Clinical impacts of concomitant left atrial appendage occlusion during mitral valve surgery in patients with mitral regurgitation.

Surgical occlusion of the left atrial appendage (LAA) during cardiac surgery in patients with atrial fibrillation (AF) is known to reduce thromboembolism. However, data on the clinical significance of LAA occlusion (LAAO) in patients with mitral regurgitation (MR) are lacking. A total of 237 AF patients with chronic severe MR who underwent mitral valve (MV) surgery were retrospectively analyzed. Patients were divided into two groups according to concomitant LAAO or LAA preservation. The primary outcome was a composite of all-cause death and thromboembolic events (ischemic stroke or systemic embolism). The LAA was surgically occluded in 98 (41%) patients and preserved in 139 (59%) patients. During the follow-up period (median, 37 months), 29 primary outcomes occurred. In the Kaplan-Meyer analysis, the LAA preservation group showed a greater cumulative incidence of the primary outcome (P = 0.002) and thromboembolic events (P = 0.003) than the LAAO group. In the univariate Cox regression analysis, coronary artery disease, CHA2DS2-VASc score, a cauliflower-shaped LAA, Maze, and no LAAO were significantly associated with the primary outcome. In the multivariate Cox regression analysis, concomitant LAAO was significantly linked to the primary outcome (hazard ratio [HR]: 0.30, 95% confidence interval [CI]: 0.10-0.91, P = 0.033) and thromboembolic events (HR: 0.19, 95% CI: 0.04-0.87, P = 0.032). These benefits from LAAO were consistent, even after propensity score-matched analysis. For patients undergoing surgery for chronic MR who also have AF, concomitant surgical LAAO is associated with favorable clinical outcome.

Menopausal Hormone Therapy and Osteoarthritis Risk: Retrospective Population-Based Study in South Korea.

OBJECTIVES: This study aimed to investigate the risk of osteoarthritis associated with menopausal hormone therapy (MHT). METHODS: This population-based retrospective cohort study used a database of Korean health insurance claims (2007-2020). Females aged ≥ 40 who initiated menopause-related healthcare visits between 2011 and 2014 were identified. The MHT group comprised females aged ≥ 40 who initiated MHT for ≥ 6 months during this period. The non-MHT group comprised females aged ≥ 40 who attended menopause-related healthcare visits but did not receive MHT. To account for potential confounding factors, the two groups were matched at a 1:1 ratio using propensity score matching. RESULTS: A cohort of 453,040 postmenopausal females aged ≥ 40 years was identified, with 26,354 assigned to either the MHT or non-MHT group after propensity matching. The median age was 49 years, and the median follow-up was 8.2 years. The Cox proportional hazards model demonstrated an elevated risk of osteoarthritis with MHT (hazard ratio [HR], 1.154; 95% confidence interval [CI], 1.117-1.193) for knee (HR, 1.148; 95% CI, 1.102-1.195) and other arthritis (HR, 1.205; 95% CI, 1.151-1.261), although not statistically significant for hip arthritis. Tibolone (HR, 1.211; 95% CI, 1.161-1.263), estrogen-progestogen therapy (EPT) (HR, 1.092; 95% CI, 1.048-1.137), and estrogen therapy (ET) (HR, 1.235; 95% CI, 1.148-1.329) were associated with a higher risk of osteoarthritis compared to non-MHT users. CONCLUSIONS: MHT was associated with an increased risk of osteoarthritis, consistently observed across tibolone, EPT, and ET, particularly affecting joints other than the hip, with a trend toward an elevated risk of hip osteoarthritis.

Effects of High-Intensity Interval Walking on Cognitive and Physical Functions in Older Adults: A Randomized Pilot Study.

