Sacubitril/valsartan versus enalapril in chronic Chagas cardiomyopathy with heart failure: Baseline characteristics of the PARACHUTE-HF trial.

Aims: The PARACHUTE-HF trial (NCT04023227) is evaluating the effect of sacubitril/valsartan compared with enalapril on a hierarchical composite of cardiovascular events (cardiovascular death, first heart failure hospitalization), and change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in participants with heart failure and reduced ejection fraction (HFrEF) caused by chronic Chagas cardiomyopathy (CCC). We describe the baseline characteristics of participants in PARACHUTE-HF compared with prior HFrEF trials.

Methods And Results: PARACHUTE-HF, a multicentre, active-controlled, open-label trial, enrolled 922 participants with confirmed CCC, New York Heart Association (NYHA) functional class II-IV, and left ventricular ejection fraction (LVEF) ≤40%.

Influence of dietary components on the gut microbiota of middle-aged adults: the gut-Mediterranean connection.

Background: A plant-focused, healthy dietary pattern, such as the Mediterranean diet enriched with dietary fiber, polyphenols, and polyunsaturated fats, is well known to positively influence the gut microbiota. Conversely, a processed diet high in saturated fats and sugars negatively impacts gut diversity, potentially leading to weight gain, insulin resistance, and chronic, low-grade inflammation. Despite this understanding, the mechanisms by which the Mediterranean diet impacts the gut microbiota and its associated health benefits remain unclear.

The Pericardial Space: Can it be Leveraged for Diagnostic, Prognostic, and Therapeutic Purposes?

There is evidence supporting the importance of local immune microenvironment with respect to physiological and pathological states. Cardiac fibrosis, post-operative atrial fibrillation, and post-surgical pericardial adhesions are the culmination of complex cascade of processes, many of which have immune-mediated etiologies. While extensive research has focused on describing the systemic markers, to date, little attention has been given to local pericardial factors that can impact fibrotic activity and/or lead to POAF and PSPA.

Taking the Pulse: A Retrospective, Population-Based Analysis of Alberta's Privatization of Cardiac Testing.

Background: Many provinces are considering an expanded role for for-profit diagnostic imaging facilities. We describe trends over time in the use of cardiac imaging studies, a subset of diagnostic imaging, in the for-profit and publicly operated facilities in Alberta. Alberta has allowed testing in private facilities since the 1970s, with formalized guidelines released in 1998.

Case report of isolated aortic valve AL-amyloidosis following aortic valve replacement.

Background: Light chain (AL)-amyloidosis is a haematologic malignancy where cardiac involvement confers a worse prognosis. There is a recognized association between aortic stenosis (AS) and transthyretin amyloidosis (ATTR) cardiomyopathy. However, there is no such reported association with AL amyloidosis.

Recent-onset atrial fibrillation: challenges and opportunities.

Atrial fibrillation (AF) is increasingly diagnosed early, close to its first occurrence due to: (i) increased public awareness with self-screening; (ii) health care initiatives including population screening and opportunistic case finding; and (iii) increased use and surveillance of implantable cardiac devices. At its onset, AF is often low burden, and cardiovascular co-morbidities may be absent or at an early stage. Thus, the management of recent-onset AF has become an issue of growing importance.

Optimizing Recovery in Cardiac Surgery: A Narrative Review of Enhanced Recovery After Surgery Protocols and Clinical Outcomes.

Enhanced Recovery After Surgery (ERAS) is an evidence-based, holistic perioperative recovery protocol intended to improve patient outcomes and decrease postoperative complication rates. While ERAS protocols were first introduced in 1997, specific guidelines for cardiac surgery were not established until 2019. Although the core principles of ERAS remain constant across surgical disciplines, ERAS guidelines for cardiac surgery have remained relatively understudied, likely due to the unique complexities posed by cardiac procedures.

Comprehensive at-home sexually transmitted and blood borne infection (STBBI) testing program: A pilot study.

BackgroundRates of sexually transmitted and blood borne infections (STBBI) are rapidly increasing. Despite the high diagnostic accuracy of self-testing, no fully remote STBBI testing programs are available in Canada. We aimed to evaluate the feasibility and acceptability of a fully-remote, web-based, at-home STBBI testing (self-collection) program in Calgary, Canada.

Regulation of K-dependent Na/Ca-exchanger subtype 4, NCKX4, by palmitoylation.

Mammalian K-dependent Na/Ca exchangers (NCKX), encoded by the SLC24 gene family, are crucial for maintaining Ca homeostasis. NCKX4, widely expressed in the brain and sensory neurons, plays a key role in neuronal satiety and enamel formation. Despite its importance, the regulatory mechanisms of NCKX4 remain largely unexplored.

Age, power, and sport-related concussion. Is there a tension between sport performance and concussion risk in tackle football?

Sport-related concussion (SRC) poses a barrier to otherwise health-promoting sport participation. Tackle Football (American Football) is a popular sport with an elevated risk of SRC, which prioritises strength and conditioning. The association between physical performance, notably lower body maximal muscle power and concussion rate, is not well understood in youth tackle football.

Beyond cardiac embolism and cryptogenic stroke: unveiling the mechanisms of cerebrovascular events in Chagas disease.

Chagas disease, caused by the protozoan parasite , remains a significant public health challenge with evolving epidemiological patterns due to migration and globalization. While its cardiac complications are well-characterized, stroke represents an underrecognized yet devastating manifestation, occurring in 3%-20% of patients. Traditionally viewed primarily as a cardioembolic pathophysiology, emerging evidence suggests a more complex pathophysiologic mechanism involving inflammatory, prothrombotic, and microvascular processes.

