bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left atrial function after successful catheter ablation for paroxysmal atrial fibrillation: cryoablation versus radiofrequency techniques
Authors: Pilichowska E , Sikorska A , Baran J , Piotrowski R , Krynski T , Kulakowski P , Zaborska B 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Purpose
It has been suggested that cryoballoon (CB) ablation for paroxysmal atrial fibrillation (PAF) may lead to more extensive left atrial (LA) injury than radiofrequency (RF) ablation, however, results are conflicting. We sought to address this issue using modern echocardiographic techniques.

Methods
We performed transthoracic echocardiography in 90 patients (66% males, mean age 57 ± 10 years) successfully treated with RF (51%) or CB (49%) ablation for PAF before and 6 months after the procedure. Peak longitudinal LA strain (LAS) and strain rate (LASR) during the reservoir (r), conduit (cd) and contraction (ct) phases were measured during sinus rhythm by speckle tracking. The LA diameter and volume (LAV) index - using biplane area-length method divided by the body surface area were also calculated.

Results
The LA diameter decreased (38.1 ± 4.0 vs 37.2 ± 3.8 mm, p = 0.004), the LAV index did not change (33.5 ± 11.9 vs 34.4 ± 8.9 mL/m², p = 0.272) at 6 months in the whole study group. The LASRr and LASRcd increased, whereas there were no changes in remaining LA function parameters in either ablation strategy (table). The CB subgroup did not differ in LA function parameters comparing to RF subgroup at six months after procedure (table).

Conclusion
CB and RF ablation did not differentially affect the LA function. Successful ablation for PAF resulted in improvement of rate of deformation during reservoir and conduit LA cycle and stable contractile LA function.
LA function parameters RF N = 46 (51%) CB N = 44 (49%) 6 months RF vs CB Parameter Baseline 6 months p Baseline 6 months p p* Global LASr [%] 27.7 ± 6.35 27.9 ± 6.0 0.833 27.9 ± 7.2 27.0 ± 6.4 0.370 0.539 Global LAScd [%] -14.6 ± 4.1 -14.8 ± 4.6 0.761 -15.3 ± 5.3 -14.1 ± 3.2 0.080 0.399 Global LASct [%] -13.0 ± 4.84 -13.0 ± 3.20 1.00 -12.6 ± 3.81 -12.9 ± 4.18 0.629 0.897 Global LASRr [sˉ&sup1;] 1.18 ± 0.22 1.27 ± 0.26 0.046 1.07 ± 0.27 1.18 ± 0.30 0.041 0.141 Global LASRcd [sˉ&sup1;] -1.11 ± 0.33 -1.25 ± 0.35 0.013 -1.07 ± 0.31 -1.16 ± 0.30 0.044 0.214 Global LASRct [sˉ&sup1;] -1.46 ± 0.40 -1.50 ± 0.31 0.500 -1.42 ± 0.51 -1.39 ± 0.42 0.742 0.187 *p value corrected for baseline values
Right atrial strain by speckle-tracking echocardiography as a prognostic predictor in a pulmonary hypertension cohort
Authors: Dias Ferreira Reis JP , Branco L , Nogueira M , Morais L , Sousa L , Galrinho A , Agapito A , Ferreira R 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Right atrial (RA) strain is as a promising technique for assessment of RA function and several studies have suggested it is a powerful prognostic marker in pulmonary hypertension (PH) patients (pts). Our aim was to assess the prognostic power of RA strain in Pulmonary Arterial Hypertension (PAH) and Chronic Thromboembolic Pulmonary Hypertension (CTEPH) pts.

Methods
Pts with PH were prospectively studied and several clinical/demographic/echocardiographic were retrieved as well as data from six-minute walk test (6MWT) and brain natriuretic peptide (BNP). Correlation between RA strain and other variables was tested with Pearson"s correlation analysis. Regression and survival analysis were performed to assess the combined endpoint of all-cause mortality or hospitalization in the first follow-up year (MH1).

