Myocardial Blood Flow Quantification in Patients with an Implanted Cardiodefibrillator during Stress and at Rest using a Wideband Perfusion Pulse Sequence: An Initial Feasibility Study.

Background: Although a recently developed wideband perfusion sequence has shown diagnostically acceptable image quality and accurate myocardial blood flow (MBF) quantification at rest in patients with cardiac implanted electronic devices (CIEDs), its performance during vasodilator stress remains unproven. This study aims to determine whether the sequence produces diagnostically acceptable image quality during stress and is capable of quantitatively detecting abnormal stress MBF and myocardial perfusion reserve (MPR) in patients with implanted cardiodefibrillators (ICDs).

Methods: We enrolled 29 patients with an ICD (mean age = 63 ± 15 years, 17 males, 12 females) and 11 control patients (mean age = 50 ± 17 years, 6 males, 5 females; negative coronary artery disease; negative stress perfusion CMR; and no cardiac event one year post CMR) with an ICD taped below the left clavicle to mimic image artifacts.

Preclinical MRI of proinflammatory epicardial adipose tissue: Accelerated methods for simultaneous fatty acid composition and relaxation parameter mapping with relationships to tissue biomarkers.

Background: Epicardial adipose tissue (EAT) plays a central role in metabolic heart disease through local inflammatory signaling. In obesity, EAT undergoes pathological remodeling marked by increased adipocyte size, saturated fatty acids (SFAs), macrophage infiltration, and inflammatory cytokine secretion. Proton density fat fraction (PDFF), T, and the fatty acid composition (FAC) (the amount of SFAs, monounsaturated fatty acids [MUFAs], and polyunsaturated fatty acids [PUFAs]) are promising metrics of EAT quality, yet their role as biomarkers of proinflammatory EAT has not been established.

Irreversible Electroporation for Prostate Tissue Ablation in Patients with Intermediate-risk Prostate Cancer: Results from the PRESERVE Trial.

Background And Objective: The PRESERVE study (NCT04972097) assessed the safety and effectiveness of irreversible electroporation (IRE) with the NanoKnife System to ablate prostate tissue in patients with intermediate-risk prostate cancer (PCa).

Methods: This prospective, nonrandomized, single-arm pivotal trial included patients in the USA who met the key inclusion criteria: age >50 yr with organ-confined, grade group 2 or 3 PCa, clinical stage ≤T2c, prostate-specific antigen (PSA) ≤15 ng/ml, or PSA density <0.15 ng/ml.

AGA Clinical Practice Update on Incorporating Functional Lumen Imaging Probe Into Esophageal Clinical Practice: Expert Review.

Description: The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) is to summarize the available evidence and offer expert best practice advice on the incorporation of the functional lumen imaging probe (FLIP) into clinical practice, specifically its utility in the evaluation of esophageal symptoms, esophageal motor dysfunction, gastroesophageal reflux disease, and eosinophilic esophagitis.

Methods: This CPU Expert Review was commissioned and approved by the AGA Institute Governing Board and CPU Committee to provide timely guidance on a topic of high clinical importance to the AGA membership. This CPU Expert Review underwent internal peer review by the CPU Committee and external peer review through the standard procedures of Gastroenterology.

Deep-learning reconstruction for noise reduction in respiratory-triggered single-shot phase sensitive inversion recovery myocardial delayed enhancement cardiac magnetic resonance.

Background: Phase-sensitive inversion recovery late gadolinium enhancement (LGE) improves tissue contrast, however it is challenging to combine with a free-breathing acquisition. Deep-learning (DL) algorithms have growing applications in cardiac magnetic resonance imaging (CMR) to improve image quality. We compared a novel combination of a free-breathing single-shot phase-sensitive LGE with respiratory triggering (FB-PS) sequence with DL noise reduction reconstruction algorithm to a conventional segmented phase-sensitive LGE acquired during breath holding (BH-PS).

Cardiac amyloidosis detection from a single echocardiographic video clip: a novel artificial intelligence-based screening tool.

Background And Aims: Accurate differentiation of cardiac amyloidosis (CA) from phenotypic mimics remains challenging using current clinical and echocardiographic techniques. The accuracy of a novel artificial intelligence (AI) screening algorithm for echocardiography-based CA detection was assessed.

