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The agm consists of just the vote count. Everyone knows no other slate of BOD was proposed prior to the meeting, so the incumbents were elected again. Is that enough excitement for you?
Your guesses are not interesting.
Explain how the sp today is diluting the company. Include an explanation of what your concept of dilution is because it will be interesting to hear since you don't know what it means.
All the videos they put out are paid so the interviewers don't really know anything new and just reiterate what we already know. I imagine the questions are rehearsed in advance.
Plant has been ordered and is expected to be running by June 30, is all anyone is going to hear unless they get ahead of schedule so it doesn't matter how many videos you watch, you won't learn anything new.
It is hilarious reading the disclaimer fppters that posters put on ihub. They must be afraid someone will mistake them for brokers, which happens to be illegal for them to post so can't happen anyway.
Today's news has a hidden gem, stating they are focusing on Western Canada which means the 80 is going to be sold there soon, otherwise why order 50 then 30? WC is a tiny market so if they can get 80 there you can see the overall potential.
1. The first order was 50 which was expanded to 80 so it must have worked pretty good initially. They upgraded the tester at some point after the 50, so perhaps it will take a few weeks to rebuild the initial ones up to the new standard.
They are bidding on some big projects but until the financing is ready for PIGCO then it looks like their November presentation won't be updated.
"A company that is healthy and doing things right wouldn’t be under this daily assault." That is a logical fallacy so I won't be able to respond to its circular claims other than to tell you that the plant hasn't arrived yet so whoever is assaulting should be booked for insanity and premature assault.
LOL, the other guy is claiming for the last year including recently that you need to look at the chart because he says it proves ETI will go up. So maybe both of you should avoid rocket science.
You don't work at the company. Did you get some negative information from a street beggar or just make up your own?
CEO got 2M shares in the market now.
None of that $30B was reserved for dead tech though and since MZEI is gone is only useful for an unsupportable theory. Here is a modern day company heading into that market in the next few years. https://investorshub.advfn.com/boards/read_msg.aspx?message_id=146601168
Jan 30 cc and presentation shows the potential markets. Just sign into it and you end up with the archive. https://edge.media-server.com/m6/p/rzpqebyy
This goes into item 2 category. imo. https://investorshub.advfn.com/boards/read_msg.aspx?message_id=146576117
There are 2 kinds of denial on this board.
1. Those who claim EM is responsible for the demise of a "great tech' that would have been a slam dunk with proper management.
Reality is the tech is dead today so caring about his life is irrelevant.
2. Those who claim there was no potential tech value in the past and that EM knew it and was responsible for scamming people into believing otherwise. Reality is there might have been some possible value waaaaaaaaaaayyyyyyyyyyyy back then but no one will ever know so it is time to move on.
You would think they also had $500k to spend on MZEI if it was a competitor with any value.
That is because the plant update doesn't make the news until next quarter. Until then investor interest is just a bunch of chart watchers and people who think volumes make a company tick.
The competitor disinfection and sterilization companies know more than shareholders and they say it is worth nothing. There is no scam, just investors who took the wrong chance but still live in denial.
EM likely lost his money paying $500k for this too.
There was no product that could make money. The competitors would know, and they wouldn't take it when it was offered basically free.
For one thing, it is 2019 so there are no MZEI investors for anything to be relevant to.
Second killer is no competitor even wanted the tech so all that crying that management did you wrong is denial.
Whatever you are objecting to has no relevance to investors.
But they wouldn't be jumping into a MZEI purchase, even if you continued your successful CEO social networking marketing program.
You should have taken your purchase orders to Shark tank for full value.
MZEI shares are 100% dead and the funeral is over, so you have to accept that and move on to something that is alive. Living in the past trying to pretend there is hope is just wasting time.
It would be quite stupid to do social media marketing since they didn't have an approved product.
Do you think a hospital cares in the slightest about unapproved wanna-be devices? You think they have people with nothing to do all day but study social media to debate the ongoing progress of companies tied up in regulatory with an unproven novel product?
