of Anesthesiology,
Centre for Cancer and Organ Diseases, Rigshospitalet Copenhagen University
Hospital, Copenhagen, Denmark
(Awada, Steinthorsdottir, Kehlet) Surgical Pathophysiology Unit,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Schultz, Hillingso, Larsen) Department of Gastrointestinal Surgery and
Transplantation, Centre for Cancer and Organ Diseases, Rigshospitalet
Copenhagen University Hospital, Copenhagen, Denmark
(Aasvang) Department of Clinical Medicine, Faculty of Health and Medical
Sciences, University of Copenhagen, Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Emergence delirium (ED) and postoperative delirium (POD) are
associated with increased morbidity and mortality and occur in up to
one-third of patients undergoing major non-cardiac surgery, where the
underlying pathogenesis is multifactorial, including increased
inflammation. We aimed to assess the effect of pre-operative high- versus
low-dose glucocorticoid on the occurrence of ED and POD. Method(s):
This was a substudy from a randomized, double-blinded clinical trial.
Patients >=18 years, undergoing open liver resection were randomized 1:1
to high-dose (HD, 10 mg/kg methylprednisolone) or low-dose (LD, 8 mg
dexamethasone) glucocorticoid and assessed for ED and POD for a maximum of
4 days during hospitalization. The 3-min Diagnostic Interview for
CAM-defined delirium (3D-CAM) was used for assessment, 15 and 90 min after
arrival in the post-anesthesia care unit (PACU), and subsequently once
daily in the ward. Result(s): Fifty-three patients were included in
this secondary substudy (26 HD-group and 27 LD-group). ED occurred in n =
5 HD versus n = 6 LD patients 15 min after PACU arrival. At 90 min after
PACU arrival, 4 patients had ED, all from LD-group, and resulted in
significantly longer PACU admission, 273 versus 178 min in ED versus
Non-ED patients. During the first 4 days in the ward, n = 5 patients had
at least one occurrence of POD, all from LD-group. Conclusion(s): The
primary finding of the current substudy was a lower occurrence of ED/POD
in the PACU 90 min after arrival and during the first four postoperative
days in patients receiving high-dose glucocorticoid compared with patients
receiving low-dose glucocorticoid. The two study groups were not evenly
balanced concerning known explanatory factors, i.e., age and size of
surgery, which calls for larger studies to elucidate the
matter. Copyright © 2022 The Authors. Acta Anaesthesiologica
Scandinavica published by John Wiley & Sons Ltd on behalf of Acta
Anaesthesiologica Scandinavica Foundation.

<25>
Accession Number
2015109159
Title
Comparison of ECMO vs ECpella in Patients With Non-Post-Pericardiotomy
Cardiogenic Shock: An Updated Meta-Analysis.
Source
Cardiovascular Revascularization Medicine. 40 (pp 134-141), 2022. Date of
Publication: July 2022.
Author
Iannaccone M.; Venuti G.; di Simone E.; De Filippo O.; Bertaina M.;
Colangelo S.; Boccuzzi G.; de Piero M.E.; Attisani M.; Barbero U.; Zanini
P.; Livigni S.; Noussan P.; D'Ascenzo F.; de Ferrari G.M.; Porto I.;
Truesdell A.G.
Institution
(Iannaccone, di Simone, Bertaina, Colangelo, Boccuzzi, Zanini, Noussan)
Division of Cardiology, San Giovanni Bosco Hospital, ASL Citta di Torino,
Turin, Italy
(Venuti) Division of Cardiology, A.O. Papardo, Messina, Italy
(De Filippo, Attisani, D'Ascenzo, de Ferrari) Division of Cardiology,
Citta della Scienza e della Salute, University of Turin, Turin, Italy
(de Piero, Livigni) Department of Anesthesiology and Intensive Care, San
Giovanni Bosco Hospital, ASL Citta di Torino, Turin, Italy
(Barbero) Division of Cardiology, Sevigliano ASL CN1, Italy
(Porto) Cardiovascular Disease Unit, IRCCS Policlinic Hospital San
Martino, Genova, Italy
(Truesdell) Virginia Heart/Inova Heart and Vascular Institute, Falls
Church, VA, United States
Publisher
Elsevier Inc.
Abstract
Introduction: The impact of Impella and ECMO (ECPELLA) in cardiogenic
shock (CS) remains to be defined. The aim of this meta-analysis is to
evaluate the benefit of ECPELLA compared to VA-ECMO in patients with non
post-pericardiotomy CS. Method(s): All studies reporting short term
outcomes of ECpella or VA ECMO in non post-pericardiotomy CS were
included. The primary endpoint was 30-day mortality. Vascular and bleeding
complications and LVAD implantation/heart transplant within 30-days were
assessed as secondary outcomes. Result(s): Of 407 studies identified,
13 observational studies (13,682 patients, 13,270 with ECMO and 412 with
ECpella) were included in this analysis. 30-day mortality was 55.8%
(51.6-59.9) in the VA-ECMO group and 58.3% (53.5-63.0) in the ECpella
group. At meta-regression analysis the implantation of IABP did not affect
mortality in the ECMO group. The rate of major bleeding in patients on
VA-ECMO and ECpella support were 21.3% (16.9-26.5) and 33.1% (25.9-41.2)
respectively, while the rates of the composite outcome of LVAD
implantation and heart transplantation within 30-days in patients on
VA-ECMO and ECpella support were 14.4% (9.0-22.2) and 10.8%. When directly
compared in 3 studies, ECpella showed a positive effect on 30-day
mortality compared to ECMO (OR: 1.81: 1.039-3.159). Conclusion(s):
Our data suggest that ECpella may reduce 30-day mortality and increase
left ventricle recovery, despite increased of bleeding
rates. Copyright © 2021 Elsevier Inc.

<26>
[Use Link to view the full text]
Accession Number
2018928619
Title
Continuous Titration of Inspired Oxygen Using Oxygen Reserve Index to
Decrease Oxygen Exposure During One-Lung Ventilation: A Randomized
Controlled Trial.
Source
Anesthesia and Analgesia. 135(1) (pp 91-99), 2022. Date of Publication: 01
Jul 2022.
Author
Yang M.; Kim J.A.; Ahn H.J.; Choi Y.S.; Park M.; Jeong H.; Kim K.; Lee
N.Y.
Institution
(Yang, Kim, Ahn, Park, Jeong, Lee) Department of Anesthesiology and Pain
Medicine, Samsung Medical Center, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Choi) Department of Thoracic and Cardiovascular Surgery, Samsung Medical
Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
(Kim) Department of Anesthesiology and Pain Medicine, School of Dentistry,
Dankook University, Cheonan-si, South Korea
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: A high fraction of inspired oxygen (Fio<inf>2</inf>) is
administered during one-lung ventilation (OLV). However, a high
Fio<inf>2</inf>is not physiologic and may lead to various complications.
We hypothesized that continuous titration of Fio<inf>2</inf>using the
oxygen reserve index (ORI) reduces oxygen exposure compared to
conventional management during OLV. METHOD(S): In this randomized,
double-blinded trial, patients undergoing thoracic surgery were assigned
to an ORI (n = 64) or a control group (n = 60). In the ORI group, ORI was
continuously displayed using multiwavelength pulse co-oximetry (Masimo)
between 0 and 1 (0, no reserve; 1, maximum reserve), and
Fio<inf>2</inf>was titrated for a target ORI of 0.21 at 5-minute intervals
during OLV. In the control group, Fio<inf>2</inf>was adjusted using
arterial blood gas analysis measured at 15 minutes after OLV initiation.
The primary end point was the time-weighted average Fio<inf>2</inf>during
OLV. RESULT(S): Overall, time-weighted average Fio<inf>2</inf>did not
differ between the groups (control versus ORI: median [interquartile
range], 0.87 [0.73-1.00] vs 0.82 [0.68-0.93]; P =.09). However, in a
subgroup analysis, the ORI group reduced time-weighted average
Fio<inf>2</inf>after pulmonary vascular ligation compared to the control
group (control versus ORI: median [interquartile range], 0.75 [0.70-1.00]
vs 0.72 [0.59-0.89]; P =.0261). The incidence of intraoperative hypoxia
(arterial oxygen saturation [Spo<inf>2</inf>] <94%; control versus ORI:
32% [19/60; 95% confidence interval (CI), 20-45] vs 19% [12/64; 95% CI,
10-31]; P =.09), and postoperative complications within the first 7 days
did not differ between the groups. CONCLUSION(S): ORI-guided
continuous Fio<inf>2</inf>titration does not reduce overall oxygen
exposure during OLV. Copyright © 2022 Lippincott Williams and
Wilkins. All rights reserved.

<27>
Accession Number
2018925995
Title
Clinical Validation of a Virtual Planner for Coronary Interventions Based
on Coronary CT Angiography.
Source
JACC: Cardiovascular Imaging. 15(7) (pp 1242-1255), 2022. Date of
Publication: July 2022.
Author
Sonck J.; Nagumo S.; Norgaard B.L.; Otake H.; Ko B.; Zhang J.; Mizukami
T.; Maeng M.; Andreini D.; Takahashi Y.; Jensen J.M.; Ihdayhid A.;
Heggermont W.; Barbato E.; Mileva N.; Munhoz D.; Bartunek J.; Updegrove
A.; Collinsworth A.; Penicka M.; Van Hoe L.; Leipsic J.; Koo B.-K.; De
Bruyne B.; Collet C.
Institution
(Sonck, Nagumo, Mizukami, Heggermont, Barbato, Mileva, Munhoz, Bartunek,
Penicka, De Bruyne, Collet) Cardiovascular Center Aalst, OLV Clinic,
Aalst, Belgium
(Sonck, Barbato, Munhoz) Department of Advanced Biomedical Sciences
University Federico II, Naples, Italy
(Nagumo) Department of Cardiology, Showa University Fujigaoka Hospital,
Kanagawa, Japan
(Norgaard, Maeng, Jensen) Department of Cardiology, Aarhus University
Hospital, Aarhus, Denmark
(Otake, Takahashi) Division of Cardiovascular Medicine, Department of
Internal Medicine, Kobe University Graduate School of Medicine, Kobe,
Japan
(Ko, Ihdayhid) Monash Cardiovascular Research Centre, Monash University
and Monash Heart, Monash Health, Clayton, Victoria, Australia
(Zhang, Koo) Department of Internal Medicine and Cardiovascular Center,
Seoul National University Hospital, Seoul, South Korea
(Mizukami) Division of Clinical Pharmacology, Department of Pharmacology,
Showa University School of Medicine, Tokyo, Japan
(Andreini) Centro Cardiologico Monzino, IRCCS, Milan, Italy
(Andreini) Department of Clinical Sciences and Community Health,
Cardiovascular Section, University of Milan, Milan, Italy
(Munhoz) Department of Internal Medicine, Discipline of Cardiology,
University of Campinas (Unicamp), Campinas, Brazil
(Updegrove, Collinsworth) HeartFlow Inc, Redwood City, CA, United States
(Van Hoe) Department of Radiology, OLV Clinic, Aalst, Belgium
(Leipsic) Department of Medicine and Radiology, University of British
Columbia, Vancouver, BC, Canada
(De Bruyne) Department of Cardiology, University Hospital of Lausanne,
Lausanne, Switzerland
Publisher
Elsevier Inc.
Abstract
Background: Low fractional flow reserve (FFR) values after percutaneous
coronary intervention (PCI) carry a worse prognosis than high post-PCI FFR
values. Therefore, the ability to predict post-PCI FFR might play an
important role in procedural planning. Post-PCI FFR values can now be
computed from pre-PCI coronary computed tomography angiography (CTA) using
the fractional flow reserve derived from coronary computed tomography
angiography revascularization planner (FFR<inf>CT</inf> Planner).
 Objective(s): The aim of this study was to validate the accuracy of
the FFR<inf>CT</inf> Planner. Method(s): In this multicenter,
investigator-initiated, prospective study, patients with chronic coronary
syndromes and significant lesions based on invasive FFR <=0.80 were
recruited. The FFR<inf>CT</inf> Planner was applied to the fractional flow
reserve derived from coronary computed tomography angiography
(FFR<inf>CT</inf>) model, simulating PCI. The primary objective was the
agreement between the predicted post-PCI FFR by the FFR<inf>CT</inf>
Planner and measured post-PCI FFR. Accuracy of the FFR<inf>CT</inf>
Planner's luminal dimensions was assessed by using post-PCI optical
coherence tomography as the reference. Result(s): Overall, 259
patients were screened, with 120 patients (123 vessels) included in the
final analysis. The mean patient age was 64 +/- 9 years, and 24% had
diabetes. Measured FFR post-PCI was 0.88 +/- 0.06, and the
FFR<inf>CT</inf> Planner FFR was 0.86 +/- 0.06 (mean difference: 0.02 +/-
0.07 FFR unit; limits of agreement: -0.12 to 0.15). Optical coherence
tomography minimal stent area was 5.60 +/- 2.01 mm2, and
FFR<inf>CT</inf> Planner minimal stent area was 5.0 +/- 2.2 mm2
(mean difference: 0.66 +/- 1.21 mm2; limits of agreement: -1.7
to 3.0). The accuracy and precision of the FFR<inf>CT</inf> Planner
remained high in cases with focal and diffuse disease and with low and
high calcium burden. Conclusion(s): The FFR<inf>CT</inf>-based
technology was accurate and precise for predicting FFR after PCI. (Precise
Percutaneous Coronary Intervention Plan Study [P3];
NCT03782688) Copyright © 2022 The Authors

<28>
Accession Number
2010817377
Title
Association of obesity with mortality and clinical outcomes in children
and adolescents with transplantation: A systematic review and
meta-analysis.
Source
Reviews in Endocrine and Metabolic Disorders. 22(4) (pp 847-858), 2021.
Date of Publication: December 2021.
Author
Yaseri M.; Alipoor E.; Seifollahi A.; Rouhifard M.; Salehi S.;
Hosseinzadeh-Attar M.J.
Institution
(Yaseri, Rouhifard) Department of Epidemiology and Biostatistics, School
of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Alipoor) Department of Nutrition, School of Public Health, Iran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Seifollahi, Salehi, Hosseinzadeh-Attar) Department of Clinical Nutrition,
School of Nutritional Sciences and Dietetics, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Hosseinzadeh-Attar) Cardiac Primary Prevention Research Center,
Cardiovascular Diseases Research Institute, Tehran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Springer
Abstract
Obesity might be associated with mortality and clinical outcomes following
transplantation; however, the direction of this relationship has not been
well-recognized in youth. The aim of this systematic review and
meta-analysis was to investigate the association of obesity with
post-transplant mortality and clinical outcomes in children and
adolescents. Following a systematic search of observational studies
published by December 2018 in PubMed, Scopus, Embase, and Cochrane
library, 15 articles with total sample size of 50,498 patients were
included in the meta-analysis. The main outcome was mortality and
secondary outcomes included acute graft versus host disease (GVHD), acute
rejection, and overall graft loss. The pooled data analyses showed
significantly higher odds of long term mortality (OR 1.30, 95% CI
1.15-1.48, P < 0.001, I2 = 50.3%), short term mortality (OR
1.79, 95% CI 1.19-2.70, P = 0.005, I2 = 59.6%), and acute GVHD
(OR 2.13, 95% CI 1.5-3.02, P < 0.001, I2 = 1.7%) in children
with obesity. There were no significant differences between patients with
and without obesity in terms of acute rejection (OR 1.07, 95% CI
0.98-1.16, P = 0.132, I2 = 7.5%) or overall graft loss (OR
1.04, 95% CI 0.84-1.28, P = 0.740, I2 = 51.6%). This systematic
review and meta-analysis has stated higher post-transplant risk of short
and long term mortality and higher risk of acute GVHD in children with
obesity compared to those without obesity. Future clinical trials are
required to investigate the effect of pre-transplant weight management on
post-transplant outcomes to provide insights into the clinical application
of these findings. This may in turn lead to establish guidelines for the
management of childhood obesity in transplantations. Copyright ©
2021, The Author(s), under exclusive licence to Springer Science+Business
Media, LLC, part of Springer Nature.

<29>
Accession Number
636480103
Title
Conventional sternotomy versus right mini-thoracotomy versus robotic
approach for mitral valve replacement/repair: insights from a network
meta-analysis.
Source
The Journal of cardiovascular surgery. 63(4) (pp 492-497), 2022. Date of
Publication: 01 Aug 2022.
Author
Yokoyama Y.; Kuno T.; Takagi H.; Briasoulis A.; Ota T.
Institution
(Yokoyama) Department of Surgery, St. Luke's University Health Network,
Fountain Hill, PA, United States
(Kuno) Department of Medicine, Icahn School of Medicine at Mount Sinai,
Mount Sinai Beth Israel, New York, NY, USA -
(Kuno) Department of Cardiology, Montefiore Medical Center, Albert
Einstein Medical College, Bronx, NY, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Briasoulis) Division of Cardiovascular Medicine, Section of Heart Failure
and Transplantation, University of Iowa, Iowa City, IA, United States
(Ota) Department of Surgery, University of Chicago Medicine, Chicago, IL,
United States
Publisher
NLM (Medline)
Abstract
INTRODUCTION: Minimally invasive cardiac surgery (MICS) through right
mini-thoracotomy as well as robotic surgery has emerged for the last
decade for mitral valve surgery. However, their risks and benefits are not
fully understood yet. Thus, we conducted a network meta-analysis comparing
the early- and long-term outcomes of mitral valve surgery via the
conventional sternotomy, MICS, and robotic approaches. EVIDENCE
ACQUISITION: MEDLINE and EMBASE were searched through November 2020 to
identify randomized controlled trials (RCTs) and propensity-score matched
(PSM) trials that investigated early- and long-term outcomes after mitral
surgery via the conventional sternotomy, MICS, and robotic approaches. A
subanalysis focusing on only subjects who initially underwent mitral valve
repair was also conducted. EVIDENCE SYNTHESIS: Our systematic literature
search identified two RCTs and 19 PSM studies. MICS was related to
significant risk reductions of permanent pacemaker implantation, surgical
site infection, and transfusion compared to the sternotomy approach. The
robotic approach was associated with a significant increase in
re-exploration for bleeding compared to sternotomy. The subanalysis showed
that MICS was associated with a significant increase requiring mitral
valve reoperation compared to the sternotomy approach (hazard ratio 7.33
[95% CI: 1.54-34.97], P=0.012), while no significant difference was
observed between the sternotomy and the robotic approach.
 CONCLUSION(S): Our network meta-analysis demonstrated that MICS was
associated with better short-term outcomes compared to the sternotomy
approach. Mitral valve reoperation was more frequent with MICS compared
with the sternotomy approach after mitral valve repair, while no
difference was observed between the sternotomy and robotic approaches.

<30>
Accession Number
2018871232
Title
Direct oral anticoagulants in atrial fibrillation following cardiac
surgery: a systematic review and meta-analysis with trial sequential
analysis.
Source
British Journal of Anaesthesia. 129(2) (pp 154-162), 2022. Date of
Publication: August 2022.
Author
Koh K.K.; Ling R.R.; Tan S.Y.S.; Chen Y.; Fan B.E.; Shekar K.; Sule J.A.;
Subbian S.K.; Ramanathan K.
Institution
(Koh, Ling, Tan, Ramanathan) Yong Loo Lin School of Medicine, National
University of Singapore, Singapore
(Chen) Agency for Science, Technology and Research, Singapore
(Fan) Department of Haematology, Tan Tock Seng Hospital, Singapore
(Shekar) Adult Intensive Care Services, Prince Charles Hospital, Brisbane,
QLD, Australia
(Shekar) Queensland University of Technology, Brisbane, QLD, Australia
(Shekar) University of Queensland, Brisbane, QLD, Australia
(Shekar) Bond University, Gold Coast, QLD, Australia
(Sule, Subbian) Department of Cardiac, Thoracic, and Vascular Surgery,
National University Heart Centre, National University Hospital, Singapore
(Ramanathan) Cardiothoracic Intensive Care Unit, National University Heart
Centre, National University Hospital, Singapore
Publisher
Elsevier Ltd
Abstract
Background: Direct oral anticoagulants (DOACs) have been increasingly used
as anticoagulation therapy in the postoperative period. However, their
effectiveness in post-cardiac surgical atrial fibrillation is yet to be
determined. Method(s): We conducted a meta-analysis, searching three
international databases from 1 January 2003 to 26 January 2022 for studies
reporting on DOACs in at least 10 adult patients (>18 yr of age) with
post-cardiac surgical atrial fibrillation. The primary outcomes were major
neurological events and bleeding; secondary outcomes were mortality,
hospital and ICU length of stay, cost, and other complications from
therapy. We included studies of any design, including RCTs, cohort studies
with and without propensity score matching methods, and single-armed case
series. Result(s): Twelve studies (8587 DOACs; 8315 warfarin) were
included in this meta-analysis. The incidences of postoperative bleeding
and major neurological events with DOACs were 7.3% (95% confidence
interval [CI]: 3.4-14.7%) and 2.2% (95% CI: 0.9-4.9%), respectively. The
incidence of major neurological events was lower in high-risk patients,
including those with hypertension and higher
CHA<inf>2</inf>DS<inf>2</inf>-VASc score, whereas patients with prior
transient ischaemic attack or stroke had higher incidence of bleeding.
Trial sequential analysis revealed that the cumulative Z-curve crossed the
conventional boundary of benefit. Compared with warfarin, DOACs reduced
the risk of bleeding (relative risk [RR] 0.74; 95% CI: 0.62-0.89;
P=0.0011) and major neurological events (RR 0.63; 95% CI: 0.48-0.83;
P=0.0012) but not mortality (RR 1.02; 95% CI: 0.77-1.35; P=0.090).
 Conclusion(s): DOACs reduced bleeding and major neurological events
in patients with post-cardiac surgical atrial fibrillation, appearing
safer than warfarin in this context. However, which specific DOAC provides
the most effective anticoagulation in this patient population needs
further investigation. Clinical trial registration: PROSPERO
CRD42021282777. Copyright © 2022 British Journal of Anaesthesia

<31>
Accession Number
2018291005
Title
Indications, Clinical Impact, and Complications of Critical Care
Transesophageal Echocardiography: A Scoping Review.
Source
Journal of Intensive Care Medicine. (no pagination), 2022. Date of
Publication: 2022.
Author
Prager R.; Bowdridge J.; Pratte M.; Cheng J.; McInnes M.D.F.; Arntfield R.
Institution
(Prager, Cheng, Arntfield) Division of Critical Care, Western University,
Stn B, London, ON, Canada
(Bowdridge, Pratte) Department of Medicine, University of Ottawa, Ottawa,
ON, Canada
(McInnes) Department of Radiology, University of Ottawa, Ottawa, ON,
Canada
(McInnes) Clinical Epidemiology Program, The Ottawa Hospital Research
Institute, Ottawa, ON, Canada
Publisher
SAGE Publications Inc.
Abstract
Background: Critical care transesophageal echocardiography (ccTEE) is an
increasingly popular tool used by intensivists to characterize and manage
hemodynamics at the bedside. Its usage appears to be driven by expanded
diagnostic scope as well as the limitations of transthoracic
echocardiography (TTE) - lack of acoustic windows, patient positioning,
and competing clinical interests (eg, the need to perform chest
compressions). The objectives of this scoping review were to determine the
indications, clinical impact, and complications of ccTEE. Method(s):
MEDLINE, EMBASE, Cochrane, and six major conferences were searched without
a time or language restriction on March 31st, 2021. Studies
were included if they assessed TEE performed for adult critically ill
patients by intensivists, emergency physicians, or anesthesiologists.
Intraoperative or post-cardiac surgical TEE studies were excluded. Study
demographics, indication for TEE, main results, and complications were
extracted in duplicate. Result(s): Of the 4403 abstracts screened,
289 studies underwent full-text review, with 108 studies (6739 patients)
included. Most studies were retrospective (66%), performed in academic
centers (84%), in the intensive care unit (73%), and were observational
(55%). The most common indications for ccTEE were hemodynamic instability,
trauma, cardiac arrest, respiratory failure, and procedural guidance.
Across multiple indications, ccTEE was reported to change the diagnosis in
52% to 78% of patients and change management in 32% to79% patients. During
cardiac arrest, ccTEE identified the cause of arrest in 25% to 35% of
cases. Complications of ccTEE included two cases of significant
gastrointestinal bleeding requiring intervention, but no other major
complications (death or esophageal perforation) reported.
 Conclusion(s): The use of ccTEE has been described for the diagnosis
and management of a broad range of clinical problems. Overall, ccTEE was
commonly reported to offer additional diagnostic yield beyond TTE with a
low observed complication rate. Additional high quality ccTEE studies will
permit stronger conclusions and a more precise understanding of the trends
observed in this scoping review. Copyright © The Author(s) 2022.

