Stress-localized durable anti-biofouling surfaces.

Growing demands for bio-friendly antifouling surfaces have stimulated the development of new and ever-improving material paradigms. Despite notable progress in bio-friendly coatings, the biofouling problem remains a critical challenge. In addition to biofouling characteristics, mechanically stressed surfaces such as ship hulls, piping systems, and heat exchangers require long-term durability in marine environments. Here, we introduce a new generation of anti-biofouling coatings with superior characteristics and high mechanical, chemical and environmental durability. In these surfaces, we have implemented the new physics of stress localization to minimize the adhesion of bio-species on the coatings. This polymeric material contains dispersed organogels in a high shear modulus matrix. Interfacial cavitation induced at the interface of bio-species and organogel particles leads to stress localization and detachment of bio-species from these surfaces with minimal shear stress. In a comprehensive study, the performance of these surfaces is assessed for both soft and hard biofouling including Ulva, bacteria, diatoms, barnacles and mussels, and is compared with that of state-of-the-art surfaces. These surfaces show Ulva accumulation of less than 1%, minimal bacterial biofilm growth, diatom attachment of 2%, barnacle adhesion of 0.02 MPa and mussel adhesion of 7.5 N. These surfaces promise a new physics-based route to address the biofouling problem and avoid adverse effects of biofouling on the environment and relevant technologies.

Evaporation Mass Flux: A Predictive Model and Experiments.

Evaporation is a fundamental and core phenomenon in a broad range of disciplines including power generation and refrigeration systems, desalination, electronic/photonic cooling, aviation systems, and even biosciences. Despite its importance, the current theories on evaporation suffer from fitting coefficients with reported values varying in a few orders of magnitude. Lack of a sound model impedes simulation and prediction of characteristics of many systems in these disciplines. Here, we studied evaporation at a planar liquid-vapor interface through a custom-designed, controlled, and automated experimental setup. This experimental setup provides the ability to accurately probe thermodynamic properties in vapor, liquid, and close to the liquid-vapor interface. Through analysis of these thermodynamic properties in a wide range of evaporation mass fluxes, we cast a predictive model of evaporation based on nonequilibrium thermodynamics with no fitting parameters. In this model, only the interfacial temperatures of liquid and vapor phases along with the vapor pressure are needed to predict evaporation mass flux. The model was validated by the reported study of an independent research group. The developed model provides a foundation for all liquid-vapor phase change studies including energy, water, and biological systems.

Lifetime abuse and perceived social support among the elderly: a study from seven European countries.

Background: Being a victim of abuse during one's life course may affect social relations in later life. The aims of this study were to: (i) examine the association between lifetime abuse and perceived social support and (ii) identify correlates of perceived social support among older persons living in seven European countries. Methods: A sample of 4467 women and men aged 60-84 years living in Germany, Greece, Italy, Lithuania, Portugal, Spain and Sweden was collected through a cross-sectional population-based study. Abuse (psychological, physical, sexual, financial and injury) was assessed through interviews or interviews/self-response questionnaire based on the Conflict Tactics Scale-2 and the UK study on elder abuse. Perceived social support was assessed by the Multidimensional Scale of Perceived Social Support. Results: Victims of lifetime abuse perceived poorer social support in later life. Multivariate analyses showed that high levels of perceived social support were associated with being from Greece and Lithuania (compared to Germany), being female, not living alone, consuming alcohol and physical activity. Poorer perceived social support was associated with being from Portugal, being old, having social benefits as the main source of income, experiencing financial strain and being exposed to lifetime psychological abuse and injuries. Conclusions: Our findings showed that exposure to psychological abuse and injuries across the lifespan were associated with low levels of perceived social support, emphasizing the importance of detection and appropriate treatment of victims of abuse during their life course. Future research should focus on coping strategies buffering the negative effects of abuse on social relationships.

Gender differences in health conditions and socio-economic status of adults with congenital heart disease in a developing country.

