Benefit of coronary stenting using available intracoronary tools in high-risk patients. The OPTI-XIENCE study.

Background: The clinical benefit of using ICT for coronary stent optimization remains uncertain in randomized trials, in which a unique ICT was used in most cases.

Aim: To assess the clinical impact of intracoronary techniques (ICT) for stent optimization in high-risk patients.

Methods: The OPTI-XIENCE study is a prospective, observational, multicenter international study including high-risk patients undergoing coronary stenting, in whom any ICT was used for stent optimization at the operator's discretion.

Refining Bleeding Risk Stratification After TAVR: Added Value of CT-ADP Beyond High Breeding Risk Criteria.

Background: Acquired von Willebrand factor (vWF) deficiency is a key contributor to bleeding after transcatheter aortic valve replacement (TAVR).

Objective: To evaluate whether assessing primary hemostatic disorder using closure time of adenosine diphosphate (CT-ADP), a marker of vWF dysfunction, enhances bleeding risk stratification in TAVR patients at high bleeding risk (HBR).

Methods: We analyzed 884 patients from a prospective TAVR registry.

Long-term Outcomes Following Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Atheroma.

Although aorta atheroma morphology is associated with acute outcomes post-transcatheter aortic valve replacement (TAVR), its association with long-term outcomes post-TAVR remains unknown. This study evaluates the impact of severe aortic atheroma on long-term outcomes following TAVR. We enrolled 977 patients who underwent TAVR between February 2010 and May 2019, with available contrast-enhanced computed tomography data.

Contribution of Seasonal Variation and Inflammation to Increased In-Hospital Events and Early Mortality in Patients With Takotsubo Syndrome.

Background: Initially regarded as a benign acute cardiomyopathy, recent insights have shown that takotsubo syndrome (TTS) carries a prognosis comparable to that of acute coronary syndrome, with a notable impact of inflammatory burden. Given the seasonal variation seen in air pollution, inflammation, and coronary events, we investigated whether chronobiology and inflammation contribute to adverse outcomes.

Methods And Results: Between 2008 and 2020, all consecutive TTS patients were retrospectively included in a multicenter registry.

Transcatheter Aortic Valve Durability: Focus on Structural Valve Deterioration.

Transcatheter aortic valve replacement has emerged as a valuable alternative to surgical aortic valve replacement in patients with severe aortic stenosis. Given the expansion of transcatheter aortic valve replacement to lower-risk and younger populations with longer life expectancy, the durability of transcatheter heart valves (THVs) has become an important issue that may impact cardiovascular outcomes. THVs share similarities with surgical valves but have unique features, including a trend to larger effective orifice area and less prosthesis-patient mismatch, interactions with the native valve, and crimping process, that may all potentially influence a THV's life span.

Left atrial remodeling and voltage-guided ablation outcome in persistent atrial fibrillation patients over 75 years of age.

Background: The prevalence of atrial fibrillation (AF) increases with age. The improvement in ablation techniques has widened the indications, particularly in elderly patients. Data on LA remodeling and low-voltage zone (LVZ) extent in this subgroup are scarce.

Protruding and Ulcerated Aortic Atheromas as Predictors of Periprocedural Ischemic Stroke Post-Transcatheter Aortic Valve Replacement.

Background: Aortic atherosclerosis can affect the strategy and outcomes of transcatheter aortic valve replacement (TAVR). Limited investigation exists into how aortic atheroma morphology influences outcomes post-TAVR.

Objectives: This study aimed to assess the influence of protruding and ulcerated aortic atheromas on periprocedural ischemic stroke post-TAVR.

Mortality risk stratification for Takotsubo syndrome: Evaluating CRP measurement alongside the InterTAK prognostic score.

Background And Objectives: Initially described as a benign acute cardiomyopathy, Takotsubo syndrome has been linked to elevated mortality rates. Emerging evidence suggests that unresolved myocardial inflammation may contribute to this adverse prognosis. This study aimed to evaluate the incremental prognostic utility of C-reactive protein (CRP) in conjunction with the InterTAK prognosis score for stratifying long-term mortality in Takotsubo syndrome.

SGLT2 expression in human vasculature and heart correlates with low-grade inflammation and causes eNOS-NO/ROS imbalance.

Aims: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) show a cardioprotective effect in heart failure and myocardial infarction, pathologies often associated with low-grade inflammation. This cross-sectional study aims to investigate whether low-grade inflammation regulates SGLT2 expression and function in human vasculature, heart, and endothelial cells (ECs).

Methods And Results: Human internal thoracic artery (ITA), left ventricle (LV) specimens, and cultured porcine coronary artery ECs were used.

Left atrial remodeling and voltage-guided ablation outcome in persistent atrial fibrillation patients according to CHADS-VASc score.

