Impact of oral abrocitinib on signs, symptoms and quality of life among adolescents with moderate-to-severe atopic dermatitis: an analysis of patient-reported outcomes

Background

A significant improvement in clinical signs was demonstrated with abrocitinib relative to placebo in adolescents with moderate‐to‐severe atopic dermatitis (AD) in three phase 3, randomized, double‐blinded, placebo‐controlled studies (JADE TEEN [ClinicalTrials.gov, NCT03796676], JADE MONO‐1 [NCT03349060] and JADE MONO‐2 [NCT03575871]).

Objectives

To evaluate the impact of abrocitinib on patient‐reported signs/symptoms, including sleep loss and quality of life among adolescents with moderate‐to‐severe AD.

Methods

JADE TEEN, JADE MONO‐1 and JADE MONO‐2 were conducted in the Asia‐Pacific region, Europe and North America and included patients aged 12–17 years with moderate‐to‐severe AD and inadequate response to ≥ 4 consecutive weeks of topical medication or treatment with systemic therapy for AD. Patients were randomly assigned (1 : 1 : 1, JADE TEEN; 2 : 2 : 1, JADE MONO‐1/‐2) to receive once‐daily oral abrocitinib (200 or 100 mg) or placebo for 12 weeks in combination with topical therapy (JADE TEEN) or as monotherapy (JADE MONO‐1/‐2). Data from adolescent patients in JADE MONO‐1/‐2 were pooled for these analyses.

Results

At week 12, more adolescents treated with abrocitinib (200 or 100 mg) vs. placebo achieved a ≥ 4‐point improvement from baseline in the Patient‐Oriented Eczema Measure in JADE TEEN (83.9% and 77.0% vs. 60.2%) and JADE MONO‐1/‐2 (83.0% and 69.4% vs. 43.5%) and a ≥ 6‐point improvement from baseline in the Children’s Dermatology Life Quality Index in JADE TEEN (73.8% and 67.5% vs. 56.5%) and JADE MONO‐1/‐2 (70.0% and 57.1% vs. 19.0%). Significant improvements in SCORing Atopic Dermatitis Visual Analog Scale for sleep loss scores were demonstrated with abrocitinib vs. placebo at weeks 2‐12 in JADE TEEN and JADE MONO‐1/‐2.

Conclusions

Patient‐reported signs/symptoms, including reduction of sleep loss and quality of life, were substantially improved with abrocitinib monotherapy or combination therapy relative to placebo in adolescents with moderate‐to‐severe AD.

Electrostatically Tunable Near-Infrared Plasmonic Resonances in Solution-Processed Atomically Thin NbSe2

In the broad spectral range, near-infrared (NIR) plasmonics find applications in telecommunication, energy harvesting, sensing, and more, all of which would benefit from an electrostatically controllable NIR plasmon source. However, it is difficult to control bulk NIR plasmonics directly with electrostatics because of the strong electric-field screening effect and high carrier concentration required to support NIR plasmons. Here, this constraint is overcome and the observation of NIR plasmonic resonances that can be modulated electrostatically over a range of ≈360 cm^-1 in few-layer NbSe₂ gratings is reported, thanks to the enhanced electrostatics of atomically thin 2D materials and the high-quality film produced by a solution method. NbSe₂ plasmons also render strong field confinement due to their atomic thickness and provide an extra degree of resonance frequency modulation from the layered structure. This study identifies metallic 2D materials as promising (easily produced and well-performing) candidates to extend electrostatically tunable plasmonics to the technologically important NIR range.

From colloidal particles to photonic crystals: advances in self-assembly and their emerging applications

