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Typically used to enhance visibility on dark backgrounds.\n\n$link-color-dark\t\t\t- #126657; Link Color dark\t\t\t\n$link-color-dark--hover\t- #051f1a; Link Color dark--hover\t\n$link-color-dark--visited\t- #42665f; Link Color dark--visited\t\n\nWeight:2\n\nStyleguide DesignBase.Colors.LinksLight\n */\n/*\n\nLink Colors\n\nLink colors in all of its states, default, hover, visited.\n\n\n$link-color-light\t\t\t- #8cebda; Link Color light\t\t\t\n$link-color-light--hover\t- #e8fbf8; Link Color light--hover\t\n$link-color-light--visited\t- #84afa7; Link Color light--visited\t\n$link-color-dark\t\t\t- #126657; Link Color dark\t\t\t\n$link-color-dark--hover\t- #051f1a; Link Color dark--hover\t\n$link-color-dark--visited\t- #42665f; Link Color dark--visited\t\n\nWeight:1\n\nStyleguide DesignBase.Colors.Links\n */\n/** Fonts **/\n/* Define the \"system\" font family */\n@font-face {\n font-family: system;\n font-style: normal;\n font-weight: 300;\n src: local(\".SFNSText-Light\"), local(\".HelveticaNeueDeskInterface-Light\"), local(\".LucidaGrandeUI\"), local(\"Ubuntu Light\"), local(\"Segoe UI Light\"), local(\"Roboto-Light\"), local(\"DroidSans\"), local(\"Tahoma\");\n}\nhtml {\n -webkit-font-smoothing: antialiased;\n -webkit-line-break: after-white-space;\n -webkit-locale: \"en\";\n -webkit-tap-highlight-color: rgba(0, 0, 0, 0);\n line-break: white-space;\n}\n\n/** Textures **/\n/** logos **/\n/** ACC Brands *********************************/\n/** SCSS DOC: __brand.journal.scss **/\n/*\n\nprimary: Color Variations \n\nThe Modified versions of the primary color from this theme\n\nMarkup:\n\n\n\t\t

primary-n5

\n\t\t

primary-n4

\n\t\t

primary-n3

\n\t\t

primary-n2

\n\t\t

primary-n1

\n\t\t

primary-0

\n\t\t

primary-1

\n\t\t

primary-2

\n\t\t

primary-3

\n\t\t

primary-4

\n\t\t

primary-5

\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.primary\n\n*/\n/*\n\nsecondary: Color Variations \n\nThe Modified versions of the secondary color from this theme\n\nMarkup:\n\n\n\t\t

secondary-n5

  • HEX: #111111
  • RGB: 17, 17, 17
  • HSL: 0deg ,8.5%, 6.8235294118%
\n\t\t

secondary-n4

  • HEX: #232323
  • RGB: 35, 35, 35
  • HSL: 0deg ,7%, 13.6470588235%
\n\t\t

secondary-n3

  • HEX: #3a3a3a
  • RGB: 58, 58, 58
  • HSL: 0deg ,5%, 22.7450980392%
\n\t\t

secondary-n2

  • HEX: #515151
  • RGB: 81, 81, 81
  • HSL: 0deg ,3%, 31.8431372549%
\n\t\t

secondary-n1

  • HEX: #636363
  • RGB: 99, 99, 99
  • HSL: 0deg ,1.5%, 38.6666666667%
\n\t\t

secondary-0

  • HEX: #747474
  • RGB: 116, 116, 116
  • HSL: 0deg, 0%, 45.4901960784%
\n\t\t

secondary-1

  • HEX: #828282
  • RGB: 130, 130, 130
  • HSL: 0deg ,0%, 50.9411764706%
\n\t\t

secondary-2

  • HEX: #979797
  • RGB: 151, 151, 151
  • HSL: 0deg ,0%, 59.1176470588%
\n\t\t

secondary-3

  • HEX: #bababa
  • RGB: 186, 186, 186
  • HSL: 0deg ,0%, 72.7450980392%
\n\t\t

secondary-4

  • HEX: gainsboro
  • RGB: 220, 220, 220
  • HSL: 0deg ,0%, 86.3725490196%
\n\t\t

secondary-5

  • HEX: #f1f1f1
  • RGB: 241, 241, 241
  • HSL: 0deg ,0%, 94.5490196078%
\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.secondary\n\n*/\n/*\n\nsuccess: Color Variations \n\nThe Modified versions of the success color from this theme\n\nMarkup:\n\n\n\t\t

success-n5

  • HEX: #021906
  • RGB: 2, 25, 6
  • HSL: 130deg ,84.75%, 5.2941176471%
\n\t\t

success-n4

  • HEX: #05320c
  • RGB: 5, 50, 12
  • HSL: 130deg ,84.5%, 10.5882352941%
\n\t\t

success-n3

  • HEX: #085314
  • RGB: 8, 83, 20
  • HSL: 130deg ,84.1666666667%, 17.6470588235%
\n\t\t

success-n2

  • HEX: #0b741c
  • RGB: 11, 116, 28
  • HSL: 130deg ,83.8333333333%, 24.7058823529%
\n\t\t

success-n1

  • HEX: #0d8c22
  • RGB: 13, 140, 34
  • HSL: 130deg ,83.5833333333%, 30%
\n\t\t

success-0

  • HEX: #0fa528
  • RGB: 15, 165, 40
  • HSL: 130deg, 83.3333333333%, 35.2941176471%
\n\t\t

success-1

  • HEX: #12c32f
  • RGB: 18, 195, 47
  • HSL: 130deg ,79.1666666667%, 41.7647058824%
\n\t\t

success-2

  • HEX: #1cea3f
  • RGB: 28, 234, 63
  • HSL: 130deg ,72.9166666667%, 51.4705882353%
\n\t\t

success-3

  • HEX: #68f17f
  • RGB: 104, 241, 127
  • HSL: 130deg ,62.5%, 67.6470588235%
\n\t\t

success-4

  • HEX: #b3f8bf
  • RGB: 179, 248, 191
  • HSL: 130deg ,52.0833333333%, 83.8235294118%
\n\t\t

success-5

  • HEX: #e1fce5
  • RGB: 225, 252, 229
  • HSL: 130deg ,45.8333333333%, 93.5294117647%
\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.success\n\n*/\n/*\n\nshade: Color Variations \n\nThe Modified versions of the shade color from this theme\n\nMarkup:\n\n\n\t\t

shade-n5

  • HEX: #111111
  • RGB: 17, 17, 17
  • HSL: 0deg ,8.5%, 6.8235294118%
\n\t\t

shade-n4

  • HEX: #232323
  • RGB: 35, 35, 35
  • HSL: 0deg ,7%, 13.6470588235%
\n\t\t

shade-n3

  • HEX: #3a3a3a
  • RGB: 58, 58, 58
  • HSL: 0deg ,5%, 22.7450980392%
\n\t\t

shade-n2

  • HEX: #515151
  • RGB: 81, 81, 81
  • HSL: 0deg ,3%, 31.8431372549%
\n\t\t

shade-n1

  • HEX: #636363
  • RGB: 99, 99, 99
  • HSL: 0deg ,1.5%, 38.6666666667%
\n\t\t

shade-0

  • HEX: #747474
  • RGB: 116, 116, 116
  • HSL: 0deg, 0%, 45.4901960784%
\n\t\t

shade-1

  • HEX: #828282
  • RGB: 130, 130, 130
  • HSL: 0deg ,0%, 50.9411764706%
\n\t\t

shade-2

  • HEX: #979797
  • RGB: 151, 151, 151
  • HSL: 0deg ,0%, 59.1176470588%
\n\t\t

shade-3

  • HEX: #bababa
  • RGB: 186, 186, 186
  • HSL: 0deg ,0%, 72.7450980392%
\n\t\t

shade-4

  • HEX: gainsboro
  • RGB: 220, 220, 220
  • HSL: 0deg ,0%, 86.3725490196%
\n\t\t

shade-5

  • HEX: #f1f1f1
  • RGB: 241, 241, 241
  • HSL: 0deg ,0%, 94.5490196078%
\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.shade\n\n*/\n/*\n\nwarning: Color Variations \n\nThe Modified versions of the warning color from this theme\n\nMarkup:\n\n\n\t\t

