Myocardial infarction (MI), one of the cardiovascular diseases (CVDs) with high incidence and mortality rate, seriously endangers human health. The poor ways of fully repairing and regenerating the infarcted myocardium may have an impact on peoples life quality, therefore scientists have devoted continuously to exploring the way of myocardial repair after MI so as to strive for a better prognosis of these patients. In recent years, non-coding RNAs (ncRNAs) have been identified and become one of the exciting fields of research in the development of CVDs. In a wide range of areas, more and more research has found that ncRNAs play important roles in myocardial repair. This review mainly introduces some strategies for myocardial repair and the role or mechanism of microRNA (miRNA), long non-coding RNA (lncRNA), circular RNA (circRNA) and circRNA/lncRNA-miRNA-mRNA regulatory axis in the repair of myocardial tissue after MI, in order to build a better understanding and find new therapeutic targets for MI.

Objective: We compared the long-term cossmposites of valve-related reoperation, morbidity and mortality following two types of mitral bioprostheses in young rheumatics aged <45 years. Methods: Retrospective comparative analysis of structural valve-related reoperations, and survival data were performed on 260 propensity matched patients, undergoing bioprosthetic MVR between 2000 and 2019, using Epic (Group I, n=130) or PERIMOUNT bioprostheses (Group II, n=130). Results: The median age was 34.5 (IQR: 28-39) and 34 (IQR: 29-40) years for group I and II respectively. Hazard regression for mortality included HR (95% CI) preoperative congestive heart failure (CHF) 4.70 (1.76-12.56), p=0.002; renal failure 66.91 (12.88-347.59), p<0.0001; low left ventricular ejection fraction <0.25, 3.76 (1.72-7.27), p=0.004; and valve-related reoperations 3.82 (1.81-9.56), p=0.001. Although the structural valve degeneration (SVD)-related reoperations were more among the perimount group, propensity score matching did not exhibit any difference between the groups [8.5% (Group I) vs 14.6% (Group II), SMD -0.23, p=0.5]. At a median follow-up of 134 (IQR: 99.5-178.5) months, actuarial survival was 96.36%±0.01% (93.11-98.10), and there was no difference in survival between the groups (Log rank p=0.70). Conclusions: Both Epic and PERIMOUNT mitral bioprostheses provide similar long-term clinical outcomes and are an appealing alternative to mechanical prosthesis in younger rheumatics.

Background Percutaneous coronary intervention (PCI) of lesions with heavily coronary artery calcium (CAC) still represents a challenge for interventionists, with increased risk of immediate complications, late failure due to stent underexpansion and malapposition, and consequently poor clinical outcome. In this focused review, we provide the summary of principles, technique and contemporary evidence for various existing and emergent plaque modifying strategies. Main text PCI of lesions with heavy CAC still poses a challenge for the interventionists due to an increased risk of incomplete lesion preparation with subsequent suboptimal stent deployment and higher rates of acute and chronic stent failure. With the emergence of many novel devices and technologies, the treatment of lesions with heavy CAC has become increasingly feasible, safe and predictable. It seems likely that combining enhanced intravascular imaging modalities with traditional or new dedicated tools for the treatment of such lesions grant better lesion preparation. This optimizes delivery and deployment of drug-eluting stents translating into improved patient outcome. Conclusion The lesions with significant CAC are likely to surge due to aging population and increased rates of diabetes and chronic renal disease. The optimal therapy for such lesions is multi-adjunctive and requires the availability of several modalities including intracoronary imaging which could impact the clinical outcome favourably.

Aim: Preprocedural imaging of the left atrial appendage (LAA) plays a crucial role in the process of LAA closure (LAAC). This study aimed to compare the influence of preprocedural planning of the LAAC with 3D-transesophageal echocardiography (TEE) and cardiac computed tomography (CCT) versus 3D-TEE alone in patients who underwent LAAC with an Amplatzer Cardiac Plug or Amulet. Materials and Methods: In a retrospective study, 176 patients received a preprocedural 3D-TEE and CCT and 167 patients a 3D-TEE only. Both groups had similar patient characteristics and indications for LAAC. Results: There was no difference in terms of procedural success, procedure time, amount of contrast medium, fluoroscopy time, or radiation dose. Patients with CCT/3D-TEE had a longer hospital stay on average. Besides, there was a different incidence of renal diseases (49% for 3D-TEE versus 27% for CCT/3D-TEE; p < 0.001). The number of periprocedural adverse events was comparable. A device-related thrombus occurred three times in each group, and the peri-device leaks reported were similar. Conclusion: A preprocedural CCT does not decrease major adverse events or improve outcome in patients undergoing LAAC.

Aim: We report our single-center experience with the retrieval and replacement of the chronically implanted Micra transcatheter pacing system (TPS). Material and Methods: We included 6 patients with an implanted the Micra TPSs who subsequently underwent transvenous method of retrieval at our institution. The indication for device retrieval was pacemaker syndrome in two patients, battery depletion in three patients, and need for upgrade to biventricular pacing in one patient. Results: After an implantation duration of 555 ± 373 days, the overall retrieval success rate was 83.3%, 5 of 6 patients. No procedure-related adverse device events occurred. In the single patient with unsuccessful retrieval, intracardiac echocardiography revealed that the Micra TPS was embedded within the cardiac wall and surrounding tissue. After retrieval, four patients received a new Micra TPS. Conclusions: Late retrieval of an implanted Micra TPS was safe and feasible, which indicates the possibility for their safe and elective replacement with a new leadless pacing device.