Melton Hertz (margintimer91)

A poor nutritional status of patients before transcatheter aortic valve implantation (TAVI) has been reported to be associated with poor clinical outcomes. However, changes in the nutritional status following TAVI have not been fully elucidated. In this single-center retrospective observational study, 129 patients whose nutritional status at baseline and 6 months after TAVI were available were investigated. The prognostic nutritional index (PNI) and geriatric nutritional risk index (GNRI) were used to assess the nutritional status of the patients at baseline and at 6 months. We further assessed changes in the nutritional status of patients in the subgroups stratified according to the baseline levels as low and high. The PNI and GNRI values at 6 months were significantly better than at baseline [PNI, baseline 44.5 (41.0-48.0), 6 months 46.0 (41.9-48.3), p=0.02; GNRI, baseline 95.3 (89.0-100.3), 6 months 97.8 (91.5-101.4), p=0.006]. Both PNI and GNRI values at 6 months were significantly better in the patients with a low baseline nutritional status, while no significant change was observed in those with high baseline levels [PNI, low; baseline 36.8 (36.1-39.4), 6 months 40.8 (39.0-43.4), p=0.002, high; baseline 47.0 (43.0-49.5), 6 months 46.5 (43.5-50.5), p=0.44 and GNRI, low; baseline 86.4 (81.7-88.7), 6 months 88.6 (83.4-95.3), p=0.001, high; baseline 99.8 (95.3-102.8), 6 months 100.7 (96.8-103.4), p=0.34]. Nutritional status of patients might improve during the chronic phase after TAVI, especially in those with poor baseline levels. Nutritional status of patients might improve during the chronic phase after TAVI, especially in those with poor baseline levels. Although the time difference between peak of left ventricular (LV) and aortic systolic pressures (T ), which is considered to in part reflect pulsus tardus, is reported to be associated with clinical outcome in aortic stenosis (AS), its physiological determinants remain to be elucidated. We hypothesized that not only AS severity but also LV systolic dysfunction could be associated with occurrence of pulsus tardus. T was measured by simultaneous LV and aortic pressure tracing in 74 AS patients and prolonged T was defined as ≥66ms according to the previous report. Mean transaortic valvular pressure gradient (mPG) and effective orifice area index (EOAI) were estimated by Doppler echocardiography and severe AS was defined as EOAI ≤0.60cm /m . Global longitudinal strain (GLS) was measured by using speckle-tracking method. Although a weak correlation was observed between EOAI and T , there was substantial population showing discordance between the parameters severe AS despite normal T (10 of 47 patients) and moderate AS despite prolonged T (9 of 17 patients). In severe AS, mPG was significantly higher in patients showing prolonged T (57±20 vs 36±10 mmHg, p<0.0001) whereas GLS was comparable between the groups (-15.2±3.5% vs -14.8±3.2%). In contrast, in moderate AS, GLS was significantly smaller in patients showing prolonged T (-12.6±4.7% vs -17.4±3.4%, p=0.0271) while mPG was comparable (34±7mmHg vs 35±8mmHg). Multivariable analysis revealed that not only mPG but also GLS was an independent determinant of T . The occurrence of pulsus tardus could be associated with not only AS severity but also LV systolic dysfunction in AS patients. The occurrence of pulsus tardus could be associated with not only AS severity but also LV systolic dysfunction in AS patients. Starting in spring 2020, the COVID-19 pandemic markedly impacted the French healthcare system. Lockdown and risks of exposure to the coronavirus induced patients to modify their ways of use. The objective of this article was to share feedback on the implementation of a real-time monitoring system concerning (a) the activity of private practitioners in southeast