Environmental Science & Technology Letters Environ.最新文献

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Mechanically constrained into naivety 被机械地限制在天真之中
IF 41.2 2区 环境科学与生态学
Environmental Science & Technology Letters Environ. Pub Date : 2024-11-14 DOI: 10.1038/s41563-024-02052-2
Milica Radisic
{"title":"Mechanically constrained into naivety","authors":"Milica Radisic","doi":"10.1038/s41563-024-02052-2","DOIUrl":"https://doi.org/10.1038/s41563-024-02052-2","url":null,"abstract":"Substrates with concave curvatures resembling those found in the developing embryo mechanically revert mouse and human pluripotent stem cells into a naivety-like state.","PeriodicalId":37,"journal":{"name":"Environmental Science & Technology Letters Environ.","volume":"38 1","pages":""},"PeriodicalIF":41.2,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142609906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multimodal imaging in Löffler's endocarditis. 洛夫勒心内膜炎的多模态成像。
IF 37.6 2区 环境科学与生态学
Environmental Science & Technology Letters Environ. Pub Date : 2024-11-14 DOI: 10.1093/eurheartj/ehae620
Kosuke Morita, Nobuhiro Tahara, Yoshihiro Fukumoto
{"title":"Multimodal imaging in Löffler's endocarditis.","authors":"Kosuke Morita, Nobuhiro Tahara, Yoshihiro Fukumoto","doi":"10.1093/eurheartj/ehae620","DOIUrl":"10.1093/eurheartj/ehae620","url":null,"abstract":"","PeriodicalId":37,"journal":{"name":"Environmental Science & Technology Letters Environ.","volume":" ","pages":"4663"},"PeriodicalIF":37.6,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Terra incognita unravelled 揭开未知领域的神秘面纱
IF 41.2 2区 环境科学与生态学
Environmental Science & Technology Letters Environ. Pub Date : 2024-11-13 DOI: 10.1038/s41563-024-02047-z
Erin Ratcliff, Natalie Stingelin
{"title":"Terra incognita unravelled","authors":"Erin Ratcliff, Natalie Stingelin","doi":"10.1038/s41563-024-02047-z","DOIUrl":"https://doi.org/10.1038/s41563-024-02047-z","url":null,"abstract":"Direct visualization of polymer semiconductor structure in electrolyte environments and across length scales facilitates mechanistic understanding of this versatile but complex class of materials.","PeriodicalId":37,"journal":{"name":"Environmental Science & Technology Letters Environ.","volume":"7 1","pages":""},"PeriodicalIF":41.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Electrochemically mutable soft metasurfaces 电化学可变软元表面
IF 41.2 2区 环境科学与生态学
Environmental Science & Technology Letters Environ. Pub Date : 2024-11-13 DOI: 10.1038/s41563-024-02042-4
Siddharth Doshi, Anqi Ji, Ali I. Mahdi, Scott T. Keene, Skyler P. Selvin, Philippe Lalanne, Eric A. Appel, Nicholas A. Melosh, Mark L. Brongersma
{"title":"Electrochemically mutable soft metasurfaces","authors":"Siddharth Doshi, Anqi Ji, Ali I. Mahdi, Scott T. Keene, Skyler P. Selvin, Philippe Lalanne, Eric A. Appel, Nicholas A. Melosh, Mark L. Brongersma","doi":"10.1038/s41563-024-02042-4","DOIUrl":"https://doi.org/10.1038/s41563-024-02042-4","url":null,"abstract":"<p>Active optical metasurfaces, capable of dynamically manipulating light in ultrathin form factors, enable novel interfaces between humans and technology. In such interfaces, soft materials bring many advantages based on their flexibility, compliance and large stimulus-driven responses. Here, we create electrochemically mutable, soft metasurfaces that capitalize on the swelling of soft conducting polymers to alter the shape and associated resonant response of metasurface elements. Such geometric tuning overcomes the typical trade-off between achieving substantial tuning and low optical loss that is intrinsic to dynamic metasurfaces relying on index tuning of materials. Using the commercial polymer PEDOT:PSS, we demonstrate dynamic, high-resolution colour tuning and high-diffraction-efficiency (&gt;19%) beam-steering devices that operate at CMOS-compatible voltages (~1.5 V). These results highlight how the deformability of soft materials can enable a class of high-performance metasurfaces that are suitable for body-worn technologies.</p>","PeriodicalId":37,"journal":{"name":"Environmental Science & Technology Letters Environ.","volume":"43 1","pages":""},"PeriodicalIF":41.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antithrombotic coating with sheltered positive charges prevents contact activation by controlling factor XII–biointerface binding 带有正电荷的抗血栓涂层通过控制因子 XII 与生物界面的结合防止接触激活
