Cardiovascular Research Digest

Hemoptysis, often life-threatening in its massive form, is predominantly caused by bronchial artery pathology. Bronchial artery embolization (BAE) is the established first-line intervention, yet the relationship between bronchial artery morphology and embolization outcomes remains insufficiently defined. This prospective pilot study aimed to assess the association between bronchial artery anatomical features and short-term outcomes following BAE, and to evaluate concordance between computed tomography (CT) angiography and digital subtraction angiography (DSA) in detecting hypertrophy and tortuosity. Twenty-eight patients with hemoptysis requiring BAE were prospectively enrolled in a cohort study. Baseline multidetector CT angiography characterized bronchial artery origin, diameter, hypertrophy, tortuosity, and systemic collaterals. All patients underwent DSA-guided BAE. Treatment success was defined as cessation of hemoptysis within 48 hours, with recurrence assessed at 30 days. Inter-modality agreement was measured using Cohen's kappa. Immediate success was achieved in 92.9% of cases, with recurrence observed in 14.3% at 30 days. No statistically significant associations were found between artery morphology and outcomes. Descriptive trends suggested higher recurrence in patients with systemic collaterals and smaller left bronchial artery diameters (<2 mm). Moderate agreement was observed between CT and DSA for hypertrophy detection (Kappa = 0.563 for right bronchial artery, 0.500 for left), while substantial agreement was found for tortuosity (Kappa = 0.710 and 0.774, respectively). CT angiography demonstrated moderate concordance with DSA for hypertrophy detection (Kappa = 0.563 for right bronchial artery, 0.500 for left), while substantial agreement was found for tortuosity (Kappa = 0.710 and 0.774, respectively). Bronchial artery morphology was not significantly predictive of short-term BAE outcomes, though systemic collaterals and small vessel diameters may contribute to recurrence risk. While moderate agreement limits CTA as a sole tool, it aids in identifying targets efficiently. Larger, multicenter studies are warranted to refine risk stratification and optimize hemoptysis management.

Understanding aging men's perspective on functional ability is of utmost importance to tailor the delivery of medical care and to inform policy makers about aging men's primary health concerns. The purpose of this analysis was to describe trends in self-perceived physical and mental health problems causing functional limitations in US men aged ≥60 years based on National Health and Nutrition Examination Surveys data from 2011 to 2018. Data from 2,494 males with a mean age of 68.56 years was analyzed. Participants reported a median number of 1 health problem causing functional limitations. With 20.54% and 17.75%, respectively, arthritis/rheumatism and back/neck problems emerged as the main problems. The predicted prevalence of arthritis/rheumatism causing functional limitations increased significantly from 2011-2012 to 2017-2018 by 9% (p = 0.028). Back/neck problems increased by 10% from 2011-2012 to 2015-2016 (p = 0.004). The predicted number of health problems causing functional difficulties was 1.81 times higher in those aged ≥80 years when compared to those aged 60 years (p < 0.001). Health conditions which attract higher attention from a public health point of view (e.g. cardiovascular disease or metabolic disorders) are less frequently reported among aging men when it comes to functional disabilities and physical functioning.

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Animal experimental studies involving the Igaki-Tamai stent (ITS), a bioresorbable poly-l-lactic acid scaffold, in peripheral arteries are limited, and existing studies evaluated only short-term (3-month) outcomes. This study compared arterial responses associated with the ITS and bare metal stent (BMS) over 6 months using intravascular ultrasound (IVUS) analysis and evaluated feasibility in porcine iliac arteries. Four miniature pigs underwent stent implantation with the ITS in the right iliac artery and the BMS in the left iliac artery. Follow-up evaluations at 6, 12, and 24 weeks included angiographic and IVUS analyses to assess neointimal hyperplasia, percent area stenosis (%AS), and percent in-stent volume obstruction (%VO). Histological analysis was performed to evaluate tissue injury and inflammation scores. At 6 weeks, the neointimal area did not differ significantly between the ITS and BMS groups (8.49 ± 2.10 mm² vs 13.47 ± 6.67 mm², P = .205). However, the ITS group exhibited a significantly smaller neointimal area at 12 weeks (6.87 ± 1.15 mm² vs 20.65 ± 10.99 mm², P = .050) and 24 weeks (5.20 ± 0.85 mm² vs 22.32 ± 12.03 mm², P = .042). %AS and %VO were significantly lower in the ITS group at all follow-ups. The ITS group showed reduced tissue damage (injury score: 0.80 ± 0.430 vs 1.74 ± 0.908, P < .001) and inflammation (inflammation score: 1.25 ± 0.516 vs 1.67 ± 0.832, P < .001) compared with the BMS group. The ITS was associated with reduced vessel injury, lower inflammatory response, and favorable luminal remodeling over 6 months in healthy porcine iliac arteries.