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Changes in skin resistance and beat-by-beat heart rate, derived from the EKG, were obtained from the same pair of dry silver electrodes applied to the finger tips. The electronic criteria to be satisfied for application of this technique are discussed. The recording system was constructed using low-cost, solid-state circuitry. A typical record of changes in skin resistance and beat-by-beat heart rate is presented to demonstrate the performance characteristics of the equipment. [ABSTRACT FROM AUTHOR]

Intracoronary streptokinase administration during acute myocardial infarction is a time-consuming and potentially dangerous technique. However, it does appear to be beneficial in terms of reduced mortality and improved left ventricular function. We have prospectively studied 258 patients with acute myocardial infarction of whom 180 were subjected to acute cardiac catheterisation and intracoronary streptokinase administration. The remaining 78 either refused the protocol or met exclusion criteria and were studied prospectively as a control group. Patients with anterior myocardial infarction demonstrated a most profound improvement in both mortality and myocardial function with intracoronary thrombolytic therapy. Patients with inferior myocardial infarction demonstrated an improvement in left ventricular function with successful coronary reperfusion, but did not achieve a statistically significant improvement in mortality compared to controls. Time from onset of pain to reperfusion up to 18 h after onset of pain did not affect improvement in left ventricular function or survival. Patients more than 65 years of age did not show a difference in survival when treated with thrombolytic therapy compared with controls of similar age group. However, patients less than 65 years of age treated with intracoronary streptokinase therapy demonstrated a mortality of 4% compared to 18% in similar controls. Two patients may have died as a direct result of intracoronary thrombolytic therapy, but no patients died as a result of bleeding complications. Thus, the most striking results with intracoronary thrombolytic therapy during evolving myocardial infarction are seen in patients with anterior myocardial who are less than 65 years of age. Time from onset of pain to reperfusion and presence of Q waves on initial electrocardiogram do not affect the observed outcome of this intervention. [ABSTRACT FROM PUBLISHER]

Objective. This study aimed to investigate the application value of intracardiac echocardiography (ICE) in transcatheter closure of a patent foramen ovale (PFO) combined with an adjacent atrial septal defect (ASD). Methods. This retrospective study included five patients with PFO combined with adjacent ASD who underwent transcatheter closure and were admitted to the Zhongshan Hospital of Fudan University from June to September 2023. General conditions, ultrasound and ICE findings, and operative data were recorded and followed up for 2–6 months. Results. Of the five patients, two and three had embolic stroke of undetermined source and migraine, respectively, aged 45.6 ± 12.0 years. All patients underwent successful transcatheter closure via the PFO tunnel under the guidance of ICE, without complications or new stroke, and showed significantly reduced migraine at the follow-up. Conclusion. In patients with PFO combined with adjacent ASD, closure of a PFO tunnel could be successfully achieved under ICE guidance; its clinical efficacy was accurate and worthy of promotion. [ABSTRACT FROM AUTHOR]

Photoacoustic imaging is a novel biomedical imaging modality that has emerged over the recent decades. Due to the conversion of optical energy into the acoustic wave, photoacoustic imaging offers high-resolution imaging in depth beyond the optical diffusion limit. Photoacoustic imaging is frequently used in conjunction with ultrasound as a hybrid modality. The combination enables the acquisition of both optical and acoustic contrasts of tissue, providing functional, structural, molecular, and vascular information within the same field of view. In this review, we first described the principles of various photoacoustic and ultrasound imaging techniques and then classified the dual-modal imaging systems based on their preclinical and clinical imaging applications. The advantages of dual-modal imaging were thoroughly analyzed. Finally, the review ends with a critical discussion of existing developments and a look toward the future. [ABSTRACT FROM AUTHOR]

