Ehlers-Danlos syndrome (cutaneous asthenia) in a Campbell's dwarf hamster (Phodopus campbelli).

A case of cutaneous asthenia in a Campbell's dwarf hamster is described. The animal was found to have hyperextensible skin, glaucoma and lens dislocation. Histopathological examination revealed an irregular, haphazard arrangement of collagen fibres in the dermis. The animal underwent surgical reduction of the skin folds which provided only temporary relief.

Un cas d'asthénie cutanée chez un hamster nain de Campbell est décrit. L'animal présente une peau hyperextensible, un glaucome et une luxation du cristallin. L'examen histopathologique révèle une disposition irrégulière et désordonnée des fibres de collagène dans le derme. L'animal a subi une réduction chirurgicale des plis cutanés qui n'a apporté qu'un soulagement temporaire.

Descreve­se um caso de astenia cutânea em um hamster anão de Campbell. O animal apresentou hiperextensibilidade cutânea, glaucoma e deslocamento de lentes. Ao exame histopatológico, observou­se um arranjo irregular e aleatório das fibras colágenas na derme. O animal foi submetido à redução cirúrgica das dobras cutâneas que resultou em alívio apenas temporário.

Se describe un caso de astenia cutánea en un hámster enano Campbell. Se examinó al animal obsevando piel hiperextensible, glaucoma y luxación del cristalino. El examen histopatológico reveló una orientación aleatoria e irregular de las fibras de colágeno en la dermis. Se utilizó una técnica de reducción quirúrgica de los pliegues de la piel que solo indujo una mejora temporal.

The influence of treatment with lokivetmab on transepidermal water loss (TEWL) in dogs with spontaneously occurring atopic dermatitis.

BACKGROUND: Atopic dermatitis (AD) is one of the most common skin diseases in dogs. Monitoring the progress of treatment may include assessment of lesion severity by use of Canine Atopic Dermatitis Extent and Severity Index (CADESI), assessment of pruritus and measurement of biophysical parameters of the skin. HYPOTHESIS: This study aimed to assess changes in transepidermal water loss (TEWL) during 12 weeks of treatment with lokivetmab and its correlation with the CADESI-04 and the severity of pruritus. ANIMALS: Ten client-owned dogs with canine AD. METHODS AND MATERIALS: The animals were administered lokivetmab three times at four week intervals. Pruritus and CADESI-04 were assessed, and TEWL was measured at six body regions, on Day 0 and repeated at weeks 4, 8 and 12. RESULTS: There was a significant decrease in the CADESI-04 score, the severity of pruritus and the mean TEWL between baseline and each of the time points. TEWL also decreased in the majority of body sites examined. Significant correlations between the CADESI-04 and mean TEWL (r = 0.519, P = 0.0003), and between pruritus severity and mean TEWL (r = 0.517, P = 0.0003), were found. CONCLUSIONS AND CLINICAL SIGNIFICANCE: Overall TEWL decreased during lokivetmab treatment but not at all body sites. If TEWL is used to assess the effectiveness of a treatment, a mean TEWL score should be calculated from several areas of the body.

Evaluation of the correlation between Scoring Feline Allergic Dermatitis and Feline Extent and Severity Index and skin hydration in atopic cats.

BACKGROUND: Evaluation of the severity of clinical signs of cats with allergic skin diseases has used two scoring systems: Scoring Feline Allergic Dermatitis (SCORFAD) and the Feline Extent and Severity Index (FeDESI). The integrity of the cutaneous barrier can also be evaluated by measuring skin hydration. A correlation between the clinical score and skin hydration has been observed in humans and dogs with atopic dermatitis (AD). HYPOTHESIS: To demonstrate a correlation between the clinical score and skin hydration of cats affected with presumed AD. ANIMALS: European short hair cats (n = 18): 11 females and seven males with a confirmed diagnosis of AD. METHODS: SCORFAD and FeDESI scores were calculated and the measurements of skin hydration were assessed from seven body sites using corneometry. The correlation between the SCORFAD and FeDESI systems and skin hydration of each site, and the average skin hydration was calculated. RESULTS: There was a positive correlation between the SCORFAD score and skin hydration for the axilla, thorax and forelimb; for FeDESI and axilla and lumbar sites. There was a negative correlation between the FeDESI and skin hydration for the pinna (r = -0.47). CONCLUSIONS AND CLINICAL IMPORTANCE: Measurements of skin hydration could be a useful tool for the evaluation of allergic cats. There is limited evidence of any useful correlation between clinical scoring systems and measurements of hydration. The pinna may be a suitable region for the assessment of skin barrier function in normal and allergic cats.