However, you are interchanging hospitals with competitors so your claim is irrelevant to my previous point. Competitors are the people who know the value of MZEI and it is a fact that they valued it at zero, otherwise they would have bid.
You saw the list. It is denial to claim the sale was a secret - most if not all companies in sterilization and disinfection not on the list would be aware of a public company this old in their space.
Sarcoidosis market in Canada: At least 13 sites minimum
Timing couldn't be better for VPT.
That's also an important market, by taking a look just at the canadian sites that could buy our technology.
At the bottom of this clinical trial record (below), you'll find all the canadian multi-sites (13) that participate in this related Sarcoidosis trial lead by the Ottawa Heart Institute.
The the Ottawa Heart Institute seems to be clearly THE expert in Canada and by looking at this trial, VPT's technology clearly comes answer a need:
Cardiac Sarcoidosis Multi-Center Prospective Cohort - Full Text View - ClinicalTrials.gov
ClinicalTrials.gov Identifier: NCT01477359
Recruitment Status : Recruiting
First Posted : November 22, 2011
Last Update Posted : September 19, 2018
Study Design:
Study Type : Observational
Estimated Enrollment : 1500 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Cardiac Sarcoidosis Multi-Center Prospective Cohort Study
Study Start Date : August 2012
Estimated Primary Completion Date : December 2025
Estimated Study Completion Date : December 2025
Study Description
Brief Summary:
Recent data has shown that sarcoidosis, presenting initially with cardiac manifestations (CS) of either conduction system disease or cardiomyopathy and sustained VT, is not uncommon.
A Canadian physician survey found that most physicians do not investigate for CS as a possibility in these situations. Thus many patients with clinically important CS are going un-diagnosed. A study from Finland showed that missing the diagnosis of CS in these patients' leads to significant mortality and morbidity.
There are no published clinical consensus guidelines on treatment of CS. Corticosteroid therapy is advocated by most experts. This is based on very modest data from small retrospective observational studies using variable definitions of clinical response. The effect of corticosteroid treatment on the clinical course of CS has not been studied in prospective studies and will be one of the aims of this project. Recent physician surveys regarding CS, in Canada and the US, found that current clinical practice varies widely. The 2008 American College of Cardiology/American Heart Association/Heart Rhythm society guidelines recommend implantation of a defibrillator (Class IIa recommendation) to prevent sudden cardiac death. The most recent Canadian device therapy guidelines do not mention CS.
A multi-center collaborative approach to study CS is greatly needed." The investigators propose exactly that i.e. a multi-center prospective cohort to start to answer clinical questions. The investigators have formed the CANADIAN CARDIAC SARCOIDOSIS RESEARCH GROUP. The group includes respirologists with an interest in sarcoidosis, cardiac electrophysiologists, cardiac imaging specialists with extensive experience in imaging of sarcoidosis and biostatisticians. The research will be in two phases; a registry of current diagnostic approaches, treatment and prognosis, and a randomized clinical trial of the effect of corticosteroid treatment on the clinical course of cardiac sarcoidosis.
Detailed Description:
Baseline assessment of Clinically Manifest CS patients consists of: history, echocardiogram, ECG, chest CT scan, FDG-PET scan, blood for biomarkers within 2 months of the PET scan, cardiac MRI and possibly a signal average ECG and biopsy (encouraged-either endomyocardial or extra-cardiac).
Follow-up and clinical management of clinically manifest patients diagnosed with CS will occur at 3-6 months with a repeat FDG-PET scan and blood biomarkers. Follow-up will then be annually with an echo and ECG. Treatment with steroids/immunosuppressants and device therapy will be at the discretion of the treating physician.
Baseline assessment of patients diagnosed with extra-cardiac sarcoidosis and being screened for CS consists of: history, echocardiogram, ECG, holter, chest CT scan, biopsy, and cardiac MRI (CMR). If the CMR is suggestive of CS the patient will be have a FDG-PET scan done and be followed as a Clinically Silent patient. They will be contacted every 2 years. If the CMR is negative the patient will be followed as a extra-cardiac sarcoidosis patient with no evidence of CS and be in the control group. They will be contacted at 5 years and at the time of study completion.
