The Effects of Morning vs. Evening Mindfulness Meditation on Sleep, Anxiety, and Decentering: A Pilot Analysis

According to the CDC, most children and about 1 in 3 adults in the United States fail to reach their age group recommended quantity of sleep. Recently, non-pharmacological sleep aids, such as meditation, have gained popularity. However, to our knowledge there is no research data that compares sleep metrics or psychological well-being between those that meditate in the morning vs. in the evening. This study aims to investigate the potential circadian-dependent effects of meditation timing and how it may influence metrics of sleep and psychological well-being. We hypothesized that those who meditate just before sleep would have improved sleep parameters and self-reported feelings of psychological well-being when compared to those that meditate in the morning. Sixteen college students participated in the study, eight who meditated in the morning (5M; 3F) after waking and eight who meditated in the evening (4M; 4F) just before going to sleep. Participants were asked to wear an Actiwatch Spectrum PRO to evaluate physical activity and sleep throughout the recording periods. The first phase of the protocol consisted of a 4-day (Monday-Thursday) baseline recording period where total sleep time (TST) and sleep efficiency measures were recorded. Participants were instructed to not meditate during the baseline period. During the 4-day intervention period which occurred the following week (Monday-Thursday), participants were randomized to a 24-minute pre-sleep or morning mindfulness meditation intervention from the app Insight Timer. At the conclusion of both baseline and intervention time periods (on Friday of each respective week), participants were instructed to complete a state-trait anxiety inventory (STAI), a Five Facts of Mindfulness Questionnaire, and a Decentering Questionnaire. Means were considered to be significantly different when p \u3c 0.05. The acute meditation protocols did not significantly change TST from baseline in the morning (6.7 ± 0.2 vs. 6.8 ± 0.2 hours) or evening (6.9 ± 0.3 vs. 7.2 ± 0.2 hours) meditators. Likewise, sleep efficiency was not significantly changed in either group. However, there was a significant decrease in both state and trait anxiety (baseline vs. treatment, p \u3c 0.02 for both), and a significant increase in the five facets of mindfulness and ability to decenter (baseline vs. treatment, p \u3c 0.01 for both). Our preliminary results suggest that acute meditation can help to improve several measures of psychological well-being whether it is done in the morning or evening. Further investigation within our own study and from others may help to better understand whether evening meditation can offer specific sleep benefits

Repolarization Injury and Occurrence of Torsades de Pointes During Acute Takotsubo Syndrome

Background: During takotsubo syndrome (TS), QTc prolongation is common, reflecting repolarization injury and providing the substrate for torsades de pointes (TdP). TdP has been reported sporadically in TS, yet QTc prolongation and TdP risk are often overlooked during management. Objectives: In TS patients, we sought to document TdP incidence, characteristics of patients with TdP, and association of QTc with postdischarge survival. Methods: Among consecutive TS patients at a single institution, we documented admission and discharge QTc, TdP incidence, and postdischarge 1-year mortality from 2006 to 2019. For perspective regarding TdP-TS risk, we characterized all published TdP cases from 2003 to 2022. Results: Of 259 patients, median age was 68 (range: 59-77) years; 92% were female. The QTc interval was prolonged (≥460 ms) on admission in 129 (49.8%) patients and at discharge in 140 (54%) patients. QTc was ≥500 ms either on admission or at discharge in 98 (37.8%) patients. In-hospital TdP incidence was 0.8%. Postdischarge mortality was associated with admission but not discharge, QTc: <460 ms (1.6%); 460-499 ms (12.6%); ≥500 ms (8.8%); P = 0.0056. Among 38 published TdP-TS cases, 80% of TdP events were within 48 hours of hospitalization, 90% of events occurred with QTc ≥500 ms, and 47.5% of events occurred with QTc ≥600 ms. Conditions associated with TdP risk were present in fewer than one-third of patients. Conclusions: During TS, QTc ≥500 ms was frequent. TdP incidence was low, with unpredictable occurrence and observed almost entirely with QTc ≥500 ms. A normal admission QTc was associated with >98% survival at 1-year postdischarge. © 2024 The Author

TCT-56 Effectiveness of Image-Guided Percutaneous Coronary Intervention in Contemporary Practice: Insights From BMC2