Successful control of disseminated follicular cysts in a dog with low dose isotretinoin.

A case of disseminated cysts in a dog is described. Histopathological examination revealed the presence of follicular infundibular cysts, which were treated with isotretinoin at a dose of 2 mg/kg body weight (BW), q24h for 1 week, followed by a dose of 1 mg/kg BW for 3 months. Symptoms resolved after this course of treatment.

Contrôle réussi de kystes folliculaires disséminés chez un chien à l'aide d'une faible dose d' isotrétinoïne . Nous décrivons un cas de kystes disséminés chez un chien. L'examen histopathologique a révélé la présence de kystes infundibuliformes folliculaires qui ont été traités à l'aide de l'isotrétinoïne à une dose de 2 mg/kg poids corporel (PC), q24h pendant 1 semaine, suivie d'une dose de 1 mg/kg PC pendant 3 mois. Les symptômes se sont résorbés après ce régime de traitement.(Traduit par Isabelle Vallières).

[The coexistence of systemic lupus erythematosus and psoriasis - diagnostic and therapeutic problems].

The coexistence of systemic lupus erythematosus (SLE) and psoriasis is rarely observed in everyday clinical practice. Apart from providing a correct diagnosis, a major difficulty is to provide a proper treatment. In this case, for example, the use of systemic glucocorticosteroids may have a negative effect on the course of psoriasis, whereas phototherapy, which is widely practiced in psoriasis, may cause SLE exacerbation. The aim of the paper is to present the difficulty along the diagnostic process and in choosing the best type of treatment for patients with a coexistence of SLE and psoriasis and also a review of the subject-related literature.

Assessment of the relationship between transepidermal water loss (TEWL) and severity of clinical signs (CADESI-03) in atopic dogs.

BACKGROUND: Atopic dermatitis (AD) is a common allergic skin disease of dogs. Objective documentation of disease severity is important for the assessment of responses to therapeutic interventions. One common means of assessing the severity of clinical signs is the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-03. In addition, studies of the biophysical parameters of the skin suggest that assessment of transepidermal water loss (TEWL) may also have value for estimation of disease severity. HYPOTHESIS/OBJECTIVES: The aim of the present study was to verify the correlation between TEWL and CADESI-03 measured at 10 different body sites. ANIMALS: Twenty-six dogs with AD (age range 1-7 years, median age 3 years). METHODS: The assessment was performed at the following 10 body sites: the lumbar, inguinal, ventral abdominal, interdigital regions, axillary fossa, lateral thorax, lateral aspect of the antebrachium, concave surface of the auricle, cheek and bridge of the nose. RESULTS: Positive correlations were found between TEWL and the total CADESI-03 for the auricle (r = 0.59), bridge of nose (r = 0.62) and interdigital skin (r = 0.47). Positive correlations were also observed between TEWL and local CADESI-03 scores for the axillary fossa (r = 0.73), inguinal region (r = 0.55) and interdigital skin (r = 0.77). CONCLUSIONS AND CLINICAL IMPORTANCE: The results indicate that it may be possible to use measurement of TEWL to assess the severity of skin lesions, but a positive correlation was found in only five of 10 body regions examined.

Feline sarcoptic mange in Poland: A case series of three cats.

BACKGROUND: Sarcoptic mange is rare in cats. The main symptoms reported in cases of feline sarcoptic mange include crusty lesions and pruritus, although these may vary in severity among individuals. OBJECTIVES: This report describes three cats infested with Sarcoptes scabiei, all presenting with pruritus and excoriation. METHODS: The diagnosis was confirmed by microscopic observation of skin scrape samples. RESULTS: All three cats were treated successfully using moxidectin and imidacloprid, selamectin and ivermectin, respectively. CONCLUSIONS: The clinical presentation of feline scabies appears to be more variable in cats than in dogs. Infestation with S. scabiei should be considered a differential diagnosis for cats presenting with pruritic inflammatory skin disease.