BACKGROUND: Walking is widely recognized as a prevalent form of daily exercise worldwide. However, fewer studies have explored the health outcomes of different intensities of walking exercise for older adults. Thus, the study aimed to investigate the effects of walking at different exercise intensities on body composition, emotions, cognition, and physical function among older adults. PURPOSE: This study aimed to investigate the effects of walking at different exercise intensities on body composition, emotions, cognition, and physical function after eight weeks of group walking. Specifically, the study focused on the potential benefits of high-intensity interval walking (HIIW), exploring whether HIIW could have a more positive impact on the physical function and overall health of older adults compared to moderate-intensity continuous walking (MICW). METHODS: Participants aged 65 years or older were randomly assigned to either HIIW (n=13, 85% HRmax and 55% HRmax, alternating every three minutes) or MICW (n=13, 70% HRmax), engaging in group walking exercises for 30 minutes three times a week. The pre-test and post-test evaluations included body composition, cognition, emotions, and physical function. RESULTS: The two-minute step test showed significant improvements over time (p<0.0001) and time-group interaction (p=0.004), and sit and reach showed significant changes over time (p<0.0001). The independent T-test showed significant differences between the HIIW and MICW groups (two-minute step test: t (24)=1.80, p=0.04; sit and reach test: t (19)=3.65, p<0.001) at post-measurement. Additionally, no significant differences were found in body composition (weight, p=0.74; body mass index (BMI), p=0.35; body fat mass, p=0.45; skeletal muscle mass (SMM), p=0.77), emotions (geriatric depression scale (GDS), p=0.79; quality of life (QOL), p=0.54; Pittsburgh Sleep Quality Index, p=0.24), and cognitive function (CoSAS total score, p=0.25) between the HIIW and MICW groups after exercise. Grip strength, balance, 30-second chair stand, back scratch, and eight-foot up and go tests showed no significant effects in the time-group interaction. CONCLUSION: Regular HIIW exercise has positive effects on physical functions such as cardiorespiratory endurance and flexibility in older adults, indicating the potential for establishing a foundation for developing customized exercise programs in the future.

Catechin and flavonoid glycosides from the Ulmus genus: Exploring their nutritional pharmacology and therapeutic potential in osteoporosis and inflammatory conditions.

This review investigates the therapeutic effects of Ulmus species extracts, traditionally used as tea ingredients in East Asia, on bone health and inflammatory conditions. Through the analysis of 9757 studies, narrowing down to 56 pertinent ones, we evaluated the safety and efficacy of Ulmus extracts. The focus was on catechin glycosides (CG) and flavonoid glycosides (FG), key compounds identified for their potential benefits. The research highlights the extracts' role in enhancing bone mineral density (BMD) by stimulating osteoblast activity and suppressing osteoclast differentiation, suggesting a protective effect against osteoporosis. Furthermore, the extracts demonstrated significant anti-inflammatory properties by modulating inflammatory markers and pathways. The findings confirm the historical use of Ulmus extracts in East Asia for health benefits and recommend further exploration into functional foods and nutraceuticals. The review calls for more rigorous research, including clinical trials, to establish optimal use and integration into modern health solutions. It underscores the potential of Ulmus extracts in promoting bone health and managing inflammation, advocating for a bridge between traditional practices and contemporary scientific validation. In conclusion, Ulmus extracts, a material long consumed as tea ingredients in East Asia, exhibit significant potential for improving bone health and reducing inflammation. This review calls for additional research to explore their full therapeutic capabilities, emphasizing the need for optimized extraction methods and clinical trials. It reinforces the importance of bridging traditional knowledge with contemporary scientific approaches to health and dietary solutions, promoting overall wellness.

Impact of Conjugation of the Reactive Oxygen Species (ROS)-Generating Catalytic Moiety with Membrane-Active Antimicrobial Peptoids: Promoting Multitarget Mechanism and Enhancing Selectivity.

Antimicrobial peptides (AMPs) represent promising therapeutic modalities against multidrug-resistant bacterial infections. As a mimic of natural AMPs, peptidomimetic oligomers like peptoids (i.e., oligo-N-substituted glycines) have been utilized for antimicrobials with resistance against proteolytic degradation. Here, we explore the conjugation of catalytic metal-binding motifs─the amino terminal Cu(II) and Ni(II) binding (ATCUN) motif─with cationic amphipathic antimicrobial peptoids to enhance their efficacy. Upon complexation with Cu(II) or Ni(II), the conjugates catalyzed hydroxyl radical generation, and 22 and 22-Cu exhibited over 10-fold improved selectivity compared to the parent peptoid, likely due to reduced hydrophobicity. Cu-ATCUN-peptoids caused bacterial membrane disruption, aggregation of intracellular biomolecules, DNA oxidation, and lipid peroxidation, promoting multiple killing mechanisms. In a mouse sepsis model, 22 demonstrated antimicrobial and anti-inflammatory efficacy with low toxicity. This study suggests a strategy to improve the potency of membrane-acting antimicrobial peptoids by incorporating ROS-generating motifs, thereby adding oxidative damage as a killing mechanism.