All patients will be followed until the last patient recruited has been followed for 4 years.
The occurrence of the primary and secondary outcomes will be assessed in treated and untreated patients.
There will be 2 imaging core labs. The PET core lab will be located at UOHI under the direction of Dr. Robert Beanlands. The CMR core lab will be under the direction of Dr. Mathias Friedrich (McGill University). All scans will be read in the core labs by physicians who are blinded to the clinical details of the patients.
The Biomarker core lab will be at The University of Ottawa Heart Institute under the leadership of Dr P Liu.
Sarcoidosis Pulmonary Hypertension News
With that latest indication (Sarcoidosis), they clearly now have 2 solid selling arguments in our favors to have cardiology sites buy their technology:
- MRI equivalent accuracy for the whole heart
- ability to diagnose Sarcoidosis
That should sells like hotcakes.
This 2014 paper showed that back then, they had to rely on MRI for patients with Sacroidosis condition. Knowing that we have MRI-equivalent accuracy and that are operational costs are much lower ... investing in VPT technology sounds like a no-brainer.
Magnetic Resonance Imaging for Identifying Patients With Cardiac Sarcoidosis and Preserved or Mildly Reduced Left Ventricular Function at Risk of Ventricular Arrhythmias
2014
Background—The purpose of this study was to assess whether delayed enhancement (DE) on MRI is associated with ventricular tachycardia (VT)/ventricular fibrillation or death in patients with cardiac sarcoidosis and left ventricular ejection fraction >35%.
Methods and Results—Fifty-one patients with cardiac sarcoidosis and left ventricular ejection fraction >35% underwent DE-MRI. DE was assessed by visual scoring and quantified with the full-width at half-maximum method. The patients were followed for 48.0±20.2 months. Twenty-two of 51 patients (63%) had DE. Forty patients had no prior history of VT (primary prevention cohort). Among those, 3 patients developed VT and 2 patients died. DE was associated with risk of VT/ventricular fibrillation or death (P=0.0032 for any DE and P<0.0001 for right ventricular DE). The positive predictive values of the presence of any DE, multifocal DE, and right ventricular DE for death or VT/ventricular fibrillation at mean follow-up of 48 months were 22%, 48%, and 100%, respectively. Among the 11 patients with a history of VT before the MRI, 10 patients had subsequent VTs, 1 of whom died.
Conclusions—RV DE in patients with cardiac sarcoidosis is associated with a risk of adverse events in patients with cardiac sarcoidosis and preserved ejection fraction in the absence of a prior history of VT. Patients with DE and a prior history of VT have a high VT recurrence rate. Patients without DE on MRI have a low risk of VT. (Circ Arrhythm Electrophysiol. 2014;7:1109-1115.)
MRI and Outcomes in Cardiac Sarcoidosis
...
Methods:
Multicenter Registry for Cardiac Sarcoidosis:
A multicenter registry for the purpose of research collaboration of this rare disease was established, with the University of Michigan serving as the coordinating center for this study
Cardiac MRI:
All patients underwent cardiac MRI ...
Data Analysis:
All DE-MRI images were analyzed off-line
sarcoidosis CLINICAL PERSPECTIVE
Patients with cardiac sarcoidosis are at risk of ventricular arrhythmias and death, leading to a class IIa indication for implantable cardioverter defibrillator implantation according to expert consensus in the ACC/AHA/HRS guidelines for prevention of sudden cardiac death. However, implantable cardioverter defibrillators are associated with life-long device-related morbidity and may not be beneficial in many patients, especially those with relatively preserved left ventricular function. The relation of scar burden assessed from delayed gadolinium enhancement (DE) on cardiac MRI to ventricular tachycardia (VT) and mortality was studied in 51 patients with cardiac sarcoidosis and left ventricular ejection fraction of >35%. Among 40 patients with no prior history of VT, 3 developed VT and 2 died; all but 1 had DE, and the extent and right ventricular DE appeared to be associated with greatest risk. All patients with a history of VT had DE and 10 of 11 had recurrent VT. The presence of a low scar burden determined by DE was not associated with adverse outcomes. These findings suggest that DE-MRI may be useful for risk stratification in patients with cardiac sarcoidosis.