<32>
Accession Number
2019338513
Title
(PO-099) Guanfacine, an Old Drug with New Tricks? Anxiolysis in Lung
Transplant.
Source
Journal of the Academy of Consultation-Liaison Psychiatry. Conference:
Annual Meeting of the Academy of Consultation-Liaison Psychiatry. Virtual,
Online. 63(Supplement) (pp S47), 2022. Date of Publication: 01 May 2022.
Author
Goldstein B.; Heiber G.
Institution
(Goldstein) Northwestern Memorial Hospital
(Heiber) Northwestern University
Publisher
Elsevier B.V.
Abstract
Background: For the lung transplant patient, physical and psychological
symptoms of anxiety are especially difficult to treat as a result of the
risk for delirium, respiratory depression, drug interactions, and limited
pharmacologic options with quick onset. Guanfacine, a potent
centrally-acting alpha-2 agonist, may provide a safe and effective
alternative. Method(s): Literature review of the anxiolytic and
pharmacologic properties of guanfacine with a brief case presentation.
Case: 48-year-old female status post lung transplant with refractory
anxiety in the setting of perceived dyspnea and treatment with olanzapine,
venlafaxine, and gabapentin. Anxiety improved and psychotropic PRN
frequency decreased with up-titration of guanfacine. Discussion(s):
Anxiety is common for lung transplant patients, it is associated with
worse outcomes, and the options for effective pharmacologic treatment are
limited. Guanfacine may provide an advantageous alternative because 1) it
is not associated with respiratory depression or delirium, a crucial
difference with the commonly prescribed benzodiazepines; 2) it appears to
have a favorable side-effect and drug-interaction profile, especially
important in patients with complex medication regimens including lifetime
immunosuppressive and antibiotic therapy; 3) there is accumulating
evidence for the safe use of this medication in the acutely medical ill;
4) it has the potential benefit of modulating visceral pain; and 5)
guanfacine has a quicker onset of action in comparison with most other
agents. Conclusion(s): Guanfacine warrants further consideration and
investigation as an anxiolytic agent in hospitalized lung transplant
patients. References: 1. Courtwright AM, et al. The association between
mood, anxiety and adjustment disorders and hospitalization following lung
transplantation. General Hospital Psychiatry. 2016. 2. Kim J, et al. Use
of Guanfacine as an alternative to Dexmedetomidine for sedation and
agitation management in the Intensive Care Unit. Journal of Psychosomatic
Research. 2020; 110062. 3. Srour H, et al. Enteral Guanfacine to Treat
Severe Anxiety and Agitation Complicating Critical Care After Cardiac
Surgery. Seminars in Cardiothoracic and Vascular Anesthesia.
2018;22(4):403-6. 4. Strawn JR, et al. Extended Release Guanfacine in
Pediatric Anxiety Disorders: A Pilot, Randomized, Placebo-Controlled
Trial. Journal of Child and Adolescent Psychopharmacology.
2017;27(1):29-37. 5. Sabetkasaie M, et al. Clonidine and
guanfacine-induced antinociception in visceral pain: possible role of
alpha 2/I2 binding sites. Eur J Pharmacol 2004;501(1e3):95e101.
 Copyright © 2022

<33>
Accession Number
2019334355
Title
(PO-130) Serotonergic Toxidrome Following Methylene Blue Administration
for Vasoplegia in A Patient on Multiple Serotonergic Medications: The Role
of the Proactive Consult-Liaison Psychiatrist in Prevention.
Source
Journal of the Academy of Consultation-Liaison Psychiatry. Conference:
Annual Meeting of the Academy of Consultation-Liaison Psychiatry. Virtual,
Online. 63(Supplement) (pp S62), 2022. Date of Publication: 01 May 2022.
Author
Njoku I.; Wolfe W.; Pachano G.
Institution
(Njoku, Pachano) University of Virginia
(Wolfe) Thomas Jefferson University Hospital
Publisher
Elsevier B.V.
Abstract
Background: In cardiothoracic surgeries, there is an increased risk of
vasoplegia, characterized by widespread vasodilation and
hypotension1. In these emergencies, methylene blue (MB), a
potent MAOI, may be used to increase cardiovascular tone2. Many
antidepressants have half-lives of several weeks and continue to have
effects even if not given before surgery. Case: Mr. E is a 60-year-old
male with a psychiatric history of MDD, alcohol use disorder (in
remission), and polysubstance use (in remission). His medical history
includes COPD, HLD, Atrial fibrillation s/p ablation, CAD, and Ischemic
Cardiomyopathy (EF 30%). His surgical history is notable for eight cardiac
stents and an ICD. He presents for a planned three-vessel CABG after
recovering from NSTEMI and pneumonia a month prior. His psychiatric
regimen is duloxetine 120 mg daily, fluoxetine 80 mg daily, mirtazapine
7.5 mg daily, and gabapentin 400 mg three times per day. Preoperatively,
his home cardiac regimen was evaluated by the clinic pharmacist.
Intraoperatively, he required multiple vasopressors. After seven hours in
the ICU, intravenous MB was initiated. Four hours later, he required an
urgent re-sternotomy for exploration and control of bleeding. Two hours
later, his vasopressor requirement minimized but later increased. His
temperature was 40oC; clonus in his bilateral lower
extremities, hyperreflexia, and "full-body rigors" were present.
Psychiatry was consulted three days later for agitation recommendations
and management of his home regimen. Discussion(s): The use of MB for
vasoplegia in critical care is well-documented2,3. The risk of
serotonin syndrome complicating these episodes is beginning to be further
elucidated2,3. Given his multiple serotonergic medications and
additional as-needed medications dispensed, he was at increased risk of
serotonin syndrome. The FDA suggests not administering serotonergic
medications for at least two weeks, and five weeks for fluoxetine, for
non-emergency use of MB along with considering the risks, benefits, and
alternatives in emergent use4. Collaboration would have
decreased the likelihood of this complication. Proactive intervention
likely would have decreased his length of stay in both the general
hospital and intensive care units given his subsequent
delirium5. Electronic medical record (EMR) limitations should
also be considered. Conclusion(s): CL psychiatrists can work
proactively with physicians and pharmacists regarding MB use in patients
on multiple serotonergic medications. This work will also require
education and EMR modifications to be mindful of the long-lasting effects
of such medications. References: 1. Omar S, Zedan A, Nugent K. Cardiac
vasoplegia syndrome: pathophysiology, risk factors and treatment. Am J Med
Sci. 2015;349(1):80-88. 2. Chan BS, Becker T, Chiew AL, et al. Vasoplegic
Shock Treated with Methylene Blue Complicated by Severe Serotonin
Syndrome. J Med Toxicol. 2018;14(1):100-103. 3. Hencken L, To L, Ly N,
Morgan JA. Serotonin Syndrome Following Methylene Blue Administration for
Vasoplegic Syndrome. J Card Surg. 2016;31(4):208-210. 4. Center for Drug
Evaluation and Research. CNS reactions possible when methylene blue is
given to patients t... U.S. Food and Drug Administration. Published July
26, 2011. 5. Oldham MA, Chahal K, Lee HB. A systematic review of proactive
psychiatric consultation on hospital length of stay. Gen Hosp Psychiatry.
2019;60:120-126. doi:10.1016/j.genhosppsych.2019.08.001 Copyright
© 2022

<34>
Accession Number
2017363063
Title
THE EFFECT OF INHALED MILRINONE ON PULMONARY ARTERIAL PRESSURE IN PATIENTS
UNDERGOING CARDIAC SURGERY.
Source
Journal of Medical Sciences (Peshawar). 30(2) (pp 109-113), 2022. Date of
Publication: 29 Jun 2022.
Author
Anwar K.; Shahkar Ahmed Shah S.; Ehtisham S.
Institution
(Anwar, Shahkar Ahmed Shah) Department of Anesthesia, Peshawar Institute
of Cardiology, KP, Pakistan
(Ehtisham) Department of Cardiothoracic Surgery, Peshawar Institute of
Cardiology, KP, Pakistan
Publisher
Khyber Medical College
Abstract
Objective: To find out the effect of inhaled Milrinone on pulmonary
arterial pressure in patients undergoing cardiac surgery. Method(s):
A randomized controlled trial was done at Peshawar Institute of Cardiology
in 78 patients who had preoperative pulmonary hypertension and had
undergone cardiac surgery between the ages of 3 months and 60 years.
Divided into 2, group 1 received Intravenous (IV) Milrinone and group 2
received Inhalational (IN) Milrinone. MANOVA was used to compare the
difference between two groups across six dependent variables i.e., Heart
rate (HR), systolic arterial pressure (SAP), Cen-tral venous pressure
(CVP), Systolic pulmonary arterial pressure (SPAP), Diastolic pulmonary
arterial pressure (DPAP) and mean pulmonary arterial pressure (MPAP) at
three stages; baseline, end of nebulization, and after cardiopulmonary
bypass (labeled as stages 1,2 and 3). Intraoperative complications like
weaning from cardiaopulmonary bypass (CPB) machine, use of vasopressor,
insertion of intra-aortic balloon pump (IABP), and cardiopulmonary
re-initiation were also observed in both the groups. Analysis of the data
was done through SPSS-23. Result(s): In a total of 78 patients (39 in
each group), an insignificant change was observed regarding the effects of
IN Mil-rinone on HR, SAP, and CVP whereas significant effects of Inhaled
Milrinone on SPAP, DPAP, and MPAP were observed (P-values <0.05).
 Conclusion(s): The use of inhaled Milrinone was beneficial in
patients with pulmonary hypertension in the prevention of Intraop-erative
complications like difficulty in weaning from CPB, insertion of IABP, and
use of vasopressors, while CPB re-initiation was observed less in patients
with inhalational milrinone as compared with intravenous administration
while reducing their length of stay in ICU. Copyright © 2022,
Khyber Medical College. All rights reserved.

<35>
Accession Number
2018294635
Title
Early Aortic Valve Replacement vs. Conservative Management in Asymptomatic
Severe Aortic Stenosis Patients With Preserved Ejection Fraction: A
Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 7 (no pagination), 2021. Article
Number: 621149. Date of Publication: 03 Feb 2021.
Author
Yuan T.; Lu Y.; Bian C.; Cai Z.
Institution
(Yuan, Lu, Bian, Cai) Department of Cardiology, The Second Affiliated
Hospital, Zhejiang University School of Medicine, Hangzhou, China
(Cai) Jiaxing Key Laboratory of Cardiac Rehabilitation, Jiaxing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Aortic stenosis (AS) is the most common valvular disease in
developed countries. Until now, the specific timing of intervention for
asymptomatic patients with severe aortic stenosis and preserved ejection
fraction remains controversial. Method(s): A systematic search of
four databases (Pubmed, Web of science, Cochrane library, Embase) was
conducted. Studies of asymptomatic patients with severe AS or very severe
AS and preserved left ventricular ejection fraction underwent early aortic
valve replacement (AVR) or conservative care were included. The end points
included all-cause mortality, cardiac mortality, and non-cardiac
mortality. Result(s): Four eligible studies were identified with a
total of 1,249 participants. Compared to conservative management, patients
who underwent early AVR were associated with lower all-cause mortality,
cardiac mortality, and non-cardiac mortality rate (OR 0.16, 95% CI
0.09-0.31, P < 0.00001; OR 0.12, 95% CI 0.02-0.62, P = 0.01; OR 0.36, 95%
CI 0.21-0.63, P = 0.0003, respectively). Conclusion(s): Early AVR is
preferable for asymptomatic severe AS patients with preserved ejection
fraction. Copyright © 2021 Yuan, Lu, Bian and Cai.

<36>
Accession Number
2018294589
Title
Transcatheter and Surgical Aortic Valve Replacement in Patients With
Previous Cardiac Surgery: A Meta-Analysis.
Source
Frontiers in Cardiovascular Medicine. 7 (no pagination), 2021. Article
Number: 612155. Date of Publication: 10 Feb 2021.
Author
Li Y.-M.; Tsauo J.-Y.; Jia K.-Y.; Liao Y.-B.; Xia F.; Zhao Z.-G.; Chen M.;
Peng Y.
Institution
(Li, Tsauo, Jia, Liao, Zhao, Chen, Peng) Department of Cardiology, West
China Hospital, Sichuan University, Chengdu, China
(Xia) Department of Neurosurgery, West China Hospital, Sichuan University,
Chengdu, China
Publisher
Frontiers Media S.A.
Abstract
Background: Many patients who have aortic stenosis and are transcatheter
aortic valve replacement (TAVR) candidates have underwent prior cardiac
surgery (PCS). The aim of this study was to provide a robust summary
comparison between patients with PCS who underwent TAVR vs. surgical
aortic valve replacement (SAVR). Method(s): We conducted a systematic
review and meta-analysis of all published articles on PubMed/Medline,
Ovid, EMBASE, and Scopus from 2002 to 2019. Result(s): A total of 13
studies were finally included, yielding a total of 23,148 participants.
There was no statistical difference with 30-day [OR: 1.02 (0.86-1.21)] or
1-year mortality [OR: 1.18 (0.86-1.61)] between the two groups. Subgroup
analysis revealed that high-risk patients who underwent TAVR with the
transapical approach were associated with increased risk of mortality [OR:
1.45 (1.00-2.11)]. However, those who underwent TAVR with endovascular
approach had a comparable outcome with SAVR. Conclusion(s): Primary
outcomes after endovascular TAVR were similar to those with SAVR and
superior to transapical TAVR treatment group in patients with
PCS. Copyright © 2021 Li, Tsauo, Jia, Liao, Xia, Zhao, Chen and
Peng.

<37>
Accession Number
2018294523
Title
The Safety and Efficacy of Inspiratory Muscle Training for Patients With
Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention:
Study Protocol for a Randomized Controlled Trial.
Source
Frontiers in Cardiovascular Medicine. 7 (no pagination), 2021. Article
Number: 598054. Date of Publication: 12 Jan 2021.
Author
Liu Y.; Dai Y.; Liu Z.; Zhan H.; Zhu M.; Chen X.; Zhang S.; Zhang G.; Xue
L.; Duan C.; Chen J.; Guo L.; He P.; Tan N.
Institution
(Liu, Dai, Liu, Zhan, Zhu, Chen, Zhang, Zhang, Xue, Chen, Guo, He, Tan)
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong
Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong
Provincial People's Hospital, Guangdong Academy of Medical Sciences,
Guangzhou, China
(Duan) Department of Biostatistics, School of Public Health, Southern
Medical University, Guangzhou, China
Publisher
Frontiers Media S.A.
Abstract
Background: Uncommonly high rates of pneumonia in patients with acute
myocardial infarction (AMI) undergoing primary percutaneous coronary
intervention (PCI) have been observed during recent years. Inspiratory
muscle training (IMT) could reduce pneumonia in patients undergoing
coronary artery bypass grafting and other cardiac surgeries. The
relationship between IMT and AMI is unknown. Here, we describe the
feasibility and potential benefit of IMT in patients at high risk for
pneumonia with AMI who have undergone primary PCI. Method(s): Our
study is a prospective, randomized, controlled, single-center clinical
trial. A total of 60 participants will be randomized into an IMT group and
control group with 30 participants in each group. Participants in the IMT
group will undergo training for 15 min per session, twice a day, from 12
to 24 h after primary PCI, until 30 days post-randomization; usual care
will be provided for the control group. The primary endpoint is the change
in inspiratory muscle strength, the secondary endpoint included
feasibility, pneumonia, major adverse cardiovascular events, length of
stay, pulmonary function tests measure, and quality of life.
 Discussion(s): Our study is designed to evaluate the feasibility of
IMT and its effectiveness in improving inspiratory muscle strength in
participants with AMI who have undergone primary PCI. Clinical Trial
Registration: www.ClinicalTrials.gov, identifier:
NCT04491760. Copyright © 2021 Liu, Dai, Liu, Zhan, Zhu, Chen,
Zhang, Zhang, Xue, Duan, Chen, Guo, He and Tan.

<38>
Accession Number
638303350
Title
Effect of Automated Telephone Infectious Disease Consultations to
Nonacademic Hospitals on 30-Day Mortality among Patients with
Staphylococcus aureus Bacteremia: The SUPPORT Cluster Randomized Clinical
Trial.
Source
JAMA Network Open. 5(6) (pp E2218515), 2022. Date of Publication: 24 Jun
2022.
Author
Weis S.; Hagel S.; Palm J.; Scherag A.; Kolanos S.; Bahrs C.; Loffler B.;
Schmitz R.P.H.; Rissner F.; Brunkhorst F.M.; Pletz M.W.
Institution
(Weis, Hagel, Kolanos, Bahrs, Pletz) Institute for Infectious Diseases and
Infection Control, Jena University Hospital, Friedrich-Schiller
University, Am Klinikum 1, Jena 07747, Germany
(Weis, Pletz) Center for Sepsis Control and Care, Jena University
Hospital, Friedrich-Schiller University, Jena, Germany
(Weis) Department of Anesthesiology and Intensive Care, Jena University
Hospital, Friedrich-Schiller University, Jena, Germany
(Palm, Scherag) Institute of Medical Statistics, Computer, and Data
Sciences, Jena University Hospital, Friedrich-Schiller University, Jena,
Germany
(Bahrs) Department of Medicine, Division of Infectious Diseases and
Tropical Medicine, Medical University of Vienna, Vienna, Austria
(Loffler) Institute of Medical Microbiology, Jena University Hospital,
Friedrich-Schiller University, Jena, Germany
(Schmitz, Risner, Brunkhorst) Center for Clinical Studies, Jena University
Hospital, Friedrich-Schiller University, Jena, Germany
Publisher
American Medical Association
Abstract
Importance: Staphylococcus aureus bacteremia (SAB) is a common and
potentially severe infectious disease (ID). Retrospective studies and
derived meta-analyses suggest that bedside infectious disease consultation
(IDC) for SAB is associated with improved survival; however, such IDCs
might not always be possible because of the lack of ID specialists,
particularly at nonacademic hospitals. Objective(s): To investigate
whether unsolicited telephone IDCs (triggered by an automated blood stream
infection reporting system) to nonacademic hospitals improved 30-day
all-cause mortality in patients with SAB. Design, Setting, and
Participant(s): This patient-blinded, multicenter, interventional, cluster
randomized, controlled, crossover clinical trial was conducted in 21
rural, nonacademic hospitals in Thuringia, Germany. From July 1, 2016, to
December 31, 2018, 1029 blood culture reports were assessed for
eligibility. A total of 386 patients were enrolled, whereas 643 patients
were not enrolled for the following reasons: death before enrollment (n =
59); palliative care (n = 41); recurrence of SAB (n = 9); discharge from
the hospital before enrollment (n = 77); age younger than 18 years (n =
5); duplicate report from a single patient (n = 26); late report (n = 17);
blood culture reported during the washout phase (n = 48); and no signed
informed consent for other or unknown reasons (n = 361).
 Intervention(s): During the ID intervention phase, ID specialists
from Jena University Hospital provided unsolicited telephone IDCs to
physicians treating patients with SAB. During the control phase, patients
were treated according to local standards. Crossover was performed after
including 15 patients or, at the latest, 1 year after the first patient
was included. Main Outcomes and Measures: Thirty-day all-cause
mortality. Result(s): A total of 386 patients (median [IQR] age, 75
[63-82] years; 261 [67.6%] male) were included, with 177 randomized to the
IDC group and 209 to the control group. The 30-day all-cause mortality
rate did not differ between the IDC and control groups (relative risk
reduction [RRR], 0.12; 95% CI, -2.17 to 0.76; P =.81). No evidence was
found of a difference in secondary outcomes, including 90-day mortality
(RRR, 0.17; 95% CI, -0.59 to 0.57; P =.62), 90-day recurrence (RRR, 0.10;
95% CI, -2.51 to 0.89; P =.89), and hospital readmission (RRR, 0.04; 95%
CI, -0.63 to 0.48; P =.90). Exploratory evidence suggested that indicators
of quality of care were potentially realized more often in the IDC group
than in the control group (relative quality improvement, 0.16; 95% CI,
0.08-0.26; P =.01). Conclusions and Relevance: In this cluster
randomized clinical trial, unsolicited telephone IDC, although potentially
enhancing quality of care, did not improve 30-day all-cause mortality in
patients with SAB. Trial Registration: drks.de Identifier:
DRKS00010135. Copyright © 2022 EDP Sciences. All rights reserved.

<39>
Accession Number
2015687945
Title
Patent Foramen Ovale Closure and Decompression Sickness Among Divers.
Source
Cardiovascular Revascularization Medicine. 40 (pp 160-162), 2022. Date of
Publication: July 2022.
Author
Abdelfattah O.M.; Sayed A.; Elgendy I.Y.; Munir M.; Saleh Y.; Kapadia
S.R.; Abela G.S.; Jneid H.
Institution
(Abdelfattah) Department of Internal Medicine, Morristown Medical Center,
Atlantic Health System, Morristown, NJ, United States
(Sayed, Munir) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Elgendy) Department of Medicine, Weill Cornell Medicine-Qatar, Doha,
Qatar
(Saleh) Department of Cardiology, Houston Methodist Hospital, Houston, TX,
United States
(Kapadia) Heart Vascular and Thoracic Institute, Department of
Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
(Abela) Department Cardiology, Michigan State University, East Lansing,
MI, United States
(Jneid) Division of Cardiovascular Medicine, Baylor School of Medicine,
Houston, TX, United States
(Jneid) Division of Cardiology, Baylor College of Medicine and the Michael
E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background: Decompression sickness is a diving-related disease that
results in various clinical manifestations, ranging from joint pain to
severe pulmonary and CNS affection. Complications of this disease may
sometimes persist even after treatment with hyperbaric oxygen therapy. In
addition, it may hamper the quality of life by forcing divers to restrict
their recreational practice. The presence of a patent foramen ovale (PFO)
increases the risk of decompression sickness by facilitating air
embolization. Therefore, PFO closure may play a role in reducing such
complications. However, PFO closure remains associated with its own set of
risks and complications. We sought to assess the benefit and harm of PFO
closure for the prevention of decompression sickness in divers.
 Method(s): We conducted a comprehensive search of MEDLINE, Embase,
CENTRAL, and Web of Science. Two-armed studies comparing the incidence of
decompression sickness with or without PFO closure were included. We used
a random-effects model to compute risk ratios comparing groups undergoing
PFO closure to those not undergoing PFO closure. Result(s): Four
observational studies with a total of 309 divers (PFO closure: 141 and no
closure: 168) met inclusion criteria. PFO closure was associated with a
significantly lower incidence of decompression sickness (PFO-closure:
2.84%; no closure: 11.3%; RR: 0.29; 95% CI: 0.10 to 0.89; NNTB = 11), with
low heterogeneity (I2 = 0%). The mean follow-up was 6.12 years
(Standard deviation 0.70). Adverse events occurred in 7.63% of PFO
closures, including tachyarrhythmias and bleeding. Conclusion(s): PFO
closure may potentially reduce the risk of decompression sickness among
divers; however, it is not free of potential downsides, with nearly one in
thirteen patients in our analysis experiencing an adverse
event. Copyright © 2021

<40>
Accession Number
2015625379
Title
Gender difference in outcomes of patients undergoing MitraClip therapy: A
systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. 40 (pp 20-25), 2022. Date of
Publication: July 2022.
Author
Kanitsoraphan C.; Thangjui S.; Techorueangwiwat C.; Kewcharoen J.;
Rattanawong P.; Nagamine T.; Kanjanauthai S.
Institution
(Kanitsoraphan, Techorueangwiwat, Kewcharoen, Nagamine) University of
Hawaii Internal Medicine Residency Program, Honolulu, HI, United States
(Thangjui) Internal Medicine Residency Program, Bassett Healthcare
Network, NY, United States
(Rattanawong) Department of Cardiovascular Medicine, Mayo Clinic, Phoenix,
AZ, United States
(Kanjanauthai) Division of Cardiovascular Medicine, Keck School of
Medicine of USC, Los Angeles, CA, United States
Publisher
Elsevier Inc.
Abstract
Introduction: Transcatheter edge-to-edge repair (TEER) of the mitral valve
with MitraClip therapy is an emerging treatment in selected patients with
severe mitral regurgitation. Identifying the patient with increased risk
of poorer outcomes, including mortality, is crucial in these patients.
Recent studies suggested conflicting data regarding the effects of gender
on outcome in this patient population. We evaluate the impact of gender on
the outcome of patients undergoing MitraClip therapy by systematic review
and meta-analysis. Method(s): The authors comprehensively searched
the databases of EMBASE and MEDLINE from inception to April 2021. Included
studies were published cohorts reporting univariate or multivariate
analysis of the effects of gender on in-hospital and overall mortality
among patients undergoing MitraClip therapy. Data from each study were
combined using the random-effects, generic inverse variance method of
DerSimonioan and Laird. Result(s): A total of nine studies were
included in this meta-analysis, including 9062 patients. Male gender is
associated with higher in-hospital mortality with pooled OR 1.81 (95%
confidence interval 1.01-3.22, p-value 0.045) and overall mortality with
pooled OR 1.19 (95% CI 1.06-1.33, p-value 0.003). Conclusion(s):
According to our meta-analysis, the male gender increases the risk of
in-hospital mortality up to 1.81 folds and overall mortality up to 1.19
folds. Copyright © 2021

<41>
Accession Number
2018267551
Title
Perioperative oxygen therapy: a protocol for an overview of systematic
reviews and meta-analyses.
Source
Systematic Reviews. 11(1) (no pagination), 2022. Article Number: 140. Date
of Publication: December 2022.
Author
Elfeky A.; Chen Y.-F.; Grove A.; Hooper A.; Wilson A.; Couper K.; Thompson
M.; Uthman O.; Court R.; Tomassini S.; Yeung J.
Institution
(Elfeky, Chen, Grove, Wilson, Couper, Uthman, Court, Tomassini, Yeung)
Warwick Medical School, University of Warwick, Coventry CV4 7AL, United
Kingdom
(Hooper, Couper, Yeung) University Hospitals Birmingham NHS Foundation
Trust, Birmingham, United Kingdom
(Thompson) Independent patient and public involvement and engagement
advisor, Birmingham, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Oxygen is routinely given to patients during and after
surgery. Perioperative oxygen administration has been proposed as a
potential strategy to prevent and treat hypoxaemia and reduce
complications, such as surgical site infections, pulmonary complications
and mortality. However, uncertainty exists as to which strategies in terms
of amount, delivery devices and timing are clinically effective. The aim
of this overview of systematic reviews and meta-analyses is to answer the
research question, 'For which types of surgery, at which stages of care,
in which sub-groups of patients and delivered under what conditions are
different types of perioperative oxygen therapy clinically effective?'.
 Method(s): We will search key electronic databases (MEDLINE, EMBASE,
the Cochrane Database of Systematic Reviews, CENTRAL, Epistemonikos,
PROSPERO, the INAHTA International HTA Database and DARE archives) for
systematic reviews and randomised controlled trials comparing
perioperative oxygen strategies. Each review will be mapped according to
type of surgery, surgical pathway timepoints and clinical comparison. The
highest quality reviews with the most comprehensive and up-to-date
coverage of relevant literature will be chosen as anchoring reviews.
Standardised data will be extracted from each chosen review, including
definition of oxygen therapy, summaries of interventions and comparators,
patient population, surgical characteristics and assessment of overall
certainty of evidence. For clinical outcomes and adverse events, the
overall pooled findings and results of subgroup and sensitivity analyses
(where available) will be extracted. Trial-level data will be extracted
for surgical site infections, mortality, and potential trial-level effect
modifiers such as risk of bias, outcome definition and type of surgery to
facilitate quantitative data analysis. This analysis will adopt a multiple
indication review approach with panoramic meta-analysis using review-level
data and meta-regression using trial-level data. An evidence map will be
produced to summarise our findings and highlight any research gaps.
 Discussion(s): There is a need to provide a panoramic overview of
systematic reviews and meta-analyses describing peri-operative oxygen
practice to both inform clinical practice and identify areas of ongoing
uncertainty, where further research may be required. Systematic review
registration: PROSPERO CRD42021272361. Copyright © 2022, The
Author(s).

<42>
Accession Number
2017068936
Title
Comparing the efficacy of angiotensin receptor-neprilysin inhibitor and
enalapril in acute anterior STEMI patients after primary percutaneous
coronary intervention: a prospective randomized trial.
Source
Cardiovascular Diagnosis and Therapy. 12(1) (pp 42-54), 2022. Date of
Publication: February 2022.
Author
Dong Y.; Xu Y.; Ding C.; Yu Z.; Xia X.; Chen Y.; Jiang X.
Institution
(Dong, Xu, Ding, Yu, Yu, Xia, Chen, Jiang) Department of Cardiovascular
Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang,
China
(Ding) Center for Prevention and Treatment of Cardiovascular Diseases, The
Second Affiliated Hospital of Nanchang University, Nanchang, China
Publisher
AME Publishing Company
Abstract
Background: For patients with heart failure (HF), the effect of
angiotensin receptor-neprilysin inhibitors (ARNIs, sacubitril/valsartan)
on cardiac remodeling has been found to be superior to
angiotensin-converting enzyme inhibitors (ACEI). However, little data have
described the impact of early-initiation ARNI in patients with acute
anterior ST-segment elevation myocardial infarction (STEMI).
 Method(s): In this prospective, randomized, double-blind,
parallel-group trial, we enrolled 131 anterior STEMI patients who were
treated with primary percutaneous coronary intervention (PCI) between
February 2019 and December 2019. All patients received standard STEMI
management and were divided into 2 groups (ARNI/enalapril). Primary
efficacy outcomes were the between-group difference in change (from
baseline to 4-, 12-, and 24-week) in N-terminal pro-B-type natriuretic
peptide (NT-proBNP) concentration, left ventricular ejection fraction
(LVEF), and left ventricular end-systolic volumes and end-diastolic
volumes (LVESV and LVEDV). Secondary outcomes were determined by a
composite of death, reinfarction, outpatient HF or HF hospitalization,
malignant arrhythmia, and stroke. Safety outcomes included worsening renal
function, hypotension, hyperkalemia, angioedema and cough. Result(s):
We found that NT-proBNP concentration decreased more in the ARNI group
than in the enalapril group [4 weeks: ratio of ARNI vs. enalapril 0.36,
95% confidence interval (CI): 0.24 to 0.52, P<0.001; 12 weeks: 0.54, 95%
CI: 0.35 to 0.79, P<0.001; 24 weeks: 0.53, 95% CI: 0.32 to 0.83, P<0.001).
When compared to the enalapril group, the ARNI group patients had a
significant reduction in LVEDV (P<0.001) and LVESV (P<0.001), and an
improvement in LVEF (P=0.011) at 24 weeks. Secondary outcomes occurred in
13 participants (20.3%) in the ARNI group and 22 participants (34.4%) in
the enalapril group [hazard ratio (HR), 0.56; 95% CI: 0.28 to 1.12;
P=0.102]. The incidence of outpatient HF or HF hospitalization in the ARNI
group was significantly lower than that in the enalapril group (HR, 0.36;
95% CI: 0.14 to 0.94; P=0.037). There were no significant differences in
the safety between the 2 groups. Conclusion(s): For patients with
acute anterior STEMI undergoing primary PCI, early initiation of ARNI
provided significant clinical benefits. Copyright ©
Cardiovascular Diagnosis and Therapy. All rights reserved.

