Background: Endoscopy within 24 h of admission (early endoscopy) is a quality standard in acute upper gastrointestinal bleeding (AUGIB). We aimed to audit time to endoscopy outcomes and identify factors affecting delayed endoscopy (>24 h of admission). Methods: This prospective multicentre audit enrolled patients admitted with AUGIB who underwent inpatient endoscopy between November and December 2017. Analyses were performed to identify factors associated with delayed endoscopy, and to compare patient outcomes, including length of stay and mortality rates, between early and delayed endoscopy groups. Results: Across 348 patients from 20 centres, the median time to endoscopy was 21.2 h (IQR 12.0-35.7), comprising median admission to referral and referral to endoscopy times of 8.1 h (IQR 3.7-18.1) and 6.7 h (IQR 3.0-23.1), respectively. Early endoscopy was achieved in 58.9%, although this varied by centre (range: 31.0-87.5%, p ¼ 0.002). On multivariable analysis, lower Glasgow-Blatchford score, delayed referral, admissions between 7:00 and 19:00 hours or via the emergency department were independent predictors of delayed endoscopy. Early endoscopy was associated with reduced length of stay (median difference 1 d; p ¼ 0.004), but not 30-d mortality (p ¼ 0.344). Conclusions: The majority of centres did not meet national standards for time to endoscopy. Strategic initiatives involving acute care services may be necessary to improve this outcome.

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T ranscatheter aortic valve implantation (TAVI) is as an effective treatment alternative for patients with severe aortic stenosis who are either inoperable or high risk, for surgical aortic valve replacement (AVR).1,2 Several short-term 3 and medium-term 4 outcome studies have consistently demonstrated good clinical outcomes after TAVI, findings that have been reinforced by more recent long-term follow-up data. 5,6 As a result, the number of TAVI implants performed worldwide continues to grow year on year. Several imaging techniques can be used to assess whether a patient is suitable for TAVI 8 ; echocardiography remains the fundamental method of assessing the severity of aortic valve disease, permitting measurements of left ventricular (LV) and right ventricular (RV) functions, aortic valve area (AVA), mean and peak pressure gradients across the aortic valve, and myocardial mass.9 Two other imaging modalities are widely used in the preassessment of potential TAVI patients: multislice computerized tomography, which provides information on aortic annular Background-Cardiovascular magnetic resonance (CMR) can provide important structural information in patients undergoing transcatheter aortic valve implantation. Although CMR is considered the standard of reference for measuring ventricular volumes and mass, the relationship between CMR findings of right ventricular (RV) function and outcomes after transcatheter aortic valve implantation has not previously been reported. Methods and Results-A total of 190 patients underwent 1.5 Tesla CMR before transcatheter aortic valve implantation.Steady-state free precession sequences were used for aortic valve planimetry and to assess ventricular volumes and mass.