warning-n5

  • HEX: #231105
  • RGB: 35, 17, 5
  • HSL: 23.595505618deg ,75.8016528926%, 7.8823529412%
\n\t\t

warning-n4

  • HEX: #46220b
  • RGB: 70, 34, 11
  • HSL: 23.595505618deg ,75.4049586777%, 15.7647058824%
\n\t\t

warning-n3

  • HEX: #743812
  • RGB: 116, 56, 18
  • HSL: 23.595505618deg ,74.8760330579%, 26.2745098039%
\n\t\t

warning-n2

  • HEX: #a34f19
  • RGB: 163, 79, 25
  • HSL: 23.595505618deg ,74.347107438%, 36.7843137255%
\n\t\t

warning-n1

  • HEX: #c6601e
  • RGB: 198, 96, 30
  • HSL: 23.595505618deg ,73.9504132231%, 44.6666666667%
\n\t\t

warning-0

  • HEX: #df732d
  • RGB: 223, 115, 45
  • HSL: 23.595505618deg, 73.5537190083%, 52.5490196078%
\n\t\t

warning-1

  • HEX: #e28142
  • RGB: 226, 129, 66
  • HSL: 23.595505618deg ,69.8760330579%, 57.2941176471%
\n\t\t

warning-2

  • HEX: #e79662
  • RGB: 231, 150, 98
  • HSL: 23.595505618deg ,64.3595041322%, 64.4117647059%
\n\t\t

warning-3

  • HEX: #efb996
  • RGB: 239, 185, 150
  • HSL: 23.595505618deg ,55.1652892562%, 76.2745098039%
\n\t\t

warning-4

  • HEX: #f7dccb
  • RGB: 247, 220, 203
  • HSL: 23.595505618deg ,45.9710743802%, 88.137254902%
\n\t\t

warning-5

  • HEX: #fcf1ea
  • RGB: 252, 241, 234
  • HSL: 23.595505618deg ,40.4545454545%, 95.2549019608%
\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.warning\n\n*/\n/*\n\nalert: Color Variations \n\nThe Modified versions of the alert color from this theme\n\nMarkup:\n\n\n\t\t

alert-n5

  • HEX: #1a0503
  • RGB: 26, 5, 3
  • HSL: 4.4295302013deg ,78.4153846154%, 5.7352941176%
\n\t\t

alert-n4

  • HEX: #340a07
  • RGB: 52, 10, 7
  • HSL: 4.4295302013deg ,78.0615384615%, 11.4705882353%
\n\t\t

alert-n3

  • HEX: #56110c
  • RGB: 86, 17, 12
  • HSL: 4.4295302013deg ,77.5897435897%, 19.1176470588%
\n\t\t

alert-n2

  • HEX: #781810
  • RGB: 120, 24, 16
  • HSL: 4.4295302013deg ,77.1179487179%, 26.7647058824%
\n\t\t

alert-n1

  • HEX: #921d14
  • RGB: 146, 29, 20
  • HSL: 4.4295302013deg ,76.7641025641%, 32.5%
\n\t\t

alert-0

  • HEX: #ac2217
  • RGB: 172, 34, 23
  • HSL: 4.4295302013deg, 76.4102564103%, 38.2352941176%
\n\t\t

alert-1

  • HEX: #c8271b
  • RGB: 200, 39, 27
  • HSL: 4.4295302013deg ,72.5897435897%, 44.4117647059%
\n\t\t

alert-2

  • HEX: #e33c2f
  • RGB: 227, 60, 47
  • HSL: 4.4295302013deg ,66.858974359%, 53.6764705882%
\n\t\t

alert-3

  • HEX: #ec7d74
  • RGB: 236, 125, 116
  • HSL: 4.4295302013deg ,57.3076923077%, 69.1176470588%
\n\t\t

alert-4

  • HEX: #f6beba
  • RGB: 246, 190, 186
  • HSL: 4.4295302013deg ,47.7564102564%, 84.5588235294%
\n\t\t

alert-5

  • HEX: #fbe5e3
  • RGB: 251, 229, 227
  • HSL: 4.4295302013deg ,42.0256410256%, 93.8235294118%
\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.alert\n\n*/\n/*\n\nnavigation: Color Variations \n\nThe Modified versions of the navigation color from this theme\n\nMarkup:\n\n\n\t\t

navigation-n5

  • HEX: #060d1d
  • RGB: 6, 13, 29
  • HSL: 221.8791946309deg ,66.514893617%, 6.9117647059%
\n\t\t

navigation-n4

  • HEX: #0d1a3a
  • RGB: 13, 26, 58
  • HSL: 221.8791946309deg ,65.9659574468%, 13.8235294118%
\n\t\t

navigation-n3

  • HEX: #162c60
  • RGB: 22, 44, 96
  • HSL: 221.8791946309deg ,65.2340425532%, 23.0392156863%
\n\t\t

navigation-n2

  • HEX: #1e3e86
  • RGB: 30, 62, 134
  • HSL: 221.8791946309deg ,64.5021276596%, 32.2549019608%
\n\t\t

navigation-n1

  • HEX: #254ba3
  • RGB: 37, 75, 163
  • HSL: 221.8791946309deg ,63.9531914894%, 39.1666666667%
\n\t\t

navigation-0

  • HEX: #2b58c0
  • RGB: 43, 88, 192
  • HSL: 221.8791946309deg, 63.4042553191%, 46.0784313725%
\n\t\t

navigation-1

  • HEX: #3564d2
  • RGB: 53, 100, 210
  • HSL: 221.8791946309deg ,60.2340425532%, 51.4705882353%
\n\t\t

navigation-2

  • HEX: #567ed9
  • RGB: 86, 126, 217
  • HSL: 221.8791946309deg ,55.4787234043%, 59.5588235294%
\n\t\t

navigation-3

  • HEX: #8fa9e6
  • RGB: 143, 169, 230
  • HSL: 221.8791946309deg ,47.5531914894%, 73.0392156863%
\n\t\t

navigation-4

  • HEX: #c7d4f2
  • RGB: 199, 212, 242
  • HSL: 221.8791946309deg ,39.6276595745%, 86.5196078431%
\n\t\t

navigation-5

  • HEX: #e9eefa
  • RGB: 233, 238, 250
  • HSL: 221.8791946309deg ,34.8723404255%, 94.6078431373%
\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.navigation\n\n*/\n/*\n\naccent: Color Variations \n\nThe Modified versions of the accent color from this theme\n\nMarkup:\n\n\n\t\t

