The multidisciplinary Heart Team in mitral valve transcatheter edge-to-edge repair.

Treatment options for mitral regurgitation (MR) have markedly evolved over the past few decades, with mitral valve transcatheter edge-to-edge repair (M-TEER) expanding the clinical armamentarium of guideline-directed medical therapy and surgical techniques. However, the variety of mitral valve anatomies, the presence of heart failure (HF), and consideration of the individual patient risk require a multidisciplinary Heart Team approach to identify the optimal treatment for MR for each patient. Despite the growing field of transcatheter mitral interventions and the longstanding availability of surgical mitral valve repair and replacement, evidence from randomized clinical trials comparing intervention with surgery remains scarce.

Rationale and design of the TRIC-I-HF-DZHK24 (TRICuspid Intervention in Heart Failure) trial.

Aims: Tricuspid regurgitation (TR) is a detrimental disease frequently diagnosed in patients with right-sided heart failure (HF). While transcatheter tricuspid valve interventions (TTVI) effectively reduce TR and improve quality of life (QoL) in earlier stages of the disease, their effect on reducing HF hospitalizations (HFH) and improving survival remains unclear.

Methods: TRIC-I-HF-DZHK24 (NCT04634266) is an investigator-initiated, prospective, randomized, open-label, multicentre strategy trial.

Characterisation of β-tubulin isotypes in Uncinaria stenocephala and implications for benzimidazole resistance in hookworms.

Uncinaria stenocephala is a widespread hookworm of dogs across Europe, Canada, southern Australia, and other temperate regions, where it often outnumbers infections caused by Ancylostoma caninum. Although a putative β-tubulin isotype-1 mutation associated with resistance has been detected in U. stenocephala, clinical resistance to benzimidazoles has not yet been confirmed.

Multiple sources of atmospheric CO activated by AMOC recovery at the onset of interglacial MIS 9.

Using high-precision ice core measurements of CO, δC-CO, CH, and NO, this study provides carbon isotope constraints on a sizeable, centennial-scale CO jump at the onset of Marine Isotope Stage 9 (MIS 9). The very end of the Heinrich stadial (HS) characterizing Termination IV (T-IV, ca. 343 to 333 ka ago) shows a 250-y-long jump in greenhouse gas concentrations, followed by a 1.

Opportunities for Earth Observation to Inform Risk Management for Ocean Tipping Points.

As climate change continues, the likelihood of passing critical thresholds or tipping points increases. Hence, there is a need to advance the science for detecting such thresholds. In this paper, we assess the needs and opportunities for Earth Observation (EO, here understood to refer to satellite observations) to inform society in responding to the risks associated with ten potential large-scale ocean tipping elements: Atlantic Meridional Overturning Circulation; Atlantic Subpolar Gyre; Beaufort Gyre; Arctic halocline; Kuroshio Large Meander; deoxygenation; phytoplankton; zooplankton; higher level ecosystems (including fisheries); and marine biodiversity.

Impact of dual atrioventricular valve disease on outcomes in patients undergoing transcatheter aortic valve replacement.

Aims: Current guidelines provide no recommendations for the management of patients with dual atrioventricular valve regurgitation (DAVR) undergoing transcatheter aortic valve replacement (TAVR), and existing data on its clinical impact remain absent. Therefore, we aimed to provide detailed insights into the impact of DAVR on outcomes after TAVR, with the potential to refine clinical risk stratification tools and influence future management guidelines.

Methods And Results: We retrospectively analysed 3491 consecutive patients who underwent TAVR between 2013 and 2021.

Record sea surface temperature jump in 2023-2024 unlikely but not unexpected.

Global ocean surface temperatures were at record levels for more than a year from April 2023 onwards, exceeding the previous record in 2015-2016 by 0.25 °C on average between April 2023 and March 2024. The nearly global extent and unprecedented intensity of this event prompted questions about how exceptional it was and whether climate models can represent such record-shattering jumps in surface ocean temperatures.

Beyond 2-Dimensional Echocardiography: A Novel Multiparametric Assessment of Right Ventricular Dysfunction in Transcatheter Tricuspid Valve Repair.