Background: Studies show that intracoronary imaging (ICI)-guided percutaneous coronary intervention (PCI) results in larger stent/balloon diameters and longer stent length. Whether these findings are seen in real-world practice is poorly understood. Methods: Between July 2019 and June 2022, there were 74,621 lesions treated at 48 non-federal hospitals in Michigan. Associations between ICI use for de novo lesion PCI optimization with maximum balloon/stent diameters and total stent length were evaluated using regression models controlling for patient and procedural factors. A sensitivity analysis controlling for the operator was performed. Results: ICI was used in 16,777 (22.5%) PCI-treated lesions. Compared with angiography alone, ICI use was associated with larger stent diameters (median 3.50 mm [3.00, 3.50] vs 3.00 mm [2.50, 3.50]), larger maximum balloon diameters (3.50 mm [3.00, 4.50] vs 3.00 mm [2.50, 3.50]), and longer stent lengths (32.00 mm [22.00, 48.00] vs 24.00 mm [18.00, 38.00]) (p\u3c0.001 for all) (Figure 1). Average patient/procedural adjusted treatment effects included: +0.19-mm stent diameter (95% CI: +0.16-0.22), +0.45-mm maximum balloon diameter (95% CI: +0.40-0.51), and +3.51-mm stent length (95% CI: +2.54-4.48). These findings persisted when controlling for the operator (Figure 1). [Formula presented] Conclusion: In real-world practice, ICI-guided PCI was associated with larger stent/balloon diameters and longer stents. Categories: IMAGING AND PHYSIOLOGY: Imaging: Intravascular

TCT-55 Safety of Image-Guided Percutaneous Coronary Intervention in Contemporary Practice: Insights From BMC2

Background: Studies show that intracoronary imaging (ICI)-guided percutaneous coronary intervention (PCI) results in larger stent/balloon diameters and better patient outcomes. However, the association between ICI use and risks of dissection and perforation in real-world practice is poorly understood. Methods: Between July 2019 and June 2022, there were 74,621 lesions treated at 48 non-federal hospitals in Michigan. We evaluated associations between ICI use for de novo lesion PCI with dissections/perforations using regression models controlling for patient and procedural factors. We assessed temporal trends in ICI use, stent/balloon sizes, and rates of dissection/perforation. Results: ICI was used in 16,777 (22.5%) PCI-treated lesions and increased from 11.2% of cases in July 2019 to 32.1% in June 2022. ICI use was associated with a higher risk for dissections (aOR: 2.55; 95% CI: 2.05-3.16) and perforations (aOR: 2.25; 95% CI: 1.74-2.91). However, increased use of ICI and larger average maximal stent/balloon diameters over the study period (P \u3c 0.001 for trend for both) was not associated with a concomitant increase in rates of dissection or perforation (P = 0.78 and P = 0.33 for trend, respectively) (Figure 1), suggesting that at least some of the ICI use was in response to the complication. [Formula presented] Conclusion: In real-world practice, although ICI use was associated with dissections and perforations, there was no significant increase in these complications despite significant increases in ICI use during the study period. Categories: IMAGING AND PHYSIOLOGY: Imaging: Intravascular

Outcomes of Intracoronary Brachytherapy for In-Stent Restenosis

Because of limited alternative options, intracoronary brachytherapy (ICBT) continues to be used for treating in-stent restenosis (ISR). We examined the indications, characteristics, and outcomes of ICBT in consecutive patients who underwent ICBT for ISR between January 2014 and December 2023 at a tertiary care center. During the study period 343 patients underwent ICBT of 502 lesions. The median patient age was 67 [60, 74] years, 73.4% of the patients were men, 77.3% had prior myocardial infarction, and 49.4% had prior coronary artery bypass graft surgery. The most common target vessel was the right coronary artery (38.7%) and 7.37% of lesions were in bypass grafts (33 saphenous vein grafts, 4 arterial grafts). A diffuse ISR pattern was found in 76.2% of lesions. Among the study lesions, 58.0% had 2 stent layers and 20.6% had 3 or more stent layers. Technical success was achieved in 96.1% of lesions. Follow-up was available for all patients with a mean follow-up of 701.5 days. The 3-year incidence of target lesion failure (TLF), target vessel myocardial infarction, and major adverse cardiac events were 36.4%, 17.2%, and 45.6%, respectively. In multivariable analysis, higher brachytherapy radiation dose was associated with a lower risk for TLF (aHR per 10 Gy: 0.73; 95% CI 0.54-0.93; p = 0.048). Repeat ICBT procedures had a higher incidence of TLF over 3 years compared with lesions treated with ICBT for the first time (log-rank test: p = 0.008). In conclusion, the 3-year incidence of TLF after ICBT is 36.4% and was lower with higher radiation dose and higher in lesions retreated with ICBT

Audiovisual multisensory integration

Over the last 50 years or so, a large body of empirical research has demonstrated the importance of a variety of low-level spatiotemporal factors in the multisensory integration of auditory and visual stimuli (as, for example, indexed by research on the ventriloquism effect). Here, the evidence highlighting the contribution of both spatial and temporal factors to multisensory integration is briefly reviewed. The role played by the temporal correlation between auditory and visual signals, stimulus motion, intramodal versus crossmodal perceptual grouping, semantic congruency, and the unity assumption in modulating multisensory integration is also discussed. Taken together, the evidence now supports the view that a number of different factors, both structural and cognitive, conjointly contribute to the multisensory integration (or binding) of auditory and visual information. © 2007 The Acoustical Society of Japan