Vaccinium Species-Unexplored Sources of Active Constituents for Cosmeceuticals.

The genus Vaccinium is represented by shrubs growing in a temperate climate that have been used for ages as traditional remedies in the treatment of digestive problems, in diabetes, renal stones or as antiseptics due to the presence of polyphenols (anthocyanins, flavonoids and tannins) in their fruits and leaves. Recent studies confirm their marked potential in the treatment of skin disorders and as skin care cosmetics. The aim of this review is to present the role of Vaccinium spp. as cosmetic products, highlight their potential and prove the biological properties exerted by the extracts from different species that can be useful for the preparation of innovative cosmetics. In the manuscript both skin care and therapeutic applications of the representatives of this gender will be discussed that include the antioxidant, skin lightening, UV-protective, antimicrobial, anti-inflammatory, and chemopreventive properties to shed new light on these underestimated plants.

Non-thymoma-associated exfoliative dermatitis in a European shorthair cat: A case report.

The current case report presents a case of non-thymoma-associated exfoliative dermatitis in an 8-year-old European Shorthair female cat. The animal displayed extensive alopecia and excessive peeling of the epidermis. There were no other apparent disorders, except for the skin lesions. Roentgenographic and sonographic examinations, complete blood count and blood serum chemistry analyses, and skin biopsy were performed. The histopathological investigation revealed hyperkeratosis of the epidermis and the infiltration of lymphocytes and macrophages at the dermal-epidermal junction around the hair follicles and sebaceous glands. Moreover, edema of the basal layer and melanin migration from the epidermis to the dermis were observed. The patient underwent treatment with immunosuppressive doses of prednisolone, antibiotic therapy, and baths in anti-seborrheic shampoos and displayed resolution. However, recurrence was observed after one month. Consequently, the patient received cyclosporine A, in addition to the aforementioned treatment and the lesions resolved without relapse.

[Primary percutaneous coronary intervention with DES implantation after Bentall de Bono procedure; late in-stent restenosis after DES implantation]. / Pierwotna angioplastyka z implantacja stentuuwalniajacego lek po operacji Bentall De Bono;pózna restenoza w stencie uwalniajacym lek.

We report a case of acute coronary syndrome in a 58 year-old man with a history of double Bentall De Bono procedure (redo due to endocarditis). During the second operation, both main native coronary arteries were anastomosed end-to-end to aortic prosthesis using short vein graft insertions. Four months later the patient presented to the CCU with unstable angina. Computed tomography-scan suggested bilateral ostial stenoses. Percutaneous coronary intervention of the left proximal anastomosis was performed with DES. 14 months later the patient was treated with in-(DES) DES implantation.

A Comparison of Multiple Allergen Simultaneous Tests Using Allergen-Specific IgE Concentration and Intradermal Skin Tests in Atopic Horses With Pollen Allergy.

Intradermal tests (IDTs) and measurement of specific immunoglobulin E class (sIgE) levels in sera are the most common and reliable methods used in allergological clinical practice. The purpose of this study was to explore the sensitization of pollen allergy in atopic horses with pollinosis and to assess the diagnostic value of the multiple allergen simultaneous tests (MASTs) compared with that of the IDT. Twenty-one Malopolski horses with typical skin hypersensitivity symptoms during pollen seasons were enrolled. Intradermal tests were performed, and allergen-specific IgE concentrations in sera were measured using a monoclonal anti-IgE antibody to pollens of grass, weeds, trees, and cultivated plants. The highest sensitization rate was for Secale cereale (IDT, 76%; MAST, 66.7%), grass (IDT, 71%; MAST, 57%), and Brassica napus (IDT, 52.4%; MAST, 57%). Receiver operating characteristic (ROC) curve analysis and the area under the ROC curve (AUC) showed that Betula spp., Alnus spp., and Corylus spp. had the highest AUC at 0.854, followed by Secale cereale (AUC = 0.796), Plantago lanceolata (AUC = 0.726), Brassica napus (AUC = 0.704), and a grass allergen mixture (AUC = 0.695). The mean AUC for all allergens was 0.712 (0.604-0.867). The overall sensitivity of the sIgE plant horse panel was 78% (range, 68%-90%), the specificity was 86.3% (range, 64%-100%), and the accuracy was 79% (range, 64%-87%). Statistical kappa (κ) agreement between the MAST and IDT was reached for tree (κ = 0.767), rye (κ = 0.687), colza (κ = 0.671), and grass (κ = 0.664) pollen. The MAST showed a favorable agreement with the IDT and can be used for the detection of sIgE in atopic horses with pollinosis.

