Automated quantification of coronary plaque on CT is feasible using dedicated quantitative software with a novel 3D registration algorithm.

No abstract

Highly pathogenic H5N1 avian influenza virus (A/H5N1) of clade 2.2.1 is endemic in poultry in Egypt where the highest number of human infections worldwide was reported. During the last 12 years the Egyptian A/H5N1 evolved into several genotypes. In 2007-2014 vaccinated poultry suffered from antigenic drift variants of clade 2.2.1.1 and in 2014/2015 an unprecedented upsurge of A/H5N1 clade 2.2.1.2 occurred in poultry and humans. Factors contributing to the endemicity or re-emergence of A/H5N1 in poultry in Egypt remain unclear. Here, three potential factors were studied: climatic factors (temperature, relative humidity, and wind speed), biological fitness in vitro, and pathogenicity in domestic Pekin and Muscovy ducks. Statistical analyses using negative binomial regression models indicated that ambient temperature in winter months influenced the spread of A/H5N1 in different geographic areas analyzed in this study. In vitro, at 4 and 56°C 2.2.1.1 and recent 2.2.1.2 viruses were more stable than other viruses used in this study. Further, Pekin ducks were more resistant than Muscovy ducks and the viruses were excreted for up to 2 weeks post-infection assuming a strong role as a reservoir. Taken together, ambient temperature in winter months potentially contributes to increasing outbreaks in some regions in Egypt. Heat stability of clade 2.2.1.1 and recent 2.2.1.2 viruses probably favors their persistence at elevated temperatures. Importantly, asymptomatically infected Pekin ducks may play an important role in the spread of avian and human-like A/H5N1 in Egypt. Therefore, control measures including targeted surveillance and culling of silently infected Pekin ducks should be considered.

Cardiac CT imaging showed good correlations for transmitral velocity, mitral septal tissue velocity, and estimation of LV filling pressures when compared with 2D echocardiography. Additionally, cardiac CT and 2D echocardiography were comparable for assessment of diastolic dysfunction. Accordingly, cardiac CT may provide information on diastolic dysfunction.

Background: Increased arterial stiffness is associated with cardiovascular morbidity and mortality among hypertensive patients. Objectives: To assess the relationship between ambulatory arterial stiffness index (AASI) and subclinical left ventricular (LV) systolic dysfunction assessed by 2-D speckle-tracking echocardiography (STE). Methods: We enrolled 70 consecutive patients with hypertension. All patients were evaluated for parameters of ambulatory blood pressure monitoring (ABPM) including AASI. From those patients, 51 underwent conventional echocardiography as well as 2-D STE to assess for subclinical LV systolic dysfunction defined by global longitudinal strain (GLS) and global circumferential strain (GCS). Results: The mean age of the patients (n = 51) was 46.3 ± 12.3 years, women represented 59%. Study population were divided into two groups according to blood pressure control as defined by ABPM; controlled (n = 23), and uncontrolled (n = 28). Baseline characteristics were comparable between both groups. There were significant differences in both daytime and night-time mean ABPM (P < 0.05). Posterior wall thickness, as well as LV relative wall thickness were significantly higher in uncontrolled patients (P < 0.05 for each). AASI was significantly, but moderately correlated to GLS. Most ABPM parameters were elevated with the higher AASI values (AASI ≥0.5). Significantly more uncontrolled hypertensive patients were encountered as well. Interestingly, sex and AASI were predictors of impaired GLS by univariate linear regression analysis; however, AASI was the only independent predictor of impaired GLS on multivariate analysis (Beta = 0.3, CI = 0.2--12, and P = 0.04). Conclusion: AASI might predict subclinical LV systolic dysfunction as assessed by global longitudinal strain. Further wide-scale studies should further explore this intriguing hypothesis.