___________________
With that latest indication (Sarcoidosis), they clearly now have 2 solid selling arguments in our favors to have cardiology sites buy their technology:
- MRI equivalent accuracy for the whole heart
- ability to diagnose Sarcoidosis
That should sells like hotcakes.
This 2014 paper showed that back then, they had to rely on MRI for patients with Sacroidosis condition. Knowing that we have MRI-equivalent accuracy and that are operational costs are much lower ... investing in VPT technology sounds like a no-brainer.
Magnetic Resonance Imaging for Identifying Patients With Cardiac Sarcoidosis and Preserved or Mildly Reduced Left Ventricular Function at Risk of Ventricular Arrhythmias
2014
Background—The purpose of this study was to assess whether delayed enhancement (DE) on MRI is associated with ventricular tachycardia (VT)/ventricular fibrillation or death in patients with cardiac sarcoidosis and left ventricular ejection fraction >35%.
Methods and Results—Fifty-one patients with cardiac sarcoidosis and left ventricular ejection fraction >35% underwent DE-MRI. DE was assessed by visual scoring and quantified with the full-width at half-maximum method. The patients were followed for 48.0±20.2 months. Twenty-two of 51 patients (63%) had DE. Forty patients had no prior history of VT (primary prevention cohort). Among those, 3 patients developed VT and 2 patients died. DE was associated with risk of VT/ventricular fibrillation or death (P=0.0032 for any DE and P<0.0001 for right ventricular DE). The positive predictive values of the presence of any DE, multifocal DE, and right ventricular DE for death or VT/ventricular fibrillation at mean follow-up of 48 months were 22%, 48%, and 100%, respectively. Among the 11 patients with a history of VT before the MRI, 10 patients had subsequent VTs, 1 of whom died.
Conclusions—RV DE in patients with cardiac sarcoidosis is associated with a risk of adverse events in patients with cardiac sarcoidosis and preserved ejection fraction in the absence of a prior history of VT. Patients with DE and a prior history of VT have a high VT recurrence rate. Patients without DE on MRI have a low risk of VT. (Circ Arrhythm Electrophysiol. 2014;7:1109-1115.)
MRI and Outcomes in Cardiac Sarcoidosis
...
Methods:
Multicenter Registry for Cardiac Sarcoidosis:
A multicenter registry for the purpose of research collaboration of this rare disease was established, with the University of Michigan serving as the coordinating center for this study
Cardiac MRI:
All patients underwent cardiac MRI ...
Data Analysis:
All DE-MRI images were analyzed off-line
sarcoidosis
Right ventricular involvement in cardiac sarcoidosis ...
Definitively, we'll be in a very solid position to displace MRI for that condition.
One more study that showed that until today, MRI was THE technology.
Not anymore. ...
Note this special passage:
Until recently, limited attention has been given to right ventricular involvement in cardiac sarcoidosis, its prevalence, relevance, and prognostic value. Cardiac magnetic resonance imaging is the preferred imaging tool to evaluate the healthy and diseased right ventricle.
Right ventricular involvement in cardiac sarcoidosis demonstrated with cardiac magnetic resonance (MRI)
First published: 06 June 2017
Smedema JP1, van Geuns RJ2, Ainslie G3, Ector J4, Heidbuchel H5, Crijns HJGM1.
Author information
1
Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
2
Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
3
Respiratory Clinic, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa.
4
Department of Cardiology, University Hospitals Gasthuisberg, Leuven, Belgium.
5
University of Hasselt Heart Centre, Virga Jessa Hospital, Hasselt, Belgium.