IF 41.2 2区 环境科学与生态学
Environmental Science & Technology Letters Environ. Pub Date : 2024-11-12 DOI: 10.1038/s41563-024-02046-0
Haifeng Ji, Kai Yu, Srinivas Abbina, Lin Xu, Tao Xu, Shengjun Cheng, Sreeparna Vappala, S. M. Amin Arefi, Md Mohosin Rana, Irina Chafeeva, Matthew Drayton, Kevin Gonzalez, Yun Liu, Dana Grecov, Edward M. Conway, Weifeng Zhao, Changsheng Zhao, Jayachandran N. Kizhakkedathu
{"title":"Antithrombotic coating with sheltered positive charges prevents contact activation by controlling factor XII–biointerface binding","authors":"Haifeng Ji, Kai Yu, Srinivas Abbina, Lin Xu, Tao Xu, Shengjun Cheng, Sreeparna Vappala, S. M. Amin Arefi, Md Mohosin Rana, Irina Chafeeva, Matthew Drayton, Kevin Gonzalez, Yun Liu, Dana Grecov, Edward M. Conway, Weifeng Zhao, Changsheng Zhao, Jayachandran N. Kizhakkedathu","doi":"10.1038/s41563-024-02046-0","DOIUrl":"https://doi.org/10.1038/s41563-024-02046-0","url":null,"abstract":"<p>Antithrombotic surfaces that prevent coagulation activation without interfering with haemostasis are required for blood-contacting devices. Such materials would restrain device-induced thrombogenesis and decrease the need for anticoagulant use, thereby reducing unwanted bleeding. Here, by optimizing the interactions with coagulation factor XII rather than preventing its surface adsorption, we develop a substrate-independent antithrombotic polymeric coating with sheltered positive charges. The antithrombic properties of the coating were demonstrated in vitro with human blood and in vivo using a carotid artery–jugular vein shunt model in rabbits. The coating exhibits a strong interaction with factor XII, but results in a low reciprocal activation of the contact pathway that triggers clot formation. These findings contradict the prevailing strategy of designing antithrombotic materials through protein-repelling surfaces. Overall, the polymeric coating we describe can benefit most blood-contacting devices and is a useful engineering guideline for designing surfaces with improved antithrombotic properties.</p>","PeriodicalId":37,"journal":{"name":"Environmental Science & Technology Letters Environ.","volume":"35 1","pages":""},"PeriodicalIF":41.2,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pregnancy, aortic events, and neonatal and maternal outcomes 妊娠、主动脉事件以及新生儿和孕产妇结局
IF 39.3 2区 环境科学与生态学
Environmental Science & Technology Letters Environ. Pub Date : 2024-11-12 DOI: 10.1093/eurheartj/ehae757
Shao-Wei Chen, Feng-Cheng Chang, Chun-Yu Chen, Yu-Ting Cheng, Fu-Chih Hsiao, Ying-Chang Tung, Chia-Pin Lin, Victor Chien-Chia Wu, Pao-Hsien Chu, An-Hsun Chou
{"title":"Pregnancy, aortic events, and neonatal and maternal outcomes","authors":"Shao-Wei Chen, Feng-Cheng Chang, Chun-Yu Chen, Yu-Ting Cheng, Fu-Chih Hsiao, Ying-Chang Tung, Chia-Pin Lin, Victor Chien-Chia Wu, Pao-Hsien Chu, An-Hsun Chou","doi":"10.1093/eurheartj/ehae757","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae757","url":null,"abstract":"Background and Aims This study aimed to evaluate the association between pregnancy and aortic complications and determine related maternal and neonatal outcomes. Methods Records of pregnancies and neonatal deliveries from the Taiwan National Health Insurance Research Database from 2000 to 2020 were retrieved. The incidence rate ratio (IRR) was calculated to evaluate the risk factors for aortic events. Survival analysis was conducted to compare maternal and neonatal mortality with and without aortic events. Results A total of 4 785 266 pregnancies were identified among 2 833 271 childbearing women, and 2 852 449 delivered neonates. In the vulnerable and control periods, 57 and 20 aortic events occurred, resulting in incidence