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Bhogal S, Waksman R, Shea C, Zhang C, Gordon P, Ehsan A, Wilson SR, Levitt R, Parikh P, Bilfinger T, Hanna N, Buchbinder M, Asch FM, Weissman G, Ben-Dor I, Shults CC, Ali S, Garcia-Garcia HM, Satler LF, Rogers T. Self-expanding and balloon-expandable valves in low risk TAVR patients. Int J Cardiol 2024; 395:131431. [PMID: 37832606 DOI: 10.1016/j.ijcard.2023.131431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/31/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Recent randomized studies have broadened the indication of transcatheter aortic valve replacement (TAVR) to also include low-surgical-risk patients. However, the data on self-expanding (SE) and balloon-expandable (BE) valves in low-risk patients remain sparse. METHODS The current study is a post hoc analysis of combined data from both LRT 1.0 and 2.0 trials comparing BE and SE transcatheter heart valves. RESULTS A total of 294 patients received a BE valve, and 102 patients received an SE valve. The 30-day clinical outcomes were similar across both groups except for stroke (4.9% vs. 0.7%, p = 0.014) and permanent pacemaker implantation (17.8% vs. 5.8%, p < 0.001), which were higher in the SE cohort than the BE cohort. No difference was observed in terms of paravalvular leak (≥moderate) between the groups (0% vs. 1.5%, p = 0.577). SE patients had higher aortic valve area (1.92 ± 0.43 mm2 vs. 1.69 ± 0.45 mm2, p < 0.001) and lower mean gradient (8.93 ± 3.53 mmHg vs. 13.41 ± 4.73 mmHg, p < 0.001) than BE patients. In addition, the rate of subclinical leaflet thrombosis was significantly lower in SE patients (5.6% vs. 13.8%, p = 0.038). CONCLUSION In this non-randomized study assessing SE and BE valves in low-risk TAVR patients, SE valves are associated with better hemodynamics and lesser leaflet thrombosis, with increased rates of stroke and permanent pacemaker implantation at 30 days; however, this could be due to certain patient-dependent factors not fully evaluated in this study. The long-term implications of these outcomes on structural valve durability remain to be further investigated. CLINICAL TRIAL REGISTRY LRT 1.0: NCT02628899 LRT 2.0: NCT03557242.
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Affiliation(s)
- Sukhdeep Bhogal
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, United States of America
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, United States of America.
| | - Corey Shea
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, United States of America
| | - Cheng Zhang
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, United States of America
| | - Paul Gordon
- Division of Cardiology, Lifespan Cardiovascular Institute, Providence, RI, United States of America
| | - Afshin Ehsan
- Division of Cardiothoracic Surgery, Lifespan Cardiovascular Institute, Providence, RI, United States of America
| | - Sean R Wilson
- Department of Cardiology, North Shore University Hospital, Manhasset, NY, United States of America
| | - Robert Levitt
- Department of Cardiology, HCA Virginia Health System, Richmond, VA, United States of America
| | - Puja Parikh
- Department of Medicine, Stony Brook Hospital, Stony Brook, NY, United States of America
| | - Thomas Bilfinger
- Department of Surgery, Stony Brook Hospital, Stony Brook, NY, United States of America
| | - Nicholas Hanna
- St. John Heart Institute Cardiovascular Consultants, St. John Health System, Tulsa, OK, United States of America
| | - Maurice Buchbinder
- Foundation for Cardiovascular Medicine, Stanford University, Stanford, CA, United States of America
| | - Federico M Asch
- MedStar Health Research Institute, MedStar Washington Hospital Center, Washington DC, United States of America; Georgetown University School of Medicine, Washington DC, United States of America
| | - Gaby Weissman
- Department of Cardiology, MedStar Washington Hospital Center, Washington DC, United States of America
| | - Itsik Ben-Dor
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, United States of America
| | - Christian C Shults
- Department of Cardiac Surgery, MedStar Washington Hospital Center, Washington DC, United States of America
| | - Syed Ali
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, United States of America
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, United States of America
| | - Lowell F Satler
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, United States of America
| | - Toby Rogers
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington DC, United States of America; Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America
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Madronich S, Sulzberger B, Longstreth JD, Schikowski T, Andersen MPS, Solomon KR, Wilson SR. Changes in tropospheric air quality related to the protection of stratospheric ozone in a changing climate. Photochem Photobiol Sci 2023; 22:1129-1176. [PMID: 37310641 PMCID: PMC10262938 DOI: 10.1007/s43630-023-00369-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/13/2023] [Indexed: 06/14/2023]
Abstract
Ultraviolet (UV) radiation drives the net production of tropospheric ozone (O3) and a large fraction of particulate matter (PM) including sulfate, nitrate, and secondary organic aerosols. Ground-level O3 and PM are detrimental to human health, leading to several million premature deaths per year globally, and have adverse effects on plants and the yields of crops. The Montreal Protocol has prevented large increases in UV radiation that would have had major impacts on air quality. Future scenarios in which stratospheric O3 returns to 1980 values or even exceeds them (the so-called super-recovery) will tend to ameliorate urban ground-level O3 slightly but worsen it in rural areas. Furthermore, recovery of stratospheric O3 is expected to increase the amount of O3 transported into the troposphere by meteorological processes that are sensitive to climate change. UV radiation also generates hydroxyl radicals (OH) that control the amounts of many environmentally important chemicals in the atmosphere including some greenhouse gases, e.g., methane (CH4), and some short-lived ozone-depleting substances (ODSs). Recent modeling studies have shown that the increases in UV radiation associated with the depletion of stratospheric ozone over 1980-2020 have contributed a small increase (~ 3%) to the globally averaged concentrations of OH. Replacements for ODSs include chemicals that react with OH radicals, hence preventing the transport of these chemicals to the stratosphere. Some of these chemicals, e.g., hydrofluorocarbons that are currently being phased out, and hydrofluoroolefins now used increasingly, decompose into products whose fate in the environment warrants further investigation. One such product, trifluoroacetic acid (TFA), has no obvious pathway of degradation and might accumulate in some water bodies, but is unlikely to cause adverse effects out to 2100.
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Affiliation(s)
- S Madronich
- National Center for Atmospheric Research, Boulder, USA.
- USDA UV-B Monitoring and Research Program, Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, USA.
| | - B Sulzberger
- Academic Guest after retirement from Eawag: Swiss Federal Institute of Aquatic Science and Technology, CH-8600, Duebendorf, Switzerland
| | - J D Longstreth
- The Institute for Global Risk Research, LLC, Bethesda, USA
| | - T Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Dusseldorf, Germany
| | - M P Sulbæk Andersen
- Department of Chemistry and Biochemistry, California State University, Northridge, USA
| | - K R Solomon
- School of Environmental Sciences, University of Guelph, Guelph, Canada
| | - S R Wilson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia.
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Waksman R, Bhogal S, Gordon P, Ehsan A, Wilson SR, Levitt R, Parikh P, Bilfinger T, Hanna N, Buchbinder M, Asch FM, Kim FY, Weissman G, Ben-Dor I, Shults CC, Ali S, Sutton JA, Shea C, Zhang C, Garcia-Garcia HM, Satler LF, Rogers T. Transcatheter Aortic Valve Replacement and Impact of Subclinical Leaflet Thrombosis in Low-Risk Patients: LRT Trial 4-Year Outcomes. Circ Cardiovasc Interv 2023; 16:e012655. [PMID: 37192308 DOI: 10.1161/circinterventions.122.012655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/31/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND The LRT trial (Low-Risk Transcatheter Aortic Valve Replacement [TAVR]) demonstrated the safety and feasibility of TAVR in low-risk patients, with excellent 1- and 2-year outcomes. The objective of the current study is to provide the overall clinical outcomes and the impact of 30-day hypoattenuated leaflet thickening (HALT) on structural valve deterioration at 4 years. METHODS The prospective, multicenter LRT trial was the first Food and Drug Administration-approved investigational device exemption study to evaluate feasibility and safety of TAVR in low-risk patients with symptomatic severe tricuspid aortic stenosis. Clinical outcomes and valve hemodynamics were documented annually through 4 years. RESULTS A total of 200 patients were enrolled, and follow-up was available on 177 patients at 4 years. The rates of all-cause mortality and cardiovascular death were 11.9% and 3.3%, respectively. The stroke rate rose from 0.5% at 30 days to 7.5% at 4 years, and permanent pacemaker implantation rose from 6.5% at 30 days to 11.7% at 4 years. Endocarditis was detected in 2.5% of the cohort, with no new cases reported between 2 and 4 years. Transcatheter heart valve hemodynamics remained excellent post-procedure and were maintained (mean gradient 12.56±5.54 mm Hg and aortic valve area 1.69±0.52 cm2) at 4 years. At 30 days, HALT was observed in 14% of subjects who received a balloon-expandable transcatheter heart valve. There was no difference in valve hemodynamics between patients with and without HALT (mean gradient 14.94±5.01 mm Hg versus 12.3±5.57 mm Hg; P=0.23) at 4 years. The overall rate of structural valve deterioration was 5.8%, and there was no impact of HALT on valve hemodynamics, endocarditis, or stroke at 4 years. CONCLUSIONS TAVR in low-risk patients with symptomatic severe tricuspid aortic stenosis was found to be safe and durable at 4 years. Structural valve deterioration rates were low irrespective of the type of valve, and the presence of HALT at 30 days did not affect structural valve deterioration, transcatheter valve hemodynamics, and stroke rate at 4 years. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT02628899.
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Affiliation(s)
- Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., S.B., I.B.-D., S.A., J.A.S., C.S., C.Z., H.M.G.-G., L.F.S., T.R.)
| | - Sukhdeep Bhogal
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., S.B., I.B.-D., S.A., J.A.S., C.S., C.Z., H.M.G.-G., L.F.S., T.R.)
| | - Paul Gordon
- Division of Cardiology, Miriam Hospital, Providence, RI (P.G.)
| | - Afshin Ehsan
- Division of Cardiothoracic Surgery, Lifespan Cardiovascular Institute, Providence, RI (A.E.)
| | - Sean R Wilson
- Department of Cardiology, North Shore University Hospital, Manhasset, NY (S.R.W.)
| | - Robert Levitt
- Department of Cardiology, HCA Virginia Health System, Richmond (R.L.)
| | - Puja Parikh
- Department of Medicine (P.P.), Stony Brook Hospital, NY. St
| | | | - Nicholas Hanna
- John Heart Institute Cardiovascular Consultants, St. John Health System, Tulsa, OK (N.H.)
| | | | - Federico M Asch
- MedStar Health Research Institute, MedStar Washington Hospital Center, DC (F.M.A.)
| | - Francis Y Kim
- Department of Interventional Cardiology, Valley Health, Ridgewood, NJ (F.Y.K.)
| | - Gaby Weissman
- Department of Cardiology, MedStar Washington Hospital Center, DC (G.W.)
| | - Itsik Ben-Dor
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., S.B., I.B.-D., S.A., J.A.S., C.S., C.Z., H.M.G.-G., L.F.S., T.R.)
| | - Christian C Shults
- Department of Cardiac Surgery, MedStar Washington Hospital Center, DC (C.C.S.)
| | - Syed Ali
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., S.B., I.B.-D., S.A., J.A.S., C.S., C.Z., H.M.G.-G., L.F.S., T.R.)
| | - Joseph A Sutton
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., S.B., I.B.-D., S.A., J.A.S., C.S., C.Z., H.M.G.-G., L.F.S., T.R.)
| | - Corey Shea
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., S.B., I.B.-D., S.A., J.A.S., C.S., C.Z., H.M.G.-G., L.F.S., T.R.)
| | - Cheng Zhang
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., S.B., I.B.-D., S.A., J.A.S., C.S., C.Z., H.M.G.-G., L.F.S., T.R.)