BACKGROUND: Providing appropriate care for adults with congenital heart disease requires the evaluation of their current situation. There is limited research in Iran about these patients, particularly in relation to gender differences in the demographic/socio-economic and lifestyle factors, as well as disease parameters. MATERIALS AND METHODS: The sample consisted of 347 congenital heart disease patients in the age group of 18­64 years, including 181 women, assessed by an analytical cross-sectional study. The patients were recruited from the two major heart hospitals in Tehran. Data were collected using questionnaires. RESULTS: The mean age of the patients was 33.24 years. Women were more often married and more often had offspring than men (p < 0.001). Educational level and annual income were similar between women and men. Unemployment was higher among women (p < 0.001), but financial strain was higher among men (p < 0.001). Smoking, alcohol, and water-pipe use was higher among men than among women (p < 0.001). Cardiac factors, for example number of cardiac defects, were similar among women and men, except that there were more hospitalisations owing to cardiac problems, for example arrhythmia, among men. Disease was diagnosed mostly at the hospital (57.4%). Most medical care was provided by cardiologists (65.1%). Only 50.1% of patients had knowledge about their type of cardiac defect. CONCLUSION: Gender differences exist in the socio-economic and lifestyle characteristics of adults with congenital heart disease, in some cases related to the disease severity. Our findings also point to the need for interventions to increase patients' knowledge about, and use of, healthier lifestyle behaviours, irrespective of gender. Furthermore, providing appropriate jobs, vocational training, and career counselling may help patients to be more productive.

Combined Aortic and Mitral Valve Stenosis in Mucopolysaccharidosis Syndrome Type I-S: A Report of a Rare Case.

Mucopolysaccharidosis (MPS) syndrome is an inherited metabolic disorder. In more than half of the patients with MPS syndrome, heart valve involvement is reported; however, combined aortic and mitral valve stenosis in MPS syndrome type I-S is very rare. We describe a 39-year-old man with severe mitral and aortic valve stenosis due to MPS syndrome type I-S. Transthoracic and transesophageal echocardiography revealed severe thickening and calcification in the aortic and mitral valves with severe left ventricular hypertrophy. The coronary arteries were normal in angiography.

The prevalence, severity and chronicity of abuse towards older men: Insights from a multinational European survey.

BACKGROUND: Elder abuse is a growing public health question among policy makers and practitioners in many countries. Research findings usually indicate women as victims, whereas male elder abuse still remains under-detected and under-reported. We aimed to investigate the prevalence, severity and chronicity of abuse (psychological, physical, physical injury, sexual, and financial) against older men, and to scrutinize factors (e.g. demographics) associated with high chronicity of any abuse. METHODS: Randomly selected older men (n = 1908) aged 60-84 years from seven European cities (Ancona, Athens, Granada, Kaunas, Stuttgart, Porto, Stockholm) were interviewed in 2009 via a cross-sectional study concerning abuse exposure during the past 12 months. RESULTS: Findings suggested that prevalence of abuse towards older men varied between 0.3% (sexual) and 20.3% (psychological), with severe acts between 0.2% (sexual) and 8.2% (psychological). On the whole, higher chronicity values were for injury, followed by psychological, financial, physical, and sexual abuse. Being from Sweden, experiencing anxiety and having a spouse/cohabitant/woman as perpetrator were associated with a greater "risk" for high chronicity of any abuse. For men, severity and chronicity of abuse were in some cases relatively high. CONCLUSIONS: Abuse towards older men, in the light of severe and repeated acts occurring, should be a source of concern for family, caring staff, social work practice and policy makers, in order to develop together adequate prevention and treatment strategies.

Lipomatous tumor of the tricuspid valve: report of a rare case.

The case is reported of a 19-year-old man with cardiac valve lipomatosis which was accidentally discovered during the work-up for an atypical chest pain. Echocardiography detected an immobile mass that involved the base of the anterior leaflet of the tricuspid valve. Magnetic resonance imaging showed evidence of tricuspid valve lipomatosis, a rare cardiac valve tumor. After five months, echocardiography showed that the mass had not grown. To the best of the present authors' knowledge, very few reports exist of cardiac valve lipomatous tumors.

An in situ method on kinetics of gas hydrates.

Gas hydrate formation is a high-risk and common flow assurance problem in subsea oil production plants. The modern strategies to mitigate hydrate formation have switched from thermodynamic inhibition to risk management. In this new mitigation strategy, hydrate formation is allowed as long as it does not lead to plugging of pipelines. Thus, understanding the growth kinetics of gas hydrates plays a critical role in risk management strategies. Here, we report a new accurate and in situ approach to probe the kinetics of gas hydrate formation. This approach is based on the hot-wire method, which probes the thermal properties of the medium surrounding the hot-wire. As the thermal properties of gas hydrate and its initial constituents are different, variation in these properties is used to probe kinetics of hydrate growth front. Through this in situ method, we determine kinetics of cyclopentane hydrate formation in both mixing and flow conditions. The findings show that at ambient pressure and a temperature of 1-2 °C, the hydrate formation rate under mixing condition varies between 1.9 × 10-5 and 3.9 × 10-5 kg m-2 s-1, while in flow condition, this growth rate drops to 4.5 × 10-6 kg m-2 s-1. To our knowledge, this is the first reported growth rate of cyclopentane hydrate. This in situ approach allows us to probe kinetics of hydrate formation where there is no optical access and provides a tool to rationally design risk management strategies for subsea infrastructures.

