associated with increased all-cause mortality (normal 6.8%, mild 4.6%, moderate 20.6%, and severe LA dilation 21.6%, P=0.001) and cardiac-related mortality rate (normal 4.1%, mild 4.6%, moderate 15.5%, and severe LA dilation 13.5%, P=0.009) in this cohort. Multivariable Cox proportional hazards regression analysis showed that LA enlargement remained an independent determinant for allcause mortality (adjusted Hazard ratio [HR] Introduction: Chronic total coronary occlusion (CTO) has been demonstrated to be an independent predictor of appropriate discharges for secondary prevention implantable cardioverter-defibrillators (ICD) patients with coronary artery disease. Objetive: To assess the prevalence of CTO for secondary prevention ICD patients with ischemic heart disease and its relation to the ejection fraction (EF). Methods: We retrospectively examined 1052 ICD patients from 1996 to 2016 in our hospital. A total of 456 had suffered from previous myocardial infarction and 263 were implanted for ventricular fibrillation, sustained ventricular tachycardia or syncope. We included in the study those patients with available coronariography prior to implantation. Results: We included 143 patients, 93% male, with a median age of 68 years (61-74). The prevalence of CTO was 54% (n=77); the right coronary artery was the most affected one (n=41, 53%), followed by the left anterior descending artery in 30% (n=23) and the circumflex artery in 17% (n=13). The median EF was 40% (30-47). Of the patients with OTC, 46 patients (60%) had EF equal or greater than 35%. With a median follow-up of 48 months (9-89), 39 patients (27%) had at least one appropriate discharge. Discharge-free survival was significantly lower in CTO patients (62% vs. 85%, Log Rank p=0.003). There were no statistically significant differences in the affected artery (Log Rank p=0.856). CTO (HR 2.46, 95% CI, 1.186-5.19 p=0.016) and EF (HR 0.962, 95% CI 0.935-0.991 p=0.01) were independent predictors of appropriate discharges according to multivariate analysis. Conclusions: For secondary prevention ischemic heart disease ICD patients, CTO is highly prevalent and is not often associated with severe ventricular dysfunction. CTO and decreased EF were predictors of arrhythmic events at followup. Background: The Evolution sheath () is a power sheath frequently used for chronic lead extraction. In 2013 a novel type (bidirectional) of Evolution sheath (the RL type) was introduced. Purpose: To evaluate differences in success and complication rates of the two types. Methods: From 2009-2015 all lead extractions requiring the use of an Evolution sheath were prospectively examined. According to the current guidelines, complete procedural success was defined as the removal of all targeted lead material. Clinical success was the retention of a small portion of the lead and failure was the inability to achieve either complete procedural or clinical success, or the development of any permanently disabling complication. Results: The Evolution sheath was used to extract 149 lead...
Sustainability is an increasingly-studied topic in software engineering in general, and in software architecture in particular. There are already a number of secondary studies addressing sustainability in software engineering, but no such study focusing explicitly on software architecture. This work aims to fill this gap by conducting a systematic mapping study on the intersection between sustainability and software architecture research with the intention of (i) reflecting on the current state of the art, and (ii) identifying the needs for further research. Our results show that, overall, existing works have focused disproportionately on specific aspects of sustainability, and in particular on the most technical and "inward facing" ones. This comes at the expense of the holistic perspective required to address a multi-faceted concern such as sustainability. Furthermore, more reflection-oriented research works, and better coverage of the activities in the architecting life cycle are required to further the maturity of the area. Based on our findings we then propose a research agenda for sustainability-aware software architecture.
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