Background. Despite an association between operator volumes and procedural success, there remains an incomplete understanding of the contemporary utilization and procedural volumes for mitral valve transcatheter edge-to-edge repair (MTEER). We aimed to identify annual operator procedural volumes, temporal trends, and geographic variability for MTEER among Medicare patients in the United States (US). Methods. We queried the National Medicare Provider Utilization and Payment Database for a CPT code (33418) specific for MitraClip device from 2015 through 2019. We analyzed annual operator procedural volumes and incidence and identified longitudinal and geographic trends in MTEER utilization. Results. From 2015 through 2019, a total of 27,034 MTEER procedures were performed among Medicare patients in the US. The nationwide incidence increased from 6.2 per 100,000 patients in 2015 to 23.8 per 100,000 patients in 2019, a 283% increase over the study period (Ptrend < 0.001). The incidence of MTEER by state varied by nearly 900% (range 5.5 to 54.9 per 100,000 person-years). In 2019, the mean annual MTEER operator annual volume was 9.1 MTEER procedures and had grown from 6.2 per year in 2015. Conclusions. In this nationwide study of Medicare beneficiaries in the United States, we identified a significant and sustained increase in the utilization of MTEER devices and operators and growth in annual procedural volumes from 2015 through 2019 with considerable variability in utilization by state. Further studies are needed to understand the clinical impact of variability in utilization and the optimal procedural volumes to ensure high efficacy outcomes and maintain critical access to MTEER therapies. [ABSTRACT FROM AUTHOR]

Since the early 1990s, > 3,000 ha of wetlands (and adjacent prairie) have been restored on the row-crop agricultural landscape of Winnebago County, Iowa, U.S.A. From 2014–2016, we surveyed 45 wetlands among 19 easements for occupancy by Eastern Tiger Salamanders (Ambystoma tigrinum tigrinum) and used radio-telemetry to measure their patterns of movement and habitat use. Rates of occupancy increased with wetland age, from < 25% for wetlands 1–2 years old to ∼75% for wetlands > 11 years old. A two-year survey (2014 and 2015) of ten wetlands restored in 2013 showed that nine were occupied after two years; we did not find a relationship between distance to the nearest salamander population and occupancy of newly restored wetlands by salamanders. We tracked 30 salamanders after they left their breeding wetlands for an average of 69637 d (range 5 14–109 d) and relocated them a total of 393 times. Typically, once a salamander left its breeding wetland, it traveled 50–350 m over several days, found a suitable burrow, then remained for much of the rest of the season. Mean daily distances traveled by salamanders were 7.965.6 m (range 5 0–135 m); the range of maximum straight-line distances moved was 26–659 m; only one individual salamander traveled in a statistically linear path, relative to a random walk. While ∼90% of the landscape was composed of row-crop fields, salamanders used protective grassy habitats (e.g., restored prairie, road ditches) on ∼88% of our observations. Only three salamanders used row-crop fields, and two of them were killed by heavy equipment. Regardless of the terrestrial habitat types used by salamanders, we found them underground on 336 (84.8%) of our observations. [ABSTRACT FROM AUTHOR]

The aim of the work. To summarize and expand knowledge about current methods used for visualization of coronary arteries, their evolution, capabilities, effectiveness, indications for use, safety for patients, guided by the principles of evidence-based medicine. Coronary artery disease (CAD) is an extremely common clinical cardiovascular disease, which is caused by atherosclerosis of the subepicardial coronary arteries (CAs) and can have both acute and chronic course. The incidence of CAD is increasing every year and getting younger. CAD has not only a high morbidity rate, but also a high mortality rate. In Ukraine, mortality from CAD is the main cause of population mortality. Without timely diagnosis and effective treatment, myocardial infarction or sudden cardiac death may develop. It is possible to ascertain the etiological cause of myocardial ischemia only after visualization of the CAs. A practicing physician is able to visualize the CAs using X-ray contrast coronary angiography or contrast-enhanced computed tomography of the chest. CA visualization methods have been used in clinical practice for more than half a century. The hardware and software are constantly upgraded, the diagnostic options of these methods are improved and expanded, and recommendations regarding their use in general clinical practice are updated. The main task for clinicians is to confirm or rule out the presence of a CA atherosclerotic lesion, as well as to determine its localization, extent, degree of stenosis and its significance for coronary blood flow, the presence of CA calcification, collateral pathways, plaque composition and its internal structure. Only after identifying the anatomical and physiological aspects of the atherosclerotic process in CA, it is possible to choose the right strategy for the treatment of patients by a multidisciplinary heart team including pharmacological therapy, a method of cardiac revascularization, and measures for primary or secondary prevention. Conclusions. CAD is a common disease worldwide. Today, two methods of the CA visualization are available - invasive coronary angiography and non-invasive coronary CT angiography. Further research is needed on the efficacy and safety of different CA imaging methods in CAD. Better results of the diagnostic search depend on both the capabilities of the clinic hardware component and on the optimal sequence for diagnostic processes rationally constructed by physicians. [ABSTRACT FROM AUTHOR]

