Canadian Journal of Cardiology

BACKGROUND: Data on the long-term impact of prosthesis-patient mismatch (PPM) on outcomes after transcatheter aortic valve replacement (TAVR) remain sparse. We therefore aimed to investigate the incidence, predictive factors, and long-term prognostic impact of PPM on bioprosthesis durability, and mortality. METHODS: This is a monocentric retrospective study including 2,117 patients who underwent TAVR for aortic stenosis from 2002 to 2022. Moderate PPM was defined by 0...

BACKGROUND: The extent to which residential mobility is associated with declining health among disease-specific populations, such as survivors of acute myocardial infarction (AMI), remains unknown. METHODS: This prospective cohort study consisted of 3,377 patients followed from index AMI (Dec 1, 1999-March 30, 2003) until death or until the last available follow-up date (March 30, 2020) in Ontario, Canada. Each residential postal code move from a patient's sentinel AMI event was tracked...

BACKGROUND: There is no stent designed or approved for use in infants. We sought to obtain in-vitro and in-vivo data on a new concept conceived to implant Optimus-L stents at infant vessel diameters and offer a potential long-term stent solution. METHODS: Nineteen Optimus-L stents were mounted on 8 types of angioplasty balloons with diameters 6, 8, and 10mm using an injection-molded hand-crimper. We evaluated balloon-stent unit (BSU) stability before insertion and advancement through short Terumo introducers with incremental French (Fr)-size and possibility of side-arm contrast injections...

BACKGROUND: The impact of assisted reproductive technology on the cardiovascular system is unclear. METHODS: We conducted a retrospective longitudinal cohort study of 1,001,593 pregnancies conceived naturally or through assisted reproductive technology between 2008 and 2019 in Quebec, Canada to assess the association of assisted reproductive technology with cardiovascular disease in families. The exposure measure was assisted reproductive technology. The outcome included severe maternal cardiovascular morbidity, congenital heart defects in offspring, and long-term risk of cardiovascular hospitalization in mothers, fathers, and offspring during 11 years of follow-up...

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Aortic stenosis is the most common valvular disease. Surgical aortic valve replacement (SAVR) using mechanical valves has been the preferred treatment for younger patients, but bioprosthetic valves are gaining favor in order to avoid anticoagulation with warfarin. Transcatheter aortic valve replacement (TAVR) was approved in recent years for the treatment of severe aortic stenosis in intermediate and low-risk patients as an alternative to surgical aortic valve replacement (SAVR). The longer life expectancy of these groups of patients might exceed the durability of the TAVR or SAVR bioprosthetic valves...

Aortic intimal sarcomas are very rare and malignant tumors. Most patients are diagnosed with late stages or incidentally during autopsy. The most common clinical symptoms are similar to those of thrombus and atherosclerotic plaque. We report a case of aortic intimal sarcoma involving the prosthetic aortic valve and root manifested with similar symptoms of non-bacterial thrombotic endocarditis.

BACKGROUND: This study aimed to compare the outcomes, according to percutaneous mitral valvuloplasty (PMV) versus mitral valve replacement (MVR), of severe mitral stenosis (MS) with the updated criteria (MVA≤1.5 cm2). METHODS: From the Multicenter mitrAl STEnosis with Rheumatic etiology (MASTER) registry of 3,140 patients, we included severe MS patients who underwent PMV or MVR between January 2000 and December 2021 except previous valvular surgery/intervention, at least moderate other valvular dysfunction, and thrombus at the left atrium/appendage...

High-resolution single cell technologies have shed light on the pathogenesis of cardiovascular diseases by enabling the discovery of novel cellular and transcriptomic signatures associated with various conditions, and uncovering new contributions of inflammatory processes, immunity, metabolic stress, and risk factors. We review the information obtained from studies using single cell technologies in tissues with atherosclerosis and aortic aneurysms. Insights are provided on the biology of endothelial, smooth muscle and immune cells in the arterial intima and media...

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BACKGROUND: Left bundle branch block (LBBB) may induce or aggravate heart failure (HF). Few data are available on patients with HF and LBBB with mildly reduced left ventricular ejection fraction (LVEF) (HFmrEF: LVEF 40-50%) and those with preserved LVEF (HFpEF: LVEF≥50%). We aimed to assess the long-term outcomes of left bundle branch pacing (LBBP) on cardiac function and remodeling in patients with LBBB and symptomatic HFmrEF and HFpEF. METHODS: Non-ischemic cardiomyopathy (NICM) patients with HFmrEF and HFpEF (LVEF between 40% to 60% defined by echocardiography) with LBBB who underwent LBBP successfully (n=50) were prospectively included from four centers...

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BACKGROUND: There is dated and conflicting data about the optimal timing of initiation of P2Y12 inhibitors in elective percutaneous coronary intervention (PCI). Peri-PCI myocardial necrosis is associated with poor outcome. We aimed to assess the impact of the P2Y12 inhibitor loading time on peri-procedural myocardial necrosis in the population of the randomized ALPHEUS trial which compared ticagrelor to clopidogrel in high-risk elective PCI patients. METHODS: 1809 patients of the ALPHEUS trial were divided into quartiles of loading time...

BACKGROUND: To describe prevalence, incidence and risk factors for sarcopenic obesity (SO) phenotypes in people living with HIV (PWH) and their association with subclinical cardiovascular disease (CVD). METHODS: Observational, longitudinal study of PWH. A minimum of one criterion was necessary to diagnose sarcopenia: (i) weak hand grip (HG), (ii) low appendicular skeletal muscle index (ASMI), (iii) short physical performance battery (SPPB <11). Obesity was defined as (i) body mass index (BMI) ≥30 kg/m2 or (ii) visceral adipose tissue (VAT) ≥160 cm2 ...

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