Lifetime abuse and somatic symptoms among older women and men in Europe.

BACKGROUND: Research suggests that survivors of interpersonal violence have an increasing experience of bodily symptoms. This study aims to scrutinise the association between lifetime abuse and somatic symptoms among older women and men, considering demographics/socio-economic, social support and health variables. METHODS: A sample of 4,467 community-dwelling persons aged 60-84 years (57.3% women) living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, Sweden) was recruited for this cross-sectional study. Lifetime abuse (psychological, physical, sexual, financial and injury) was assessed on the basis of the UK study of elder abuse and the Conflict Tactics Scale-2, while somatic symptoms were assessed by the Giessen Complaint List short version. RESULTS: Women reported somatic symptoms more frequently than men. Multiple regression analyses revealed that lifetime exposure to psychological abuse was associated with higher levels of somatic symptoms among both women and men, while experiencing lifetime sexual abuse was associated with somatic symptoms only among older women, after adjusting for other demographic and socio-economic variables. Country of residence, older age, and low socio-economic status were other independent factors contributing to a higher level of somatic symptoms. CONCLUSIONS: The positive association between the experience of abuse during lifetime and the reporting of higher levels of somatic symptoms, in particular among older women, seems to suggest that such complaints in later life might also be related to the experience of mistreatment and not only to ageing and related diseases. Violence prevention throughout lifetime could help to prevent somatic symptoms in later life.

Relationship Between Obesity, Physical Activity, and Cardiorespiratory Fitness Levels in Children and Adolescents in Bosnia and Herzegovina: An Analysis of Gender Differences.

This study aimed to examine: (i) the level of physical activity (PA), obesity indices and cardiorespiratory fitness (CRF) among boys and girls in primary school, and (ii) to determine the association of obesity indices and PA with CRF for the total number of participants, and then separately for boys and girls. 753 sixth to ninth grade girls and boys aged 10-14 years took part in this cross-sectional study. The PA was assessed by the "Physical Activity Questionnaire - Children" and CRF was assessed by the Maximal multistage a 20 m shuttle run test. Body mass index (BMI), waist circumferences (WC), and waist to height ratio (WHtR) were considered as obesity indices. Multiple linear regression analyses were performed to explore correlates of CRF. The results obtained showed the prevalence of general overweight and obesity was 25.5% in our sample which was lower than that in the regional estimate (e.g., ∼28%) for Eastern Europe. Among all participants, CRF was associated with male sex, older age, a lower WC percentile, higher WHtR, and higher level of PA. The model accounted for 24% of the variance. CRF was associated with older age and higher level of PA among girls and boys. Lower WC percentile was a significant determinant of CRF among boys. In conclusion, general overweight/obesity was not independently associated with CRF. Those with better CRF were more likely to be male and older, had a higher level of PA and lower central adiposity. These findings emphasize the importance of supporting school age children to take a part in programmed physical activity regardless of their body composition.

Correlates of posttraumatic stress disorder in adults with congenital heart disease.