Over the last three decades, photonic crystals (PhCs) have attracted intense interests thanks to their broad potential applications in optics and photonics. Generally, these structures can be fabricated via either "top-down" lithographic or "bottom-up" self-assembly approaches. The self-assembly approaches have attracted particular attention due to their low cost, simple fabrication processes, relative convenience of scaling up, and the ease of creating complex structures with nanometer precision. The self-assembled colloidal crystals (CCs), which are good candidates for PhCs, have offered unprecedented opportunities for photonics, optics, optoelectronics, sensing, energy harvesting, environmental remediation, pigments, and many other applications. The creation of high-quality CCs and their mass fabrication over large areas are the critical limiting factors for real-world applications. This paper reviews the state-of-the-art techniques in the self-assembly of colloidal particles for the fabrication of large-area high-quality CCs and CCs with unique symmetries. The first part of this review summarizes the types of defects commonly encountered in the fabrication process and their effects on the optical properties of the resultant CCs. Next, the mechanisms of the formation of cracks/defects are discussed, and a range of versatile fabrication methods to create large-area crack/defect-free two-dimensional and three-dimensional CCs are described. Meanwhile, we also shed light on both the advantages and limitations of these advanced approaches developed to fabricate high-quality CCs. The self-assembly routes and achievements in the fabrication of CCs with the ability to open a complete photonic bandgap, such as cubic diamond and pyrochlore structure CCs, are discussed as well. Then emerging applications of large-area high-quality CCs and unique photonic structures enabled by the advanced self-assembly methods are illustrated. At the end of this review, we outlook the future approaches in the fabrication of perfect CCs and highlight their novel real-world applications.

Printable two-dimensional superconducting monolayers

Two-dimensional superconductor (2DSC) monolayers with non-centrosymmetry exhibit unconventional Ising pair superconductivity and an enhanced upper critical field beyond the Pauli paramagnetic limit, driving intense research interest. However, they are often susceptible to structural disorder and environmental oxidation, which destroy electronic coherence and provide technical challenges in the creation of artificial van der Waals heterostructures (vdWHs) for devices. Herein, we report a general and scalable synthesis of highly crystalline 2DSC monolayers via a mild electrochemical exfoliation method using flexible organic ammonium cations solvated with neutral solvent molecules as co-intercalants. Using NbSe₂ as a model system, we achieved a high yield (>75%) of large-sized single-crystal monolayers up to 300 µm. The as-fabricated, twisted NbSe₂ vdWHs demonstrate high stability, good interfacial properties and a critical current that is modulated by magnetic field when one flux quantum fits to an integer number of moiré cells. Additionally, formulated 2DSC inks can be exploited to fabricate wafer-scale 2D superconducting wire arrays and three-dimensional superconducting composites with desirable morphologies.

Exciton-Enabled Meta-Optics in Two-Dimensional Transition Metal Dichalcogenides

Optical wavefront engineering has been rapidly developing in fundamentals from phase accumulation in the optical path to the electromagnetic resonances of confined nanomodes in optical metasurfaces. However, the amplitude modulation of light has limited approaches that usually originate from the ohmic loss and absorptive dissipation of materials. Here, an atomically thin photon-sieve platform made of MoS₂ multilayers is demonstrated for high-quality optical nanodevices, assisted fundamentally by strong excitonic resonances at the band-nesting region of MoS₂. The atomic thin MoS₂ significantly facilitates high transmission of the sieved photons and high-fidelity nanofabrication. A proof-of-concept two-dimensional (2D) nanosieve hologram exhibits 10-fold enhanced efficiency compared with its non-2D counterparts. Furthermore, a supercritical 2D lens with its focal spot breaking diffraction limit is developed to exhibit experimentally far-field label-free aberrationless imaging with a resolution of ∼0.44λ at λ = 450 nm in air. This transition-metal-dichalcogenide (TMDC) photonic platform opens new opportunities toward future 2D meta-optics and nanophotonics.

The Significance of Metal Coordination in Imidazole-Functionalized Metal-Organic Frameworks for Carbon Dioxide Utilization

The grafting of imidazole species onto coordinatively unsaturated sites within metal-organic framework MIL-101(Cr) enables enhanced CO₂ capture in close proximity to catalytic sites. The subsequent combination of CO₂ and epoxide binding sites, as shown through theoretical findings, significantly improves the rate of cyclic carbonate formation, producing a highly active CO₂ utilization catalyst. An array of spectroscopic investigations, in combination with theoretical calculations reveal the nature of the active sites and associated catalytic mechanism which validates the careful design of the hybrid MIL-101(Cr).

MicroRNA-488 regulates diabetic nephropathy via TGF-β1 pathway

OBJECTIVE

The aim of this study was to clarify the biological roles of microRNA-488 and transforming growth factor β1 (TGF-β1) pathway in the occurrence and progression of diabetic nephropathy (DN).

MATERIALS AND METHODS

Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was used to detect the expressions of microRNA-488, fibrinogen factors coII, coIIV, and fibronectin (FN) in Human mesangial cells (HMCs) with high-glucose or low-glucose treatment. After transfection of microRNA-488 mimics or inhibitor, expression levels of coII, coIIV, and FN in HMCs were determined by qRT-PCR and Western blot. Their expressions in HMC cells treated with different doses of TGF-β1 at different time points were also detected. Finally, we evaluated the potential influence of microRNA-488 on TGF-β1-induced fibrosis of HMC cells by qRT-PCR.