Obstructive sleep apnea and hypertension; critical overview.

Obstructive sleep apnea (OSA) and hypertension are two important modifiable risk factors for cardiovascular disease and mortality. Numerous studies have highlighted the interplay between these two conditions. We provide a critical review of the current literature on the role of the OSA as a risk factor for hypertension and its effect on blood pressure (BP). We discuss several key topics: the effect of OSA on nocturnal BP, BP response to continuous positive airway pressure (CPAP) treatment, CPAP effect on BP in refractory hypertension, the role of OSA in BP variability (BPV), and maladaptive cardiac remodeling mediated by OSA's effect on BP. Finally, we discuss the unique aspects of ethnicity and social determinants of health on OSA with a focus on Asian populations and the disparity in BP control and cardiovascular outcomes.

Effect of mixed protein supplementation on golf performance and muscle function: a randomized, double-blind, placebo-controlled study.

BACKGROUND: As a relatively novel approach to enhancing skeletal muscle health, mixed protein supplementation has shown similar responses to whey protein. However, no previous studies have examined its impact on golf swing performance. This study aimed to examine the effect of mixed protein supplementation on the swing performance and muscle strength of casual golfers. METHODS: Sixty participants with a handicap of less than 20 were recruited and randomly assigned to a double-blind, placebo-controlled study design. The participants were divided into two groups: a mixed protein group (MG, n = 30), and a placebo control group (CG, n = 30). They were instructed to ingest either a supplement containing casein calcium, whey protein, and isolated pea protein, or a placebo, once daily for 8 weeks. Pre- and posttests consisted of anthropometric measurements, muscle strength (isokinetic knee and trunk strength, and handgrip strength), 2-minute push-ups, balance, and golf swing performance using a driver and 7-iron. RESULTS: After the 8-week supplementation period, ANCOVA, using baseline values as covariates, revealed significant differences for driver distance (p = .004) and driver ball speed (p < .001). MG significantly increased driver distance by 5.17 ± 12.8 m (p = .046), driver ball speed by 1.36 ± 2.87 m/s (p = .021). Additionally, significantly improvements were observed in hand grip strength (+2.12 ± 3.47 kg, p = .004), two-minute push-ups (+4.89 ± 8.14 reps, p = .004), and balance score (-0.37 ± 0.69 min, p = .009). No significant differences were observed in body composition parameters (p > .05). CONCLUSION: The intake of a mixed protein containing both animal and plant proteins had positive effects on golf performance and muscle function. Therefore, mixed proteins may represent a safe and effective approach to enhancing skeletal muscle health in golf players.

Unraveling the interplay of temperature with molecular aggregation and miscibility in TEA-water mixtures.

In the phase diagram of binary liquid mixtures, a miscibility gap is found with the concomitant liquid-liquid phase separation, wherein temperature is a key parameter in modulating the phase behavior. This includes critical temperatures such as the lower critical solution temperature (LCST) and upper critical solution temperature (UCST). Using a comprehensive approach including molecular dynamics (MD) simulation, graph theoretical analysis and spatial inhomogeneity measurement in an LCST-type mixture, we attempt to establish the relationship between the molecular aggregation pattern and phase behavior in TEA-water mixtures. At lower temperatures of binary liquid mixtures, TEA molecules tend to aggregate while simultaneously interacting with water forming a homogeneous solution. As the temperature increases, these TEA aggregates tend to self-associate by minimizing the interaction with water, which facilitates formation of two distinct liquid phases in the binary liquid. The spatial distribution analysis also reveals that the TEA aggregates compatible with water promote uniform distribution of water molecules, maintaining a homogeneous solution, while the water-incompatible ones generate isolation of water H-bond aggregates, leading to liquid-liquid phase separation in the binary system. This current study on temperature-induced molecular aggregation behavior is anticipated to contribute to a critical understanding of the phase behavior in binary liquid mixtures, including UCST, LCST, and reentrant phase behavior.

Machine Learning for Movement Pattern Changes during Kinect-Based Mixed Reality Exercise Programs in Women with Possible Sarcopenia: Pilot Study.