OBJECTIVE: The aims of this study were to compare the level of posttraumatic stress disorder between adults with and without congenital heart disease, and to examine the correlates of posttraumatic stress disorder (e.g., sociodemographics). DESIGN: Cross-sectional. SETTING: Two university-affiliated heart hospitals in Tehran, Iran. PATIENTS: A sample of 347 adults with congenital heart disease aged 18-64 years (52% women), and 353 adults without congenital heart disease matched by sex and age (±2 years) was recruited. OUTCOME MEASURES: The PTSD Scale: Self-report version was used to assess the diagnosis and severity of posttraumatic stress disorder. Hierarchical multivariate logistic regression analyses were performed to explore correlates of likely posttraumatic stress disorder diagnosis among each group of participants. RESULTS: The posttraumatic stress disorder in the patients was comparable to those of the control group, except for increased arousal (P = .027) which was scored higher among the patients. Over 52% of adults with congenital heart disease met the criteria for a likely posttraumatic stress disorder diagnosis compared with 48% of adults without congenital heart disease. The regression analyses among patients revealed that elevated depressive symptoms (OR = 1.27) and a positive history of cardiac surgery (OR = 2.02) were significantly associated with posttraumatic stress disorder. The model could explain 29% of the variance in posttraumatic stress disorder. CONCLUSIONS: The high and comparable prevalence of posttraumatic stress disorder among patients and nonpatients highlight the significance of the context in which adults with congenital heart disease may face other/additional stressors than disease-related ones, an issue that clinicians need also take into account. Furthermore, the association of posttraumatic stress disorder with elevated depressive symptoms warrant a comprehensive psychological assessment and management of adults with congenital heart disease, in particular among those with a history of invasive procedures.

Hopelessness among adults with congenital heart disease: Cause for despair or hope?

BACKGROUND: Adults with congenital heart disease (CHD) face unique life courses and challenges that may negatively influence their psychological functioning. The aims of this study were to (1) examine the level of hopelessness among adults with CHD in comparison with non-CHD participants and (2) identify correlates of elevated hopelessness among adults with CHD. METHODS: We enrolled 347 patients with CHD (18-64years, 52.2% female) and 353 matched (by sex/age) non-CHD persons in this cross-sectional study. Hopelessness was assessed by Beck Hopelessness Scale. Hierarchical multiple logistic regression analyses were performed to explore correlates of elevated hopelessness. RESULTS: The mean total hopelessness score did not significantly differ between the CHD and non-CHD groups. Twenty-eight percent of CHD patients had elevated hopelessness scores. Within the CHD patient sample, regression analyses revealed that being male (odds ratio=2.62), not having children (odds ratio=3.57), being unemployed (odds ratio=2.27), and elevated depressive symptoms (odds ratio=1.21) were significantly associated with hopelessness. Regular physical activity (odds ratio=0.36) emerged as a protective factor and all CHD disease parameters were unrelated to hopelessness. The final model explained 43% of the variance in hopelessness. CONCLUSIONS: Adult CHD teams are encouraged to continue to explore strategies to support patients to live as rich and full as lives as possible by pursuing relationships, employment and physical activity, as well as managing depression and hopelessness.

Lifetime Abuse and Quality of Life among Older People.

Few studies have evaluated the impact of lifetime abuse on quality of life (QoL) among older adults. By using a multinational study authors aimed to assess the subjective perception of QoL among people who have reported abuse during the course of their lifetime. The respondents (N = 4,467; 2,559 women) were between the ages of 60 and 84 years and living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden). Lifetime abuse was assessed by using a structured questionnaire that allowed to assess lifetime experiences of abuse. QoL was assessed with the World Health Organization Quality of Life-Old module. After adjustment for potential confounders, authors found that to have had any abusive experience decreased the score of sensory abilities. Psychological abuse was associated with lower autonomy and past, present, and future activities. Physical abuse with injuries significantly decreased social participation. Intimacy was also negatively associated with psychological abuse, physical abuse with injury, and sexual abuse. The results of this study provide evidence that older people exposed to abuse during their lifetime have a significant reduction in QoL, with several QoL domains being negatively affected.

Relationship between calculated total antioxidant status and atherosclerotic coronary artery disease.

OBJECTIVE: Antioxidants play a major role in the cellular protection cascade against oxidative damage. Oxidative stress has been linked to the pathogenesis of coronary atherosclerosis. Our aim was to evaluate the association between calculated serum total antioxidant status (cTAS) and the presence and severity of coronary artery disease (CAD). METHODS: One hundred and seventy-four patients with angiographically documented significant (≥50%) luminal stenosis (n=123) or with minimal (<50%) luminal stenosis (n=51) in at least one coronary artery or major branch segment in the epicardial coronary tree were categorized as CAD+ group; 88 patients with no luminal stenosis were considered as the control group. The level of cTAS (mmol/L) was evaluated using the following equation: (0.63×albumin concentration)+(1.02×uric acid concentration)+(1.53×bilirubin concentration). RESULTS: In univariate analyses, mean levels of cTAS, uric acid, and creatinine were significantly higher in CAD+ group than in controls. However, adjusted cTAS level was not found to be a CAD predictor in the total population [odds ratio (OR)=1.20; 95% confidence interval (CI): 0.81-1.76; p=0.364] or in men (OR=1.25; 95% CI: 0.73-2.12; p=0.420) and women (OR=1.20; 95% CI: 0.66-2.19; p=0.553). A weak but statistically significant correlation was found between cTAS and Gensini score (Spearman's ρ=0.16, p=0.015). CONCLUSION: In patients with suspicious CAD, the level of cTAS was not found to be an independent predictor for the presence of CAD. Further studies with larger sample size are required to confirm the results.

