Exploration of Cardiology最新文献

{"title":"Vascular senescence and atherosclerotic plaque vulnerability: investigating the telomere-mitochondria crosstalk—rationale and design of the VICTORIA Study","authors":"J. Campolo, Paola Canale, E. Piccaluga, Irene Bossi, Gianluca Gazzaniga, M. Parolini, C. Dellanoce, Giuseppe Esposito, J. Oreglia, Rudina Ndreu, Andrea Borghini, M. Andreassi","doi":"10.37349/ec.2024.00030","DOIUrl":"https://doi.org/10.37349/ec.2024.00030","url":null,"abstract":"Vascular aging is recognized as one of the hallmarks of atherosclerosis. Currently, a growing body of evidence suggests that there exists a mutual crosstalk between telomere dysfunction and mitochondrial dysmetabolism during the process of vascular senescence. This underscores the importance of comprehensively studying the molecular mediators involved in this complex and intricate connection. In pursuit of this goal, the “VICTORIA” protocol entails a prospective single-center cohort study aimed at recruiting patients undergoing coronary angiography at Niguarda Hospital in Italy. The primary objective is to explore potential associations between peripheral markers of cell aging (telomere length and mtDNA content), dysregulation of non-coding RNA [specifically lncRNA TERRA and mitochondrial microRNA (MitomiR)], and the varied presentations of ischemic heart disease (stable angina, unstable angina, NSTEMI, and STEMI). Furthermore, we aim to investigate whether these markers correlate with vulnerable plaque characteristics, as assessed by optical coherence tomography findings. Additionally, systemic levels of pro-inflammatory biomarkers and novel indicators of senescence will be assessed. Patients will be followed up at 1 year to monitor primary outcomes including mortality, myocardial infarction, stroke, unplanned revascularization, and rehospitalization. The anticipated findings of this study hold promise for advancing our understanding of the telomere-mitochondria crosstalk, potentially paving the way for novel treatment modalities and refined risk stratification approaches for acute coronary syndrome.","PeriodicalId":218206,"journal":{"name":"Exploration of Cardiology","volume":"44 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141809183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous versus open cannulation for mechanical support in patients with right ventricular failure after left ventricular assist device placement","authors":"Amit Prasad, Anthony Kronfli, Nadia Assiaoui, Christoph Brehm, B. Soleimani","doi":"10.37349/ec.2024.00029","DOIUrl":"https://doi.org/10.37349/ec.2024.00029","url":null,"abstract":"Aim: Temporary right ventricular assist device (t-RVAD) is an option for those patients in right ventricular failure (RVF) after left ventricular assist device (LVAD) resistant to ionotropic therapy. There are two options to placing a t-RVAD: an open, central technique or a percutaneous placement with Protek Duo® cannula.\u0000Methods: We compare these two t-RVAD devices that treat RVF after LVAD placement. Between 2013–2019, 22 patients were identified needing t-RVAD support after LVAD placement. Fourteen patients had open/central while 8 patients had percutaneous right ventricular assist device (RVAD) support.\u0000Results: There was no difference in length of ICU stay (49 ± 32 days Protek Duo® vs. 45 ± 22 days “open”; P = 0.73); hospital length of stay (57 ± 39 days vs. 55 ± 28 days; P = 0.088); discharge from ICU and hospital (62.1% Protek Duo® vs. 57% for “open”; P = 0.9 for both); or the one-year survival between the two groups (62% Protek Duo® vs. 50% “open”; P = 0.67). The Protek Duo® group had less total time on the ventilator (15 ± 9 days vs. 27 ± 17 days; P = 0.044) and required less amount of blood products (17 ± 8.9 units RBC and 2.0 ± 1.91 units FFP vs. 31 ± 20.5 units RBC and 11.5 ± 10 units FFP; P = 0.046 and P = 0.005).