Energy and decay width of the pi-K atom

The energy and decay width of the pi-K atom are evaluated in the framework of the quasipotential-constraint theory approach. The main electromagnetic and isospin symmetry breaking corrections to the lowest-order formulas for the energy shift from the Coulomb binding energy and for the decay width are calculated. They are estimated to be of the order of a few per cent. We display formulas to extract the strong interaction S-wave pi-K scattering lengths from future experimental data concerning the pi-K atom.Comment: 37 pages, 5 figures, uses Axodra

Simple scoring system to predict in-hospital mortality after surgery for infective endocarditis

BACKGROUND: Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. METHODS AND RESULTS: Outcomes of 361 consecutive patients (mean age, 59.1\ub115.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m2 (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. CONCLUSIONS: A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE

120 Assessment of right ventricular function with longitudinal two dimensional strain: comparison between low and intermediate risk pulmonary embolism

PurposeRight ventricular dysfunction is a key point for the stratification of pulmonary embolism risk and affects therapeutic strategies. Longitudinal two dimensional (L2D) strain measure is a new technique for assessment of ventricular function. The aim of our study was to determine: 1) the inter-observer variability of right ventricular longitudinal 2D strain measure in the setting of emergency, and 2) whether longitudinal 2D strain may appropriately differentiate low risk pulmonary embolism patients with intermediate risk pulmonary embolism patients.MethodsPatients with low or intermediate risk pulmonary embolism were included in the study and underwent an echocardiogram at admission in the emergency department. Intermediate risk was defined by troponin elevation and/or echocardiographic right ventricular dysfunction, as recommended by European guidelines. An apical four-chamber view was recorded and analyzed off-line by two independent observers. Right ventricle was divided in six segments, lateral and septal wall being divided in basal, mid and apical region. L2D strain was calculated for each segment, and global L2D strain calculated for lateral wall, septal wall and the whole right ventricle.Results28 patients were included, mean age 65 years, 13 with low risk and 15 with intermediate risk pulmonary embolism. Bland and Altman test showed a good inter-observer reproducibility. There was a significant difference between the intermediate and low risk patients for L2D strain of right ventricle (-13.3% vs -19.5%, p=0.0012), lateral wall (-12.1% vs -20.6%, p=0.0006) and septal wall (-14.5% vs -18.4%, p=0.05). A significant relation between L2D strain and right ventricular dilatation was observed (R2=0.187, p<0.0001).ConclusionsRight ventricle L2D strain is a reproducible technique and is potentially useful for the assessment of right ventricular function and stratification of risk of pulmonary embolism

Efficacité et sécurité d'emploi de l'enoxaparine comme traitement adjuvant à la thrombolyse dans l'embolie pulmonaire massive et sub-massive

BESANCON-BU Médecine pharmacie (250562102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Etude de radioprotection en salle d'hémodynamique lors des procédures de valvuloplasties aortiques percutanées

BESANCON-BU Médecine pharmacie (250562102) / SudocSudocFranceF

001 Thromboaspiration before primary PCI in STEMI patients reduces infarct size, but not microvascular obstruction: a magnetic resonance imaging study

BackgroundThromboaspiration (TA) during primary percutaneous intervention (PCI) is effective in opening infarct related artery (IRA) in patients (pts) with ST elevation acute myocardial infarction (STEMI), leading to better reperfusion and outcome. Microvascular obstruction (MVO) after successful IRA revascularization is associated with greater myocardial damage, left ventricular (LV) impairment and higher mortality. We evaluated relationships between (i) TA and MVO 5 days after STEMI; (ii) TA and infarct size at 5 days and 6 months; (iii) TA and LV remodelling at 6 months.Methods51 pts aged <75, with first STEMI and totally occluded IRA, referred for primary PCI within 12 hours of onset of symptoms were enrolled. All pts underwent TA before stenting. Pts were categorized according to positive or negative TA. MVO, infarct size and remodelling were assessed by contrast-enhanced cardiac magnetic resonance imaging (MRI) at 3T performed 5 days and 6 months after STEMI. Infarct size was measured by assessing global myocardial extent of hyperenhancement on delayed contrast-enhanced MRI. MVO was defined as subendocardial areas of hypoenhanced signal surrounded by hyperenhanced myocardial tissue and expressed as % of total myocardium.ResultsSee table.ConclusionPositive TA during primary PCI was associated with infarct size reduction at 5 days and 6 months follow-up in STEMI pts with TIMI 0 flow IRA. Although this phenomenon led to positive LV remodelling, it was not associated with a reduction in MVO.Negative TA(N = 34)Positive TA(N = 17)pTIMI III flow post PCI (%)91% (31/34)94% (16/17)0.86MVO at 5 days (%)7.1 ± 5.76.8 ± 4.90.85Infarct size at 5 days (%)20.6 ± 8.19.9 ± 7.2<10-5Infarct size at 6 months (%)16.4 ± 9.97.2 ± 8.1.0007LVSVI at 6 months (ml/m2)27.5 ± 9.336.4 ± 12.20.01LVSVI = left ventricular stroke volume inde

015 Impact of discharge heart rate on 30 day mortality in patients with acute myocardial infarction

BackgroundIn patients with acute myocardial infarction (MI), beta-blockers are recommended and contribute to control the heart rate (HR). The factors associated with HR and outcome of patients discharged with HR>70 beats per minute (bpm) is poorly documented.MethodsProspective registry including patients with acute MI. Recorded variables corresponded to the CARDS dataset. The proportion of patients discharged with HR>70bpm was assessed. Multivariate regression was used to determine factors associated with HR at discharge and logistic regression was used to determine the prognostic value of high HR at discharge on 30 day mortality.ResultsAmong the 837 patients, 592 survived and were discharged with a beta blocker. Discharge HR was ≤70bpm in 61% when a betablocker was given and in 31% without beta blocker (p<0.001). Discharge HR was associated with older age, admission HR, admission systolic blood pressure, BNP level, diabetes, use of beta blockers and ACEI. Patients discharged with HR>70bpm (n=227, 39%) had a threefold higher mortality as compared with those with HR ≤70 (figure). Multivariate analysis showed that a HR ≥70 at discharge was an independent predictor of 30 day mortality on top of the GRACE risk score and use of beta blockers.ConclusionsAmong patients discharged after acute MI, those with HR>70 have higher 30 day mortality, independently of the GRACE risk score and use of beta blockers.Mortality by discharge heart rat