Evaluation of multiple allergen simultaneous (sIgE) testing compared to intradermal testing in the etiological diagnosis of atopic dermatitis in horses.

Although intradermal testing (IDT) is commonly used in the etiological diagnosis of allergies, in vitro testing for specific IgE (sIgE) is an attractive alternative. Currently, new laboratory techniques in veterinary allergological practice, including multiple allergen simultaneous tests (MASTs), gradually supersede in vivo tests. Both, serological (sIgE) and IDTs in fourteen atopic Malopolski horses were performed. Correlation and agreement between test results were evaluated. Receiver operating characteristic analysis showed that sIgE to Acarus siro had the best diagnostic performance (Area under the ROC curve [AUC] = 0.969), followed by Dermatophagoides pteronyssinus (AUC = 0.844), Dermatophagoides farinae (AUC = 0.813) and Tyrophagus putrescentiae (AUC = 0.803). A significant positive correlation between IDT and MAST was found for A. siro (rS = 0.870; p = 0.00005), and D. farinae (rS = 0.657; p = 0.011). There was significant moderate agreement for 2 of 5 allergens, A. siro (κ = 0.569) and D. farinae (κ = 0.485) in semiquantitative assessment and significant fair to substantial agreement for 3 of 5 allergens, D. pteronyssinus (κ = 0.689), A. siro (κ = 0.569), D. farinae (κ = 0.432) in dichotomic assessment. Sensitivity ranged from 44% to 89%, depending on the allergen, while specificity was significantly higher for all allergens in MAST (60%-100%); the mean accuracy was 73% (manufacturer cut-off) and 77.4% (optimal cut-off) based on the Youden index. Compared with IDT, serological MAST showed good detection performance for 60% allergen sIgE in dichotomic assessment with substantial diagnostic capability, but careful clinical interpretation is needed for some allergens.

A Comparison of Intradermal Skin Testing and Serum Insect Allergen-specific IgE Determination in Horses With Insect Bite Hypersensitivity From 2008 to 2016.

New techniques in equine veterinary allergy testing include multiple allergen simultaneous tests (MASTs) that cover insect bite hypersensitivity (IBH), respiratory and atopic allergic diseases. The in vivo intradermal test (IDT) method is one of the most widely used techniques in veterinary practice, but recently, in vitro methods have been introduced as possible alternatives. This study was designed to assess the correlation between IDTs and MASTs based on IgE determination in serum. The study was performed on Malopolski breed horses with IBH (n = 26). IDTs were performed, and allergen-specific IgE serum concentrations were measured using a monoclonal anti-IgE antibody during the years 2008-2016. An allergen panel containing Tabanus spp., Culicoides nubeculosus, mosquito (Culex spp.), Simulium equinum, and Stomoxys calcitrans was used. This study shows good agreement and correlation (correlation coefficient rho, 0.413-0.589) between the two tests for four (Tabanus spp, Culicoides nubeculosus, Culex spp., Simulium equinum) of the five tested allergens in horses with IBH. The overall sensitivity (Se) of the allergen-specific IgE insect horse panel was 72.6% (range, 30.8%-91.3%), the specificity (Sp) was 63.6% (range, 50%-70.1%), and the accuracy (Acc) was 73.3% (range, 48%-88.5%) compared with IDTs. This study found good agreement and correlation between IDTs and serological MASTs based on monoclonal antibodies for most of the determined allergens for horses with IBH.

Long-term observation of adults after successful repair of aortic coarctation.