\u0000Conclusions: Percutaneous t-RVAD support is a viable option for patients whom undergo LVAD placement and require right ventricular mechanical support.","PeriodicalId":218206,"journal":{"name":"Exploration of Cardiology","volume":" 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141827907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac tamponade after thrombectomy","authors":"Shruthi Sivakumar, Asher Gorantla, Wayne-Andrew Palmer, Anandita Kishore, Michael Schiable, E. Nnadi, Ammar Y Abdulfattah, Suzette B. Graham-Hill","doi":"10.37349/ec.2024.00028","DOIUrl":"https://doi.org/10.37349/ec.2024.00028","url":null,"abstract":"Pulmonary embolism (PE) is the third leading cause of cardiovascular mortality worldwide. Percutaneous mechanical thrombectomy is indicated in patients with contraindications to thrombolysis. Complications include atrial or ventricular perforation causing tamponade. We describe one case of pericardial tamponade in an elderly woman who underwent thrombectomy for acute PE. An 88-year-old woman presented with acute shortness of breath. She was tachycardic, oxygen saturation of 80% and blood pressure of 95/57 mmHg. Bedside ultrasound showed a dilated right ventricle. Electrocardiogram showed large S wave in lead I, Q wave and inverted T wave in lead III. Computed tomography (CT) angiogram of the chest revealed an extensive saddle PE. Tissue plasminogen activator was deferred given patient’s age. Full dose anticoagulation was started and she underwent a successful percutaneous thrombectomy with FlowTriever device. Two hours later, she developed severe back pain and hypotension to 88/63 mmHg. Hemoglobin dropped from 13.7 g/dL to 8.8 g/dL. CT chest angiogram showed dense pericardial effusion, likely hemopericardium, with mass effect on the heart. Bedside pericardiocentesis was attempted and converted to pericardial window given sustained hypotension. She went into cardiac arrest. Emergent thoracotomy revealed significant hemothorax. The pericardium was opened yielding a blue, globally ischemic, and non-contracting heart. Cardiac massage and intra-cardiac epinephrine attempted unsuccessfully. Percutaneous thrombectomy using the large bore design FlowTriever system has shown promising results in reducing clot burden and improving hemodynamics. Attention must be paid to life threatening complications such as cardiac tamponade which can be precipitated by using these devices.","PeriodicalId":218206,"journal":{"name":"Exploration of Cardiology","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who is the author: genuine, honorary, ghost, gold, and fake authors?","authors":"Eugenio Picano","doi":"10.37349/ec.2024.00024","DOIUrl":"https://doi.org/10.37349/ec.2024.00024","url":null,"abstract":"While authorship practices can vary across different disciplines, authorship should reflect the individuals who have made a substantial contribution to the research project, take public responsibility for the paper’s content, and agree to its submission for publication. In real life, the article is usually authored by at least one truly genuine author and some parasitic authors. The first author and the last author are especially important. The middle authors are less important, and their participation is often wrongly seen as an inconsequential decorative favor. The honorary author, a gift or guest author, is added as a bonus to please someone higher in the hierarchy than the submitting author. This practice is believed to enhance the chances of publication, but usually, the excess of honorary authors will make reviewers more critical. A ghost author contributed substantially but it does not appear in the list of authors to avoid declaring an overt conflict of interest. The gold author is someone paid by a third party in direct or indirect forms, and capable of writing and signing everything asked by the payer, including overstating the merits of a new drug or ignoring its drawbacks. A fake author does not exist, and while it may seem humorous it is a breach of scientific integrity and can lead to serious consequences for the individuals involved. With Chat-generative pre-trained transformer (Chat-GPT), artificial intelligence may contribute decisively to the article content and presentation. Overall, it is important to maintain high standards of integrity and transparency in authorship practices to ensure that research findings are trustworthy and reliable. The reputation of your work is in the hands of your coauthors, so choose them carefully and make sure they share your commitment to scientific integrity.","PeriodicalId":218206,"journal":{"name":"Exploration of Cardiology","volume":"32 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of iodinated contrast media on X-ray-induced DNA damage: a comprehensive review","authors":"Chiara Iacconi, Maria Xiarcou, Valeria Piagneri, Enrica Ciofini","doi":"10.37349/ec.2024.00023","DOIUrl":"https://doi.org/10.37349/ec.2024.00023","url":null,"abstract":"Drawing