<43>
Accession Number
2017055298
Title
Noteworthy Cardiac Literature From 2021: Coronary Guideline Change Without
New Data, Heart Transplant Donation After Cardiac Death, Covid Effects on
Global Cardiac Surgery, and Attempt to Improve Dissection Remodeling.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 26(2) (pp 154-161),
2022. Date of Publication: June 2022.
Author
Hoffman J.R.H.; Higa K.C.; Lin Y.; Reece T.B.; Cleveland J.C.; Aftab M.;
Rove J.Y.
Institution
(Hoffman) Cardiac Surgery, Vanderbilt University, Nashville, TN, United
States
(Higa, Lin, Reece, Cleveland, Aftab, Rove) Division of Cardiothoracic
Surgery, Department of, Surgery, University of Colorado School of
Medicine, Aurora, CO, United States
Publisher
SAGE Publications Inc.
Abstract
Cardiac surgery continues to evolve. The last year has been notable for
many reasons. The guidelines for coronary revascularization introduced
significant discord. The pandemic continues to affect the care on a global
scale. Advances in organ procurement and dissection care move forward with
better understanding and better technology. Copyright © The
Author(s) 2022.

<44>
Accession Number
2017046944
Title
Propensity-Matched 1-Year Outcomes Following Transcatheter Aortic Valve
Replacement in Low-Risk Bicuspid and Tricuspid Patients.
Source
JACC: Cardiovascular Interventions. 15(5) (pp 511-522), 2022. Date of
Publication: 14 Mar 2022.
Author
Deeb G.M.; Reardon M.J.; Ramlawi B.; Yakubov S.J.; Chetcuti S.J.; Kleiman
N.S.; Mangi A.A.; Zahr F.; Song H.K.; Gada H.; Mumtaz M.; Heiser J.; Merhi
W.; Murrah C.P.; Noel T.; Kirshner M.; Byrne T.; Ito S.; Huang J.; Forrest
J.K.
Institution
(Deeb) Department of Cardiac Surgery, University of Michigan Hospitals,
Ann Arbor, MI, United States
(Reardon) Department of Cardiothoracic Surgery, Houston Methodist DeBakey
Heart and Vascular Institute, Houston, TX, United States
(Ramlawi) Department of Cardiothoracic Surgery, Valley Health, Winchester,
Virginia, United States
(Yakubov) Department of Interventional Cardiology, Riverside
Methodist-OhioHealth, Columbus, OH, United States
(Chetcuti) Department of Interventional Cardiology, University of Michigan
Hospitals, Ann Arbor, MI, United States
(Kleiman) Department of Interventional Cardiology, Houston Methodist
DeBakey Heart and Vascular Institute, Houston, TX, United States
(Mangi) Department of Surgery (Cardiac Surgery), Yale University School of
Medicine, New Haven, CT, United States
(Zahr) Department of Interventional Cardiology, Oregon Health and Science
University, Portland, OR, United States
(Song) Department of Cardiothoracic Surgery, Oregon Health and Science
University, Portland, OR, United States
(Gada) Department of Interventional Cardiology, University of Pittsburgh
Pinnacle, Wormsleyburg, Pennsylvani, United States
(Mumtaz) Department of Cardiothooracic Surgery, University of Pittsburgh
Pinnacle, Wormsleyburg, PA, United States
(Heiser) Department of Cardiothoracic Surgery, Spectrum Health, Grand
Rapids, MI, United States
(Merhi) Department of Interventional Cardiology, Spectrum Health, Grand
Rapids, MI, United States
(Murrah) Department of Cardiothoracic Surgery, Tallahassee Research
Institute, Tallahassee, FL, United States
(Noel) Department of Interventional Cardiology, Tallahassee Research
Institute, Tallahassee, FL, United States
(Kirshner) Department of Cardiothoracic Surgery, Abrazo Arizona Heart
Hospital, Phoenix, AZ, United States
(Byrne) Department of Interventional Cardiology, Abrazo Arizona Heart
Hospital, Phoenix, AZ, United States
(Ito) Division of Cardiovascular Ultrasound, Mayo Clinic, Rochester, MN,
United States
(Huang) Department of Statistics, Medtronic, Minneapolis, MN, United
States
(Forrest) Department of Internal Medicine (Cardiology), Yale University
School of Medicine, New Haven, CT, United States
Publisher
Elsevier Inc.
Abstract
Objectives: The aim of this study was to compare 1-year outcomes after
transcatheter aortic valve replacement (TAVR) in low surgical risk
patients with bicuspid aortic stenosis to patients with tricuspid aortic
stenosis. Background(s): The pivotal TAVR trials excluded patients
with bicuspid aortic valves. The Low Risk Bicuspid Study 30-day primary
endpoint of death or disabling stroke was 1.3%. Method(s): The Low
Risk Bicuspid Study is a prospective, single-arm, TAVR trial that enrolled
patients from 25 U.S. sites. A screening committee confirmed bicuspid
anatomy and valve classification on computed tomography using the Sievers
classification. Valve sizing was by annular measurements. An independent
clinical events committee adjudicated all serious adverse events, and an
independent core laboratory assessed all echocardiograms. The 150 patients
from the Low Risk Bicuspid Study were propensity matched to the TAVR
patients in the randomized Evolut Low Risk Trial using the 1:1 5-
to-1-digit greedy method, resulting in 145 pairs. Result(s):
All-cause mortality or disabling stroke at 1 year was 1.4% in the bicuspid
and 2.8% in the tricuspid group (P = 0.413). A pacemaker was implanted in
16.6% of bicuspid and 17.9% of tricuspid patients (P = 0.741). The
effective orifice area was similar between groups at 1 year (2.2 +/- 0.7
cm2 vs 2.3 +/- 0.6 cm2, P = 0.677) as was the mean
gradient (8.7 +/- 3.9 mm Hg vs 8.5 +/- 3.1 mm Hg, P = 0.754). Fewer
patients in the bicuspid group had mild or worse paravalvular leak (21.3%
vs 42.6%, P < 0.001). Conclusion(s): There were no significant
differences in clinical or forward flow hemodynamic outcomes between the
propensity-matched groups at 1 year. Copyright © 2022 American
College of Cardiology Foundation

<45>
Accession Number
2016140587
Title
Network Meta-Analysis Comparing the Short- and Long-Term Outcomes of
Alternative Access for Transcatheter Aortic Valve Replacement.
Source
Cardiovascular Revascularization Medicine. 40 (pp 1-10), 2022. Date of
Publication: July 2022.
Author
Ranka S.; Lahan S.; Chhatriwalla A.K.; Allen K.B.; Chiang M.; O'Neill B.;
Verma S.; Wang D.D.; Lee J.; Frisoli T.; Eng M.; Bagur R.; O'Neill W.;
Villablanca P.
Institution
(Ranka) Department of Cardiovascular Medicine, University of Kansas
Medical Center, Kansas City, KS, United States
(Lahan) Division of Cardiovascular Prevention & Wellness, Department of
Cardiology, Houston Methodist, Houston, TX, United States
(Chhatriwalla, Allen) Department of Cardiothoracic Surgery, Saint Luke's
Mid America Heart Institute and University of Missouri-Kansas City, Kansas
City, MO, United States
(Chiang, O'Neill, Wang, Lee, Frisoli, O'Neill, Villablanca) Department of
Medicine, Division of Cardiology, Henry Ford Health System, Detroit, MI,
United States
(Verma) Department of Family Medicine, Henry Ford Allegiance Health,
Jackson, MI, United States
(Eng) Department of Cardiology, Banner University Medical Center, Phoenix,
AZ, United States
(Bagur) Division of Cardiology, Department of Medicine, London Health
Sciences Centre, Western University, London, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: Several studies have pair-wise compared access sites for
transcatheter aortic valve replacement (TAVR) but pooled estimate of
overall comparative efficacy and safety outcomes are not well known. We
sought to compare short- and long-term outcomes following various
alternative access routes for TAVR. Method(s): Thirty-four studies
with a pooled sample size of 32,756 patients were selected by searching
PubMed and Cochrane library databases from inception through 11th June
2021 for patients undergoing TAVR via 1 of 6 different access sites:
Transfemoral (TF), Transaortic (TAO), Transapical (TA), Transcarotid (TC),
Transaxillary/Subclavian (TSA), and Transcaval (TCV). Data were extracted
to conduct a frequentist network meta-analysis with a random-effects model
using TF access as a reference group. Result(s): Compared with TF,
both TAO [RR 1.91, 95% CI (1.46-2.50)] and TA access [RR 2.12, 95% CI
(1.84-2.46)] were associated with an increased risk of 30-day mortality.
No significant difference was observed for stroke, myocardial infarction,
major bleeding, conversion to open surgery, and major adverse
cardiovascular or cerebrovascular events at 30 days between different
accesses. Major vascular complications were lower in TA [RR 0.43, (95% CI,
0.28-0.67)] and TC [RR 0.51, 95% CI (0.35-0.73)] access compared to TF.
The 1-year mortality was higher in TAO [RR of 1.35, (95% CI, 1.01-1.81)]
and TA [RR 1.44, (95% CI, 1.14-1.81)] groups. Conclusion(s):
Non-thoracic alternative access site utilization for TAVR implantation
(TC, TSA and TCV) is associated with outcomes similar to conventional TF
access. Thoracic TAVR access (TAO and TA) translates into increased short
and long-term mortality. Copyright © 2021 Elsevier Inc.

<46>
Accession Number
2014814923
Title
Surgical techniques for the treatment of anomalous origin of right
coronary artery from the left sinus: A comparative review.
Source
Journal of the American Heart Association. 10(22) (no pagination), 2021.
Article Number: e022377. Date of Publication: 16 Nov 2021.
Author
Gharibeh L.; Rahmouni K.; Hong S.J.; Crean A.M.; Grau J.B.
Institution
(Gharibeh, Grau) Division of Cardiac Surgery, University of Ottawa Heart
Institute, Ottawa, ON, Canada
(Gharibeh, Rahmouni) Department of Biochemistry, Microbiology and
Immunology, University of Ottawa, Ottawa, ON, Canada
(Crean) Division of Cardiology, University of Ottawa Heart Institute,
Ottawa, ON, Canada
(Hong, Grau) Division of Cardiothoracic Surgery, The Valley Hospital,
Ridgewood, NJ, United States
Publisher
American Heart Association Inc.
Abstract
The anomalous aortic origin of the right coronary artery (AAORCA) from the
left sinus is a congenital anomaly affecting both the origin and course of
the right coronary artery. AAORCA is nowadays easily and increasingly
recognized by several cardiac imaging modalities. In most cases, patients
remain asymptomatic; however, in some, and especially in young athletes,
symptoms start to appear following exertion. A literature review was
conducted on the surgical management of AAORCA by searching the Pubmed and
Google Scholar databases. The inclusion criteria included manuscripts
reporting surgical outcomes of AAORCA for >=1 of the 3 techniques of
interest (unroofing, reimplantation, and coronary artery bypass grafting)
and manuscripts written in English and that were published between 2010
and 2020. The surgical management of AAORCA can be done through several
techniques, most commonly the unroofing of the intramural segment of the
AAORCA, the reimplantation of the native right coronary artery onto the
right sinus of the aortic root, and coronary artery bypass grafting with
either arterial or venous graft conduits with or without ligation of the
proximal right coronary artery. Superiority of one surgical technique has
not yet been formally proven because of the rare nature of this condition
and the lack of any prospective randomized controlled trial or robust
prospective observational studies. Copyright © 2021 The Authors.

<47>
Accession Number
2018286547
Title
Current evidence for pharmacologic therapy following stage 1 palliation
for single ventricle congenital heart disease.
Source
Expert Review of Cardiovascular Therapy. (no pagination), 2022. Date of
Publication: 2022.
Author
Broberg M.C.G.; Cheifetz I.M.; Plummer S.T.
Institution
(Broberg, Cheifetz) Department of Pediatrics, Division of Pediatric
Cardiac Critical Care, University Hospitals Rainbow Babies and Children's
Hospital, Case Western Reserve University School of Medicine, Cleveland,
OH, United States
(Cheifetz, Plummer) Department of Pediatrics, Division of Pediatric
Cardiology, University Hospitals Rainbow Babies and Children's Hospital,
Case Western Reserve University School of Medicine, Cleveland, OH, United
States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Infants with single ventricle congenital heart disease are
vulnerable to complications between stage 1 and stage 2 of palliation.
Pharmaceutical treatment during this period is varied and often dependent
on institutional practices as there is little evidence supporting a
particular treatment path. Areas Covered: This review focuses on medical
management of patients following stage I palliation. We performed a
scoping review of the current literature regarding angiotensin converting
enzyme inhibitors and digoxin treatment in the interstage period. In
addition, we discuss other medication classes frequently used in these
patients. Expert Opinion: Due to significant heterogeneity of anatomy,
rarity of disease, and other confounding factors, there is limited
evidence to support most commonly used medications within the interstage
period. Digoxin is associated with improved mortality within the
interstage period and should be considered; however, no large randomized
controlled trial exists supporting its use. Prevention of thrombotic
complication with aspirin is also associated with improved outcomes and
should be considered unless a contraindication exists. The addition of
other prescriptions in this patient population should be considered only
after an evaluation of the risks and benefits of each medication,
recognizing the burden and risk of polypharmacy in this fragile patient
population. Copyright © 2022 Informa UK Limited, trading as
Taylor & Francis Group.

<48>
Accession Number
2018283879
Title
Incidental findings on routine preoperative noncontrast chest computed
tomography and chest radiography prior to cardiac surgery in the
multicenter randomized controlled CRICKET study.
Source
European Radiology. (no pagination), 2022. Date of Publication: 2022.
Author
Knol W.G.; den Harder A.M.; de Heer L.M.; Benke K.; Maurovich-Horvat P.;
Leiner T.; Merkely B.; Krestin G.P.; Bogers A.J.J.C.; Budde R.P.J.
Institution
(Knol, Bogers) Department of Cardiothoracic Surgery, Erasmus MC,
Rotterdam, Netherlands
(Knol, Krestin, Budde) Department of Radiology & Nuclear Medicine, Erasmus
MC, PO BOX 2040, ND-547, CA, Rotterdam 3000, Netherlands
(den Harder, Leiner) Department of Radiology, University Medical Center
Utrecht and Utrecht University, Utrecht, Netherlands
(de Heer) Department of Cardiothoracic Surgery, University Medical Center
Utrecht and Utrecht University, Utrecht, Netherlands
(Benke) Department of Cardiovascular Surgery, Heart and Vascular Center,
Semmelweis University, Budapest, Hungary
(Maurovich-Horvat, Merkely) Department of Cardiology, Heart and Vascular
Center, Semmelweis University, Budapest, Hungary
(Maurovich-Horvat) Department of Radiology, Medical Imaging Center,
Semmelweis University, Budapest, Hungary
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To describe the prevalence and consequences of incidental
findings when implementing routine noncontrast CT prior to cardiac
surgery. Method(s): In the multicenter randomized controlled CRICKET
study, 862 adult patients scheduled for cardiac surgery were randomized
1:1 to undergo standard of care (SoC), which included a chest-radiograph,
or an additional preoperative noncontrast chest CT-scan (SoC+CT). In this
subanalysis, all incidental findings detected on the chest radiograph and
CT-scan were analyzed. The influence of smoking status on incidental
findings was also evaluated, adjusting for sex, age, and group allocation.
 Result(s): Incidental findings were observed in 11.4% (n = 49) of
patients in the SoC+CT group and in 3.7% (n = 16) of patients in the
SoC-group (p < 0.001). The largest difference was observed in findings
requiring follow-up (SoC+CT 7.7% (n = 33) vs SoC 2.3% (n = 10), p <
0.001). Clinically relevant findings changing the surgical approach or
requiring specific treatment were observed in 10 patients (1.2%, SoC+CT:
1.6% SoC: 0.7%), including lung cancer in 0.5% of patients (n = 4) and
aortic dilatation requiring replacement in 0.2% of patients (n = 2).
Incidental findings were more frequent in patients who stopped smoking (OR
1.91, 1.03-3.63) or who actively smoked (OR 3.91, 1.85-8.23).
 Conclusion(s): Routine CT-screening increases the rate of incidental
findings, mainly by identifying more pulmonary findings requiring
follow-up. Incidental findings are more prevalent in patients with a
history of smoking, and preoperative CT might increase the yield of
identifying lung cancer in these patients. Incidental findings, but not
specifically the use of routine CT, are associated with delay of surgery.
Key Points: * Clinically relevant incidental findings are identified more
often after a routine preoperative CT-scan, when compared to a standard of
care workup, with some findings changing patient management. * Patients
with a history of smoking have a higher rate of incidental findings and a
lung cancer rate comparable to that of lung cancer screening trials. * We
observed no clear delay in the time to surgery when adding routine CT
screening. Copyright © 2022, The Author(s).

<49>
Accession Number
2019357770
Title
Postoperative Atrial Fibrillation and Risk for Reoccurrence at Long-Term
in Adults with Obstructive Sleep Apnea Undergoing Coronary Artery Bypass
Grafting in the RICCADSA Cohort.
Source
Sleep Medicine. Conference: 16th World Sleep Congress. Rome Italy.
100(Supplement 1) (pp S267), 2022. Date of Publication: December 2022.
Author
Peker Y.; Holtstrand Hjalm H.; Celik Y.; Thunstrom E.
Institution
(Peker, Celik) Koc University School of Medicine, Pulmonary Medicine,
Istanbul, Turkey
(Peker, Holtstrand Hjalm, Thunstrom) Sahlgrenska Academy University of
Gothenburg, Gothenburg, Sweden
(Peker) Lund University School of Medicine, Lund, Sweden
(Peker) Pittsburgh University School of Medicine, Pittsburgh, United
States
Publisher
Elsevier B.V.
Abstract
Introduction: Postoperative Atrial Fibrillation (POAF) occurs up to 33%
after coronary artery bypass grafting (CABG) in patients with coronary
artery disease (CAD). Obesity is one of the risk factors for POAF
following CABG. Obstructive sleep apnea (OSA) is also common in patients
with CAD, and may contribute to POAF, since obesity and OSA co-exist. Less
is known regarding the reoccurrence of AF in patients with POAF and
concomitant OSA following CABG. Material(s) and Method(s): In the
current secondary analysis of the Randomized Intervention with Continuous
Positive Airway Pressure (CPAP) in Coronary Artery Disease and Obstructive
Sleep Apnea (RICCADSA) trial, we included 157 patients with CABG, who
underwent a home sleep apnea testing, in average 73+/-30 days after the
surgical intervention. POAF was defined as a new-onset AF occurring during
or within the 30 days following the CABG. After excluding 10 patients with
chronic AF, 147 remained as the final study population. Result(s):
POAF was observed in 50 (34.0%). The occurrence of POAF across the
apnea-hypopnea-index (AHI) categories <5.0 events/h (no-OSA); 5.0-14.9
events/h (mild OSA); 15.0-29.9 events/h (moderate OSA); and >=30 events/h
(severe OSA) were 11.1%, 29.2%, 32.1%, and 46.9%, respectively (p=0.042).
In a multivariate logistic regression model, there was a significant risk
increase across the AHI categories with the highest odds ratio for severe
OSA (odds ratio 7.03, %95 confidence Interval 1.42-34.73; p=0.017)
independent of age, sex and body-mass-index. During a median follow-up
period of 67 months, only 2 patients (none with POAF) were hospitalized
due to AF. Conclusion(s): Severe OSA is associated with POAF in
patients with CAD undergoing CABG. Notwithstanding, those patients do not
seem to have an increased risk for reoccurrence of AF at long-term
regardless of the treatment of OSA with CPAP. ClinicalTrialRegistration:
clinicaltrials.gov NCT00519597. Acknowledgements: The study was funded by
the Swedish Research Council, Swedish Heart and Lung Foundation, and
ResMed Foundation. Copyright © 2022

<50>
Accession Number
2019317896
Title
482 How Much Experience Is Required For Aortic Valve Morphology Assessment
And Valve Size Selection In Tavr Patients?.
Source
Journal of Cardiovascular Computed Tomography. Conference: Society of
Cardiovascular Computed Tomography - 17th Annual Scientific Meeting. Las
Vegas United States. 16(4 Supplement) (pp S41), 2022. Date of Publication:
01 Jul 2022.
Author
Evertz R.; Hub S.; Kowallick J.; Seidler T.; Danner B.; Hasenfuss G.;
Toischer K.; Schuster A.
Institution
(Evertz, Hub, Kowallick, Seidler, Danner, Hasenfus, Toischer, Schuster)
University Medical Centre, Goettingen, Germany
Publisher
Elsevier Inc.
Abstract
Introduction: Transcatheter aortic valve replacement (TAVR) has become the
standard treatment in aortic stenosis (AS) in older patients and
increasingly relies on accurate pre-procedural planning using
multidetector computed tomography (MDCT). Since little is known about the
required competence levels for MDCT analyses we comprehensively assessed
MDCT TAVR planning reproducibility and accuracy regarding valve selection
in various healthcare workers. Method(s): 20 randomly selected MDCT
of TAVR patients were analysed using dedicated software by differently
experienced healthcare professionals (structural interventionalist,
imaging specialist, cardiac surgeon, general physician, medical student).
Following the analysis, the most appropriate Edwards SAPIEN 3TM and
Medtronic CoreValve valve size was selected. Intra- and inter-observer
variability were assessed. Result(s): Excellent intra- and
inter-observer variability was observed for all observers regarding to
MDCT measurements. Best intra-observer agreement and reproducibility was
found for the structural interventionalist, while the medical student had
the lowest reproducibility. The highest inter-observer agreement was
observed between the structural interventionalist and the imaging
specialist. Regarding valve size selection, the structural
interventionalist had the highest intra-observer reproducibility
independently of the valve manufacturer. Compared to the structural
interventionalist, the cardiac surgeon showed the highest level of
inter-observer valve size selection agreement [ICC 0.947, 95%CI
0.900-0.972] and the medical student [ICC 0.507, 95%CI 0.067-0.739] the
lowest. Conclusion(s): While current state of the art MDCT analysis
software provides excellent reproducibility for anatomical measurements
the highest levels of confidence in terms of valve size selection is
achieved by the performing interventional physician which can be likely
attributed to observer experience. Copyright © 2022

<51>
Accession Number
2018299116
Title
A comparative study on the results of beating and arrested heart isolated
tricuspid valve surgery: A cross-sectional study.
Source
Health Science Reports. 5(4) (no pagination), 2022. Article Number: e702.
Date of Publication: July 2022.
Author
Bigdelu L.; Azari A.; Mashayekhi Z.; Dadgarmoghaddam M.; Baradaran Rahimi
V.
Institution
(Bigdelu, Azari) Division of Cardiovascular, Vascular Surgery Research
Center, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Mashayekhi, Baradaran Rahimi) Department of Cardiovascular Diseases,
Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad,
Iran, Islamic Republic of
(Dadgarmoghaddam) Department of Community Medicine, Faculty of Medicine,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background and Aims: The isolated tricuspid valve surgery is performed
using beating or arrested heart surgery. The present study aimed to
evaluate and compare the results of patients who underwent isolated
tricuspid valve surgery using the beating and arrested heart techniques.
 Method(s): In this retrospective observational study, all patients
undergoing isolated tricuspid valve surgery between 2011 and 2018 were
included. The patient's demographic information, echocardiographic,
surgery, and hospitalization results were collected, and the EuroSCORE was
calculated from the patient's medical records. Result(s): Fifty-three
patients were included in the study of which 21 (39.63%) and 32 (60.37%)
underwent a beating heart and arrested heart surgeries, respectively.
There were no significant differences between the two studied groups in
the echocardiographic results before and after the surgery, total
hospitalization days (p = 0.56), and the mortality in the first 30 days
after the surgery (p = 0.152). However, the duration of surgery (p <
0.001), EuroSCORE (p = 0.005), and patients who underwent lateral
thoracotomy (p = 0.007) were notably lower in the arrested heart than in
the beating heart group. In contrast, the duration of cardiopulmonary
bypass and hospitalization in an intensive care unit after the surgery was
remarkably lower in the beating heart than in the arrested heart group (p
< 0.001 for both cases). Conclusion(s): Although there were some
significant differences between the two kinds of surgery techniques, it
seems superficial that made a particular decision to consider each
method's superiority. Therefore, further studies with larger populations
and meta-analyses are required to recommend the preferred method for the
surgeons certainly. Copyright © 2022 The Authors. Health Science
Reports published by Wiley Periodicals LLC.

<52>
Accession Number
623345069
Title
The application of mitraclip in the treatment of mitral regurgitation: A
clinical policy.
Source
Shiraz E Medical Journal. 19(6) (no pagination), 2018. Article Number:
e64244. Date of Publication: June 2018.
Author
Mobinizadeh M.; Olyaeemanesh A.; Zargar S.; Ghiasvand H.; Akbarisari A.
Institution
(Mobinizadeh, Olyaeemanesh) National Institute of Health Research and
Health Equity Research Center, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Zargar) Department of Health Management and Economics, School of
Medicine, AJA University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Ghiasvand) Social Determinants of Health Research Center, University of
Social Welfare and Rehabilitation Sciences, Tehran, Iran, Islamic Republic
of
(Akbarisari) Department of Health Management and Economics, School of
Public Health, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
Publisher
Shriaz University of Medical Sciences
Abstract
Context: The mitral valve conducts blood flow from the left atrium to the
left ventricle. Mitral regurgitation occurs when the valve couldn't be
closed properly at the end of ventricular filling. Mitraclip, a
catheter-based device that can reduce mitral regurgitation without
requiring open surgery, is routinely used for patients with unacceptable
risk of conventional mitral valve repair or replacement. The purpose of
this study is assessing the safety, efficacy, and economic aspects of
Mitraclip treatment for mitral regurgitation. Evidence Acquisition:
The Cochrane Library, the TRIP database, and Google Scholar have been
searched through appropriate strategies. Seven studies were included in
the final phase based on the inclusion and exclusion criteria. Data
collected from these studies were analyzed based on four main themes;
applications, safety, efficacy, and economic evaluation. Result(s):
The most potential side effects were related to an improper transfer of
catheters and low durability of the device. One of the included studies
showed that improved outcomes of the New York Heart Association (NYHA) was
more in the clip group with better quality of life that were observed
after 1 to 12 months in 192 patients and also one-year mortality rate
after using clip ranged between 10% and 24%. This included study found
that 72% to 100% of patients with Mitraclip have been successfully treated
and the duration of hospital stays in these patients was between 5 to 10
days. The cost-effectiveness of the procedure still needs more robust
evidence. Conclusion(s): Given the lack of high quality evidence and
relatively high cost of Mitraclip, it seems that until further robust
evidence is produced; it should be used in research and in high risk
patients selected after detailed examination with strict indications and
appropriate opinions of cardiologists. Copyright © 2018, Shiraz
E-Medical Journal.

<53>
Accession Number
369796921
Title
The efficacy of intrathecal bupivacaine in combination with general
anesthesia versus general anesthesia alone on time to extubation in
patients with Coronary Artery Bypass Graft (CABG) surgery.
Source
Shiraz E Medical Journal. 14(1) (no pagination), 2013. Date of
Publication: January 2013.
Author
Pourmehdi Z.; Tabatabaei S.; Salimbahrami S.; Borzouei S.
Institution
(Pourmehdi) Razi Hospital, Ahwaz University of Medica Sciences, Ahwaz,
Iran, Islamic Republic of
(Tabatabaei) Emam Khomeini Hospital, Ahwaz University of Medical Sciences,
Ahwaz, Iran, Islamic Republic of
(Salimbahrami) Besat Hospital, Hamadan University of Medical Sciences,
Hamadan, Iran, Islamic Republic of
(Borzouei) Shahid beheshti Hospital, Hamadan University of Medical
Sciences, Hamadan, Iran, Islamic Republic of
Publisher
Shriaz University of Medical Sciences
Abstract
Objective: we compared the use of intrathecal bupivacaine in combination
with general anesthesia to general anesthesia alone in patients undergoing
coronary artery bypass grafting (CABG) surgery for its impact on time to
extubation. Methodology: In this case control double blind study we
compared 34 patients in Imam Khomeini Hospital, Ahwaz, Iran, from May 2011
to September 2011.The patients were randomly assigned to receive general
anesthesia with prior administration of intrathecal bupivacaine 0.5% at a
dosage of 20 mg (bupivacaine or case group n = 17) or general anesthesia
alone (control group n = 17) according to a simple computer-generated
list. Result(s): Mean extubation time in bupivacaine group was213.00
+/- 3.06 (3h and 33m) and in control group was 257.12 +/- 4.49 minutes (4h
and 17m).the difference between two groups was significant(P < 0.05).
 Conclusion(s): Intrathecal bupivacaine offers promise as a useful
adjunct in reducing postoperative time to extubation in coronary artery
bypass grafting (CABG) surgery. © 2013, Shiraz E Medical Journal,
Shiraz, Iran. All rights reserved.