Objectives. To study trends of utilization, in-hospital outcomes, and short outcomes in patients undergoing transcatheter mitral valve repair (TMVR) vs. surgical mitral valve repair (SMVR) in atrial fibrillation (AF). Background. TMVR is a treatment option in inoperable or high-risk patients with mitral regurgitation (MR). AF is a common comorbidity of MR. Data comparing between TMVR and SMVR in MR patients with AF is lacking. Methods. The National Readmission Database from 2016 to 2019 was utilized to identify hospitalizations undergoing TMVR or SMVR with AF. Outcomes of interest included mortality, postoperative complications, length of stay, and 30-day readmission rate. Results. A total of 9,195 patients underwent TMVR and 16,972 patients underwent SMVR with AF; the number of AF undergoing TMVR was increasing from 1,342 in 2016 to 4,215 in 2019 and SMVR. The incidence of in-hospital mortality decreased from 2.6% in 2016 to 1.8% in 2019. We identified length of stay>5 days, dyslipidemia, cerebrovascular disease, heart failure with reduced ejection fraction, and urgent/emergent admissions as independent risk factors for in-hospital mortality. After matching, we included 4,680 patients in each group; the in-hospital death, transfusion, acute kidney injury, sepsis, stroke, and mechanical ventilation were lower in TMVR compared with SMVR. TMVR was associated with a similar rate of all-cause readmission at 30 days compared with SMVR. Conclusion. Patients with AF receiving TMVR have been increasing along with progressive improvement in in-hospital death and length of stay. Compared to SMVR, AF patients receiving TMVR had a lower rate of in-hospital death and postoperative complications. [ABSTRACT FROM AUTHOR]

Objective. We aimed to investigate outcomes in transcatheter versus surgical mitral valve repair in patients with secondary mitral regurgitation (MR) by leveraging a global, multi-institutional federated network database. Methods. Using validated ICD-10 and CPT codes, the TriNetX Analytics Research Data Network (a global federated database of electronic health records from 58 healthcare organizations) was queried to identify patients diagnosed with chronic, severe, ischemic MR and undergoing either transcatheter mitral valve repair (TMVr) or surgical mitral valve repair (SMVr) between January 1, 2015 and December 31, 2020. To adjust for baseline differences, 1 : 1 propensity score matching was performed via logistic regression using the nearest-neighbor approach and matching for 29 covariates including demographics, comorbidities, surgical history, preoperative medications, left ventricular function and heart failure status. We compared 1- and 3-year mortality rates and 1- and 3-year mitral valve reoperation rates in the matched cohorts using Kaplan-Meier estimates and adjusted Cox proportional hazards models. Results. A total of 2,352 patients met inclusion criteria (1,392 in the surgical mitral valve repair group and 960 in the TMVr group). After 1 : 1 propensity score matching, a total of 550 patients undergoing surgical mitral valve repair (SMVr) were compared to 550 patients undergoing TMVr. All characteristics were adequately matched between the cohorts (standardized mean difference <0.1). At 1- and 3-years respectively, mortality rate was 13.4% and 20.7% for surgical patients and 19.8% and 40.3% for TMVr patients. When compared to TMVr, patients undergoing SMVr were significantly less likely to face mortality at 3 years (HR: 0.42, 95% CI: 0.31–0.56, p < 0.0001). At 1- and 3-years respectively, mitral valve reoperation was 2.2%, and 2.4% for surgical patients and 6.6% and 7.8% for TMVr patients. When compared to TMVr, patients undergoing SMVr were significantly less likely to undergo mitral valve reintervention at 3 years (HR: 0.29, 95% CI: 0.14–0.58, p = 0.0002). Conclusion. In a real-world, propensity score matching analysis of a large cohort of patients with chronic ischemic MR, surgical mitral valve repair had significantly better survival rates and significantly lower reintervention rates at 1- and 3-years compared to TMVr. [ABSTRACT FROM AUTHOR]