RESULTS

Compared with low-glucose treatment, the expression of microRNA-488 markedly increased in HMCs treated with high-glucose, as well as coII, coIIV, and FN. Overexpression of microRNA-488 remarkably upregulated mRNA and protein levels of coII, coIIV, and FN, whereas microRNA-488 knockdown downregulated their levels. Expression levels of microRNA-488, coII, coIIV, and FN gradually upregulated with the increase of TGF-β1 dose and treatment duration.

CONCLUSIONS

MicroRNA-488 regulates the development of diabetic nephropathy-induced fibrosis by TGF-β1 pathway.

Engineering multimodal dielectric resonance of TiO2 based nanostructures for high-performance refractive index sensing applications

Optical metasurface based refractive index (RI) sensors find applications in chemical, environmental, biomedical, and food processing industries. The existing RI sensors based on metals suffer from the plasmonic loss in the optical regime; in contrast, those based on Fano-type resonances generated by dielectric materials are either polarization-sensitive or are based on complex geometrical structures prone to fabrication imperfections that can lead to severe performance degradation. Here, we demonstrate that careful engineering of resonance modes in dielectric metasurfaces based on simple symmetric meta-atoms can overcome these limitations. More specifically, we have designed low-loss high-performance RI sensors using all-dielectric metasurfaces composed of TiO₂ based nanostructures of three different shapes (i.e., cylindrical, square and elliptical) operating at near-infrared (NIR) wavelengths, which are robust against the perturbations of geometric parameters. In terms of physics, this work reports sensor structures achieving sharp resonant dips of high Q-factor in the transmission spectra corresponding to multiple dielectric resonance modes (i.e., electric quadrupole, magnetic dipole, and electric dipole) with superior performance as compared to the state-of-the-art. Four absolute liquids (water, ethanol, pentanol, and carbon tetrachloride) with a refractive index ranging from 1.333 to 1.453 are used to numerically validate the performance, and a maximum sensitivity of 798 nm/RIU with FOM up to 732 has been achieved.

High oscillator strength interlayer excitons in two-dimensional heterostructures for mid-infrared photodetection

The development of infrared photodetectors is mainly limited by the choice of available materials and the intricate crystal growth process. Moreover, thermally activated carriers in traditional III-V and II-VI semiconductors enforce low operating temperatures in the infrared photodetectors. Here we demonstrate infrared photodetection enabled by interlayer excitons (ILEs) generated between tungsten and hafnium disulfide, WS₂/HfS₂. The photodetector operates at room temperature and shows an even higher performance at higher temperatures owing to the large exciton binding energy and phonon-assisted optical transition. The unique band alignment in the WS₂/HfS₂ heterostructure allows interlayer bandgap tuning from the mid- to long-wave infrared spectrum. We postulate that the sizeable charge delocalization and ILE accumulation at the interface result in a greatly enhanced oscillator strength of the ILEs and a high responsivity of the photodetector. The sensitivity of ILEs to the thickness of two-dimensional materials and the external field provides an excellent platform to realize robust tunable room temperature infrared photodetectors.

0143 Vigilance Declines Following Sleep Deprivation are Associated with Two Previously Identified Dynamic Connectivity States

Introduction

Dynamic functional connectivity (DFC) analysis of resting-state fMRI data has been successfully used to track fluctuations in arousal in the human brain. Changes in DFC have also been reported with acute sleep deprivation. Here, we demonstrate that dynamic connectivity states (DCS) previously related to arousal are reproducible, and are associated with individual differences in sustained attention declines after one night of total sleep deprivation.

Methods

32 participants underwent two counterbalanced resting-state fMRI scans: during rested wakefulness (RW) and following total sleep deprivation (SD). They also completed the Psychomotor Vigilance Test (PVT), a sustained attention task that is highly sensitive to the effects of sleep loss. SD vulnerability was computed as the decrease in response speed (∆RS) and increase in lapses (∆lapse) in SD compared with RW.

Dynamic functional connectivity analysis was conducted on rs-fMRI data. Connectivity matrices were clustered to obtain 5 prototypical DCS. We calculated the proportion of time participants spent in each of these DCS, as well as how often participants transitioned between DCSs. Relationships between SD vulnerability and connectivity metrics were then correlated.