Background: CHADS-VASc score-related differences have been reported in atrial fibrotic remodeling and prognosis of atrial fibrillation (AF) patients after ablation. There are currently no data on the efficacy of low voltage zone (LVZ)-guided ablation in persistent AF patients according to CHADS-VASc score. We assessed in a cohort of persistent AF patients the extent of LVZ, the regional distribution of LA voltage and the outcome of LA voltage-guided substrate ablation in addition to PVI according to CHADS-VASc score.

Predictors and rate of survival after Out-of-Hospital Cardiac Arrest.

Background: Out-of-hospital cardiac arrest (OHCA) is a major public health concern and encloses a wide spectrum of causes. The purpose of this study is to assess predictors and rate of survival at hospital discharge and long-term in the setting of OHCA. The secondary endpoint is to compare OHCA-survival outcomes of presumed ischemic versus non ischemic cause.

Impact of New-Onset Right Bundle-Branch Block After Transcatheter Aortic Valve Replacement on Permanent Pacemaker Implantation.

Background: A delayed and recurrent complete atrioventricular block (CAVB) is a life-threatening complication of transcatheter aortic valve replacement (TAVR). Post-TAVR evaluation may be important in predicting delayed and recurrent CAVB requiring permanent pacemaker implantation (PPI). The impact of new-onset right bundle-branch block (RBBB) after TAVR on PPI remains unknown.

Left atrial remodeling and voltage-guided ablation outcome in obese patients with persistent atrial fibrillation.

Background: Obesity is a risk factor for atrial fibrillation (AF). Data regarding left atrial (LA) remodeling in obese patients are scarce. Whether obesity favors AF recurrence after catheter ablation (CA) is still controversial.

A review of therapeutic approaches for post-infarction left ventricular remodeling.

Left ventricular remodeling is an adaptive process initially developed in response to acute myocardial infarction (AMI), but it ends up with negative adverse outcomes such as infarcted wall thinning, ventricular dilation, and cardiac dysfunction. A prolonged excessive inflammatory reaction to cardiomyocytes death and necrosis plays the crucial role in the pathophysiological mechanisms. The pharmacological treatment includes nitroglycerine, β-blockers, ACEi/ARBs, SGLT2i, mineralocorticoid receptor antagonists, and some miscellaneous aspects.

Reducing length of stay after transfemoral transcatheter aortic valve implantation: the FAST-TAVI II trial.

Background And Aims: The length of stay (LOS) after transcatheter aortic valve implantation (TAVI) remains extremely variable whereas early discharge has been shown to be feasible and safe. The study objective was to evaluate the efficacy and safety of an intervention aimed at reducing LOS after transfemoral TAVI.

Methods: FAST-TAVI II is a prospective, multicentre, cluster, randomized, controlled study including patients with severe symptomatic aortic stenosis, who had transfemoral TAVI.

Survival outcomes of TAVR and self-expanding versus balloon-expandable valves in patients with advanced cardiac dysfunction.

Aims: There is a growing body of literature on long-term outcomes post-transcatheter aortic valve replacement (TAVR), but to our knowledge, few research have focused on patients with advanced cardiac dysfunction. This challenging category of patients was excluded from the Partner 3 clinical trial. There are no data to guide the choice of valve type in patients with severely depressed ejection fraction.

Outcomes after TAVI in patients with atrial fibrillation and a history of recent PCI: Results from the ENVISAGE-TAVI AF trial.

Background: Patients with atrial fibrillation (AF) and a recent (≤ 90 days) percutaneous coronary intervention (PCI) undergoing transcatheter aortic valve implantation (TAVI) are at high bleeding risk due to the addition of oral antiplatelet (OAP) agents on top of oral anticoagulants. Data on outcomes of these patients are needed to optimize antithrombotic treatment.

Methods: This analysis compared annualized clinical event rates in patients with and without a recent PCI enrolled in ENVISAGE-TAVI AF, a prospective, randomized, open-label, adjudicator-masked trial comparing edoxaban and vitamin K antagonists in AF patients after TAVI.

A review of the conservative versus invasive management of ischemic heart failure with reduced ejection fraction.

Heart failure is increasing in terms of prevalence, morbidity, and mortality rates. Clinical trials and studies are focusing on heart failure as it is the destiny end-stage for several cardiovascular disorders. Recently, medical therapy has dramatically progressed with novel classes of medicines providing better quality of life and survival outcomes.

Ratio of left ventricular outflow tract area to aortic annulus area and complete atrioventricular block after transcatheter aortic valve replacement for aortic stenosis.

Background: Mechanical compression of cardiac conduction system by transcatheter heart valves leads to complete atrioventricular block (CAVB) after transcatheter aortic valve replacement (TAVR). Bulging of ventricular septum in the left ventricular outflow tract (LVOT) may be associated with greater compression of conduction system, leading to irreversible CAVB.

Objective: This study aimed to investigate the association of ventricular septal bulging with TAVR-related CAVB and permanent pacemaker implantation (PPI).