Objective. To determine prognostic role of endothelial progenitor cells (EPCs) in intensive care patients with acute myocardial infarction (AMI). Materials and Methods. From December 2018 to July 2021, a total of 91 eligible patients with AMI were consecutively examined in a single intensive care unit (ICU) in China. Patients with a history of acute coronary artery disease were excluded from the study. Samples were collected within 24 hr of onset of symptoms. EPCs, defined as coexpression of CD34+/CD133+ cells or CD133+/CD34+/KDR+, were studied using flow cytometry and categorized by quartiles. Based on the 28-days mortality outcome, the patients were further divided into two groups: death and survival. The study incorporated various variables, including cardiovascular risk factors such as body mass index, hypertension, diabetes, hypercholesterolemia, atherosclerotic burden, and medication history, as well as clinical characteristics such as APACHEⅡscore, central venous-arterial carbon dioxide difference (GAP), homocysteine, creatinine, C-reactive protein, HbAlc, and cardiac index. Cox regression analysis was employed to conduct a multivariate analysis. Results. A total of 91 patients with AMI who were admitted to the ICU were deemed eligible for inclusion in the study. Among these patients, 23 (25.3%) died from various causes during the follow-up period. The counts of EPCs were found to be significantly higher in the survival group compared to the death group (P < 0.05). In the univariate analysis, it was observed that the 28-days mortality rate was associated with the several factors, including the APACHEⅡscore (P = 0.00), vasoactive inotropic score (P = 0.03), GAP (P = 0.00), HCY (P = 0.00), creatinine (P = 0.00), C-reactive protein (P = 0.00), HbAlc (P = 0.00), CI (P = 0.01), quartiles of CD34+/CD133+ cells (P = 0.00), and quartiles of CD34+/CD133+/KDR+ cells (P = 0.00). CD34+/CD133+/KDR+ cells retained statistical significance in Cox regression models even after controlling for clinical variables (HR: 6.258 × 10−10 and P = 0.001). Nevertheless, no significant correlation was observed between CD34+/CD133+ cells and all-cause mortality. Conclusions. The decreased EPCs levels, especially for CD34+/CD133+/KDR+ cells subsets, were an independent risk factor for 28-days mortality in AMI patients. [ABSTRACT FROM AUTHOR]

