Purpose: Degenerative mitral stenosis (DMS) is an increasingly recognized cause of mitral stenosis. The goal of this study was to compare echocardiographic differences between DMS and rheumatic mitral stenosis (RMS), identify echocardiographic variables reflective of DMS severity, and propose a dimensionless mitral stenosis index (DMSI) for assessment of DMS severity. Methods: This is a single-center, retrospective cohort study. We included patients with at least mild MS and a mean transmitral pressure gradient (TMPG) [?] 4 mmHg. Mitral valve area by the continuity equation (MVACEQ) was used as an independent reference. The DMSI was calculated as follows: DMSI = VTILVOT / VTIMV. All-cause mortality data were collected retrospectively. Results: A total of 64 patients with DMS and 24 patients with RMS were identified. MVACEQ was larger in patients with DMS (1.43 ? 0.4 cm2) than RMS (0.9 ? 0.3 cm2) by~0.5 cm2 (p = <0.001) and mean TMPG was lower in the DMS group (6.0? 2 vs. 7.9?3 mmHg, p=0.003). A DMSI of ? 0.50 and [?] 0.351 were associated with MVACEQ [?] 1.5 and MVACEQ [?] 1.0 cm2 (p<0.001), respectively. With the progression of DMS from severe to very severe, there was a significant drop in DMSI. There was a non-significant trend towards worse survival in patients with MVACEQ [?] 1.0 cm2 and DMSI [?] 0.35, suggesting severe stenosis severity. Conclusion: Our results show that TMPG correlates poorly with MVA in patients with DMS. Proposed DMSI may serve as a simple echocardiographic indicator of hemodynamically significant DMS.

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Purpose: Degenerative mitral stenosis (DMS) is an increasingly recognized cause of mitral stenosis. The goal of this study was to compare echocardiographic differences between DMS and rheumatic mitral stenosis (RMS), identify echocardiographic variables reflective of DMS severity, and propose a dimensionless mitral stenosis index (DMSI) for assessment of DMS severity. Methods: This is a single-center, retrospective cohort study. We included patients with at least mild MS and a mean transmitral pressure gradient (TMPG) ≥4 mm Hg. Mitral valve area by the continuity equation (MVA CEQ) was used as an independent reference. The DMSI was calculated as follows: DMSI = VTI LVOT / VTI MV. All-cause mortality data were collected retrospectively. Results: A total of 64 patients with DMS and 24 patients with RMS were identified. MVA CEQ was larger in patients with DMS (1.43 ± 0.4 cm 2) than RMS (0.9 ± 0.3 cm 2) by ~0.5 cm 2 (P = <.001), and mean TMPG was lower in the DMS group (6.0 ± 2 vs 7.9 ± 3 mm Hg, P = .003). A DMSI of ≤0.50 and ≤0.351 was associated with MVA CEQ ≤1.5 and MVA CEQ ≤1.0 cm 2 (P < .001), respectively. With the progression of DMS from severe to very severe, there was a significant drop in DMSI. There was a nonsignificant trend toward worse survival in patients with MVA CEQ ≤1.0 cm 2 and DMSI ≤0.35, suggesting severe stenosis severity. Conclusion: Our results show that TMPG correlates poorly with MVA in patients with DMS. Proposed DMSI may serve as a simple echocardiographic indicator of hemodynamically significant DMS.

This case study describes the generation of a synthetic voice resembling that of an individual before she underwent a laryngectomy. Recordings of this person (6-7 min) speaking prior to the operation were used to create the voice. Synthesis was based on statistical speech models and this method allows models pre-trained on many speakers to be adapted to resemble an individual voice. The results of a listening test in which participants were asked to judge the similarity of the synthetic voice to the pre-operation (target) voice are reported. Members of the patient's family were asked to make a similar judgment. These experiments show that, for most listeners, the voice is quite convincing despite the low quality and small quantity of adaptation data.

Background and Aim: For successful radiofrequency ablation of atrioventricular nodal reentrant tachycardia (AVNRT), slow-pathway radiofrequency catheter ablation leads to junctional rhythm (JR) is now being considered as a very sensitive substitute end goal. During AVNRT RF ablation, a favorable result could be predicted based on the pattern of JR produced. Patients and Methods: This cross-sectional study was conducted on 64 patients presenting with symptomatic AVNRT and undergoing slow-pathway RF ablation in the Department of Cardiology, Hayatabad Medical Complex, Peshawar for the duration from January 2022 to June 2022. RF ablation of slow pathway was performed using a combined anatomical and electrogram mapping approach. Ablation was performed by controlling the temperature and delivering energy over 60 seconds at 60°C. In order to determine if the developed JR was successful, isoproterenol infusion was performed after every ablation pulse. Four different patterns of AVNRT inducibility were considered: intermittent, continuous, sparse, and transient. Position, pattern, and number of junctional beats were used to assess the success rate of ablation. SPSS version 28 was used for descriptive statistics. Results: Of the total patients, there were 36 (56.2%) women and 28 (43.8%) men. The overall mean age was 38.64 ± 18.36 years with an age range 16-80 years. The most prevalent symptom during AVNRT was palpitation found in 41 (64.1%) cases. The prevalence of pre-syncope, dyspnea, and syncope was 3.8%, 3.8%, and 3.4% respectively. The incidence of more than one symptoms were found in 21 (32.8%) patients. Almost all the patients displayed antegrade AH jumps and indicated dual AV nodal conduction. Out of total 156 RF, it took 114 (73.1%) RF energy applications to successfully ablate 38 (59.4%) patients with loss of AVNRT inducibility. About 126 (80.8%) patients developed JR with given specificity 42.6%, sensitivity 89.6%, and negative predictive value 61.8%. Conclusion: The present study found that the JR predicts the success of AVNRT RF ablation at a high level of sensitivity, but not to a specific degree. However, the findings indicate that its specificity may rise with the appearance of > 14 total tight junctions beats. Furthermore, if the forecast of effective slow-route RF ablation in relation to the existence of JR remains not consistent adequate, its absence might be a trustworthy marker of the pathway needing greater energy application delivery to be abolished. Keywords: Atrioventricular nodular re-entrant tachycardia (AVNRT), Slow pathway catheter ablation, Junctional rhythm, success rate