insights from a spectrum of in vitro, in vivo experimental, and clinical studies, this review illuminates the underlying mechanism by which iodinated contrast media (ICM) exerts an indirect genotoxic effect. The mechanism involves the photoelectric effect induced by iodine molecules, thereby augmenting radiation attenuation and subsequently elevating the locally absorbed radiation dose. The ensuing generation of secondary electrons from each photoelectric absorption interaction triggers molecular reactions, culminating in discernible DNA damage, notably in the form of DNA double-strand breaks. A convergence of evidence from in vitro, experimental, and clinical investigations underscores a consistent pattern: the addition of iodine contrast linearly heightens the absorbed radiation dose and associated DNA damage. This quantification was evident through alterations in attenuation and the manifestation of double-strand breaks in circulating lymphocytes, serving as an intermediate endpoint and a potential long-term indicator of cancer. The observed surplus of DNA damage in contrast-enhanced images compared to non-contrast images ranged notably from +30% to +200%. This broad range accentuates a substantial amplification effect on radiation-induced damage, particularly noteworthy at clinically relevant iodine doses. Crucially, this effect remains unaffected by brands or manufacturers and exhibits a robust, exclusive correlation with the concentration of iodine in the bloodstream. The significant augmentation of absorbed dose and genotoxic impact of X-rays due to the use of contrast agents warrants critical attention within the medical community. This often-unacknowledged genotoxic influence may play a pivotal role in elevating cancer risks among patients undergoing radiation-based procedures, necessitating a reconsideration of risk assessment protocols and clinical practices.","PeriodicalId":218206,"journal":{"name":"Exploration of Cardiology","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140682774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary calcification on invasive angiography and the Agatston score—a single-center experience","authors":"Zafraan Zathar, M. Pandit, Anne Karunatilleke, Alp Notghi, Vinod P Sharma","doi":"10.37349/ec.2024.00022","DOIUrl":"https://doi.org/10.37349/ec.2024.00022","url":null,"abstract":"Aim: The pattern and severity of coronary artery calcification (CAC) can influence prognosis and outcome in percutaneous coronary intervention. An objective assessment of CAC during invasive angiography may provide additional prognostic information. This study aimed to assess the correlation between the angiographic Birmingham calcium score (BCS) and the Agatston coronary calcium score (CCS) performed as part of single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI).\u0000Methods: In this retrospective observational study, patients undergoing SPECT-MPI and invasive coronary angiography as part of their routine management were included. BCS was calculated by reviewing angiography images in retrospect by an observer blinded to the SPECT-MPI calcium score. Spearman’s correlation was used to analyze the correlation between BCS and SPECT-MPI. Receiver operating characteristic curve was used to detect cut-off for BCS that would detect clinically significant CAC [> 400 Agatston units (AU)]. Kaplan-Meier was used to report on outcomes at 5 years follow-up.\u0000Results: In this cohort of 151 patients, there was a positive correlation between BCS and CCS [Spearman correlation coefficient (r) = 0.558, P < 0.001]. Cumulative BCS of 1 was able to identify clinically significant CAC [area under the curve 0.788, 95% confidence interval (CI) 0.714–0.863]. Cumulative BCS ≥ 3 was associated with major adverse outcomes at 5 years follow-up (log rank P = 0.013).