Methods: Utilizing a multisite, multiethnic dataset (n = 2612, 52% CA), a convolutional neural network was trained to differentiate CA from phenotypic controls using transthoracic apical four-chamber video clips.

Cardiac Magnetic Resonance in the Evaluation and Management of Nonischemic Cardiomyopathies.

Cardiac magnetic resonance is an essential tool in the evaluation and management of patients with suspected or diagnosed nonischemic cardiomyopathies (NICMs). It is considered the gold standard for accurately quantifying cardiac chamber dimensions, function, and mass, aiding in the initial diagnosis of myocardial dysfunction and/or dilation. Its unique value lies in its ability to characterize the myocardium using techniques such as late gadolinium enhancement, T1, T2, and T2∗ mapping, and extracellular volume fraction estimation, all of which have been histologically validated in specific clinical scenarios.

Combined Lyon and Milan Scores Predict Gerd Management Outcome Better Than Either Score Alone or Their Individual Components.

Background: Confidence in gastro-oesophageal reflux disease (GERD) diagnosis is crucial to improve outcomes from escalation of treatment. The Lyon score phenotypes patients through endoscopy and pH-impedance (MII-pH). The Milan score quantifies antireflux barrier through high-resolution manometry (HRM) parameters.

The prevalence and prognostic impact of additive abnormal stress exercise markers in patients with normal stress myocardial perfusion imaging.

Background: While the rate of ischemia on stress myocardial perfusion imaging (MPI) has decreased over the last two decades, many symptomatic patients remain at an intermediate to high risk for cardiac events. Exercise workload, heart rate (HR) response, HR recovery, hemodynamic gain index, and blood pressure response to exercise have established prognostic value in isolation; however, the utility of these markers in patients with normal myocardial perfusion and no ischemic electrocardiogram ST segment depression (normal stress MPI) is unknown.

Methods: We performed a retrospective, single-center analysis of abnormal stress exercise markers in 892 patients who had a normal stress MPI from 2015 to 2017.

Disparities in diagnosis and outcomes in American patients with transthyretin cardiac amyloidosis.

Although Afro-Caribbean (AC) race has been associated with worse outcomes in many cardiovascular diseases, its potential association with transthyretin cardiac amyloidosis (ATTR-CA) is less understood. We aimed to assess the relationship between race and serum biomarkers, adverse cardiac remodeling, and outcomes in AC vs white ATTR-CA patients. 114 AC and 117 white patients confirmed ATTR-CA who underwent cardiac magnetic resonance (CMR) exam were identified.

Global Practices in Cardiac Imaging for Cardiac Sarcoidosis: A Survey Study of International Experts With Delphi Consensus.

Background: Cardiac imaging is a cornerstone in the initial diagnosis, management, and follow-up of cardiac sarcoidosis. However, ordering thresholds, access, and follow-up imaging vary across the globe.

Objectives: A Delphi study was conducted to define areas of consensus and areas requiring further study in the use of cardiac imaging in suspected or established cardiac sarcoidosis.

Argyreia nervosa (Brum.f.) Bojer. alleviates diabetes mellitus-induced male infertility.

Background: Diabetes Mellitus (DM) impairs male reproductive functions by modulating apoptosis, oxidation, and the inflammatory pathway. The studies were planned to screen the ability of the hydro-alcoholic extract (AN) prepared using the roots of Argyreia nervosa (A. nervosa) (Burm.

Spinal Anesthesia for Cesarean Section in a Class III Obese Parturient: A Case Report.

The rising prevalence of obesity, including among pregnant patients, presents challenges for anesthetic management during cesarean sections. We report the case of a parturient with class III obesity (BMI > 60) undergoing elective cesarean section successfully managed with single-shot spinal anesthesia. This case report supports the feasibility of single-shot spinal anesthesia in parturients with class III obesity and emphasizes the importance of rapid recognition and management of potential complications.

Systematic review and meta-analysis of the efficacy of biologic and targeted synthetic therapies in sarcoidosis.

Objectives: Infliximab, an anti-TNF agent, is used to treat sarcoidosis that does not respond to corticosteroids or second-line agents. The efficacy of other anti-TNF agents, non-TNF biologics and targeted synthetic therapies remains unclear. This study aims to evaluate the role of these therapies in the management of multisystem sarcoidosis.