State-of-the-Art Review: Operating Room Extubation.

Enhancing recovery protocols seek to optimize multiple aspects of care throughout the patient's perioperative cardiac surgery journey. Fast-track recovery protocols, specifically those involving earlier extubation, have been among the early methods to enhance a patient's recovery. However, how early these protocols should be implemented after surgery remains a source of ongoing controversy.

Interventions to improve cognitive performance in chronic kidney disease: A scoping review.

Rationale & Objective: Cognitive impairment is commonly associated with chronic kidney disease (CKD. A number of intervention approaches have the potential to improve cognitive performance in CKD. Our objective was to characterize interventions studied to improve cognitive performance for adults with CKD across all categories of severity, including kidney failure.

Using Compression Stockings to Prevent Recurrence of Vasovagal Syncope: A Randomized Sham-Controlled Trial.

Background: Vasovagal syncope (VVS) is a common yet challenging condition with limited effective treatments. Elastic compression stockings (ECS) have been proposed as a potential therapy, but their real-world effectiveness remains unclear.

Objectives: This study sought to compare the effectiveness of lower extremity compression with thigh-high ECS vs sham stockings for the prevention of VVS recurrence.

Interventions to Reduce the Risk of Hypocalcemia After Parathyroidectomy for People With Advanced Chronic Kidney Disease: A Systematic Review.

Background: People with advanced chronic kidney disease (CKD) and secondary hyperparathyroidism (sHPT) refractory to medical therapy often require surgical parathyroidectomy. Severe and prolonged hypocalcemia immediately following parathyroidectomy for sHPT is often termed "hungry bone syndrome" (HBS).

Objective: To systematically review the effect of pre-operative interventions on post-operative hypocalcemia, HBS, and other related outcomes in patients with CKD and sHPT undergoing parathyroidectomy.

Apixaban for stroke prevention in subclinical atrial fibrillation detected by an implantable cardiac monitor: A subgroup analysis of ARTESiA.

Background: The ARTESiA trial randomized patients with a pacemaker (PM), implantable cardioverter-defibrillator (ICD), or implantable cardiac monitor (ICM) and with subclinical atrial fibrillation to either apixaban or aspirin.

Objective: We aimed to explore the effects of apixaban in the subset of patients with an ICM.

Methods: We assessed the efficacy outcome of stroke or systemic embolism and the safety outcome of major bleeding, stratifying by device type.

Predicting dysglycaemia in individuals with gestational diabetes immediately postpartum using continuous glucose monitoring (PREDISPOSE) in a multicentre prospective cohort study in Canada: a study protocol.

Introduction: Gestational diabetes is a common metabolic disorder in pregnancy which identifies a substantial increased risk of future diabetes. Despite this risk, many individuals are not screened for dysglycaemia in the postpartum period. Continuous glucose monitoring (CGM) is an evolving technology that provides details of an individual's glucose levels throughout the day; however, it has not yet been evaluated as a screening tool for postpartum dysglycaemia.

circSP199a, a circularized RNA sponge targeting miR-199a-5p and -3p, mitigates mouse cardiac hypertrophy and fibrosis.

Increasing evidence shows that microRNAs (miRNAs) are functionally associated with cardiac remodeling. Functionally, some cytoplasmic circRNAs may act as miRNA sponges to inhibit functions of the combined miRNAs. Our previous study showed that miR-199a-5p and -3p promote cardiac hypertrophy and fibrosis.

Understanding Physical Activity Facilitated by a Single Session of Robotic Walking for Children and Small Adults Living With Severe Mobility Impairments.

Background: Physical activity has many benefits but can be hard to achieve for people living with severe mobility impairments. Robotic walking may be an effective way for these individuals to achieve physical activity.

Objective: The aim of this study is to characterize the physical activity performed by children and small adults with severe mobility impairments during a single session of robotic walking.

Characterization of lipoprotein (a) testing in Alberta, Canada: a retrospective cohort study.

Background And Aims: Patients with elevated lipoprotein (a) (Lp(a)) levels face increased risk of cardiovascular events. However, Lp(a) testing has only recently been recommended as routine clinical practice. This study examines real-world baseline characteristics, healthcare resource utilization (HCRU), costs, lipid-lowering therapy (LLT) treatment intensification, and major adverse cardiovascular events (MACE) among individuals with Lp(a) testing.

Cholesterol Levels and Cardiovascular Outcomes Following Statin Initiation for Primary Prevention: A Cohort Study.

Background: Non-high-density lipoprotein cholesterol (HDL-C) is increasingly incorporated into guidelines along with low-density lipoprotein cholesterol (LDL-C) to guide lipid-lowering therapy decisions.

Objectives: The purpose of this study was to examine patterns of LDL-C and non-HDL-C levels after statin initiation for primary prevention and their association with incident cardiovascular events.

Methods: This was a population-based cohort study in Ontario, Canada, among persons aged ≥66 years starting a statin for primary prevention between January 1, 2012, and December 31, 2019.

Cost Analysis for Minimally Invasive Mitral Valve Surgery: A Single-Centre Canadian Study.

Background: Stakeholders within a publicly funded healthcare system have a duty to consider costs and economics, to utilize finite resources in the most effective manner. We aimed to quantify the postoperative costs associated with mitral valve repair (MVR) at the Foothills Medical Centre in Calgary, Canada.

Methods: A retrospective review of patients who underwent MVR from January 2020 to November 2023 was performed.