Luca Saba’s Post

Second Prospective Randomized Control Trial Demonstrating the Benefit of Peripheral IVUS! 237 patients with fempop disease randomized to IVUS-guided DCB treatment vs angio-guided DCB treatment. 14% improvement in patency at 1 year. Summary of results here: https://lnkd.in/gU-3Vggz This aligns with the 17% patency improvement seen in the Allan et al 150 person fem-pop RCT trail published in 2022: (https://lnkd.in/gRtz-rQr). Time is now to change your peripheral practice!! Learn more about peripheral IVUS here: https://lnkd.in/g-m7EpWg Society for Vascular Medicine Society for Cardiovascular Angiography & Interventions Society of Interventional Radiology VIVA Physicians

❤️🧲 The study evaluates mitral valve orifice area as a predictor of outcomes following biventricular repair in patients with hypoplastic left ventricles (HLV). Conducted at Boston Children’s Hospital, this single-center retrospective analysisinvolved 122 patients with HLV who underwent biventricular repair between 2005 and 2022. The focus was on preoperative cardiovascular magnetic resonance (CMR) measurements of the mitral valve (MV) orifice area during diastole. Key findings include: 1.The study identified a low MV orifice area and pre-existing MV pathology as significant risk factors for adverse outcomes post-biventricular repair. Primary composite outcomes were analyzed, including death, transplant, biventricular takedown, heart failure admission, left atrial decompression, or unexpected reoperation. 2.The median follow-up was 0.7 years, with a primary outcome freedom rate of 53% for atrioventricular canal (AVC) patients and 69% for non-AVC at two years. 3.Secondary outcomes focused on ≥ moderatemitral stenosis or regurgitation, showing a freedom rate of 49% for AVC and 79% for non-AVC at two years. 4.Independent predictors of adverse primary outcomes included MV orifice area z-score < -2, transitional AVC for AVC patients, and abnormal MV anatomy and conal-septal ventricular septal defect for non-AVC patients.This study highlights the critical role of MV orifice area in predicting outcomes in HLV patients undergoing biventricular repair, suggesting that detailed preoperative CMR evaluation of the MV is essential for optimal surgical planning and risk assessment. Dr. Kolandaivelu explains below. Full text available here 👉 https://lnkd.in/gms8HM7C

“Ordering a coronary computed tomography angiography (CCTA) exam is the most effective first step when evaluating patients with stable chest pain, according to new research being presented at the American College of Cardiology (ACC) Cardiovascular Summit 2024 meeting in Washington, D.C. CCTA has gained significant momentum in recent years, especially after updated chest pain guidelines released in 2021 by the ACC and American Heart Association gave the modality a Class 1A recommendation. CCTA is also noninvasive, widely available and relatively cheap compared to some other imaging modalities, making it even more appealing to heart teams throughout the United States. Another factor that appears to be in CT’s favor is the fact that artificial intelligence models are already available that can help evaluate patients with suspected coronary artery disease (CAD)”

Supraflex Cruz RCT in high bleeding risk patients now published in Circulation. Supraflex Cruz has large body of evidence in High bleeding risk patients subset. With 2 RCTs, 2 Registry and more to come. The patients in this study had high bleeding and high ischemic risk. This is the first study in pure HBR patients as per the ARC HBR definition. Supraflex Cruz gave numerically better and consistent industry beating results for safety and efficacy. #HBR #Supraflexcruz #cruz #SMT #cardiology #clinicaltrial