Results

We recovered two DCS that were highly similar (ρ = .89-.91) to arousal-related DCS observed in previous work (high arousal state (HAS); low arousal state (LAS)).

After sleep deprivation, the proportion of time spent in the LAS increased significantly (t29=3.16, p=.0039), while there was no significant change in HAS (t29=-1.43, p=.16). We observed significantly more state transitions in RW compared with SD. Change in LAS and HAS across sleep conditions correlated significantly with SD vulnerability (ΔLASxΔRS: r=-0.64, p<.0001; ΔLASxΔlapse: r=0.43, p=.018; ΔHASxΔRS; r=0.43, p=.019; ΔHASxΔlapse; r=-0.39, p=.033). Finally, Δ%transitions was correlated with ΔRS but not Δlapse.

Conclusion

This study adds to the evidence that two specific reproducible DCS are robust markers of arousal and attention, and may be useful indicators of SD vulnerability.

Support

This work was supported by the National Medical Research Council, Singapore (STaR/0015/2013), and the National Research Foundation Science of Learning (NRF2016-SOL002-001).

0519 Mindfulness Based Therapy for Insomnia Improves Objective Markers of Sleep in the Elderly: Preliminary Data from the Mindfulness Sleep Therapy (MIST) Study

Introduction

Mindfulness-based treatment for insomnia (MBTI) is a viable intervention for improving poor sleep. We report preliminary data from an ongoing pre-registered, randomized controlled trial which investigates the effect of MBTI on elderly adults.

Methods

Participants above 50 years old with PSQI ≥ 5 were recruited and randomised into either MBTI or an active control group (Sleep hygiene education and exercise program, SHEEP) in sequential cohorts with about 20 participants per cohort (10 per group). Before and after the intervention, 1 night of portable polysomnography (PSG) and 1 week of actigraphy (ACT) and sleep diary (DIARY) data were collected. We report the ACT and DIARY results of the first 3 cohorts (n = 46, male = 23, mean age = 62.3, std = 6.3) and PSG data of the first 2 cohorts (n = 29, male = 12, mean age = 62.5, std = 5.7). Time in bed (TIB), total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), and sleep efficiency (SE) were analysed with mixed-model repeated-measures ANOVA.

Results

We observed increases in TIBDIARY (F1,44 = 5.151, p < .05) and SEDIARY (F1,44 = 22.633, p < .0001), and significant reductions in SOLDIARY (F1,44 = 7.031, p < .05) and WASODIARY (F1,39 = 7.411, p < .05). In the actigraphy data, we found a significant interaction in SOLACT (F1,39 = 4.273, p < .05) with an increase in SHEEP SOLACT (t18= 2.36, p < .05). Significant reductions were also observed in WASOACT (F1,44 = 16.459, p < .0001) Finally, we observed a reduction in SOLPSG (F1,26 = 5.037, p <. 05). All other tests were non-significant.

Conclusion

Preliminary results suggest that both interventions lead to improvements in sleep with more pronounced effects in subjective sleep reports. Objective sleep data suggest that improvements in sleep is a result of improved sleep quality and not simply extending sleep opportunity. These preliminary data shows that MBTI may be a promising intervention for elderly individuals with sleep difficulties.

Support

This study was supported by an award from the 7th grant call of the Singapore Millennium Foundation Research Grant Programme

0824 Improving Subjective Sleep Quality Measures Through Mindfulness Training in the Elderly: Preliminary Data from the Mindfulness Sleep Therapy (MIST) Study

Introduction

Poor sleep is a modifiable risk factor for multiple chronic disorders. Mindfulness-based therapies potentially improve sleep by enhancing awareness and acceptance of internal and external experiences, thus reducing pre-sleep hyper-arousal. In this pre-registered, randomized controlled trial, we tested the effect of mindfulness-based treatment for insomnia (MBTI) on subjective sleep quality measures (Pittsburgh Sleep Quality Questionnaire, PSQI) in the elderly.