accent-n5

  • HEX: #260f00
  • RGB: 38, 15, 0
  • HSL: 24deg ,100%, 7.5%
\n\t\t

accent-n4

  • HEX: #4d1f00
  • RGB: 77, 31, 0
  • HSL: 24deg ,100%, 15%
\n\t\t

accent-n3

  • HEX: #803300
  • RGB: 128, 51, 0
  • HSL: 24deg ,100%, 25%
\n\t\t

accent-n2

  • HEX: #b34700
  • RGB: 179, 71, 0
  • HSL: 24deg ,100%, 35%
\n\t\t

accent-n1

  • HEX: #d95700
  • RGB: 217, 87, 0
  • HSL: 24deg ,100%, 42.5%
\n\t\t

accent-0

  • HEX: #ff6600
  • RGB: 255, 102, 0
  • HSL: 24deg, 100%, 50%
\n\t\t

accent-1

  • HEX: #ff751a
  • RGB: 255, 117, 26
  • HSL: 24deg ,95%, 55%
\n\t\t

accent-2

  • HEX: #ff8c40
  • RGB: 255, 140, 64
  • HSL: 24deg ,87.5%, 62.5%
\n\t\t

accent-3

  • HEX: #ffb380
  • RGB: 255, 179, 128
  • HSL: 24deg ,75%, 75%
\n\t\t

accent-4

  • HEX: #ffd9bf
  • RGB: 255, 217, 191
  • HSL: 24deg ,62.5%, 87.5%
\n\t\t

accent-5

  • HEX: #fff0e6
  • RGB: 255, 240, 230
  • HSL: 24deg ,55%, 95%
\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.accent\n\n*/\n/*\n\ninfo: Color Variations \n\nThe Modified versions of the info color from this theme\n\nMarkup:\n\n\n\t\t

info-n5

  • HEX: #191714
  • RGB: 25, 23, 20
  • HSL: 31.3043478261deg ,18.6666666667%, 8.9117647059%
\n\t\t

info-n4

  • HEX: #332e28
  • RGB: 51, 46, 40
  • HSL: 31.3043478261deg ,17.3333333333%, 17.8235294118%
\n\t\t

info-n3

  • HEX: #544c43
  • RGB: 84, 76, 67
  • HSL: 31.3043478261deg ,15.5555555556%, 29.7058823529%
\n\t\t

info-n2

  • HEX: #766b5e
  • RGB: 118, 107, 94
  • HSL: 31.3043478261deg ,13.7777777778%, 41.5882352941%
\n\t\t

info-n1

  • HEX: #8f8173
  • RGB: 143, 129, 115
  • HSL: 31.3043478261deg ,12.4444444444%, 50.5%
\n\t\t

info-0

  • HEX: #a3988c
  • RGB: 163, 152, 140
  • HSL: 31.3043478261deg, 11.1111111111%, 59.4117647059%
\n\t\t

info-1

  • HEX: #aca298
  • RGB: 172, 162, 152
  • HSL: 31.3043478261deg ,10.5555555556%, 63.4705882353%
\n\t\t

info-2

  • HEX: #bab2a9
  • RGB: 186, 178, 169
  • HSL: 31.3043478261deg ,9.7222222222%, 69.5588235294%
\n\t\t

info-3

  • HEX: #d1ccc6
  • RGB: 209, 204, 198
  • HSL: 31.3043478261deg ,8.3333333333%, 79.7058823529%
\n\t\t

info-4

  • HEX: #e8e5e2
  • RGB: 232, 229, 226
  • HSL: 31.3043478261deg ,6.9444444444%, 89.8529411765%
\n\t\t

info-5

  • HEX: #f6f5f4
  • RGB: 246, 245, 244
  • HSL: 31.3043478261deg ,6.1111111111%, 95.9411764706%
\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.info\n\n*/\n/*\n\nhighlight: Color Variations \n\nThe Modified versions of the highlight color from this theme\n\nMarkup:\n\n\n\t\t

highlight-n5

  • HEX: #120919
  • RGB: 18, 9, 25
  • HSL: 273.0275229358deg ,52.0524017467%, 6.7352941176%
\n\t\t

highlight-n4

  • HEX: #241233
  • RGB: 36, 18, 51
  • HSL: 273.0275229358deg ,51.2663755459%, 13.4705882353%
\n\t\t

highlight-n3

  • HEX: #3c1e55
  • RGB: 60, 30, 85
  • HSL: 273.0275229358deg ,50.2183406114%, 22.4509803922%
\n\t\t

highlight-n2

  • HEX: #542a76
  • RGB: 84, 42, 118
  • HSL: 273.0275229358deg ,49.1703056769%, 31.431372549%
\n\t\t

highlight-n1

  • HEX: #663390
  • RGB: 102, 51, 144
  • HSL: 273.0275229358deg ,48.384279476%, 38.1666666667%
\n\t\t

highlight-0

  • HEX: #783ca9
  • RGB: 120, 60, 169
  • HSL: 273.0275229358deg, 47.5982532751%, 44.9019607843%
\n\t\t

highlight-1

  • HEX: #8744bd
  • RGB: 135, 68, 189
  • HSL: 273.0275229358deg ,45.2183406114%, 50.4117647059%
\n\t\t

highlight-2

  • HEX: #9b63c8
  • RGB: 155, 99, 200
  • HSL: 273.0275229358deg ,41.6484716157%, 58.6764705882%
\n\t\t

highlight-3

  • HEX: #bc97da
  • RGB: 188, 151, 218
  • HSL: 273.0275229358deg ,35.6986899563%, 72.4509803922%
\n\t\t

highlight-4

  • HEX: #decbed
  • RGB: 222, 203, 237
  • HSL: 273.0275229358deg ,29.7489082969%, 86.2254901961%
\n\t\t

highlight-5

  • HEX: #f2eaf8
  • RGB: 242, 234, 248
  • HSL: 273.0275229358deg ,26.1790393013%, 94.4901960784%
\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.highlight\n\n*/\n/*\n\nacc: Color Variations \n\nThe Modified versions of the acc color from this theme\n\nMarkup:\n\n\n\t\t

acc-n5

  • HEX: #000a12
  • RGB: 0, 10, 18
  • HSL: 206.9491525424deg ,100%, 3.4705882353%
\n\t\t

acc-n4

  • HEX: #001423
  • RGB: 0, 20, 35
  • HSL: 206.9491525424deg ,100%, 6.9411764706%
\n\t\t

acc-n3

  • HEX: #00213b
  • RGB: 0, 33, 59
  • HSL: 206.9491525424deg ,100%, 11.568627451%
\n\t\t

acc-n2

  • HEX: #002e53
  • RGB: 0, 46, 83
  • HSL: 206.9491525424deg ,100%, 16.1960784314%
\n\t\t

acc-n1

  • HEX: #003764
  • RGB: 0, 55, 100
  • HSL: 206.9491525424deg ,100%, 19.6666666667%
\n\t\t

acc-0

  • HEX: #004176
  • RGB: 0, 65, 118
  • HSL: 206.9491525424deg, 100%, 23.137254902%
\n\t\t

acc-1

  • HEX: #00579d
  • RGB: 0, 87, 157
  • HSL: 206.9491525424deg ,95%, 30.8235294118%
\n\t\t

acc-2

  • HEX: #0077d8
  • RGB: 0, 119, 216
  • HSL: 206.9491525424deg ,87.5%, 42.3529411765%
\n\t\t

acc-3

  • HEX: #3ba7ff
  • RGB: 59, 167, 255
  • HSL: 206.9491525424deg ,75%, 61.568627451%
\n\t\t

