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Rates of complications have decreased especially after the use of optical coherence tomography, which helps in proper sizing of the balloons. Patients with CTEPH who are ineligible for PTE should be evaluated for BPA. In addition to medical therapy, BPA has shown promising clinical and hemodynamic outcomes in patients with CTEPH.Patent foramen ovale (PFO) is present in about one-quarter of the population and should be considered an anatomical variant rather than a malformation. The association of PFO with cryptogenic stroke, migraine, peripheral embolism and other pathologies is still controversial. The evaluation of anatomical complexity, and particularly the long-tunnel morphology, is crucial for the assessment of the risk profile and for a targeted therapeutic management. Long-tunnel PFOs seem to be more prone to clot formation and complications related to percutaneous closure procedures. Echocardiography is the most useful method to investigate anatomical complexity, confirm and reinforce the indication to treatment, select the appropriate device and guide the PFO closure towards a successful procedure.Cardiovascular diseases (CVD) are a leading cause of death worldwide. There is a rising prevalence of CVDs in Nigeria, including in rural communities. The present study assessed the total CVD risk among two rural communities in Bayelsa State, South-south Nigeria. Adults aged ≥ 40 years in 264 randomly selected households in two rural communities in Bayelsa State were interviewed in this descriptive cross-sectional survey. Using a structured questionnaire, data on socio-demographic characteristics, anthropometry, blood pressure (BP) and random blood sugar measurements were obtained. The WHO/ISH risk assessment chart for the African sub-region was used to estimate the 10-year total risk of fatal or non-fatal CVD events using five predictor variables age, gender, smoking, systolic BP, and coexistence of diabetes mellitus (DM). Of the 264 participants, majority was men (70.1%) and married (93.2%). Mean age was 50.9±8.1 years. Most participants were overweight (53.4%), add salt to food on table (97.0%), lead a sedentary lifestyle (79.2%) and greater than a third of participants (36.7%) were known hypertensive patients. Using the WHO/ISH risk prediction chart for Africa, 90.0% and 10.0% of the study population had low and moderate risk, respectively of developing cardiovascular events in 10 years. As the age of participants increases, the 10-year risk of a cardiovascular event increased (X 2-48.9; P-0.001). History of hypertension (X 2-20.0; P-0.001), DM (X 2-5.87; P-0.016) and smoking (X 2-23.42; P-0.001) were significantly related to the level of 10-year cardiovascular event risk. Sex showed no significant relationship. There is a high prevalence of several cardiovascular risk factors in this rural population, though the 10-year risk of CV event is still low. CVD risk in rural communities requires awareness, monitoring and an integrated approach in their prevention, detection, and treatment.

The COVID-19 outbreak harmed acute coronary syndromes. During the national lockdown in Italy, the fear of post-admission contagion translated into significant delays in seeking medical help among STEMI (ST-elevation myocardial infarction) patients.

Our analysis aimed to assess the ACS (Acute Coronary Syndromes) admissions during the pandemic, together with time to presentation and clinical outcomes compared to 2019 in a cardiovascular hub in Milan. Data of ACS patients admitted during the pandemic year 2020 were extracted by the hospital’s database and compared to a historical cohort of patients admitted for the same clinical indications in 2019.

A total of 599 ACS cases were recorded in 2020 vs. 386 cases in 2019, with a net 55% increase, associated with late clinical presentations, a threefold increase in cardiogenic shock, and a more than two-fold higher mortality rate.

The ultimate goal of this analysis is to preserve the life-saving focus on universal and prompt STEMI diagnosis and treatment, even in a time of dynamic global crisis.

The ultimate goal of this analysis is to preserve the life-saving focus on universal and prompt STEMI diagnosis and treatment, even in a time of dynamic global crisis.

Prolonged afterload increase in aortic stenosis (AS) may alter left ventricular (LV) contractility, irrespective of LV ejection fraction (LVEF). The prevalence and morbimortality associated with the apical sparing strain pattern (ASP), a typical finding of cardiac amyloidosis (CA), are not fully understood in patients with AS. We assessed the prevalence of the ASP in patients with severe AS and its clinical impact after transcatheter aortic valve implantation (TAVI).

Eighty-nine consecutive patients with severe AS and LV hypertrophy referred for TAVI were included. Baseline clinical and echocardiographic data were assessed, including the ASP in bull’s eye plots (ASPB), relative apical longitudinal strain (RALS) and EF to global longitudinal strain (EF/GLS) ratio. We analysed all-cause mortality; a composite of all-cause mortality, stroke, and heart failure hospitalizations; and the rate of pacemaker implantation, after TAVI.

Mean age was 82 ± 6 years and mean LVEF was 57 ± 10%. ASPB and RALS >1 were present in 43.8% and 24.7% of patients, respectively. Over a median follow-up of 13 months (IQR 6-32), ASPB was associated with higher rates of all-cause mortality (log-rank P=0.001) and was an independent predictor of all-cause mortality in multivariate analysis. Combination of the ASPB and GLS or EF/GLS ratio improved the risk stratification. Patients with RALS >1 were more likely to have new BBB and an indication for pacemaker implantation (P=0.048).

The ASP, as assessed by the ASPB and RALS, was frequent in patients with AS regardless of the diagnosis of CA. The ASPB may refine risk stratification in patients referred for TAVI.