Abstract
Aims
Cardiac involvement in sarcoidosis is reported in up to 30% of patients. Left ventricular involvement demonstrated by contrastenhanced cardiac magnetic resonance has been well validated. We sought to determine the prevalence and distribution of right ventricular late gadolinium enhancement in patients diagnosed with pulmonary sarcoidosis.
Methods and results
We prospectively evaluated 87 patients diagnosed with pulmonary sarcoidosis with contrastenhanced cardiac magnetic resonance for right ventricular involvement. Pulmonary artery pressures were noninvasively evaluated with Doppler echocardiography. Patient characteristics were compared between the groups with and without right ventricular involvement, and right ventricular enhancement was correlated with pulmonary hypertension, ventricular mass, volume, and systolic function. Left ventricular late gadolinium enhancement was demonstrated in 30 patients (34%). Fourteen patients (16%) had right ventricular late gadolinium enhancement, with sole right ventricular enhancement in only two patients. The pattern of right ventricular enhancement consisted of right ventricular outflow tract enhancement in 1 patient, free wall enhancement in 8 patients, ventricular insertion point enhancement in 10 patients, and enhancement of the right side of the interventricular septum in 11 patients. Pulmonary arterial hypertension correlated with the presence of right ventricular enhancement (P < 0.001). Right ventricular enhancement correlated with systolic ventricular dysfunction (P < 0.001), hypertrophy (P = 0.001), and dilation (P < 0.001).
Conclusions
Right ventricular enhancement was present in 16% of patients diagnosed with pulmonary sarcoidosis and in 48% of patients with left ventricular enhancement. The presence of right ventricular enhancement correlated with pulmonary arterial hypertension, right ventricular systolic dysfunction, hypertrophy, and dilation.
Introduction
Sarcoidosis is a rare, inflammatory condition, resulting from an uncontrolled cellular inflammatory response in genetically predisposed individuals, which affects the heart in approximately a third of patients.1 Left ventricular involvement demonstrated by contrastenhanced cardiac magnetic resonance has been well validated.2 Until recently, limited attention has been given to right ventricular involvement in cardiac sarcoidosis, its prevalence, relevance, and prognostic value.3 Cardiac magnetic resonance imaging is the preferred imaging tool to evaluate the healthy and diseased right ventricle.4, 5 Right ventricular volumes, mass, and function can be quantified without geometric assumptions and excellent intraobserver and interobserver agreement and interstudy reproducibility.4-6 Delayed contrastenhanced magnetic resonance allows for the detection and quantification of focal scar and interstitial fibrosis. Although there are numerous reports on delayed contrastenhanced cardiac magnetic resonance delineating left ventricular sarcoidosis, relatively few studies have reported on right ventricular involvement.3, 7-10 We sought to determine the prevalence and distribution of right ventricular late gadolinium enhancement in patients diagnosed with pulmonary sarcoidosis and determine the relationship with pulmonary hypertension, ventricular volume, mass, and systolic function.
Methods
Patient selection
Between July 2001 and March 2014, we enrolled 87 consecutive patients with histologically proven pulmonary sarcoidosis. Cardiac evaluation was performed because of symptoms or routine screening to exclude cardiac involvement. Patients were excluded when the standard contraindications for contrastenhanced cardiac magnetic resonance existed. Institutional Review Board approval was obtained for this study.
Baseline investigations
Baseline investigations included 12lead electrocardiography, Doppler echocardiography, and contrastenhanced cardiac magnetic resonance.
Cardiac magnetic resonance protocol and analysis
Studies were performed using a commercial 1.5 T scanner with a cardiacdedicated phasedarray coil. The cardiac magnetic resonance studies were electrocardiographically triggered by standard software.
Sarcoidosis Recognition of Early Cardiac Involvement in Systemic Sarcoid
Another recent study (2017) that was using cardiac MRI to detect Sarcoidosis.
So it sounds VPT will offer a very interesting alternative to MRI in terms of technology, cost and accuracy.