rates of 1.19 and 0.42 aortic events per 100 000 pregnancies, respectively. Pregnancy was established as a risk factor for aortic events (IRR: 2.86, P &amp;lt; .001). The 1-year maternal mortality rate was significantly higher in pregnancies with aortic events than in those without such events (19.3% vs. 0.05%, P &amp;lt; .001). Neonates whose mothers experienced aortic events had a higher late mortality (6.3% vs. 0.6%, P &amp;lt; .001). Conclusions The association between pregnancy and aortic events was established in this study. The results revealed that women are at risk of aortic events from the gestational period to 1-year postpartum. Maternal mortality was significantly higher in pregnancies with aortic events than in those without. A higher late mortality and more complications were noted for neonatal deliveries with maternal aortic events. Early awareness of pregnant women at risk of aortic events—especially those with concomitant hypertensive disorders of pregnancy, contributive family histories, or aortopathy—is crucial.","PeriodicalId":37,"journal":{"name":"Environmental Science & Technology Letters Environ.","volume":"4 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diabetes and obesity: leveraging heterogeneity for precision medicine 糖尿病和肥胖症:利用异质性实现精准医疗
IF 39.3 2区 环境科学与生态学
Environmental Science & Technology Letters Environ. Pub Date : 2024-11-11 DOI: 10.1093/eurheartj/ehae746
Paul W Franks, Jennifer L Sargent
{"title":"Diabetes and obesity: leveraging heterogeneity for precision medicine","authors":"Paul W Franks, Jennifer L Sargent","doi":"10.1093/eurheartj/ehae746","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae746","url":null,"abstract":"The increasing prevalence of diabetes, obesity, and their cardiometabolic sequelae present major global health challenges and highlight shortfalls of current approaches to the prevention and treatment of these conditions. Representing the largest global burden of morbidity and mortality, the pathobiological processes underlying cardiometabolic diseases are in principle preventable and, even when disease is manifest, sometimes reversable. Nevertheless, with current clinical and public health strategies, goals of widespread prevention and remission remain largely aspirational. Application of precision medicine approaches that reduce errors and improve accuracy in medical and health recommendations has potential to accelerate progress towards these goals. Precision medicine must also maintain safety and ideally be cost-effective, as well as being compatible with an individual’s preferences, capabilities, and needs. Initial progress in precision medicine was made in the context of rare diseases, with much focus on pharmacogenetic studies, owing to the cause of these diseases often being attributable to highly penetrant single gene mutations. By contrast, most obesity and type 2 diabetes are heterogeneous in aetiology and clinical presentation, underpinned by complex interactions between genetic and non-genetic factors. The heterogeneity of these conditions can be leveraged for development of approaches for precision therapies. Adequate characterization of the heterogeneity in cardiometabolic disease necessitates diversity of and synthesis across data types and research methods, ideally culminating in precision trials and real-world application of precision medicine approaches. This State-of-the-Art Review provides an overview of the current state of the science of precision medicine, as well as outlining a roadmap for study designs that maximise opportunities and address challenges to clinical implementation of precision medicine approaches in obesity and diabetes.","PeriodicalId":37,"journal":{"name":"Environmental Science & Technology Letters Environ.","volume":"70 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aluminium surface work hardening enables multi-scale 3D lithography 通过铝表面加工硬化实现多尺度 3D 光刻技术
IF 41.2 2区 环境科学与生态学
Environmental Science & Technology Letters Environ. Pub Date : 2024-11-11 DOI: 10.1038/s41563-024-02036-2