Methods

Participants above 50 years old with sleep difficulties (PSQI ≥ 5) (mean (sd) age = 62.0 (6.35), 44 female) attended either an 8-week MBTI (N = 34) or sleep hygiene education and exercise program (SHEEP; N = 35). Before and after the interventions, we collected PSQI, insomnia symptoms and features measures (Pre-Sleep Arousal Scale, PSAS; Insomnia Severity Index, ISI; Dysfunctional Beliefs and Attitudes about Sleep, DBAS-30), mindfulness (Five-Facets Mindfulness Questionnaire, FFMQ), and mood and anxiety (Back Depression Inventory, BDI; State-Trait Anxiety Inventory, STAI). PSQI and PSAS (N = 26 to date) were collected at 6-month follow-up. Data were analysed with repeated-measures ANCOVA with group as a between-subject variable for the first 69 participants who completed the study.

Results

We observed significant improvement across both groups for sleep measures (PSQI: F1,67=36.442, p<.01; PSAS-Cognitive: F1,67=12.664, p<.01; ISI: F1,67=36.442, p<.0; DBAS: F1,67=28.749, p<.01) and mood (BDI: F1,67=26.393, p<.01; STAI-State: F1,67=4.608, p=.04; STAI-Trait: F1,67=7.687, p<.01), but not for Mindfulness (F1,67=2.256, p=.14) nor PSAS-somatic. No significant group by time interactions were found. We observed a correlation between PSQI decreases and FFMQ increases in MBTI (r=-.53, p<.01), but not in SHEEP (r=-.07, p=.70) participants. ANCOVA of 6-month PSQI data revealed a significant group by time interaction (F1,24=19.525, p=.03), with reduction from baseline in MBTI (t12=4.769, p<.01), but not in SHEEP group (t12=3.813, p=.08).

Conclusion

Preliminary results support MBTI as an accessible but effective behavioural intervention with potential long-term benefits for improving sleep and mood, and reducing cognitive-emotional arousal in the elderly.

Support

This study was supported by an award from the 7th grant call of the Singapore Millennium Foundation Research Grant Programme

Giant Emission Enhancement of Solid-State Gold Nanoclusters by Surface Engineering

Ligand-induced surface restructuring with heteroatomic doping is used to precisely modify the surface of a prototypical [Au₂₅ (SR¹ )₁₈ ]^- cluster (1) while maintaining its icosahedral Au₁₃ core for the synthesis of a new bimetallic [Au₁₉ Cd₃ (SR² )₁₈ ]^- cluster (2). Single-crystal X-ray diffraction studies reveal that six bidentate Au₂ (SR¹ )₃ motifs (L2) attached to the Au₁₃ core of 1 were replaced by three quadridentate Au₂ Cd(SR² )₆ motifs (L4) to create a bimetallic cluster 2. Experimental and theoretical results demonstrate a stronger electronic interaction between the surface motifs (Au₂ Cd(SR² )₆ ) and the Au₁₃ core, attributed to a more compact cluster structure and a larger energy gap of 2 compared to that of 1. These factors dramatically enhance the photoluminescence quantum efficiency and lifetime of crystal of the cluster 2. This work provides a new route for the design of a wide range of bimetallic/alloy metal nanoclusters with superior optoelectronic properties and functionality.

Safety and efficacy of fixed-dose combination calcipotriol (50 μg/g) and betamethasone dipropionate (0.5 mg/g) cutaneous foam in adolescent patients (aged 12 to <17 years) with plaque psoriasis: results of a phase II, open-label trial

Background

Fixed‐dose combination of calcipotriol (50 μg/g; Cal) and betamethasone dipropionate (0.5 mg/g; BD) foam is approved for plaque psoriasis treatment in adults, with a paucity of data supporting use in adolescents.

Objectives

To evaluate safety of 4 weeks’ treatment with Cal/BD foam in adolescent patients with psoriasis, and additional safety outcomes in patients with more severe disease (HPA‐axis cohort). Primary objectives included treatment‐emergent adverse events (TEAEs) and systemic calcium levels in the overall population, and HPA‐axis function, change in calcium excretion and the calcium:creatinine ratio in the HPA‐axis cohort. Secondary objectives included exploratory efficacy endpoints [treatment success: change in Psoriasis Area and Severity Index (PASI)]. Systemic exposure to Cal/BD was also assessed.

Methods

A phase II, open‐label, study (NCT02387853) in patients (12 to <17 years) with at least mild psoriasis, to evaluate Cal/BD foam applied once daily for ≤4 weeks.