Influenza is a virus that attacks the nasal passages, including the throat and lungs. Influenza-like virus in adults is partly due to changes in the body's defense system. The present study was performed to evaluate influenza-like virus effects in adults. This case-control study was performed on 50 patients admitted to the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine during the autumn and winter seasons with myocardial infarction and 50 patients as controls. History, tests, and clinical examinations in both groups did not show diabetes, hypertension, dyslipidemia, or smoking. For both groups, Influenza-like experiments were performed in the form of fever with cough or sore throat. The mean age was 53.7 ± 8.99 years in the case group and 54.1 ± 8.89 years in the control group. 25 patients (50%) in the case group and 6 patients (12%) in the control group had influenza-like infection and the comparison between the two groups showed a statistically significant difference (CI=1.165-8.551, OR=4.5, P=0.005). The frequency of influenza-like infections in both sexes was higher in the case group than the control group (men CI = 1.032-6.742, OR = 3.8, P = 0.002 and women CI = 1.102-11.155, OR = 5.7, P = 0.003). The influenza-like test was more than twice as positive in the case group as in the control group. Therefore, influenza-like infection is a risk factor for heart attack and getting an influenza vaccine is recommended for people who are prone to heart disease. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To assess the effectiveness of educational interventions and the relative effect of intervention duration on secondary prevention health behaviours in adults with coronary heart disease. Background: Patient education can reduce disease progression and improve outcomes. However, there is a lack of knowledge of its efficacy and the relative impact of education duration on health behaviour change in this population. Design: A systematic review and meta‐analysis. Methods: Seven electronic databases and grey literature were searched from Inception to July 2021. The review followed the PRISMA guidelines. This meta‐analysis was analysed in Comprehensive Meta‐Analysis version 3 software. Outcomes considered were disease knowledge and health behavioural outcomes. Data were pooled together with random‐effects models using the inverse‐variance method. The effect of education duration (<3 vs. ≥3 months) was examined by meta‐regressions. Results: In summary, 73 studies were included with a total of participants (n = 24,985) aged mean of 60.5 ± 5.7 years and mostly male (72.5%). Patient education improved all behaviours including disease knowledge at <6 and 6–12 months follow‐up, the likelihood of quitting smoking at <6, and 6–12 months, medication adherence at <6 and 6–12 months; physical activity and exercise participation at <6 and 6–12 months and healthy dietary behaviours, at <6 and 6–12 months. Furthermore, education programmes with a longer duration (≥3 months) improved disease knowledge and physical activity more than shorter programmes. Conclusion: Patient education for secondary prevention, in various delivery modes and intensities, improves multiple self‐reported health behaviours in patients with coronary heart disease. Relevance to clinical practice: This study assessed the effectiveness of secondary prevention education and demonstrated improvements in all outcomes in this population. Longer duration programmes were more effective in improving disease knowledge and physical activity in the long term. These findings can assist the cardiac programmes' design, particularly in ensuring sufficient intervention duration. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effects of a theory of goal attainment–based care plan on quality of life among patients with myocardial infarction. One hundred two patients were randomly assigned to two groups. The intervention group received a theory of goal attainment–based care plan during their hospital stay and a two-month follow-up assessment after hospital discharge. Quality of life was assessed using the Persian version of the MacNew Heart Disease Health-Related Quality of Life questionnaire. Despite no significant difference between the groups with respect to the pretest mean scores of quality of life and its dimensions (p >.05), the posttest mean scores of quality of life and its dimensions in the intervention group were significantly greater than those of the control group (p <.001). Moreover, while the mean scores of quality of life and its dimensions significantly increased in the intervention group (p <.001), they did not significantly change in the control group (p >.05), except for the mean score of physical functioning (p =.032). [ABSTRACT FROM AUTHOR]

Background. Transcatheter aortic valve replacement (TAVR) is known to increase the incidence of conduction disturbances compared to surgical aortic valve replacement; however, there are limited data on the impact and duration of these conduction disturbances on longer term outcomes. Objective. To determine the differential impact of persistent versus nonpersistent new-onset conduction disturbances on TAVR-related complications and outcomes. Methods. This is a single-center retrospective analysis of 927 consecutive patients with aortic stenosis who underwent TAVR at Yale New Haven Hospital from July 2012 to August 2019. Patients with new-onset conduction disturbances within 7 days following TAVR were selected for this study. Persistent and nonpersistent disturbances were, respectively, defined as persisting or not persisting on all patient ECGs for up to 1.5 years after TAVR or until death. Results. Within 7 days after TAVR, conduction disturbances occurred in 42.3% (392/927) of the patients. Conduction disturbances persisted in 150 (38%) patients and did not persist in 187 (48%) patients, and 55 (14%) patients were excluded for having mixed (both persistent and nonpersistent) disturbances. Compared with nonpersistent disturbances, patients with persistent disturbances were more likely to receive a PPM within 7 days after the TAVR procedure (46.0% versus 4.3%, p < 0.001) and had a greater unadjusted 1-year cardiac-related and all-cause mortality risk (HR 2.54, p = 0.044 and HR 1.90, p = 0.046 , respectively). Conclusion. Persistent conduction disturbances were associated with a greater cardiac and all-cause mortality rate at one year following TAVR. Future research should investigate periprocedural factors to reduce persistent conduction disturbances and outcomes beyond one year follow-up. [ABSTRACT FROM AUTHOR]