The prevalence of lifetime abuse among older adults in seven European countries.

OBJECTIVES: To investigate the lifetime prevalence rate of abuse among older persons and to scrutinize the associated factors (e.g. demographics). METHODS: This cross-sectional population-based study had 4467 participants, aged 60-84, from seven European cities. Abuse (psychological, physical, sexual, financial and injuries) was measured based on The Revised Conflict Tactics Scale, and the UK survey of abuse/neglect of older people. RESULTS: Over 34 % of participants reported experiencing lifetime psychological, 11.5 % physical, 18.5 % financial and 5 % sexual abuse and 4.3 % reported injuries. Lifetime psychological abuse was associated with country, younger age, education and alcohol consumption; physical abuse with country, age, not living in partnership; injuries with country, female sex, age, education, not living in partnership; financial abuse with country, age, not living in partnership, education, benefiting social/partner income, drinking alcohol; and sexual abuse with country, female sex and financial strain. CONCLUSIONS: High lifetime prevalence rates confirm that elder abuse is a considerable public health problem warranting further longitudinal studies. Country of residence is an independent factor associated with all types of elder abuse which highlights the importance of national interventions alongside international collaborations.

Quality of life and life satisfaction among adults with and without congenital heart disease in a developing country.

BACKGROUND: Life-expectancy of adults with congenital heart disease (CHD) has improved world-wide, but there are limited data on these patients' experiences of quality of life (QoL), life satisfaction (LS), and their determinants (e.g. social support), particularly among patients from developing countries. DESIGN: Cross-sectional case-control. METHODS: A total of 347 CHD patients (18-64 years, 52.2% women) and 353 non-CHD participants, matched by sex/age, were recruited from two heart hospitals in Tehran, Iran. LS and QoL served as dependent variables, and demographic/socioeconomic status, mental-somatic symptoms, social support, and clinical factors (e.g. defect category) served as independent variables in multiple regression analyses once among all participants, and once only among CHD patients. RESULTS: The CHD patients had significantly lower scores in LS and all domains of QoL than the control group. However, having CHD was independently negatively associated only with overall QoL, physical health, and life and health satisfaction. Additionally, multivariate analyses among the CHD patients revealed that female sex, younger age, being employed, less emotional distress, and higher social support were significantly associated with higher perceived QoL in most domains, while LS was associated with female sex, being employed, less emotional distress, and better social support. Neither QoL nor LS was associated with cardiac defect severity. CONCLUSIONS: The adults with CHD had poorer QoL and LS than their non-CHD peers in our developing country. Socio-demographics, emotional health, and social support were important 'determinants' of QoL and LS among the CHD patients. Longitudinal studies are warranted to establish causal links.

Style of coping and its determinants in adults with congenital heart disease in a developing country.

OBJECTIVE: The objective of this study is to compare coping strategies between adults with and without congenital heart disease and to scrutinize the associations between different available resources (e.g., social support) and adoption of certain coping strategies. DESIGN: The study has a cross-sectional case-control design. SETTING: The study was conducted in two university-affiliated heart hospitals in Tehran, Iran. PATIENTS: The participants comprised 347 persons (18-64 years) with and 353 individuals without congenital heart disease, matched by gender and age. OUTCOME MEASURES: Coping strategies, assessed with the Utrecht Coping List-short form, were compared between both groups. Block-wise multiple regression analyses were conducted to scrutinize the associations between different independent variables (e.g., demographic/socioeconomic statuses) and adoption of certain styles of coping (dependent variables) among all participants and separately for each group. RESULTS: The styles of coping in the patients were comparable with those of the control group. Multivariate analyses revealed that congenital heart disease per se was not associated with style of coping except for palliative reaction pattern. The active problem-solving coping style was associated with never married marital status, parenthood, unemployment, higher level of anxiety/somatic symptoms, lower level of depressive symptoms, and better social support. The avoidance behavior style was associated with having a low income, whereas the expression of emotion style was associated with higher anxiety symptoms, experience of financial strain, and income. None of the adopted coping strategies was related to the heart disease variables. CONCLUSIONS: The adults with congenital heart disease coped as well as adults without congenital heart disease. Marital status, parenthood, annual income, financial strain, psychological adjustment, and perceived social support were important explanatory factors in adopting a certain style of coping among adults with congenital heart disease. However, longitudinal studies with repeated measures are warranted.