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., S.B., I.B.-D., S.A., J.A.S., C.S., C.Z., H.M.G.-G., L.F.S., T.R.)
| | - Lowell F Satler
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., S.B., I.B.-D., S.A., J.A.S., C.S., C.Z., H.M.G.-G., L.F.S., T.R.)
| | - Toby Rogers
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., S.B., I.B.-D., S.A., J.A.S., C.S., C.Z., H.M.G.-G., L.F.S., T.R.)
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD (T.R.)
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Park BJ, Cheng A, Hasani A, Galmer A, Johnston-Cox H, Manetta F, Wilson SR. MANAGEMENT OF MASSIVE PULMONARY EMBOLISM COMPLICATED BY CARDIAC ARREST IN HIGH BLEEDING RISK PATIENT. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)03581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Bhogal S, Waksman R, Gordon P, Ehsan A, Wilson SR, Levitt R, Parikh P, Bilfinger T, Hanna N, Buchbinder M, Asch FM, Weissman G, Ben-Dor I, Shults CC, Ali S, Shea C, Zhang C, Garcia-Garcia HM, Satler LF, Rogers T. Subclinical leaflet thrombosis and antithrombotic therapy post-TAVI: An LRT substudy. Int J Cardiol 2023; 371:305-311. [PMID: 36272571 DOI: 10.1016/j.ijcard.2022.10.134] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/23/2022] [Accepted: 10/16/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Subclinical leaflet thrombosis (SLT) is characterized on computed tomography (CT) imaging as hypoattenuated leaflet thickening (HALT), reduced leaflet motion (RELM), and hypoattenuation affecting motion (HAM). How antithrombotic regimen type impacts SLT remains poorly understood. We evaluated how antithrombotic regimen type impacts SLT in low-risk subjects following transcatheter aortic valve implantation (TAVI). METHODS This substudy is a post hoc analysis of the LRT 1.0 and 2.0 trials to assess SLT in subjects who underwent CT or transoesophageal echocardiogram (TOE) imaging at 30 days, stratified by antithrombotic regimen received (single antiplatelet therapy [SAPT], dual antiplatelet therapy [DAPT], or oral anticoagulation). We also utilized univariable logistic regression modelling to identify echocardiographic predictors of HALT. RESULTS Rates of HALT, RELM, and HAM were all significantly lower with oral anticoagulation compared to SAPT or DAPT at 30 days (HALT: 2.6% vs 14.3% vs 17.2%, respectively, with p < 0.001; RELM: 1.8% vs 9.6% vs 13.1%, respectively, with p = 0.004; and HAM: 0.9% vs 8.5% vs 9.8%, respectively, with p = 0.011). Additionally, short-term oral anticoagulation was not associated with higher bleeding rates compared to SAPT or DAPT (0.8% vs. 1.8% vs. 3.6%, p = 0.291). The presence of HALT did not significantly impact echocardiographic haemodynamic parameters at 30 days. CONCLUSION This is the largest study to date that evaluated the impact of different antithrombotic regimens on SLT in low-risk TAVI patients. Oral anticoagulation was associated with significantly lower rates of SLT at 30 days compared to DAPT or SAPT, and there was no apparent benefit of DAPT over SAPT.
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Affiliation(s)
- Sukhdeep Bhogal
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
| | - Paul Gordon
- Division of Cardiology, Miriam Hospital, Providence, RI, USA
| | - Afshin Ehsan
- Division of Cardiothoracic Surgery, Lifespan Cardiovascular Institute, Providence, RI, USA
| | - Sean R Wilson
- Department of Cardiology, North Shore University Hospital, Manhasset, NY, USA
| | - Robert Levitt
- Department of Cardiology, HCA Virginia Health System, Richmond, VA, USA
| | - Puja Parikh
- Department of Medicine, Stony Brook Hospital, Stony Brook, NY, USA
| | - Thomas Bilfinger
- Department of Surgery, Stony Brook Hospital, Stony Brook, NY, USA
| | - Nicholas Hanna
- St. John Heart Institute Cardiovascular Consultants, St. John Health System, Tulsa, OK, USA
| | - Maurice Buchbinder
- Foundation for Cardiovascular Medicine, Stanford University, Stanford, CA, USA
| | - Federico M Asch
- MedStar Health Research Institute, MedStar Washington Hospital Center, Washington, DC, USA
| | - Gaby Weissman
- Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Itsik Ben-Dor
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Christian C Shults
- Department of Cardiac Surgery, MedStar Washington Hospital Center, Washington, DC, USA
| | - Syed Ali
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Corey Shea
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Cheng Zhang
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Lowell F Satler
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Toby Rogers
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
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Li LT, Alexis M, Wilson SR, Yu PJ. Suction-based catheter retrieval of right ventricular clot-in-transit. Catheter Cardiovasc Interv 2022; 101:478-480. [PMID: 36573416 DOI: 10.1002/ccd.30533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/06/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022]
Abstract
Right ventricular clot-in-transit (CIT) is a rare finding in venous thromboembolic disease and carries a high mortality rate. Its optimal treatments have yet to be established in the literature. Here we describe the usage of a suction-based catheter, the INARI FlowTriever® system (INARI Medical Inc.) to successfully retrieve a CIT from the right ventricle of a patient with coronavirus disease 2019 acute respiratory distress syndrome on veno-veno extracorporeal membrane oxygenation.
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Affiliation(s)
- Leo T Li
- Northwell Health, North Shore/Long Island Jewish General Surgery, Manhasset, New York, USA
| | - Miguel Alexis
- Division of Cardiovascular and Thoracic Surgery, Northwell Health, North Shore University Hospital, New York, Manhasset, USA
| | - Sean R Wilson
- Department of Cardiology, North Shore University Hospital, Manhasset, New York, USA
| | - Pey-Jen Yu
- Division of Cardiovascular and Thoracic Surgery, Northwell Health, North Shore University Hospital, New York, Manhasset, USA
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Medranda GA, Soria Jimenez CE, Torguson R, Case BC, Forrestal BJ, Ali SW, Shea C, Zhang C, Wang JC, Gordon P, Ehsan A, Wilson SR, Levitt R, Parikh P, Bilfinger T, Hanna N, Buchbinder M, Asch FM, Weissman G, Shults CC, Garcia-Garcia HM, Ben-Dor I, Satler LF, Waksman R, Rogers T. Lifetime management of patients with symptomatic severe aortic stenosis: a computed tomography simulation study. EUROINTERVENTION 2022; 18:e407-e416. [PMID: 35321859 PMCID: PMC10259244 DOI: 10.4244/eij-d-21-01091] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Given enough time, transcatheter heart valves (THVs) will degenerate and may require reintervention. Redo transcatheter aortic valve implantation (TAVI) is an attractive strategy but carries a risk of coronary obstruction. AIMS We sought to predict how many TAVIs patients could undergo in their lifetime using computed tomography (CT) simulation. METHODS We analysed paired CT scans (baseline and 30 days post-TAVI) from patients in the LRT trial and EPROMPT registry. We implanted virtual THVs on baseline CTs, comparing predicted valve-to-coronary (VTC) distances to 30-day CT VTC distances to evaluate the accuracy of CT simulation. We then simulated implantation of a second virtual THV within the first to estimate the risk of coronary obstruction due to sinus sequestration and the need for leaflet modification. RESULTS We included 213 patients with evaluable paired CTs. There was good agreement between virtual (baseline) and actual (30 days) CT measurements. CT simulation of TAVI followed by redo TAVI predicted low coronary obstruction risk in 25.4% of patients and high risk, likely necessitating leaflet modification, in 27.7%, regardless of THV type. The remaining 46.9% could undergo redo TAVI so long as the first THV was balloon-expandable but would likely require leaflet modification if the first THV was self-expanding. CONCLUSIONS Using cardiac CT simulation, it is possible to predict whether a patient can undergo multiple TAVI procedures in their lifetime. Those who cannot may prefer to undergo surgery first. CT simulation could provide a personalised lifetime management strategy for younger patients with symptomatic severe aortic stenosis and inform decision-making. CLINICALTRIALS gov: NCT02628899; ClinicalTrials.gov: NCT03557242; ClinicalTrials.gov: NCT03423459.
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Affiliation(s)
- Giorgio A Medranda
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | | | - Rebecca Torguson
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian C Case
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Brian J Forrestal
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Syed W Ali
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Corey Shea
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Cheng Zhang
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - John C Wang
- Department of Interventional Cardiology, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Paul Gordon
- Division of Cardiology, Miriam Hospital, Providence, RI, USA
| | - Afshin Ehsan
- Division of Cardiothoracic Surgery, Lifespan Cardiovascular Institute, Providence, RI, USA
| | - Sean R Wilson
- Department of Cardiology, North Shore University Hospital, Manhasset, NY, USA
| | - Robert Levitt
- Department of Cardiology, HCA Virginia Health System, Richmond, VA, USA
| | - Puja Parikh
- Department of Medicine, Stony Brook Hospital, Stony Brook, NY, USA
| | - Thomas Bilfinger
- Department of Surgery, Stony Brook Hospital, Stony Brook, NY, USA
| | - Nicholas Hanna
- St. John Heart Institute Cardiovascular Consultants, St. John Health System, Tulsa, OK, USA
| | - Maurice Buchbinder
- Foundation for Cardiovascular Medicine, Stanford University, Stanford, CA, USA
| | - Federico M Asch
- MedStar Health Research Institute, MedStar Washington Hospital Center, Washington, DC, USA
| | - Gaby Weissman
- Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Christian C Shults
- Department of Cardiac Surgery, MedStar Washington Hospital Center, Washington, DC, USA
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Itsik Ben-Dor
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Lowell F Satler
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Toby Rogers
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.,Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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Bhogal S, Torguson R, Gordon P, Ehsan A, Wilson SR, Levitt R, Parikh P, Bilfinger T, Hanna N, Buchbinder M, Asch FM, Weissman G, Ben-Dor I, Shults CC, Ali S, Shea C, Zhang C, Garcia-Garcia HM, Satler LF, Waksman R, Rogers T. Self-Expandable Versus Balloon-Expandable Valve in Low Risk TAVR Patients: 30-Day Outcomes of LRT Substudy. Cardiovascular Revascularization Medicine 2022. [DOI: 10.1016/j.carrev.2022.06.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kokroo A, Hou L, Cunningham TF, Laighold S, Koss E, Jauhar R, Wilson SR. PLATYPNEA-ORTHODEOXIA SYNDROME AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT AND CONCOMITANT AORTIC ROOT ELONGATION. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)03781-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kodra A, Wang D, Rahming HS, Li A, Hmoud H, Basman C, Mustafa A, Mahani S, Pirelli L, Mehla P, Uttara S, Mihelis E, Rutkin B, Koss E, Wilson SR, Maniatis GA, Imam MN, Gandotra P, Kalimi R, Supariwala AA, Meraj PM, Patel N, Scheinerman SJ, Kliger C. COMPLEX AND HIGH-RISK PERCUTANEOUS INTERVENTION WITH TRANSCATHETER AORTIC VALVE REPLACEMENT: ARE WE PUSHING THE LIMIT IN THE TREATMENT OF CORONARY ARTERY DISEASE AND AORTIC STENOSIS? J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01752-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Barnes PW, Robson TM, Neale PJ, Williamson CE, Zepp RG, Madronich S, Wilson SR, Andrady AL, Heikkilä AM, Bernhard GH, Bais AF, Neale RE, Bornman JF, Jansen MAK, Klekociuk AR, Martinez-Abaigar J, Robinson SA, Wang QW, Banaszak AT, Häder DP, Hylander S, Rose KC, Wängberg SÅ, Foereid B, Hou WC, Ossola R, Paul ND, Ukpebor JE, Andersen MPS, Longstreth J, Schikowski T, Solomon KR, Sulzberger B, Bruckman LS, Pandey KK, White CC, Zhu L, Zhu M, Aucamp PJ, Liley JB, McKenzie RL, Berwick M, Byrne SN, Hollestein LM, Lucas RM, Olsen CM, Rhodes LE, Yazar S, Young AR. Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, Update 2021. Photochem Photobiol Sci 2022; 21:275-301. [PMID: 35191005 PMCID: PMC8860140 DOI: 10.1007/s43630-022-00176-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/14/2022] [Indexed: 12/07/2022]
Abstract
The Environmental Effects Assessment Panel of the Montreal Protocol under the United Nations Environment Programme evaluates effects on the environment and human health that arise from changes in the stratospheric ozone layer and concomitant variations in ultraviolet (UV) radiation at the Earth’s surface. The current update is based on scientific advances that have accumulated since our last assessment (Photochem and Photobiol Sci 20(1):1–67, 2021). We also discuss how climate change affects stratospheric ozone depletion and ultraviolet radiation, and how stratospheric ozone depletion affects climate change. The resulting interlinking effects of stratospheric ozone depletion, UV radiation, and climate change are assessed in terms of air quality, carbon sinks, ecosystems, human health, and natural and synthetic materials. We further highlight potential impacts on the biosphere from extreme climate events that are occurring with increasing frequency as a consequence of climate change. These and other interactive effects are examined with respect to the benefits that the Montreal Protocol and its Amendments are providing to life on Earth by controlling the production of various substances that contribute to both stratospheric ozone depletion and climate change.