<54>
Accession Number
2019263993
Title
Coronary Artery Revascularization in Heart Transplant Patients: A
Systematic Review and Meta-Analysis.
Source
Cardiology (Switzerland). 147(3) (pp 348-363), 2022. Date of Publication:
01 Jul 2022.
Author
El-Andari R.; Bozso S.J.; Fialka N.M.; Kang J.J.H.; Macarthur R.G.G.;
Meyer S.R.; Freed D.H.; Nagendran J.
Institution
(El-Andari, Fialka) Faculty of Medicine and Dentistry, University of
Alberta, Edmonton, AB, Canada
(Bozso, Kang, Macarthur, Meyer, Freed, Nagendran) Division of Cardiac
Surgery, Department of Surgery, University of Alberta, Edmonton, AB,
Canada
Publisher
S. Karger AG
Abstract
Background: Cardiac allograft vasculopathy (CAV) is the primary cause of
late mortality after heart transplantation. We look to provide a
comprehensive review of contemporary revascularization strategies in CAV.
 Method(s): PubMed and Web of Science were systematically searched by
3 authors. 1,870 articles were initially screened and 24 were included in
this review. Result(s): PCI is the main revascularization technique
utilized in CAV. The pooled estimates for restenosis significantly favored
DES over BMS (OR 4.26; 95% CI: 2.54-7.13; p < 0.00001; I2 =
4%). There were insufficient data to quantitatively compare mortality
following DES versus BMS. There was no difference in short-term mortality
between CABG and PCI. In-hospital mortality was 0.0% for CABG and ranged
from 0.0 to 8.34% for PCI. One-year mortality was 8.0% for CABG and
5.0-25.0% for PCI. CABG had a potential advantage at 5 years. Five-year
mortality was 17.0% for CABG and ranged from 14 to 40.4% following PCI.
Select measures of postoperative morbidity trended toward superior
outcomes for CABG. Conclusion(s): In CAV, PCI is the primary
revascularization strategy utilized, with DES exhibiting superiority to
BMS regarding postoperative morbidity. Further investigation into outcomes
following CABG in CAV is required to conclusively elucidate the superior
management strategy in CAV. Copyright © 2022 S. Karger AG, Basel.
All rights reserved.

<55>
Accession Number
2019263988
Title
Sex-Related Differences in Transcatheter Mitral Valve Repair: A Systematic
Review and Meta-Analysis.
Source
Cardiology (Switzerland). 147(3) (pp 337-347), 2022. Date of Publication:
01 Jul 2022.
Author
El-Andari R.; Bozso S.J.; Kang J.J.H.; Adams C.; Nagendran J.
Institution
(El-Andari) Faculty of Medicine and Dentistry, University of Alberta,
Edmonton, AB, Canada
(Bozso, Kang, Nagendran) Division of Cardiac Surgery, Department of
Surgery, University of Alberta, Edmonton, AB, Canada
(Adams) Section of Cardiac Surgery, Department of Cardiac Sciences, Libin
Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB,
Canada
Publisher
S. Karger AG
Abstract
Objective: Inequalities in postoperative outcomes between males and
females are well described with females often experiencing inferior
outcomes after heart valve surgery. The recent literature has demonstrated
equivalent or improved outcomes for females after transcatheter aortic
valve replacement. Transcatheter mitral valve repair (TMVr) and
replacement (TMVR) is a relatively newer field with significantly less
literature comparing sex differences. This systematic review and
meta-analysis looks to provide a comprehensive summary of the published
literature comparing outcomes between males and females undergoing
transcatheter MV interventions. Method(s): PubMed, MEDLINE, and
Scopus were systematically searched for all studies comparing outcomes
between males and females undergoing TMVr and TMVR. A total of 2,178
English manuscript titles and abstracts were reviewed. Articles were
excluded if data were not provided regarding sex differences,
transcatheter MV intervention, full-length text was not accessible, or if
insufficient data was provided. A total of 2,170 articles were excluded,
and 8 articles were included in this study. Result(s): Pooled
estimates of outcomes demonstrated rates of acute kidney injury (OR 1.28
[95% CI, 1.14-1.44; p < 0.0001]) favored females, while rates of major
bleeding favored males (OR 0.85 [95% CI 0.76-0.96; p = 0.01]). Rates of
mortality, postoperative MI, and stroke did not differ significantly.
 Conclusion(s): A trend has emerged in heart valve interventions with
males tending to have improved outcomes after surgical intervention and
females experiencing equivalent or improved outcomes after transcatheter
interventions. This meta-analysis identified increased rates of acute
kidney injury for males, increased rates of major bleeding for females,
and otherwise comparable morbidity and mortality in males and females
undergoing TMVr. Copyright © 2022 S. Karger AG, Basel. All rights
reserved.

<56>
Accession Number
2015124694
Title
Intraoperative Methylprednisolone and Neurodevelopmental Outcomes in
Infants After Cardiac Surgery.
Source
Annals of Thoracic Surgery. 113(6) (pp 2079-2084), 2022. Date of
Publication: June 2022.
Author
Zyblewski S.C.; Martin R.H.; Shipes V.B.; Hamlin-Smith K.; Atz A.M.;
Bradley S.M.; Kavarana M.N.; Mahle W.T.; Everett A.D.; Graham E.M.
Institution
(Zyblewski, Hamlin-Smith, Atz, Graham) Department of Pediatrics, Medical
University of South Carolina, South Carolina, Charleston
(Martin, Shipes) Department of Public Health Sciences, Medical University
of South Carolina, South Carolina, Charleston
(Bradley, Kavarana) Section of Pediatric Cardiac Surgery, Medical
University of South Carolina, South Carolina, Charleston
(Mahle) Department of Pediatrics, Children's Healthcare of Atlanta and
Emory University, Georgia, Atlanta, Georgia
(Everett) Department of Pediatrics, The Johns Hopkins University,
Maryland, Baltimore
Publisher
Elsevier Inc.
Abstract
Background: Neurodevelopmental impairment is an important consequence for
survivors of surgery for critical congenital heart disease. This study
sought to determine whether intraoperative methylprednisolone during
neonatal cardiac surgery is associated with neurodevelopmental outcomes at
12 months of age and to identify early prognostic variables associated
with neurodevelopmental outcomes. Method(s): We performed a planned
secondary analysis of a 2-center, double-blind, randomized,
placebo-controlled trial of intraoperative methylprednisolone in neonates
undergoing cardiac surgery. A brain injury biomarker was measured during
surgery. Bayley Scales of Infant and Toddler Development-III (BSID-III)
were performed at 12 months of age. Two-sample t tests and generalized
linear models were used. Result(s): There were 129 participants (n =
61 methylprednisolone; n = 68 placebo). There were no significant
differences in BSID-III scores and brain injury biomarker levels between
treatment groups. Participants who underwent a palliative (versus
corrective) procedure had lower mean BSID-III cognitive (101 +/- 15 versus
106 +/- 14; P = .03) and motor scores (85 +/- 18 versus 94 +/- 16; P <
.01). Longer ventilation time was associated with lower motor scores.
Longer cardiac intensive care unit stay was associated with lower
cognitive, language, and motor scores. Cardiopulmonary bypass time, aortic
cross-clamp time, and deep hypothermic circulatory arrest were not
associated with BSID-III scores. Conclusion(s): Neurodevelopmental
outcomes were not associated with intraoperative methylprednisolone or
intraoperative variables. Participants who underwent a neonatal palliative
(versus corrective) procedure had longer cardiac intensive care unit stays
and worse neurodevelopmental outcomes at 1 year. This work suggests that
interventions focused solely on the operative period may not be associated
with a long-term neurodevelopmental benefit. Copyright © 2022 The
Society of Thoracic Surgeons

<57>
[Use Link to view the full text]
Accession Number
2018928669
Title
Traditional Chinese medicine injections with activating blood circulation,
equivalent effect of anticoagulation or antiplatelet, for acute myocardial
infarction: A protocol for the systematic review and meta-analysis of
randomized clinical trials.
Source
Medicine (United States). 101(24) (pp E29089), 2022. Date of Publication:
17 Jun 2022.
Author
Li X.; Lou Y.; Shang J.-J.; Liu H.-X.; Chen J.-P.; Zhou H.-W.
Institution
(Li, Lou, Shang, Liu, Chen, Zhou) Department Of Cardiology, Beijing
Hospital Of Traditional Chinese Medicine Affiliated To Capital Medical
University, Beijing, China
Publisher
Lippincott Williams and Wilkins
Abstract
BackgroundIn spite of a growing number in the use of percutaneous coronary
intervention (PCI) in China, the mortality of acute myocardial infarction
(AMI) has not decreased. Traditional Chinese medicine injections for
Activating Blood Circulation (TCMi-ABC), equivalent effect of
anticoagulation or antiplatelet, are widely used in China; however, the
improvement of fatality towards AMI is unclear. Therefore, we intend to
conduct a systematic review and meta-analysis to evaluate the efficacy and
safety of TCMi-ABC in treatment with AMI.MethodsBased on the "National
Medical Products Administration of China,"TCMi-ABC with AMI treatment
indication will be selected, including Danhong injection, Sodium
Tanshinone IIA Sulfonate injection, Danshen Chuanxiongqin injection, and
Puerarin injection. Randomized controlled studies will be searched from as
follows: PubMed, Embase, the CENTRAL in Cochrane Library, Chinese
Biomedical Literature Database (SinoMed), China National Knowledge
Infrastructure (CNKI), China Science and Technology Journal Database
(VIP), and Wanfang Data Knowledge Service Platform. Two researchers will
work independently on literature selection, data extraction, and quality
assessment. The outcomes focus on the effects of TCMi-ABC on fatality of
patients with AMI in hospitalization and in the long term, the incidence
of malignant arrhythmia, left ventricular ejection fraction, and adverse
events. RevMan 5.4.1 software was used for mate analysis.ResultsThis study
will conduct a comprehensive literature search and provide a systematic
synthesis of current published data to explore the efficacy and safety of
TCMi-ABC for AMI.ConclusionThis study will provide high-quality evidence
for treatment of AMI with TCMi-ABC in terms of efficacy and safety, which
may help clinicians make a better complementary treatment schedule of
patients with AMI. Copyright © 2022 the Author(s).

<58>
Accession Number
2018880635
Title
The impact of coronary revascularization on vessel-specific coronary flow
capacity and long-term outcomes: a serial [15O]H<inf>2</inf>O
positron emission tomography perfusion imaging study.
Source
European Heart Journal Cardiovascular Imaging. 23(6) (pp 743-752), 2022.
Date of Publication: 01 Jun 2022.
Author
De Winter R.W.; Jukema R.A.; Van Diemen P.A.; Schumacher S.P.; Driessen
R.S.; Stuijfzand W.J.; Everaars H.; Bom M.J.; Van Rossum A.C.; Van De Ven
P.M.; Verouden N.J.; Nap A.; Raijmakers P.G.; Danad I.; Knaapen P.
Institution
(De Winter, Jukema, Van Diemen, Schumacher, Driessen, Stuijfzand,
Everaars, Bom, Van Rossum, Verouden, Nap, Danad, Knaapen) Department of
Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan
1117, Amsterdam 1081 HV, Netherlands
(Van De Ven) Department of Epidemiology & Data Science, Amsterdam UMC,
Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam 1081 HV,
Netherlands
(Raijmakers) Department of Radiology, Nuclear Medicine & PET Research,
Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam
1081 HV, Netherlands
Publisher
Oxford University Press
Abstract
Aims: Coronary flow capacity (CFC) integrates quantitative hyperaemic
myocardial blood flow (hMBF) and coronary flow reserve (CFR) to
comprehensively assess physiological severity of coronary artery disease
(CAD). This study evaluated the effects of revascularization on CFC as
assessed by serial [15O]H2O positron emission tomography (PET) perfusion
imaging. Methods and Results: A total of 314 patients with stable CAD
underwent [15O]H2O PET imaging at baseline and after myocardial
revascularization to assess changes in hMBF, CFR, and CFC in 415
revascularized vessels. Using thresholds for ischaemia and normal
perfusion, vessels were stratified in five CFC categories: myocardial
steal, severely reduced CFC, moderately reduced CFC, minimally reduced
CFC, and normal flow. Additionally, the association between CFC increase
and the composite endpoint of death and non-fatal myocardial infarction
(MI) was studied. Vessel-specific CFC improved after revascularization (P
< 0.01). Furthermore, baseline CFC was an independent predictor of CFC
increase (P < 0.01). The largest changes in DELTAhMBF (0.90 +/- 0.74, 0.93
+/- 0.65, 0.79 +/- 0.74, 0.48 +/- 0.61, and 0.29 +/- 0.66 mL/min/g) and
DELTACFR (1.01 +/- 0.88, 0.99 +/- 0.69, 0.87 +/- 0.88, 0.66 +/- 0.91, and
-0.01 +/- 1.06) were observed in vessels with lower baseline CFC (P < 0.01
for both). During a median follow-up of 3.5 (95% CI 3.1-3.9) years, an
increase in CFC was independently associated with lower rates of death and
non-fatal MI (HR 0.43, 95% CI 0.19-0.98, P = 0.04). Conclusion(s):
Successful revascularization results in an increase in CFC. Furthermore,
baseline CFC was an independent predictor of change in hMBF, CFR, and
subsequently CFC. In addition, an increase in CFC was associated with a
favourable outcome in terms of death and non-fatal MI. Copyright
© 2021 The Author(s).

<59>
[Use Link to view the full text]
Accession Number
2018843046
Title
New developments in the understanding of right ventricular function in
acute care.
Source
Current Opinion in Critical Care. 28(3) (pp 331-339), 2022. Date of
Publication: 01 Jun 2022.
Author
Couture E.J.; Gronlykke L.; Denault A.Y.
Institution
(Couture) Department of Anesthesiology and Department of Medicine,
Division of Intensive Care Medicine, Institut universitaire de cardiologie
et de pneumologie de Quebec, Universite Laval, Quebec, Canada
(Gronlykke) Department of Cardiothoracic Anaesthesiology, Copenhagen
University Hospital, Rigshospitalet, Copenhagen, Denmark
(Denault) Department of Anesthesiology and Division of Intensive Care
Medicine, Montreal Heart Institute, Universite de Montreal, 5000 Belanger
Street, Montreal, QC H1T 1C8, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of reviewRight ventricular dysfunction has an important impact on
the perioperative course of cardiac surgery patients. Recent advances in
the detection and monitoring of perioperative right ventricular
dysfunction will be reviewed here.Recent findingsThe incidence of right
ventricular dysfunction in cardiac surgery has been associated with
unfavorable outcomes. New evidence supports the use of a pulmonary artery
catheter in cardiogenic shock. The possibility to directly measure right
ventricular pressure by transducing the pacing port has expanded its use
to track changes in right ventricular function and to detect right
ventricular outflow tract obstruction. The potential role of myocardial
deformation imaging has been raised to detect patients at risk of
postoperative complications.SummaryPerioperative right ventricular
function monitoring is based on echocardiographic and extra-cardiac flow
evaluation. In addition to imaging modalities, hemodynamic evaluation
using various types of pulmonary artery catheters can be achieved to track
changes rapidly and quantitatively in right ventricular function
perioperatively. These monitoring techniques can be applied during and
after surgery to increase the detection rate of right ventricular
dysfunction. All this to improve the treatment of patients presenting
early signs of right ventricular dysfunction before systemic organ
dysfunction ensue. Copyright © 2022 Lippincott Williams and
Wilkins. All rights reserved.

<60>
Accession Number
2018837836
Title
Risk factors for apathy in Alzheimer's disease: A systematic review of
longitudinal evidence.
Source
Ageing Research Reviews. 79 (no pagination), 2022. Article Number: 101672.
Date of Publication: August 2022.
Author
Azocar I.; Rapaport P.; Burton A.; Meisel G.; Orgeta V.
Institution
(Azocar, Rapaport, Meisel, Orgeta) Division of Psychiatry, University
College London, London, United Kingdom
(Burton) Department of Behavioural Science and Health, University College
London, London, United Kingdom
Publisher
Elsevier Ireland Ltd
Abstract
Background: Apathy is frequent and persistent in Alzheimer's disease (AD),
associated with poor prognosis and carer distress; yet our knowledge of
risk factors remains limited. Aim(s): To identify risk factors
associated with apathy incidence and progression in AD over time.
 Method(s): We systematically reviewed evidence based on longitudinal
studies assessing risk factors for apathy in AD up to June 2021. Two
authors independently assessed article eligibility and rated quality.
 Result(s): 13,280 articles were screened, of which 13 met inclusion
criteria. Studies had a mean follow-up of 2.7 years reporting on a total
of 2012 participants. Most findings were based on single studies of
moderate quality evidence. Risk factors increasing apathy onset were:
being a carrier of the T allele of the PRND gene polymorphism, and having
high levels of the IL-6 and TNFalpha cytokines at baseline. Risk factors
for apathy worsening were: reduced inferior-temporal cortical thickness,
taking antidepressants, being an ApoE epsilon4 carrier, living longer with
AD, lower cognitive test scores, higher baseline apathy, premorbid
personality traits (lower agreeableness, higher neuroticism), and higher
midlife motivational abilities. Conclusion(s): Although results are
limited by the small number of studies, this review identified specific
genetic, neurobiological, AD specific, and dispositional factors that may
increase risk of apathy onset and worsening in AD. Copyright ©
2022 The Authors

<61>
Accession Number
2019144990
Title
Transcatheter Aortic Valve Implantation with ACURATE neo: Results from the
PROGRESS PVL Registry.
Source
Journal of Interventional Cardiology. 2022 (no pagination), 2022. Article
Number: 9138403. Date of Publication: 2022.
Author
Kim W.-K.; Thiele H.; Linke A.; Kuntze T.; Fichtlscherer S.; Webb J.; Chu
M.W.A.; Adam M.; Schymik G.; Geisler T.; Kharbanda R.; Christen T.;
Allocco D.
Institution
(Kim) Department of Cardiology and Cardiac Surgery, Kerckhoff Heart
Center, Bad Nauheim, Germany
(Thiele) Department of Cardiology, Heart Center Leipzig at University of
Leipzig and Leipzig Heart Institute, Leipzig, Germany
(Linke) Department of Internal Medicine and Cardiology, Herzzentrum
Dresden at Technische Universitat Dresden, Dresden, Germany
(Kuntze) Department of Cardiology, Heart Centre, Central Clinic in Bad
Berka, Bad Berka, Germany
(Fichtlscherer) Department of Internal Medicine, Division of Cardiology,
Johann W. Goethe University, Frankfurt, Germany
(Webb) Centre for Heart Valve Innovation, St. Paul's and Vancouver General
Hospitals, University of British Columbia, Vancouver, BC, Canada
(Chu) Division of Cardiac Surgery, Department of Surgery, Western
University, London Health Sciences Centre, London, ON, Canada
(Adam) Clinic for Cardiology, University Hospital Cologne, Cologne,
Germany
(Schymik) Medical Clinic IV, Department of Cardiology, Municipal Hospital
Karlsruhe, Baden-Wurttemberg, Karlsruhe, Germany
(Geisler) Department of Cardiology and Angiology, University Hospital
Tubingen, Tubingen, Germany
(Kharbanda) Oxford Heart Centre, John Radcliffe Hospital, Oxford, United
Kingdom
(Christen, Allocco) Boston Scientific, Marlborough, MA, United States
Publisher
Hindawi Limited
Abstract
Objectives. The PROGRESS PVL registry evaluated transcatheter aortic valve
implantation (TAVI) in patients treated with ACURATE neo, a supra-annular
self-expanding bioprosthetic aortic valve. Background. While clinical
outcomes with TAVI are comparable with those achieved with surgery,
residual aortic regurgitation (AR) and paravalvular leak (PVL) are common
complications. The ACURATE neo valve has a pericardial sealing skirt
designed to minimize PVL. Methods. The primary endpoint was the rate of
total AR over time, as assessed by a core echocardiographic laboratory.
The study enrolled 500 patients (mean age: 81.8 +/- 5.1 years; 61% female;
mean baseline STS score: 6.0 +/- 4.5%) from 22 centers in Europe and
Canada; 498 patients were treated with ACURATE neo. Results. The rate of
>= moderate AR was 4.6% at discharge and 3.1% at 12 months; the rate of >=
moderate PVL was 4.6% at discharge and 2.6% at 12 months. Paired analyses
showed significant improvement in overall PVL between discharge and 12
months (P<0.001); 64.6% of patients had no change in PVL grade, 24.9%
improved, and 10.5% worsened. Patients also exhibited significant
improvement in transvalvular gradient (P<0.001) and effective orifice area
(P=0.01). The mortality rate was 2.2% at 30 days and 11.3% at 12 months.
The permanent pacemaker implantation (PPI) rate was 10.2% at 30 days and
12.2% at 12 months. Conclusions. Results from PROGRESS PVL support the
sustained safety and performance of TAVI with the ACURATE neo valve,
showing excellent valve hemodynamics, good clinical outcomes, and
significant interindividual improvement in PVL from discharge to 12-month
follow-up. Copyright © 2022 Won-Keun Kim et al.

<62>
Accession Number
2019080536
Title
Impact of combined epidural anaesthesia/analgesia on postoperative
cognitive impairment in patients receiving general anaesthesia: a
meta-analysis of randomised controlled studies.
Source
Anaesthesia Critical Care and Pain Medicine. 41(5) (no pagination), 2022.
Article Number: 101119. Date of Publication: October 2022.
Author
Teng I.-C.; Sun C.-K.; Ho C.-N.; Wang L.-K.; Lin Y.-T.; Chang Y.-J.; Chen
J.-Y.; Chu C.-C.; Hsing C.-H.; Hung K.-C.
Institution
(Teng, Ho, Wang, Lin, Chang, Chen, Chu, Hsing, Hung) Department of
Anaesthesiology, Chi Mei Medical Centre, Tainan, Taiwan (Republic of
China)
(Sun) Department of Emergency Medicine, E-Da Hospital, Kaohsiung city,
Taiwan (Republic of China)
(Sun) College of Medicine, I-Shou University, Kaohsiung city, Taiwan
(Republic of China)
(Wang, Lin, Hung) Department of Hospital and Health Care Administration,
College of Recreation and Health Management, Chia Nan University of
Pharmacy and Science, Tainan city, Taiwan (Republic of China)
(Chang) Department of Recreation and Health-Care Management, College of
Recreation and Health Management, Chia Nan University of Pharmacy and
Science, Tainan city, Taiwan (Republic of China)
(Hsing) Department of Medical Research, Chi-Mei Medical Centre, Tainan,
Taiwan (Republic of China)
Publisher
Elsevier Masson s.r.l.
Abstract
Background: To investigate the efficacy of combined epidural
anaesthesia/analgesia (EAA) against postoperative delirium/cognitive
dysfunction (POD/POCD) in adults after major non-cardiac surgery under
general anaesthesia (GA). Method(s): The databases of PubMed, Google
Scholar, Embase and Cochrane Central Register were searched from inception
to November 2021 for available randomised controlled trials (RCTs) that
assessed the impact of EAA on risk of POD/POCD. The primary outcome was
risk of POD/POCD, while the secondary outcomes comprised postoperative
pain score, length of hospital stay (LOS), risk of complications, and
postoperative nausea/vomiting (PONV). Result(s): Meta-analysis of
eight studies with a total of 2376 patients (EAA group: 1189 patients;
non-EAA group: 1187 patients) revealed no difference in risk of POD/POCD
between the EAA and the non-EAA groups [Risk ratio (RR): 0.68; 95% CI:
0.41 to 1.13, p = 0.14, I2 = 73%], but the certainty of
evidence was very low. Nevertheless, the EAA group had lower pain score at
postoperative 24 h [mean difference (MD): -1.49, 95% CI: -2.38 to -0.61;
I2 = 98%; five RCTs; n = 476] and risk of PONV (RR = 0.73, 95%
CI: 0.57 to 0.93, p = 0.01, I2 = 0%; three RCTs, 1876 patients)
than those in the non-EAA group. Our results showed no significant impact
of EAA on the pain score at postoperative 36-72 h, LOS, and risk of
complications. Conclusion(s): This meta-analysis demonstrated that
EAA had no significant impact on the incidence of POD/POCD in patients
following non-cardiac surgery. Copyright © 2022 Societe francaise
d'anesthesie et de reanimation (Sfar)

<63>
Accession Number
2017046992
Title
Assessment and Management of Transplant Renal Artery Stenosis. A
Literature Review.
Source
Annals of Vascular Surgery. 82 (pp 13-29), 2022. Date of Publication: May
2022.
Author
Pini A.; Faggioli G.; Pini R.; Mauro R.; Gallitto E.; Mascoli C.;
Grandinetti V.; Donati G.; Odaldi F.; Ravaioli M.; La Manna G.; Gargiulo
M.
Institution
(Pini, Faggioli, Pini, Mauro, Gallitto, Mascoli, Gargiulo) Department of
Experimental, Diagnostic and Specialty Medicine (DIMES), Vascular Surgery
Unit, IRCCS University Hospital, Policlinico S. Orsola-Malpighi, Bologna,
Italy
(Grandinetti, Donati, La Manna) Department of Experimental, Diagnostic and
Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplantation
Unit, IRCCS University Hospital, Policlinico S. Orsola-Malpighi, Bologna,
Italy
(Odaldi, Ravaioli) Department Medical and Surgical Sciences, General
Surgery and Transplant Unit, IRCCS University Hospital, Policlinico S.
Orsola-Malpighi, Bologna, Italy
Publisher
Elsevier Inc.
Abstract
Background: Transplant renal artery stenosis (TRAS) following kidney
transplantation is a possible cause of graft failure. This review aimed to
summarize the evidence about physiopathology, diagnosis and early and late
effectiveness of the endovascular treatment (EVT), including angioplasty
and stenting procedures. Method(s): A literature research was
performed using Pubmed, Scopus and the Cochrane Library databases (January
2000-September 2020) according to PRISMA guidelines. Studies were included
if they describe EVT, percutaneous transluminal angioplasty or stent
placement of TRAS, published in English and with a minimum of ten
patients. Result(s): Fifty-six studies were included. TRAS incidence
ranges from 1% up to 12% in transplanted kidneys. The TRAS risk factors
were: elderly donor and recipient, cytomegalovirus match status, Class II
Donor Specific Antibodies (DSA), expanded donor criteria, delayed graft
functioning and other anatomical and technical factors. The highest
frequency of TRAS presentation is after 3-6 months after kidney
transplantation. The most frequent localization of stenosis was
para-anastomotic (ranging from 25% to 78%). In 9 studies, all patients
were treated by percutaneous transluminal angioplasty (PTA), in 16 studies
all patients received percutaneous transluminal stenting (PTS) and in 21
series patients received either PTA or PTS. The twelve months patency
rates after EVT ranged from 72% to 94%. The overall complication rate was
9%, with pseudoaneurysms and hematomas as most frequent complications.
 Conclusion(s): TRAS can be successfully and safely treated through an
endovascular approach. Stent delivery seems to guarantee a higher patency
rate compared to simple angioplasty, however further studies are needed to
confirm these results. Copyright © 2022 Elsevier Inc.