Results

In patients assigned to treatment (n = 106), 32 TEAEs occurred in 22 patients (20.8%). All but two TEAEs were mild; none led to study withdrawal or death. Changes (0–4 weeks) in albumin‐corrected serum calcium (overall population) and urinary calcium excretion (HPA‐axis cohort) were small, transient and not considered clinically relevant. In the HPA‐axis cohort, no change in urinary calcium:creatinine ratio was observed and responses to adrenocorticotropic–hormone (ACTH) challenge did not suggest disruption of the HPA‐axis. Prespecified treatment success on the body and scalp was achieved by 71.8% and 75.7% of the overall population, respectively. Mean PASI decreased by 82.0% vs. baseline at Week 4. Systemic exposure to Cal/BD was minimal.

Conclusions

Cal/BD foam was well tolerated in adolescent patients with body/scalp psoriasis. There was no evidence for dysregulation of the HPA‐axis nor calcium homoeostasis in patients with more severe disease. Exploratory efficacy data in the overall population were encouraging.

Wavelength-tunable focusing via a Fresnel zone microsphere

In this Letter, a novel, to the best of our knowledge, structural configuration on a transparent microsphere is proposed to engineer the focusing light field. By patterning a hybrid diffractive Fresnel zone plate structure on a partially milled microsphere using a focused ion beam, wavelength-dependent switching between mono-focal and multi-focal functionalities can be achieved. Generation of on-axis tri-foci and mono-focus light fields under high numerical-aperture (${\rm NA}\gt {0.67}$NA>0.67) conditions at two working wavelengths (405 nm and 808 nm) have been demonstrated both numerically and experimentally.

Fano-like chiroptical response in plasmonic heterodimer nanostructures

Plasmonic chirality has attracted more and more attention recently due to the enhanced chiroptical response and its potential applications in biosensing. Plasmonic Fano resonance arises from the interference between a dark narrow resonance and a bright broad resonance, and it provides a new paradigm to control the plasmon mode interactions. Even though a strong circular dichroism (CD) effect has been predicted in chiral nanostructures with a Fano resonance, there are few experimental studies, and the correlation between the two effects is unclear. In this research, we investigate these two effects in plasmonic heterodimer nanorods in the same spectral range. We find that the heterodimer nanostructure exhibits a Fano-like resonance and Fano-like chiroptical response, both of which are correlated with the coupling between a super-radiant electric dipole and a sub-radiant magnetic dipole mode. Due to the interference nature of the Fano resonance, the Fano-like chiroptical response exhibits distinctively sharp features in a narrow spectral range. This Fano-like chiroptical response can be explained by a modified chiral molecule theory and a simplified coupled electric-magnetic dipole model. This research may provide new insight into the physics picture of plasmonic chirality and paves the way for the development of sensitive plasmonic sensors.

P889 3D guided CT assessment to define the right pulmonary vein on standard apical 4-chamber view

Introduction

Pulmonary vein(PV) assessment is an integral component of the transthoracic echocardiogram(TTE) examination; typically assessed in the apical four-chamber view(A4Ch). There is disagreement in current textbooks and literature regarding which specific right pulmonary vein is visualised on A4Ch; as either the right superior(RSPV) or right inferior PV(RIPV).

Given the high reliability of cardiac CT for PV assessment, we aimed to characterize right PV anatomy on A4Ch by utilizing multi-modality comparison of echocardiography and a 3D-guided A4Ch on CT.

Methods

Retrospective analysis was performed on consecutive patients with TTE demonstrating PV flow(by colour or pulse-wave Doppler) and cardiac CT within 30days; studies not meeting image quality criteria excluded. To simulate the A4Ch on CT, multi-planar reconstruction was used to create an image plane including right PV ostia and LV apex. This image was rotated along the long-axis to achieve an A4Ch with both ventricles and atria, tricuspid and mitral valves in view without LVOT or aorta. This was attempted for right superior, inferior and middle(RMPV, if present) PV’s.

Results

50 patients were analysed: mean age 66yrs, 48% female, mean LA volume(indexed) 43.5ml/m². A4Ch was feasible in 100%(n = 50) of CT simulations using the RIPV, only 24%(n = 12) were feasible using RSPV with all excluded cases due to LVOT/aorta persistently in view. RMPV was present in 6 cases with feasible A4ch in 67%.

Conclusion

This study demonstrates that the right PV on A4Ch is highly likely to be the RIPV due to the RSPV being anatomically impossible in the significant majority of cases.

Abstract P889 Figure. CT multiplanar reconstruction of A4Ch