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Affiliation(s)
- P W Barnes
- Biological Sciences and Environment Program, Loyola University New Orleans, New Orleans, USA
| | - T M Robson
- Organismal and Evolutionary Biology (OEB), Viikki Plant Science Centre (ViPS), University of Helsinki, Helsinki, Finland
| | - P J Neale
- Smithsonian Environmental Research Center, Edgewater, USA
| | | | - R G Zepp
- ORD/CEMM, US Environmental Protection Agency, Athens, GA, USA
| | - S Madronich
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, USA
| | - S R Wilson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - A L Andrady
- Chemical and Biomolecular Engineering, North Carolina State University, Apex, USA
| | - A M Heikkilä
- Finnish Meteorological Institute, Helsinki, Finland
| | | | - A F Bais
- Laboratory of Atmospheric Physics, Department of Physics, Aristotle University, Thessaloniki, Greece
| | - R E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - J F Bornman
- Food Futures Institute, Murdoch University, Perth, Australia.
| | | | - A R Klekociuk
- Antarctic Climate Program, Australian Antarctic Division, Kingston, Australia
| | - J Martinez-Abaigar
- Faculty of Science and Technology, University of La Rioja, La Rioja, Logroño, Spain
| | - S A Robinson
- Securing Antarctica's Environmental Future, Global Challenges Program and School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - Q-W Wang
- Institute of Applied Ecology, Chinese Academy of Sciences (CAS), Shenyang, China
| | - A T Banaszak
- Unidad Académica De Sistemas Arrecifales, Universidad Nacional Autónoma De México, Puerto Morelos, Mexico
| | - D-P Häder
- Department of Biology, Friedrich-Alexander University, Möhrendorf, Germany
| | - S Hylander
- Centre for Ecology and Evolution in Microbial Model Systems-EEMiS, Linnaeus University, Kalmar, Sweden.
| | - K C Rose
- Biological Sciences, Rensselaer Polytechnic Institute, Troy, USA
| | - S-Å Wängberg
- Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - B Foereid
- Environment and Natural Resources, Norwegian Institute of Bioeconomy Research, Ås, Norway
| | - W-C Hou
- Environmental Engineering, National Cheng Kung University, Tainan, Taiwan
| | - R Ossola
- Environmental System Science (D-USYS), ETH Zürich, Zürich, Switzerland
| | - N D Paul
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - J E Ukpebor
- Chemistry Department, Faculty of Physical Sciences, University of Benin, Benin City, Nigeria
| | - M P S Andersen
- Department of Chemistry and Biochemistry, California State University, Northridge, USA
- Department of Chemistry, University of Copenhagen, Copenhagen, Denmark
| | - J Longstreth
- The Institute for Global Risk Research, LLC, Bethesda, USA
| | - T Schikowski
- Research Group of Environmental Epidemiology, Leibniz Institute of Environmental Medicine, Düsseldorf, Germany
| | - K R Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, Canada
| | - B Sulzberger
- Academic Guest, Swiss Federal Institute of Aquatic Science and Technology, 8600, Dübendorf, Switzerland
| | - L S Bruckman
- Materials Science and Engineering, Case Western Reserve University, Cleveland, USA
| | - K K Pandey
- Wood Processing Division, Institute of Wood Science and Technology, Bangalore, India
| | - C C White
- Polymer Science and Materials Chemistry (PSMC), Exponent, Bethesda, USA
| | - L Zhu
- College of Materials Science and Engineering, Donghua University, Shanghai, China
| | - M Zhu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, China
| | - P J Aucamp
- Ptersa Environmental Consultants, Pretoria, South Africa
| | - J B Liley
- National Institute of Water and Atmospheric Research, Alexandra, New Zealand
| | - R L McKenzie
- National Institute of Water and Atmospheric Research, Alexandra, New Zealand
| | - M Berwick
- Internal Medicine, University of New Mexico, Albuquerque, USA
| | - S N Byrne
- Applied Medical Science, University of Sydney, Sydney, Australia
| | - L M Hollestein
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - R M Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - C M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - L E Rhodes
- Photobiology Unit, Dermatology Research Centre, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - S Yazar
- Garvan Institute of Medical Research, Sydney, Australia
| | - A R Young
- St John's Institute of Dermatology, King's College London (KCL), London, UK
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Bhogal S, Torguson R, Gordon P, Ehsan A, Wilson SR, Levitt R, Parikh P, Bilfinger T, Hanna N, Buchbinder M, Asch FM, Weissman G, Ben-Dor I, Shults CC, Ali S, Shea C, Zhang C, Garcia-Garcia HM, Satler LF, Waksman R, Rogers T. CRT-700.40 Self-Expandable Versus Balloon-Expandable Valve in Low Risk TAVR Patients: 30-Day Outcomes of LRT Substudy. JACC Cardiovasc Interv 2022. [DOI: 10.1016/j.jcin.2022.01.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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13
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Bhogal S, Torguson R, Gordon P, Ehsan A, Wilson SR, Levitt R, Parikh P, Bilfinger T, Hanna N, Buchbinder M, Asch FM, Weissman G, Ben-Dor I, Shults CC, Ali S, Shea C, Zhang C, Garcia-Garcia HM, Waksman R, Rogers T. CRT-700.39 Subclinical Leaflet Thrombosis and Antithrombotic Therapy Post-TAVR: An LRT Substudy. JACC Cardiovasc Interv 2022. [DOI: 10.1016/j.jcin.2022.01.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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14
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Medranda GA, Rogers T, Ali SW, Zhang C, Shea C, Sciandra KA, Case BC, Forrestal BJ, Sutton JA, McFadden EP, Malla P, Gordon P, Ehsan A, Wilson SR, Levitt R, Parikh P, Bilfinger T, Torguson R, Asch FM, Weissman G, Ben-Dor I, Shults CC, Garcia-Garcia HM, Satler LF, Waksman R. Prosthetic valve endocarditis after transcatheter aortic valve replacement in low-risk patients. Catheter Cardiovasc Interv 2021; 99:896-903. [PMID: 34505737 DOI: 10.1002/ccd.29943] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/06/2021] [Accepted: 08/27/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVES We sought to report details of the incidence, organisms, clinical course, and outcomes of prosthetic valve endocarditis (PVE) after transcatheter aortic valve replacement (TAVR) in low-risk patients. BACKGROUND PVE remains a rare but devastating complication of aortic valve replacement. Data regarding PVE after TAVR in low-risk patients are lacking. METHODS We performed a detailed review of all patients in the low-risk TAVR trials who underwent TAVR from 2016 to 2020 and were adjudicated to have definitive PVE by the independent Clinical Events Committee. RESULTS We analyzed 396 low-risk patients who underwent TAVR (including 72 with bicuspid valves). PVE occurred in 11 patients at a median 379 days (210, 528) from TAVR. The incidence within the first 30 days was 0%; days 31-365, 1.5%; and after day 365, 2.8%. The most common organism identified was Streptococcus (n = 4/11). Early PVE (≤ 365 days) occurred in five patients, of whom three demonstrated evidence of embolic stroke and two underwent surgical aortic valve re-intervention. Late PVE (> 365 days) occurred in six patients, of whom thee demonstrated evidence of embolic stroke and only one underwent surgical aortic valve re-intervention. Of the six patients with evidence of embolic stroke, two died, two were discharged to rehabilitation, and two were discharged home with home care. CONCLUSIONS PVE was infrequent following TAVR in low-risk patients but was associated with substantial morbidity and mortality. Embolic stroke complicated the majority of PVE cases, contributing to worse outcomes in these patients. Efforts must be undertaken to minimize PVE in TAVR.