<64>
Accession Number
2016610003
Title
Postoperative Renal Failure, Shunt Type, and Mortality After Norwood
Palliation.
Source
Annals of Thoracic Surgery. 113(6) (pp 2046-2053), 2022. Date of
Publication: June 2022.
Author
Chamberlain R.C.; Andersen N.D.; McCrary A.W.; Hornik C.P.; Hill K.D.
Institution
(Chamberlain, McCrary, Hornik, Hill) Department of Pediatrics, Duke
University Medical Center, North Carolina, Durham
(Andersen) Department of Surgery, Duke University Medical Center, North
Carolina, Durham
(Hornik, Hill) Duke Clinical Research Institute, Duke University Medical
Center, North Carolina, Durham
Publisher
Elsevier Inc.
Abstract
Background: The Single Ventricle Reconstruction Trial demonstrated
increased risk of death or heart transplant 1 year after Norwood among
subjects randomly assigned to modified Blalock-Taussig shunts compared
with right ventricle to pulmonary artery (RV-PA) shunts. We used the
Single Ventricle Reconstruction Trial public use database to evaluate
incidence and risk factors for postoperative renal failure and
relationships between renal failure, shunt type, and outcomes after
Norwood. Method(s): Postoperative renal failure was defined a priori
as a threefold rise in creatinine from baseline, or dialysis use, within 7
days of Norwood. We used multivariate logistic regression to evaluate risk
factors for postoperative renal failure and Cox hazard regression to
determine the association between postoperative renal failure and 1 year
after Norwood mortality. Result(s): Overall, postoperative renal
failure occurred in 8.4% (46 of 544) patients with risk factors including
receipt of a modified Blalock-Taussig shunt (adjusted odds ratio [aOR]
3.3, P = .02), low center volume (aOR 2.7, P = .005), two or more
preoperative complications (aOR 4.0, P < .001), low birth weight (aOR 3.2,
P = .002), postoperative heart block (aOR 8.5, P = .001), and delayed
sternal closure (aOR 5.3, P = .026). Renal failure was an independent risk
factor for 1-year mortality (aHR 1.9, P = .019). Assessing interaction by
shunt type, mortality risk associated with renal failure was greatest in
the RV-PA shunt group (aHR 3.3 vs RV-PA shunt without renal failure, P =
.001), but was also increased in the modified Blalock-Taussig shunt group
(aHR 1.9, P = .03). Conclusion(s): Postoperative renal failure is
common after Norwood and is independently associated with mortality.
Although renal failure is more common after modified Blalock-Taussig
shunt, the highest mortality risk with renal failure occurs after RV-PA
shunt. Copyright © 2022 The Society of Thoracic Surgeons

<65>
Accession Number
2016161827
Title
Impact of proton pump inhibitors on efficacy of antiplatelet strategies
with ticagrelor or aspirin after percutaneous coronary intervention:
Insights from the GLOBAL LEADERS trial.
Source
Catheterization and Cardiovascular Interventions. 100(1) (pp 72-82), 2022.
Date of Publication: July 1, 2022.
Author
Ono M.; Onuma Y.; Kawashima H.; Hara H.; Gao C.; Wang R.; O'Leary N.;
Benit E.; Janssens L.; Ferrario M.; Zurakowski A.; Dominici M.; Huber K.;
Buszman P.; Garg S.; Wykrzykowska J.J.; Piek J.J.; Juni P.; Hamm C.;
Windecker S.; Vranckx P.; Deliargyris E.N.; Bhatt D.L.; Storey R.F.;
Valgimigli M.; Serruys P.W.
Institution
(Ono, Kawashima, Hara, Wykrzykowska, Piek) Department of Clinical and
Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC,
Heart Center, University of Amsterdam, Amsterdam, Netherlands
(Ono, Onuma, Kawashima, Hara, O'Leary, Serruys) Interventional Medicine
and Innovation, National University of Ireland Galway (NUIG), Galway,
Ireland
(Gao, Wang) Department of Cardiology, Radboud University Medical Center,
Nijmegen, Netherlands
(Gao, Wang) Department of Cardiology, Xijing Hospital, Xi'an, China
(Benit) Department of Cardiology and Critical Care Medicine, Hartcentrum
Hasselt, Jessa Ziekenhuis, Hasselt, Belgium
(Benit) Faculty of Medicine and Life Sciences, University of Hasselt,
Hasselt, Belgium
(Janssens) Imelda Ziekenhuis, Bonheiden, Belgium
(Ferrario) Policlinico San Matteo, Pavia, Italy
(Zurakowski) Frycz-Modrzewski Academy-Cracow, Cracow, Poland
(Dominici) Azienda Ospedaliera S. Maria, Terni, Italy
(Huber) Wilhelminenspital, Vienna, Austria
(Buszman) Department of Epidemiology, Silesian Medical School, Katowice,
Poland
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Wykrzykowska) University Medical Center Groningen, Groningen, Netherlands
(Juni) Applied Health Research Centre, Li Ka Shing Knowledge Institute, St
Michael's Hospital, University of Toronto, Toronto, ON, Canada
(Hamm) University of Giessen and Kerckhoff Heartand Thorax Center,
University of Giessen, Bad Nauheim, Germany
(Windecker) Department of Cardiology, Inselspital, University of Bern,
Bern, Switzerland
(Vranckx) Jessa Ziekenhuis, Faculty of Medicine and Life Sciences at the
Hasselt University, Hasselt, Belgium
(Deliargyris) Cytosorbents Corporation, Monmouth Junction, NJ, United
States
(Bhatt) Harvard Medical School, Brigham and Women's Hospital Heart &
Vascular Center, Boston, MA, United States
(Storey) Cardiovascular Research Unit, Department of Infection, Immunity
and Cardiovascular Disease, University of Sheffield, Sheffield, United
Kingdom
(Valgimigli) Cardiocentro Ticino Institute, Universita della Svizzera
Italiana (USI), Lugano, Switzerland
(Serruys) NHLI, Imperial College London, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Several studies have suggested that proton pump inhibitors
(PPIs) may reduce the antiplatelet effects of clopidogrel and/or aspirin,
possibly leading to cardiovascular events. Aim(s): We aimed to
investigate the association between PPI and clinical outcomes in patients
treated with ticagrelor monotherapy or conventional antiplatelet therapy
after percutaneous coronary intervention (PCI). Method(s): This is a
subanalysis of the randomized GLOBAL LEADERS trial, comparing the
experimental antiplatelet arm (23-month ticagrelor monotherapy following
1-month dual antiplatelet therapy [DAPT]) with the reference arm (12-month
aspirin monotherapy following 12-month DAPT) after PCI. Patient-oriented
composite endpoints (POCEs: all-cause mortality, myocardial infarction,
stroke, or repeat revascularization) and its components were assessed
stratified by PPI use as a time-dependent covariate in patients with the
experiment or reference antiplatelet arm. Result(s): Among 15,839
patients, 2115 patients (13.5%) experienced POCE at 2 years. In the
reference arm, the use of PPIs was independently associated with POCE
(hazard ratio [HR]: 1.27; 95% confidence interval [CI]: 1.12-1.44) and its
individual components, whereas it was not in the experimental arm (HR:
1.04; 95% CI: 0.92-1.19; p<inf>interaction</inf> = 0.035). During the
second-year follow-up, patients taking aspirin with PPIs had a
significantly higher risk of POCE compared to those on aspirin without
PPIs (HR: 1.57; 95% CI: 1.27-1.94), whereas the risk did not differ
significantly irrespective of PPI in ticagrelor monotherapy group (HR:
1.03; 95% CI: 0.83-1.28; p<inf>interaction</inf> = 0.008).
 Conclusion(s): In contrast to conventional antiplatelet strategy,
there were no evidence suggesting the interaction between ticagrelor
monotherapy and PPIs on increased cardiovascular events, which should be
confirmed in further studies. Clinical Trial Registration: URL:
https://clinicaltrials.gov. Copyright © 2022 The Authors.
Catheterization and Cardiovascular Interventions published by Wiley
Periodicals LLC.

<66>
Accession Number
2014416838
Title
Target blood pressure management during cardiopulmonary bypass improves
lactate levels after cardiac surgery: a randomized controlled trial.
Source
BMC Anesthesiology. 21(1) (no pagination), 2021. Article Number: 309. Date
of Publication: December 2021.
Author
Miao Q.; Wu D.J.; Chen X.; Xu M.; Sun L.; Guo Z.; He B.; Wu J.
Institution
(Miao, Wu, Chen, Xu, Wu) Department of Anesthesiology, Shanghai Chest
Hospital, Shanghai Jiao Tong University, No. 241 West Huaihai Road,
Shanghai 200030, China
(Sun, Guo) Department of Cardiopulmonary Bypass, Shanghai Chest Hospital,
Shanghai Jiao Tong University, Shanghai, China
(He) Department of Intensive Care Unit, Shanghai Chest Hospital, Shanghai
Jiao Tong University, Shanghai, China
Publisher
BioMed Central Ltd
Abstract
Background: Hyperlactatemia is associated with a poor prognosis in cardiac
surgery patients. This study explored the impact of target blood pressure
management during cardiopulmonary bypass (CPB) on blood lactate levels
after cardiac surgery. Method(s): Adult patients undergoing cardiac
valve surgery between 20/1/2020 and 30/6/2020 at Shanghai Chest Hospital
were enrolled. The patients were randomized into a low mean arterial
pressure (L-MAP) group (target MAP between 50 and 60 mmHg) or a high mean
arterial pressure (H-MAP) group (target MAP between 70 and 80 mmHg), n =
20 for each. Norepinephrine was titrated only during CPB to maintain MAP
at the target level. Blood lactate levels in the two groups were detected
before the operation (T0), at the end of CPB (T1), at the end of the
operation (T2), 1 h after the operation (T3), 6 h after the operation (T4)
and 24 h after the operation (T5). The primary outcome was the blood
lactate level at the end of the operation (T2). The secondary outcomes
included the blood lactate level at T1, T3, T4, and T5 and the dose of
epinephrine and dopamine within 24 h after the operation, time to
extubation, length of stay in the ICU, incidence of readmission within 30
days, and mortality within 1 year. Result(s): Forty patents were
enrolled and analyzed in the study. The lactate level in the H-MAP group
was significantly lower than that in the L-MAP group at the end of the
operation (3.1 [IQR 2.1, 5.0] vs. 2.1 [IQR 1.7, 2.9], P = 0.008) and at
the end of CPB and 1 hour after surgery. The dose of epinephrine within 24
h after the operation, time to extubation and length of stay in the ICU in
the L-MAP group were significantly higher than those in the H-MAP group.
 Conclusion(s): Maintaining a relatively higher MAP during CPB
deceased the blood lactate level at the end of surgery, reduced
epinephrine consumption, and shortened the time to extubation and length
of stay in the ICU after surgery. Trial registration: This single-center,
prospective, RCT has completed the registration of the Chinese Clinical
Trial Center at 8/1/2020 with the registration number ChiCTR2000028941. It
was conducted from 20/1/2020 to 30/6/2020 as a single, blinded trial in
Shanghai Chest Hospital. Copyright © 2021, The Author(s).

<67>
Accession Number
2014306375
Title
Angiographic-only or intravascular ultrasound-guided approach for
left-main coronary artery intervention: a systematic review and
meta-analysis.
Source
Expert Review of Cardiovascular Therapy. 19(11) (pp 1029-1035), 2021. Date
of Publication: 2021.
Author
Saleem S.; Ullah W.; Mukhtar M.; Sarvepalli D.; Younas S.; Arab S.A.; Al
Hemyari B.; Zahid S.; Nazir S.; Cheema T.; Mir T.; Abdul-Waheed M.
Institution
(Saleem, Al Hemyari, Abdul-Waheed) Cardiovascular Medicine, University of
Kentucky, Lexington, United States
(Ullah) Cardiovascular Medicine, Thomas Jefferson University,
Philadelphia, PA, United States
(Mukhtar) Cardiovascular Medicine, University Hospitals of Leicester NHS
Trust, Leicester, United Kingdom
(Sarvepalli) Cardiovascular Medicine, Guntur Medical College, Guntur,
India
(Younas, Arab) Cardiovascular Medicine, Western Kentucky Heart and Lung,
Bowling Green, KY, United States
(Zahid) Cardiovascular Medicine Rochester General Hospital, Rochester,
United States
(Nazir) Cardiovascular Medicine, University of Toledo, Toledo, OH, United
States
(Cheema) Cardiovascular Medicine, West Suburban Medical Center, Oak Park,
IL, United States
(Mir) Cardiovascular Medicine, Detroit Medical Center, Detroit, MI, United
States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: The use of intravascular ultrasound (IVUS) in percutaneous
revascularization of left-main coronary artery disease (LMCAD) warrants
further exploration. We aimed to collate all available data on the merits
of IVUS in LMCAD to help decision-making. Method(s): The MEDLINE,
Embase, and Cochrane databases were queried for relevant randomized
controlled trials (RCTs) and observational cohort studies (OCS). The data
were analyzed using random-effects model to calculate unadjusted odds
ratio (OR) between IVUS-guided and angiography-only LMCA
revascularization. Result(s): A total of 14 studies (2 RCTs and 12
OCS), comprising 18944 patients, were included. The pooled odds of
all-cause mortality (OR 0.57, 95%CI 0.46-0.70, p = <0.00001),
cardiovascular mortality (OR 0.37, 95%CI 0.26-0.54, p = <0.00001),
left-main revascularization (OR 0.63, 95%CI 0.45-0.89, p = 0.009) and
myocardial infarction (OR 0.80, 95% CI 0.66-0.97, p = 0.02) were
significantly lower with IVUS-guidance. There was no difference observed
in the odds of the stent thrombosis (OR 0.57, 95% CI 0.31-1.05, p = 0.07)
and stroke (OR 1.7, 95%CI 0.56-5.14, p = 0.35) between the two groups. A
subgroup analysis based on the study design and follow-up duration
mirrored the pooled estimates. Conclusion(s): IVUS-guided LMCA
intervention is associated with overall improved cardiovascular outcomes
than the angiography-only approach. This needs to be tested in a large
randomized controlled trial. Copyright © 2021 Informa UK Limited,
trading as Taylor & Francis Group.

<68>
Accession Number
638479253
Title
Factors affecting adherence to physical training in the outpatient phase
of rehabilitation, in patients after coronary artery bypass grafting.
Source
Kardiologiia. 62(6) (pp 37-44), 2022. Date of Publication: 30 Jun 2022.
Author
Pomeshkina S.A.; Bezzubova V.A.; Zvereva T.N.; Kagan E.S.; Barbarash O.L.
Institution
(Pomeshkina, Zvereva, Barbarash) Research Institute for Complex Issues of
Cardiovascular Diseases, Kemerovo, Russian Federation
(Bezzubova) Barbarash Kemerovo Regional Clinical Cardiological Dispensary,
Kemerovo, Russian Federation
(Kagan) Kemerovo State Medical University, Kemerovo, Russian Federation
Publisher
NLM (Medline)
Abstract
Aim To evaluate the outpatient physical exercise (PE) compliance and the
affecting factors in patients after coronary bypass (CB).Material and
methods The study included 67 men with ischemic heart disease younger than
75 years who had had CB. All patients were randomized to 2 groups: group 1
exercised on a bicycle ergometer at the rehabilitation center, under the
monitoring of medical staff; patients of group 2 performed home-based
exercise (HBE) by dosed walking. In the preoperative period, at one month
after CB, and after 3 months of exercise, the following was evaluated:
clinical condition of patients in different groups, plasma concentrations
of lipids, body weight index, waist circumference, echocardiography and
bicycle ergometry data, and questionnaire data (SF-36, Bek's Depression
Inventory). At 3 months of follow-up, the outpatient exercise compliance
and the affecting factors were also evaluated.Results The study
demonstrated the effectiveness of the proposed alternative 3-month program
of home-based PE. Both the patients exercising on a bicycle and those
performing HBE had increased exercise tolerance (ET) and improved blood
lipid concentrations. The number of obese patients decreased. Also,
depression severity decreased, quality of life (physical and psychological
components) improved, and compliance with drug therapy increased in both
groups. Analysis of the training attendance in the recommended period
showed that patients who had undergone CB were insufficiently adherent to
physical rehabilitation programs, regardless of the program type
(home-based or monitored). The highest PE adherence was observed in men
with the following characteristics: married, working urban residents, with
a previous history of cardiovascular diseases, who had regularly taken
medications in the preoperative period, and who also had higher quality of
life.Conclusion The proposed outpatient 3-month physical rehabilitation
programs increase the effectiveness of CB, which is evident as improved
adherence to modifying cardiovascular risk factors, increased ET,
optimization of the psychological status and quality of life, and improved
compliance with drug therapy. However, despite the proposed alternative,
home-based 3-month physical rehabilitation programs aimed at increasing
the treatment compliance, the level of ET remained low. This requires
further improvement of methods for monitoring and motivation of patients
to physical rehabilitation and psychological support that would start
already at the preoperative stage.

<69>
Accession Number
2019251029
Title
Neurological outcomes of transcatheter aortic valve implantation with or
without cerebral embolic protection devices: A meta-analysis.
Source
Journal of Stroke and Cerebrovascular Diseases. 31(9) (no pagination),
2022. Article Number: 106605. Date of Publication: September 2022.
Author
Perez-Camargo D.; Travieso A.; Carnero-Alcazar M.; Taramasso M.;
Cobiella-Carnicer J.; Maroto-Castellanos L.C.
Institution
(Perez-Camargo, Carnero-Alcazar, Cobiella-Carnicer, Maroto-Castellanos)
Cardiac Surgery Department, Hospital Universitario Clinico San Carlos,
Madrid, Spain
(Travieso) Cardiology Department, Hospital Universitario Clinico San
Carlos, Madrid, Spain
(Taramasso) HerzZentrum Hirslanden Zurich, Zurich, Switzerland
Publisher
W.B. Saunders
Abstract
Introduction: Cerebral embolic protection devices (CEPDs) are designed to
prevent embolization of debris during transcatheter aortic valve
implantation (TAVI). Current evidence from randomized clinical trials
(RCTs) and observational studies is controversial. Aim(s): The
purpose of this meta-analysis was to study the influence of CEPDs on
stroke, silent ischemic lesions and neurocognitive function.
 Method(s): A systematic search was conducted including RCTs or
adjusted observational studies comparing TAVI with or without CEPDs.
Pooled odds ratios, risk ratios or standardized mean differences with 95%
confidence intervals were calculated using the inverse of variance method.
Risk of bias sensitivity analyses and meta regression for CEPD type were
also conducted. Result(s): Five RCTs and five adjusted observational
studies were included (n= 159,865). Mean age of the patients was 81.1 (SD
1.04) years in CEPDs and 81 (SD 1.86) in non-CEPD. The overall quality of
evidence using the GRADE system for each endpoint was low to very low,
mainly due to serious risk of bias, inconsistency and imprecision. Random
effects meta-analysis detected no significant differences between CEPD and
non-CEPD (OR= 0.74; 95% CI 0.51-1.07; P= 0.105; I2= 82.1%) for
30-day stroke. This finding was consistent in meta regression for CEPD
type and subgroup analyses by study type and CEPD type. No significant
differences between groups were observed in cerebral DW-MRI assessment and
neurocognitive function evaluation. Conclusion(s): In the present
meta- analysis of five RCTs and five adjusted observational studies, the
use of a CEPD during TAVI was not associated with a significant benefit on
30- day stroke, total lesion volume per patient, number of ischemic
lesions per patient and neurocognitive function assessments. Copyright
© 2022 Elsevier Inc.

<70>
Accession Number
2017632589
Title
Intravenous iron supplement for iron deficiency in patients with severe
aortic stenosis scheduled for transcatheter aortic valve implantation:
results of the IIISAS randomised trial.
Source
European Journal of Heart Failure. 24(7) (pp 1269-1279), 2022. Date of
Publication: July 2022.
Author
Kvaslerud A.B.; Bardan S.; Andresen K.; Klove S.F.; Fagerland M.W.;
Edvardsen T.; Gullestad L.; Broch K.
Institution
(Kvaslerud, Bardan, Andresen, Edvardsen, Gullestad, Broch) Faculty of
Medicine, University of Oslo, Oslo, Norway
(Kvaslerud, Andresen, Klove, Edvardsen, Gullestad, Broch) Department of
Cardiology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
(Kvaslerud, Gullestad, Broch) KG Jebsen Center for Cardiac Research and
Center for Heart Failure Research, University of Oslo, Oslo, Norway
(Fagerland) Oslo Centre for Biostatistics and Epidemiology, Research
Support Services, Oslo University Hospital, Oslo, Norway
Publisher
John Wiley and Sons Ltd
Abstract
Aims: The aim of this trial was to evaluate whether intravenous iron could
provide benefit beyond transcatheter aortic valve implantation (TAVI) in
iron-deficient patients with severe aortic stenosis. Methods and
Results: In this randomised, placebo-controlled, double-blind,
single-centre trial, we enrolled patients with severe aortic stenosis and
iron deficiency (defined as ferritin <100 microg/L, or 100-299 microg/L
with a transferrin saturation <20%) who were evaluated for TAVI. Patients
were randomly assigned (1:1) to receive intravenous ferric derisomaltose
or placebo ~3 months before TAVI. The primary endpoint was the
between-group, baseline-adjusted 6-min walk distance measured 3 months
after TAVI. Secondary outcomes included quality of life, iron stores, hand
grip strength, New York Heart Association (NYHA) class, and safety.
Between January 2020 and September 2021, we randomised 74 patients to
ferric derisomaltose and 75 patients to placebo. The modified
intention-to-treat population comprised the 104 patients who completed the
6-min walk test at baseline and 3 months after successful TAVI. Iron
stores were restored in 76% of the patients allocated to iron and 13% of
the patients allocated to placebo (p < 0.001). There was no difference in
the baseline-adjusted 6-min walk distance between the two treatment arms
(p = 0.82). The number of serious adverse events, quality of life, hand
grip strength, and NYHA class did not differ between the treatment arms.
 Conclusion(s): Treatment with intravenous iron did not provide
clinical benefit beyond TAVI in iron-deficient patients with severe aortic
stenosis. Clinical Trial Registration: ClinicalTrials.gov
NCT04206228. Copyright © 2022 The Authors. European Journal of
Heart Failure published by John Wiley & Sons Ltd on behalf of European
Society of Cardiology.

<71>
Accession Number
2017586995
Title
Clinical Impact of Tricuspid Regurgitation on Transcatheter Edge-to-Edge
Mitral Valve Repair for Mitral Regurgitation.
Source
Cardiovascular Revascularization Medicine. 41 (pp 1-9), 2022. Date of
Publication: August 2022.
Author
Chitturi K.R.; Bhardwaj B.; Murtaza G.; Karuparthi P.R.; Faza N.N.; Goel
S.S.; Reardon M.J.; Kleiman N.S.; Aggarwal K.
Institution
(Chitturi, Bhardwaj, Murtaza, Karuparthi, Aggarwal) Division of
Cardiovascular Medicine, University of Missouri-Columbia School of
Medicine, Columbia, MO, United States
(Karuparthi, Aggarwal) Harry S. Truman Memorial Veterans Hospital,
Columbia, MO, United States
(Faza, Goel, Kleiman) Department of Cardiology, Houston Methodist DeBakey
Heart & Vascular Center, Houston, TX, United States
(Reardon) Department of Cardiothoracic Surgery, Houston Methodist DeBakey
Heart & Vascular Center, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Objectives: This study aimed to evaluate whether baseline tricuspid
regurgitation (TR) impacted clinical outcomes after mitral valve
transcatheter edge-to-edge repair (M-TEER) for severe secondary mitral
regurgitation (MR). Background(s): Baseline TR is common among
patients undergoing M-TEER for secondary MR, although its impact on
clinical outcomes is unclear. Method(s): The Cochrane Library,
PubMed/MEDLINE, and Google Scholar were searched according to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
guidelines from January 1, 2011 through January 31, 2021. Randomized
controlled trials and nonrandomized prospective studies that evaluated
baseline TR by echocardiography before M-TEER for MR were included. The
primary outcome was a composite of mortality and heart failure
hospitalization (HFH) at 1-year. Result(s): A total of 5 studies (n =
1395 patients) were included in the primary analysis. Concurrent
moderate/severe TR was associated with a worse 1 year composite of
all-cause mortality and HFH (OR: 2.13; 95% CI: 1.12-4.05; p = 0.02) after
M-TEER for severe MR. In studies that reported TR grade pre- and
post-M-TEER for severe MR, 32% of patients with moderate-to-severe
baseline TR had a reduction in TR severity after the intervention.
 Conclusion(s): Baseline moderate-to-severe TR was associated with
increased 1-year mortality and heart failure hospitalizations among
patients undergoing M-TEER. Further randomized studies are needed to
assess the interaction of TR among patients undergoing
M-TEER. Copyright © 2022

<72>
Accession Number
638517665
Title
Dietary remodeling of intestinal microbiota to reduce the number of
cardiovascular events in patients after acute myocardial infarction.
Source
European Journal of Clinical Pharmacology. Conference: 15th Congress of
the European Association for Clinical Pharmacology and Therapeutics,
EACPT. Athens Greece. 78 (pp S42), 2022. Date of Publication: June 2022.
Author
Sergazy S.; Zhashkeyev A.; Gulyayev A.; Aljofan M.; Zhumadilov Z.
Institution
(Sergazy, Gulyayev, Aljofan, Zhumadilov) Nazarbayev University,
Nur-Sultan, Kazakhstan
(Zhashkeyev) Karaganda Medical University, Karaganda, Kazakhstan
Publisher
Springer Verlag
Abstract
Introduction: Intestinal microbiome is one of important regulators of the
pathogenesis of atherogenesis and other related diseases. Changes in the
level of trimethylamine N-oxide (TMAO) and oxidative stress in blood
plasma are can be used as biomarkers to determine the relationship between
cardiovascular diseases and the state of the intestinal microbiome
(gut-heart axis), as well as the degree of risk of cardiovascular events.
It is proposed that correcting the state of the gut microbiome with plant
polyphenols, as determined by the dynamics of TMAO and indicators of
oxidative stress in blood plasma will reduce the risk of cardiovascular
events in patients with coronary heart disease. Objective(s): To
investigate the relationship between cardiovascular events in patients
with acute myocardial infarction during dietary remodeling of the
intestinal microbiota using grape polyphenol concentrate. Method(s):
We initiated a randomized, placebo-controlled clinical trial in 150
patients to evaluate the effect of daily (for 3 months of the year,
starting one week after acute myocardial infarction with coronary artery
stenting) oral administration of 15 Cabernet Sauvignon grape polyphenol
concentrate (a dietary supplement with a concentration of polyphenols 2
mg/ml). We measured the change in TMAO concentration, the level of
oxidative stress, as well as the number of cardiovascular events during
the year in patients after acute myocardial infarction with ST segment
elevation (STEMI). Secondary endpoint: was to measure the degree of
progression of coronary atherosclerotic plaques according to the SYNTAX
scale. Result(s): Up until now (6 months of the study), the
administration of grape polyphenol concentrate in patients after acute
myocardial infarction, resulted in a significant reduction of oxidative
stress level and approximately 2-fold increase in the antioxidant capacity
of blood plasma, compared to placebo (placebo - red grape juice). On
average the initial level of TMAO concentration decreased by 38.0 +/-
1.27% in patients who had a three-month intake of grape polyphenol
concentrate, which might be due to the correction of the state of the
intestinal microbiome. Also, there were no major CV events reported in
patients in the polyphenol concentrate group for 6 months.
 Conclusion(s): The observed reduction of oxidative stress and TMAO
formation during the dietary intervention with grape polyphenol
concentrate can be regarded a significant improvement and positive
biomarkers of the relationship between the state of the
intestinalmicrobiome and the state of the cardiovascular system. The
established changes in biomarkers are evidence of the correction of the
intestinal microbiome and may be predictors of a decrease in the risk of
cardiovascular events. Evidence for the prevention ofmajorCVevents in
patients aftermyocardial infarctionwith grape polyphenol concentrate is
expected to come at the end of the clinical trial.

