In discordant subgroups of severe AS, the CF reclassified patients to moderate AS in 40% in the low flow (LF), low gradient (LG), and low ejection fraction (EF) group; 53% in the LF, LG, and normal EF group; and 68% in the LF, high gradient, and normal EF group. CONCLUSIONS CF of 1.13 derived from MDCTA improved the accuracy of TTE-derived LVOT area and AVA and improved correlation with hemodynamic variables in AS patients. Reclassification of AS patients using CF may have clinical applicability for patient selection for early intervention. © 2020 Wiley Periodicals, Inc.OBJECTIVES Inhomogeneity in the atrial conduction time is a predisposing factor for atrial fibrillation. The aim of our study was to determine the independent determinants of the left intra-atrial electromechanical delay (LIAEMD) as a marker of left atrial (LA) dyssynchrony in candidates for coronary artery bypass graft surgery (CABGS). METHODS This prospective cross-sectional study recruited 516 consecutive candidates for CABGS. Via the pulsed-wave tissue Doppler imaging modality in echocardiography, the times between the P wave and the peak of the a' wave at the septal and lateral mitral annuli were measured and the difference between these times was considered to be LIAEMD. Additionally, clinical and laboratory data on each patient were gathered. The odds ratio for an increased LIAEMD was calculated in patients with and without diabetes in univariate and multivariate analyses. RESULTS The multivariable analysis revealed that in the patients without diabetes, obesity, calcium-channel blocker usage, an increased maximal LA volume, and a decreased lateral e'/a' ratio and in the diabetic patients, diuretic usage and a decreased lateral e'/a' ratio were independently correlated with an increased likelihood of LIAEMD occurrence (P  less then  .05). CONCLUSIONS In our study on CABGS candidates, in the patients without diabetes, obesity, an increased maximal LA volume, calcium-channel blocker usage, and a decreased lateral e'/a' ratio and in the diabetic patients, diuretic usage and a decreased lateral e'/a' ratio independently determined increased LIAEMD. The prevention or treatment of factors that are detrimental to the LA electromechanical function may be helpful for the preservation of the LA electromechanical integrity. © 2020 Wiley Periodicals, Inc.OBJECTIVE We aimed to assess whether peritraumatic threat experienced during a period of armed conflict predicted subsequent depression symptoms. METHOD Ninety-six Israeli civilians provided real-time reports of exposure to rocket warning sirens and subjective sense of threat, twice daily for 30 days, during the 2014 Israel-Gaza conflict. Depression symptoms were reported 2 months after the conflict. Mixed-effects models were used to estimate peritraumatic threat levels and peritraumatic threat reactivity (within-person elevations in threat following siren exposure). These were then assessed as predictors of depression symptoms at 2 months in an adjusted regression model. RESULTS Individual peritraumatic threat level, but not peritraumatic threat reactivity, was a significant predictor of 2 months depression symptoms, even after controlling for baseline depression symptoms. CONCLUSIONS The findings imply that in situations of ongoing exposure, screening for perceived levels of peritraumatic threat might be useful in identifying those at risk for developing subsequent depression symptoms. © 2020 Wiley Periodicals, Inc.Analyzing the behavior of potential energy surfaces (PESs) of diabatic excited states (ESs) becomes of crucial importance for a complete understanding of complex photochemical reactions. Since the definition of a compact representation for the transition density matrix, the use of the natural transition orbitals (NTOs) has become a routine practice in time-dependent density functional theory calculations. Their popularity has remarkably grown due to its simple orbital description of electronic excitations. Indeed, very recently, we have presented a new formalism used for the optimization of ESs by tracking the state of interest computing the NTO's overlap between consecutive steps of the procedure. In this new contribution, we generalize the use of this NTO's overlap-based state-tracking formalism for the analysis of all the desired diabatic states along any chemical reaction pathway. Determining the PES of the different diabatic states has been automatized by developing an extension of our recently presented algorithm, the so-called SDNTO "Steepest Descent minimization using NTOs." This automatized overlap-based procedure allows an agile and convenient analysis of the evolution of the ESs avoiding the intrinsic ambiguity of visualizing orbitals or comparing physical observables. The analysis of two photochemical reactions of the same nature with different PES landscapes perfectly illustrates the utility of this new tool. © 2020 Wiley Periodicals, Inc.BACKGROUND Mechanical stress caused by blood flow, such as wall shear stress (WSS) and its related parameters, is key moderator of endothelial degeneration. However, an in vivo method to measure WSS on heart valves has not been developed. METHODS We developed a novel approach, based on vector flow mapping using intraoperative epi-aortic echocardiogram, to measure WSS and oscillatory shear index (OSI) on the aortic valve. We prospectively enrolled 15 patients with normal valves, who underwent coronary artery bypass graft. RESULTS Systolic WSS on the ventricularis (2.40 ± 0.44 Pa [1.45-3.00 Pa]) was higher than systolic WSS on the fibrosa (0.33 ± 0.08 Pa [0.14-0.47 Pa], P  less then  .001) and diastolic WSS on the ventricularis (0.18 ± 0.07 Pa [0.04-0.28 Pa], P  less then  .001). Oscillatory shear index on the fibrosa was higher than on the ventricularis (0.29 ± 0.04 [0.24-0.36] vs 0.05 ± 0.03 [0.01-0.12], P  less then  .001). A pilot study involving two patients with severe aortic regurgitation showed significantly different values in fluid dynamics. CONCLUSION Vector flow mapping method using intraoperative epi-aortic echocardiogram is an effective way of measuring WSS and OSI on normal aortic leaflet in vivo, allowing for better understanding of the pathophysiology of aortic valve diseases. ACY-241 datasheet © 2020 Wiley Periodicals, Inc.