acc-4

  • HEX: #9dd3ff
  • RGB: 157, 211, 255
  • HSL: 206.9491525424deg ,62.5%, 80.7843137255%
\n\t\t

acc-5

  • HEX: #d8edff
  • RGB: 216, 237, 255
  • HSL: 206.9491525424deg ,55%, 92.3137254902%
\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n\nStyleguide DesignBase.CrayonBox.acc\n\n*/\n/*\nCrayon Box\n\nThis is all of the colors of the theme broken out with its modifications written in hex code.\n\n\nWeight:0\n\nHideCodeBlock: display_none \n\nStyleguide DesignBase.CrayonBox\n*/\n/*Adobe XD Color Map*/\n/* $xd-color_primary-0: #002e5a*/\n/* $xd-color_primary-n5: #00070e*/\n/* $xd-color_primary-n4: #000e1b*/\n/* $xd-color_primary-n3: #00172d*/\n/* $xd-color_primary-n2: #00203f*/\n/* $xd-color_primary-n1: #00274d*/\n/* $xd-color_primary-1: #004384*/\n/* $xd-color_primary-2: #0064c3*/\n/* $xd-color_primary-3: #2d98ff*/\n/* $xd-color_primary-4: #96ccff*/\n/* $xd-color_primary-5: #d5eaff*/\n/* $xd-color_secondary-0: #747474*/\n/* $xd-color_secondary-n5: #111111*/\n/* $xd-color_secondary-n4: #232323*/\n/* $xd-color_secondary-n3: #3a3a3a*/\n/* $xd-color_secondary-n2: #515151*/\n/* $xd-color_secondary-n1: #636363*/\n/* $xd-color_secondary-1: #828282*/\n/* $xd-color_secondary-2: #979797*/\n/* $xd-color_secondary-3: #bababa*/\n/* $xd-color_secondary-4: gainsboro*/\n/* $xd-color_secondary-5: #f1f1f1*/\n/* $xd-color_success-0: #0fa528*/\n/* $xd-color_success-n5: #021906*/\n/* $xd-color_success-n4: #05320c*/\n/* $xd-color_success-n3: #085314*/\n/* $xd-color_success-n2: #0b741c*/\n/* $xd-color_success-n1: #0d8c22*/\n/* $xd-color_success-1: #12c32f*/\n/* $xd-color_success-2: #1cea3f*/\n/* $xd-color_success-3: #68f17f*/\n/* $xd-color_success-4: #b3f8bf*/\n/* $xd-color_success-5: #e1fce5*/\n/* $xd-color_shade-0: #747474*/\n/* $xd-color_shade-n5: #111111*/\n/* $xd-color_shade-n4: #232323*/\n/* $xd-color_shade-n3: #3a3a3a*/\n/* $xd-color_shade-n2: #515151*/\n/* $xd-color_shade-n1: #636363*/\n/* $xd-color_shade-1: #828282*/\n/* $xd-color_shade-2: #979797*/\n/* $xd-color_shade-3: #bababa*/\n/* $xd-color_shade-4: gainsboro*/\n/* $xd-color_shade-5: #f1f1f1*/\n/* $xd-color_warning-0: #df732d*/\n/* $xd-color_warning-n5: #231105*/\n/* $xd-color_warning-n4: #46220b*/\n/* $xd-color_warning-n3: #743812*/\n/* $xd-color_warning-n2: #a34f19*/\n/* $xd-color_warning-n1: #c6601e*/\n/* $xd-color_warning-1: #e28142*/\n/* $xd-color_warning-2: #e79662*/\n/* $xd-color_warning-3: #efb996*/\n/* $xd-color_warning-4: #f7dccb*/\n/* $xd-color_warning-5: #fcf1ea*/\n/* $xd-color_alert-0: #ac2217*/\n/* $xd-color_alert-n5: #1a0503*/\n/* $xd-color_alert-n4: #340a07*/\n/* $xd-color_alert-n3: #56110c*/\n/* $xd-color_alert-n2: #781810*/\n/* $xd-color_alert-n1: #921d14*/\n/* $xd-color_alert-1: #c8271b*/\n/* $xd-color_alert-2: #e33c2f*/\n/* $xd-color_alert-3: #ec7d74*/\n/* $xd-color_alert-4: #f6beba*/\n/* $xd-color_alert-5: #fbe5e3*/\n/* $xd-color_navigation-0: #2b58c0*/\n/* $xd-color_navigation-n5: #060d1d*/\n/* $xd-color_navigation-n4: #0d1a3a*/\n/* $xd-color_navigation-n3: #162c60*/\n/* $xd-color_navigation-n2: #1e3e86*/\n/* $xd-color_navigation-n1: #254ba3*/\n/* $xd-color_navigation-1: #3564d2*/\n/* $xd-color_navigation-2: #567ed9*/\n/* $xd-color_navigation-3: #8fa9e6*/\n/* $xd-color_navigation-4: #c7d4f2*/\n/* $xd-color_navigation-5: #e9eefa*/\n/* $xd-color_accent-0: #ff6600*/\n/* $xd-color_accent-n5: #260f00*/\n/* $xd-color_accent-n4: #4d1f00*/\n/* $xd-color_accent-n3: #803300*/\n/* $xd-color_accent-n2: #b34700*/\n/* $xd-color_accent-n1: #d95700*/\n/* $xd-color_accent-1: #ff751a*/\n/* $xd-color_accent-2: #ff8c40*/\n/* $xd-color_accent-3: #ffb380*/\n/* $xd-color_accent-4: #ffd9bf*/\n/* $xd-color_accent-5: #fff0e6*/\n/* $xd-color_info-0: #a3988c*/\n/* $xd-color_info-n5: #191714*/\n/* $xd-color_info-n4: #332e28*/\n/* $xd-color_info-n3: #544c43*/\n/* $xd-color_info-n2: #766b5e*/\n/* $xd-color_info-n1: #8f8173*/\n/* $xd-color_info-1: #aca298*/\n/* $xd-color_info-2: #bab2a9*/\n/* $xd-color_info-3: #d1ccc6*/\n/* $xd-color_info-4: #e8e5e2*/\n/* $xd-color_info-5: #f6f5f4*/\n/* $xd-color_highlight-0: #783ca9*/\n/* $xd-color_highlight-n5: #120919*/\n/* $xd-color_highlight-n4: #241233*/\n/* $xd-color_highlight-n3: #3c1e55*/\n/* $xd-color_highlight-n2: #542a76*/\n/* $xd-color_highlight-n1: #663390*/\n/* $xd-color_highlight-1: #8744bd*/\n/* $xd-color_highlight-2: #9b63c8*/\n/* $xd-color_highlight-3: #bc97da*/\n/* $xd-color_highlight-4: #decbed*/\n/* $xd-color_highlight-5: #f2eaf8*/\n/* $xd-color_acc-0: #004176*/\n/* $xd-color_acc-n5: #000a12*/\n/* $xd-color_acc-n4: #001423*/\n/* $xd-color_acc-n3: #00213b*/\n/* $xd-color_acc-n2: #002e53*/\n/* $xd-color_acc-n1: #003764*/\n/* $xd-color_acc-1: #00579d*/\n/* $xd-color_acc-2: #0077d8*/\n/* $xd-color_acc-3: #3ba7ff*/\n/* $xd-color_acc-4: #9dd3ff*/\n/* $xd-color_acc-5: #d8edff*/\n/*\n\nBasic HTML\n\nThe Arches Design System, at its core, is a Utility Class Styling Design. It is built not to prescribe the design of the HTML and components but to paint with classes to create complicated UI without having to create more styles. Arches rely on the browser or branding defaults for basic HTML styling. Below is a kitchen sink of HTML elements so you can see how this variation look without further alteration from adding classes. There is No basic styling around the pure DOM with the utility class only, and there is improved styling as you add Bootstrap or Foundation. \n\nWeight: -100\n\nStyleguide HTML\n*/\n/*\n\nReading Typography\n\nReading typography is a container class to opt into an override of the basic typography from arches. Basic Typography is un-styled and rely on the most basic styles from the browser stylesheets so there is less overriding when making UI but it leaves reading typography lacking. Most ways typography content is added to a site is devoid of hooks to add styles to an element so work around that restriction and to unified styling across reading experiences the \"reading-typography\" class is used on the parent container. Please note that the reading typography can still look a bit different look depending on the brand or the framework.
modifier classcustomizationusage
.inherit_colorremoves all color rules from colored typography and sets it to inherit.inverting a block of typography where all text and headlines should be white.
.font-size_upshifts all typography up one font size stepintro blocks of text where the text. Or in articles where you can shift all text up a size.
`.font-size_down`shifts all typography down one font size step.citation blocks or boiler plate content where the text should be smaller and less impactful.
.links_darkturns all links to the dark color standard.this is used in junction with the .inherit_color class.
.links_lightturns all links to the light color standard.this is used in junction with the .inherit_color class when text is on a dark background.
* there are further advanced features if you want to apply CSS Property Overrides. \n\nMarkup:\n
\n
\n\t\n\t\t\n\t\t\n\t\t\n\t\t \n\t\t\"\"\n\t\n
\n
\n User Name\n Log Out \n
\n
\n
\n