Results
A total of 51 PH pts (mean age 54 ± 46 years, 33.3% male, baseline BNP of 342.4 ± 439.9pg/mL and baseline pulmonary artery systolic pressure – PASP - of 78 ± 26mmHg), of which 64.7% had PAH and 35.3% presented CTEPH. 19 ots (37.3%) met the primary endpoint. The mean RA strain was -21.9 ± -4.9%, with no significant difference between groups (-23.4% vs -17.8%, p = 0.150), however male pts had a significantly lower RA strain (-15.9% vs -25.1%, p = 0.014). There was a statistically significant (p &lt; 0.05) correlation between RA strain and age (r = -0.287), indexed RA area (r = -0.539), index RA volume (r = -0.522) and right ventricular strain (r = -0.453). There was no correlation between RA strain and BNP value (p = 0.150), 6MWT distance (p = 0.145) or PASP (p = 0.072). RA strain was a predictor of MH1 (OR = 0.94, 95% CI: 0.894-0.998, p = 0.048). Pts who met the primary endpoint had a significantly worse RA strain (-17.0 vs -24.6%, p = 0.032). Those with a RA strain worse than -19% presented a significantly lower survival free of events during the first follow-up year (log rank p = 0.022).

Conclusion
RA strain is a powerful predictor of adverse events in a PH population and should be systematically assessed in order to improve risk stratification.
Abstract Figure.
Vena contracta area size predicts effectiveness of interventional edge-to-edge repair in tricuspid valve regurgitation
Authors: Goebel B , Salomon C , Awada H , Costello E , Sassenberg N , Lauten P , Lapp H 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Percutaneous tricuspid valve edge-to-edge repair (pTVR) is a promising interventional technique for patients with tricuspid regurgitation (TR), but guidance regarding patient selection and echocardiographic screening is lacking. The aim of this study was to identify echocardiographic measurements which may predict pTVR success.

Methods
Before and after pTVR, echocardiographic data, including 3D full-volume datasets, were obtained and quantified. Right ventricular assessments included ejection fraction (RVEF3D) and diastolic (RVVd3D) and systolic (RVVs3D) volumes. Also evaluated were: right atrial (RA) volume, effective regurgitant orifice area by PISA method (EROAPISA), vena contracta area (VCA3D) by multiplanar reconstruction from a 3D colour Doppler loop (Figure 1a), maximal diastolic tricuspid annulus area from a 3D zoom image (Figure 1b), and tricuspid tenting area. TR severity was graded according to EROAPISA and VCA3D as grade 1+ to 5+.

Results
Patients (n= 44, age 72 ± 9 years, 20 male) with at least moderate to severe TR undergoing pTVR were consecutively included. The patients were divided into groups according to their post-pTVR TR grade. Group 1 had TR grade ≤2+, and group 2 had TR grade ≥3+.Echocardiographic parameters before pTVR for both groups are presented in Table 1. As expected, patients with TVR ≥3+ after pTVR had significantly worse pre-intervention echocardiographic measurements of TR severity, valve dimensions, and chamber volumes. ROC curves for the prediction of TR ≤2+ (mild to moderate) after pTVR (defined as VCA3D &lt;0.75 cm² and EROAPISA &lt;0.4 cm²) were drawn for different echocardiographic features (Figure 2). VCA3D by 3D colour Doppler yielded the highest area under the ROC curve followed by TV anatomy measurements (Annulus area3D, Tenting area) and right atrial volume.

Conclusion
A thorough evaluation of TR and valve dimensions by 3D echocardiography, particulary the evaluation of VCA3D by 3D colour Doppler, aids in the prediction of the probability of pTVR success.
Abstract Figure.
CT of the coronary arteries in patients with non-coronary chest pain. An educational intervention aimed at improving reliance and reducing episodes of recurring chest pain
Authors: Krohn I , Rygh CB , Norekvaal TM 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Chest pain is a symptom closely linked to coronary disease (CAD) and a common complaint in the general practitioner’s office. Nevertheless, most of these complaints are benign and of non-coronary origin. Computed Tomography (CT) is the main diagnostic tool to investigate the coronary arteries, an examination with a low probability of false-negative result (&lt;1%). Despite negative findings of CAD, this patient group still experience higher degree of morbidity and anxiety and decreased quality of life when compared to a population without chest pain.