INTRODUCTION: Despite successful repair of aortic coarctation, cardiovascular complications occur. AIM: To analyse type and frequency of late complications and their impact on exercise capacity in adults after aortic coarctation repair. MATERIAL AND METHODS: Fifty-eight adults after aortic coarctation repair, 36 male, median age 27.46 ±10.57, were compared to 30 healthy volunteers. Physical examination, transthoracic echocardiography, carotid intima-media thickness measurement, cardiopulmonary exercise test and 24-hour ambulatory blood pressure monitoring were performed. RESULTS: The main complications were: arterial hypertension 48.3%, myocardial hypertrophy in echocardiography 29.34%, recoarctation 25.86%, aortic dilation 13.79% and coronary artery disease 6.89%. Exercise tolerance was reduced in the cardiopulmonary exercise test. The VO2/kg peak was lower, 29.01 ±8.79 vs. 49.16 ±7.38 ml/kg/min, p < 0.001, VE/VCO2 peak higher 28.18 ±4.69 vs. 26.78 ±3.13, p = 0.017. The peak heart rate was reduced, 157.28 ±22.22 vs. 177.93 ±23.08 bpm, p < 0.001, peak systolic blood pressure was higher, 174.79 ±17.62 vs. 153.33 ±4.79 mm Hg, p < 0.001. Systolic blood pressure in 24-hour ambulatory monitoring correlated with left ventricle mass index, r = 0.29, p = 0.025, wall thickness, r = 0.31, p = 0.039. Age at operation was related to left ventricle wall thickness, r = 0.27, p = 0.041, and carotid intima-media thickness, r = 0.26, p = 0.046. There was no association of any cardio-pulmonary parameters with time from surgery, type of operation or echocardiography results. CONCLUSIONS: Adults after aortic coarctation repair suffer from arterial hypertension, recurrent aortic stenosis, aortic aneurysms, and coronary artery disease. Reduced exercise capacity in cardio-pulmonary exercise test is related to hypertensive reaction and chronotropic incompetence.

Pituitary-testicular Axis Dysfunction in Methimazole-induced Hypothyroidism in Rats.

INTRODUCTION: Thyroid hormones play a major role in the regulation of testicular maturation and growth and in the control of Sertoli and Leydig cell functions in adulthood. When naturally occurring, hypothyroidism causes male hypogonadotropic hypogonadism and Sertoli cell function disorders, but when iatrogenic and methimazole-induced its influence on the pituitary-testicular axis function with respect to Sertoli cells is poorly known. MATERIAL AND METHODS: Male adult Wistar rats (n = 14) were divided into two groups: E - taking methimazole orally for 60 days, and C - control animals. After 60 d, the concentrations in serum of testosterone, follicle-stimulating and luteinising hormones, and inhibins A and B were measured. Testicles were examined morphologically: the apoptotic Sertoli cell percentage (ASC%) and number of these cells functional per tubular mm2 (FSCN/Tmm2) were calculated. RESULTS: In group E, inhibin A was higher while inhibin B was lower than in group C. ASC% was higher and FSCN/Tmm2 lower in group E than in group C. CONCLUSION: A specific modulation of Sertoli cell function in the course of methimazole-induced hypothyroidism leads to a simultaneous concentration increase in inhibin A and decrease in B. Inhibin A might share responsibility for pituitary-testicular axis dysfunction and hypogonadotropic hypogonadism in this model of hypothyroidism.

Correlation between transepidermal water loss (TEWL) and severity of clinical symptoms in cats with atopic dermatitis.

The aim of this study was to demonstrate whether there is a correlation between transepidermal water loss (TEWL) and the severity of skin lesions in cats with feline atopic dermatitis (AD). The severity of symptoms was determined by using 2 scoring systems for clinically assessing the skin lesions in cats: Scoring Feline Allergic Dermatitis (SCORFAD) and Feline Extent and Severity Index (FeDESI). Such a correlation between TEWL and systems for clinically evaluating symptoms has already been shown in humans and dogs. Measurements were taken in 18 European Shorthair cats: 11 females and 7 males. Scores were calculated using SCORFAD and FeDESI and TEWL was measured in 7 areas of the body. Correlations were calculated between SCORFAD and TEWL and between FeDESI and TEWL for each body region and the average TEWL was also calculated with each system. Positive correlations were found between SCORFAD and TEWL in 3 of the examined areas: thorax (r = 0.44, P = 0.02); axilla (r = 0.39, P = 0.04); and forelimb (r = 0.55, P = 0.02). A correlation was also found between the average TEWL and SCORFAD (r = 0.41, P = 0.03). In the case of FeDESI, a correlation was found in the forelimb (r = 0.53, P = 0.02), but no correlation was found between FeDESI and the average TEWL. The results obtained showed that TEWL can be used as an additional tool in clinically assessing atopic dermatitis in cats, although it seems to be less useful in cats than in humans.

