A range of force (F) and velocity (V) data obtained from functional movement tasks (e.g., running, jumping, throwing, lifting, cycling) performed under variety of external loads have typically revealed strong and approximately linear F-V relationships. The regression model parameters reveal the maximum F (F-intercept), V (V-intercept), and power (P) producing capacities of the tested muscles. The aim of the present study was to evaluate the level of agreement between the routinely used "multiple-load model" and a simple "two-load model" based on direct assessment of the F-V relationship from only 2 external loads applied. Twelve participants were tested on the maximum performance vertical jumps, cycling, bench press throws, and bench pull performed against a variety of different loads. All 4 tested tasks revealed both exceptionally strong relationships between the parameters of the 2 models (median R = 0.98) and a lack of meaningful differences between their magnitudes (fixed bias below 3.4%). Therefore, addition of another load to the standard tests of various functional tasks typically conducted under a single set of mechanical conditions could allow for the assessment of the muscle mechanical properties such as the muscle F, V, and P producing capacities.

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The present study demonstrated that bleeding events defined according to the BARC classification hierarchically correlate with 1-year mortality after admission for primary PCI. The strongest predictor of 1-year mortality is the BARC type 3b bleeding.

The objective of the study was to evaluate major adverse cardiovascular events (MACE) after successful versus failed percutaneous coronary intervention for chronic total occlusion (PCI-CTO).Limited data are available on long-term clinical follow-up in the treatment of chronic total occlusion (CTO).Between January 2009 and December 2010 PCI-CTO was attempted in 283 consecutive patients with 289 CTO lesions. Procedural success was 62.3% and clinical follow-up covered 83% (235/283) of the study population with a median follow-up of 66 months (range, 59-74).The total incidence of MACE was 57/235 (24.3%), and was significantly higher in the procedural failure group than in the procedural success group (33/87 (37.9%) versus 24/148 (16.2%), P < 0.001). All-cause mortality was significantly lower in patients with successful PCI-CTO compared to failed PCI-CTO (10.8% versus 20.7%, P < 0.05). Also, the rate of cardiovascular death in the procedural failure group (14.9%) was slightly higher than that in the procedural success group (7.4%, P = 0.066). The rate of TVR was statistically higher in the procedural failure group (P < 0.009). Propensity score-adjusted Cox regression showed that procedural success remained a significant predictor of MACE (adjusted HR 0.402; 95% CI 0.196-0.824; P = 0.013).Our study emphasizes the importance of CTO recanalization in improving long-term outcome including all-cause mortality with a borderline effect on cardiovascular mortality.

These results support the two-point method as a reliable, valid, and fatigue-free procedure of assessing the muscle mechanical capacities through the F-V relationship.

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ObjectivesThe influence of the bleeding site on long-term survival after the primary percutaneous coronary intervention (PCI) is poorly understood. This study sought to investigate the relationship between in-hospital access site versus non-access site bleeding and very late mortality in unselected patients treated with primary PCI.MethodsData of the 2715 consecutive patients with ST-segment elevation myocardial infarction treated with primary PCI, enrolled in a prospective registry of a high volume tertiary centre, were analysed. Bleeding events were assessed according to the Bleeding Academic Research Consortium (BARC) criteria. The primary outcome was 4-year mortality.ResultsThe BARC type ≥2 bleeding occurred in 171 patients (6.3%). Access site bleeding occurred in 3.8%, and non-access site bleeding in 2.5% of patients. Four-year mortality was significantly higher for patients with bleeding (BARC type ≥2) than in patients without bleeding (BARC type 0+1), (36.3% vs 16.2%, p<0.001). Patients with non-access site bleeding had higher 4 year mortality (50.7% vs 26.5%, p=0.001). After multivariable adjustment, BARC type ≥2 bleeding was the independent predictor of 4 year mortality (HR 2.01; 95% CI 1.49 to 2.71, p<0.001). Patients with a non-access site bleeding were at 2-fold higher risk of very late mortality than patients with an access site bleeding (HR 2.62; 1.78 to 3.86, p<0.001 vs HR 1.57; 1.03 to 2.38, p=0.034).ConclusionsBoth access and non-access site BARC type ≥2 bleeding is independently associated with a high risk of 4-year mortality after primary PCI. Patients with non-access site bleeding were at higher risk of late mortality than patients with access site bleeding.

Finite element simulation of fluid-structure interaction was used to investigate patient-specific flow dynamics and wall mechanics at coronary artery bifurcations. Simulation model revealed that lateral walls of the main branch and lateral walls distal to the carina are exposed to low endothelial shear stress which is a predilection site for development of atherosclerosis. This conclusion is confirmed by the low values of oscillatory shear index in those places.