Purpose
To determine the effect of an intervention for reliance in the CT-examination and recurring chest pain in patients with non-coronary chest pain in follow-up after one month.

Methods
Patients with chest pain, but with normal CT-findings, i.e. no CAD, were randomised into two groups. The intervention group received extended information about the examination, such as the reliability of the result due to CTs low probability of false-negative result and also the great prognostic value it provides. The examination result was then conveyed to the patient. The control group received standard care; i.e no extended information was given and the examination result was obtained from their general practitioner after one week. The effect of the intervention was measured with a specific question regarding reliance in the CT-examination and the Seattle Angina Questionnaire (SAQ) at follow-up after one month.

Results
The study included 92 patients; follow-up response rate was 80%. Of the participants were 63 females (68%), and the mean age was 51 years. Analysis showed that the intervention group had significantly higher reliance in the CT-examination (p = 0.016) and significantly reduced incidences of chest pain (p = 0.042) when compared to the control group at 1-month follow-up (Figure 1).

Conclusion
This intervention demonstrates that relatively simple actions may have a great impact on patient care. Providing patients with extended information and an early communication of CT results have a positive effect on reliance and chest pain after one month. Such an effect may lead to lower morbidity, less anxiety and a higher quality of life in this group. Further examinations after six or twelve months might provide additional knowledge of the long-term effect of the performed intervention.
Abstract Figure 1
Delayed radiofrequency ablation efficacy in slow pathway ablation: a case report
Authors: Zeljković Ivan , Pavlović Nikola , Radeljić Vjekoslav , Manola Šime 
Published: February 2021

AbstractBackgroundThe delayed effect of radiofrequency (RF) ablation was described in cases of accessory pathway and premature ventricular contraction ablation, as well as delayed atrioventricular (AV) block after slow pathway ablation.Case summaryWe report a case of a female patient with AV nodal re-entry tachycardia (AVNRT), in whom the first electrophysiology study ended with acute failure of slow pathway ablation, despite using long steerable sheath, both right and left-sided ablation with &gt;15 min of RF energy application and repeatedly achieving junctional rhythm. Six weeks afterwards, during scheduled three-dimensional electroanatomical mapping procedure, there was no proof of dual AV nodal conduction nor could the tachycardia be induced. Also, the patient did not have palpitations between the two procedures nor during the 12-month follow-up period.DiscussionThis case illustrates that watchful waiting for delayed RF ablation efficacy in some cases of AVNRT ablation could be reasonable, in order to reduce the risk of complications associated with slow pathway ablation.
A rare cause of culture negative bioprosthetic valve endocarditis: a case report of Aggregatibacter aphrophilus infection
Authors: Wassef Nancy , Sarkar David , Viswanathan Girish , Hughes Gareth Morgan , Salisbury Thomas , Kuo James , de Silva Ravi 
Published: February 2021

Abstract

Background
The prevalence of culture negative infective endocarditis (IEC) is reported as 2–7% though this figure may be as high as 70% in developing countries.1 This higher rate will, at least in part, be due to reduced diagnostic facilities though some data suggests higher rates even when appropriate cultures were taken. The frequency is significantly elevated in patients who have already been exposed to antibiotics prior to blood cultures.1,2 A rare cause of culture negative IEC is the HACEK group of organisms that are normal habitants of the oropharyngeal flora and account for 1–3% of native valve endocarditis.3 Aggregatibacter aphrophilus (A. aphrophilus) is a member of the HACEK group of organisms.