Blood pump design efforts are focused on enhancing hydraulic effectiveness and minimizing shear stress. Unlike conventional blood pumps, interventional microaxial blood pumps have a unique outflow structure due to minimally invasive technology. The outflow structure, composed of the diffuser and cage bridges, is crucial in minimizing the pump size to provide adequate hemodynamic support. This study proposed four outflow structures of an interventional microaxial blood pump depending on whether the diffuser with or without blades and cage bridges were straight or curved. The outflow flow structure’s effect on the blood pump’s hydraulic performance and shear stress distribution was evaluated by computational fluid dynamics and hydraulic experiments. The results showed that all four outflow structures could achieve the pressure and flow requirements specified at the design point but with significant differences in shear stress distribution. Among them, the outflow structure with curved bridges would make the blood dispersed more evenly when flowing out of the pump, which could effectively reduce the shear stress at the cage bridges. The outflow structure with blades would aggravate the secondary flow at the leading edge of the impeller, increasing the risk of flow stagnation. The combination of curved bridges and the bladeless diffuser had a relatively better shear stress distribution, with the proportion of fluid exposed to low scalar shear stress (<50 Pa) and high scalar shear stress (>150 Pa) in the blood pump being 97.92% and 0.26%, respectively. It could be concluded that the outflow structure with curved bridges and bladeless diffuser exhibited relatively better shear stress distribution and a lower hemolysis index of 0.00648%, which could support continued research on optimizing the microaxial blood pumps. [ABSTRACT FROM AUTHOR]

Background. Percutaneous coronary intervention using a drug-eluting stent (DES) is a common therapeutic option for acute coronary syndrome (ACS). However, stent-associated complications, such as bleeding associated with dual antiplatelet therapy, in-stent restenosis, stent thrombosis, and neoatherosclerosis, remain. Drug-coated balloons (DCBs) are expected to reduce stent-associated complications. This study aimed to assess the efficacy of DCB therapy and compare it with that of DES therapy in patients with ACS. Materials and Methods. In this single-center, retrospective, observational study, we examined all patients with ACS treated with DCB or DES between July 2014 and November 2020. Patients with left main trunk lesions were excluded. The primary outcome was a composite of major adverse cardiovascular events (MACE: cardiac death, myocardial infarction, and target lesion revascularization) at one year. Results. Three hundred and seventy-two patients were treated with DES, and 83 patients were treated with DCB. MACE occurred in 10 (12.0%) patients in the DCB group and in 50 (13.4%) patients in the DES group (P = 0.73). Conclusions. DCB is a valuable and effective therapy for patients with ACS. Moreover, DCB may become an alternative therapy for DES in patients with ACS. [ABSTRACT FROM AUTHOR]