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Affiliation(s)
- Giorgio A Medranda
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Toby Rogers
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA.,Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Syed W Ali
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Cheng Zhang
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Corey Shea
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Kathryn A Sciandra
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Brian C Case
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Brian J Forrestal
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Joseph A Sutton
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | | | - Prerna Malla
- Department of Neurology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Paul Gordon
- Division of Cardiology, Lifespan Cardiovascular Institute, Providence, Rhode Island, USA
| | - Afshin Ehsan
- Division of Cardiothoracic Surgery, Lifespan Cardiovascular Institute, Providence, Rhode Island, USA
| | - Sean R Wilson
- Department of Medicine, Valley Hospital, Ridgewood, New Jersey, USA
| | - Robert Levitt
- Department of Cardiology, Henrico Doctors' Hospital, Richmond, Virginia, USA
| | - Puja Parikh
- Department of Medicine, Stony Brook Hospital, Stony Brook, New York, USA
| | - Thomas Bilfinger
- Department of Surgery, Stony Brook Hospital, Stony Brook, New York, USA
| | - Rebecca Torguson
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Federico M Asch
- MedStar Health Research Institute, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Gaby Weissman
- Department of Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Itsik Ben-Dor
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Christian C Shults
- Department of Cardiac Surgery, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Lowell F Satler
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
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15
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Waksman R, Torguson R, Medranda GA, Shea C, Zhang C, Gordon P, Ehsan A, Wilson SR, Levitt R, Hahn C, Parikh P, Bilfinger T, Butzel D, Buchanan S, Hanna N, Buchbinder M, Asch F, Weissman G, Ben-Dor I, Shults C, Garcia-Garcia HM, Satler LF, Rogers T. Transcatheter aortic valve replacement in low-risk patients: 2-year results from the LRT trial. Am Heart J 2021; 237:25-33. [PMID: 33713618 DOI: 10.1016/j.ahj.2021.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Previous studies from the Low Risk TAVR (LRT) trial demonstrated that transcatheter aortic valve replacement (TAVR) is safe and feasible in low-risk patients, with excellent 30-day and 1-year outcomes. The objective of this study was to report clinical outcomes and the impact of 30-day hypoattenuated leaflet thickening (HALT) on structural valve deterioration (SVD) 2 years after TAVR. METHODS The LRT trial was the first Food and Drug Administration-approved Investigational Device Exemption trial in the United States to evaluate the safety and feasibility of TAVR in low-risk patients with symptomatic severe tricuspid aortic stenosis (AS). Valve hemodynamics and SVD by echo were recorded 30 days, 1 year, and 2 years post-TAVR. RESULTS The LRT trial enrolled 200 low-risk patients to receive TAVR. Their mean age was 73.6 years and 61.5% were men. At 2-year follow-up, the mortality rate was 4.2%; the cardiovascular death rate was 1.6%. The disabling stroke rate was 1.1%, permanent pacemaker implantation rate was 8.6%, and 4 patients (2.2%) presented with endocarditis (2 between years 1 and 2). Of the 14% of TAVR subjects who had evidence of HALT at 30 days, there was no impact on valve hemodynamics, endocarditis or stroke at 2 years. CONCLUSIONS TAVR for low-risk patients with symptomatic severe tricuspid AS is safe at 2 years. The presence of HALT at 30 days did not impact the early hemodynamic improvements nor the durability of the valve structure.
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16
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Neale RE, Barnes PW, Robson TM, Neale PJ, Williamson CE, Zepp RG, Wilson SR, Madronich S, Andrady AL, Heikkilä AM, Bernhard GH, Bais AF, Aucamp PJ, Banaszak AT, Bornman JF, Bruckman LS, Byrne SN, Foereid B, Häder DP, Hollestein LM, Hou WC, Hylander S, Jansen MAK, Klekociuk AR, Liley JB, Longstreth J, Lucas RM, Martinez-Abaigar J, McNeill K, Olsen CM, Pandey KK, Rhodes LE, Robinson SA, Rose KC, Schikowski T, Solomon KR, Sulzberger B, Ukpebor JE, Wang QW, Wängberg SÅ, White CC, Yazar S, Young AR, Young PJ, Zhu L, Zhu M. Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, Update 2020. Photochem Photobiol Sci 2021; 20:1-67. [PMID: 33721243 PMCID: PMC7816068 DOI: 10.1007/s43630-020-00001-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 01/31/2023]
Abstract
This assessment by the Environmental Effects Assessment Panel (EEAP) of the United Nations Environment Programme (UNEP) provides the latest scientific update since our most recent comprehensive assessment (Photochemical and Photobiological Sciences, 2019, 18, 595-828). The interactive effects between the stratospheric ozone layer, solar ultraviolet (UV) radiation, and climate change are presented within the framework of the Montreal Protocol and the United Nations Sustainable Development Goals. We address how these global environmental changes affect the atmosphere and air quality; human health; terrestrial and aquatic ecosystems; biogeochemical cycles; and materials used in outdoor construction, solar energy technologies, and fabrics. In many cases, there is a growing influence from changes in seasonality and extreme events due to climate change. Additionally, we assess the transmission and environmental effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for the COVID-19 pandemic, in the context of linkages with solar UV radiation and the Montreal Protocol.
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Affiliation(s)
- R E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - P W Barnes
- Biological Sciences and Environmental Program, Loyola University New Orleans, New Orleans, LA, USA
| | - T M Robson
- Organismal and Evolutionary Biology (OEB), Viikki Plant Sciences Centre (ViPS), University of Helsinki, Helsinki, Finland
| | - P J Neale
- Smithsonian Environmental Research Center, Maryland, USA
| | - C E Williamson
- Department of Biology, Miami University, Oxford, OH, USA
| | - R G Zepp
- ORD/CEMM, US Environmental Protection Agency, Athens, GA, USA
| | - S R Wilson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - S Madronich
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - A L Andrady
- Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, NC, USA
| | - A M Heikkilä
- Finnish Meteorological Institute, Helsinki, Finland
| | - G H Bernhard
- Biospherical Instruments Inc, San Diego, CA, USA
| | - A F Bais
- Department of Physics, Laboratory of Atmospheric Physics, Aristotle University, Thessaloniki, Greece
| | - P J Aucamp
- Ptersa Environmental Consultants, Pretoria, South Africa
| | - A T Banaszak
- Unidad Académica de Sistemas Arrecifales, Universidad Nacional Autónoma de México, Puerto Morelos, México
| | - J F Bornman
- Food Futures Institute, Murdoch University, Perth, Australia.
| | - L S Bruckman
- Department of Materials Science and Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - S N Byrne
- The University of Sydney, School of Medical Sciences, Discipline of Applied Medical Science, Sydney, Australia
| | - B Foereid
- Environment and Natural Resources, Norwegian Institute of Bioeconomy Research, Ås, Norway
| | - D-P Häder
- Department of Biology, Friedrich-Alexander University, Möhrendorf, Germany
| | - L M Hollestein
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - W-C Hou
- Department of Environmental Engineering, National Cheng Kung University, Tainan, Taiwan, Republic of China
| | - S Hylander
- Centre for Ecology and Evolution in Microbial model Systems-EEMiS, Linnaeus University, Kalmar, Sweden.
| | - M A K Jansen
- School of BEES, Environmental Research Institute, University College Cork, Cork, Ireland
| | - A R Klekociuk
- Antarctic Climate Program, Australian Antarctic Division, Kingston, Australia
| | - J B Liley
- National Institute of Water and Atmospheric Research, Lauder, New Zealand
| | - J Longstreth
- The Institute for Global Risk Research, LLC, Bethesda, MD, USA
| | - R M Lucas
- National Centre of Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - J Martinez-Abaigar
- Faculty of Science and Technology, University of La Rioja, Logroño, Spain
| | | | - C M Olsen
- Cancer Control Group, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - K K Pandey
- Department of Wood Properties and Uses, Institute of Wood Science and Technology, Bangalore, India
| | - L E Rhodes
- Photobiology Unit, Dermatology Research Centre, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - S A Robinson
- Securing Antarctica's Environmental Future, Global Challenges Program and School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - K C Rose
- Department of Biological Sciences, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - T Schikowski
- IUF-Leibniz Institute of Environmental Medicine, Dusseldorf, Germany
| | - K R Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, Canada
| | - B Sulzberger
- Academic Guest Eawag: Swiss Federal Institute of Aquatic Science and Technology, Duebendorf, Switzerland
| | - J E Ukpebor
- Chemistry Department, Faculty of Physical Sciences, University of Benin, Benin City, Nigeria
| | - Q-W Wang
- Institute of Applied Ecology, Chinese Academy of Sciences (CAS), Shenyang, China
| | - S-Å Wängberg
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - C C White
- Bee America, 5409 Mohican Rd, Bethesda, MD, USA
| | - S Yazar
- Garvan Institute of Medical Research, Sydney, Australia
| | - A R Young
- St John's Institute of Dermatology, King's College London, London, UK
| | - P J Young
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - L Zhu
- Center for Advanced Low-Dimension Materials, Donghua University, Shanghai, China
| | - M Zhu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, China
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Khan JM, Rogers T, Weissman G, Torguson R, Rodriguez-Weisson FJ, Chezar-Azerrad C, Greenspun B, Gupta N, Medvedofsky D, Zhang C, Gordon P, Ehsan A, Wilson SR, Goncalves J, Levitt R, Hahn C, Parikh P, Bilfinger T, Butzel D, Buchanan S, Hanna N, Garrett R, Shults C, Buchbinder M, Garcia-Garcia HM, Kolm P, Satler LF, Hashim H, Ben-Dor I, Asch FM, Waksman R. Anatomical Characteristics Associated With Hypoattenuated Leaflet Thickening in Low-Risk Patients Undergoing Transcatheter Aortic Valve Replacement. Cardiovasc Revasc Med 2020; 27:1-6. [PMID: 33129688 DOI: 10.1016/j.carrev.2020.09.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND/PURPOSE This sub-analysis of the prospective Low Risk TAVR (LRT) trial determined anatomical characteristics associated with hypoattenuated leaflet thickening (HALT), which may contribute to early transcatheter heart valve (THV) degeneration. METHODS/MATERIALS The LRT trial enrolled 200 low-risk patients between February 2016 and February 2018. All subjects underwent baseline and 30-day CT studies, analyzed by an independent core laboratory. Additional measurements, namely THV expansion, eccentricity, depth, and commissural alignment, were made by consensus of three independent readers. HALT was observed only in the Sapien 3 THV, so Evolut valves were excluded from this analysis. RESULTS In the LRT trial, 177 subjects received Sapien 3 THVs, of whom 167 (94.3%) had interpretable 30-day CTs and were eligible for this analysis. Twenty-six subjects had HALT (15.6%). Baseline characteristics were similar between groups. There was no difference in THV size implanted and baseline aortic-root geometry between groups. In patients who developed HALT, THV implantation depth was shallower than in patients who did not develop HALT (2.6 ± 1.1 mm HALT versus 3.3 ± 1.8 mm no-HALT, p = 0.03). There were more patients in the HALT group with commissural malalignment (40% vs. 28%; p = 0.25), but this did not reach statistical significance. In a univariable regression model, no predetermined variables were shown to independently predict the development of HALT. CONCLUSIONS This study did not find anatomical or THV implantation characteristics that predicted the development of HALT at 30 days. This study cannot exclude subtle effects or interaction between factors because of the small number of events.
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Affiliation(s)
- Jaffar M Khan
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America; Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Toby Rogers
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America; Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Gaby Weissman
- Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Rebecca Torguson
- Department of Cardiovascular Research and Clinical Trials, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | | | - Chava Chezar-Azerrad
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | | | - Neha Gupta
- Department of Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Diego Medvedofsky
- MedStar Health Research Institute, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Cheng Zhang
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Paul Gordon
- Division of Cardiology, The Miriam Hospital, Providence, RI, United States of America
| | - Afshin Ehsan
- Division of Cardiothoracic Surgery, Lifespan Cardiovascular Institute, Providence, RI, United States of America
| | - Sean R Wilson
- Department of Medicine, The Valley Hospital, Ridgewood, NJ, United States of America
| | - John Goncalves
- Cardiac Surgery Program, The Valley Hospital, Ridgewood, NJ, United States of America
| | - Robert Levitt
- Department of Cardiology, Henrico Doctors' Hospital, Richmond, VA, United States of America
| | - Chiwon Hahn
- Department of Cardiothoracic Surgery, Henrico Doctors' Hospital, Richmond, VA, United States of America
| | - Puja Parikh
- Department of Medicine, Stony Brook Hospital, Stony Brook, NY, United States of America
| | - Thomas Bilfinger
- Department of Surgery, Stony Brook Hospital, Stony Brook, NY, United States of America
| | - David Butzel
- Cardiovascular Service Line, Maine Medical Center, Portland, ME, United States of America
| | - Scott Buchanan
- Cardiovascular Service Line, Maine Medical Center, Portland, ME, United States of America
| | - Nicholas Hanna
- St. John Heart Institute Cardiovascular Consultants, St. John Health System, Tulsa, OK, United States of America
| | - Robert Garrett
- St. John Clinic Cardiovascular Surgery, St. John Heart Institute Cardiovascular Consultants, St. John Health System, Tulsa, OK, United States of America
| | - Christian Shults
- Department of Cardiac Surgery, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Maurice Buchbinder
- Foundation for Cardiovascular Medicine, Stanford University, Stanford, CA, United States of America
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Paul Kolm
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Lowell F Satler
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Hayder Hashim
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Itsik Ben-Dor
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Federico M Asch
- MedStar Health Research Institute, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America.