Les maladies allergéniques de la peau sont un problème très fréquent chez les chats. Les deux systèmes d'évaluation Scoring Feline Allergic Dermatitis (SCORFAD) et Feline Extent and Severity Index (FeDESI) utilisent l'évaluation clinique de la gravité des symptômes cliniques. Chez les humains et les chiens, il existe une corrélation entre la gravité des symptômes cliniques et le Transepidermal Water Loss (TEWL). Le but de l'étude était de démontrer si cette corrélation était observée chez les chats. Des mesures ont été réalisées dans 18 chats européens à courtes poils: 11 femelles, 7 mâles, SCORFAD et FeDESI ont été calculées, les mesures TEWL ont été effectuées dans 7 régions corporelles. Les corrélations entre SCORFAD et FeDESI et TEWL ont été calculées pour chaque région corporelle et entre la TEWL moyenne. Il y avait des corrélations positives entre TEWL et SCORFAD sur la poitrine: (r = 0,44, P = 0,02), alisselle (r = 0,39, P = 0,04) et avant bras (r = 0,55, P = 0,02). La corrélation entre TEWL moyen et SCORFAD a été montrée (r = 0,41, P = 0,03). FeDESI a été trouvé sur l'avant-bras (r = 0,53, P = 0,02). Les résultats montrent que TEWL est un paramètre qui peut être utilisé comme outil supplémentaire dans l'évaluation clinique de la dermatite atopique chez les chats. La pertinence de ce paramètre semble être plus faible chez le chat que chez les humains.(Traduit par les auteurs).

Improvement of physical capacity in patients undergoing transcatheter closure of atrial septal defects.

INTRODUCTION: Atrial septal defect (ASD) is the most common congenital cardiac anomaly diagnosed in adults. It often remains asymptomatic until the fourth or fifth decade of life. Significant left-to-right interatrial shunting is associated with the risk of heart failure, pulmonary hypertension and atrial fibrillation. Percutaneous ASD closure is a recognized method of treatment. AIM: To evaluate the clinical outcomes and physical capacity in patients undergoing transcatheter closure of ostium secundum ASD. MATERIAL AND METHODS: One hundred and twenty adult patients (75 females and 45 males) with a mean age of 43.1 ±13.3 (17-78) years who underwent transcatheter device closure of ostium secundum ASD were analyzed. Clinical evaluation and transthoracic color Doppler echocardiographic study were repeated in all patients before as well as 1 and 24 months after the procedure. To assess the physical capacity symptom-limited treadmill exercise tests with respiratory gas-exchange analysis were performed in all patients before the procedure and after 24 months of follow-up. RESULTS: The devices were successfully implanted in all patients. During 24 months of follow-up all patients showed significant clinical and spiroergometric improvement of exercise capacity, and a significant decrease of right heart chamber overload features on echocardiography. CONCLUSIONS: Transcatheter closure of ASD in patients with significant shunt resulted in significant clinical and hemodynamic improvement regardless of the baseline functional class.

Temporal changes in the pattern of invasive angiography use and its outcome in suspected coronary artery disease: implications for patient management and healthcare resources utilization.