Anxiety, depressive and somatic symptoms in adults with congenital heart disease.

OBJECTIVE: Despite the improvement in life-expectancy of adults with congenital heart disease, they may experience unique medical and social challenges that could impact on their psychological functioning. The aims of this study were to address the experience of anxiety, depressive and somatic symptoms among adults with congenital heart disease in comparison with that of non-heart diseased persons considering the role of various factors (e.g. socio-economic). METHODS: In cross-sectional case-control study, the participants consisted of 347 patients with congenital heart disease (18-64 years, 52.2% female) and 353 matched (by sex/age) non-heart diseased persons. The participants completed a questionnaire. The data were analyzed with bivariate and multivariate methods. RESULTS: In bivariate analyses, scores in anxiety and somatic symptoms were higher among patients than the healthy controls (both at p≤0.001), whereas the groups did not differ in depressive symptoms. Following multiple-linear-regression-analyses, only the association between congenital heart disease and somatic symptoms was confirmed. Among the patients, perceived financial strain was significantly related to anxiety, depressive and somatic symptoms; lower perceived social support to anxiety and depression; and low annual income to somatic symptoms. Additionally, somatic symptoms were associated with anxiety and depressive symptoms, and vice versa. And no medical variables were related to anxiety, depressive and somatic symptoms. CONCLUSIONS: Congenital heart disease was only independently associated with somatic symptoms. Financial strain, social support and co-existence of emotional distress with somatic symptoms should be considered in developing appropriate interventions to improve the well-being of patients with congenital heart disease. However, longitudinal research is warranted to clarify causality.

Quadricuspid aortic valve diagnosed by transesophageal echocardiography: a case report.

Quadricuspid aortic valve (QAV) is an uncommon congenital anomaly which was an incidental finding during surgery or autopsy in the past. We present the case of a 44-year-old woman with moderately severe aortic regurgitation due to unequal cusp size QAV diagnosed via transesophageal echocardiography. Due to echocardiographic imaging improvement, the diagnosis of QAV is now easier and earlier than the past.

Tricuspid regurgitation improvement in relation to the amount of pulmonary artery pressure reduction.

BACKGROUND: Given the common concomitance of tricuspid regurgitation (TR) with significant mitral stenosis, we aimed at exploring the relation between TR severity and pulmonary artery hypertension (PAH) in patients who underwent mitral balloon valvotomy (MBV). METHODS: We analyzed the echocardiography data of 133 consecutive patients (82.0% female, mean age 44.68 ± 12.56 years) with different degrees of TR severity that underwent MBV between April 2006 and March 2008. The pulmonary artery systolic pressure (PAPs) > 35 mmHg was considered as PAH. RESULTS: Before MBV, 36.20% of the patients had moderate to severe TR, 92.5% PAH, and 18.0% right ventricular (RV) dilation (RV dimension ≥ 33 mm). After MBV, TR severity improved in 41.4%, worsened in 8.3%, and did not change in 50.4%. Before and after MBV, PAPs was significantly correlated with TR severity, and the mean PAPs change in patients with improved TR was significantly more than that of patients without TR improvement (p value = 0.042). Tricuspid regurgitation severity and mean PAPs (from 52.83 ± 18.82 to 35.89 ± 9.39 mmHg) decreased significantly after MBV (both p values < 0.001); this reduction was significantly correlated to the amount of PAPs decrease. A cut-off point of ≥ 19 mmHg reduction in PAPs had a specificity of 71.79% and sensitivity of 52.73% to show TR severity improvement (by Receiver-Operative-Characteristics analysis). The mean of RV dimension decreased from 28.94 ± 5.43 to 27.95 ± 4.67 mm (p value < 0.001). In contrast to patients with RV dilation, TR reduced significantly in patients without RV dilation (p value < 0.001). CONCLUSION: Improvement in TR severity was directly correlated with the amount of PAPs reduction after MBV. More studies are needed to better define a cut-off value for PAPs reduction related to TR severity improvement.