Short-Term Outcomes of Transcatheter Aortic Valve Replacement in Low-Risk Patients With Pure Severe Aortic Regurgitation.

Transcatheter aortic valve replacement (TAVR) has emerged as an alternative treatment for patients with pure severe aortic regurgitation (PSAR) who are contraindicated for surgery or have a high surgical risk. However, the therapeutic efficacy and safety of TAVR in low Society of Thoracic Surgeons (STS) score risk patients remain to be clarified. This study aimed to explore the feasibility of TAVR treatment in different STS-risk patients and to compare the adverse events between the groups. In this study, patients with PSAR who underwent TAVR at Zhongshan Hospital, Fudan University, China, during the inclusion period were included and categorized into 3 groups based on STS scores. The baseline data, imaging results, and follow-up data of the patients were documented. Therefore, of 75 TAVR patients, 38 (50.7%) were categorized as low risk (STS <4), and 37 (49.3%) patients were categorized as intermediate and high risk (STS ≥4). Compared with patients at intermediate and high risk, those in the low-risk group were younger, had a lower body mass index, had a lower prevalence of hypertension, chronic obstructive pulmonary disease, and previous percutaneous coronary intervention, and had better cardiac function (p all <0.05). In the hospital and at the 1-month follow-up, the degree of aortic regurgitation and cardiac function were significantly improved. No significant difference was found between the 2 groups in the hospital or during the 30-day follow-up. In conclusion, TAVR for PSAR in low-STS-risk patients is safe and efficient during 30 days of follow-up compared with intermediate- and high-STS-risk groups. TAVR for PSAR should not be limited to inoperable or STS-defined high-risk patients. Long-term follow-up is needed for further investigation.

Modeling dendritic arborization based on 3D-reconstructions of adult rat phrenic motoneurons

Stereological techniques that rely on morphological assumptions and direct three-dimensional (3D) on focal measurements have been previously used to estimate the dendritic surface areas of phrenic motoneurons (PhrMNs). Given that97% of a motoneuron’s receptive area is provided by dendrites, dendritic branching and overall extension are physiologically important in determining the output of their synaptic receptive fields. However, limitations intrinsic to shape-based estimations and incomplete labeling of dendritic trees by retrograde techniques have hindered systematic approaches to examine dendritic morphology of PhrMNs. In this study, a novel method that improves dendritic filling of PhrMNs in lightly-fixed samples was used. Confocal microscopy allowed accurate 3D reconstruction of dendritic arbors from adult rat PhrMNs. Following pre-processing,segmentation was semi-automatically performed in 3D, and direct measurements of dendritic surface area were obtained. A quadratic model for estimating dendritic tree surface area based on measurements of primary dendrite diameter was derived (r2 =0.932; p<0.0001). This method may enhance interpretation of motoneuron plasticity in response to injury or disease by permitting estimations of dendritic arborization of PhrMNs since measurements of primary dendrite diameter can be reliably obtained from a number of retrograde labeling techniques

El área superficial de las dendritas en motoneuronas frénicas (PhrMNs) ha sido estimada anteriormente mediante técnicas estereológicas basadas en suposiciones geométricas, y medida en tres dimensiones (3D) utilizando microscopía confocal. Dado que el 97% del área receptora de una motoneurona corresponde a sus dendritas, la ramificación y extensión dendrítica son fisiológicamente importantes para determinar la salida de sus campos receptivos. Sin embargo, limitaciones inherentes a las estimaciones basadas en morfología neuronal y la tinción incompleta de los árboles dendríticos mediante técnicas retrógradas han dificultado los estudios sistemáticos de la morfología dendrítica en PhrMNs. En este estudio, se utilizó una nueva técnica que mejora la tinción dendrítica de las PhrMNs en preparaciones fijadas ligeramente. La reconstrucción dendrítica en 3D se logró con gran precisión utilizando microscopía confocal en PhrMNs de ratas adultas. Luego de una etapa de pre-procesamiento, la segmentación de los árboles dendríticos se realizó semi-automáticamente en 3D y usando mediciones directas del área superficial, se derivó un modelo cuadrático para estimar dicha área partiendo del diámetro de la dendrita primaria (r2 = 0.932; p<0.0001). Este método podría mejorar la evaluación de la plasticidad neuronal en respuesta a trauma u otras enfermedades permitiendo la estimación de la arborización dendrítica en PhrMNs, ya que el diámetro de la dendrita primaria puede obtenerse confiablemente de numerosas técnicas de tinción retrógrada