Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulmonary arterial systolic pressure (PASP) has prognostic significance in patients undergoing cardiac resynchronization therapy (CRT). Methods: Patients undergoing CRT were prospectively included. The primary endpoint was adverse cardiovascular events (death and HF-related hospitalizations). RV global longitudinal strain (RVGLS) and RV free wall strain (RVfwS) were measured by speckle tracking and indexed to echocardiographic estimated PASP. Results: A total of 54 patients (64.0 ± 13.8 years; 58% male) were included. After 33 ± 12.9 months, the primary endpoint occurred in 18 patients. Baseline RVGLS/PASP and RVfwS/PASP showed good discriminative ability for response to CRT (AUC = 0.88, 95% CI (0.74–1) and AUC = 0.87, 95% CI (0.77–1)). RVGLS/PASP and RVfwS/PASP were significantly associated with high risk of events at univariate analysis (HR 0.039, 95% CI (0.001–0.8) p < 0.05, respectively HR = 0.049, 95% CI (0.0033–0.72), p < 0.05). Upon multivariate Cox regression analysis, RVGLS/PASP and RVfwS/PASP remained associated with high risk of events (HR 0.018, 95% CI (0.0005–0.64), p = 0.02 and HR 0.015, 95% CI (0.0004–0.524), p = 0.01) after correction for gender, etiology, QRS duration and morphology. Conclusions: Indexing RV longitudinal strain (global and free wall) by PASP provides a parameter, which independently identifies patients with high risk of cardiovascular events and predicts non-response to CRT.
Hypertrophic cardiomyopathy (HCM) is an inherited primary myocardial disease characterized by asymmetrical/symmetrical left ventricle (LV) hypertrophy, with or without LV outflow tract (LVOT) dynamic obstruction, and poor prognosis. Cardiac resynchronization therapy (CRT) has emerged as a minimally invasive tool for patients with heart failure (HF) with decreased LV ejection fraction (LVEF) and prolonged QRS duration of over 120 ms with or without left bundle branch block (LBBB). Several HCM patients are at risk of developing LBBB because of disease progression or secondary to septal myomectomy, while others might develop HF with decreased LVEF, alleged end-stage/dilated HCM, especially those with thin myofilament mutations. Several studies have shown that patients with myectomy-induced LBBB might benefit from left bundle branch pacing or CRT to relieve symptoms, improve exercise capacity, and increase LVEF. Otherwise, patients with end-stage/dilated HCM and prolonged QRS interval could gain from CRT in terms of NYHA class improvement, LV systolic performance increase and, to some degree, LV reverse remodeling. Moreover, several electrical and imaging parameters might aid proper selection and stratification of HCM patients to benefit from CRT. Nonetheless, current available data are scarce and further studies are still required to accurately clarify the view. This review reassesses the importance of CRT in patients with HCM based on current research by contrasting and contextualizing data from various published studies.
The purpose of this paper is to illustrate the opportunities for adopting robotic applications, through a marketing mix perspective, as well as depicting the current state of industrial robot integration in Romanian enterprises and the labor market, in contrast to other economies of the European Union. In this research, we highlight the impact of industrial robots within enterprises, while also considering the perceived standard of living through GDP per capita. For this, we conducted exploratory research based on secondary data regarding the evolution of the robotics sector in Romania, in connection to the dynamics of the global and European Union robotics market. We also performed a principal components analysis, which revealed the main factors that contributed to the dynamics of nation-level enterprise statistics. Our analysis revealed that a higher integration of industrial robots contributed to the reduction of employment rates amongst all six EU countries considered, while also having positive correlations with the GDP per capita and apparent labor productivity. Mixed results were only observed for the impact of industrial robots on remuneration growth, suggesting the potential adverse effects automation could have on incomes.
Consumer behaviour is one of the basic factors precisely analysed by major companies to identify the main requirements, needs, desires and trends in people’s consumption habits and to generate profit. Do these occur when consumers’ financial resources are limited and whether consumer habits are changing according to their financial availability? In this study, the impact of discounts on people’s buying behaviour, especially during the product’s expiration when it is sold with only 50% of the initial price was analysed. An online quantitative research was carried out with a sample of 160 respondents concluding that most of the consumers bought 50% less products even if they are not on their shopping list, most of the time there was only the illusion of an economy, not the saving itself. As a final remark, people are very sensitive when it comes to discounts changing the mindset of individuals who usually waste money for useless amounts of food and other products.Keywords: Happy money, discount, consumer behaviour, quantitative research.
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