Case summary
A 32-year-old gentleman with a previous bioprosthetic aortic valve presented with a 1-week history of diarrhoea, vomiting, malaise, and weight loss. He was awaiting redo surgery for stenosis of the bioprosthesis, which had been inserted aged 17 for aortic stenosis secondary to a bicuspid valve. The initial blood tests revealed liver and renal impairment with anaemia. A transoesophageal echocardiogram demonstrated a complex cavitating aortic root abscess, complicated by perforation into the right ventricle. He underwent emergency redo surgery requiring debridement of the aortic abscess, insertion of a mechanical aortic prosthesis (St Jude Medical, USA), annular reconstruction and graft replacement of the ascending aorta. Despite antibiotic therapy, he remained septic with negative blood and tissue cultures. Bacterial 16S rRNA gene sequencing confirmed A. aphrophilus infection, for which intravenous ceftriaxone was initiated. This was subsequently changed to ciprofloxacin due to neutropenia. The patient self-discharged from the hospital during the third week of antibiotic therapy. One week later, he was re-admitted with fever, night sweats, and dyspnoea. Transthoracic echocardiogram revealed a large recurrent aortic abscess cavity around the aortic annulus fistulating into the right heart chambers; this was confirmed by a computed tomography scan. There was dehiscence of the patch repair. Emergency redo aortic root replacement (25 mm mechanical valve conduit, ATS Medical, USA) and annular reconstruction was performed with venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. VA-ECMO was weaned after 3 days. The patient completed a full course of intravenous meropenem and ciprofloxacin and made a good recovery.

Discussion
IEC with oropharyngeal HACEK organisms is rare and difficult to diagnose, due to negative blood culture results. The broad-range polymerase chain reaction and gene sequencing with comparison to the DNA database is useful in these circumstances. This case demonstrates the importance of the 16S rRNA gene sequencing for HACEK infection diagnosis and appropriate antibiotic treatment.
Catheter-based closure of a large atrial septal defect with inferior rim deficiency using pulmonary vein slide-out assisted implantation technique: a case report
Authors: Evola Salvatore , Triolo Oreste Fabio , Novo Giuseppina , Onorato Eustaquio Maria 
Published: February 2021

Abstract

Background
Transcatheter approach for large and complex atrial septal defects may represent a therapeutic challenge, particularly when the postero-inferior rim is deficient and floppy.

Case summary
Here, we describe a successful catheter-based closure of a large (&gt;30 mm) secundum atrial septal defect associated with postero-inferior rim deficiency in a 35-year-old female with congestive heart failure using pulmonary vein slide-out assisted implantation technique.

Discussion
Inferior–posterior rim deficiency is a well-known risk factor for device instability or embolization. Transcatheter closure may represent a safe and effective alternative to the traditional surgical approach provided that modified implantation techniques are employed.
Heterophile antibodies, false-positive troponin, and acute coronary syndrome: a case report indicating a pitfall in clinical practice
Authors: Lakusic Nenad , Sopek Merkas Ivana , Lucinger Daren , Mahovic Darija 
Published: February 2021

Abstract

Background
Heterophile antibodies are one of the most common causes of false-positive troponin.

Case summary
We report a case of a 53-year-old woman with false-positive troponin elevation and a clinical presentation understood and treated as non-ST-elevation acute coronary syndrome. Because of chronic basal elevation of troponin (at a ‘plateau’ level) and chest pain, the patient underwent several invasive coronary angiograms until false-positive increase of troponin due to heterophile antibodies was suspected. Borderline stenosis of a left circumflex coronary artery found on first coronary angiogram was a coincidental finding and heterophile antibodies in the patient’s serum were confirmed.