Background: Sarcopenia is a muscle wasting condition that affects elderly individuals. It can lead to changes in movement patterns, which can increase the risk of falls and other injuries. Methods: Elderly women participants aged ≥65 years who could walk independently were recruited and classified into two groups based on knee extension strength (KES). Participants with low KES scores were assigned to the possible sarcopenia group (PSG, n=7) and an 8-week exercise intervention was implemented. Healthy seniors with high KES scores were classified as the reference group (RG, n=4), and a 3-week exercise intervention was conducted. Kinematic movement data were recorded during the intervention period. All participants' exercise repetitions were used in the data analysis (number of data points =1,128). Results: The PSG showed significantly larger movement patterns in knee rotation during wide squats compared to the RG, attributed to weakened lower limb strength. The voting classifier, trained on the movement patterns from wide squats, determined that significant differences in overall movement patterns between the two groups persisted until the end of the exercise intervention. However, after the exercise intervention, significant improvements in lower limb strength in the PSG resulted in reduced knee rotation ROM and Max, thereby stabilizing movements and eliminating significant differences with the RG. Conclusions: This study suggests that exercise interventions can modify the movement patterns in elderly individuals with possible sarcopenia. These findings provide fundamental data for developing an exercise management system that remotely tracks and monitors the movement patterns of older adults during exercise activities.

Impact of Taekwondo training on cognitive and physical function in elderly individuals: A comprehensive review of randomized controlled trials.

BACKGROUND: Researchers have investigated the physical and psychosocial advantages of Taekwondo for older adults. However, prior studies of Taekwondo's impact on physical function and psychological well-being in this demographic have produced inconsistent findings. Thus, this systematic review aimed to assess how Taekwondo practice affects the physical function and psychological well-being of older adults. METHODS: We systematically searched PubMed, EMBASE, CINAHL, SPORTDiscus, Scopus, Korea Education and Research Information Service, Korean Studies Information Service System, Korean National Assembly Library, Research Information Sharing Service, National Digital Science Library, and China National Knowledge Infrastructure from their inception to December 2023. Two reviewers independently selected and extracted data from each study. We calculated effect sizes using a random-effects model with a 95 % confidence interval (CI) and evaluated study quality using the Physiotherapy Evidence Database scale. RESULTS: This review included ten studies with 227 participants aged 66.1-73.6 years. The meta-analysis revealed significant enhancements in cognitive function [Korean Version of Mini-Mental State Examination, standard mean difference (SMD) = 0.700, 95 % CI (0.364-1.037), I2 = 0 %, p < .001], blood indicators [ß-amyloid, SMD = 0.613, 95 % CI (0.103-1.123), I2 = 34.920 %, p < .05; brain-derived neurotrophic factor, SMD = 0.566, 95 % CI (0.166-0.966), I2 = 0 %, p < .01; high-density lipoprotein cholesterol, SMD = 0.677, 95 % CI (0.357-0.966), I2 = 0 %, p < .001; low-density lipoprotein cholesterol, SMD = 0.809, 95 % CI (0.376-1.242), I2 = 42.621 %, p < .001; and total cholesterol, SMD = 0.979, 95 % CI (0.603-1.356), I2 = 22.221 %, p < .001], and physical function [lean body mass, SMD = 0.465, 95 % CI (0.109-0.821), I2 = 0 %, p < .05, and handgrip strength, SMD = 0.929, 95 % CI (0.194-1.663), I2 = 48.217 %, p < .05]. CONCLUSIONS: This meta-analysis indicates that Taekwondo training is a beneficial therapy with protective effects on cognitive function, physical function, and body composition in older adults. These findings highlight its potential significance in cognitive rehabilitation and physiological health promotion among this demographic population.

Photoprotective activities of Capsosiphon fulvescens in UVB-induced SKH-1 mice and human keratinocytes.

Capsosiphon fulvescens (CF) is a green alga widely consumed in East Asian countries, particularly in Korea. It has a rich composition of vitamins, minerals, dietary fibers, and bioactive compounds, which contribute to its multiple therapeutic properties. Its application ranges from acting as an antioxidant and anti-inflammatory agent to supporting the skin system. Despite these benefits of CF, the effects and mechanisms of action related to photoaging of the skin have not yet been elucidated. To investigate the photoprotective effects of CF against photoaging, both animal (SKH-1 mouse) and cell models (HaCaT cell line) were used in this study. As a result, administering the CF extract over a period of 10 weeks, which included times of Ultraviolet B (UVB) exposure, significantly reduced erythema and various UVB-induced skin changes, such as wrinkle formation, and the thickening of the epidermis and dermis, as well as alterations in the length and depth of wrinkles. Furthermore, our investigation into CF extract's antiwrinkle properties revealed its efficacy in enhancing skin hydration and collagen content, counteracting the collagen depletion and moisture loss induced by UVB radiation. Also, the fact that the levels of p-ERK, p-p38, and p-JNK proteins went down shows that the CF extract might have a controlling effect on the MAPK signaling pathways. Our findings suggest that CF holds significant potential for preventing photoaging, providing a foundation for the development of functional foods or botanical drugs targeting skin aging and related skin disorders. PRACTICAL APPLICATION: This research proved that Capsosiphon fulvescen, a green alga widely consumed in East Asian countries, provides photoprotective activities against UV-induced skin aging. Therefore, Capsosiphon fulvescen can be utilized as functional foods or botanical drugs targeting skin aging and related skin disorders.