INTRODUCTION: Invasive coronary angiography (CAG), the 'gold standard' in coronary artery disease (CAD) diagnosis, requires hospitalization, is not risk-free, and engages considerable healthcare resources. AIM: To assess recent (throught out 10 years) evolution of 'significant' (≥ 50% stenosis(es)) CAD prevalence in subjects undergoing CAG for CAD diagnosis in a high-volume tertiary referral center. MATERIAL AND METHODS: Anonymized medical records were compared for the last vs. the first 2-years of the decade (June 2007 to May 2018). Referrals for suspected CAD were 2067 of 4522 hospitalizations (45.7%) and 1755 of 5196 (33.8%) respectively (p < 0.001). RESULTS: The median patient age (64 vs. 68 years) and the prevalence of heart failure (24.1% vs. 42.2%) increased significantly (p < 0.001). The CAG atherosclerotic lesions, for all stenosis categories (< 50%; ≥ 50%; ≥ 70%; occlusion(s)), were significantly more prevalent in men. The proportion of subjects with any atherosclerosis on CAG increased (80.7% vs. 77.6%, p = 0.015). However, in the absence of any gross change in, for instance, the fraction of women (40.4% vs. 41.8%), the proportion of CAGs with significant CAD (lesion(s) ≥ 50%) decreased from 55.2% in 2007/2008 to below 1 in every 2 angiograms (48.9%) in 2017/2018 (p < 0.001). This unexpected finding occurred consistently across nearly all CAG referral categories. CONCLUSIONS: Despite more advanced age and a higher proportion of subjects with 'any' coronary atherosclerosis on CAG, the likelihood of a 'negative' angiogram (lesion(s) < 50%; no further evaluation/intervention) has increased significantly over the last decade. The exact nature of this phenomenon requires further investigation, particularly as a reverse trend would be expected with the growing role (and current high penetration) of contemporary non-invasive diagnostic tools to rule out significant CAD.

Aortic pulse wave velocity and carotid-femoral pulse wave velocity: similarities and discrepancies.

The objectives of this study were to determine the relationship between carotid-femoral (cfPWV) and aortic pulse wave velocity (aPWV) and to compare their modulators and association with coronary artery disease (CAD). We studied 107 consecutive patients (68 men) with a mean age of 60.49+/-8.31 years who had stable angina and had been referred for coronary angiography. cfPWV and aPWV were measured simultaneously during cardiac catheterization using the Complior device and aortic pressure waveform recordings, respectively. Based on the presence or absence of significant coronary artery stenosis (CAS) patients were subdivided into a CAS+ or CAS- group. The mean values of cfPWV and aPWV were 10.65+/-2.29 m/s and 8.78+/-2.24 m/s, respectively. They were significantly higher in the CAS+ (n=71) compared with the CAS- (n=36) group and predicted significant CAS independently of cardiovascular risk factors and mean or systolic aortic blood pressure. aPWV and cfPWV were significantly correlated (r=0.70; p<0.001) but the degree of correlation differed significantly (p<0.03) between the CAS+ (r=0.74, p<0.001) and CAS- group (r=0.46, p=0.003). Age and mean aortic blood pressure were independent predictors for aPWV as well as cfPWV. In the receiver operating characteristic (ROC) analysis, aPWV and cfPWV had similar accuracy in identification of significant CAS (AUC [area under the ROC curve]=0.76 and 0.69, respectively; p=0.13). However, neither cfPWV nor aPWV was effective at differentiating the extent of CAD. In conclusion, aPWV and cfPWV are highly correlated parameters with similar determinants and comparable accuracy in predicting significant CAS. The strength of correlation between these two indices differed significantly between subjects with and those without CAS.

Efficacy and Safety of Novel NovaCross Microcatheter for Chronic Total Occlusions: First-in-Human Study.

OBJECTIVES: The aim of this first-in-human (FIH) study was to evaluate the efficacy and safety of the novel NovaCross microcatheter system in eligible consecutive patients with chronic total occlusion (CTO). BACKGROUND: CTOs remain the most challenging lesion subset in percutaneous coronary intervention (PCI). Failure to cross to the distal true lumen with the guidewire is one of the major causes of procedural failure in CTO-PCI. The NovaCross microcatheter (Nitiloop, Ltd) is designed to improve antegrade recanalization success. METHODS: This study was a prospective, non-randomized, FIH investigational study. Patients with total occlusion of a coronary artery determined to be more than 3 months old and accepted for coronary CTO-PCI with an intended antegrade strategy were enrolled. RESULTS: Twenty-four patients were enrolled in this study. Despite the high complexity of the lesions (including 80% J-CTO score ≥3 and 50% of the cases having had a previous failed CTO-PCI attempt), technical success was 81.8%. No patients reported any major adverse cardiac event up to and including 30 days post procedure. CONCLUSION: In this FIH study, the NovaCross microcatheter exhibited the potential to stabilize guidewires and enhance crossing of coronary CTO lesions.