This is the primary heading and there should only be one of these per page

\n
sub heading
\n

A small paragraph to emphasis and show important bits.

\n
    \n
  • This is a list item
    • \n
  • So is this - there could be more
    • \n
  • Make sure to style list items to:\n
      \n
    • Not forgetting child list items
      • \n
    • Not forgetting child list items
      • \n
    • Not forgetting child list items
      • \n
    • Not forgetting child list items
      • \n
    \n
    • \n
  • A couple more
    • \n
  • top level list items
    • \n
\n

Don't forget Ordered lists:

\n
    \n
  1. Lorem ipsum dolor sit amet, consectetuer adipiscing elit.
    2. \n
  2. Aliquam tincidunt mauris eu risus.\n
      \n
    1. Lorem ipsum dolor sit amet, consectetuer adipiscing elit.
      2. \n
    2. Aliquam tincidunt mauris eu risus.
      3. \n
    \n
    3. \n
  3. Lorem ipsum dolor sit amet, consectetuer adipiscing elit.
    4. \n
  4. Aliquam tincidunt mauris eu risus.\n
\n

A sub heading which is not as important as the first, but is quite imporant overall

\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.

\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n
Table HeadingTable Heading
table datatable data
table datatable data
table datatable data
table datatable data
\t\n

A sub heading which is not as important as the second, but should be used with consideration

\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.

\n

“Ooh - a blockquote! Lorem ipsum dolor sit amet, consectetur adipiscing elit. Vivamus magna. Cras in mi at felis aliquet congue. Ut a est eget ligula molestie gravida. Curabitur massa. Donec eleifend, libero at sagittis mollis, tellus est malesuada tellus, at luctus turpis elit sit amet quam. Vivamus pretium ornare est.”

\n

A sub heading which is not as important as the second, but should be used with consideration

\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.

\n 
\n#header h1 a { \n    display: block; \n    width: 300px; \n    height: 80px; \n}\n
\n
A sub heading which is not as important as the second, but should be used with consideration
\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.

\n
\n
Definition list
\n
Consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna \n\taliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea \n\tcommodo consequat.
\n\t
Lorem ipsum dolor sit amet
\n\t
Consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna \n\taliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea \n\tcommodo consequat.
\n\t
\n\t
This heading plays a relatively small bit part role, if you use it at all
\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.

\n
\n\nWeight: -9\n\nHideCodeBlock: display_none \n\nStyleguide HTML.Typography\n\n*/\n/*\n\nSample Typography\n\nThis text is used as a lorem content in many of our containers. \n\n.p_4 - This is the basic typogrpahy from the browser.\n.reading-typography.p_4 - this is the standard styling for typography of reading content\n.reading-typography.font-size_up.p_4 - This font increased their sizes across all typography in the container.\n.reading-typography.font-size_down.p_4 - This font decreses their sizes across all typography in the container.\n.reading-typography.color_inherit.bg_acc.c_white.p_4.links_light - This removes all color defining styles to make it easer to reverse colors. This sets all typography and borders to inherit their colors.\n\nMarkup:\n
\n

Lorem Ipsum

\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Pellentesque sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo. Quisque sit amet est et sapien ullamcorper pharetra. Vestibulum erat wisi, condimentum sed, commodo vitae, ornare sit amet, wisi. Aenean fermentum, elit eget tincidunt condimentum, eros ipsum rutrum orci, sagittis tempus lacus enim ac dui. Donec non enim in turpis pulvinar facilisis. Ut felis.

\n

Header Level 2

\n
    \n
  1. Lorem ipsum dolor sit amet, consectetuer adipiscing elit.
    2. \n
  2. Aliquam tincidunt mauris eu risus.
    3. \n
\n

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Vivamus magna. Cras in mi at felis aliquet congue. Ut a est eget ligula molestie gravida. Curabitur massa. Donec eleifend, libero at sagittis mollis, tellus est malesuada tellus, at luctus turpis elit sit amet quam. Vivamus pretium ornare est.

\n

Header Level 3

\n
    \n
  • Lorem ipsum dolor sit amet, consectetuer adipiscing elit.
    • \n
  • Aliquam tincidunt mauris eu risus.
    • \n
\n \n
\n\nWeight: -9\n\nHideCodeBlock: display_none \n\nMarkupWrapperClasses: br_solid br_radius br_black-1 br_1 m_3 max-w_50\n\nStyleguide HTML.Typography.Sample\n\n*/\n/*\n\nBasic Typography\n\nBasic Typography is unstyled and relys on the most basic styles from the browser stylesheets so there is less overriding when making UI but it leaves the reading of content text lacking. The overriding styles that are applied to Basic typography is a consistent font treatment (font sizing, font family, and font-weight) and what comes from the baseline frameworks that build the brand. \n\n\nMarkup:\n

Basic Typography: Lorem ipsum dolor sit amet, consectetuer adipiscing \nelit.

\n

Aenean commodo ligula eget dolor aenean massa

\n

Cut sociis natoque penatibus et magnis dis \nparturient montes nascetur ridiculus mus

\n

Donec quam felis ultricies nec pellentesque eu \npretium quis sem nlla consequat massa quis enim

\n
Donec pede justo fringilla vel aliquet nec vulputate \neget arcu
\n
In enim justo rhoncus ut imperdiet a venenatis vitae \njusto
\n

Lorem ipsum dolor sit amet, consectetuer adipiscing \nelit. Aenean commodo ligula eget dolor. Aenean massa. \nCum sociis natoque penatibus et magnis dis parturient \nmontes, nascetur ridiculus mus. Donec quam felis, \nultricies nec, pellentesque eu, pretium quis, sem.

