Diastolic coronary artery narrowing due to left ventricular dilatation

A 56 year old man with a large anterior myocardial infarction and diffuse left ventricular hypocontractility and dilatation was found to have narrowing of the distal part of the left anterior descending coronary artery in diastole. This most unusual finding was ascribed to diastolic compression of the vessel by the enlarged left ventricle. Only 3 similar cases have been found in the literature up to now.     

Effect of air-abrasion pre-treatment with bioactive glass 45S5 on enamel surface loss after erosion/abrasion challenge

ObjectivesThe aim of this in vitro study was to evaluate the effect of air-abrasion surface pre-treatment with bioactive glass (BAG) 45S5 on enamel surface loss after erosion/abrasion challenge.MethodsTwenty-four sound bovine incisors were used for this study. Four experimental groups (n = 12) were assigned as follows: Group 1 was the negative control group, Group 2 specimens were treated with a SnF₂ gel (positive control group), Group 3 specimens were air-abraded with BAG 45S5 (ProSylc) and Group 4 received both treatments. The specimens were submitted to erosion/abrasion challenge using a common soft drink. Enamel surface loss was evaluated using an optical profilometer. Additionally, surface roughness (VSI method) and surface microhardness (Vickers method) changes were evaluated, as well as SEM and EDS analyses were performed on enamel surface. The data were statistically analyzed using one-way ANOVA and Tukey’s post-hoc test at a level of significance a = 0.05.ResultsSurface pre-treatment with BAG 45S5 reduced surface loss in comparison with negative control group (p < 0.001), which exhibited the highest surface loss of the experimental groups (p < 0.05). The positive control group (SnF₂ treatment) and Group 4 specimens, which received both air-abrasion pre-treatment and SnF₂ treatment, presented the lowest surface loss (p < 0.05), but did not show significant differences to each other (p = 0.65).SignificanceAir-abrasion pre-treatment with BAG 45S5 may be beneficial as an in-office preventive method for the limitation of enamel erosive wear induced by excessive consumption of soft drinks. The clinical significance of the results regarding this preventive method should be confirmed by clinical studies.     

An update on diastolic dysfunction

Diastolic dysfunction refers to abnormal diastolic filling properties of the left ventricle regardless of whether systolic function is normal or the patient has symptoms. Diastolic heart failure (HF), or more accurately, HF with preserved systolic function, is a distinct clinical entity characterized by the presence of the triad of impaired diastolic function, normal systolic function (left ventricular ejection fraction > 50%), and symptoms of HF. Patients with HF with preserved systolic function are frequently symptomatic from both acute and chronic elevations in left ventricular end-diastolic pressure and/or left atrial pressure.     

Pre-Dilatation Versus No Pre-Dilatation for Implantation of a Self-Expanding Valve in All Comers Undergoing TAVR: The DIRECT Trial

Objectives

The aim of this study was to compare the implantation of a self-expanding valve with or without balloon aortic valvuloplasty (BAV) in an open-label, noninferiority, randomized trial.