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18
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Bernhard GH, Neale RE, Barnes PW, Neale PJ, Zepp RG, Wilson SR, Andrady AL, Bais AF, McKenzie RL, Aucamp PJ, Young PJ, Liley JB, Lucas RM, Yazar S, Rhodes LE, Byrne SN, Hollestein LM, Olsen CM, Young AR, Robson TM, Bornman JF, Jansen MAK, Robinson SA, Ballaré CL, Williamson CE, Rose KC, Banaszak AT, Häder DP, Hylander S, Wängberg SÅ, Austin AT, Hou WC, Paul ND, Madronich S, Sulzberger B, Solomon KR, Li H, Schikowski T, Longstreth J, Pandey KK, Heikkilä AM, White CC. Environmental effects of stratospheric ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2019. Photochem Photobiol Sci 2020; 19:542-584. [PMID: 32364555 PMCID: PMC7442302 DOI: 10.1039/d0pp90011g] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/24/2022]
Abstract
This assessment, by the United Nations Environment Programme (UNEP) Environmental Effects Assessment Panel (EEAP), one of three Panels informing the Parties to the Montreal Protocol, provides an update, since our previous extensive assessment (Photochem. Photobiol. Sci., 2019, 18, 595-828), of recent findings of current and projected interactive environmental effects of ultraviolet (UV) radiation, stratospheric ozone, and climate change. These effects include those on human health, air quality, terrestrial and aquatic ecosystems, biogeochemical cycles, and materials used in construction and other services. The present update evaluates further evidence of the consequences of human activity on climate change that are altering the exposure of organisms and ecosystems to UV radiation. This in turn reveals the interactive effects of many climate change factors with UV radiation that have implications for the atmosphere, feedbacks, contaminant fate and transport, organismal responses, and many outdoor materials including plastics, wood, and fabrics. The universal ratification of the Montreal Protocol, signed by 197 countries, has led to the regulation and phase-out of chemicals that deplete the stratospheric ozone layer. Although this treaty has had unprecedented success in protecting the ozone layer, and hence all life on Earth from damaging UV radiation, it is also making a substantial contribution to reducing climate warming because many of the chemicals under this treaty are greenhouse gases.
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Affiliation(s)
- G H Bernhard
- Biospherical Instruments Inc., San Diego, California, USA
| | - R E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - P W Barnes
- Biological Sciences and Environment Program, Loyola University, New Orleans, USA
| | - P J Neale
- Smithsonian Environmental Research Center, Edgewater, Maryland, USA
| | - R G Zepp
- United States Environmental Protection Agency, Athens, Georgia, USA
| | - S R Wilson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - A L Andrady
- Department of Chemical and Biomolecular Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - A F Bais
- Department of Physics, Aristotle University of Thessaloniki, Greece
| | - R L McKenzie
- National Institute of Water & Atmospheric Research, Lauder, Central Otago, New Zealand
| | - P J Aucamp
- Ptersa Environmental Consultants, Faerie Glen, South Africa
| | - P J Young
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - J B Liley
- National Institute of Water & Atmospheric Research, Lauder, Central Otago, New Zealand
| | - R M Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - S Yazar
- Garvan Institute of Medical Research, Sydney, Australia
| | - L E Rhodes
- Faculty of Biology Medicine and Health, University of Manchester, and Salford Royal Hospital, Manchester, UK
| | - S N Byrne
- School of Medical Sciences, University of Sydney, Sydney, Australia
| | - L M Hollestein
- Erasmus MC, University Medical Center Rotterdam, Manchester, The Netherlands
| | - C M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - A R Young
- St John's Institute of Dermatology, King's College, London, London, UK
| | - T M Robson
- Organismal & Evolutionary Biology, Viikki Plant Science Centre, University of Helsinki, Helsinki, Finland
| | - J F Bornman
- Food Futures Institute, Murdoch University, Perth, Australia.
| | - M A K Jansen
- School of Biological, Earth and Environmental Sciences, University College Cork, Cork, Ireland
| | - S A Robinson
- Centre for Sustainable Ecosystem Solutions, University of Wollongong, Wollongong, Australia
| | - C L Ballaré
- Faculty of Agronomy and IFEVA-CONICET, University of Buenos Aires, Buenos Aires, Argentina
| | - C E Williamson
- Department of Biology, Miami University, Oxford, Ohio, USA
| | - K C Rose
- Department of Biological Sciences, Rensselaer Polytechnic Institute, Troy, New York, USA
| | - A T Banaszak
- Unidad Académica de Sistemas Arrecifales, Universidad Nacional Autónoma de México, Puerto Morelos, Mexico
| | - D -P Häder
- Department of Biology, Friedrich-Alexander University, Möhrendorf, Germany
| | - S Hylander
- Centre for Ecology and Evolution in Microbial Model Systems, Linnaeus University, Kalmar, Sweden
| | - S -Å Wängberg
- Department of Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - A T Austin
- Faculty of Agronomy and IFEVA-CONICET, University of Buenos Aires, Buenos Aires, Argentina
| | - W -C Hou
- Department of Environmental Engineering, National Cheng Kung University, Tainan City, Taiwan, China
| | - N D Paul
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - S Madronich
- National Center for Atmospheric Research, Boulder, Colorado, USA
| | - B Sulzberger
- Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - K R Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, Canada
| | - H Li
- Institute of Atmospheric Environment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - T Schikowski
- Research Group of Environmental Epidemiology, Leibniz Institute of Environmental Medicine, Düsseldorf, Germany
| | - J Longstreth
- Institute for Global Risk Research, Bethesda, Maryland, USA
| | - K K Pandey
- Institute of Wood Science and Technology, Bengaluru, India
| | - A M Heikkilä
- Finnish Meteorological Institute, Helsinki, Finland
| | - C C White
- , 5409 Mohican Rd, Bethesda, Maryland, USA
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Ozaki Y, Garcia-Garcia HM, Rogers T, Torguson R, Craig PE, Hideo-Kajita A, Gordon P, Ehsan A, Parikh P, Bilfinger T, Butzel D, Buchanan S, Levitt R, Hahn C, Buchbinder M, Hanna N, Garrett R, Wilson SR, Goncalves JA, Ali S, Asch FM, Weissman G, Shults C, Ben-Dor I, Satler LF, Waksman R. Coronary Artery Disease Assessed by Computed Tomography-Based Leaman Score in Patients With Low-Risk Transcatheter Aortic Valve Implantation. Am J Cardiol 2020; 125:1216-1221. [PMID: 32087995 DOI: 10.1016/j.amjcard.2020.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/13/2020] [Accepted: 01/17/2020] [Indexed: 01/05/2023]
Abstract
We aimed to evaluate the burden of coronary artery disease (CAD) using the computed tomography (CT) Leaman score in low-risk transcatheter aortic valve implantation (TAVI) patients. The extent of CAD in low-risk patients with aortic stenosis who are candidates for TAVI has not been accurately quantified. The CT Leaman score was developed to quantify coronary CT angiography (CCTA) atherosclerotic burden and has been validated to evaluate the extent of CAD. CT Leaman score >5 has been associated with an increase in major adverse cardiac events over long-term follow-up. The study population included patients enrolled in the Low Risk TAVI trial who underwent CCTA before the procedure. For the CT Leaman score, we used 3 sets of weighting factors: (1) location of coronary plaques, (2) type of plaque, and (3) degree of stenosis. A total of 200 patients were enrolled in the Low Risk TAVI trial. Excluded were 31 patients who had no analyzable CCTA imaging. For the remaining 169 patients, the mean CT Leaman score was 6.27 ± 0.27, of whom 102 (60.4%) had CT Leaman score >5. Nearly all analyzed patients (97%) had coronary plaques. Furthermore, 33 patients (19.5%) had potentially obstructive coronary plaques (>50% stenosis by CCTA) in proximal segments. Most low-risk TAVI patients have significant CAD burden by CCTA. It should be a priority for future TAVI devices to guarantee unimpeded access to the coronary arteries for selective angiography and interventions.
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20
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Rogers T, Greenspun BC, Weissman G, Torguson R, Craig P, Shults C, Gordon P, Ehsan A, Wilson SR, Goncalves J, Levitt R, Hahn C, Parikh P, Bilfinger T, Butzel D, Buchanan S, Hanna N, Garrett R, Buchbinder M, Asch F, Garcia-Garcia HM, Okubagzi P, Ben-Dor I, Satler LF, Waksman R. Feasibility of Coronary Access and Aortic Valve Reintervention in Low-Risk TAVR Patients. JACC Cardiovasc Interv 2020; 13:726-735. [DOI: 10.1016/j.jcin.2020.01.202] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/23/2019] [Accepted: 01/02/2020] [Indexed: 11/16/2022]
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21
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Khan JM, Rogers T, Waksman R, Torguson R, Weissman G, Medvedofsky D, Craig PE, Zhang C, Gordon P, Ehsan A, Wilson SR, Goncalves J, Levitt R, Hahn C, Parikh P, Bilfinger T, Butzel D, Buchanan S, Hanna N, Garrett R, Shults C, Garcia-Garcia HM, Kolm P, Satler LF, Buchbinder M, Ben-Dor I, Asch FM. Hemodynamics and Subclinical Leaflet Thrombosis in Low-Risk Patients Undergoing Transcatheter Aortic Valve Replacement. Circ Cardiovasc Imaging 2019; 12:e009608. [DOI: 10.1161/circimaging.119.009608] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
This analysis evaluated echocardiographic predictors of hypoattenuated leaflet thickening (HALT) in low-risk patients undergoing transcatheter aortic valve replacement and assessed 1-year clinical and hemodynamic consequences. HALT by computed tomography may be associated with early valve degeneration and increased neurological events.
Methods:
Echocardiograms were performed at baseline, discharge, 30 days, and 1 year post-procedure. Four-dimensional contrast-enhanced computed tomography assessed HALT at 30 days. Independent core laboratories analyzed images. Doppler hemodynamic parameters were tested in a univariable regression model to identify HALT predictors. One-year clinical and hemodynamic outcomes were compared between HALT (+) and (−) patients.
Results:
Analysis included 170 patients with Sapien 3 valves and diagnostic 30-day computed tomographies, of whom 27 (16%) had HALT. Baseline characteristics were similar between groups. After transcatheter aortic valve replacement, aortic flow was nonsignificantly reduced in patients who developed HALT. Regression analysis did not show significant association between baseline or discharge valve hemodynamics and development of HALT at 30 days. Patients with HALT had smaller aortic valve areas (1.4±0.4 versus 1.7±0.5 cm
2
;
P
=0.018) and Doppler velocity index (0.4±0.1 versus 0.5±0.1;
P
=0.003) than those without HALT at 30 days but not at 1 year. There was no difference in aortic mean gradient at 30 days. There was no difference between the groups in New York Heart Association class, 6-minute walk distance, and mortality at 1 year.
