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To evaluate the visual and refractive outcomes for presbyopia and myopia treatment using the Teneo 317 M2 platform and the myopic SUPRACOR algorithm.Percy Military Hospital and private Laser Victor Hugo Center, France.Observational retrospective nonrandomized study.Fifty eyes (25 patients) treated with bilateral myopic SUPRACOR and micromonovision using the Teneo 317 M2 platform and followed up for 12 months. Study outcomes included binocular and monocular visual acuities (without correction for distance and near vision), the spherical equivalent, predictability, stability, safety, optical aberrations and complications.The mean age was 50.6 ± 2.7 years and the mean preoperative spherical equivalent was -2.6 ± 1.4 diopters. At 12 months postoperatively, the mean binocular UDVA was 0.02 ± 0.03 logMAR and 24 patients (96%) achieved an acuity of 20/25 or better. Binocular UNVA was equal to Jaeger 1 in 18 patients (72%), and Jaeger 2 or better in 23 patients (92%). Twelve eyes (24%) had lost 1 Snellen line and 1 eye (2%) had lost 2 Snellen lines of monocular CDVA. No cases required retreatment; however, one eye (2%) underwent revision surgery, due to diffuse lamellar keratitis.Our study suggests that SUPRACOR using the Teneo 317 M2 platform is a safe and effective technique for myopia and presbyopia treatment. SUPRACOR is therefore a viable alternative to monovision for presbyopia and myopia. However, a careful patient selection is essential to satisfy realistic expectations.

We propose a novel technique for measuring directly in real time, locally and non-invasively the pulse wave velocity (PWV) on peripheral arteries. Very high frame rate ultrasonic imaging (> 1000 frames/s) was achieved for tracking in 2D the propagation of transient vibrations along arterial wall. The arterial pulse waves are observed within a single cardiac cycle allowing the estimation of the pulse wave velocity with a good accuracy. In this study, this technique was validated for PWV evaluation on 25 healthy patients using conventional sonographic probes. The mean carotid PWV was found to be 5.5 ± 1.2 m/s (from 4.5 m/s to 7 m/s) with good intra and interobserver variability (inferior of 10% of the mean). These data suggest a good accuracy and reproducibility of the technique for real time PWV evaluation in vitro and on healthy volunteers.

The concept of shear wave elastography is applied to the heart. The goal of this study is to demonstrate the potential of this technique for quantifying the elasticity time variation of the myocardium. Experiments are performed in vivo on N=10 sheep with a linear high frequency probe placed directly on the myocardium. The feasibility of generating and imaging the propagation of shear wave in the beating heart and estimating locally the myocardium elasticity at each stage of a single heart cycle is investigated by repeating acquisition of shear wave propagation between 10 and 20 times per second. The dependence of estimated shear modulus with probe angle (short axis to long axis), depth and left ventricle pressure is studied in vivo and ex vivo. The short term effect of a local ischemia is also studied by coronary arteries ligature, showing the sensitivity of the technique to a local loss of contractility in the myocardium. Finally, this study shows the potential of shear wave elastography as a quantification tool of myocardium mechanical properties.

The concept of synthetic imaging using circular wave is proposed to image with a very large field of view and at a very high frame rate (≫1000 images/sec) heart motions with a conventional cardiac phased array probe. The goal of this study is to demonstrate in vivo the feasibility of this technique. Experiments are first performed in-vitro on ultrasound phantoms to optimize the trade-off between image quality and frame rate. An in vivo study is then performed on 10 sheep with a conventional phased array probe placed directly on the epicardium at different locations to obtain cine-loop of a complete heart cycle in the conventional imaging planes (long and short axis). After classical post processing of acquired cine-loop (wall tracking and tissue Doppler velocity estimation), the propagation of mechanical waves induced naturally during the heart cycle such as aortic and mitral valves closure can be observed.

Mitral valve prolapse (MVP) by Barlow disease is recognized a genetic disease. Fibro-elastic deficiency (FED)-MVP is considered a pure degenerative condition. FLNA, the first gene involved in MVP, encodes for Filamin-A, a cytoskeleton associated protein. It interacts with a protein named Filgap, encoded by ARHGAP24 (Chr. 4), in the mechanical transduction. We hypothesized that ARHGAP24 mutations could elicit MVP with same pathway. Four probands with ARHGAP24 mutations were identified among 96 MVP. By a familial echocardiographic screening we enrolled 19 adults of whom 13 had an ARHGAP24 mutation. The mutated group was matched with a control group of 39 healthy adults. Anterior (AML) and posterior (PML) mitral leaflets length and thickness were measured. The coaptation point position was the ratio of coaptation height on the systolic annulus diameter. MVP (displacement >2mm above the annulus line), minimal systolic displacement (MSD, displacement

Objective. Cell death remains a major limitation of skeletal myoblast (SM) transplantation but the patterns of cell survival and proliferation in heart and their potential modulation by thermic stresses like heat shock (HS) and cryopreservation (Cryo) are still incompletely characterized. Methods. To track SMs in situ, we developed a dual-marker system based on the semiconservative expression of the foreign soluble protein, β-Galactosidase (β-Gal) and the constitutive expression of the Y chromosome in a myocardial infarction model. Control medium or Lewis male rat SMs (fresh or subjected to Cryo or HS) were injected in Lewis female rats. Results. There was a massive cell loss early after transplantation in the fresh group, which was only partially compensated for by a subsequent proliferation. Conversely, both Cryo and HS significantly improved early cell survival but blunted subsequent proliferation so that, at 15 days posttransplantation, the total number of engrafted donor-derived Y-positive cells did not differ significantly between the three groups. Most of them expressed a skeletal muscle phenotype. Conclusions. These data confirm the high death rate of in-scar transplanted myoblasts, demonstrate the ability of those that survive to proliferate and differentiate along the myogenic pathway but do not support the efficacy of either Cryo or HS for increasing the ultimate magnitude of myoblast engraftment.

