Background: Chronic aortic regurgitation (AR) is a common valvular disease characterized by an overload of left ventricular volume and pressure. Accurate assessment of the heart from all angles is crucial for effective clinical management and prognostic evaluation of AR patients. As an advanced imaging technique, cardiac magnetic resonance (CMR) has become the gold standard for assessing cardiac volume and function. Accordingly, this study aimed to evaluate the prognostic value of CMR in chronic AR. Methods: EMBASE, Cochrane Library, PubMed, and Web of Science were searched for clinical studies published between inception and July 19, 2022. Only studies that used CMR to assess patients with chronic isolated AR and provided prognostic data were included. Results: For our analysis, 11 studies, which involved 1702 subjects and follow-up periods of 0.6–9.7 years, were eligible. We identified 13 CMR-related parameters associated with AR prognosis. With aortic valve surgery as the outcome, we estimated the pooled hazard ratios (HRs) for four of these parameters: aortic regurgitation fraction (ARF), aortic regurgitation volume (ARV), left ventricle end-diastolic volume (LVEDV), and LV end-systolic volume (LVESV). The pooled HR for ARF was found to be 4.31 (95% confidence interval [CI]: 1.12–16.59, p = 0.034), while that for ARV was 3.88 (95% CI: 0.71–21.04, p = 0.116). Additionally, the combined HRs of LVEDV and LVESV were estimated to be 2.20 (95% CI: 1.04–4.67, p = 0.039) and 3.14 (95% CI: 1.22–8.07, p = 0.018), respectively. Conclusions: The assessment of ARF, LVEDV, and LVESV via CMR has significant prognostic value in predicting the prognosis of AR patients with aortic valve surgery as an endpoint. It is recommended to consider using multi-parameter CMR in the clinical management of AR patients for timely interventions and effective prognostic evaluation.
To the Editor—Kuitunen and colleagues [1] conducted a systematic review and meta-analysis to evaluate antibiotic treatment duration in outpatient children in high-income countries. They concluded that a short antibiotic treatment duration of 3–5 days was equally effective and safe compared with the longer recommendation of 7–10 days. However, misuse of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach in this systematic review may affect the conclusion. In the Methods section, the authors reported that they assessed reporting quality using the GRADE methodology. The GRADE approach is designed to assess the certainty (quality) of evidence rather than the reporting quality [2, 3]. Considering that the 95% confidence intervals (CIs) includes 0, the authors rated down for imprecision for all outcomes. However, when they rated the overall certainty of the evidence, the authors did not consider the serious imprecision. Therefore, the authors erroneously obtained high certainty evidence for the need for antibiotic retreatment, need for hospitalization, and treatment failure and erroneously obtained moderate certainty evidence for any antibiotic-related adverse event and severe antibiotic-related adverse event. According to the authors’ assessment of each GRADE domain, the certainty of evidence for the need for antibiotic retreatment, need for hospitalization, and treatment failure should be moderate and the certainty of evidence for any antibiotic-related adverse event and severe antibiotic-related adverse event should be low. Thus, the conclusion of this review should be more conservative without high certainty evidence.
A Ce(III)-catalyzed, visible-light induced aerobic oxidative dehydrogenative coupling reaction between glycine derivatives and electron-rich arenes is disclosed. The protocol proceeds efficiently under mild conditions, providing an efficient method for the rapid synthesis of α-arylglycine derivatives without the need for an external photosensitizer and additional oxidant. Moreover, this protocol could be performed on a 5 mmol scale, without obvious reduction of the efficiency.
This study employed multiple MRI features to comprehensively evaluate the abnormalities in morphology, and functionality associated with Parkinson's disease (PD) and distinguish them from normal physiological changes. For investigation purposes, three groups: 32 patients with PD, 42 age-matched healthy controls (HCg1), and 33 young and middle-aged controls (HCg2) were designed. The aim of the current study was to differentiate pathological cortical changes in PD from age-related physiological cortical volume changes. Integrating these findings with functional MRI changes to characterize the effects of PD on whole-brain networks. Cortical volumes in the bilateral temporal lobe, frontal lobe, and cerebellum were significantly reduced in HCg1 compared to HCg2. Although no significant differences in cortical volume were observed between PD patients and HCg1, the PD group exhibited pronounced abnormalities with significantly lower mean connectivity values compared to HCg1. Conversely, physiological functional changes in HCg1 showed markedly higher mean connectivity values than in HCg2. By integrating morphological and functional assessments, as well as network characterization of physiological aging, this study further delineates the distinct characteristics of pathological changes in PD.
Abstract Myocardial fibrosis detected by cardiac magnetic resonance (CMR) has been reported in patients with desmin‐related myopathy, although its characteristics remain unclear. Here, we describe a case of desmin‐related restrictive cardiomyopathy wherein CMR imaging revealed myocardial oedema, ischaemia, and fibrosis in the left ventricle; the different types and processes of myocardial injury were detected by CMR. Middle wall left ventricular enhancement may be a feature of late gadolinium enhancement, and the lateral wall is often involved in cases of myocardial injury. CMR is useful for the early detection of cardiac involvement and the prediction of prognosis in patients diagnosed with desmin‐related myopathy.
To investigate the “sub-aortic complex (SAC)”, a new cardiac magnetic resonance (CMR) derived parameter, for the detection and grading of left ventricular outflow tract (LVOT) obstruction in hypertrophic cardiomyopathy (HCM) patients, compared with echocardiography and CMR 2D flow.
White matter damage in patients with carbon monoxide (CO) poisoning have been extensively reported in previous studies, but neurological deficits-associated gray matter volume (GMV) changes are not well explored. Forty-one CO poisoning patients and 36 healthy controls were enrolled in this study. All subjects underwent 3D T1WI and cognition and motor function assessment. GMV change patterns of patients were explored using Voxel-based morphometry processing. This study would provide a simple neuroimaging biomarker to identify the brain anatomical signatures underlying neurological deficits in CO poisoning, and thus facilitate the ongoing effort of knowing of the neuropathologic mechanism happened in these patients.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)