<73>
Accession Number
638513646
Title
A review on recent advances in the management of Peripartum
Cardiomyopathy.
Source
BJOG: An International Journal of Obstetrics and Gynaecology. Conference:
Royal College of Obstretriscians and Gynaecologists World Congress, RCOG
2022. London United Kingdom. 129(Supplement 1) (pp 77-78), 2022. Date of
Publication: June 2022.
Author
Athar S.; Hamcho M.A.
Institution
(Athar, Hamcho) HMC, Al Wakra, Qatar
Publisher
Blackwell Publishing Ltd
Abstract
Objective: Though uncommon, peripartum cardiomyopathy (PPCM) is associated
with severe maternal morbidity and mortality. Despite several pieces of
research in this field, its etiopathogenesis and presentation are
uncertain. Its diagnosis is often delayed as symptoms and signs mimic
cardiovascular changes in pregnancy. Due to unclear pathophysiology and
variable presentation of PPCM, its management remains challenging for
physicians. So, a narrative review was conducted to assess the recent
advances in the management of PCCM. Design(s): Narrative review.
 Method(s): This review was conducted to analyze the recent
discoveries and advances in the etiopathogenesis, diagnosis and management
of PPCM. Online search from January 2000, to December 2021 was performed
using Medline data search. All article types were included in the search.
237 relevant publications were retrieved. Out of these 67 studies were
included in the review. Result(s): Damage to the cardiac myocytes and
endothelium by oxidative fragmentation of prolactin and heat shock
proteins are suggested as the etiopathogenesis of PCCM. Genetic
predisposition for PCCM with a pathogenic mutation with TTN truncations,
myosin-binding protein C, lamin A/C, beta-myosin, or sodium voltage-gated
channel alpha subunit 5 (SCN5A) was noted by many authors. PPCM was
frequently noted in elderly nullipara women but multiparous women were
also identified as at risk by some authors. Preeclampsia, multiple
gestation, iron deficiency anemia, gestational diabetes mellitus and
obesity were addressed as risk factors for PCCM. Echocardiography remains
the imaging modality of choice in these cases. The use of Ambulatory
echocardiography devices was found beneficial in diagnosis of arrhythmias.
Treatment and outcomes were essentially case-specific. A multidisciplinary
approach is advisable in all these cases. The role of heart failure
therapies, anticoagulants, vasodilator agents, and diuretics was found to
be beneficial in most of these patients. In resistant cases,
Bromocriptine, inotropic therapy, an intra-aortic balloon pump and left
ventricular assist device use has been tried with success. Cardiac
transplantation remains the last modality of treatment with variable
results. Early diagnosis and prompt management remain the mainstay in the
treatment of PCCM. Women with irreversible ventricular dysfunction had the
worst outcomes and should be advised against future pregnancy.
 Conclusion(s): Despite several studies to date, the prevalence and
outcome of PCCM are unpredictable. Usually, women with early reversal of
ventricular function have a better prognosis. Identifying women for high
risks for PCCM and multidisciplinary approach may aid in early diagnosis
and management of these cases and hence outcomes can be ameliorated.

<74>
Accession Number
2019332786
Title
The impact of coronary artery bypass grafting added to aortic valve
replacement on long-term outcomes in octogenarian patients: a
reconstructed time-to-event meta-analysis.
Source
Interactive Cardiovascular and Thoracic Surgery. 35(2) (no pagination),
2022. Article Number: ivac164. Date of Publication: 01 Aug 2022.
Author
Gallingani A.; D'Alessandro S.; Singh G.; Hernandez-Vaquero D.; Celik M.;
Ceccato E.; Nicolini F.; Formica F.
Institution
(Gallingani) Cardiac Surgery Unit, Parma University Hospital, Parma, Italy
(D'Alessandro) Cardiac Surgery Unit, San Gerardo Hospital, Monza, Italy
(Singh) Department Of Critical Care Medicine, Division Of Cardiac Surgery
Mazankowski, Alberta Heart Institute, University Of Alberta, Edmonton,
Canada
(Hernandez-Vaquero) Cardiac Surgery Department, Hospital Universitario
Central De Asturias, Oviedo, Spain
(Celik) Department Of Cardiothoracic Surgery, Erasmus University Medical
Center, Rotterdam, Netherlands
(Ceccato, Nicolini, Formica) Medical Library, University Of Parma, Parma,
Italy
(Nicolini, Formica) Department Of Medicine And Surgery, University Of
Parma, Parma, Italy
Publisher
Oxford University Press
Abstract
The long-term results in studies comparing octogenarian patients who
received either isolated surgical aortic valve replacement (i-SAVR) or
coronary artery bypass grafting (CABG) in addition to SAVR are still
debated. We performed a reconstructed time-to-event data meta-analysis of
studies comparing i-SAVR and CABG+SAVR to evaluate the impact of CABG and
to analyse the time-varying effects on long-term outcome. We performed a
systematic review of the literature from January 2000 through November
2021, including studies comparing i-SAVR and CABG+SAVR, which reported at
least 3-year follow-up and that plotted Kaplan-Meier curves of overall
survival. The primary endpoint was overall long-term survival; secondary
endpoints were in-hospital/30-day mortality and postoperative outcomes.
The pooled hazard ratio (HR) and odds ratio) with 95% confidence interval
(CI) were calculated for primary and secondary endpoints, respectively.
Random-effect model was used in all analyses. Sixteen retrospective
studies were included (5382 patients, i-SAVR = 2568 and CABG+SAVR = 2814).
I-SAVR showed a lower incidence of in-hospital mortality compared to
CABG+SAVR (odds ratio = 0.73; 95% CI= 0.60-0.89; P = 0.002). Landmark
analyses showed a significantly higher all-cause mortality within 1 year
from surgery in CABG+SAVR (HR = 1.17; 95% CI = 1.01-1.36; P = 0.03); after
1 year, no significant difference was observed (HR = 0.95; 95% CI =
0.87-1.04; P = 0.35). Landmark analysis was confirmed by time-varying
trend of HR. Late survival of octogenarians did not differ significantly
between the 2 interventions. Interestingly, CABG added to SAVR was
associated with both higher in-hospital and within 1-year mortality after
surgery, whereas this difference was statistically non-significant at
long-term follow-up. Copyright © 2022 The Author(s). Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<75>
Accession Number
2019333025
Title
Etiology, Pathophysiology and Mortality of Shock in Children in Low
(Middle) Income Countries: A Systematic Review.
Source
Journal of Tropical Pediatrics. 68(4) (no pagination), 2022. Date of
Publication: 01 Aug 2022.
Author
Assies R.; Snik I.; Kumwenda M.; Chimalizeni Y.; Langton J.; Van Woensel
J.B.M.; Doctor A.; Calis J.C.J.
Institution
(Assies, Snik, Van Woensel, Calis) Amsterdam Umc Location University Of
Amsterdam, Picu, Emma Children's Hospital, Meibergdreef 9, Amsterdam,
Netherlands
(Assies, Van Woensel, Calis) Amsterdam Centre For Global Child Health,
Amsterdam, Netherlands
(Assies, Kumwenda, Chimalizeni, Langton, Calis) Department Of Paediatrics
And Child Health, Kamuzu University Of Health Sciences KUHeS Malawi,
Blantyre, Malawi
(Doctor) University Of Maryland School Of Medicine, Baltimore, MD, United
States
Publisher
Oxford University Press
Abstract
Objectives: Shock is a life-threatening condition in children in low- and
middle-income countries (LMIC), with several controversies. This
systematic review summarizes the etiology, pathophysiology and mortality
of shock in children in LMIC. Method(s): We searched for studies
reporting on children with shock in LMIC in PubMed, Embase and through
snowballing (up to 1 October 2019). Studies conducted in LMIC that
reported on shock in children (1 month-18 years) were included. We
excluded studies only containing data on neonates, cardiac surgery
patients or iatrogenic causes. We presented prevalence data, pooled
mortality estimates and conducted subgroup analyses per definition, region
and disease. Etiology and pathophysiology data were systematically
collected. Result(s): We identified 959 studies and included 59
studies of which six primarily studied shock. Definitions used for shock
were classified into five groups. Prevalence of shock ranged from 1.5% in
a pediatric hospital population to 44.3% in critically ill children.
Pooled mortality estimates ranged between 3.9-33.3% for the five
definition groups. Important etiologies included gastroenteritis, sepsis,
malaria and severe anemia, which often coincided. The pathophysiology was
poorly studied but suggests that in addition to hypovolemia, dissociative
and cardiogenic shock are common in LMIC. Conclusion(s): Shock is
associated with high mortality in hospitalized children in LMIC. Despite
the importance few studies investigated shock and as a consequence limited
data on etiology and pathophysiology of shock is available. A uniform
bedside definition may help boost future studies unravelling shock
etiology and pathophysiology in LMIC. Copyright © 2022 The
Author(s). Published by Oxford University Press. All rights reserved.

<76>
Accession Number
2019330593
Title
Feasibility and preliminary efficacy of perioperative interventions in
patients undergoing coronary artery bypass grafting: The randomized
controlled I-COPE trial.
Source
European Journal of Cardio-thoracic Surgery. 62(1) (no pagination), 2022.
Article Number: ezac041. Date of Publication: 01 Jul 2022.
Author
Sadlonova M.; Nagel J.; Becker S.; Neumann S.; Staab J.; Meyer T.; Celano
C.M.; Amonoo H.L.; Fangauf S.V.; Herrmann-Lingen C.; Kutschka I.;
Friedrich M.
Institution
(Sadlonova, Nagel, Becker, Neumann, Staab, Meyer, Fangauf,
Herrmann-Lingen) Department of Psychosomatic Medicine and Psychotherapy,
University Medical Centre Gottingen, Gottingen, Germany
(Sadlonova, Kutschka, Friedrich) Department of Cardiovascular and Thoracic
Surgery, University Medical Centre Gottingen, Gottingen, Germany
(Sadlonova, Staab, Meyer, Herrmann-Lingen, Kutschka, Friedrich) Dzhk
(German Centre for Cardiovascular Research), Partner Site, Gottingen,
Germany
(Sadlonova, Celano) Department of Psychiatry, Massachusetts General
Hospital, Boston, MA, United States
(Sadlonova, Celano, Amonoo) Department of Psychiatry, Harvard Medical
School, Boston, MA, United States
(Amonoo) Department of Psychiatry, Brigham and Women's Hospital, Boston,
MA, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Patients undergoing coronary artery bypass graft (CABG)
surgery are exposed to multiple treatment-related stressors, which can
impact coping and health-related quality of life (HRQoL). The objective of
this trial was to analyse the feasibility and preliminary efficacy of a
multi-component intervention that combines psychological support and
reduction of hospital-specific stressors on HRQoL, length of hospital and
intensive care unit stay, self-efficacy, and plasma interleukin (IL)-6 and
-8 levels in CABG patients. METHOD(S): This three-arm, randomized
controlled, single-centre pilot trial assessed the Intervention for CABG
to Optimize Patient Experience in 88 patients undergoing elective CABG.
Standard medical care (SMC, n = 29) was compared with 2 intervention
groups: (i) psychological interventions to optimize treatment expectations
(IA group, n = 30) and (ii) multi-component intervention (IB group, n =
29) with psychological interventions plus an additional treatment package
(light therapy, noise reduction, music, and if desired, 360degree images
delivered via virtual reality). RESULT(S): The implementation of
psychological interventions in routine medical treatment was feasible
(91.5% of participants completed all intervention sessions). Both
interventions were associated with significantly shorter hospital stay
compared to SMC (IA/IB 9.8/9.3 days vs SMC 12.5 days). Self-efficacy
expectations at post-surgery were significantly higher compared to SMC
both in the IA group (P = 0.011) and marginally in the IB group (P =
0.051). However, there were no treatment effects of the interventions on
HRQoL and plasma levels of IL-6 or IL-8 after CABG. CONCLUSION(S): A
perioperative multi-component intervention may lead to shorter hospital
stay and higher self-efficacy after CABG. Further studies are needed to
determine its impact on HRQoL and inflammation. CLINICAL TRIAL
REGISTRATION NUMBER: Ethical approval (# 21/2/18) for the study was
obtained from the Research Ethics Committee of the University of Gottingen
Medical Center, and the trial was registered in the German Clinical Trials
Register (DRKS00015309, https://www.drks.de/drks_web/setLocale_EN.do).
 Copyright © 2022 The Author(s). Published by Oxford University
Press on behalf of the European Association for Cardio-Thoracic Surgery.
All rights reserved.

<77>
Accession Number
2018287374
Title
Mortality and Clinical Predictors After Percutaneous Mitral Valve Repair
for Secondary Mitral Regurgitation: A Systematic Review and
Meta-Regression Analysis.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 918712. Date of Publication: 04 Jul 2022.
Author
Shi W.; Zhang W.; Zhang D.; Ye G.; Ding C.
Institution
(Shi, Zhang, Zhang, Ye, Ding) Aerospace Center Hospital, Beijing, China
(Shi, Zhang, Zhang, Ye, Ding) Peking University Aerospace School of
Clinical Medicine, Beijing, China
Publisher
Frontiers Media S.A.
Abstract
Background: Percutaneous mitral valve repair (PMVR) provides an available
choice for patients suffering from secondary mitral regurgitation (SMR),
especially those whose symptoms persist after optimal, conventional,
heart-failure therapy. However, conflicting results from clinical trials
have created a problem in identifying patients who will benefit the most
from PMVR. Objective(s): To pool mortality data and assess clinical
predictors after PMVR among patients with SMR. To this end, subgroup and
meta-regression analyses were additionally performed. Method(s): We
searched PubMed, EMBASE, and Cochrane databases, and 13 studies were
finally included for meta-analysis. Estimated mortality and 95% confidence
intervals (CIs) were obtained using a random-effects proportional
meta-analysis. We also carried out a meta-regression analysis to clarify
the potential influence of important covariates on mortality.
 Result(s): A total of 1,259 patients with SMR who had undergone PMVR
were enrolled in our meta-analysis. The long-term estimated pooled
mortality of PMVR was 19.3% (95% CI: 13.6-25.1). Meta-regression analysis
showed that mortality was directly proportional to cardiac
resynchronization therapy (CRT) (beta = 0.009; 95% CI: 0.002-0.016; p =
0.009), an effective regurgitant orifice (ERO) (beta = 0.009; 95% CI:
0.000-0.018; p = 0.047), and a mineralocorticoid receptor antagonist (MRA)
use (beta = -0.015; 95% CI: -0.023--0.006; p < 0.001). Subgroup analysis
indicated that patients with preexisting AF (beta = -0.002; 95% CI:
-0.005- -0.000; p = 0.018) were associated with decreased mortality if
they received a mitral annuloplasty device. Among the edge-to-edge repair
device group, a higher left ventricular (LV) ejection fraction, or lower
LV end-systolic diameter, LV end-systolic volume, and LV end-diastolic
volume were proportional to lower mortality. Conclusion and Relevance: The
pooled mortality of PMVR was 19.3% (95% CI: 13.6-25.1). Further
meta-regression indicated that AF was associated with a better outcome in
conjunction with the use of a mitral annuloplasty device, while better LV
functioning predicted a better outcome after the implantation of an
edge-to-edge repair device. Copyright © 2022 Shi, Zhang, Zhang,
Ye and Ding.

<78>
Accession Number
2018277988
Title
Objectively measured preoperative physical activity and sedentary
behaviour among Finnish patients scheduled for elective cardiac
procedures: baseline results from randomized controlled trial.
Source
BMC Sports Science, Medicine and Rehabilitation. 14(1) (no pagination),
2022. Article Number: 130. Date of Publication: December 2022.
Author
Vasankari S.; Hartikainen J.; Vasankari V.; Anttila V.; Tokola K.;
Vaha-Ypya H.; Husu P.; Sievanen H.; Vasankari T.; Halonen J.
Institution
(Vasankari) Derpartment of Clinical Medicine, University of Turku, Turku,
Finland
(Hartikainen, Halonen) Heart Center, Kuopio University Hospital (KUH),
Kuopio, Finland
(Vasankari) Department of Neurosurgery, Helsinki University Hospital,
University of Helsinki, Helsinki, Finland
(Anttila) Heart Center, Turku University Hospital, Turku, Finland
(Tokola, Vaha-Ypya, Husu, Sievanen, Vasankari) The UKK Institute for
Health Promotion Research, Tampere, Finland
(Vasankari) The Faculty of Medicine and Health Technology, Tampere
University, Tampere, Finland
Publisher
BioMed Central Ltd
Abstract
Background: We investigated preoperative physical activity (PA) and
sedentary behaviour (SB) in patients scheduled for elective cardiac
procedures and compared them with population-based sample of Finnish
adults. Method(s): Cardiac patients (n = 139) undergoing cardiac
operations carried a triaxial accelerometer for seven days during the
month before the procedure. Patients were categorised into four groups
according to the procedure: percutaneous coronary intervention or coronary
angiography (PCI-CA), coronary artery bypass grafting (CABG), aortic valve
replacement (AVR) and mitral valve surgery (MVS). The raw accelerometer
data was analyzed with dedicated algorithms to determine metabolic
equivalents (METs, 3.5 mL/kg/min of oxygen consumption) of PA. The
intensity of PA was divided into two categories: light (LPA, 1.5-2.9 METs)
and moderate-to-vigorous (MVPA, >= 3.0 METs), while SB represented
intensity < 1.5 MET without movements. SB and PA were described as daily
means and accumulation from different bout lengths. Daily standing, steps
and mean and peak MET-values were calculated. The results were compared
between the patient groups and against the reference group from a
population-based study FinFit2017. Result(s): Cardiac patients had
fewer daily steps than the FinFit population (p = 0.01), and less SB
accumulating from < 20 min bouts (p = 0.002) but more from 20 to 60 min
bouts (p = 0.002). Particularly, CABG group had less daily MVPA (p =
0.002) and MVPA accumulating from > 10 min bouts (p < 0.001) than the
FinFit population. Conclusion(s): We found large differences in PA
and SB between the patient groups and the FitFit population, CABG group
having the worst activity profile. Also, the variation within the patient
groups was wide, which should be considered to individualise the
rehabilitation programs postoperatively. Trial registration
clinicaltrials.gov (NCT03470246). Registered 19 March 2018,
https://clinicaltrials.gov/ct2/show/NCT03470246. Copyright ©
2022, The Author(s).

<79>
Accession Number
638522348
Title
Preoperative anxiety among cardiac surgery patients and its impact on
major adverse cardiac events and mortality- A randomized, parallel-group
study.
Source
Annals of Cardiac Anaesthesia. 25(3) (pp 293-296), 2022. Date of
Publication: July-September 2022.
Author
Mudgalkar N.; Kandi V.; Baviskar A.; Kasturi R.; Bandurapalli B.
Institution
(Mudgalkar) Department and Anaesthesia and Cardiac Anaesthesia, Prathima
Institute of Medical Sciences, Nagnur Road, Telangana, Karimnagar, India
(Kandi) Department and Microbiology, Prathima Institute of Medical
Sciences, Nagnur Road, Telangana, Karimnagar, India
(Baviskar) Department and Cardiac Surgery, Prathima Institute of Medical
Sciences, Nagnur Road, Telangana, Karimnagar, India
(Kasturi) Department and Cardiology, Prathima Institute of Medical
Sciences, Nagnur Road, Telangana, Karimnagar, India
(Bandurapalli) Department and Cardiac Anaesthesia, Prathima Institute of
Medical Sciences, Nagnur Road, Telangana, Karimnagar, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Patients undergoing elective cardiac surgery often experience
pre-operative anxiety. Preoperative anxiety influences surgical outcome.
There are very few studies which have assessed the impact of clonidine and
Gabapentin in the treatment of anxiety especially in Indian populations
and its implications on major adverse cardiac events (MACE) and 30 days
mortality. Material(s) and Method(s): Adult patients aged 18 to 80
years old who were scheduled to have an elective coronary artery by-pass
graft (CABG) were included in the study. Those who satisfied the inclusion
criteria were given either Gabapentin (800 mg) or Clonidine (300 mcg)
90-120 minutes before the induction. State trait anxiety inventory (STAI)
was used to assess anxiety in baseline and taking just before operating
room. The primary endpoint was a reduction in the STAI associated with the
study drug, while the secondary endpoint was the incidence of MACE in the
perioperative period (30 days), which included composite episodes of
non-fatal cardiac arrest, chaotic rhythm, acute myocardial infarction,
congestive heart failure, cardiac arrhythmia, angina, and death.
 Result(s): A total of 75 patients were considered for the statistical
analysis. The demographic and clinical features of the study participants
were similar in both groups. Nearly 75-80% of participants had severe
anxiety in the preoperative period while 10-20% had moderate anxiety.
While both the drugs showed a reduction in the anxiety levels, the
clonidine group fared better (statistically insignificant). The incidence
of MACE was similar in both groups. Conclusion(s): The preoperative
anxiety levels were high among cardiac surgery patients. Both clonidine
and gabapentin were equally effective in reducing the levels of
preoperative anxiety. Preoperative STAI scores in the range of 32-53 is
not associated with MACE and 30-day mortality among cardiac surgery
patients. Copyright © 2022 Wolters Kluwer Medknow Publications.
All rights reserved.

<80>
Accession Number
638522319
Title
Intubation with vivasight double-lumen tube versus conventional
double-lumen tube in adult patients undergoing lung resection: A
retrospective analysis.
Source
Annals of Cardiac Anaesthesia. 25(3) (pp 279-285), 2022. Date of
Publication: July-September 2022.
Author
Granell M.; Petrini G.; Kot P.; Murcia M.; Morales J.; Guijarro R.; De
Andres J.
Institution
(Granell, Kot, Murcia, Morales, De Andres) Department of Anesthesia,
Critical Care and Pain Medicine, University General Hospital Consortium of
Valencia, Spain
(Granell, Guijarro, De Andres) University of Valencia, University General
Hospital Consortium of Valencia, Spain
(Guijarro) Department of Thoracic Surgery, University General Hospital
Consortium of Valencia, Spain
(Petrini) Department of Anesthesia, Critical Care and Pain Medicine, Citt
della Salute e della Scienza, Torino, Italy
Publisher
Wolters Kluwer Medknow Publications
Abstract
Objectives: The present study was designed to compare outcomes in patients
undergoing thoracic surgery using the VivaSight double-lumen tube (VDLT)
or the conventional double-lumen tube (cDLT). Design(s): A
retrospective analysis of 100 patients scheduled for lung resection
recruited over 21 consecutive months (January 2018-September 2019).
 Setting(s): Single-center university teaching hospital investigation.
 Participant(s): A randomized sample of 100 patients who underwent
lung resection during this period were selected for the purpose to compare
50 patients in the VDLT group and 50 in the cDLT group.
 Intervention(s): After institutional review board approval, patients
were chosen according to inclusion and exclusion criteria and we created a
general database. The 100 patients have been chosen through a random
process with the Microsoft Excel program (Microsoft 2018, Version
16.16.16). Measurements and Main Results: The primary endpoint of the
study was to analyze the need to use fiberoptic bronchoscopy to confirm
the correct positioning of VDLT or the cDLT used for lung isolation.
Secondary endpoints were respiratory parameters, admission to the
intensive care unit, length of hospitalization, postoperative
complications, readmission, and 30-day mortality rate. The use of
fiberoptic bronchoscopy was lower in the VDLT group, and the size of the
tube was smaller. The intraoperative respiratory and hemodynamics
parameters were optimal. There were no other preoperative, intraoperative,
or postoperative differences between both groups. Conclusion(s): The
VDLT reduces the need for fiberoptic bronchoscopy, and it seems that a
smaller size is needed. Finally, VDLT is cost-effective using disposable
fiberscopes. Copyright © 2022 Wolters Kluwer Medknow
Publications. All rights reserved.

<81>
Accession Number
638522306
Title
Effect of perioperative use of oral triidothyronine for infants undergoing
complex congenital cardiac surgeries under cardiopulmonary bypass: A
double-blinded randomised controlled study.
Source
Annals of Cardiac Anaesthesia. 25(3) (pp 270-278), 2022. Date of
Publication: July-September 2022.
Author
Karri S.; Mandal B.; Kumar B.; Puri G.; Thingnam S.; Kumar H.;
Unnikrishnan V.
Institution
(Karri, Mandal, Kumar, Puri) Department of Cardiac Anaesthesia, Pgimer,
Chandigarh, India
(Thingnam) Department of Cardiothoracic Surgery, Pgimer, Chandigarh, India
(Kumar) Department of Cardiothoracic Surgery Icu, Pgimer, Chandigarh,
India
(Unnikrishnan) Department of Pediatric Cardiac Surgery Icu, Pgimer,
Chandigarh, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Thyroid hormone metabolism disrupts after cardiopulmonary
bypass both in adults and pediatric patients. This is known as Euthyroid
sick syndrome, and it is more evident in pediatric patients who were
undergoing complex cardiac surgeries compared to adults. This decrease in
serum T3 levels increases the incidence of low cardiac output, requirement
of inotropes, prolonged mechanical ventilation, and prolonged intensive
care unit (ICU) stay. Aims and Objectives: The primary objective was to
compare the mean Vasoactive-inotropic score (VIS) at 72 hours
postoperatively between T3 and Placebo groups. Material(s) and
Method(s): One hundred patients were screened, and 88 patients were
included in the study. Triidothyronine 1 mic/kg 10 doses 8 th hourly was
given orally postoperatively to cases and sugar sachets to controls. The
blood samples for analysis of FT3, FT4, and TSH were taken every 24 hours
postoperatively, and baseline values were taken after induction. Mean VIS
scores, ejection Fraction (EF), Left ventricular outflow tract velocity
time integral (LVOT VTi), hemodynamics and partial pressure of oxygen/
fraction of inspired oxygen(PaO2/FiO2) were recorded daily.
 Result(s): The Mean VIS scores at 72 Hours postoperatively were
significantly less in the T3 group (5.49 +/- 6.2) compared to the Placebo
group (13.6 +/- 11.7). The PaO2/FiO2 ratios were comparatively more in the
T3 group than the Placebo group. The serum levels of FT3 FT4 were
significantly higher in the T3-supplemented group than the Placebo group.
The VIS scores were significantly lower from 48 hours postoperatively in
children < 6 months of age. Conclusion(s): In this study, we observed
that supplementing T3 postoperatively decreases the ionotropic requirement
from 72 hours postoperatively. This is more useful in children <6 months
of age undergoing complex cardiac surgeries. Copyright © 2022
Wolters Kluwer Medknow Publications. All rights reserved.

<82>
Accession Number
2019315413
Title
Levosimendan in paediatric cardiac anaesthesiology: A systematic review
and meta-analysis.
Source
European Journal of Anaesthesiology. 39(8) (pp 646-655), 2022. Date of
Publication: 01 Aug 2022.
Author
Lapere M.; Rega F.; Rex S.
Institution
(Lapere, Rex) Department of Anaesthesiology, University Hospitals Leuven,
Herestraat 49, Leuven 3000, Belgium
(Lapere, Rex) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Rega) Department of Cardiac Surgery, University Hospitals Leuven, Leuven,
Belgium
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUNDLow cardiac output syndrome (LCOS) after congenital cardiac
surgery has an incidence of up to 25%. Preventing and treating LCOS is of
pivotal importance as LCOS is associated with excess morbidity and
mortality.OBJECTIVESThis systematic review assesses the safety and
efficacy of peri-operative levosimendan administration in the setting of
paediatric cardiac surgery.DESIGNSystematic review of randomised
controlled trials. Meta-analyses were performed on efficacy and
exploratory outcomes.DATA SOURCESLiterature was searched in the following
databases (MEDLINE, EMBASE, Web of Science and CENTRAL) from inception to
July 2021.ELIGIBILITY CRITERIARandomised controlled trials comparing
levosimendan with other inotropes or placebo in children younger than 18
years of age undergoing cardiac surgery.RESULTSNine studies enrolling a
total of 539 children could be included in the systematic review. All
trials study the prophylactic administration of levosimendan in comparison
with placebo (n = 2), milrinone (n = 6) or dobutamine (n = 1).
Levosimendan dosing varied considerably with only three studies using a
loading dose. Levosimendan reduced the incidence of LCOS [risk ratio (RR)
0.80] [95% confidence interval (CI), 0.40 to 0.89, P = 0.01] and increased
cardiac index (MD 0.17 l min-1 m-2) (95% CI, 0.06 to
0.28, P = 0.003) without affecting other outcomes (mortality, ICU length
of stay, hospital length of stay, duration of mechanical ventilation,
serum lactate, central venous oxygen saturation, serum creatine or acute
kidney injury).CONCLUSIONThe prophylactic use of levosimendan in children
undergoing cardiac surgery reduced the incidence of LCOS and increased
cardiac index compared with other inotropes or placebo. This effect did
not translate into an improvement of other clinical
endpoints. Copyright © 2022 Lippincott Williams and Wilkins. All
rights reserved.