Contribuyente adicional: Constantinos O’Mahony (Reino Unido) Comite de la ESC para las Guias de Practica Clinica (GPC): Jose Luis Zamorano (presidente) (Espana), Stephan Achenbach (Alemania), Helmut Baumgartner (Alemania), Jeroen J. Bax (Paises Bajos), Hector Bueno (Espana), Veronica Dean (Francia), Christi Deaton (Reino Unido), Cetin Erol (Turquia), Robert Fagard (Belgica), Roberto Ferrari (Italia), David Hasdai (Israel), Arno W. Hoes (Paises Bajos), Paulus Kirchhof (Alemania/Reino Unido), Juhani Knuuti (Finlandia), Philippe Kolh (Belgica), Patrizio Lancellotti (Belgica), Ales Linhart (Republica Checa), Petros Nihoyannopoulos (Reino Unido), Massimo F. Piepoli (Italia), Piotr Ponikowski (Polonia), Per Anton Sirnes (Noruega), Juan Luis Tamargo (Espana), Michal Tendera (Polonia), Adam Torbicki (Polonia), William Wijns (Belgica) y Stephan Windecker (Suiza). Revisores del documento: David Hasdai (Israel) (coordinador de revision), Piotr Ponikowski (Polonia) (coordinador de revision), Stephan Achenbach (Alemania), Fernando Alfonso (Espana), Cristina Basso (Italia), Nuno Miguel Cardim (Portugal), Juan Ramon Gimeno (Espana), Stephane Heymans (Paises Bajos), Per Johan Holm (Suecia), Andre Keren (Israel), Paulus Kirchhof (Alemania/Reino Unido), Philippe Kolh (Belgica), Christos Lionis (Grecia), Claudio Muneretto (Italia), Silvia Priori (Italia), Maria Jesus Salvador (Espana), Christian Wolpert (Alemania) y Jose Luis Zamorano (Espana) Otras entidades de la ESC que han participado en la elaboracion de este documento: Asociaciones: European Association of Cardiovascular Imaging (EACVI), European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Heart Rhythm Association (EHRA), Heart Failure Association (HFA). Grupos de Trabajo: Cardiovascular Pharmacology and Drug Therapy, Cardiovascular Surgery, Developmental Anatomy and Pathology, Grown-up Congenital Heart Disease, Myocardial and Pericardial Diseases. Consejos: Cardiology Practice, Cardiovascular Primary Care. El contenido de esta Guia de Practica Clinica de la Sociedad Europea de Cardiologia (ESC) se publica solo para uso exclusivamente personal y educativo. No esta autorizado su uso comercial. No se autoriza la traduccion o reproduccion en ningun formato de las GPC de la ESC ni de ninguna de sus partes sin un permiso escrito de la ESC. El permiso puede obtenerse enviando una solicitud por escrito a Oxford University Press, la empresa editorial de European Heart Journal y representante autorizada de la ESC para gestionar estos permisos. Descargo de responsabilidad: Esta guia recoge la opinion de la ESC y se ha elaborado tras una consideracion minuciosa de las evidencias medicas y cientificas disponibles hasta la fecha. La ESC no es responsable en caso de que exista alguna contraindicacion, discrepancia o ambiguedad entre las guias de practica clinica (GPC) de la ESC y cualquier otra recomendacion o guia oficial expedida por otras autoridades publicas sanitarias relevantes, especialmente en lo relativo al uso adecuado de estrategias terapeuticas o de cuidado de la salud. Se anima a los profesionales de la sanidad a que las tengan en plena consideracion cuando ejerzan su juicio clinico, asi como en la determinacion de implantar estrategias medicas preventivas, diagnosticas o terapeuticas. No obstante, las guias no deben invalidar la responsabilidad individual de los profesionales de la salud a la hora de tomar decisiones adecuadas a las circunstancias individuales de cada paciente, consultando con el propio paciente y, cuando sea necesario y pertinente, con la persona encargada de su cuidado. Las GPC de la ESC no deben eximir a los profesionales de tomar en plena consideracion las recomendaciones o guias oficiales actualizadas que sean relevantes y que hayan sido elaboradas por las autoridades sanitarias publicas competentes para manejar a cada paciente individual de acuerdo con los datos cientificamente aceptados, de conformidad con sus obligaciones eticas y profesionales respectivas. Tambien es responsabilidad del profesional de la salud verificar las normas y los reglamentos que se aplican a los farmacos o dispositivos en el momento de la prescripcion. La lista de los revisores de las sociedades nacionales de la ESC aparece en el anexo 1. Los formularios de conflictos de intereses de los autores y revisores estan disponibles en la pagina web de la ESC (www.escardio.org/guidelines).