The application of the new 2016 ASE/EACVI recommendations resulted in a much lower prevalence of DD. The concordance between the classifications was poor. The updated algorithm seems to be able to diagnose only the most advanced cases.

Background: Exercise-based cardiac rehabilitation (EBCR) plays a pivotal role in the management of acute myocardial infarction (AMI). Studies have shown that older individuals have a worse prognosis after an AMI, attesting to the importance of risk reduction strategies. We aimed at assessing the impact of age (patients dichotomized as ≥65 years old or <65 years old) on the functional benefits of an EBCR program among AMI survivors. Design: Observational, retrospective cohort study. Participants: All patients admitted due to an AMI who completed a phase II EBCR program after discharge, between November 2012 and April 2017. Intervention: EBCR program. Measurements: Functional parameters were assessed by a symptom-limited cardiopulmonary exercise test. Results: A total of 379 patients were included (30% aged ≥65 years). After the EBCR program, peak oxygen uptake (pVO2) and exercise duration increased significantly. Patients aged ≥65 years presented with more comorbidities and a lower functional capacity. Those aged ≥65 years presented significantly smaller improvements in pVO2 (0.79 ± 2.61 vs. 1.60 ± 3.11 mL/kg/min, p = 0.016) and exercise duration [75 (59–120) vs. 120 s (60–180), p = 0.002]. This was maintained after adjusting for several potential confounders. Conclusion: Older patients have a worse functional capacity than their younger counterparts. Still, a contemporary EBCR program was associated with significant functional improvements among those aged ≥65 years. The smaller improvements even after adjustments for potential confounders suggest that physiological differences may contribute to this finding. These results highlight the relevance of EBCR among this higher-risk subgroup.

Background The first step in evaluating a patient with suspected stable coronary artery disease (CAD) is the determination of the pretest probability. The European Society of Cardiology guidelines recommend the use of the CAD Consortium 1 score (CAD1), which contrary to CAD Consortium 2 (CAD2) score and Duke Clinical Score (DCS), does not include modifiable cardiovascular risk factors. Hypothesis Using scores that include modifiable risk factors (DCS and CAD2) enhances prediction of CAD. Methods We retrospectively included all patients referred to invasive coronary angiography for suspected CAD from January/2008–December/2012 (N = 2234). Pretest probability was calculated using 3 models (CAD1, DCS, and CAD2), and they were compared using the net reclassification improvement. Results Mean patient age was 63.7 years, 67.5% were male, and the majority (66.9%) had typical angina. Coronary artery disease was diagnosed in 58.5%, and the area under the curve was 0.685 for DCS, 0.664 for CAD1, and 0.683 for CAD2, with a statistically significant difference between CAD1 and the others (P < 0.001). The net reclassification improvement was 20% for DCS, related to adequate reclassification of 32% of patients with CAD to a higher risk category, and 5% for CAD2, at the cost of adequate reclassification of 34% of patients without CAD to a lower risk category. Conclusions Prediction of CAD using scores that include modifiable cardiovascular risk factors seems to improve accuracy. Our results suggest that, in high‐prevalence populations, DCS may better identify patients at higher risk and CAD2 those at lower risk for CAD.

No abstract

Vascular access site complications are frequent in patients undergoing TF TAVI. SIFAR was the only independent predictor of access site complications and therefore should be systematically assessed during pre-procedural imaging study.

Percutaneous therapeutic options for an increasing variety of structural heart diseases (SHD) have grown dramatically. Within this context of continuous expansion of devices and procedures, there has been increased demand for physicians with specific knowledge, skills, and advanced training in multimodality cardiac imaging. As a consequence, a new subspecialty of ‘Interventional Imaging’ for SHD interventions and a new dedicated professional figure, the ‘Interventional Imager’ with specific competencies has emerged. The interventional imager is an integral part of the heart team and plays a central role in decision-making throughout the patient pathway, including the appropriateness and feasibility of a procedure, pre-procedural planning, intra-procedural guidance, and post-procedural follow-up. However, inherent challenges exist to develop a training programme for SHD imaging that differs from traditional cardiovascular imaging pathways. The purpose of this document is to provide the standard requirements for the training in SHD imaging, as well as a starting point for an official certification process for SHD interventional imager.

The majority of requests for transthoracic echocardiograms at a Portuguese tertiary care center were appropriate. Requests by cardiologists and outpatient referrals presented the highest rates of inappropriateness.

Edited by ME LightKeywords: Cold storage Gibberellic acid Salt marsh Myrsine parvifolia A. DC. (Myrsinoideae, Primulaceae) is a native pioneer tree on the Brazilian coastal plain that occupies a diversity of sunny and wet sandy habitats. This study evaluated the germination of three seed batches of this species, collected near its southern limit in South America (Rio Grande, RS, Brazil) during two different years (2008 and 2009), with or without cold storage. The seeds were incubated for 30 days at four constant temperatures (15°C, 20°C, 25°C and 30°C) and one thermoperiod (20/30°C, 12 h:12 h). Pooled data from the three batches showed higher final germination (~75%) at temperatures of 15°C and 20°C, whereas significantly lower germination (between 20% and 30%) occurred at 25°C, 30°C and during a 20/30°C thermoperiod. Inhibition at 25°C, 30°C and 20/30°C was completely reversed (resulting in ≥90% germination) by transferring the seeds to 20°C and incubating them for an additional 30 days, or it was partially reversed (rose to 50-65%) by mechanical abrasion of the seed testa or gibberellic acid application. A higher germination speed index was also observed at a constant temperature of 20°C than the other temperature regimes tested. Cold storage did not significantly affect the final germination percentage, but it resulted in higher germination synchrony. The seeds of the southern population of M. parvifolia are non-dormant and orthodox and denote a marked adaptation to the local warm-temperate climate.