\u0000Conclusion: BCS correlates well with established higher CCS. Application of BCS during invasive coronary angiography will aid risk stratification, management, and follow-up with no extra patient involvement, radiation, or costs.","PeriodicalId":218206,"journal":{"name":"Exploration of Cardiology","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140699266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanoparticles loaded with the DNA methyltransferase inhibitor SGI-1027 decrease murine atherosclerosis and inflammation in cultured human macrophages","authors":"A. C. Márquez-Sánchez, Alejandro Manzanares-Guzmán, Ramón Carriles-Jaimes, L. Sánchez-Segura, Dannia Colín-Castelán, Dan Kamen, Ekaterina K. Koltsova, A. Martínez-Antonio, Dalia Rodríguez‐Ríos, Gloria del Carmen Romo-Morales, G. Lund, S. Zaina","doi":"10.37349/ec.2024.00021","DOIUrl":"https://doi.org/10.37349/ec.2024.00021","url":null,"abstract":"Aim: The DNA of the atheroma is hypermethylated relative to adjacent healthy vascular tissue. A significant portion of hypermethylated loci in the atheroma DNA map to genes related to macrophage function. Reversing macrophage DNA methylation to physiological levels by targeting DNA methyltransferase (DNMT) activity may therefore slow atherogenesis. Here, the anti-inflammatory and anti-atherogenic activity of macrophage-targeted DNMT inhibitor SGI-1027 were tested.\u0000Methods: SGI-1027 was encapsulated into human serum albumin (HSA) nanoparticle (HSANP) functionalized with the PP1 peptide, a macrophage scavenger receptor 1 ligand, fused to a FLAG epitope (S-HSANP-FLAGPP1).\u0000Results: Nanoparticle physico-chemical characteristics predicted good marginalization towards the vascular wall, although SGI-1027 encapsulation efficiency was relatively low (~23%). S-HSANP-FLAGPP1 were rapidly internalized compared to non-functionalized and, surprisingly, functionalized void controls, and induced a shift towards an anti-inflammatory profile of secreted cytokines in human THP-1 macrophages. S-HSANP-FLAGPP1 colonized the atheroma and induced a significant ~44% reduction of atherosclerosis burden in the aortic tree of apolipoprotein E (ApoE)-null mice compared to controls. A reduction in aortic root atherosclerosis was observed, although primarily induced by HSANP irrespective of loading or functionalization. No alteration of body weight, non-vascular tissue gross histology, plasma glucose, triglyceride or cholesterol were observed. HSA whether free or structured in nanoparticles, induced a 3–4-fold increase in high-density lipoprotein (HDL) compared to vehicle.\u0000Conclusions: Unexpectedly, effects that were likely non-epigenetic and induced by HSA per se were observed. HSANP loaded with SGI-1027 were anti-atherogenic but in an anatomical location-dependent fashion. SGI-1027 displayed a novel anti-inflammatory activity in non-proliferating THP-1 cells, implying that those effects are likely unrelated to DNMT inhibition. HSA elevated HDL per se, thus underlining a possible additional advantage of HSA-based nanocarriers.","PeriodicalId":218206,"journal":{"name":"Exploration of Cardiology","volume":"27 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140716412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of cardio-ankle vascular index as a predictor of left ventricular hypertrophy in the evaluation of pediatric hypertension","authors":"Evan Harvey, Noel Delos Santos, Bruce Alpert, Naema Zarish, Brittany Hedge, Ronak Naik, R. Philip","doi":"10.37349/ec.2024.00020","DOIUrl":"https://doi.org/10.37349/ec.2024.00020","url":null,"abstract":"Aim: Cardio-ankle vascular index (CAVI) is a marker of arterial stiffness independent of blood pressure (BP) at the time of measurement. This work sought to evaluate the association of CAVI with left ventricular hypertrophy (LVH), a marker of long-standing hypertension (HTN) in the pediatric population.\u0000Methods: CAVI values from 236 children being evaluated for HTN were compared with their BP grade (normal, elevated, stage I HTN, and stage II HTN) in accordance with clinical guidelines. CAVI values were correlated to the presence of LVH and lipid profiles. One hundred seven of the studied patients had transthoracic echocardiograms available for comparison, and 126 had available lipid results. CAVI means between the groups were compared using analysis of variance.\u0000Results: There was no significant difference in CAVI values between the BP groups [median/interquartile range: normal BP (4.95/4.4–5.7), elevated BP (5.1/4.5–5.6), stage I/II HTN (5.0/4.3–5.5)]. Mean CAVI value was higher in the group that had LVH (5.53, standard deviation = 1.4 vs. 5.1, standard deviation = 1; P = 0.13) but was not statistically significant. However, higher mean CAVI value in children ≥ 15 years was significantly associated with the presence of LVH (5.9, standard deviation = 1.8 vs. 5.2 standard deviation = 0.8; P = 0.018).