Heart transplantation (HTx) remains the definitive therapy for select patients with Stage D heart failure. Donation after circulatory death (DCD) has emerged as a promising strategy to expand the donor pool, with studies showing comparable survival to donation after brain death (DBD). However, little is known about how DCD impacts post-transplant quality of life. Days alive and out of the hospital (DAOH) at 1 year is a validated, patient-centered metric reflecting both post-transplant morbidity and survival. We conducted a single-center, retrospective cohort study of 226 adult patients who underwent HTx between January 2021 and June 2023 (117 DBD and 109 DCD recipients). The primary outcome was DAOH at 1 year. Secondary outcomes included post-transplant graft function, inotrope and intensive care unit (ICU) duration, readmissions, and mortality. Baseline characteristics and outcomes were compared using appropriate statistical methods, and quantile regression was used to adjust for clinical confounders. Baseline characteristics were largely similar, although DBD recipients had higher pre-operative acuity. Median DAOH at 1 year did not differ significantly between DBD and DCD recipients (344 vs 343 days; p = 0.896). Adjusted analyses confirmed no clinically meaningful difference. Secondary outcomes, including 1-year mortality, ICU stay, and readmission rates, were also comparable. In this cohort, DCD recipients achieved similar DAOH at 1 year compared to DBD recipients, supporting the use of DCD as a viable strategy in HTx. This is one of the first studies to compare post-transplant quality of life in DBD and DCD HTx recipients.

Various factors may alter the risk for cardiovascular disease in adults with Down syndrome (Ds), yet few studies have examined differences in cardiac physiology in this population. Previous research suggested lower systolic and diastolic function, but inconsistent methodologies and younger samples warrant research in adults with Ds. Our aim is to compare the cardiac structure and function of adults with Ds to age- and sex-matched adults without Ds. Echocardiography was used to assess systolic function, diastolic function, and cardiac structure in n = 19 adults (Ds n = 9, control n = 10). Regarding cardiac structure, adults with Ds had increased left ventricular posterior wall thickness at end-systole compared to adults without Ds (p = 0.007). Regarding systolic and diastolic function, adults with Ds were found to have lower septal peak systolic annular velocity (S’) (p = 0.026), lower lateral and septal mitral annular early diastolic velocity (E’) (p = 0.007 and p = 0.025, respectively), lower lateral peak mitral annular late diastolic velocity (A’) (p = 0.027), and higher lateral and septal mitral annular early systolic velocity to diastolic velocity ratios (E/e’) (p = 0.001 and p = 0.001, respectively). Differences in both cardiac structure and function were found when comparing adults with Ds to matched adults without Ds. Most of the differences were indicative of worse diastolic function.

Background The loss of a free flap in reconstructive microsurgery is a devastating complication in both the intraoperative and postoperative setting. Previous research has identified a variety of genetic polymorphisms that induce a hypercoagulable state and predispose patients to clot formation and subsequent free flap loss. We aim to review the risks of performing microsurgery on patients who are genetically predisposed to hypercoagulability, as well as identify options, for preoperative screening of inherited thrombophilia. Methods A thorough literature review was conducted with an online database. A total of 30 studies were reviewed to identify genetic polymorphisms that cause inherited thrombophilia. Through manual review of the literature, a table was created that included thrombotic risk factors and their associated genetic polymorphisms. If the information was available, prevalence for each thrombotic risk was also reported. Results Overall, 18 thrombotic risk factors that contribute to hereditary thrombophilia were identified and linked with specific genes and/or genetic polymorphisms. In studies that did not look at particular ethnic groups, 13 unique thrombotic risk factors were identified. In studies that examined specific ethnic groups exclusively, 12 thrombotic risk factors were identified and related to their respective gene or group of genes. Five of the 18 thrombotic risk factors identified were associated with increased risks of both venous and arterial thrombosis. The remainder of the thrombotic risk factors was associated with increased risk of venous thrombosis exclusively. Conclusion The use of genetic screening tests for hereditary thrombophilia in the preoperative setting can serve as an effective preventative measure against postoperative thrombosis. Further exploration of thrombotic risk factors and their related genetic polymorphisms are important steps in reducing postoperative free flap loss.

Remdesivir is an antiviral drug recommended for the treatment of COVID-19. The therapeutic benefits of remdesivir remain under investigation, with further literature emerging regarding its cardiac side-effect profile. The objective of this study was to investigate the association of remdesivir with bradycardia using a propensity score-matched analysis. Secondary outcomes included assessing in-patient mortality and hospital length of stay following remdesivir treatment for COVID-19. A single-institution retrospective study investigating treatment with and without remdesivir in 645 patients admitted for COVID-19 management was performed. Following treatment with remdesivir, patients were analyzed for episodes of bradycardia, defined in this study as 2 consecutive episodes of a heart rate <60 beats per minute. Matched cohorts were generated after controlling for potential confounders associated with remdesivir exposure. Subsequently, a propensity score-matched analysis was conducted to minimize selection bias and to account for the characteristics between the 2 comparison groups. In a sample of 645 COVID-19 patients, 58% were in the treatment group (Remdesivir+) and 42% were in the control group (Remdesivir-). 59% were males with a mean age of 57 ± 14.5 years. After propensity score matching, the remdesivir + group had a higher incidence of bradycardia (48.5% vs 30.7%, P = .028). The remdesivir + group was found to have a lower rate of in-patient mortality (1.0% vs 3.0% P < .001) and longer in-patient length of stay (13.7 vs 6.3 days, P < .001) compared to the remdesivir- group. Patients with COVID-19 had a greater prevalence of bradycardia following treatment with remdesivir. For these patients, remdesivir reduced in-patient mortality compared with untreated COVID-19 patients.

Objective: The Emotional Verbal Learning Test (ELVT) is a neuropsychological measure that assesses emotional learning and memory. The current study compared a Spanish (SPN) adaptation of the Emotional Verbal Learning Test (EVLT-S) with the original EVLT. Specifically, the number of words recalled in the learning trials in the four specific emotion categories (Happiness, Sadness, Anger, and Anxiety) were investigated to assess item equivalence. Method: Participants (N = 71) were recruited from the University of Nevada, Las Vegas for the piloting phase of the EVLT-S. Participants were administered a comprehensive battery of tests, including the EVLT, in either English (ENG) or SPN. The final sample consisted of 29 participants in the ENG group...