Background: Right ventricular (RV) heart failure as assessed by RV to pulmonary artery coupling (RVPAc) is a prognostic marker in transcatheter tricuspid valve repair (T-TEER). However, quantification of RVPAc components by 2-dimensional (2D) echocardiography in patients with severe tricuspid regurgitation (TR) has significant limitations, and the traditional RVPAc parameter neglects the degree of volume overload/dilatation of the RV, which is another key clinical indicator for right ventricular dysfunction (RVD). Therefore, we aimed to assess RVD by a novel RVPAc parameter, including the 3 important drivers of RVD, for an improved prediction of 1-year mortality after T-TEER.

The Ronne Ice Shelf survived the last interglacial.

The fate of the West Antarctic Ice Sheet (WAIS) is the largest cause of uncertainty in long-term sea-level projections. In the last interglacial (LIG) around 125,000 years ago, data suggest that sea level was several metres higher than today, and required a significant contribution from Antarctic ice loss, with WAIS usually implicated. Antarctica and the Southern Ocean were warmer than today, by amounts comparable to those expected by 2100 under moderate to high future warming scenarios.

Simplified Outcome Prediction in Patients Undergoing Transcatheter Tricuspid Valve Intervention by Survival Tree-Based Modelling.

Background: Patients with severe tricuspid regurgitation (TR) typically present with heterogeneity in the extent of cardiac dysfunction and extra-cardiac comorbidities, which play a decisive role for survival after transcatheter tricuspid valve intervention (TTVI).

Objectives: This aim of this study was to create a survival tree-based model to determine the cardiac and extra-cardiac features associated with 2-year survival after TTVI.

Methods: The study included 918 patients (derivation set, n = 631; validation set, n = 287) undergoing TTVI for severe TR.

Widespread occurrence of benzimidazole resistance single nucleotide polymorphisms in the canine hookworm, Ancylostoma caninum, in Australia.

Canine hookworm (Ancylostoma caninum), a gastrointestinal nematode of domestic dogs, principally infects the small intestine of dogs and has the potential to cause zoonotic disease. In greyhounds and pet dogs in the USA, A. caninum has been shown to be resistant to multiple anthelmintics.

Prognostic impact of left- and right-atrial strain in patients undergoing transcatheter aortic valve replacement.

Aims: Data on the prognostic value of left- and right-atrial strain after transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS) are limited. Aim of this study was to evaluate outcomes of patients undergoing TAVR stratified by left- and right-atrial strain.

Methods And Results: Using data from a high-volume academic centre, left- and right-atrial reservoir strain (LASr and RASr) was obtained in patients who underwent TAVR for severe AS from 2018 until 2021.

Management of acute decompensated valvular heart disease.

Worldwide, valvular heart disease (VHD) is a common cause of hospitalization for acute heart failure. In acute heart failure caused by VHD, symptoms result from rapid haemodynamic changes and subsequent decline in cardiac function, and if left untreated, leads to acute decompensation and cardiogenic shock. Current evidence remains scarce and recommendations regarding the management of acute heart failure caused by VHD are lacking in most recent international guidelines.

Biphasic Right Ventricular Reverse Remodeling Following Tricuspid Valve Transcatheter Edge-to-Edge Repair.

Background: Transcatheter tricuspid valve edge-to-edge repair (T-TEER) has been reported to be associated with right ventricular reverse remodeling (RVRR). Data on the temporal evolution of this phenomenon are scarce.

Objectives: The aim of this study was to evaluate RVRR over the course of 2-year follow-up after T-TEER using sequential 3-dimensional echocardiograms (3DE).

Relevance of residual tricuspid regurgitation for right ventricular reverse remodelling after tricuspid valve intervention in patients with severe tricuspid regurgitation and right-sided heart failure.

Aims: Right ventricular reverse remodelling (RVRR) is linked to improved survival in patients with severe tricuspid regurgitation (TR) and right-sided heart failure who underwent interventional treatment. However, the role of residual TR on RVRR remains unclear. In this analysis the impact of residual TR on RVRR after interventional TR treatment, which was validated by two independent cohorts at four sites using echocardiography or cardiac magnetic resonance (CMR) imaging, was investigated.

Geological Net Zero and the need for disaggregated accounting for carbon sinks.

Achieving net-zero global emissions of carbon dioxide (CO), with declining emissions of other greenhouse gases, is widely expected to halt global warming. CO emissions will continue to drive warming until fully balanced by active anthropogenic CO removals. For practical reasons, however, many greenhouse gas accounting systems allow some 'passive' CO uptake, such as enhanced vegetation growth owing to CO fertilization, to be included as removals in the definition of net anthropogenic emissions.