Neural network model for prediction of possible sarcopenic obesity using Korean national fitness award data (2010-2023).

Sarcopenic obesity (SO) is characterized by concomitant sarcopenia and obesity and presents a high risk of disability, morbidity, and mortality among older adults. However, predictions based on sequential neural network SO studies and the relationship between physical fitness factors and SO are lacking. This study aimed to develop a predictive model for SO in older adults by focusing on physical fitness factors. A comprehensive dataset of older Korean adults participating in national fitness programs was analyzed using sequential neural networks. Appendicular skeletal muscle/body weight was defined as SO using an anthropometric equation. Independent variables included body fat (BF, %), waist circumference, systolic and diastolic blood pressure, and various physical fitness factors. The dependent variable was a binary outcome (possible SO vs normal). We analyzed hyperparameter tuning and stratified K-fold validation to optimize a predictive model. The prevalence of SO was significantly higher in women (13.81%) than in men, highlighting sex-specific differences. The optimized neural network model and Shapley Additive Explanations analysis demonstrated a high validation accuracy of 93.1%, with BF% and absolute grip strength emerging as the most influential predictors of SO. This study presents a highly accurate predictive model for SO in older adults, emphasizing the critical roles of BF% and absolute grip strength. We identified BF, absolute grip strength, and sit-and-reach as key SO predictors. Our findings underscore the sex-specific nature of SO and the importance of physical fitness factors in its prediction.

Characterization of high Zn content Cd0.87Zn0.13Te0.98Se0.02 grown using Bridgman technique.

CdZnTe (CZT) is a promising commercial material used as a room-temperature operating semiconductor detector for gamma-ray detection. Recently, CdZnTeSe (CZTS) detectors improved upon the properties of CZT by improving homogeneity and reducing defect properties, thereby enabling higher production yield of high-quality crystals. However, addition of selenium to CZT will reduce the bandgap and increase the amount of thermally stimulated electrons, resulting in low resistivity of the crystal. In this study, the enhancement of zinc content was introduced to compensate the bandgap reduction owing to selenium addition, while maintaining the improved properties of selenium addition. The morphology and stoichiometry of CZTS were determined using scanning electron microscopy and electron probe micro-analyzer. Furthermore, the calculated bandgap with stoichiometry was compared with the measured bandgap using UV-Vis measurement and Tauc plot. The electrical, chemical, and other spectroscopic properties were characterized using an I-V curve, X-ray photoelectron spectroscopy, and gamma-spectroscopic techniques, respectively. Moreover, it was proven that the high zinc CZTS can exhibit superior properties owing to selenium addition without affecting the bandgap reduction.

Evaluation of left ventricular filling pressure by echocardiography in patients with atrial fibrillation.