\n

This paragraph is nested inside an article. It contains many different, sometimes useful, HTML5 tags. Of course there are classics like emphasis, strong, and small but there are many others as well. Hover the following text for abbreviation tag: abbr. Similarly, you can use acronym tag like this: ftw. You can define deleted text which often gets replaced with inserted text.

You can also use keyboard text, which sometimes is styled similarly to the <code> or samp tags. Even more specifically, there is a tag just for variables. Not to be mistaken with blockquotes below, the quote tag lets you denote something as quoted text. Lastly don't forget the sub (H2O) and sup (E = MC2) tags.

\n\nWeight: -1000\n\nHideCodeBlock: display_none \n\nMarkupWrapperClasses: max-w_65\n\nStyleguide HTML.Unstyled\n\n*/\n/*\nACC Article\n\nMarkup:\n
\n\t

Article Title

\n\t

Tricuspid regurgitation (TR) is a common valvular disease estimated to affect >1.5 million people in the U.S., with a yearly incidence of about 200,000 and >300,000 patients in the U.S and Europe, respectively.1 Stated another way, a clinically significant form of this valvular disease affects 4% (or 1 in 25) of patients ages 75 and older.2

\n\t

Despite the current guidelines favoring early tricuspid valve repair, especially when undergoing concomitant left-sided cardiac surgery, most patients with TR receive lifetime medical therapy until intractable right-sided heart failure (HF) and end-organ dysfunction appear.1 In recent years, multiple studies have drawn attention to the poor prognosis of untreated TR, and demonstrated a clear tendency of excess mortality in patients with increasing severity of TR, highlighting the need for interventional options to improve outcomes.3

\n\t
\n\t\t
\n\t\t\t
\n\t\t\t\t\"Bill\n\t\t\t
\n\t\t\t
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TR associated with left-sided valvular or myocardial disease is often a marker for late-stage chronic HF with limited treatment options and an unfavorable overall prognosis. However, isolated TR is also independently associated with excess mortality if left untreated. Thus, TR represents an important public health problem with an unmet clinical need.

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Surgical approaches, either repair or replacement, have been shown to carry a high risk of in-hospital mortality, reaching 10%, without significant improvement over the past 10 years.4 As transcatheter interventional options for valvular heart disease continue to expand, transcatheter tricuspid valve repair through leaflet approximation or annuloplasty has been investigated.

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Despite studies showing promising results with greater survival and freedom from HF rehospitalization compared with conservative management, its use can be limited by anatomical infeasibility such as large leaflet coaptation gap, perforation, significant leaflet tethering with dense chordae, and leaflet impingement with a cardiac implantable electronic device lead.

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A myriad of investigational transcatheter tricuspid valve replacement (TTVR) devices have emerged as an alternative to surgery and to address this outstanding need, with promising early results related to safety, efficacy and improvements in patients' functional status and quality of life.

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Orthotopic Valve Replacement

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Orthotopic TTVR is a form of valve replacement performed by implanting a bioprosthetic valve on an existing tricuspid annulus, in a fashion similar to how it is performed in transcatheter aortic or mitral valve replacement. Several investigational devices are available with a variety of access and anchoring systems.

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EVOQUE

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The EVOQUE system (Edwards Lifesciences, Irvine, CA) is a self-expanding bovine pericardial valve mounted on a nitinol frame with a fabric skirt delivered through a transfemoral approach. The perimeter is surrounded by nine anchors that allow stabilization through anchoring to the annulus, leaflets and chords of the tricuspid apparatus. Its compassionate use in 27 patients with severe symptomatic TR at inoperable or high surgical risk has demonstrated 92% success with no periprocedural mortality.5

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The reduction in TR remained excellent at one year (≤moderate in 96% and ≤mild in 87%) with sustained symptomatic improvement (NYHA I/II in 69% compared with 11% at baseline).5 All-cause death and HF hospitalization at one year were both at 7% without any deaths being identified as device-related. An early feasibility trial of this device, TRISCEND, is ongoing with an early report of 56 patients demonstrating a similar success rate, reduction in TR and symptomatic improvement.6

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Lux-Valve

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The Lux-Valve (Jenscare Biotechnology Co., Ningbo, China) is a bovine pericardium valve with a self-expanding nitinol atrial disc, self-adaptive fabric skirt, two graspers and an interventricular septal anchor. It is deployed via a minimally invasive right thoracotomy and transatrial approach. First-in-human experience including 31 patients reported a 100% technical success rate with TR reduction to ≤moderate and ≤mild in 100% and 85.2%, respectively at one year. Symptomatic improvement has persisted at one year with 82.8% maintaining NYHA I/II and a 96.8% survival rate.7 A study investigating the second-generation LuX-Valve Plus delivered through transjugular access is currently underway (NCT05436028).

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GATE

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The GATE (NaviGate Cardiac Structures, Inc., Lake Forest, CA) device was the first TTVR performed and is composed of an equine pericardium tricuspid valve mounted on a nitinol alloy stent. Twelve right ventricular tines grasp the native leaflets and 12 right atrial winglets covered by microfiber polyester cloth provide a seal. It is delivered through a right thoracotomy and transatrial access. An early study including five patients reported 100% technical success, with all patients demonstrating TR reduction to ≤mild; however, one patient died before discharge.8

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Prominent Stressors For CVD Among LGBTQIA+ Adults

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Excess cardiovascular disease risk is associated with three categories of stressors, as described by the Minority Stress Model: psychosocial (depression, anxiety, stress); behavioral (diet quality, physical activity, substance use); and physiological (hypothalamic-pituitary-adrenal axis, chronic inflammation, autonomic nervous system dysfunction).4

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Structural/institutional stressors are also in place. The Behavioral Risk Factor Surveillance System survey 2014-2017 found a higher rate of poverty in LGBT people compared with cisgender heterosexual people vs. 15.7%, respectively).9

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In 2018, a large portion of LGBTQIA+ individuals lived in states that did not have public accommodation (hospitals and schools) and employment nondiscrimination laws.10

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For many transgender individuals, employee-sponsored health insurance is often not an option. Many employee-sponsored health insurance programs do not acknowledge partners or spouses with gender identities that align with the insured. More than two-thirds of gender minority adults report having experienced some form of discrimination from clinicians (including the use of abusive language). Roughly a quarter of transgender individuals have been denied health care by clinicians.11

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Cardiovascular Disease Risk Factors

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The data on cardiovascular health in LGBTQIA+ adults are limited because of a lack of research and challenges with study design. In terms of cardiovascular disease risk factors, the use of tobacco products is more likely among LGBTQIA+ adults than cisgender heterosexual adults.12 Alcohol and illicit drug use disorder, poor mental health and elevated body mass index are greater risk factors among sexual minority women than heterosexual women.13 Current studies also suggest that decreased sleep duration, which has been associated with higher rates of hypertension, diabetes and cardiovascular disease, was higher among sexual minority women compared with heterosexual women.14

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Cardiovalve

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The Cardiovalve (Venus Medtech Inc., Hangzhou, China) is deployed through transfemoral access and consists of a bovine pericardial leaflet mounted on a dual nitinol atrial and ventricular frame creating 24 grasping points for anchoring. The atrial portion of the frame has a covered flange to allow sealing to prevent paravalvular leak. Its compassionate use has been reported in 15 patients demonstrating significant reduction in TR to ≤moderate in 100% and ≤mild in 8% at 30 days.9 An early feasibility study is currently underway (NCT04100720).

