Anti-MVP monoclonal antibody, clone 2143 [Biotin]

Background: We sought to determine whether presence, amount and distribution of scar impacts the degree of acute hemodynamic response (AHR) with multisite pacing. Multi-vein pacing (MVP) or multipolar pacing (MPP) with a multi-electrode left ventricular (LV) lead may offer benefits over conventional biventricular pacing in patients with myocardial scar. Methods: In this multi-center study left bundle branch block patients underwent an hemodynamic pacing study measuring LV dP/dt(max). Patients had cardiac magnetic resonance scar imaging to assess the effect of scar presence, amount and distribution on AHR. Results: 24 patients (QRS 171 +/- 20 ms) completed the study (83% male). An ischemic etiology was present in 58% and the mean scar volume was 6.0 +/- 7.0%. Overall discounting scar, MPP and MVP showed no significant AHR increase compared to an optimized "best BiV" (BestBiV) site. In aminority of patients (6/24) receiver-operator characteristic analysis of scar volume (cut off 8.48%) predicted a small AHR improvement with MPP (sensitivity 83%, specificity 94%) but not MVP. Patients with scar volume > 8.48% had a MPP-BestBiV of 3 +/- 6.3% vs. -6.4 +/- 7.7% for those below the cutoff. There was a significant correlation between the difference in AHR and scar volume for MPP-BestBiV (R = 0.49, p = 0.02) but not MVP-BestBiV(R = 0.111, p = 0.62). The multielectrode lead positioned in scar predicted MPP AHR improvement (p = 0.04). Conclusions: Multisite pacing with MPP and MVP shows no AHR benefit in all-comers compared to optimized BestBiV pacing. There was aminority of patients with significant scar volume in relation to the LV site that exhibited a small AHR improvement with MPP. (C) 2018 The Authors. Published by Elsevier B.V.

The Memory Validity Profile (MVP) is a performance validity test (PVT) designed specifically for pediatric populations and utilizes specific cut-points for identifying noncredible performance at different ages. This study aims to evaluate the MVP using a known-groups design to determine optimal cut-off scores for detecting noncredible performance in youths with mild traumatic brain injury (mTBI) across different age-groups. Participants were 114 youths (age 5-17) with mTBI who were referred for neuropsychological evaluation in a hospital-based concussion clinic. All participants were administered the Nonverbal-Medical Symptom Validity Test (NV-MSVT) and the MVP. Participants who failed the NV-MSVT were also administered the TOMM. Participants who failed both the NV-MSVT and the TOMM comprised the criterion group (i.e., the "Failed two PVTs" group). Participants who failed only one PVT were excluded from the analysis. ROC curve analyses revealed good discriminability (AUC = .844: 95%, CI = 676-1.0, p = .001) with acceptable sensitivity (.73) and specificity (.91) for an optimal MVP Total score cut-off <= 31. There were no differences in MVP Total scores across age-groups. In conclusion, adopting stricter cut-points for non-credible performance and applying these consistently across all age groups in a mTBI population increases the clinical utility of the MVP.