<83>
Accession Number
2019282312
Title
Rational and Initiative of the Impella in Cardiac Surgery (ImCarS)
Register Platform.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2022. Date of
Publication: 2022.
Author
Niemann B.; Stoppe C.; Wittenberg M.; Rohrbach S.; Diyar S.; Billion M.;
Potapov E.; Oezkur M.; Akhyari P.; Schmack B.; Schibilsky D.; Bernhardt
A.M.; Schmitto J.D.; Hagl C.; Masiello P.; Boning A.
Institution
(Niemann, Boning) Department of Cardiovascular Surgery, University
Hospital Giessen, Germany
(Stoppe) Department of Anesthesiology and Intensive Care Medicine,
University Hospital Wurzburg, Wurzburg, Bavaria, Germany
(Stoppe) Abiomed, Danvers, MA, United States
(Wittenberg) Coordinating Center for Clinical Trials, Philipps-University
of Marburg, Hessia, Marburg, Germany
(Rohrbach) Institute of Physiology, Justus-Liebig-University Giessen,
Hessen, Giessen, Germany
(Diyar) Department for Cardiac Surgery, Leipzig Heart Center, Leipzig,
Germany
(Billion) Department of Cardiac Surgery, Schuchtermann Hospital Bad
Rothenfelde, Niedersachsen, Bad Rothenfelde, Germany
(Potapov) Department of Cardiac Surgery, Deutsches Herzzentrum Berlin
Ringgold Standard Institution, Berlin, Berlin, Germany
(Oezkur) Department of Cardiac and Vascular Surgery, University of Mainz,
Mainz, Germany
(Akhyari) Department of Cardiac Surgery, Medical Faculty, Heinrich Heine
University, Dusseldorf, Germany
(Schmack) Department of Cardiac Surgery, University of Essen, Essen,
Germany
(Schibilsky) Department of Cardiac Surgery, University of Freiburg,
Freiburg, Germany
(Bernhardt) Department of Cardiovascular Surgery, University Heart Center
Hamburg, Hamburg, Germany
(Schmitto) Department of Cardiac- Thoracic-, Transplantation- and Vascular
Surgery, Hannover Medical School, Hannover, Germany
(Hagl) Department of Cardiothoracic, Transplantation and Vascular Surgery,
Hannover Medical School, Munchen, Germany
(Masiello) Department of Cardiac Surgery, San Giovanni di Dio e R.A.
Hospital, Salerno, Salerno, Italy
Publisher
Georg Thieme Verlag
Abstract
Objectives Cardiac support systems are being used increasingly more due to
the growing prevalence of heart failure and cardiogenic shock. Reducing
cardiac afterload, intracardiac pressure, and flow support are important
factors. Extracorporeal membrane oxygenation (ECMO) and intracardiac
microaxial pump systems (Impella) as non-permanent MCS (mechanical
circulatory support) are being used increasingly. Methods We reviewed the
recent literature and developed an international European registry for
non-permanent MCS. Results Life-threatening conditions that are observed
preoperatively often include reduced left ventricular function, systemic
hypoperfusion, myocardial infarction, acute and chronic heart failure,
myocarditis, and valve vitia. Postoperative complications that are
commonly observed include severe systemic inflammatory response,
ischemia-reperfusion injury, trauma-related disorders, which ultimately
may lead to low cardiac output (CO) syndrome and organ dysfunctions, which
necessitates a prolonged ICU stay. Choosing the appropriate device for
support is critical. The management strategies and complications differ by
system. The heart-team approach is inevitably needed. However despite
previous efforts to elucidate these topics, it remains largely unclear
which patients benefit from certain systems, when is the right time to
initiate (MCS), which support system is appropriate, what is the optimal
level and type of support, which therapeutic additive and supportive
strategies should be considered and ultimately, what are the future
prospects and therapeutic developments. Conclusion The European cardiac
surgical register ImCarS has been established as an IIT with the overall
aim to evaluate data received from the daily clinical practice in cardiac
surgery. Interested colleagues are cordially invited to join the register.
Clinical registration number: DRKS00024560. Positive Ethics Vote: AZ
246/20 Faculty of Medicine,
Justus-Liebig-University-Giebetaen. Copyright © 2022 Georg Thieme
Verlag. All rights reserved.

<84>
Accession Number
2018288368
Title
Mortality and adverse events of hemoadsorption with CytoSorb in critically
ill patients: A systematic review and meta-analysis of randomized
controlled trials.
Source
Acta Anaesthesiologica Scandinavica. (no pagination), 2022. Date of
Publication: 2022.
Author
Heymann M.; Schorer R.; Putzu A.
Institution
(Heymann, Schorer, Putzu) Division of Anesthesiology, Department of Acute
Medicine, Geneva University Hospitals, Geneva, Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Background: The effects and safety of extracorporeal hemoadsorption with
CytoSorb in critically ill patients with inflammatory conditions are
controversial. Method(s): We performed a systematic review with
meta-analysis and trial sequential analysis (TSA) of randomized-controlled
trials to assess the mortality and safety of CytoSorb therapy in
critically ill patients with inflammatory conditions. Electronic databases
were searched up to April 2022. The primary outcome was mortality at
longest follow-up and secondary outcomes included various adverse event
(AE) outcomes. Conflict of interest and funding of each trial were
assessed. We calculated relative risk (RR) and 95% confidence interval
(CI). Result(s): Fourteen published (n = 764) and 4 unpublished (n =
111) trials were included. Eight trials were performed in medical ICU
patients and 10 in complex cardiac surgery. Ten trials had significant
industrial funding or an author conflict of interest. Hemoadsorption with
CytoSorb was associated with higher mortality at latest follow-up (16
trials, n = 807, 120 of 402 [29.85%] patients in the CytoSorb group vs. 98
of 405 [24.20%] patients in the control group, RR = 1.24 [95% CI,
1.04-1.49], p =.02, [TSA-adjusted CI, 0.92-1.68]) and at 30-days or
in-hospital (11 trials, n = 727; RR = 1.41 [95% CI, 1.06-1.88], p =.02,
[TSA-adjusted CI, 0.44-4.62]). Only one trial reported the definition of
adverse event, while detailed results were reported in 3 trials; the risk
of adverse events was not higher with CytoSorb. Certainty of evidence
ranged from low to very low. Conclusion(s): Low certainty of evidence
showed that the use of CytoSorb might increase mortality in critically ill
patients with inflammatory conditions. Adverse events were frequent but
underreported and not systematically evaluated. Industrial funding and
conflict of interest were common. Considerable uncertainty about the
findings does not allow firm conclusions and suggests a need for
high-quality randomized trials to clarify mortality and adverse events
related to CytoSorb. Editorial Comment: Hemoadsorption with CytoSorb have
been used in critically ill patients despite lack of high quality data
from RCTs suggesting any patient-important benefits. The findings from
this systematic review and meta-analysis suggests an increased risk of
adverse events including mortality. With no apparent benefits and at the
same time risk of harm, use of hemoadsorption with CytoSorb in daily
clinical practice cannot be recommended at this time. Copyright ©
2022 The Authors. Acta Anaesthesiologica Scandinavica published by John
Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica
Foundation.

<85>
Accession Number
615452596
Title
Cardiovascular efficacy and safety of bococizumab in high-risk patients.
Source
New England Journal of Medicine. 376(16) (pp 1527-1539), 2017. Date of
Publication: 20 Apr 2017.
Author
Ridker P.M.; Revkin J.; Amarenco P.; Brunell R.; Curto M.; Civeira F.;
Flather M.; Glynn R.J.; Jukema J.W.; Karpov Y.; Kastelein J.J.P.; Koenig
W.; Lorenzatti A.; Manga P.; Masiukiewicz U.; Miller M.; Mosterd A.; Murin
J.; Nicolau J.C.; Nissen S.; Ponikowski P.; Santos R.D.; Schwartz P.F.;
Soran H.; White H.; Wright R.S.; Vrablik M.; Yunis C.; Shear C.L.; Tardif
J.-C.; Conde D.; Colquhoun D.; Missault L.; Gregoire J.; Gao R.; Urina M.;
Solar M.; Jensen H.K.; Grobbee D.; Savolainen M.; Schiele F.N.;
Montalescot G.; Edes I.; Blake G.; Lotan C.; Maggioni A.; Savonitto S.;
Lee C.W.; Leiva Pons J.L.; Dan G.A.; Cortada J.B.; Mellbin L.; Kahan T.;
Noble S.; Hwang J.J.; Sritara P.; Tokgozoglu L.; Tarasenko L.; Borer J.S.;
Black H.; Carmena R.; Furie K.L.; McMurray J.; Neaton J.; Zannad F.;
O'Neill B.; Welty F.; McNamara R.; Chun H.; Abbott J.D.; Jacoby D.;
McPherson C.; Jadbabaie F.; Pinto D.; McCullough L.; Silverman I.E.;
Sansing L.H.; Dearborn-Tomazos J.; Foody J.; Schindler J.; Piazza G.;
Chakrabarti A.; Pride Y.; Gelfand E.; Baultrukonis D.; Chaudhuri S.;
Frederich R.; Johnson M.; Mridha K.; Powell C.; Wang E.; Wei C.; Anderson
P.; Buonanno M.; Epsley C.; Evans B.; Frolova M.; Goetsch M.; Hessinger
D.; Ikehara E.; Ivanac K.; Kizko J.; Le K.; McNally-Dufort C.; Morocco T.;
Nadkarni S.; Nye R.; Pak R.; Pence D.; Redifer P.; Sattler C.; Schade R.;
Sullivan B.; Wegner J.; Alvarez C.A.; Budassi N.; Vogel D.R.; Avaca H.;
Conde D.G.; Estol C.C.; Gelersztein E.; Glenny J.A.; Hershson A.R.; Bruno
R.L.; Maffei L.E.; Soler J.M.; Zaidman C.J.; Carnero G.S.; Colombo H.R.;
Jure H.O.; Luquez H.A.; Ramos H.R.; Resk J.H.; Rusculleda M.M.; Ulla M.R.;
Caccavo A.; Farias E.F.; Wenetz L.M.; Cabella P.R.; Cuadrado J.A.; Chahin
M.; Mackinnon I.J.; Zarandon R.B.; Schmidberg J.; Fernandez A.A.; Montana
O.; Codutti O.R.; Gorosito V.M.; Maldonado N.; Sala J.; De La Fuente R.A.;
Casabella T.E.; Di Gennaro J.P.; Guerrero R.A.; Alvarez M.S.; Berli M.;
Botta C.E.; Montenegro E.E.; Vico M.L.; Begg A.; Lehman R.; Gilfillan
C.P.; d'Emden M.; Markovic T.P.; Sullivan D.; Aroney C.; Stranks S.N.;
Crimmins D.S.; Arstall M.; Van Gaal W.; Davis T.; Aylward P.E.; Amerena
J.; William M.; Proietto J.; Purnell P.W.; Singh B.; Arya K.W.; Dart A.M.;
Thompson P.; Davis S.M.; Carroll P.A.; De Looze F.; Jayasinghe R.; Bhindi
R.; Buysschaert I.; Sarens T.; van de Borne P.; Scott B.P.; Roosen J.;
Cools F.; Missault L.H.; Debroye C.; Schoors D.F.; Hollanders G.; Schroe
H.H.; De Sutter J.; Hermans K.; Carlier M.; van Landegem P.; Verwerft J.;
Mulleners T.; Delforge M.D.; Soufflet V.; Elegeert I.; Descamps O.S.;
Janssens S.; Lemmens R.C.; Desfontaines P.; Scheen A.; Heijmans S.; Capiau
L.; Vervoort G.; Carlier S.G.; Faes D.; Alzand B.; Keuleers S.; De Wolf
L.; Thoeng J.; De Bruyne L.; de Santos M.O.; Felicio J.S.; Areas C.A.;
Figueiredo E.L.; Michalaros Y.L.; Neuenschwander F.C.; Reis G.; Saad J.A.;
Kormann A.P.; Nascimento C.V.; Precoma D.B.; Abib E.; dos Santos F.R.;
Mello Y.G.; Saraiva J.F.; Rech R.L.; Cerci R.; Fortes J.A.; Rossi P.R.; de
Lima e Silva F.A.; Hissa M.; Silva R.P.; de Souza W.K.; Guimaraes Filho
F.V.; Mangili O.C.; de Oliveira Paiva M.S.; Tumelero R.; Abrantes J.A.;
Caramori P.R.; Dutra O.P.; Leaes P.E.; Manenti E.R.; Polanczyk C.A.;
Bandeira e Farias F.A.; de Moraes Junior J.B.; Russo L.A.; Alves A.R.;
Dracoulakis M.D.; Ritt L.E.; Saporito W.F.; Herdy A.H.; Maia L.N.;
Sternieri M.V.; Ayoub J.C.; Bianco H.T.; da Costa F.A.; Eliaschewitz F.G.;
Fonseca F.A.; Nakandakare E.R.; Bonansea T.C.; Castro N.M.; de Barros e
Silva P.G.; Smith P.; Botelho R.V.; Resende E.S.; Barbieri D.S.; Hernandes
M.E.; Bajaj H.; Beaudry P.; Berlingieri J.C.; Salter T.J.; Ajala B.;
Anderson T.J.; Nanji A.; Ross S.; Pandey S.; Desrosiers D.; Gaudet D.;
Moran G.; Csanadi M.A.; St-Amour E.; Cusimano S.; Halperin F.A.; Babapulle
M.; Vizel S.; Petrella J.; Spence J.D.; Gupta N.; Tellier G.; Bourgeois
R.; Gregoire J.C.; Wesson T.; Zadra R.; Twum-Barima D.Y.; Cha J.Y.;
Hartleib M.C.; Bergeron J.; Chouinard G.; McPherson T.P.; Searles G.;
Peterson S.R.; Mukherjee A.; Lepage S.; Conway J.R.; Kouz S.M.; Dion D.;
Pesant Y.; Cheung S.S.; Goldenberg R.M.; Aronson R.; Gupta A.K.; O'Mahoney
M.; Pliamm L.; Teitelbaum I.; Hoag G.N.; Nadra I.J.; Yared Z.; Yao L.C.;
Nguyen T.; Saunders K.K.; Potthoff S.; Varleta P.; Assef V.; Godoy J.G.;
Olivares C.; Roman O.; Vejar M.; Montecinos H.; Pincetti C.; Li Y.; Wang
D.; Li J.; Yang X.; Du Y.; Wang G.; Yang P.; Zhang X.; Xu P.; Zhao Y.;
Chen J.; Li S.; Li W.; Zhang L.; Zhu Y.; Zhang Y.; Zhou C.; Wang Y.; Liu
F.; Ma Y.; Ti Z.; Zeng X.; Zhou Y.; Cui G.; Li D.; Xue L.; Jiang J.; Lian
Y.; He Y.; Mendoza J.A.; Bonfanti J.A.; Dada F.A.; Urina-Triana M.A.;
Rodriguez W.R.; Sanchez M.L.; Lozno H.Y.; Triana E.H.; Arambula R.M.;
Rico-Carrillo A.E.; Gallo H.J.; Catano J.S.; Jattin F.G.; Plazas J.A.;
Gomez J.E.; Botero-Lopez R.; Gomez N.I.; Munoz C.F.; Pelaez S.V.; Eraso
A.M.; Goyes A.R.; Elbl L.; Fiserova N.; Vesely J.; Wasserburger B.; Blaha
V.; Vojacek J.; Maskova P.; Hutyra M.; Vrkoc J.; Hala T.; Vodnansky P.;
Bocek P.; Cifkova R.; Bufka V.; Ceska R.; Machkova M.; Zidkova E.; Lukac
M.; Mikusova T.; Kellnerova I.; Kuchar L.; Ferkl R.; Cech V.; Zemek S.;
Monhart Z.; Davidsen F.; Joensen A.; Lihn A.S.; Rasmussen T.K.; Wiggers
H.; Lindgren L.M.; Schmidt U.; Galatius S.; Sillesen H.; Bronnum Schou J.;
Thomsen K.K.; Urhammer S.; Jeppensen J.; Schou M.; May O.; Steffensen R.;
Nielsen W.B.; Nielesen T.; Jepsen J.M.; Rai A.; Sykulski R.; Andersen
L.T.; Rickers H.; Frost L.; Lomholdt J.; Egstrup K.; Wermuth S.; Klausen
L.; Lassus J.; Palomaki A.; Khari J.; Tatlisumak T.; Kekki S.; Vanttinen
E.; Strandberg A.; Valtonen M.; Sia S.M.; Nerg O.; Puhakka M.; Strand J.;
Timonen M.; Levola J.; Arstila L.; Taurio J.; Kantola I.; Suomi J.;
Humaloja K.; Askonen K.; Schiele F.; Sibon I.; Zemour G.; Goube P.; Petit
C.; Chati Z.; Range G.; Rabahi F.; Rihani R.; Bergerot C.; Roubille F.;
Boye A.; Probst V.; Ferrari E.; Cayla G.; Thouvenot E.; Delarche N.;
Couffinhal T.; Coisne D.; Paillard F.; Elbaz M.; Decoulx E.; Angoulvant
D.; Agraou B.; Caudmont S.; Berrouschot J.; Lauer B.; Schoell I.; Trenk
D.; Derwahl K.M.; Khariouzov A.; Proepper F.; Stawowy P.; Da Stephan U.;
Stoessel J.; Voehringer H.F.; Dorsel T.; Stellbrink C.; Rinke A.;
Northroff J.; Bourhaial H.; Stratmann M.; Wetzel T.; Axthelm C.; Guenzel
A.; Weigmann I.; Faghih M.; Hagemann D.; Schaefer A.; Weber D.; Luedemann
J.; Contzen C.; Kornmann M.O.; Winkelmann B.; Simon J.; Felix S.; Brauer
C.; Laufs U.; Schmidt E.; Marten I.; Licka M.; Heisters J.; Appel K.F.;
Kleinecke-Pohl U.; Klein C.; von Hodenberg E.F.; Maus O.; Sigal H.;
Taeschner H.; Schwimmbeck P.; Lemke B.; Perings C.; Illies G.; Pfuetzner
A.; Salbach P.; Hengstenberg C.; Kohler A.; Mudra H.; Behnke T.; Baar M.;
Jeserich M.; Scholz G.; Naudts I.; Voller H.; Herrmann H.J.; von
Engelhardt C.B.; Gerke S.; Pohlmeier L.; Schaufele T.; Woehrle J.;
Al-Zoebi A.; Horacek T.; Peterfai E.; Kemeny V.; Lakatos F.; Bod E.;
Andrassy P.; Andreka P.; Balo T.; Davidovits Z.; Laszlo Z.; Nagy K.; Papp
A.; Somogyi A.; Toldy-Schedel E.; Vertes A.; Voros P.; Paragh G.; Martyin
T.; Hajdu C.; Deak L.; Farago K.; Nagy A.; Kirschner R.; Koszegi Z.;
Zilahi Z.; Toth K.; Wittmann I.; Bajcsi D.; Reiber I.; Toth L.; Benczur
B.; Nagy L.; Sydo T.; Lupkovics G.; Oroszlan T.; Crean P.; Mahon N.G.;
McAdam B.; MacNeill B.; Katz A.; Tsalihin D.; Vazan A.; Eitan A.; Lewis
B.S.; Gavish D.; Wainstein J.; Mosenzon O.; Mosseri M.; Vishlitzky V.;
Atar S.; Nseir W.B.; Brenner H.; Elis A.; Fuchs S.; Shimon I.; Solodky A.;
Goldhaber A.; Tanne D.; Knobler H.; Kracoff O.H.; Hussein O.; Auriel E.;
Chorin E.; Sharir T.; Bitzur R.; Shechter M.; Antonicelli R.; Franceschini
E.; Porcu M.; Sesti G.; Maggiolini S.; Salvioni A.; Filardi P.P.; Trimarco
B.; Averna M.; Pasqualini L.; Pirro M.; Pantaleoni M.; Piovaccari G.; Arca
M.; Fedele F.; Roncon L.; Anselmi M.; Sganzerla P.; Morocutti G.; Bonora
E.; Dimas A.L.; Esperon G.A.; Morales-Villegas E.; Isunza J.M.; Beltran
L.G.; Molina C.A.; Garcia D.K.; Ruiz L.A.; Reyna L.S.; De los Rios Ibarra
M.O.; Soto J.R.; Gonzalez-Ortiz M.; Herrera-Marmolejo M.; Ramos S.A.;
Ramos-Lopez G.A.; Stobschinski C.A.; AguilarSalinas C.A.; Alpizar-Salazar
M.; Jimenez-Sanchez M.; Sanchez Mijangos J.H.; Elizondo Moreno E.R.;
Garcia Castillo A.; Garcia Hernandez P.A.; Gonzalez-Gonzalez J.G.; Riojas
Charles C.M.; Valdez Lopez H.G.; Nuriulu Escobar P.L.; Lechuga Martin del
Campo A.; Castro Montes B.E.; Mendez Bucio A.; Rodriguez-Briones I.; Torre
Amione G.; Violante Ortiz R.; Luna Ceballos R.I.; Lopez Rosas E.; Bax
W.A.; Alhakim M.; van de Wiel A.; Liem S.S.; Groutars R.G.; Herrman J.P.;
Hovingh G.K.; van de Wetering M.L.; van Royen N.; Groenemeijer B.E.;
Hoedemaker G.; Schaap J.; Ronner E.; Angun M.; Mairuhu A.T.; Van Alem
A.P.; Martens F.M.; Heijmeriks J.A.; van Hal J.M.; Schoofs M.W.; den
Hartog F.R.; Kentgens S.; Post J.C.; Louwerenburg J.W.; van Rossum P.;
Viergever E.P.; Donders S.H.; Kamphuisen P.W.; van Beek E.; Nijmeijer R.;
Lenderink T.; Schreuder T.; Kuijper A.F.; The S.H.; Van het Hof-Wiersma
J.J.; Tichelaar P.; Westerndorp I.; Breedveld R.W.; Karalis I.; Romer
T.J.; Bogaard K.; Van Koningsbruggen P.; Kroon A.A.; Hoogslag P.A.;
Rensing B.J.; Cramer E.; Remmen J.J.; Riksen N.P.; Bokern M.J.; Cabezas
M.C.; Mulder H.; Nierop P.R.; van Kempen W.W.; Zoet-Nugteren S.K.; van
Daele M.E.; Swart H.P.; van der Zwaan C.T.; Hermans W.R.; Magro M.; van de
Wal R.M.; Hassink R.J.; Visseren F.; Veenendaal A.; De Nooijer C.; Troquay
R.P.; Imholz B.P.; van der Meer P.; Visser R.P.; van Leendert R.J.;
Gosselink M.A.; Baker J.; Benatar J.R.; Kerr J.; Pryke J.R.; Scott R.S.;
Millar-Corte G.D.; Williams M.; Montgomery B.; Venter D.J.; Ternouth I.F.;
DeCaigney S.C.; Hart H.H.; Corin A.; Garden P.I.; Sheahan D.; Harding
S.A.; Korecki J.; Supronik J.; Styczkiewicz M.; Bijata-Bronisz R.; Rusicka
T.; Walczak M.; Krolikowski Z.; Ostrowski J.; Lukaszewicz M.;
Przekwas-Jaruchowska M.; Zieba B.; Miekus P.; Orkwiszewska-Nalewajko A.;
Piepiorka M.; Kubalski P.; Wychota K.; Blach E.; Ochala A.; Okopien B.;
Wronska D.; Janion M.; Czarnecka D.; Kolodziejczyk J.; Konieczynska M.;
Landa K.; Mirek-Bryniarska E.; Necki M.; Pasternak D.A.; Rozpondek P.;
Trebacz J.; Walczewska J.; Sidor M.; Broncel M.; Drozdz J.; Kosmider M.;
Saryusz-Wolska M.; Kucharska D.; Opalinska E.; Pijanowski Z.; Wozniak I.;
Banaszkiewicz K.; Klecha A.; Horodecki M.; Piskorz-Wapinska J.;
Kobielusz-Gembala I.; Kim M.H.; Kim D.K.; Cho B.R.; Kim K.S.; Her S.H.;
Lee S.Y.; Rhee M.Y.; Kim K.; Kang W.C.; Kim D.H.; Cho Y.S.; Kim S.H.; Rim
S.J.; Tahk S.J.; Jeon H.K.; Yoon J.; Mociran M.; Pop C.F.; Minescu B.;
Andrei L.D.; Radoi M.; Calin A.; Ciomag R.M.; Copaci I.; Fruntelata A.G.;
Popescu M.; Tivadar S.; Roman G.; Avram R.I.; Mistodie C.V.; Morosanu M.;
Popa A.R.; Popescu M.L.; Popoviciu M.S.; Tase A.; Busegeanu M.; Popescu
A.; Szilagyi I.; Sitterli-Natea C.N.; Maximov D.M.; Munteanu M.; Negrisanu
G.D.; Kuzin A.; Popov D.; Shapovalova J.; Vishneva E.; Shutemova E.;
Pasechnik E.; Bogdanov E.; Khasanov N.; Barbarash O.L.; Shangina O.A.;
Tarasov N.; Solonev O.; Kosmacheva E.; Chernyatina M.A.; Ginzburg M.;
Blokhin A.; Bulanova N.; Drapkina O.M.; Gordeev I.G.; Libov I.A.; Lomakin
N.; Panchenko E.; Shogenov Z.S.; Zateyshchikov D.; Klein G.; Motylev I.;
Belenkiy D.I.; Demin A.; Nikolaev K.Y.; Oleynikov V.; Zrazhevskiy K.;
Katelnitskiy I.; Khaisheva L.; Aksentiev S.; Nedoshivin A.; Popova V.B.;
Agafina A.S.; Ballyuzek M.; Baranova E.; Burova N.; Eryshev S.; Filippov
A.; Goloshchekin B.M.; Konstantinov V.; Kostenko V.A.; Simanenkov V.I.;
Volkova A.; Duplyakov D.; Reshetko O.; Shvarts Y.; Kuznetsov V.A.;
Samoylova Y.G.; Tolkacheva V.; Shalaev S.V.; Khokhlov A.L.; Malygin A.;
Shilkina N.P.; Yakusevich V.V.; Margoczy R.; Zubek V.; Dzupina A.; Dubrava
J.; Dulkova K.; Fabryova L.; Gaspar L.; Kamensky G.; Kokles M.; Raslova
K.; Soosova I.; Stevlik J.; Strbova J.; Sumbal J.; Uhliar R.; Micik J.;
Truban J.; Fedacko J.; Pastrnakova E.; Pella D.; Fazekas F.; Ambrovicova
V.; Kycina P.; Martinka E.; Nociar J.; Belicova M.; Banik M.; Kanderkova
D.; Hranai M.; Duris T.; Krahulec B.; Benacka J.; Vinanska D.; Roskova E.;
Skripova D.; Macek V.; Vohnout B.; Buganova I.; Engelbrecht J.M.;
Pretorius M.M.; Ebrahim I.O.; Bayat J.; Ganesh S.; Ranjith N.; Coetzer
T.F.; Jacovides A.; Distiller L.A.; Hellig F.S.; Engelbrecht I.V.; Mahomed
A.A.; Blignault S.C.; Burgess L.J.; Kotze H.J.; van Nieuwenhuizen E.;
Musungaie D.B.; Emanuel S.; van der Walt E.; Pretorius C.E.; Roos J.S.;
Roux S.M.; Badat A.E.; Fouche L.; Vahed Y.A.; Jansen van Resburg D.; van
Zyl L.J.; Soto Gonzalez A.; Diaz J.L.; Segura T.; Botella Serrano M.;
Botas Rodrigues J.; Molto-Jorda J.M.; Dominguez Escribano J.R.; Sogorb
Garri F.; Blanco Coronado J.L.; Gaztambide Saenz M.S.; Brotons Cuixart C.;
Bruguera Cortada J.; Garcia-Moll Marimon X.; Gonzalbez Morgaez J.D.;
Maisterra Santos O.; Roquer Gonzalez J.; Sobrino-Martinez J.; Chueca
Fernandez J.E.; Narejos S.; Suarez Garcia S.; Perez Martinez P.; Figueras
Camos R.; Medrano Martinez V.; Bellido Guerrero D.; Martinez Deben F.;
Vila Belmonte A.; Mediavilla Garcia J.D.; Romero Hinojosa J.A.; Martorell
Mateu E.; Cequier Fillat A.R.; Pinto Sala X.; Adroer Martori R.; Bueno
Diez M.; Lopez Cano C.; Worner Diz F.; Gonzalez Juanatey C.; Alvarez-Sala
Walther L.A.; De Dios Garcia Diaz J.; Garcia Puig J.; Jodar Gimeno E.;
Plaza Perez I.; Suarez-Fernandez C.; Tunon J.; Zamorano Gomez J.L.; Brito
Sanfiel M.A.; Escudier Villa J.M.; de Mora Martin M.; Dominguez Lopez M.;
Hernandez Garcia J.M.; Tinahones Madueno F.J.; Perez Paredes M.; Aracil
Villar J.; Barreda Gonzalez M.J.; Ripoll Vera T.V.; Tofe Povedano S.;
Sanchez Alvarez J.; Martinez Via L.; Robles Iniesta A.; Masana L.;
Vinyoles Bargallo E.; Calvo Gomez C.; Gonzalez Juanatey J.R.; Cruz
Fernandez J.M.; De La Cuesta Mayor C.; Duran Garcia S.; Jimenez Hernandez
M.D.; Morales Portillo C.; Muniz Grijalvo O.; De Castro R.; Taverna
Llaurado E.; Pons Amate J.M.; Terns Riera M.; Linderfalk C.; Curiac D.;
Saldeen-Nilehn K.; Koskinen P.; Khalili P.; Tortensson I.; Lindholm C.J.;
Luts A.; Koskinen P.T.; Gottsater A.; Persson B.E.; Mooe T.; Larnefeldt
H.; Boman K.; Crisby M.; Rasmanis G.; Tengmark B.O.; Witt N.; Hagstrom E.;
Viklund J.; Muller C.; Mach F.; Burnier M.; Nanchen D.; Wuerzner G.;
Banyai M.; Moccetti T.; Miserez A.R.; Bilz S.; Weber K.; Lai W.T.; Chang
K.C.; Ueng K.C.; Tsai W.C.; Chiang C.E.; Hou C.; Pei D.; Krittayaphong R.;
Kiatchoosakun S.; Srimahachota S.; Boonyavarakul A.; Jintapakorn W.; Gullu
H.; Onrat E.; Erkan A.F.; Demirci D.; Sari R.; Ceyhan C.; Ari H.; Araz M.;
Degertekin M.; Goktekin O.; Uresin A.Y.; Yigit Z.; Akdeniz B.; Comlekci
A.; Kayikcioglu M.; Sahin T.; Ozcan T.; Durakoglugil E.; Asamoah-Owusu N.;
Reed R.; Bakhai A.; Dixon L.; Sharma R.; Avornyo A.A.; Jones A.F.; Lip G.;
Clark R.; Banerjee M.; Wakeling J.; Arden C.; Blagden M.D.; Walukiewica
P.; Marshall A.; Maxwell T.G.; Gunstone A.E.; Kadr H.H.; Patle R.; Arif
I.; Jhund P.S.; McKaig G.; Douglas F.; Mierzejewski L.; Turner W.;
Sathyapalan T.; Ivan P.; Manoj A.; Rice S.; Collier D.J.; Nair D.R.; Thom
S.; Fiore G.; De Belder M.; Price D.; Sobolewska J.; Martin S.; Takhar A.;
Moriarty A.; Kondagunta V.; Myhill T.; Gibson J.M.; Cecil J.T.; Halcox J.;
Annamalai N.; Gorog D.A.; McCormack T.; Pegge N.; Field A.; Adams F.;
Klein J.J.; Busch R.S.; Bretton E.M.; Jaffrani N.; Salacata A.;
Assadourian A.; Gogia H.S.; Dyke C.K.; Rubenfire M.; Essandoh L.K.; Welker
J.A.; Ledesma G.; Lupovitch S.; Delgado J.P.; Hendrix E.L.; Quyyumi A.A.;
Riesenberg R.A.; Robertson D.G.; Weinstein D.L.; Weiss R.; Casaubon L.;
Gammon R.S.; Brar H.S.; Bittar G.D.; Guarnieri T.T.; Ince C.S.; Quraishi
A.M.; Saeed S.; Albert M.; Sotolongo R.P.; Bernard J.V.; Karlsbergg R.P.;
Lepor N.E.; Kirby W.E.; McLean B.; Ovalle F.; Townsend J.C.; Beckett P.L.;
Eaves W.B.; West S.H.; Kosinski E.J.; Zarich S.W.; Mahal S.S.; Maw K.;
Maynard K.M.; Chen J.C.; Gelormini J.; Gottlieb D.W.; Gabra N.W.; Narayan
P.; Sparks J.; Field J.C.; Willits V.L.; O'Steen M.B.; Pasquini J.A.;
Sensebrenner J.W.; Yarows S.A.; Hiotis L.; Jagielo T.J.; Levinson D.J.;
Diller P.M.; Kereiakes D.J.; Turner T.A.; Vincent S.; Camp A.D.; Denker
P.S.; Manning M.B.; Rocco M.B.; Stamps H.B.; Strader J.R.; Uusinarkaus
K.T.; Kennett J.D.; Leichter S.B.; McNeil D.L.; Schumacher D.R.; Chang
A.R.; Ellison H.S.; Updegrove J.D.; Hamroff G.S.; Kay J.S.; Marar I.E.;
Flores E.; Saini S.; Abdullah S.; Berk M.R.; Fordan S.; Joshi P.H.;
McCullough P.A.; Reynolds R.D.; Rosenstock J.; Sachson R.A.; Shammas N.;
Fishbein G.J.; Randall W.J.; Henderson D.A.; Nash M.L.; Barker B.A.; Cohen
S.S.; Seidman B.; Odekirk L.L.; Grillo R.S.; Martinez L.M.; Multani P.;
Alwine L.K.; McGarvey J.F.; Mollerus M.E.; Miller A.B.; Kotek L.W.;
Changlani M.; Zavaro S.H.; Munoz F.; Mehta P.M.; Helm R.J.; Farhat N.Z.;
Farsad R.; Raoof T.J.; Shultz J.H.; Geohas J.G.; Allaw M.A.; Dela Llana
A.; Gutmann J.E.; Inzerello A.T.; Alappat P.; George A.R.; Haddad T.M.;
Lillestol M.J.; Grodman R.; Peniston J.H.; Wadud K.; Garcia B.; Hamilton
M.E.; Lerman S.; Perloff D.E.; Graff A.; Saxena S.; Alvarado O.P.; Malik
A.; Reddy R.D.; Kinzfogl G.; Cornett G.M.; Norwood P.C.; Gilbert J.M.;
Willis J.G.; McGrew F.; Sharma S.; Castro M.A.; Cucher F.H.; Altafullah
I.M.; Khurana S.; Knutson T.J.; Kinnaman S.J.; Stuckey T.; Pudi K.K.;
Mayfield R.K.; Funk G.S.; Nixon W.A.; Dor I.; Boyett B.E.; Srivastava S.;
Elosegui A.M.; Isserman S.M.; Cheek H.B.; Promisloff S.D.; Tami L.F.; Zeig
S.; fitz-Patrick D.; Dave K.N.; Ahmad A.; Arain S.; Ballantyne C.M.; Doshi
A.; El Hafi S.E.; Feldman J.; Fragoso V.G.; Gilford T.; Hoffman A.S.;
Pouzar J.E.; Vivekananthan K.; Ansari S.H.; Strzinek R.A.; Crater T.A.;
Robinson J.G.; Fulmer J.J.; Patel A.M.; Pereira E.S.; Stich M.A.; Sultan
S.; Geskin G.; Ruoff G.E.; Gillespie E.; Bybee K.A.; Moriarty P.M.; Savin
V.; Agaiby J.M.; Melucci M.B.; Jantzi C.M.; Davidson E.; Smith W.B.;
Treasure C.B.; Wakefield P.H.; Deck K.; Edris M.A.; Gilmore R.M.; Seep
M.K.; Andersen J.L.; Detweiler R.O.; Rosenfeld J.C.; Strobl D.J.;
Steinhoff J.P.; Adams A.; Estevez R.; Molin C.J.; Kim C.Y.; Dy J.; Fox
K.E.; Farris N.R.; Wayne J.D.; Whitney R.T.; Randhawa P.M.; Mego D.M.;
MacDolnald L.; Caputo R.P.; Rigolosi R.; VanNatta B.; Pacheco T.R.;
El-Shahawy M.; Gonzalez E.J.; Guice M.J.; Cherlin R.S.; Bays H.E.;
Shoukfeh M.; Morris F.H.; Loy J.; Vora S.K.; Staab P.K.; Frisoli A.;
Kimmel M.A.; Cohen A.J.; Green C.B.; Whitlock L.; Butuk D.J.; McCartney
M.J.; Ables L.R.; Acosta R.; Alvarez J.G.; Barrera C.M.; Benitez O.;
Berenguer R.A.; Breton C.F.; Chiong R.; Delgado M.I.; Dufreny A.; Fialkow
J.A.; Franczek S.; Frias J.J.; Iglesias C.; Landron-Garcia L.; Llerena
S.N.; Martinez R.F.; Miranda A.A.; Morytko J.A.; Rodriguez I.J.; Sotolongo
R.; Suarez-Sarmiento A.; Terrelonge A.E.; Vaca C.E.; Venereo J.M.; Verdeza
C.; Zeno M.L.; Chilka S.; Felten W.R.; Hartman A.N.; Shayani S.S.; Duprez
D.; Knickelbine T.; Chambers J.D.; Cone C.L.; Broughton R.; Napoli M.C.;
Seaton B.L.; Smith S.K.; Reedy M.A.; Kesani M.K.; Nicol P.R.; Stringam
S.O.; Talano J.V.; Barnum O.; Desai V.; Montero M.; Jacks R.K.; Kostis
J.B.; Owen J.G.; Makam S.K.; Grosman I.; Underberg J.A.; Masri B.E.;
Peters S.S.; Serje J.; Lenhard M.J.; Glover R.; Paraboschi C.F.; Lim E.H.;
Connery L.; Kipgen W.; Bravo P.; DiGiovanna M.J.; Tayoum H.; Gabriel J.D.;
Ariani M.K.; Robinson M.F.; Clemens P.C.; Corder C.N.; Schifferdecker B.;
Tahirkheli N.K.; Hurling R.T.; Rendell M.S.; Shivaswamy V.; Madu I.J.;
Dahl C.F.; Ayesu K.; Kim C.; Barettella M.B.; Jamidar H.A.; Bloom S.A.;
Vora K.N.; Ong S.T.; Aggarwala G.; Sack G.; Blaze K.; Krichmar P.; Murcia
A.; Teltser M.; Villaman-Bencosme Y.; Fahdi I.E.; Williams D.G.; Lain
E.L.; Garcia H.L.; Karim S.N.; Francyk D.M.; Gordon M.B.; Palchick B.A.;
McKenzie M.E.; Gimness M.P.; Greiff J.; Ruiz-R L.; Vazquez-Tanus J.B.;
Schlager D.; Connelly T.; Soroka E.; Hastings W.L.; O'Dea D.J.; Purdy
D.A.; Jackson B.; Arcanese M.L.; Strain J.E.; Schmedtje J.F.; Davis M.G.;
Prasada S.; Scott D.L.; Vukotic G.; Akhtar N.; Larsen D.C.; Rhudy J.M.;
Zebrack J.S.; Bailey S.R.; Grant D.C.; Mora A.; Perez J.A.; Reyes R.G.;
Sutton J.C.; Brandon D.M.; First B.P.; Risser J.A.; Claudio J.;
Figueroa-Cruz W.L.; Sosa-Padilla M.A.; Tan A.E.; Traboulssi M.A.; Morcos
N.C.; Glaser L.A.; Bredlau C.E.; El Shahawy M.; Ramos M.J.; Kandath D.D.;
Kaluski E.; Akright L.; Rictor K.W.; Pluto T.M.; Hermany P.R.; Bellingar
B.; Clark G.B.; Herrod J.N.; Goisse M.; Hook M.; Barrington P.; Lentz
J.D.; Singal D.K.; Gleason G.P.; Lipetz R.S.; Schuchard T.N.; Bonner J.H.;
Forgosh L.B.; Lefebvre G.C.; Pierpoint B.E.; Radin D.M.; Stoller S.R.;
Segall N.; Shah S.A.; Ramstad D.S.; Nisnisan J.M.; Trippett J.M.; Benjamin
S.A.; Labissiere J.C.; Nashed A.N.; Maaieh M.; Aslam A.A.; Mandviwala M.;
Budoff M.J.; French W.J.; Vlach J.J.; DeStefano P.; Bayron C.J.; Fraser
N.J.; Sandberg J.H.; Fagan T.C.; Peart B.C.; Suryanarayana P.G.; Gupta
D.K.; Lee M.W.; Bertolet B.D.; Hartley P.A.; Kelberman M.; Behmanesh B.;
Buynak R.J.; Chochinov R.H.; Steinberg A.A.; Chandna H.; Bjasker K.R.;
Perlman R.L.; Ball E.M.; Pock J.; Singh S.; Baldari D.; Kaster S.; Lovell
J.P.; Horowitz B.S.; Gorman T.A.; Pham D.N.; Landzberg J.S.; Mootoo K.I.;
Moon E.; Krawczyk J.; Alfieri A.D.; Janik M.J.; Herrington D.M.;
Koilpillai R.N.; Waxler A.R.; Hoffman D.A.; Sahul Z.H.; Gumbiner B.; Cropp
A.; Fujita K.; Garzone P.; Imai K.; Levisetti M.; Plowchalk D.; Sasson S.;
Skaggs J.; Sweeney K.; Vincent J.
Institution
(Ridker, Glynn) Center for Cardiovascular Disease Prevention, Brigham and
Women's Hospital, Harvard Medical School, 900 Commonwealth Ave., Boston,
MA 02215, United States
(Revkin, Brunell, Curto, Masiukiewicz, Schwartz, Yunis, Shear) Pfizer, New
York, United States
(Amarenco) Paris-Diderot Sorbonne Paris Cite University, Paris, France
(Civeira) Universidad de Zaragoza, IIS Aragon, Zaragoza, Spain
(Flather) University of East Anglia, Norwich, United Kingdom
(Soran) Central Manchester University Hospital, Manchester, United Kingdom
(Gregoire, Tardif) Montreal Heart Institute, Universite de Montreal,
Montreal, Canada
(Jukema) Leiden University Medical Center, Leiden, Netherlands
(Kastelein) Academic Medical Center, University of Amsterdam, Amsterdam,
Netherlands
(Mosterd) Meander Medical Center, Amersfoort, Netherlands
(Karpov) Russian Cardiology Research and Production Center, Moscow,
Russian Federation
(Koenig) Deutsches Herzzentrum Munchen, Technische Universitat Munchen,
Munich Heart Alliance, Munich, Germany
(Lorenzatti) Cordoba Hospital, Cordoba, Argentina
(Manga) University of the Witwatersrand, Johannesburg, South Africa
(Miller) University of Maryland, Baltimore, United States
(Murin) University of Comenius, Bratislava, Slovakia
(Nicolau) Heart Institute, University of Sao Paulo Medical School, Sao
Paulo, Brazil
(Santos) Lipid Clinic Heart Institute, University of Sao Paulo Medical
School Hospital, Sao Paulo, Brazil
(Nissen) Cleveland Clinic Foundation, Cleveland, United States
(Ponikowski) Wroclaw Medical University, Wroclaw, Poland
(White) Green Lane Cardiovascular Service, Auckland City Hospital,
Auckland, New Zealand
(Wright) Mayo Clinic, Rochester, MN, United States
(Vrablik) First Faculty of Medicine, Charles University, Prague, Czechia
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Bococizumab is a humanized monoclonal antibody that inhibits
proprotein convertase subtilisin- kexin type 9 (PCSK9) and reduces levels
of low-density lipoprotein (LDL) cholesterol. We sought to evaluate the
efficacy of bococizumab in patients at high cardiovascular risk. METHODS
In two parallel, multinational trials with different entry criteria for
LDL cholesterol levels, we randomly assigned the 27,438 patients in the
combined trials to receive bococizumab (at a dose of 150 mg)
subcutaneously every 2 weeks or placebo. The primary end point was
nonfatal myocardial infarction, nonfatal stroke, hospitalization for
unstable angina requiring urgent revascularization, or cardiovascular
death; 93% of the patients were receiving statin therapy at baseline. The
trials were stopped early after the sponsor elected to discontinue the
development of bococizumab owing in part to the development of high rates
of antidrug antibodies, as seen in data from other studies in the program.
The median follow-up was 10 months. RESULTS At 14 weeks, patients in the
combined trials had a mean change from baseline in LDL cholesterol levels
of -56.0% in the bococizumab group and +2.9% in the placebo group, for a
between-group difference of -59.0 percentage points (P<0.001) and a median
reduction from baseline of 64.2% (P<0.001). In the lower-risk,
shorter-duration trial (in which the patients had a baseline LDL
cholesterol level of >=70 mg per deciliter [1.8 mmol per liter] and the
median follow-up was 7 months), major cardiovascular events occurred in
173 patients each in the bococizumab group and the placebo group (hazard
ratio, 0.99; 95% confidence interval [CI], 0.80 to 1.22; P = 0.94). In the
higher-risk, longer-duration trial (in which the patients had a baseline
LDL cholesterol level of >=100 mg per deciliter [2.6 mmol per liter] and
the median follow-up was 12 months), major cardiovascular events occurred
in 179 and 224 patients, respectively (hazard ratio, 0.79; 95% CI, 0.65 to
0.97; P = 0.02). The hazard ratio for the primary end point in the
combined trials was 0.88 (95% CI, 0.76 to 1.02; P = 0.08). Injection-site
reactions were more common in the bococizumab group than in the placebo
group (10.4% vs. 1.3%, P<0.001). CONCLUSIONS In two randomized trials
comparing the PCSK9 inhibitor bococizumab with placebo, bococizumab had no
benefit with respect to major adverse cardiovascular events in the trial
involving lower-risk patients but did have a significant benefit in the
trial involving higher-risk patients. Copyright © 2017
Massachusetts Medical Society. All rights reserved.