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Intrepid

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The Intrepid (Medtronic Plc, Minneapolis, MN) is a transfemoral system with a bovine pericardial valve housed within a nitinol dual stent frame. Early experience with three patients reported technical success in all, and an early feasibility study is currently recruiting patients with a goal to include 15 patients (NCT04433065).10

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This article was authored by Hiroki Ueyama, MD, and Isida Byku, MD, FACC, from the Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, in Atlanta, GA.

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References

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  1. Asmarats L, Puri R, Latib A, Navia JL, Rodés-Cabau J. Transcatheter tricuspid valve interventions: Landscape, challenges, and future directions. J Am Coll Cardiol 2018;71:2935-56.
    2. \n\t\t
  2. Topilsky Y, Maltais S, Medina Inojosa J, et al. Burden of Tricuspid regurgitation in patients diagnosed in the community setting. JACC Cardiovasc Imaging 2019;12:433-42.
    3. \n\t\t
  3. Taramasso M, Benfari G, van der Bijl P, et al. Transcatheter versus medical treatment of patients with symptomatic severe tricuspid regurgitation. J Am Coll Cardiol 2019;74:2998-3008.
    4. \n\t\t
  4. Dreyfus J, Flagiello M, Bazire B, et al. Isolated tricuspid valve surgery: Impact of aetiology and clinical presentation on outcomes. Eur Heart J 2020;41:4304-17.
    5. \n\t\t
  5. Webb JG, Chuang AM, Meier D, et al. Transcatheter Tricuspid valve replacement with the evoque system: 1-year outcomes of a multicenter, first-in-human experience. JACC Cardiovasc Interv 2022;15:481-91.
    6. \n\t\t
  6. Kodali S, Hahn RT, George I, et al. Transfemoral tricuspid valve replacement in patients with tricuspid regurgitation: TRISCEND study 30-Day results. JACC Cardiovasc Interv 2022;15:471-80.
    7. \n\t\t
  7. Modine T. Transcatheter tricuspid valve replacement with the LuX-Valve system 1-Year results of a multicenter FIH experience. Presented at TVT 2022, June 8, 2022.
    8. \n\t\t
  8. Hahn RT, George I, Kodali SK, et al. Early Single-site experience with transcatheter tricuspid valve replacement. JACC Cardiovasc Imaging 2019;12:416-29.
    9. \n\t\t
  9. Fam NP. Cardiovalve TTVR update. Presented at TVT 2022, June 8, 2022.
    10. \n\t\t
  10. Bapat VN. The INTREPID Valve for severe tricuspid regurgitation: First-in-man case experience. Presented at TCT 2020.
    11. \n\t\t
  11. Lauten A, Figulla HR, Unbehaun A, et al. Interventional treatment of severe tricuspid regurgitation: Early clinical experience in a multicenter, observational, first-in-man study. Circ Cardiovasc Interv 2018;11:e006061.
    12. \n\t\t
  12. Dreger H, Mattig I, Hewing B, et al. Treatment of severe tricuspid regurgitation in patients with advanced heart failure with CAval Vein Implantation of the Edwards Sapien XT VALve (TRICAVAL): a randomised controlled trial. EuroIntervention 2020;15:1506-13.
    13. \n\t\t
  13. Lauten A, Doenst T, Hamadanchi A, Franz M, Figulla HR. Percutaneous bicaval valve implantation for transcatheter treatment of tricuspid regurgitation: clinical observations and 12-month follow-up. Circ Cardiovasc Interv 2014;7:268-72.
    14. \n\t\t
  14. Wild MG, Lubos E, Cruz-Gonzalez I, et al. Early clinical experience with the TRICENTO bicaval valved stent for treatment of symptomatic severe tricuspid regurgitation: A multicenter registry. Circ Cardiovasc Interv 2022;15:e011302.
    15. \n\t\t
  15. Lurz P, von Bardeleben R, Weber M, et al. Transcatheter edge-to-edge repair for treatment of tricuspid regurgitation. J Am Coll Cardiol 2021;77:229-39.
    16. \n\t\t
  16. Hahn RT. Transcatheter tricuspid valve repair:CLASP TR study one-year results. . Presented at EuroPCR 2022.
    17. \n\t\t
  17. Kodali S, Hahn RT, Eleid MF, et al. Feasibility study of the transcatheter valve repair system for severe tricuspid regurgitation. J Am Coll Cardiol 2021;77:345-56.
    18. \n\t\t
  18. Zack CJ, Fender EA, Chandrashekar P, et al. National trends and outcomes in isolated tricuspid valve surgery. J Am Coll Cardiol 2017;70:2953-60.
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These colors are used to give a distinct theme to the social nav that is in different locations.\n\n$twitter - #000; \t\ttwitter \n$facebook - #3b5998; \tfacebook \n$linkedin - #007bb6; \tlinkedin \n$apple-store - #ea4cc0; \tapple-store \n$google-play - #689f38; \tgoogle-play \n$youtube - #bb0000; \tyoutube \n\n\n\nWeight: 100\n\nStyleguide DesignBase.Colors.ColorCoding.Social Networks\n\n*/\n/*\n\tTextures\n\n\tAll textures in the Arches design are a subtle variation of transparent. Allowing for colors to bleed through from behind. Different textures have intentions or are reserved for certain usagaes. \n\n\t.texture_light \t\t- Light textures is reserved for the base of a page where it can gve a soft area for text or cards to live on top of. \n\t.texture_medium \t\t\t\t\t- medium texture are used for area that are hidden away. Collapsable navs, areas, or sidebars ususaly use the medium texture.\n\t.texture_dust \t\t\t\t\t- Dust is the most transparent texture allowing for the color of the background to show through the most. This is used for the painted tops of cards, or score bars.\n\t.texture_dark \t\t\t\t\t- This texture predominatly used on the footer. Its rich black will alway requrie reversed text and buttons to be readable. \n\t.texture_cross \t\t\t\t\t- A mostly transparent cross texture used for alternating rows of content when a little extra texture is needed.\n\t.texture_disabled \t\t\t\t- This texture is used to paint disabled buttons and ui items giving it a greyed and X'ed out appearand. \n\n\tMarkup:\n\t
{{modifier_class}} with a light primary color background
\n\n\tStyleguide DesignBase.Textures\n\n */\n.address {\n font-style: unset;\n}\n\n@media only screen and (min-width: 640px) {\n .reverse-indent {\n display: inline-block;\n margin-left: 1em;\n padding-right: 1em;\n text-indent: -1em;\n width: 100%;\n }\n .reverse-indent:after {\n content: \"\";\n display: table;\n clear: both;\n }\n}\n/*\nGeneric Footer\n\nThis defines the web footer. \n\nMarkup:\n
\n
 
\n
\n
\n
logo_primary-alt max-w_10
\n {{> \"Recipes.Footer.Address\" modifier_class=\"\"}}\n {{> \"Recipes.Footer.Social\" modifier_class=\"\"}}\n
\n
\n {{> \"Recipes.Footer.ACC Product Links\" modifier_class=\"\"}}\n
\n
\n {{> \"Recipes.Footer.Subfooter\" modifier_class=\"\"}}\n {{> \"Recipes.Footer.Cite\" }}\n
\n\nWeight: 40\n\nStyleguide Recipes.Footer\n*/\n/*\nSub Footer\n\nDescription: ACC has some basic legal information that should be on every property. \n\nMarkup:\n\n\n\n\n\nWeight: 0\n\n Styleguide Recipes.Footer.Subfooter\n*/\n/*\n\tCite and Copyright\n\n\tContains copy right \n\n\tMarkup:\n
\n © 2023 American College of Cardiology Foundation. All rights reserved.\n
\n\n\n\tStyleguide Recipes.Footer.Cite\n\n*/\n/*\nAddress\n\nAddress and contact information for Heart House\n\nMarkup:\n
\n

