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Background: It is important to identify further predictors of outcome after successful transcatheter mitral valve repair (TMVR), as optimal patient selection remains difficult., Objective: The study investigates the prognostic benefit of the mean arterial pressure (MAP) to right atrial pressure (RAP) ratio (MAP/RAP ratio) after successful TMVR in patients with congestive heart failure (CHF) and severe mitral regurgitation (MR)., Method: Patients with CHF and severe MR were enrolled after successful TMVR (MR ≤ 2+ at discharge). The primary endpoint was a composite of all-cause mortality or hospitalisation for heart failure. The median follow-up time was 16 ± 9 months. Receiver Operating Characteristic (ROC) analysis was applied to assess the discriminatory power of the MAP/RAP ratio. The predictive value of the MAP/RAP ratio threshold was investigated using a Kaplan-Meier analysis. Multivariable logistic regression analysis was conducted to evaluate independent risk factors for the combined primary endpoint., Results: 145 patients (median age 76 [69-80 years], 60.3% male) were included. ROC curve analysis showed that MAP/RAP ratio was associated with an area under the curve of 0.62 (95% confidence interval (CI) 0.53-0.71; p = 0.01). A MAP/RAP ratio threshold of 7.13 was associated with 67.4% sensitivity and 57.0% specificity for the combined primary endpoint. Event-free survival was significantly lower in the MAP/RAP ratio < 7.13 group compared to those with MAP/RAP ratio ≥ 7.13 (62.2% versus 39.4%; log-rank p = 0.022). In logistic regression analysis MAP/RAP ratio was an independent predictor for the combined primary endpoint (odds ratio 0.75; 95% CI 0.62-0.90; p = 0.002)., Conclusions: The MAP/RAP ratio is associated with an unfavorable outcome in patients undergoing successful TMVR. Therefore, this new index could improve prognostic assessment of TMVR candidates., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Rico Osteresch received lecture honoraria from Abbott Vascular. Christian Frerker received lecture honoraria and travel support from Abbott Vascular. The other authors have no relationships with industry to declare]., (© 2021 The Authors.)

Impact of COVID-19 pandemic and pandemic-related social restrictions on clinical course of patients treated for acute ST-elevation myocardial infarction (STEMI) is unclear. In the present study presentation and outcome of patients with STEMI in the year 2020 were compared with the years before in a German registry that includes all patients hospitalized for acute STEMI in a region with approximately 1 million inhabitants. In the year 2020 726 patients with STEMI were registered compared with 10.226 patients in the years 2006 to 2019 (730 ± 57 patients per year). No significant differences were observed between the groups regarding age, gender and medical history of patients. However, in the year 2020 a significantly higher rate of patients admitted with cardiogenic shock (21.9% vs 14.2%, p <0.01) and out-of-hospital cardiac arrest (OHCA) (14.3% vs 11.1%, p <0.01) was observed. The rate of patients with subacute myocardial infarction (14.3% vs 11.6%, p <0.05) was elevated in 2020. Hospital mortality increased by 52% from the years 2006 to 2019 (8.4%) to the year 2020 (12.8%, p <0.01). Only 4 patients (0.6%) with STEMI in the year 2020 had SARS-CoV-2 infection, none of those died in-hospital. In conclusion, in the year 2020 a highly significant increase of STEMI-patients admitted to hospital with advanced infarction and poor prognosis was observed. As the structure of the emergency network to treat patients with STEMI was unchanged during the study period, the most obvious reason for these changes was COVID-19 pandemic-related lockdown and the fear of many people to contact medical staff during the pandemic., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Lipid rafts are highly ordered membrane microdomains enriched in cholesterol, glycosphingolipids, and certain proteins. They are involved in the regulation of cellular processes in diverse cell types, including mast cells (MCs). The MC lipid raft protein composition was assessed using qualitative mass spectrometric characterization of the proteome from detergent-resistant membrane fractions from RBL-2H3 MCs. Using two different post-isolation treatment methods, a total of 949 lipid raft associated proteins were identified. The majority of these MC lipid raft proteins had already been described in the RaftProtV2 database and are among highest cited/experimentally validated lipid raft proteins. Additionally, more than half of the identified proteins had lipid modifications and/or transmembrane domains. Classification of identified proteins into functional categories showed that the proteins were associated with cellular membrane compartments, and with some biological and molecular functions, such as regulation, localization, binding, catalytic activity, and response to stimulus. Furthermore, functional enrichment analysis demonstrated an intimate involvement of identified proteins with various aspects of MC biological processes, especially those related to regulated secretion, organization/stabilization of macromolecules complexes, and signal transduction. This study represents the first comprehensive proteomic profile of MC lipid rafts and provides additional information to elucidate immunoregulatory functions coordinated by raft proteins in MCs.