Lang Wang, Hangtong Li, Chen Zhao, Liqiang Zhang, Jiye Li, Salah Ud Din, Zichen Wang, Jiacheng Sun, Sergio Andres Galindo Torres, Zhiyong Fan, Liaoyong Wen
{"title":"Aluminium surface work hardening enables multi-scale 3D lithography","authors":"Lang Wang, Hangtong Li, Chen Zhao, Liqiang Zhang, Jiye Li, Salah Ud Din, Zichen Wang, Jiacheng Sun, Sergio Andres Galindo Torres, Zhiyong Fan, Liaoyong Wen","doi":"10.1038/s41563-024-02036-2","DOIUrl":"https://doi.org/10.1038/s41563-024-02036-2","url":null,"abstract":"<p>Multi-scale structures are ubiquitous in biological systems. However, manufacturing man-made structures with controllable features spanning multiple length scales, particularly down to nanoscale features, is very challenging, which seriously impacts their collective properties. Here we introduce an aluminium-based three-dimensional lithography that combines sequential nano–micro–macro-imprinting and anodization of multi-scale anodic aluminium oxide templates to manufacture well-defined multi-scale structures, using various materials. The high-fidelity nano-patterns and micro-patterns were facilitated by the surface work hardening phenomenon, where the nano-patterns can be further fine-tailored by anodization to have high-aspect-ratio and tunable nano-holes. Based on the aluminium-based three-dimensional lithography, multi-scale materials across length scales of at least 10<sup>7</sup> orders of magnitude were precisely fabricated, including carbon, semiconductors and metals. We integrated pressure sensors and biosensors with superior and customizable performances by tailoring the multi-scale carbon networks on different length scales from nanofibres and micropyramids to macrodome arrays. This work provides a versatile technique for prototyping on-demand multi-scale structures and materials to explore desirable mechanical and physical properties.</p>","PeriodicalId":37,"journal":{"name":"Environmental Science & Technology Letters Environ.","volume":"153 1","pages":""},"PeriodicalIF":41.2,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Amyloid-beta metabolism in age-related neurocardiovascular diseases 与年龄相关的神经心血管疾病中的淀粉样蛋白-β代谢
IF 39.3 2区 环境科学与生态学
Environmental Science & Technology Letters Environ. Pub Date : 2024-11-11 DOI: 10.1093/eurheartj/ehae655
Evmorfia Aivalioti, Georgios Georgiopoulos, Simon Tual-Chalot, Dimitrios Bampatsias, Dimitrios Delialis, Kateryna Sopova, Stavros G Drakos, Konstantinos Stellos, Kimon Stamatelopoulos
{"title":"Amyloid-beta metabolism in age-related neurocardiovascular diseases","authors":"Evmorfia Aivalioti, Georgios Georgiopoulos, Simon Tual-Chalot, Dimitrios Bampatsias, Dimitrios Delialis, Kateryna Sopova, Stavros G Drakos, Konstantinos Stellos, Kimon Stamatelopoulos","doi":"10.1093/eurheartj/ehae655","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae655","url":null,"abstract":"Epidemiological evidence suggests the presence of common risk factors for the development and prognosis of both cardio- and cerebrovascular diseases, including stroke, Alzheimer's disease, vascular dementia, heart, and peripheral vascular diseases. Accumulation of harmful blood signals may induce organotypic endothelial dysfunction affecting blood–brain barrier function and vascular health in age-related diseases. Genetic-, age-, lifestyle- or cardiovascular therapy–associated imbalance of amyloid-beta (Aβ) peptide metabolism in the brain and periphery may be the missing link between age-related neurocardiovascular diseases. Genetic polymorphisms of genes related to Aβ metabolism, lifestyle modifications, drugs used in clinical practice, and Aβ-specific treatments may modulate Aβ levels, affecting brain, vascular, and cardiac diseases. This narrative review elaborates on the effects of interventions on Aβ metabolism in the brain, cerebrospinal fluid, blood, and peripheral heart or vascular tissues. Implications for clinical applicability, gaps in knowledge, and future perspectives of Aβ as the link among age-related neurocardiovascular diseases are also discussed.","PeriodicalId":37,"journal":{"name":"Environmental Science & Technology Letters Environ.","volume":"105 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142599702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aortic valve replacement vs. conservative treatment in asymptomatic severe aortic stenosis: long-term follow-up of the AVATAR trial. 无症状重度主动脉瓣狭窄的主动脉瓣置换术与保守治疗:AVATAR 试验的长期随访。