Original Research
Cardiac Imaging
T1 and T2 Mapping in Recognition of Early Cardiac Involvement in Systemic Sarcoidosis
Valentina O. Puntmann , Alexander Isted, Rocio Hinojar, Lucy Foote, Gerald Carr-White, Eike Nagel
Author Affiliations
From the Department of Cardiology, Guy’s and St Thomas’ NHS Trust, London, England (V.O.P., A.I., R.H., L.F., G.C., E.N.); Institute of Experimental and Translational Cardiovascular Imaging, DZHK Centre for Cardiovascular Imaging, Goethe University Hospital Frankfurt, Theodor-Stern-Kai 7, Frankfurt am Main 60590, Germany (V.O.P., E.N.); Department of Cardiology, Goethe University Hospital Frankfurt, Frankfurt am Main, Germany (V.O.P.); Department of Cardiovascular Imaging, King’s College London, St. Thomas’ Hospital, London, England (V.O.P.); Ramn y Cajal University Hospital, University of Alcal, Madrid, Spain (R.H.); and King’s College Hospital NHS Trust, Denmark Hill, London, England (G.C.).
Address correspondence to V.O.P. (email: vppapers@icloud.com).
Published Online: Apr 27, 2017
https://doi.org/10.1148/radiol.2017162732
Abstract
Purpose
To determine whether quantitative tissue characterization with T1 and T2 mapping supports recognition of myocardial involvement in patients with systemic sarcoidosis.
Materials and Methods
Fifty-three consecutive patients with a biopsy-proven extracardiac diagnosis of systemic sarcoidosis (21 men; median age, 45 years; interquartile range, 22 years) and 36 normotensive previously healthy control subjects (14 men; median age, 43 years; interquartile range, 18 years) underwent cardiovascular magnetic resonance imaging, which was performed to assess cardiac function and late gadolinium enhancement, and T1 and T2 mapping. A follow-up substudy was performed in 40 patients (mean follow-up interval, 144 days ± 35 [standard deviation]); of these 40 patients, 18 underwent anti-inflammatory treatment for systemic symptoms. Binary logistic regression and receiver operating characteristic curve analyses were used to assess discrimination between health and disease; Wilcoxon signed rank test was used to assess the effect of treatment.
Results
When compared with control subjects, patients had higher ventricular volume, higher myocardial native T1 and T2, and lower longitudinal strain and ejection fraction (P < .05 for all). Myocardial native T1 and T2 had higher discriminatory accuracy (area under the receiver operating characteristic curve [AUC]: 0.96 and 0.89, respectively) for separation between control subjects and patients when compared with the standard diagnostic criteria (AUC < 0.67). Native T1 was the independent discriminator between health and disease (specificity, 90%; sensitivity, 96%; accuracy, 94%). There was a significant reduction of native T1 and T2 in the patients who underwent treatment (z score: -3.72 and -2.88; P < .01) but not in the patients who did not (z score, -1.42 and -1.38; P > .15).
Conclusion
Quantitative myocardial tissue characterization with T1 and T2 mapping may enable noninvasive recognition of cardiac involvement and activity of myocardial inflammation in patients with systemic sarcoidosis. Future studies will be performed to confirm their role in risk stratification and guidance of clinical management.
Introduction
Systemic sarcoidosis is a chronic systemic inflammatory condition that is histologically characterized by noncaseating granulomatous tissue infiltration (1,2). Most patients present with systemic symptoms and signs of disease due to involvement of the pulmonary system or skin. Clinical symptoms due to cardiac involvement are rare and manifest in only those patients with advanced disease in the form of heart failure and arrhythmia (3,4). The predominantly subclinical inflammatory myocardial involvement poses an overall challenge to disease recognition and treatment (5,6).
