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Value of a comprehensive geriatric assessment for predicting one-year outcomes in patients undergoing transcatheter aortic valve implantation: results from the CGA-TAVI multicentre registry

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Journal of Geriatric Cardiology 2019年第6期16卷 468-477页

作者： Martijn S.van Mourik Nathalie van der Velde Giulio Mannarino Marie-Pierre Thibodeau Jean-Bernard Masson Gennaro Santoro Jan Baan Sofie Jansen Jana Kurucova Martin Thoenes Cornelia Deutsch ANDreas W.Schoenenberger ANDrea Ungar Peter Bramlage M Marije Vis Department of Cardiology Amsterdam UMC University of Amsterdam Department of Internal Medicine Section of Geriatric Medicine Amsterdam UMC University of Amsterdam Geriatric Intensive Care Unit Department of Geriatrics and Medicine Careggi Hospital and University of Florence Centre Hospitalier de l’Université de Montréal edwards lifesciences edwards lifesciences Nyon Switzerland Institute for Pharmacology und Preventive Medicine Department of Geriatrics Inselspital Bern University Hospital University of Bern Switzerland

Background In a three-month report from the CGA-TAVI registry, we found the Multidimensional Prognostic Index (MPI) and Short Physical Performance Battery (SPPB) to be of value for predicting short-term outcomes in elderly patients undergoing transcatheter aortic valve implantation (TAVI). In the present analysis, we examined the association of these tools with outcomes up to one year post-TAVI. Methods CGA-TAVI is an international, observational registry of geriatric patients undergoing TAVI. Patients were assessed using the MPI and SPPB. Efficacy of baseline values and any postoperative change for predicting outcome were established using logistic regression. Kaplan- Meier analysis was carried out for each comprehensive geriatric assessment tool, with survival stratified by risk category. Results One year after TAVI, 14.1% of patients deceased, while 17.4% met the combined endpoint of death and/or non-fatal stroke, and 37.7% the combined endpoint of death and/or hospitalisation and/or non-fatal stroke. A high-risk MPI score was associated with an increased risk of all-cause mortality (aOR = 36.13, 95% CI: 2.77–470.78, P = 0.006) and death and/or non-fatal stroke (aOR = 10.10, 95% CI: 1.48–68.75, P = 0.018). No significant associations were found between a high-risk SPPB score and mortality or two main combined endpoints. In contrast to a worsening SPPB, an aggravating MPI score at three months post-TAVI was associated with an increased risk of death and/or non-fatal stoke at one year (aOR = 95.16, 95% CI: 3.41–2657.01). Conclusions The MPI showed value for predicting the likelihood of death and a combination of death and/or non-fatal stroke by one year after TAVI in elderly patients.

关键词： Comprehensive geriatric assessment Multidimensional prognostic index Short physical performance battery Silver code Transcatheter aortic valve implantation

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BME2.1: The Need for a Systems Approach to Addressing Race-Based Disparities in Health and Health Care

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Biomedical Engineering Frontiers 2023年第1期4卷 100-102页

作者： Naomi C.Chesler Gilda A.Barabino edwards lifesciences Foundation Cardiovascular Innovation and Research Center and Department of Biomedical Engineering Samueli School of EngineeringUniversity of CaliforniaIrvineCAUSA Olin College of Engineering NeedhamMAUSA

The recent article by Miller et al.[1]in BMEF on reimagining the Biomedical Engineering(BME)curriculum of the future proposes several exciting and transformative core *** include(a)incorporating modern molecular biology and analytical/computational modeling,(b)providing instruction in data science fundamentals,(c)integrating clinical needs for innovation and translation,(d)fostering an educational culture of inclusive excellence,and(e)ensuring that new research discoveries inform the core curriculum.

关键词： integrating translation culture

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ENHANCED FLUORESCENCE IMAGING WITH DMSO-MEDIATED OPTICAL CLEARING

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Journal of Innovative Optical Health Sciences 2010年第3期3卷 153-158页

作者： SANJEEV KARMA JAMES HOMAN CHARLES STOIANOVICI BERNARD CHOI Department of Biomedical Engineering University of California IrvineCA 92697USA Department of Developmental and Cell Biology University of California IrvineCA 92697USA Department of Chemistry University of California IrvineCA 92612USA Beckman Laser Institute University of California IrvineCA 92612USA edwards lifesciences Center for Advanced Cardiovascular Technology University of California IrvineCA 92697USA

Recent studies have demonstrated that topical application of glycerol on intact skin does not affect its optical scattering *** from our research group recently revisited the use of dimethyl sulfoxide(DMSO)as an agent with optical clearing *** address the use of optical clearing to enhance quantitation of subsurface fluorescence *** employed both in vitro and in vivo model systems to study the effect of topical DMSO application on fluorescence *** in vitro experiments performed on a tissue-simulating phantom suggest that DMSO-mediated optical clearing enables enhanced characterization of subsurface *** topical DMSO application,a marked increase in fluorescence emission was *** 30 min,the fluorescence signal at the DMSO-treated site was 9×greater than the contralateral saline-treated *** ratio increased to 13×at 105 min after agent *** summary,DMSO is an effective optical clearing agent for improved fluorescence emission quantitation and warrants further study in preclinical in vivo *** on outcomes from previous clinical studies on the toxicity profile of DMSO,we postulate that clinical application of DMSO as an optical clearing agent,can be performed safely,although further study is warranted.

关键词： Glycerol spectroscopy fluorescein toxicity

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