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- Généreux, Philippe, et al.
(author)
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Evolution and Prognostic Impact of Cardiac Damage After Aortic Valve Replacement.
- 2022
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In: Journal of the American College of Cardiology. - 1558-3597.
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Journal article (peer-reviewed)abstract
- The impact of aortic valve replacement (AVR) on progression/regression of extra-valvular cardiac damage and its association with subsequent prognosis is unknown.To describe evolution of cardiac damage post-AVR and its association with outcomes.Patients undergoing transcatheter or surgical AVR from the PARTNER 2 and 3 trials were pooled and classified by cardiac damage stage at baseline and 1-year (Stage 0, no damage; Stage 1, left ventricular damage; Stage 2, left atrial or mitral valve damage; Stage 3, pulmonary vasculature or tricuspid valve damage; Stage 4, right ventricular damage). Proportional hazards models determined association between change in cardiac damage post-AVR and 2-year outcomes.Among 1974 patients, 121 (6.1%) were Stage 0, 287 (14.5%) Stage 1, 1014 (51.4%) Stage 2, 412 (20.9%) Stage 3, and 140 (7.1%) Stage 4 pre-AVR. Two-year mortality was associated with extent of cardiac damage at baseline and 1-year. Compared with baseline, cardiac damage improved in ∼15%, remained unchanged in ∼60%, and worsened in ∼25% of patients at 1-year. One-year change in cardiac damage stage was independently associated with mortality (adjHR for improvement=0.49; no change=1.0; worsening=1.95; p=0.023) and composite of death or heart failure hospitalization (adjHR for improvement=0.60; no change=1.0; worsening=2.25; p<0.001) at 2 years.In patients undergoing AVR, extent of extravalvular cardiac damage at baseline and its change at 1-year have important prognostic implications. These findings suggest that earlier detection of AS and intervention prior to development of irreversible cardiac damage may improve global cardiac function and prognosis.
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| 2. |
- Hudson, Mark, et al.
(author)
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Global processes of anthropogenesis characterise the early Anthropocene in the Japanese Islands
- 2022
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In: Humanities and Social Sciences Communications. - : Springer Nature. - 2662-9992. ; 9
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Journal article (peer-reviewed)abstract
- Although many scholars date the onset of the Anthropocene to the Industrial Revolution or the post-1945 ‘Great Acceleration’, there is growing interest in understanding earlier human impacts on the earth system. Research on the ‘Palaeoanthropocene’ has investigated the role of fire, agriculture, trade, urbanisation and other anthropogenic impacts. While there is increasing consensus that such impacts were more important than previously realised, geographical variation during the Palaeoanthropocene remains poorly understood. Here, we present a preliminary comparative analysis of claims that pre-industrial anthropogenic impacts in Japan were significantly reduced by four factors: the late arrival of agriculture, an emphasis on wet-rice farming limited to alluvial plains, a reliance on seafood rather than domesticated animals as a primary source of dietary protein, and cultural ideologies of environmental stewardship. We find that none of these claims of Japanese exceptionalism can be supported by the archaeological and historical records. We make some suggestions for further research but conclude that the Japanese sequence appears consistent with global trends towards increased anthropogenic impacts over the course of the Palaeoanthropocene.
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| 3. |
- Zoghbi, William A, et al.
(author)
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Atrial Functional Mitral Regurgitation : A JACC: Cardiovascular Imaging Expert Panel Viewpoint
- 2022
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In: JACC Cardiovascular Imaging. - : Elsevier. - 1936-878X .- 1876-7591. ; 15:11, s. 1870-1882
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Journal article (peer-reviewed)abstract
- Functional or secondary mitral regurgitation (MR) is associated with increased cardiovascular morbidity and mortality. Mechanistically, secondary MR is attributable to an imbalance between mitral leaflet tethering and closure forces, leading to poor coaptation. The pathophysiology of functional MR is most often the result of abnormalities in left ventricular function and remodeling, seen in ischemic or nonischemic conditions. Less commonly and more recently recognized is the scenario in which left ventricular geometry and function are preserved, the culprit being mitral annular enlargement associated with left atrial dilatation, termed atrial functional mitral regurgitation (AFMR). This most commonly occurs in the setting of chronic atrial fibrillation or heart failure with preserved ejection fraction. There is variability in the published reports and in current investigations as to the definition of AFMR. This paper reviews the pathophysiology of AFMR and focus on the need for a collective definition of AFMR to facilitate consistency in reported data and enhance much-needed research into outcomes and treatment strategies in AFMR.
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