Mitral annular disjunction in idiopathic ventricular fibrillation patients: just a bystander or a potential cause?

AIMS: Previously, we demonstrated that inferolateral mitral annular disjunction (MAD) is more prevalent in patients with idiopathic ventricular fibrillation (IVF) than in healthy controls. In the present study, we advanced the insights into the prevalence and ventricular arrhythmogenicity by inferolateral MAD in an even larger IVF cohort. METHODS AND RESULTS: This retrospective multi-centre study included 185 IVF patients [median age 39 (27, 52) years, 40% female]. Cardiac magnetic resonance images were analyzed for mitral valve and annular abnormalities and late gadolinium enhancement. Clinical characteristics were compared between patients with and without MAD. MAD in any of the 4 locations was present in 112 (61%) IVF patients and inferolateral MAD was identified in 24 (13%) IVF patients. Mitral valve prolapse (MVP) was found in 13 (7%) IVF patients. MVP was more prevalent in patients with inferolateral MAD compared with patients without inferolateral MAD (42 vs. 2%, P < 0.001). Pro-arrhythmic characteristics in terms of a high burden of premature ventricular complexes (PVCs) and non-sustained ventricular tachycardia (VT) were more prevalent in patients with inferolateral MAD compared to patients without inferolateral MAD (67 vs. 23%, P < 0.001 and 63 vs. 41%, P = 0.046, respectively). Appropriate implantable cardioverter defibrillator therapy during follow-up was comparable for IVF patients with or without inferolateral MAD (13 vs. 18%, P = 0.579). CONCLUSION: A high prevalence of inferolateral MAD and MVP is a consistent finding in this large IVF cohort. The presence of inferolateral MAD is associated with a higher PVC burden and non-sustained VTs. Further research is needed to explain this potential interplay.

Innovative active packaging systems to prolong the shelf life of Mozzarella cheese.

In this work the effectiveness of different antimicrobial packaging systems on the microbial quality decay kinetics during storage of Mozzarella cheese was evaluated. Lemon extract, at 3 different concentrations, was used as active agent, in combination with brine and with a gel solution made of sodium alginate. Shelf life tests were run at 15 degrees C to simulate thermal abuse. The cell load of spoilage and dairy functional microorganisms were monitored at regular time intervals during storage. By fitting the experimental data through a modified version of the Gompertz equation, the shelf life of dairy products packaged in the different systems was calculated. Results show an increase in the shelf life of all active packaged Mozzarella cheeses, confirming that the investigated substance may exert an inhibitory effect on the microorganisms responsible for spoilage phenomena without affecting the functional microbiota of the product.

Use of chitosan to prolong mozzarella cheese shelf life.

This study was undertaken to evaluate the feasibility of using chitosan, a natural antimicrobial substance, to improve the preservation of a very perishable cheese. The effectiveness of chitosan to inhibit the growth of spoilage microorganisms in Mozzarella cheese was studied during refrigerated storage. A lactic acid/chitosan solution was added directly to the starter used for Mozzarella cheese manufacturing. Mozzarella cheese samples were stored at 4 degrees C for about 10 d and microbial populations as well as the pH were monitored. Results demonstrated that chitosan inhibited the growth of some spoilage microorganisms such as coliforms, whereas it did not influence the growth of other microorganisms, such as Micrococcaceae, and lightly stimulated lactic acid bacteria.