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Myocardial bridging (MB) is a common anatomic variant in coronary arteries with unclear functional significance. We evaluated regional myocardial strain by speckle tracking during dobutamine stress echocardiography (DSE) in patients with MB in the left anterior descending coronary artery (LAD). We studied 11 patients with MB in the LAD and no obstructive coronary artery disease (CAD), 7 patients without MB, but obstructive CAD in the LAD, and 12 controls without MB or obstructive CAD. MB was defined as either > 1 mm (superficial) or > 2 mm (deep) intramyocardial course of the LAD in coronary CT angiography. Regional longitudinal, radial and circumferential strains and strain rates as well as post-systolic strain index (PSI) were measured at rest, peak stress, and early recovery (1 min after stress). Strain parameters during DSE were similar in the myocardium distal to MB and other myocardial regions of the same patients as well as the LAD territory in controls. However, patients with obstructive CAD showed impaired LS and strain rate as well as increased PSI at peak stress. None of the MB was associated with systolic compression in invasive coronary angiography and strain parameters were similar between superficial and deep MB. Stress myocardial blood flow by positron emission tomography correlated with LS and RS at peak stress in the myocardium distal to MB (r = - 0.73, p = 0.03, and r = 0.64, p = 0.04, respectively). Myocardial strain is not reduced during DSE in patients with MB in the LAD and no significant systolic compression., (© 2024. The Author(s).)

Background: Cardiac sarcoidosis (CS) is a rare but potentially fatal inflammatory cardiomyopathy., Objectives: The authors studied temporal changes in the incidence, characteristics, and outcome of CS., Methods: A retrospective analysis was made of a 30-year nationwide cohort of CS., Results: The cohort comprised 511 patients with a median age of 52 years and female preponderance (69%). Altogether 77, 166, and 268 cases of CS were diagnosed in years 1988 to 2009, 2010 to 2014, and 2015 to 2019, respectively; the 5-year count of 2015 to 2019 was 134-fold the count of 1990 to 1994 (268/2) and 18-fold the count of 2000 to 2004 (268/15). Prior to 2010, compared with the later periods, CS presented more often with ventricular tachycardia/fibrillation (prevalence 36% vs 19% in 2010-2014 and 11% in 2015-2019, P  < 0.001), left ventricular ejection fraction <50% (49%, 35%, and 31%; P  = 0.010), and elevation of natriuretic peptides (87%, 57%, and 49%; P  < 0.001). On magnetic resonance imaging, late gadolinium enhancement involved a median of 15% (IQR: 11%-22%) of left ventricular mass in studies of 1988 to 2009 (n = 16), 15% (IQR: 9%-22%) in studies of 2010 to 2014 (n = 87), and 11% (IQR: 5%-19%) in studies of 2015 to 2019 (n = 150) ( P  = 0.031). The respective 5-year incidences of the composite of death, heart transplantation, left ventricular-assisted device implantation, or ventricular tachyarrhythmia were 40% (95% CI: 29%-51%), 32% (95% CI: 25%-39%), and 23% (95% CI: 16%-30%) ( P  = 0.002). The prognostic trend disappeared after adjustment for differences in the presenting phenotype., Conclusions: Diagnoses of incident CS have increased exponentially in Finland. Concurrently, the phenotype has turned milder and prognosis better, suggesting detection of CS at an earlier stage of its course., Competing Interests: Dr Pöyhönen was supported by the 10.13039/501100003125Finnish Cultural Foundation (Helsinki, Finland), 10.13039/501100005633Finnish Foundation for Cardiovascular Research (Helsinki, Finland) and Finnish government grant for medical research (Helsinki, Finland). Dr Uusitalo has scientific collaboration with lecture fees with GE Healthcare; and has received lecture fee and advisory board activity with Pfizer. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)

Competing Interests: Disclosures Dr Uusitalo reports advisory board activity with and lecture honoraria from GE Healthcare and Pfizer. Dr Lehtonen reports lecture honoraria from Pfizer. The other authors report no conflicts.

Mitigation actions in all sectors of society, including sports, to limit global warming have become an increasingly hot topic in public discussions and sports management. However, so far, there has been a lack of understanding and practical examples of how these organizations, especially in team sports, can holistically assess and reduce their climate impacts to achieve carbon neutrality. This paper presents a carbon footprint assessment, implemented actions for GHG emission reduction, and offers the example of a professional Finnish ice hockey team that achieved carbon neutrality. The study is based on a life cycle assessment method. The Results show that the team's carbon footprint was reduced from 350 tCO 2eq by more than 50% between seasons 2018-2019 and 2021-2022 in the assessed categories. The most GHG emission reductions were achieved in the team's and spectators' mobility and ice hall energy consumption. Furthermore, the team compensated for their remaining emissions to achieve carbon neutrality. Multiple possibilities for further GHG emission reductions were recognized. The majority of the GHG emissions were linked to the Scope 3 category, indicating that co-operation with partners and stakeholders was a key to success in attaining carbon neutrality. This paper also discusses the possible limitations and challenges that sport organizations face in assessing climate impacts and reducing GHG emissions, as well as the prospects of overcoming them. Since there are many opportunities for sports to contribute to climate change mitigation, relevant targets and actions to reduce GHG emissions should be integrated into all sport organizations' management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Cardiac transthyretin amyloidosis (ATTR) is a possible incidental finding on bone scintigraphy imaged due to prostate cancer. We investigated its significance in 1426 elderly prostate cancer patients (>70 years) who underwent bone scintigraphy in three nuclear medicine departments in Finland. Patients with Perugini grade two or three uptakes were considered positive for cardiac uptake. Heart failure diagnoses and pacemaker implantations were collected from the hospital's records. Mortality data were gathered from the Finnish national statistical service (Statistics Finland). The Median follow-up time was 4 years (interquartile range: 2-5 years). Cardiac uptake was detected in 37 individuals (2.6%), and it was associated with an elevated risk of both overall and cardiovascular death in univariable analysis. However, cardiac uptake did not predict overall mortality in the multivariable analysis when adjusted to age, bone metastases or the diagnosis of heart failure (p > 0.05). The risk of heart failure was higher in patients with cardiac uptake (47% vs. 15%, p < 0.001), while the risk of pacemaker implantations was not elevated (5% vs. 5%, p = 0.89). In conclusion, cardiac uptake on bone scintigraphy imaged due to prostate cancer is associated with an elevated risk of heart failure and both overall and cardiovascular death. However, cardiac uptake was not independently associated with overall mortality when adjusted to age, bone metastasis or heart failure. Therefore, they are essential to consider when incidental cardiac uptake is detected on bone scintigraphy. The need for pacemaker implantation was not elevated in patients with cardiac uptake., (© 2023 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.)