Objective To evaluate the utility of subchondral bone texture from a baseline x-ray image for predicting 3-year knee osteoarthritis (OA) progression. Methods A total of 138 participants in the Prediction of Osteoarthritis Progression (POP) study were evaluated at baseline and 3 years. Fixed-flexion knee radiographs of the 248 non-replaced knees underwent fractal analysis of the medial subchondral tibial plateau using a commercially available software tool. OA progression was defined as a 1-grade change in joint space narrowing (JSN) or osteophyte based on a standardized knee atlas. Statistical analysis of fractal signatures was performed using a new method based on modeling the overall shape of fractal dimension versus radius curves. Results Baseline fractal signature of the medial tibial plateau was predictive of medial knee JSN progression (area under the curve [AUC] of Receiver Operating Characteristic plot of 0.75), but not progression based on osteophyte or progression of the lateral compartment. The traditional covariates (age, gender, body mass index, knee pain), general bone mineral content, and baseline joint space width fared little better than random variables for predicting OA progression (AUC 0.52–0.58). The maximal predictive model combined baseline fractal signature, knee alignment, traditional covariates, and bone mineral content (AUC 0.79). Conclusions We identified a prognostic marker of OA that is readily extracted from a plain radiograph by fractal signature analysis. The global shape approach to analyzing these data is a potentially efficient means of identifying individuals at risk of knee OA progression that needs to be validated in a second cohort.

No abstract

Ventricular septal defects post-TAVR were seen more with balloon expandable valves and with pre-dilation or post-dilation. Percutaneous treatment of the VSD was preferred over open cardiac surgery given the high surgical risk in this patient population. Some, but not all, patients survived TAVR and VSD and had a good prognosis for both patient groups with or without VSD closure.

Objectives:To report the clinical outcomes (early death, late death, and rate of reintervention) and performance of the Contegra conduit as a right ventricle outflow tract implant and to determine the risk factors for early reintervention.Methods:Forty-nine Contegra conduits were implanted between January 2002 and June 2009. Data collection was retrospective. The mean age and follow-up duration of Contegra recipients was 3.5 ± 4.6 years and 4.2 ± 2.0 years, respectively.Results:There were three deaths (two early, one late), giving a survival rate of 93.9%. The rate of conduit-related reintervention was 19.6% and was most often due to distal conduit stenosis. Age at implantation of <3 months, receipt of a conduit of 12–16 mm diameter, and a diagnosis of truncus arteriosus were each significant contributors to the rate of reintervention.Conclusion:The Contegra is a cost-effective and readily available solution. However, there is a limited range of larger calibers, which means that the homograft conduit (>22 mm) remains the first choice of implant in older children. The rates of reintervention are significantly higher with a diagnosis of truncus arteriosus, age at implantation of <3 months, and implantation of conduits sized 12–16 mm.

No abstract

No abstract

No abstract

When performed early after AMI, LGE is a moderate predictor of late remodeling and CS is a powerful predictor of late myocardial remodeling. When combined, they can predict late remodeling, a surrogate of SCD, with high accuracy.