Two sets of diagnostic criteria have evolved to provide a pathway for recognition of cardiac involvement in the presence of known systemic disease (7). The 1993 Japanese Ministry of Health and Welfare (JMHW) guidelines (summarized in Appendix E1 [online]) (7–9) integrated findings of multiple cardiac diagnostic tests, including electrocardiography and a dedicated cardiac imaging study (echocardiography, radionuclide scintigraphy, or cardiac catheterization). These later evolved into 2014 Heart Rhythm Society (HRS) expert consensus criteria by including cardiovascular magnetic resonance (MR) imaging based on the visualization of regional myocardial scarring at late gadolinium enhancement (LGE) (Figs 1,2) (8,10–12). These cardiac diagnostic tests rely on detection of gross and advanced abnormalities of structure and function. As such, they are insensitive to the myocardial inflammatory tissue process, precluding early recognition of disease and disease activity. Quantitative tissue characterization imaging with T1 and T2 mapping enables detection of myocardial inflammation by directly relating to the altered magnetization properties (reviewed by Puntmann et al [13]). We and others have shown that T1 and T2 mapping values correlate with histologic evidence of myocardial inflammation, severity of left ventricular (LV) remodeling and longitudinal strain, and activity of myocardial inflammation in patients with other systemic inflammatory conditions (14–18). Quantitative tissue characterization with T1 and T2 mapping may support recognition of myocardial involvement in patients with systemic sarcoidosis.
A total of 13 patients underwent endomyocardial biopsy independently of the cardiovascular MR imaging findings by using the right ventricular approach; 11 subjects showed nonspecific chronic inflammatory infiltrate, and eight had evidence of chronic inflammation with noncaseating granulomas (4). All 13 patients with endomyocardial biopsy had abnormal native T1 (22) and evidence of LGE.
Management of sudden cardiac death in cardiac sarcoidosis
Additional cardiologists that could be targeted by the marketing team to create awareness of our technology ...
Management of sudden cardiac death in cardiac sarcoidosis using the wearable cardioverter defibrillator
Dirk Skowasch (Email: Dirk.Skowasch@ukb.uni-bonn.de)
Georg Nickenig,
Ren Andri
Department of Internal Medicine II, Division of Cardiology and Pneumology, University of Bonn, Bonn, Germany
Published: March 22, 2018
Abstract
Background
Patients with cardiac sarcoidosis are at increased risk of ventricular achycardia/fibrillation.
Objective
We tested the hypothesis that the wearable cardioverter defibrillator can be used to mitigate the risk of sudden cardiac death among cardiac sarcoidosis patients.
Methods
A retrospective review of the commercial database identified cardiac sarcoidosis patients who wore the wearable cardioverter defibrillator. Evidence for cardiac sarcoidosis diagnosis as well as demographic, co-morbidity and left ventricular ejection fraction were provided by patient clinical records. Clinical data also included daily wearable cardioverter defibrillator wear, shock treatment and survival information.
Results
The wearable cardioverter defibrillator was worn by 46 cardiac sarcoidosis patients, 24 (52%) male. The median age was 48 years and median left ventricular ejection fraction was 30%. The wearable cardioverter defibrillator was worn a median of 23.6 hours each day. There were 11 ventricular tachycardia/fibrillation episodes occurring in 10 (22%) patients. Ventricular tachycardia/fibrillation occurred over a range of 1 to 79 days, median 24 days. First-shock success for conversion of ventricular tachycardia/fibrillation was 100%. Patient survival 24 hours after shock treatment was 100%. Follow up to determine the reason for discontinuing wearable cardioverter defibrillator use indicated that among shocked patients 7 received an implantable cardioverter defibrillator, 1 patient was admitted to the hospital ending in death 2 weeks after discontinuing wearable cardioverter defibrillator use, and 2 patients were lost to follow up. Among the not shocked patients, there were 16 who received an implantable cardioverter defibrillator while 7 achieved improved left ventricular ejection fraction.
Conclusion
Management of sudden cardiac death among cardiac sarcoidosis patients was aided by the wearable cardioverter defibrillator resulting in successful termination of ventricular tachycardia/fibrillation upon delivery of shock.