Addition of mycophenolate mofetil to a calcineurin inhibitor and post-transplant cyclophosphamide results in lower incidence of extensive chronic graft-versus-host disease in HLA-matched allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia in complete remission: a matched-pair analysis on behalf of the Acute Leukemia Working Party of the EBMT.

Whether one or two agents added to post-transplant cyclophosphamide (PTCy) are needed in HLA-matched allogeneic hematopoietic stem cell transplantation (allo-HSCT) with peripheral blood stem cells (PBSC) is debated. We retrospectively compared PTCy in association with a calcineurin inhibitor (PTCy+CNI) or with a CNI plus mycophenolate mofetil (PTCy+CNI+MMF) in adult patients transplanted for acute myeloid leukemia in first complete remission and receiving PBSC in the period from 2010 to 2020. Propensity score matching was performed using exact matching for donor type (related or unrelated) and the nearest neighbor for other variables (i.

Proteomic Analysis of Valsartan for Attenuating Disease Evolution in Early Sarcomeric Hypertrophic Cardiomyopathy (VANISH) Clinical Trial.

Background: In hypertrophic cardiomyopathy (HCM), the mechanisms through which pathogenic sarcomere variants (G+) lead to left ventricular hypertrophy (LVH) are not understood.

Methods: VANISH (Valsartan for Attenuating Disease Evolution in Early Sarcomeric Hypertrophic Cardiomyopathy) was a multicenter, double-blind, placebo-controlled, randomized trial testing valsartan's ability to attenuate phenotypic progression in early sarcomeric (G+LVH+) and subclinical HCM (G+LVH‒). The outcome was a composite z-score reflecting change in cardiac remodeling from baseline to year 2 (end of study).

Prevalence and predictors of low bone mineral density in pediatric inflammatory bowel disease.

Objectives: Bone health is at risk in children with inflammatory bowel disease (IBD). This study examined the prevalence and predictors of low bone mineral density (BMD) in a cohort of children and young adults with IBD.

Methods: This single-center retrospective study included patients with IBD, ages 3.

AGA Clinical Practice Update on Endoscopic Lifting Agents: Commentary.

Description: This American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) reviews endoscopic lifting agents and their use in the gastrointestinal tract.

Methods: This CPU was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership. This CPU underwent internal peer review by the Clinical Practice Updates Committee and external peer review through standard procedures of Clinical Gastroenterology and Hepatology.

Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide Study.

Background And Aims: To study the associations of neighborhood socioeconomic disadvantage with 30-day mortality and readmission for common gastrointestinal conditions, adjusting for individual demographics, comorbidities, access to health-care resources, and treatment facility characteristics.

Methods: We analyzed a nationwide sample of United States Medicare beneficiaries hospitalized from 2017 to 2019 for common gastrointestinal diseases, grouped by diagnosis-related groups. We then estimated the association of neighborhood socioeconomic disadvantage, measured by the Area Deprivation Index, with 30-day mortality and readmission utilizing logistic regression models with restricted cubic splines.

Incidence, prevalence, and mortality of sarcoidosis in England: a population-based study.

Background: The epidemiology of sarcoidosis in England is largely uncharted, with no population-level prevalence data and outdated incidence and mortality estimates. Our objective was to investigate contemporary trends in incidence, prevalence, and mortality.

Methods: This cohort study used primary care data from the UK Clinical Practice Research Datalink (CPRD), linked to secondary-care and national death registration.

Cardiac Magnetic Resonance Guidance for the Pathogenetic Definition of Cardiomyopathies.

Purpose Of Review: Pathogenetics is the study of genetics in disease pathogenesis. Many abnormal gene alleles have been identified in cardiomyopathies, but their clinical utility remains limited. This review aims to examine the integration of cardiac MRI (CMR) with genetic data to enhance early detection, prognostication, and treatment strategies for cardiomyopathies.

AI-Quantitative CT Coronary Plaque Features Associate With a Higher Relative Risk in Women: CONFIRM2 Registry.

Background: Coronary plaque features are imaging biomarkers of cardiovascular risk, but less is known about sex-specific patterns in their prognostic value. This study aimed to define sex differences in the coronary atherosclerotic phenotypes assessed by artificial intelligence-based quantitative computed tomography (AI-QCT) and the associated risk of major adverse cardiovascular events (MACEs).

Methods: Global multicenter registry including symptomatic patients with suspicion of coronary artery disease referred for coronary computed tomography angiography.