The ASP, as assessed by the ASPB and RALS, was frequent in patients with AS regardless of the diagnosis of CA. The ASPB may refine risk stratification in patients referred for TAVI.

Stress-gated myocardial perfusion scintigraphy (MPS) is used for prognosis in stable coronary artery disease (CAD). We sought to assess coronary artery bypass grafting (CABG) outcomes in stable coronary artery disease patients who had myocardial perfusion scintigraphy and left ventricular (LV) dysfunction.

Stable CAD patients who underwent CABG (2012-2019) and had stress-gated MPS were identified retrospectively. Based on the post-stress LV ejection fraction, a total of 130 patients were divided into a control group (51%) and LV dysfunction group (49%).

Patients with left ventricular dysfunction had significantly more mean summed stress score (22.1 ± 9 Vs. 12.5 ± 8; P ≤ 0.001) and summed resting score (14.6 ± 8 Vs. GX15-070 manufacturer 3.7 ± 4; P ≤ 0.001) compared to the control group respectively. They also had a greater risk for developing low cardiac output syndrome after surgery (OR 2.9, 95% CI 1.1-6.6, P=0.033). At 4.7 years, freedom from cardiac death was not statistically significant between the left ventricular dysfunction and control groups, respectively (90.2% vs. 95.6%; P=0.157). Cardiac death was not influenced by either ventricular dysfunction at the time of surgery (HR 2.6, 95% CI 0.64-10.6, P=0.182) nor by having percent ischemic myocardium > 10% (HR 0.86, 95% CI 0.23-3.24, P=0.826).

Significant myocardial ischemia and ventricular dysfunction before complete surgical revascularization did not influence the risk of cardiac-related deaths on long-term follow-up. This might be related to the improved survival after CABG in patients with myocardial ischemia and left ventricular dysfunction.

Significant myocardial ischemia and ventricular dysfunction before complete surgical revascularization did not influence the risk of cardiac-related deaths on long-term follow-up. This might be related to the improved survival after CABG in patients with myocardial ischemia and left ventricular dysfunction.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown promise in improving cardiovascular outcome in patients with heart failure (HF) and diabetes mellitus (DM). Although these benefits have been confirmed by several meta-analyses, small studies have not been included into these pooled analyses.

Publication of recent RCTs prompted us to perform this updated meta-analysis to examine the consistency of favorable cardiovascular outcomes of SGLT2 inhibitors in HF patients by inclusion of clinical trials with small sample size.

We conducted a systematic review of the literature in PubMed/Medline and ClinicalTrials.gov to identify all RCTs investigating the benefits of SGLT2 inhibitors in patients with HF. The primary endpoint of this meta-analysis was to compare the cardiovascular death (CVD) and hospitalization for HF (HHF) between patients who received an SGLT2 inhibitor and those who received a placebo or a non-SGLT2 inhibitor. We used a risk difference (RD) and log hazard ratio (HR) to pool the rebetes status.

SGLT2 inhibitors have shown a promise in reducing CVD and HHF in patients with HF, regardless of ejection fraction or diabetes status.

Procoagulant profile of 2019-nCoV/SARS-CoV-2 has been well documented over the last year. Perturbance in coagulating factors has also been reported in Covid-19 patients, including increased d-dimers and reports of lupus anticoagulant (LA).

The current study aimed to identify the incidence of positivity of lupus anticoagulant in Covid-19 patients and analyze the association between LA and D-dimer in predicting thrombosis and mortality in one-hundred and five hospitalized adult (age >14 years) patients and forty-three hospitalized pediatric (age <14 years) patients with a confirmed diagnosis of Covid-19 between June 2020 and September 2020.

Twenty-one (20%) adult patients were tested positive for PTT LA, of which nine (8.6%) turned out to be confirmed positive for LA through StaClot and DRVVT Ratio tests. Six (14%) pediatric patients were positive for PTT LA, and only one (2.3%) had positive StaClot. Median D-dimer at admission was positively correlated with age and CRP among adult patients and was significantly higher in expired cases (P=0.001). No association between any of the coagulation tests and thrombosis or mortality was observed in the pediatric cohort.

We report an increased incidence of LA in Covid-19 patients, yet we didn’t find any association between thrombotic events or mortality, probably due to the small sample size.

We report an increased incidence of LA in Covid-19 patients, yet we didn’t find any association between thrombotic events or mortality, probably due to the small sample size.

Transfusion is commonly done in clinical indications and complications arising due to Anemia, shock, blood loss, thrombocytopenia due to any cause, ineffective erythropoiesis. Pregnancy is a physiological condition characterized by Anemia, fluid overload, hypercoagulable state, and antifibrinolytic condition, which can cause various reactions that could be anticipated during a blood transfusion. With an aim to understand the effects of transfusions on hematological parameters in pregnancy. The results of whole blood and component transfusion were studied to understand increments and their effects so that rationalized transfusion decisions during pregnancy can be undertaken, considering the physiological changes in pregnancy on hemodynamics are present.

A prospective study with 80 pregnant females undergoing blood transfusion was studied. Their coagulation and hematological profile were correlated to derive a conclusion for the effect of transfusion of blood and its products.

A mean increment of 0.55+0.07 g/dL hemoglobin (Hb) was noted along with a slight increase in RBC count (0.