Sarcoidosis: Current Concepts, Research Imperative
Additional sarcoidosis experts from 4 major institutions that could be targeted by VPT's sales/marketing team as they're all using MRI for the moment.
High-Risk Sarcoidosis. Current Concepts and Research Imperatives (2017)
William H. Sauer1, Barney J. Stern 2*, Robert P. Baughman 3, Daniel A. Culver 4, and Walter Royal 2
-Author Affiliations:
Corresponding Author: William H. Sauer
1University of Colorado School of Medicine, Denver, Colorado
2University of Maryland School of Medicine, Baltimore, Maryland
3University of Cincinnati School of Medicine, Cincinnati, Ohio; and
4Cleveland Clinic Foundation, Cleveland, Ohio
Dec 01, 2017
https://doi.org/10.1513/AnnalsATS.201707-566OT PubMed: 29073361
Pulmonary Hypertension
Sarcoidosis-associated pulmonary hypertension has a reported prevalence of 5 to 10% among all patients with sarcoidosis (21), but the prevalence exceeds 50% in patients with persistent dyspnea (22, 23) and in cases severe enough to warrant lung transplantation (24). The detection of pulmonary hypertension in sarcoidosis is often elusive because of the nonspecific presenting symptoms (e.g., exertional dyspnea). Although transthoracic echocardiography may be a useful screening tool, it is inaccurate in many patients with sarcoidosis-associated pulmonary hypertension (25, 26), and other factors, including exertional hypoxemia, may be used to screen for this entity (21). Table 2 lists some of the features that have been associated with the presence of pulmonary hypertension in patients with pulmonary sarcoidosis, but it requires further validation. Some of the features, such as persistent dyspnea, reduced DlCO, and reduced 6-minute-walk distance, may be due to underlying lung disease. However, it has been found that the presence of these features is more common in patients with sarcoidosis with pulmonary hypertension and should warrant further consideration. The definitive test is the right heart catheterization, which should be considered in patients with sarcoidosis with one or more of the features listed in the table. Other objective methods to detect sarcoidosis-associated pulmonary hypertension include determining the ratio of the diameter of the main pulmonary artery to aorta (27). Cardiac magnetic resonance imaging (MRI) may also provide insight into right ventricular function. Although these noninvasive approaches are effective for screening, it is often necessary to perform invasive hemodynamic monitoring to accurately characterize pulmonary hypertension associated with sarcoidosis to guide therapeutic interventions. Future studies may obviate the need for invasive monitoring by better establishing the correlations between noninvasive techniques (e.g., transthoracic echocardiography and cardiac MRI) and through the further development of emerging imaging technology (e.g., myocardial strain detection) (28).
The crew managed a dead company. That which is dead cannot live again, or be on the cusp of accomplishment.
Competitors weren't interested in bidding $500k for it.
I have the same ownership of MZEI as you have - zero.
There are easier ways to make money than investing in novel products with a big market capitalization that don't even have regulatory approval so that is why I stayed away. You can buy medical device companies with approval that have low market caps today.
More GA email.
Lots of news coming next week.
Marketing campaign to sarcoidosis doctors going well with 170 reading the promotional materials and requesting additional information.
PH News helped as well.
Some people never realize that traders don't make company news or know it is advance.
One can only hope that most people are able to focus on their own lives instead of wasting them dreaming of courts "questioning office space".
Your charts for ETI and MWX have been 100% wrong for the last 12 months, so their value is zero. Only news moves stocks, and no one knows which day the important news will come out. We only know that the BC plant will be at full production and making money before July, so it might take that long before people believe in these companies.
You can privately sell them to anyone at arm's length for $1 to claim your loss, if you have a signed and dated agreement. IRS isn't going to accept a claim for a loss when you still own them, otherwise people would claim deemed losses with any stock that is down, which would create a murky audit trail.
Broken link. After it gets fixed, please delete this post. Their site says sometimes the error is on their part and will get fixed later.
Another big US acquisition of PIGCO makes CVX more US than Cdn, so it is going to get more US trading after this deal goes past the LOI stage.