Background. Acute kidney injury (AKI) was a common and serious complication in patients with acute myocardial infarction (AMI). Novel biomarkers and therapies were deficient and imperative for AKI's early diagnosis and therapy after AMI. α-Klotho was considered as an early biomarker and potential therapy for AKI recently. Previous studies reported that the expression of α-Klotho was decreased in AKI rodents, and supplement of α-Klotho alleviated kidney injury. Nevertheless, its effect has not been studied in patients presenting with AMI. Methods. A total of 155 consecutive diagnosed with AMI at emergency department whose eGFR >60 ml/min ∗ 1.73 m2 were enrolled in this prospective observational cohort study which conducted between May 2016 and April 2019 in Peking University People's Hospital. AKI was defined according to the KDIGO criteria in 2012. At admission, the clinical data of patients were collected and serum α-Klotho was tested by ELISA. The relationship between α-Klotho, serum creatinine, eGFR, systolic pressure, BNP, LVEF, and Hgb of AKI were analyzed and their discrimination performances were compared. The association variables were calculated (adjusted odds ratio) with a confidence interval (CI) of 95% by binary logistic regression. And, we followed up the incidence of CKD and rehospitalization after patients' discharge in one year. Our study was approved by the ethics committee (no. 2016PHB042-01). Results. AKI incidence was 17.4% (27/155) during hospitalization. Compared to patients without AKI, the AKI group had obviously higher mortality and was more female and had higher incidence of chronic kidney disease, worse cardiac function, more cardiac complications, larger doses of diuretics, and less use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker. By contrary to previous animal experiments, we found serum α-Klotho levels were increased significantly in AKI patients (740.2 ± 306.8 vs. 419.0 ± 272.6 pg/mL, p < 0.001). And, the areas under the receiver operating curves indicated serum α-Klotho levels had a superior discriminative power for predicting AKI after AMI compared with other risk factors (0.792, 95% CI, 0.706–0.878, p < 0.001). Meanwhile, logistic regression model indicates extensive anterior myocardial infarction, Killip classification ≥2 grade, α-Klotho ≥516.9 pg/mL, eGFR (decrease per 10 ml/min ∗ 1.73 m2), Hgb, and nonuse of ACEI/ARB were the risk factors of AKI after AMI. Moreover, one-year follow-up presented AMI patients developed CKD had higher α-Klotho levels (739.7 ± 315.2 vs. 443.8 ± 292.5 pg/mL, p = 0.001), but no significant difference in rehospitalization. And, patients with α -Klotho ≥516.9 pg/ml was 6.699 times more likely to develop CKD than those with α-Klotho <516.9 pg/ml (relative risk 6.699, 95% CI 1.631–27.519, p = 0.007). Conclusion. Compared with traditional cardiac and renal biomarkers, serum α-Klotho could be a more appropriate predict biomarker for AKI after AMI in patients' eGFR >60 ml/min ∗ 1.73 m2. Higher α-Klotho levels are related to the development of AKI during hospitalization and suggest a higher prevalence of CKD after discharge. By contrary to animal experiments, whether the increased expression of α-Klotho could be a protective factor secreted by AKI after AMI, is remained to be further studied. [ABSTRACT FROM AUTHOR]

Background. Limited data exist regarding the association between the quality of life (QoL) and clinical outcomes following transcatheter mitral valve repair (TMVr). We aimed to evaluate the prognostic significance of QoL assessment following TMVr and to characterize those who had procedural success, yet reported a low Kansas City Cardiomyopathy Questionnaire (KCCQ-12) score. Methods. We reported the experience of Cedars-Sinai Medical Center patients between 2013 and 2020. Patients were allocated into four groups according to the 30-day KCCQ: <25, 25–49, 50–74, and ≥75. Primary outcome included 1-year all-cause death or heart failure (HF) hospitalizations. We also examined the association between QoL and the primary outcome in those with procedural success. Results. A total of 555 patients were included in our analysis, median follow-up of 650 days (IQR 243–1113). The lower KCCQ groups had a higher prevalence of functional mitral regurgitation (65%, 60%, 56%, and 43%, p = 0.001), as well as a higher Society of Thoracic Surgeon (STS) score. These groups had a significantly higher occurrence of 1-year all-cause death or HF hospitalizations in a stepwise fashion (40%, 22%, 16%, and 10%, p < 0.001). Multivariable Cox regression analysis revealed 30-day KCCQ as the strongest predictor of the 1-year primary outcome (HR 0.98, 95%CI (0.97–0.99), p = 0.006). Approximately a quarter of patients with procedural success had a low KCCQ score. These patients had a higher rate of the combined 1-year outcome regardless of procedural success or failure. Conclusion. QoL following TMVr is a powerful prognostic factor. KCCQ assessment is an important indicator for identifying patients prone to adverse outcomes even after procedural success. [ABSTRACT FROM AUTHOR]

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