Discussion
This interesting case report aims to remind the clinicians about the possibility of false-positive troponin level due to laboratory analytical interference caused by heterophile antibodies. In this case, it is important to suspect false-positive troponin elevation, even when coronary artery disease is found. This rare and less mentioned and/or recognized cause of troponin elevation may lead to unnecessary invasive diagnostics and aggressive treatment of patients.
UK house prices and three decades of decline in the risk-free real interest rate
Authors: Miles David , Monro Victoria 
Published: February 2021

SUMMARY
House prices have risen substantially faster than the prices of consumer goods in most G7 countries over the past few decades. This raises major policy issues: such rises affect the distribution of wealth within and between generations, the mobility of labour and financial stability. This paper explores why such rises have happened, and what the policy implications are. The price rises have been greatest in the United Kingdom, where real house prices have risen more than three and a half times since the 1970s, substantially outpacing real income growth. Meanwhile, rental yields have been trending downwards—particularly since the mid-90s. This paper reconciles these observations by analysing the contribution of a number of drivers of house prices. It shows that the rise in house prices relative to incomes between 1985 and 2018 in the United Kingdom can be more than accounted for by the substantial decline in real risk-free interest rates over the period. This is slightly offset by net increases in home-ownership costs from higher rates of tax. Changes in the risk-free real rate are likely to have been a major driver of changes in house prices. We analyse why they have driven house prices up faster in the United Kingdom than in other advanced economies. Our model predicts that a 1% sustained increase in index-linked gilt yields from current rates could ultimately result in a fall in real house prices of around 20%.
Drosophilasensory receptors—a set of molecular Swiss Army Knives
Authors: Montell Craig 
Published: February 2021

AbstractGenetic approaches in the fruit fly, Drosophila melanogaster, have led to a major triumph in the field of sensory biology—the discovery of multiple large families of sensory receptors and channels. Some of these families, such as transient receptor potential channels, are conserved from animals ranging from worms to humans, while others, such as “gustatory receptors,” “olfactory receptors,” and “ionotropic receptors,” are restricted to invertebrates. Prior to the identification of sensory receptors in flies, it was widely assumed that these proteins function in just one modality such as vision, smell, taste, hearing, and somatosensation, which includes thermosensation, light, and noxious mechanical touch. By employing a vast combination of genetic, behavioral, electrophysiological, and other approaches in flies, a major concept to emerge is that many sensory receptors are multitaskers. The earliest example of this idea was the discovery that individual transient receptor potential channels function in multiple senses. It is now clear that multitasking is exhibited by other large receptor families including gustatory receptors, ionotropic receptors, epithelial Na+ channels (also referred to as Pickpockets), and even opsins, which were formerly thought to function exclusively as light sensors. Genetic characterizations of these Drosophila receptors and the neurons that express them also reveal the mechanisms through which flies can accurately differentiate between different stimuli even when they activate the same receptor, as well as mechanisms of adaptation, amplification, and sensory integration. The insights gleaned from studies in flies have been highly influential in directing investigations in many other animal models.
Deformation due to surface temperature variation on a spherically layered, transversely isotropic and self-gravitating Earth
Authors: Zhou Jiangcun , Pan Ernian , Bevis Michael 
Published: February 2021

SUMMARYWe present a theory of modern, thermally induced deformation in a realistic Earth. The heat conduction equation is coupled with standard elastic deformation theory to construct a boundary-value problem comprised of eighth-order differential equations. The accurate and stable dual variable and position propagating matrix technique is introduced to solve the boundary-value problem. The thermal load Love numbers are defined to describe the displacements and potential changes driven by thermally induced deformation. The proposed analytical method is validated by comparing the present results with exact solutions for a homogeneous sphere, which are also derived in this paper. The analytical method is then applied to a realistic Earth model to evaluate the effects of layering and self-gravitation of the Earth on displacement and changes of potential. Furthermore, the frequency dependence in the thermal load is illustrated by invoking different thermal periodicities in the computation. Thermal anisotropy is also considered by comparing the results obtained using isotropic and transversely isotropic Earth models. Results show that, when simulating thermally induced deformation, invoking a homogeneous spherical Earth leads to results that substantially differ from those obtained using a more realistic Earth model.