Conclusions:
There were no early hemodynamic predictors of HALT. At 30 days, patients with HALT had worse valve hemodynamics than those without HALT, but hemodynamic and clinical outcomes at 1 year were similar.
Clinical Trial Registration:
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02628899.
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Affiliation(s)
- Jaffar M. Khan
- Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC
- Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (J.M.K., T.R.)
| | - Toby Rogers
- Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC
- Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD (J.M.K., T.R.)
| | - Ron Waksman
- Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC
| | - Rebecca Torguson
- Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC
| | - Gaby Weissman
- Department of Cardiology (G.W.), Medstar Washington Hospital Center, DC
| | - Diego Medvedofsky
- MedStar Health Research Institute (D.M., F.M.A.), Medstar Washington Hospital Center, DC
| | - Paige E. Craig
- Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC
| | - Cheng Zhang
- Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC
| | - Paul Gordon
- Division of Cardiology, The Miriam Hospital, Providence, Rhode Island (P.G.)
| | - Afshin Ehsan
- Division of Cardiothoracic Surgery, Lifespan Cardiovascular Institute, Providence, Rhode Island (A.E.)
| | - Sean R. Wilson
- Department of Medicine (S.R.W.), The Valley Hospital, Ridgewood, NJ
| | - John Goncalves
- Cardiac Surgery Program (J.G.), The Valley Hospital, Ridgewood, NJ
| | - Robert Levitt
- Department of Cardiology (R.L.), Henrico Doctors’ Hospital, Richmond, Virginia
| | - Chiwon Hahn
- Department of Cardiothoracic Surgery (C.W.), Henrico Doctors’ Hospital, Richmond, Virginia
| | - Puja Parikh
- Department of Medicine (P.P.), Stony Brook Hospital, NY
| | | | - David Butzel
- Cardiovascular Service Line, Maine Medical Center, Portland (D.B., S.B.)
| | - Scott Buchanan
- Cardiovascular Service Line, Maine Medical Center, Portland (D.B., S.B.)
| | - Nicholas Hanna
- St John Heart Institute Cardiovascular Consultants, St John Health System, Tulsa, Oklahoma (N.H.)
| | - Robert Garrett
- St John Clinic Cardiovascular Surgery, St John Heart Institute Cardiovascular Consultants, St John Health System, Tulsa, Oklahoma (R.G.)
| | - Christian Shults
- Department of Cardiac Surgery (C.S.), Medstar Washington Hospital Center, DC
| | - Hector M. Garcia-Garcia
- Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC
| | - Paul Kolm
- Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC
| | - Lowell F. Satler
- Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC
| | - Maurice Buchbinder
- Foundation for Cardiovascular Medicine, Stanford University, California (M.B.)
| | - Itsik Ben-Dor
- Section of Interventional Cardiology (J.M.K., T.R., R.W., R.T., P.E.C., C.Z., H.M.G.-G., P.K., L.F.S., I.B.-D.), Medstar Washington Hospital Center, DC
| | - Federico M. Asch
- MedStar Health Research Institute (D.M., F.M.A.), Medstar Washington Hospital Center, DC
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Waksman R, Corso PJ, Torguson R, Gordon P, Ehsan A, Wilson SR, Goncalves J, Levitt R, Hahn C, Parikh P, Bilfinger T, Butzel D, Buchanan S, Hanna N, Garrett R, Buchbinder M, Asch F, Weissman G, Ben-Dor I, Shults C, Bastian R, Craig PE, Ali S, Garcia-Garcia HM, Kolm P, Zou Q, Satler LF, Rogers T. TAVR in Low-Risk Patients. JACC Cardiovasc Interv 2019; 12:901-907. [DOI: 10.1016/j.jcin.2019.03.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/07/2019] [Accepted: 03/07/2019] [Indexed: 10/27/2022]
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Wilson SR, Madronich S, Longstreth JD, Solomon KR. Interactive effects of changing stratospheric ozone and climate on tropospheric composition and air quality, and the consequences for human and ecosystem health. Photochem Photobiol Sci 2019; 18:775-803. [PMID: 30810564 DOI: 10.1039/c8pp90064g] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The composition of the air we breathe is determined by emissions, weather, and photochemical transformations induced by solar UV radiation. Photochemical reactions of many emitted chemical compounds can generate important (secondary) pollutants including ground-level ozone (O3) and some particulate matter, known to be detrimental to human health and ecosystems. Poor air quality is the major environmental cause of premature deaths globally, and even a small decrease in air quality can translate into a large increase in the number of deaths. In many regions of the globe, changes in emissions of pollutants have caused significant changes in air quality. Short-term variability in the weather as well as long-term climatic trends can affect ground-level pollution through several mechanisms. These include large-scale changes in the transport of O3 from the stratosphere to the troposphere, winds, clouds, and patterns of precipitation. Long-term trends in UV radiation, particularly related to the depletion and recovery of stratospheric ozone, are also expected to result in changes in air quality as well as the self-cleaning capacity of the global atmosphere. The increased use of substitutes for ozone-depleting substances, in response to the Montreal Protocol, does not currently pose a significant risk to the environment. This includes both the direct emissions of substitutes during use and their atmospheric degradation products (e.g. trifluoroacetic acid, TFA).
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Affiliation(s)
- S R Wilson
- Centre for Atmospheric Chemistry, School of Earth, Atmosphere and Life Sciences, University of Wollongong, NSW, Australia.
| | - S Madronich
- National Center for Atmospheric Research, Boulder, CO, USA
| | - J D Longstreth
- The Institute for Global Risk Research, LLC, Bethesda, MD, USA and Emergent BioSolutions, Gaithersburg, MD, USA
| | - K R Solomon
- Centre for Toxicology and School of Environmental Sciences, University of Guelph, ON, Canada
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Waksman R, Rogers T, Torguson R, Gordon P, Ehsan A, Wilson SR, Goncalves J, Levitt R, Hahn C, Parikh P, Bilfinger T, Butzel D, Buchanan S, Hanna N, Garrett R, Asch F, Weissman G, Ben-Dor I, Shults C, Bastian R, Craig PE, Garcia-Garcia HM, Kolm P, Zou Q, Satler LF, Corso PJ. Transcatheter Aortic Valve Replacement in Low-Risk Patients With Symptomatic Severe Aortic Stenosis. J Am Coll Cardiol 2018; 72:2095-2105. [DOI: 10.1016/j.jacc.2018.08.1033] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/03/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
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Vehus T, Roberg-Larsen H, Waaler J, Aslaksen S, Krauss S, Wilson SR, Lundanes E. Versatile, sensitive liquid chromatography mass spectrometry - Implementation of 10 μm OT columns suitable for small molecules, peptides and proteins. Sci Rep 2016; 6:37507. [PMID: 27897190 PMCID: PMC5126632 DOI: 10.1038/srep37507] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/28/2016] [Indexed: 12/14/2022] Open
Abstract
We have designed a versatile and sensitive liquid chromatographic (LC) system, featuring a monolithic trap column and a very narrow (10 μm ID) fused silica open tubular liquid chromatography (OTLC) separation column functionalized with C18-groups, for separating a wide range of molecules (from small metabolites to intact proteins). Compared to today’s capillary/nanoLC approaches, our system provides significantly enhanced sensitivity (up to several orders) with matching or improved separation efficiency, and highly repeatable chromatographic performance. The chemical properties of the trap column and the analytical column were fine-tuned to obtain practical sample loading capacities (above 2 μg), an earlier bottleneck of OTLC. Using the OTLC system (combined with Orbitrap mass spectrometry), we could perform targeted metabolomics of sub-μg amounts of exosomes with 25 attogram detection limit of a breast cancer-related hydroxylated cholesterol. With the same set-up, sensitive bottom-up proteomics (targeted and untargeted) was possible, and high-resolving intact protein analysis. In contrast to state-of-the-art packed columns, our platform performs chromatography with very little dilution and is “fit-for-all”, well suited for comprehensive analysis of limited samples, and has potential as a tool for challenges in diagnostics.
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Affiliation(s)
- T Vehus
- Department of Chemistry, University of Oslo, Post Box 1033 Blindern, NO-0315 Oslo, Norway.,Department of Engineering Sciences, University of Agder, Jon Lilletunsvei 9, NO-4891 Grimstad, Norway
| | - H Roberg-Larsen
- Department of Chemistry, University of Oslo, Post Box 1033 Blindern, NO-0315 Oslo, Norway
| | - J Waaler
- Unit for Cell Signaling, SFI-CAST Biomedical Innovation Center, Oslo University Hospital, Rikshospitalet, NO-0027 Oslo, Norway
| | - S Aslaksen
- Unit for Cell Signaling, SFI-CAST Biomedical Innovation Center, Oslo University Hospital, Rikshospitalet, NO-0027 Oslo, Norway
| | - S Krauss
- Unit for Cell Signaling, SFI-CAST Biomedical Innovation Center, Oslo University Hospital, Rikshospitalet, NO-0027 Oslo, Norway
| | - S R Wilson
- Department of Chemistry, University of Oslo, Post Box 1033 Blindern, NO-0315 Oslo, Norway
| | - E Lundanes
- Department of Chemistry, University of Oslo, Post Box 1033 Blindern, NO-0315 Oslo, Norway
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Grau JB, Kuschner CE, Ferrari G, Wilson SR, Brizzio ME, Zapolanski A, Yallowitz J, Shaw RE. Effects of a protocol-based management of type A aortic dissections. J Surg Res 2015; 197:265-9. [PMID: 25963164 DOI: 10.1016/j.jss.2015.04.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/12/2015] [Accepted: 04/03/2015] [Indexed: 01/16/2023]
Abstract
BACKGROUND Ascending aortic dissections (AADs) require prompt diagnosis and surgical treatment. We present the results of implementing a multidisciplinary aortic dissection protocol on the outcomes of AAD treatment at a nonteaching hospital. METHODS From January 2002-December 2013, 54 patients with the diagnosis of AAD were treated at our institution. Thirty-seven (68.5%) were male with a mean age of 62.3 y. Cardiogenic shock was present in 25.9% of patients. An AAD protocol, focused on educating physicians on presenting signs and symptoms, adequate triaging, and the need for immediate surgical intervention, was implemented, alongside the standardization of surgical treatment. We divided the cohort into two eras, based on AAD program's implementation in 2006, to better assess the impact of this protocol. RESULTS Patients from the early era had significantly longer time from Emergency Department to the operating room, more postoperative occurrence of prolonged ventilation, and a longer postoperative hospital stay at 8.7 ± 8 versus 3.1 ± 2.6 h (P = 0.002), 63% versus 18% (P = 0.002), and 63% versus 18% (P = 0.002), respectively. The overall mortality for the cohort was 9.3%, decreasing from 12.5% before 2006 to 7.9% after 2006. CONCLUSIONS The implementation of a multidisciplinary aortic dissection protocol has resulted in faster diagnosis and transport of AAD cases from the emergency room to the operating room, improving outcomes. Our data support the concept that nonteaching institutions can deliver excellent care to patients with acute aortic emergencies.