BACKGROUND: Echocardiography is widely used to evaluate left ventricular (LV) diastolic function in patients suspected of heart failure. For patients in sinus rhythm, a combination of several echocardiographic parameters can differentiate between normal and elevated LV filling pressure with good accuracy. However, there is no established echocardiographic approach for the evaluation of LV filling pressure in patients with atrial fibrillation. The objective of the present study was to determine if a combination of several echocardiographic and clinical parameters may be used to evaluate LV filling pressure in patients with atrial fibrillation. RESULTS: In a multicentre study of 148 atrial fibrillation patients, several echocardiographic parameters were tested against invasively measured LV filling pressure as the reference method. No single parameter had sufficiently strong association with LV filling pressure to be recommended for clinical use. Based on univariate regression analysis in the present study, and evidence from existing literature, we developed a two-step algorithm for differentiation between normal and elevated LV filling pressure, defining values ≥ 15 mmHg as elevated. The parameters in the first step included the ratio between mitral early flow velocity and septal mitral annular velocity (septal E/e'), mitral E velocity, deceleration time of E, and peak tricuspid regurgitation velocity. Patients who could not be classified in the first step were tested in a second step by applying supplementary parameters, which included left atrial reservoir strain, pulmonary venous systolic/diastolic velocity ratio, and body mass index. This two-step algorithm classified patients as having either normal or elevated LV filling pressure with 75% accuracy and with 85% feasibility. Accuracy in EF ≥ 50% and EF < 50% was similar (75% and 76%). CONCLUSIONS: In patients with atrial fibrillation, no single echocardiographic parameter was sufficiently reliable to be used clinically to identify elevated LV filling pressure. An algorithm that combined several echocardiographic parameters and body mass index, however, was able to classify patients as having normal or elevated LV filling pressure with moderate accuracy and high feasibility.

Comparison of face mask effects on cardiorespiratory responses between physically active and sedentary individuals.

BACKGROUND: Alterations caused by face masks on physiological responses vary among different population groups. This study aimed to investigate whether physically active and sedentary individuals respond differently to face mask use during exercise. METHODS: Sixteen healthy college students were divided into two groups: Physically active group (N.=10; 26.50±2.80 years) and Sedentary group (N.=6; 26.33±2.81 years). They performed three maximal cardiopulmonary exercise test (CPET)s following the Bruce protocol: one without a face mask (NON), one with a surgical mask (SUR) and one with a cloth mask (CLO). Cardiorespiratory parameters and heart rate were monitored continuously during the test. Blood pressure, oxygen saturation and lactate level were measured immediately before and after exertion. RESULTS: Significant differences were found between the Physically active and the Sedentary group in peak VO2 (VO2peak) in NON (P=0.030). However, this difference disappeared when the face masks were used. Furthermore, VO2/kg (P=0.002) and METs (P=0.002) decreased significantly at the respiratory compensation point (RCP) only in the Physically active group with face masks. No significant differences were found between the two groups for exercise time, lactate level and dyspnea (P>0.05). CONCLUSIONS: The decrease in exercise tolerance and cardiorespiratory responses, particularly VO2peak, due to face mask use was greater in physically active individuals compared to sedentary individuals. Population group characteristics should be considered when adapting face masks to daily life.

Diminished Immune Cell Adhesion in Hypoimmune ICAM-1 Knockout Pluripotent Stem Cells.

Hypoimmune gene edited human pluripotent stem cells (hPSCs) are a promising platform for developing reparative cellular therapies that evade immune rejection. Existing first-generation hypoimmune strategies have used CRISPR/Cas9 editing to modulate genes associated with adaptive (e.g., T cell) immune responses, but have largely not addressed the innate immune cells (e.g., monocytes, neutrophils) that mediate inflammation and rejection processes occurring early after graft transplantation. We identified the adhesion molecule ICAM-1 as a novel hypoimmune target that plays multiple critical roles in both adaptive and innate immune responses post-transplantation. In a series of studies, we found that ICAM-1 blocking or knock-out (KO) in hPSC-derived cardiovascular therapies imparted significantly diminished binding of multiple immune cell types. ICAM-1 KO resulted in diminished T cell proliferation responses in vitro and in longer in vivo retention/protection of KO grafts following immune cell encounter in NeoThy humanized mice. The ICAM-1 KO edit was also introduced into existing first-generation hypoimmune hPSCs and prevented immune cell binding, thereby enhancing the overall hypoimmune capacity of the cells. This novel hypoimmune editing strategy has the potential to improve the long-term efficacy and safety profiles of regenerative therapies for cardiovascular pathologies and a number of other diseases.

Determinants and effects of microvascular obstruction on serial change in left ventricular diastolic function after reperfused acute myocardial infarction.