IF 37.6 2区 环境科学与生态学
Environmental Science & Technology Letters Environ. Pub Date : 2024-11-08 DOI: 10.1093/eurheartj/ehae585
Marko Banovic, Svetozar Putnik, Bruno R Da Costa, Martin Penicka, Marek A Deja, Martin Kotrc, Radka Kockova, Sigita Glaveckaite, Hrvoje Gasparovic, Nikola Pavlovic, Lazar Velicki, Stefano Salizzoni, Wojtek Wojakowski, Guy Van Camp, Sinisa Gradinac, Michael Laufer, Sara Tomovic, Ivan Busic, Milica Bojanic, Arsen Ristic, Andrea Klasnja, Milos Matkovic, Nikola Boskovic, Katarina Zivic, Miodrag Jovanovic, Serge D Nikolic, Bernard Iung, Jozef Bartunek
{"title":"Aortic valve replacement vs. conservative treatment in asymptomatic severe aortic stenosis: long-term follow-up of the AVATAR trial.","authors":"Marko Banovic, Svetozar Putnik, Bruno R Da Costa, Martin Penicka, Marek A Deja, Martin Kotrc, Radka Kockova, Sigita Glaveckaite, Hrvoje Gasparovic, Nikola Pavlovic, Lazar Velicki, Stefano Salizzoni, Wojtek Wojakowski, Guy Van Camp, Sinisa Gradinac, Michael Laufer, Sara Tomovic, Ivan Busic, Milica Bojanic, Arsen Ristic, Andrea Klasnja, Milos Matkovic, Nikola Boskovic, Katarina Zivic, Miodrag Jovanovic, Serge D Nikolic, Bernard Iung, Jozef Bartunek","doi":"10.1093/eurheartj/ehae585","DOIUrl":"10.1093/eurheartj/ehae585","url":null,"abstract":"<p><strong>Background and aims: </strong>The question of when and how to treat truly asymptomatic patients with severe aortic stenosis (AS) and normal left ventricular (LV) systolic function is still subject to debate and ongoing research. Here, the results of extended follow-up of the AVATAR trial are reported (NCT02436655, ClinicalTrials.gov).</p><p><strong>Methods: </strong>The AVATAR trial randomly assigned patients with severe, asymptomatic AS and LV ejection fraction ≥ 50% to undergo either early surgical aortic valve replacement (AVR) or conservative treatment with watchful waiting strategy. All patients had negative exercise stress testing. The primary hypothesis was that early AVR will reduce a primary composite endpoint comprising all-cause death, acute myocardial infarction, stroke, or unplanned hospitalization for heart failure (HF), as compared with conservative treatment strategy.</p><p><strong>Results: </strong>A total of 157 low-risk patients (mean age 67 years, 57% men, mean Society of Thoracic Surgeons score 1.7%) were randomly allocated to either the early AVR group (n = 78) or the conservative treatment group (n = 79). In an intention-to-treat analysis, after a median follow-up of 63 months, the primary composite endpoint outcome event occurred in 18/78 patients (23.1%) in the early surgery group and in 37/79 patients (46.8%) in the conservative treatment group [hazard ratio (HR) early surgery vs. conservative treatment 0.42; 95% confidence interval (CI) 0.24-0.73, P = .002]. The Kaplan-Meier estimates for individual endpoints of all-cause death and HF hospitalization were significantly lower in the early surgery compared with the conservative group (HR 0.44; 95% CI 0.23-0.85, P = .012, for all-cause death and HR 0.21; 95% CI 0.06-0.73, P = .007, for HF hospitalizations).</p><p><strong>Conclusions: </strong>The extended follow-up of the AVATAR trial demonstrates better clinical outcomes with early surgical AVR in truly asymptomatic patients with severe AS and normal LV ejection fraction compared with patients treated with conservative management on watchful waiting.</p>","PeriodicalId":37,"journal":{"name":"Environmental Science & Technology Letters Environ.","volume":" ","pages":"4526-4535"},"PeriodicalIF":37.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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