\u0000Conclusions: In post-pubertal children, CAVI may be a good predictor of LVH from long-standing HTN. This tool could prove useful in screening for the presence of atherosclerotic changes and provide opportunity for intervention/improved long-term outcomes.","PeriodicalId":218206,"journal":{"name":"Exploration of Cardiology","volume":"35 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140734385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary myocardial bridge imaging by stress-echocardiography and coronary adipose tissue attenuation on computed tomography angiography","authors":"D. Tuttolomondo, D. Dey, Piotr J. Slomka, Carmine Pizzi, Luca Bergamaschi, N. Gaibazzi","doi":"10.37349/ec.2024.00019","DOIUrl":"https://doi.org/10.37349/ec.2024.00019","url":null,"abstract":"Myocardial bridging is a congenital defect characterized by the course of a segment of the coronary arteries within the heart muscle most frequently affecting the left anterior descending coronary artery (LAD). Patients with myocardial bridging may present with episodes of exertional anginal chest pain. The gold standard for non-invasive diagnosis of myocardial bridge is coronary computed tomography angiography (CCTA), which allows anatomical characterization. Coronary flow velocity reserve (CFVR) of the LAD on stress echocardiography (SE) can play an important role in the diagnosis of myocardial bridging of the LAD; a relationship between CVFR-LAD and coronary inflammation by estimating the attenuation of peri-coronary adipose tissue at CCTA has been demonstrated in patients without obstructive ischaemic heart disease. Therefore, coronary inflammation localized to the LAD has been assessed in patients diagnosed with myocardial bridging of the LAD and previous SE with CFVR-LAD in a case series.","PeriodicalId":218206,"journal":{"name":"Exploration of Cardiology","volume":"82 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140410755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrium stress echocardiography: correlation between left atrial volume, function, and B-lines at rest and during stress","authors":"C. Prota, L. Cortigiani, Ettore Campagnano, Karina Wierzbowska-Drabik, Jarosław D. Kasprzak, Paolo Colonna, Elisa Merli, Fiore Manganelli, N. Gaibazzi, A. D’Andrea, Emma Cerracchio, Laura Meola, Rodolfo Citro, B. Villari, Q. Ciampi","doi":"10.37349/ec.2024.00018","DOIUrl":"https://doi.org/10.37349/ec.2024.00018","url":null,"abstract":"Aim: Left atrial volume index (LAVI), left atrial reservoir function through left atrial reservoir strain (LASr), and B-lines in lung ultrasound serve as supplementary indicators of left ventricular filling pressures. This study analyzes the interrelation between LAVI, LASr, and B-lines in both resting and peak vasodilator stress.\u0000Methods: Dipyridamole stress echocardiography (SE) was conducted on 252 individuals (180 males, 71%, age 65 years ± 10 years) with chronic coronary syndromes. LAVI was quantified using the biplane disk summation method; LASr was obtained using 2-dimensional speckle tracking echocardiography; B-lines were evaluated through a simplified 4-site scan in the third intercostal space during lung ultrasound.\u0000Results: During SE, a reduction in LAVI (26 ml/m2 ± 14 ml/m2 vs. 24 ml/m2 ± 12 ml/m2, P < 0.001) and an increase in LASr from rest (33% ± 8% vs. 38% ± 10%, P < 0.001) were respectively observed from rest to stress. B-lines were increased significantly during SE, from 19 (7.5%) to 29 (11.5%), P < 0.001. A substantial, inverse linear correlation was identified between LAVI and LASr both at rest (r = –0.301, P < 0.001) and peak stress (r = –0.279, P < 0.001). At group analysis, peak B-lines showed a direct correlation with peak LAVI (r = 0.151, P = 0.017) and an inverse correlation with peak LASr (r = –0.234, P < 0.001). In individual assessments, 9.7% (20/207) of patients displayed stress B-lines with normal LAVI and preserved LASr, while 20% (9/45) exhibited stress B-lines with abnormalities in both LAVI and LASr.\u0000Conclusions: Vasodilator SE with combined left atrial and volume assessment, related to pulmonary congestion, is feasible with a high success rate. Pulmonary congestion is more frequent with dilated left atrium with reduced atrial contractile reserve (ClinicalTrials.gov identifier: NCT030.49995; NCT050.81115).","PeriodicalId":218206,"journal":{"name":"Exploration of Cardiology","volume":"130 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140429023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}