Background: Although left ventricular (LV) diastolic dysfunction is more related to functional capacity after acute myocardial infarction (AMI), the determinants of LV diastolic functional change after reperfused AMI remain unknown. This study aimed to investigate the effects of microvascular obstruction (MVO) on mid-term changes in LV diastolic function after reperfused AMI. Methods: In a cohort of 72 AMI patients who underwent successful revascularization, echocardiography and cardiovascular magnetic resonance imaging were repeated at 9-month intervals. The late gadolinium enhancement (LGE) amount, segmental extracellular volume fraction, global LV, and left atrial (LA) phasic functions, along with mitral inflow and tissue Doppler measurements, were repeated. Results: Among the included patients, 31 (43%) patients had MVO. During the 9-month interval, LV ejection fraction (EF) and LV global longitudinal strain (GLS) were significantly improved in accordance with a decrease in LGE amount (from 18.2 to 10.3 g, p < 0.001) and LV mass. The deceleration time (DT) of early mitral inflow (188.6 ms-226.3 ms, p < 0.001) and LV elastance index (Ed; 0.133 1/ml-0.127 1/ml, p = 0.049) were significantly improved, but not in conventional diastolic functional indexes. Their improvements occurred in both groups; however, the degree was less prominent in patients with MVO. The degree of decrease in LGE amount and increase in LVEF was significantly correlated with improvement in LV-Ed or LA phasic function, but not with conventional diastolic functional indexes. Conclusions: In patients with reperfused AMI, DT of early mitral inflow, phasic LA function, and LV-Ed were more sensitive diastolic functional indexes. The degree of their improvement was less prominent in patients with MVO.

Shifts in Clinical Characteristics, Treatment, and Outcome for Rheumatic Mitral Stenosis: Insights From a 20-Year Multicentre Registry Study in Korea.

BACKGROUND: The rapid economic development of South Korea provides a unique model to study changes in the clinical characteristics, treatment approaches, and clinical outcomes of patients with rheumatic mitral stenosis (MS) relative to socioeconomic growth. METHODS: From the Multicenter mitrAl STEnosis with Rheumatic etiology (MASTER) registry, 2,337 patients diagnosed with moderate or severe rheumatic MS between January 2001 and December 2020 were analyzed. Patients were grouped into consecutive 5-year intervals based on their year of diagnosis. Clinical characteristics, echocardiographic data, and clinical outcomes were assessed. RESULTS: Over 20 years, the severity of mitral stenosis increased from 79.1% to 90.2%; similarly, the average age at diagnosis increased from 54.3 to 63.0 years (all P < 0.001). Comorbidities such as hypertension and atrial fibrillation increased (6.3% to 29.5% and 41.4% to 46.9%, respectively; all P for trend < 0.05). The rate of mitral intervention within five years after diagnosis increased from 31.2% to 47.4% (P for trend < 0.001). However, clinical outcomes of rheumatic mitral stenosis deteriorated over time in the composite outcomes (log-rank test, P < 0.001). Conversely, the incidence of stroke remained stable (60.6-73.7%; P < 0.001), which might be attributed to the increased use of anticoagulation therapy. CONCLUSION: This study observed an increase in patient age, comorbidities, and valve disease severity as the country transitioned from a developing to developed status. Despite a rise in mitral valve interventions, clinical outcomes deteriorated over 20 years, highlighting the need for modified treatment approaches to improve patient outcomes.

Highly visible-light-active sulfur and carbon co-doped TiO2 (SC-TiO2) heterogeneous photocatalysts prepared by underwater discharge plasma.

To promptly and simply create highly crystalline S/C co-doped TiO2 (SC-TiO2) photocatalysts at room temperature and atmospheric pressure, we suggest a novel plasma-assisted sol-gel synthesis method. This method is a simultaneous synthetic process, in which an underwater plasma undergoes continuous reactions to generate high-energy atomic and molecular species that enable TiO2 to achieve crystallinity, a large surface area, and a heterogeneous structure within a few minutes. In particular, it was demonstrated that the heterogeneously structured TiO2 was formed by doping that sulfur and carbon replace O or Ti atoms in the TiO2 lattice depending on the composition of the synthesis solution during underwater plasma treatment. The resultant SC-TiO2 photocatalysts had narrowed bandgap energies and extended optical absorption scope into the visible range by inducing the intermediate states within bandgap due to generation of oxygen vacancies on the surface of TiO2 through synthesis, crystallization, and doping. Correspondingly, SC-TiO2 showed a significant degradation efficiency ([k] = 6.91 h-1) of tetracycline (TC, antibiotics) under solar light irradiation, up to approximately 4 times higher compared to commercial TiO2 ([k] = 1.68 h-1), resulting in great water purification. Therefore, we anticipate that this underwater discharge plasma system will prove to be an advantageous technique for producing heterostructural TiO2 photocatalysts with superior photocatalytic efficiency for environmental applications.