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Affiliation(s)
- Juan B Grau
- The Valley Hospital, The Valley Heart Center, Ridgewood, New Jersey; Columbia University, College of Physicians and Surgeons, New York, New Jersey; The University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania.
| | - Cyrus E Kuschner
- The Valley Hospital, The Valley Heart Center, Ridgewood, New Jersey
| | - Giovanni Ferrari
- The Valley Hospital, The Valley Heart Center, Ridgewood, New Jersey; The University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania
| | - Sean R Wilson
- The Valley Hospital, The Valley Heart Center, Ridgewood, New Jersey
| | | | - Alex Zapolanski
- The Valley Hospital, The Valley Heart Center, Ridgewood, New Jersey
| | - Joseph Yallowitz
- The Valley Hospital, Emergency Department, Ridgewood, New Jersey
| | - Richard E Shaw
- The Valley Hospital, The Valley Heart Center, Ridgewood, New Jersey
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Quirinale DG, Rustan GE, Wilson SR, Kramer MJ, Goldman AI, Mendelev MI. Appearance of metastable B2 phase during solidification of Ni50Zr50 alloy: electrostatic levitation and molecular dynamics simulation studies. J Phys Condens Matter 2015; 27:085004. [PMID: 25650946 DOI: 10.1088/0953-8984/27/8/085004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
High-energy x-ray diffraction measurements of undercooled, electrostatically levitated Ni50Zr50 liquid droplets were performed. The observed solidification pathway proceeded through the nucleation and growth of the metastable B2 phase, which persisted for several seconds before the rapid appearance of the stable B33 phase. This sequence is shown to be consistent with predictions from classical nucleation theory using data obtained from molecular dynamics (MD) simulations. A plausible mechanism for the B2-B33 transformation is proposed and investigated through further MD simulations.
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Affiliation(s)
- D G Quirinale
- Division of Materials Sciences and Engineering, Ames Laboratory, Ames, IA 50011, USA. Department of Physics and Astronomy, Iowa State University, Ames, IA 50011, USA
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Wilson SR, Kliger C, Sharma S, Dillon W, Jelnin V, Kronzon I, Perk G, Al-Badri A, Patel N, Fontana G, Ruiz C. LARGEST SERIES OF COMPLETELY PERCUTANEOUS ANTEGRADE TRANSSEPTAL-TRANSAPICAL MITRAL VALVE-IN-VALVE IMPLANTATION FOR BIOPROSTHETIC DYSFUNCTION. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61701-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gunawardana KGSH, Wilson SR, Mendelev MI, Song X. Theoretical calculation of the melting curve of Cu-Zr binary alloys. Phys Rev E Stat Nonlin Soft Matter Phys 2014; 90:052403. [PMID: 25493799 DOI: 10.1103/physreve.90.052403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Indexed: 06/04/2023]
Abstract
Helmholtz free energies of the dominant binary crystalline solids found in the Cu-Zr system at high temperatures close to the melting curve are calculated. Our theoretical approach combines fundamental measure density functional theory (applied to the hard-sphere reference system) and a perturbative approach to include the attractive interactions. The studied crystalline solids are Cu(fcc), Cu_{51}Zr_{14}(β), CuZr(B2), CuZr_{2}(C11b), Zr(hcp), and Zr(bcc). The calculated Helmholtz free energies of crystalline solids are in good agreement with results from molecular-dynamics (MD) simulations. Using the same perturbation approach, the liquid phase free energies are calculated as a function of composition and temperature, from which the melting curve of the entire composition range of this system can be obtained. Phase diagrams are determined in this way for two leading embedded atom method potentials, and the results are compared with experimental data. Theoretical melting temperatures are compared both with experimental values and with values obtained directly from MD simulations at several compositions.
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Affiliation(s)
| | - S R Wilson
- Ames Laboratory, Iowa State University, Ames, Iowa 50011, USA
| | - M I Mendelev
- Ames Laboratory, Iowa State University, Ames, Iowa 50011, USA
| | - Xueyu Song
- Ames Laboratory and Department of Chemistry, Iowa State University, Ames, Iowa 50011, USA
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Abstract
Objective: To investigate whether the effects on weight loss and cardiometabolic risk factor reduction of two technology-mediated lifestyle interventions for 15 months in a primary care-based translation trial sustained at 24 months (that is, 9 months after the end of intervention). Design: This study analyzed data from an extended follow-up of participants in the original ‘E-LITE' (Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care)-randomized controlled trial, which demonstrated the effectiveness of two adapted Diabetes Prevention Program (DPP) lifestyle interventions compared with usual primary care. Subjects: E-LITE randomized 241 overweight or obese participants with pre-diabetes and/or metabolic syndrome to receive usual care alone (n=81) or usual care plus a coach-led (n=79) or self-directed intervention (n=81). The interventions provided coach-led group behavioral weight-loss treatment or a take-home, self-directed DVD using the same 12-week curriculum, followed by 12 additional months of technology-mediated coach contact and self-monitoring support. Participants received no further intervention after month 15. A blinded assessor conducted 24-month visits by following the measurement protocols of the original trial. Measurements include weight and cardiometabolic risk factors (waist circumference, fasting plasma glucose, resting blood pressure, triglycerides, high- and low-density lipoprotein cholesterol, total cholesterol and triglyceride to high-density lipoprotein cholesterol ratio). Results: At month 24, mean±s.e. changes in body mass index (trial primary outcome) and weight (kg) from baseline were –1.9±0.3 (P=0.001) and –5.4±0.9 (P<0.001) in the coach-led intervention, and –1.6±0.3 (P=0.03) and –4.5±0.9 (P=0.001) in the self-directed intervention, compared with –0.9±0.3 and 2.4±0.9 in the usual care group. In addition, both interventions led to a greater percentage of participants maintaining ⩾7% weight loss and sustained improvements in waist circumference and fasting plasma glucose levels than usual care. Conclusion: This study shows sustained benefits of the two primary care-based, technology-mediated DPP lifestyle interventions. The findings warrant replication in long-term studies involving diverse populations.
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Affiliation(s)
- L Xiao
- Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
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Dele-Michael AO, Fujikura K, Devereux RB, Islam F, Hriljac I, Wilson SR, Lin F, Weinsaft JW. Left ventricular stroke volume quantification by contrast echocardiography - comparison of linear and flow-based methods to cardiac magnetic resonance. Echocardiography 2013; 30:880-8. [PMID: 23488864 DOI: 10.1111/echo.12155] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Echocardiography (echo)-quantified LV stroke volume (SV) is widely used to assess systolic performance after acute myocardial infarction (AMI). This study compared 2 common echo approaches - predicated on flow (Doppler) and linear chamber dimensions (Teichholz) - to volumetric SV and global infarct parameters quantified by cardiac magnetic resonance (CMR). METHODS Multimodality imaging was performed as part of a post-AMI registry. For echo, SV was measured by Doppler and Teichholz methods. Cine-CMR was used for volumetric SV and LVEF quantification, and delayed-enhancement (DE) CMR for infarct size. RESULTS Overall, 142 patients underwent same day echo and CMR. On echo, mean SV by Teichholz (78 ± 17 mL) was slightly higher than Doppler (75 ± 16 mL; Δ = 3 ± 13 mL; P = 0.02). Compared to SV on CMR (78 ± 18 mL), mean difference by Teichholz (Δ = -0.2 ± 14; P = 0.89) was slightly smaller than Doppler (Δ = -3 ± 14; P = 0.02), but limits of agreement were similar between CMR and echo methods (Teichholz: -28, 27 mL, Doppler: -31, 24 mL). For Teichholz, differences with CMR SV were greatest among patients with anteroseptal or lateral wall hypokinesis (P < 0.05). For Doppler, differences were associated with aortic valve abnormalities or root dilation (P = 0.01). SV by both echo methods decreased stepwise in relation to global LV injury as assessed by CMR-quantified LVEF and infarct size (P < 0.01). CONCLUSIONS Teichholz and Doppler calculated SV yield similar magnitude of agreement with CMR. Teichholz differences with CMR increase with septal or lateral wall contractile dysfunction, whereas Doppler yields increased offsets in patients with aortic remodeling.
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Affiliation(s)
- Abiola O Dele-Michael
- Departments of Medicine (Cardiology) and Radiology, Weill Cornell Medical College, New York, New York
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Wilson SR, Kaple R, Kampaktsis P, Baduashvili A, Zemedkun M, Kyaw H, Bergman GS, Minutello RM, Devereux RB, Salemi A, Krieger KH, Horn EM, Wong SC, Lin FY. ETIOLOGY AND DOWNSTREAM HEMODYNAMIC IMPACT OF PULMONARY HYPERTENSION IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)61254-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Laslett LJ, Alagona P, Clark BA, Drozda JP, Saldivar F, Wilson SR, Poe C, Hart M. The worldwide environment of cardiovascular disease: prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology. J Am Coll Cardiol 2013; 60:S1-49. [PMID: 23257320 DOI: 10.1016/j.jacc.2012.11.002] [Citation(s) in RCA: 485] [Impact Index Per Article: 44.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 11/05/2012] [Indexed: 12/17/2022]
Abstract
The environment in which the field of cardiology finds itself has been rapidly changing. This supplement, an expansion of a report created for the Board of Trustees, is intended to provide a timely snapshot of the socio-economic, political, and scientific aspects of this environment as it applies to practice both in the United States and internationally. This publication should assist healthcare professionals looking for the most recent statistics on cardiovascular disease and the risk factors that contribute to it, drug and device trends affecting the industry, and how the practice of cardiology is changing in the United States.
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Affiliation(s)
- Lawrence J Laslett
- University of California, Davis, Medical Center, Sacramento, California, USA
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Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nolsøe CP, Piscaglia F, Wilson SR, Barr RG, Chammas MC, Chaubal NG, Chen MH, Clevert DA, Correas JM, Ding H, Forsberg F, Fowlkes JB, Gibson RN, Goldberg BB, Lassau N, Leen ELS, Mattrey RF, Moriyasu F, Solbiati L, Weskott HP, Xu HX. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) in the liver--update 2012: a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall Med 2013; 34:11-29. [PMID: 23129518 DOI: 10.1055/s-0032-1325499] [Citation(s) in RCA: 210] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Initially, a set of guidelines for the use of ultrasound contrast agents was published in 2004 dealing only with liver applications. A second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some non-liver applications. Time has moved on, and the need for international guidelines on the use of CEUS in the liver has become apparent. The present document describes the third iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS) using contrast specific imaging techniques. This joint WFUMB-EFSUMB initiative has implicated experts from major leading ultrasound societies worldwide. These liver CEUS guidelines are simultaneously published in the official journals of both organizing federations (i.e., Ultrasound in Medicine and Biology for WFUMB and Ultraschall in der Medizin/European Journal of Ultrasound for EFSUMB). These guidelines and recommendations provide general advice on the use of all currently clinically available ultrasound contrast agents (UCA). They are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis and improve the management of patients worldwide.
