Left ventricle systolic function is an essential parameter in different clinical scenarios and the usual methods available for its assessment are sometime suboptimal, depending on the filling conditions of the heart. Therefore, the development and implementation in clinical practice of a new parameter for assessing left ventricle contractile function is desirable. Mechanical work defined as energy transferred to or from an object via the application of force along a displacement seems to be a promising method for myocardial performance estimation. Although initially this parameter was calculated on the left ventricle volume-pressure curve estimated by cardiac catheterization, an easier method considering non-invasive left ventricle pressure and global longitudinal strain assessed by speckle tracking echocardiography was developed recently. Myocardial work offers information regarding the segmental and global function of the left ventricle, and it is considered a more sensitive marker for assessing left ventricle performance compared to ejection fraction and global longitudinal strain. Its applicability in various cardiac pathologies was demonstrated recently in several studies and its use in every day practice may bring important additional information for clinical decision making.
The SARS-CoV-2 pandemic challenged the authorities into taking measures that limit the spread of the virus in the community. TAMEC project (Advanced Community Approaches to Epidemic Management) developed a system that detects the contacts of patients infected with the SARS-CoV-2 virus and alerts them using mobile applications. It allows real-time analysis of confirmed patients and identified contacts, early detection of new outbreaks, and provides decision- making information to prevent viral transmission. The system uses its patent for homomorphic encryption, a method that allows to process and manipulate data in an encrypted format, without having access to the original data. Thus, the solution proposed in the TAMEC project fully respects the privacy rules of citizens imposed by the EU, using the concept of privacy preservation. Our solution offers the possibility to identify and validate a risk score that could become an extremely helpful tool in the stratification of COVID-19 patients. The TAMEC system is innovative in its simplicity and ability to facilitate the prevention of the spread of the SARS-CoV-2 virus in the community
Background: Degenerative aortic stenosis (AS) and transthyretin cardiac amyloidosis (ATTR-CM), particularly wild-type ATTR (ATTRwt), are age-associated disorders that frequently converge in elderly patients. Their coexistence may obscure diagnosis, amplify heart-failure burden, and complicate risk stratification before and after aortic valve replacement. Methods: This narrative review was conducted using a structured literature search focused on ATTR-CM, AS, transcatheter aortic valve implantation/replacement (TAVI/TAVR), and nuclear cardiology. Priority was given to cohort studies, systematic reviews, consensus documents, and guideline statements. Main findings: Across observational cohorts and meta-analyses, ATTR-CM is consistently identified in a clinically meaningful minority of older patients with severe AS, especially among those referred for TAVI. Reported prevalence varies with age, referral pathway, diagnostic protocol, and whether equivocal grade 1 uptake is included, but most contemporary TAVI-oriented cohorts place definite ATTR-CM in the high single-digit to mid-teen percentage range. Clinical suspicion should increase in patients with disproportionate left-ventricular wall thickening, low-flow low-gradient AS, restrictive physiology, elevated cardiac biomarkers, conduction disease, atrial fibrillation, or extracardiac ATTR clues such as bilateral carpal tunnel syndrome. Conclusions: Bone-avid tracer scintigraphy with 99mTc-pyrophosphate, 99mTc-3,3-diphosphono-1,2-propanodicarboxylic acid, or 99mTc-hydroxymethylene diphosphonate, interpreted with SPECT or SPECT/CT and combined with mandatory exclusion of a monoclonal protein, enables robust non-biopsy diagnosis of ATTR-CM. In severe AS, nuclear diagnosis should be embedded in a pragmatic, multidisciplinary pathway that identifies patients likely to benefit from valve intervention, ATTR-specific therapy, genetic testing, and tailored follow-up.