Stereotactic arrhythmia radioablation (STAR) is a non-invasive therapeutic alternative for cardiac arrhythmia. This sub-study evaluated left atrial strain (LAS) in elderly AF patients underwent STAR. Symptomatic paroxysmal AF patients aged > 70 years, with antiar- rhythmic drugs failure or intolerance, enrolled in a phase II trial that have demonstrated the feasibility of LINAC-based STAR (total dose of 25 Gy single fraction delivered in 3 min), performed a 15-day electrocardiogram Holter monitoring to detect AF episodes (≥ 30 s) and an echocardiographic LAS evaluation before and after STAR (at 1-, 3-, 6- and 12-month). Out 18 patients underwent STAR in the trial, 16 (7 males, 78 ± 5 years) completed the follow-up for LAS study. No base- line difference in echocardiographic and LAS parameters was observed between the 9 patients with AF recurrence during follow-up and those who maintained sinus rhythm. At 6- and 12-month after STAR, LAS reservoir was lower in patients with AF episodes than those without (respectively, p = 0.039 and p = 0.001). Values of left atrial area and volume as well as LAS conduit and contractile phase were not statistically significant different by patient’s outcome across evaluations. Although no baseline LAS parameter before STAR seems predict AF recurrence after treatment in elderly patients, lower values of reservoir phase were observed during follow-up in those experiencing AF episodes. More research is needed to better assess the value of LAS monitoring in paroxysmal AF patients underwent Stereotactic cardiac radioablation. Thanks to Federica Troisi MD, Antonio Di Monaco, Massimo Grimaldi Ente Ecclesiastico Ospedale Generale Regionale 'F. MIULLI' Università LUM

Exciting news! Here are the latest published results demonstrating Cleerly’s superior accuracy versus other methods when diagnosing coronary ischemia (i.e. a reduction in blood flow to the heart). Take a look!

Myocardial infarction is defined as a sudden decrease or interruption in blood flow to the coronary arteries, causing ischemic necrosis of the corresponding cardiomyocytes. It is unclear whether systemic macrovascular alterations are associated with retinal microvascular changes. This study utilized optical coherence tomography angiography (OCTA) to compare variations in conjunctival vascular density and fundus retinal vessel density between patients with myocardial infarction (MI) and healthy controls. This study recruited 16 patients (32 eyes) with MI and 16 healthy controls (32 eyes). The superficial retinal layer (SRL), deep retinal layer (DRL) and conjunctival capillary plexus in each eye were evaluated by OCTA. Parameters measured included the density of the temporal conjunctival capillary, retinal microvascular (MIR) and macrovascular (MAR) alterations and total MIR (TMI). The microvascular density of each retinal region was evaluated by the hemisphere segmentation (SR, SL, IL, and IR), annular partition (C1, C2, C3, C4, C5 and C6), and modified early treatment of diabetic retinopathy study (R, S, L, and I) methods. In the macular area, the superficial and deep retinal microvascular densities displayed notable variations. In the superficial layers, the superficial TMI, superficial MIR, and superficial MAR, as well as densities in the SL, IL, S, L, C1, C2, C5 and C6 regions, were significantly lower in MI patients (p < 0.05 each). In the deep layers, the deep MIR and deep TMI), as well as densities in the SL, IL, L, C1, C2 and C6 regions were significantly lower in MI patients (p < 0.05 each). In contrast, the conjunctival microvascular density was significantly higher in MI patients than in healthy controls (p < 0.001). The microvascular densities measured in the deep and superficial retinal layers and in the conjunctiva differ in MI patients and healthy controls. OCTA is effective in detecting changes in the ocular microcirculation. https://lnkd.in/gX8uAXmY

In the near future the war versus cardiovascular diseases will add a further track: LpA #CARDIOLOGIA #LDL #MD #dislipidemia #cardiologist #cardiology #SANDOZ #LpA #ESC #EAS

🚨📰: 𝐂𝐓 𝐅𝐢𝐫𝐬𝐭 𝐒𝐭𝐫𝐚𝐭𝐞𝐠𝐲 𝐟𝐨𝐫 𝐂𝐡𝐞𝐬𝐭 𝐏𝐚𝐢𝐧 - A study presented last week at the American College of Cardiology Cardiovascular Summit provided reinforced support for Coronary CTA's guideline recommended role as a first line test for Chest Pain. 🔬: 𝐑𝐞𝐬𝐞𝐚𝐫𝐜𝐡𝐞𝐫𝐬 𝐀𝐧𝐚𝐥𝐲𝐳𝐞𝐝 - 786 Atrium Health patients who had no prior diagnose of #coronaryarterydisease and underwent invasive coronary angiography. Patients who’s pre-ICA testing started with CCTA led to far more revascularizations (62%) than patients who received Stress MRI, Stress Echo, No Tests, or SPECT (50%, 40%, 34%, 31% respectively). #cad #cardiology #cardiacimaging #hearthealth #CCTA #cathlab