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Affiliation(s)
- M Claudon
- Department of Pediatric Radiology, INSERM U947, Centre Hospitalier Universitaire de Nancy and Université de Lorraine, Vandoeuvre, France
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Timken MD, Strouse CE, Soltis SM, Daverio SA, Hendrickson DN, Abdel-Mawgoud AM, Wilson SR. Dynamics of spin-state interconversion and cooperativity for ferric spin-crossover complexes in the solid state. 5. Variable-temperature spectroscopic, magnetic, and single-crystal x-ray structural characterizations of the spin-state and order-disorder transformations of a Schiff base complex. J Am Chem Soc 2012; 108:395-402. [PMID: 22175454 DOI: 10.1021/ja00263a009] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wilson SR, Leonard JP, Geyer JT, Osborne JR, Weinsaft JW. A worrisome interventricular septum: more than meets the eye. J Am Coll Cardiol 2011; 58:e43. [PMID: 22133864 DOI: 10.1016/j.jacc.2011.06.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 06/02/2011] [Accepted: 06/14/2011] [Indexed: 11/26/2022]
Affiliation(s)
- Sean R Wilson
- Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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Wilson SR, Sabatine MS, Wiviott SD, Ray KK, De Lemos JA, Zhou S, Rifai N, Cannon CP, Morrow DA. Assessment of adiponectin and the risk of recurrent cardiovascular events in patients presenting with an acute coronary syndrome: observations from the Pravastatin Or atorVastatin Evaluation and Infection Trial-Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22). Am Heart J 2011; 161:1147-55.e1. [PMID: 21641362 DOI: 10.1016/j.ahj.2011.02.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 02/10/2011] [Indexed: 01/17/2023]
Abstract
BACKGROUND Adiponectin, an adipocytokine, is secreted by fatty cells and exerts a regulatory role in atherogenesis, modulating foam cell formation and cellular adhesion. In stable atherosclerosis, plasma adiponectin has been reported to be associated with both increased and decreased cardiovascular risk. Recent data have suggested a possible discordant adverse risk relationship in acute coronary syndrome (ACS). Therefore, we investigated the association between adiponectin and cardiovascular events in patients with ACS. METHODS We measured plasma adiponectin in 3,931 patients stabilized following ACS and assessed the relationship with 2-year outcome. Patients were followed for all-cause death and major cardiovascular events. Using multivariable Cox regression, we adjusted for age, sex, race, ACS type, diabetes, smoking status, triglycerides, blood pressure, body mass index, estimated glomerular filtration rate, treatment group (atorvastatin), B-type natriuretic peptide, and C-reactive protein. RESULTS Adiponectin correlated negatively with age, diabetes, body mass index, and triglycerides (each, P < .001) but showed a positive relationship with the risk of death (P = .01), myocardial infarction (P = .01), and heart failure (P < .001). After adjusting for clinical risk factors, B-type natriuretic peptide, and C-reactive protein, adiponectin greater than the median (4,477 ng/mL) was independently associated with an increased risk of death or myocardial infarction (hazard ratio 1.58, 95% CI 1.10-2.28, P = .013) and congestive heart failure (hazard ratio 2.17, 95% CI 1.21-3.89, P = .010). CONCLUSIONS Higher adiponectin concentrations early after ACS are independently associated with a higher risk of recurrent cardiovascular events. This finding is directionally opposite to that observed in patients at risk for atherosclerosis and reveals the need for investigation to elucidate differences in the pathobiology of adiponectin in stable versus unstable coronary artery disease.
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Affiliation(s)
- Sean R Wilson
- TIMI Study Group, Brigham and Women's Hospital, Boston, MA 02115, USA
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Southam AH, Wilson SR. CANCER OF THE SCROTUM: The Etiology, Clinical Features, and Treatment of the Disease. Br Med J 2011; 2:971-970.1. [PMID: 20770922 DOI: 10.1136/bmj.2.3229.971] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wilson SR, Min JK. The potential role for the use of cardiac computed tomography angiography for the acute chest pain patient in the emergency department. J Nucl Cardiol 2011; 18:168-76. [PMID: 21190100 DOI: 10.1007/s12350-010-9328-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Sean R Wilson
- The Greenberg Division of Cardiology, Department of Medicine, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, NY, USA
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Farling PA, Flynn PA, Darwent G, De Wilde J, Grainger D, King S, McBrien ME, Menon DK, Ridgway JP, Sury M, Thornton J, Wilson SR. Safety in magnetic resonance units: an update. Anaesthesia 2010; 65:766-70. [PMID: 20642539 PMCID: PMC2904502 DOI: 10.1111/j.1365-2044.2010.06377.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The number of anaesthetists who are involved in magnetic resonance (MR) units is increasing. Magnetic resonance systems are becoming more powerful and interventional procedures are now possible. This paper updates information relating to safety terminology, occupational exposure, reactions to gadolinium-based contrast agents and the risk of nephrogenic systemic fibrosis. Magnetic resonance examinations of patients with pacemakers are still generally contra-indicated but have been carried out in specialist centres under strictly controlled conditions. As availability of MR increases, so the education of anaesthetists, who are occasionally required to provide a service, must be considered. Anaesthesia in MR units was first described in the 1980s. Guidelines on the provision of anaesthetic services in MR units were published by the Association of Anaesthetists of Great Britain and Ireland (AAGBI) in 2002 [1]. Since then, the number of hospitals with MR units, and hence the number of patients requiring anaesthesia for MR, has increased. While the issues relating to setting up anaesthetic services in MR have not changed, there have been a number of developments that warrant this update: Safety terminology and guidelines have changed. MR systems utilise higher magnetic-field strengths and more open designs are available. Interventional and intra-operative MR are now routine in some centres. Mobile MR scanners are increasingly used to reduce waiting lists. Although still generally contra-indicated, some patients with pacemakers have been scanned under strictly controlled conditions in specialist centres. ‘MR safe’ medical implants are now being produced. New equipment is now available for use in MR. Out-of-hours availability of MR investigations has increased. Reports of allergic reactions to MR contrast media have increased. Gadolinium based contrast agents (Gd-CAs) are associated with a varying degree of risk of nephrogenic systemic fibrosis in patients with impaired renal function.
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Jorgenson JW, Novotny M, Carmack M, Copland GB, Wilson SR, Katona S, Whitten WK. Chemical Scent Constituents in the Urine of the Red Fox (Vulpes vulpes L.) During the Winter Season. Science 2010; 199:796-8. [PMID: 17836296 DOI: 10.1126/science.199.4330.796] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Four volatile chemical compounds have been identified as apparently unique constituents in urines of red foxes (both sexes) during the winter season when mating occurs. Quinaldine was found only in male fox urine. Several other compounds identified are found in other species also. Some or all of these compounds may function in olfactory communication in the red fox.
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Wilson SR, Givertz MM, Stewart GC, Mudge GH. Reply. J Am Coll Cardiol 2010. [DOI: 10.1016/j.jacc.2009.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wilson SR, Wiviott SD, Antman EM, Giugliano RP, Murphy SA, Sloan S, Braunwald E, Morrow DA. APPLICATION OF THE TIMI RISK SCORE, A SIMPLE BEDSIDE TOOL, FOR TIMING OF DISCHARGE AFTER FIBRINOLYSIS OR PRIMARY ANGIOPLASTY FOR ST-ELEVATION MI IN THE EXTRACT-TIMI 25 AND TRITON-TIMI 38 TRIALS. J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)61174-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wilson SR, Givertz MM, Stewart GC, Mudge GH. Ventricular Assist Devices. J Am Coll Cardiol 2009; 54:1647-59. [DOI: 10.1016/j.jacc.2009.06.035] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 06/18/2009] [Accepted: 06/21/2009] [Indexed: 11/15/2022]
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Wilson SR, Scirica BM, Braunwald E, Murphy SA, Karwatowska-Prokopczuk E, Buros JL, Chaitman BR, Morrow DA. Efficacy of Ranolazine in Patients With Chronic Angina. J Am Coll Cardiol 2009; 53:1510-6. [DOI: 10.1016/j.jacc.2009.01.037] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Revised: 01/09/2009] [Accepted: 01/20/2009] [Indexed: 12/19/2022]
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Affiliation(s)
- Joseph P Mazzie
- Department of Radiology, St. Vincent's Catholic Medical Center-Manhattan, New York, NY, USA
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Wilson SR, Solomon KR, Tang X. Changes in tropospheric composition and air quality due to stratospheric ozone depletion and climate change. Photochem Photobiol Sci 2007; 6:301-10. [PMID: 17344964 DOI: 10.1039/b700022g] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
It is well-understood that reductions in air quality play a significant role in both environmental and human health. Interactions between ozone depletion and global climate change will significantly alter atmospheric chemistry which, in turn, will cause changes in concentrations of natural and human-made gases and aerosols. Models predict that tropospheric ozone near the surface will increase globally by up to 10 to 30 ppbv (33 to 100% increase) during the period 2000 to 2100. With the increase in the amount of the stratospheric ozone, increased transport from the stratosphere to the troposphere will result in different responses in polluted and unpolluted areas. In contrast, global changes in tropospheric hydroxyl radical (OH) are not predicted to be large, except where influenced by the presence of oxidizable organic matter, such as from large-scale forest fires. Recent measurements in a relatively clean location over 5 years showed that OH concentrations can be predicted by the intensity of solar ultraviolet radiation. If this relationship is confirmed by further observations, this approach could be used to simplify assessments of air quality. Analysis of surface-level ozone observations in Antarctica suggests that there has been a significant change in the chemistry of the boundary layer of the atmosphere in this region as a result of stratospheric ozone depletion. The oxidation potential of the Antarctic boundary layer is estimated to be greater now than before the development of the ozone hole. Recent modeling studies have suggested that iodine and iodine-containing substances from natural sources, such as the ocean, may increase stratospheric ozone depletion significantly in polar regions during spring. Given the uncertainty of the fate of iodine in the stratosphere, the results may also be relevant for stratospheric ozone depletion and measurements of the influence of these substances on ozone depletion should be considered in the future. In agreement with known usage and atmospheric loss processes, tropospheric concentrations of HFC-134a, the main human-made source of trifluoroacetic acid (TFA), is increasing rapidly. As HFC-134a is a potent greenhouse gas, this increasing concentration has implications for climate change. However, the risks to humans and the environment from substances, such as TFA, produced by atmospheric degradation of hydrochlorofluorocarbons (HCFCs) and hydrofluorocarbons (HFCs) are considered minimal. Perfluoropolyethers, commonly used as industrial heat transfer fluids and proposed as chlorohydrofluorocarbon (CHFC) substitutes, show great stability to chemical degradation in the atmosphere. These substances have been suggested as substitutes for CHFCs but, as they are very persistent in the atmosphere, they may be important contributors to global warming. It is not known whether these substances will contribute significantly to global warming and its interaction with ozone depletion but they should be considered for further evaluation.
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Affiliation(s)
- S R Wilson
- Department of Chemistry, University of Wollongong, NSW 2522, Australia
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Andrady AL, Aucamp PJ, Bais AF, Ballaré CL, Bjorn LO, Bornman JF, Caldwell MM, Cullen AP, de Gruijl FR, Erickson DJ, Flint SD, Häder DP, Hamid HS, Ilyas M, Kulandaivelu G, Kumar HD, McKenzie RL, Longstreth J, Lucas RM, Noonan FP, Norval M, Paul ND, Smith RC, Soloman KR, Sulzberger B, Takizawa Y, Tang X, Torikai A, van der Leun JC, Wilson SR, Worrest RC, Zepp RG. Environmental effects of ozone depletion: 2006 assessment: interactions of ozone depletion and climate change : Executive summary. Photochem Photobiol Sci 2007; 6:212-7. [PMID: 17344958 DOI: 10.1039/b700050m] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Wilson SR, Katz DS. Computed tomography demonstration of epididymitis with extension to vas deferens. Urology 2006; 68:1339-40. [PMID: 17141825 DOI: 10.1016/j.urology.2006.08.1083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2006] [Revised: 05/25/2006] [Accepted: 08/17/2006] [Indexed: 11/23/2022]
Affiliation(s)
- Sean R Wilson
- Department of Diagnostic Radiology, Winthrop University Hospital, Mineola, New York 11501, USA.
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