<86>
Accession Number
2018161681
Title
Treatment of Hyperlactatemia in Acute Circulatory Failure Based on
CO<inf>2</inf>-O<inf>2</inf>-Derived Indices: Study Protocol for a
Prospective, Multicentric, Single, Blind, Randomized, Superiority Study
(The LACTEL Study).
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 898406. Date of Publication: 23 Jun 2022.
Author
Caruso V.; Besch G.; Nguyen M.; Pili-Floury S.; Bouhemad B.; Guinot P.-G.
Institution
(Caruso, Nguyen, Bouhemad, Guinot) Anaesthesiology and Critical Care
Department, Dijon Bourgogne University Hospital, Dijon, France
(Caruso, Nguyen, Bouhemad, Guinot) University of Burgundy Franche-Comte,
LNC UMR1231, Dijon, France
(Besch, Pili-Floury) Department of Anesthesiology and Intensive Care
Medicine, University Hospital of Besancon, Besancon, France
(Besch, Pili-Floury) EA3920, University of Franche-Comte, Besancon, France
Publisher
Frontiers Media S.A.
Abstract
Background: Hyperlactatemia is a biological marker of tissue hypoperfusion
with well-known diagnostic, prognostic, and therapeutic implications in
shock states. In daily clinical practice, it is difficult to find out the
exact mechanism underlying hyperlactatemia. Central venous to arterial
CO<inf>2</inf> difference (pCO<inf>2</inf> gap) is a better parameter of
tissue hypoperfusion than the usual ones (clinical examination and mixed
venous saturation). Furthermore, the ratio between the pCO<inf>2</inf> gap
and p(v-a)CO<inf>2</inf>/C(a-v)O<inf>2</inf> may be a promising indicator
of anaerobic metabolism, allowing for the identification of different
causes of tissue hypoxia and hyperlactatemia. The main aim of the study is
to demonstrate that initial hemodynamic resuscitation based on an
algorithm integrating the pCO<inf>2</inf> gap and
p(v-a)CO<inf>2</inf>/C(a-v)O<inf>2</inf> ratio vs. usual clinical practice
in acute circulatory failure improves lactate clearance. Method(s):
LACTEL is a randomized, prospective, multicentric, controlled study. It
compares the treatment of hyperlactatemia using an algorithm based on the
pCO<inf>2</inf> gap and P(v-a)CO<inf>2</inf>/C(a-v)O<inf>2</inf> ratio vs.
usual clinical practice in acute circulatory failure. A total of 90
patients were enrolled in each treatment group. The primary endpoint is
the number of patients with a lactate clearance of more than 10% 2 h after
inclusion. Lactate levels were monitored during the first 48 h of
treatment as hemodynamic parameters, biological markers of organ failure,
and 28-day mortality. Discussion(s): pCO<inf>2</inf> derivate indices
may be of better interest than routine clinical indices to differentiate
causes of hyperlactatemia and diagnose anaerobiosis. LACTEL results will
provide clinical insights into the role of these indices in the early
hemodynamic management of acute circulatory failure in the ICU. Clinical
Trial Registration: www.clinicaltrials.gov; identifier:
NCT05032521. Copyright © 2022 Caruso, Besch, Nguyen, Pili-Floury,
Bouhemad, Guinot and the Lactel Study Group.

<87>
Accession Number
2018278516
Title
Prospective, randomized, controlled, noninferiority clinical trial to
evaluate the safety and efficacy of absorbable macroporous polysaccharide
composites as adjunct to hemostasis during open surgery.
Source
Journal of Cardiac Surgery. (no pagination), 2022. Date of Publication:
2022.
Author
Li H.; Li Z.; He X.; Zhang F.; OuYang Z.; Wu G.; Liu P.; Yang S.; Dong L.;
Zhen M.; Xu L.
Institution
(Li, Xu) State Key Laboratory of Molecular Immunology and Molecular
Diagnostics, School of Public Health, Xiamen University, Xiamen, China
(Li) General Surgery, Peking University Third Hospital, Beijing, China
(He, Dong) General Surgery, Tianjin Medical University General Hospital,
Tianjin, China
(Zhang, OuYang) General Surgery, Breast Surgery, The First Affiliated
Hospital of Xiamen University, Xiamen, China
(Wu, Liu, Yang, Zhen) General Surgery, Hepatopancreatobiliary Surgery,
Breast Surgery, Zhongshan Hospital Affiliated to Xiamen University,
Xiamen, China
Publisher
John Wiley and Sons Inc
Abstract
Background: To address intraoperative bleeding in cardiac surgery,
reducing blood transfusion requirements, is mandatory to achieve effective
hemostasis. Hemostatic agents may limit localized persistent bleeding. The
introduction of carboxymethyl-chitosan component into the hemostatic agent
and the application of the radiation crosslinking technique maintain its
capacity for achieving intraoperative hemostasis, thus increasing the
clinical utility. Method(s): A prospective, noninferiority and
randomized controlled clinical trial to compare the safety and efficacy of
absorbable macroporous polysaccharide composites (AMPC, treatment group)
with compound microporous polysaccharide hemostatic powder (CMPHP, control
group) (2:1 ratio) as adjuncts to hemostasis in open surgery. The main
indication was used for hemostasis in various traumatic hemorrhage areas,
including cardiothoracic, vascular, and general surgery. The primary
endpoint was success rate of hemostasis within 300 s (at a 10%
noninferiority margin). The secondary endpoint was hemostasis time. Both
endpoints were assessed in the modified intention-to-treat (MITT)
population. Safety parameters were assessed. This study is fully compliant
with the CONSORT statement. Result(s): Randomized patients in AMPC
and CMPHP groups were 168 and 84, respectively. In MITT population, the
success rates of hemostasis within 300 s were 98.8% (163 of 165) in AMPC
and 94.0% (78 of 83) in CMPHP (treatment difference 4.8% [95% CI -0.57% to
10.20%]). AMPC was thus noninferior to CMPHP. Hemostasis time (median
[interquartile range]) with AMPC (87 [52.5, 180] s) was better than CMPHP
(110 [54.5, 181] s). Changes in laboratory parameters over time and shifts
to abnormal values were typical of surgeries and similar between two
groups. No noticeable adverse effects associated with AMPC or CMPHP were
observed. Conclusion(s): AMPC is well tolerated as topical hemostatic
agent, noninferior to commercial CMPHP, and exhibits excellent safety.
This study provides a novel hemostatic agent which appears to offer
significant clinical advantage in various hemorrhage areas. Copyright
© 2022 Wiley Periodicals LLC.

<88>
Accession Number
638077818
Title
Cardiac Surgery 2021 Reviewed.
Source
Thoracic and Cardiovascular Surgeon. 70(4) (pp 278-288), 2022. Date of
Publication: 01 Jun 2022.
Author
Doenst T.; Schneider U.; Can T.; Caldonazo T.; Diab M.; Siemeni T.; Farber
G.; Kirov H.
Institution
(Doenst, Schneider, Can, Caldonazo, Diab, Siemeni, Farber, Kirov)
Department of Cardiothoracic Surgery, Friedrich-Schiller-University of
Jena, Am Klinikum 1, Jena 07747, Germany
Publisher
Georg Thieme Verlag
Abstract
PubMed displayed more than 35,000 hits for the search term cardiac surgery
AND 2021. We used the PRISMA (Preferred Reporting Items for Systematic
Reviews and Meta-analyses) approach and selected relevant publications for
a results-oriented summary. As in recent years, we reviewed the fields of
coronary and conventional valve surgery and their overlap with their
interventional alternatives. COVID reduced cardiac surgical activity
around the world. In the coronary field, the FAME 3 trial dominated
publications by practically repeating SYNTAX, but with modern stents and
fractional flow reserve (FFR)-guided percutaneous coronary interventions
(PCIs). PCI was again unable to achieve non-inferiority compared with
coronary artery bypass graft surgery (CABG) in patients with triple-vessel
disease. Survival advantages of CABG over PCI could be linked to a
reduction in myocardial infarctions and current terminology was criticized
because the term myocardial revascularization is not precise and does not
reflect the infarct-preventing collateralization effect of CABG. In
structural heart disease, new guidelines were published, providing
upgrades of interventional treatments of both aortic and mitral valve
disease. While for aortic stenosis, transcatheter aortic valve
implantation (TAVI) received a primary recommendation in older and
high-risk patients; recommendations for transcatheter mitral edge-to-edge
treatment were upgraded for patients considered inappropriate for surgery.
For heart team discussions it is important to know that classic aortic
valve replacement currently provides strong signals (from registry and
randomized evidence) for a survival advantage over TAVI after 5 years.
This article summarizes publications perceived as important by us. It can
neither be complete nor free of individual interpretation, but provides
up-to-date information for decision-making and patient
information. Copyright © 2022 Georg Thieme Verlag. All rights
reserved.

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