The first multicentre study on coronary anomalies in the Netherlands: MuSCAT

BackgroundCurrent guidelines on coronary anomalies are primarily based on expert consensus and a limited number of trials. A gold standard for diagnosis and a consensus on the treatment strategy in this patient group are lacking, especially for patients with an anomalous origin of a coronary artery from the opposite sinus of Valsalva (ACAOS) with an interarterial course.AimTo provide evidence-substantiated recommendations for diagnostic work-up, treatment and follow-up of patients with anomalous coronary arteries.MethodsA clinical care pathway for patients with ACAOS was established by six Dutch centres. Prospectively included patients undergo work-up according to protocol using computed tomography (CT) angiography, ischaemia detection, echocardiography and coronary angiography with intracoronary measurements to assess anatomical and physiological characteristics of the ACAOS. Surgical and functional follow-up results are evaluated by CT angiography, ischaemia detection and a quality-of-life questionnaire. Patient inclusion for the first multicentre study on coronary anomalies in the Netherlands started in 2020 and will continue for at least 3 years with a minimum of 2 years of follow-up. For patients with a right or left coronary artery originating from the pulmonary artery and coronary arteriovenous fistulas a registry is maintained.ResultsPrimary outcomes are: (cardiac) death, myocardial ischaemia attributable to the ACAOS, re-intervention after surgery and intervention after initially conservative treatment. The influence of work-up examinations on treatment choice is also evaluated.ConclusionsStructural evidence for the appropriate management of patients with coronary anomalies, especially (interarterial) ACAOS, is lacking. By means of a structured care pathway in a multicentre setting, we aim to provide an evidence-based strategy for the diagnostic evaluation and treatment of this patient group.Supplementary InformationThe online version of this article (10.1007/s12471-021-01556-9) contains supplementary material, which is available to authorized users.     

Response of Three Semi-Arid Plant Species to Fluoride; Consequences for Chlorophyll Florescence

The study was done to investigate the ability of three semi-arid plant species viz. Acacia tortilis, Cassia fistula and Prosopis juliflora to adapt to fluoride (F) stress. Here we examined the changes in activities of chlorophyll a fluorescence and photosynthetic pigment concentration during early growth of these plants. One month old plants were treated with 10, 20, and 50 mg kg^?1 F in soilrite. We did not observe any major change in photosynthetic performance of these plants during early growth. This was revealed by ETR, ETRmax, PPFD-sat and ΔF/Fm′-sat values which were higher in these plants. The decrease in chl a, chl b and total chl concentrations were significant only at 5 days. For most of the parameters, C. fistula was found to be more sensitive to F stress and P. juliflora showed least damage from F. The lesser inhibition in the parameters reflected the F tolerant nature of these plants with respect to photosynthesis. This opens the possibility of potential use of these species for treatment of F contaminated soil and water.