American College of Cardiology

\n
\n \n

Heart House

\n
\n
\n \n
\n
\n \n
\n
\n
\n
\n\nMarkupWrapperClasses:\n texture_dark p_4 max-w_30\n\nStyleguide Recipes.Footer.Address\n\n*/\n/*\nFat Footers Links\n\nFooters in the ACC sometimes have fat footers with a list of categories and links. \n\nMarkup:\n
\n

\n \n \n Conditions & Topics\n

\n \n
\n\nMarkupWrapperClasses:\n texture_dark p_4\n\n\nStyleguide Recipes.Footer.Fat Footer-Links\n\n*/\n/*\nACC Product Links\n\nLinks to the other major products in the ACC portfolio \n\nMarkup:\n\n
\n \n
\n\n\nMarkupWrapperClasses:\ntexture_dark p_4\n\nStyleguide Recipes.Footer.ACC Product Links\n\n*/\n/*\nSocial Links\n\nThe college has a collection of social or secondary platforms we interact with.\n\nMarkup:\n\n

Stay Connected\n

\n
    \n
    • \n
    • \n
    • \n
    • \n
    • \n \n
\n\n\nMarkupWrapperClasses:\ntexture_dark p_4 max-w_40\n\nStyleguide Recipes.Footer.Social\n\n*/\n/*\nJACC.acc.org Footer\n\nThe Footer of JACC.acc.org \n\nMarkup:\n
\n
\n \n
YOU ARE HERE: Home
\n \n \n
\n
\n
logo_primary-alt max-w_10
\n {{> \"Recipes.Footer.Address\" modifier_class=\"\"}}\n {{> \"Recipes.Footer.Social\" modifier_class=\"\"}}\n
\n
\n {{> \"Recipes.Footer.ACC Product Links\" modifier_class=\"\"}}\n
\n
\n {{> \"Recipes.Footer.Subfooter\" modifier_class=\"\"}}\n {{> \"Recipes.Footer.Cite\" }}\n
\n
\n\nWeight: -100\n\nStyleguide Recipes.Footer.Complete\n\n*/\n/** SCSS DOC: __globalshame_uc.scss **/","/** Pattern Sheet **/\n\n\n/** Build Comment: NaN Pattern Sheet **/ \n@use \"sass:math\";\n@use \"sass:color\";\n\n// Consider using https://www.purgecss.com/ to remove styles not used in the project.\n/** SCSS DOC: _preheader.scss **/\n$debug-trace: false !default;\n$name-mode: 'SHORT' !default; // $name-mode: \"SHORT\",\"LONG\",\"ALL\"\n$ms-base: 1rem !default; // needs to be in rem's\n$colors: ();\n$grays: ();\n$theme-palette: ();\n$usingFontAwesome:true;\n@import 'helpers/helpers';\n@import 'vendor/modular-scale';\n/** SCSS DOC: _utility-css.vars.scss **/\n@import 'setup/config/utility-css.vars';\n@import 'helpers/breakpoint';\n%font-awesome-pro {\n\t-webkit-font-smoothing: antialiased;\n\tdisplay: inline-block;\n\tfont-style: normal;\n\tfont-variant: normal;\n\ttext-rendering: auto;\n\tline-height: 1;\n\tfont-family: 'Font Awesome 6 Pro', 'Font Awesome 5 Pro';\n\tfont-weight: 900;\n}\n\n\n/** SCSS DOC: _setup.none.scss **//** SCSS DOC: __brand.base.scss **/\n/** Colors **/\n\n@import 'setup/config/colors';\n/** Fonts **/\n@import 'setup/config/fonts';\n/** Textures **/\n@import 'setup/config/textures';\n\n/** logos **/\n@import 'setup/config/logo';\n\n\n\n// reading-typography\n$headline-color: inherit !default;\n$reading-min:16px;\n/** ACC Brands *********************************/\n/** SCSS DOC: __brand.journal.scss **/\n$teal: #198dae;\n$green-blue: #16a385;\n$dark-grey: #676a72;\n$alt-grey: #a3988c;\n$green: #0fa528;\n$orange: #df732d;\n$red: #ac2217;\n$blue: #2b58c0;\n$purple: #783ca9;\n$magenta: #c34198;\n$acc-blue: #004176;\n$white: rgb(255, 255, 255);\n$black: #222;\n$real-black: #000;\n$jacc-orange: #ff6600;\n$jacc-blue:#002e5a;\n\n\n// Currently Un used in the design but part of bootstrap.\n$indigo: #6610f2 !default;\n$pink: #e83e8c !default;\n$yellow: #ffc107 !default;\n$cyan: #17a2b8 !default;\n\n$gray-100: mix($white, $black, 10%);\n$gray-200: mix($white, $black, 20%);\n$gray-300: mix($white, $black, 30%);\n$gray-400: mix($white, $black, 40%);\n$gray-500: mix($white, $black, 50%);\n$gray-600: mix($white, $black, 60%);\n$gray-700: mix($white, $black, 70%);\n$gray-800: mix($white, $black, 80%);\n$gray-900: mix($white, $black, 90%);\n\n$theme-palette: map-merge(\n\t$theme-palette,\n\t(\n\t\tprimary: $jacc-blue,\n\t\tsecondary:#747474, \n\t\tshade: #747474,\n\t\tsuccess: $green,\n\t\twarning: $orange,\n\t\talert: $red,\n\t\t//navigation: $blue,\n\t\taccent: $jacc-orange,\n\t\tinfo: $alt-grey,\n\t\thighlight: $purple,\n\t\tacc: $acc-blue,\n\t)\n);\n\n@import url('https://fonts.googleapis.com/css2?family=Roboto+Condensed:wght@300;400;700&family=Roboto+Flex:wght@300;400;500;600;700;800;900&display=swap');\n\n$fonts: (\n\taccent: (\n\t\tname: 'Roboto Slab',\n\t\tshort-name: 'RS',\n\t\tstack: '\"Roboto Slab\",\"Times New Roman\",\"Lucida Bright\",Georgia,\"slab\",serif',\n\t\tweight:(\n\t\t\tlight:200,\n\t\t\tregular:400,\n\t\t\tmedium:500,\n\t\t\tbold:700,\n\t\t\txbold:900\n\t\t)\n\t),\n\tdisplay: (\n\t\tname: 'Roboto Flex',\n\t\tshort-name: 'RF',\n\t\tstack: '\"Roboto Flex\",Roboto,\"Open Sans\",-apple-system, BlinkMacSystemFont, \"Segoe UI\", Helvetica, Arial, sans-serif',\n\t\tweight:(\n\t\t\tlight:200,\n\t\t\tregular:400,\n\t\t\tmedium:600,\n\t\t\tbold:800,\n\t\t\txbold:1000\n\t\t)\n\t\t),\n\tcopy: (\n\t\tname: 'Roboto Flex',\n\t\tshort-name: 'RF',\n\t\tstack: '\"Roboto Flex\",Roboto,\"Open Sans\",-apple-system, BlinkMacSystemFont, \"Segoe UI\", Helvetica, Arial, sans-serif',\n\t\tweight:(\n\t\t\tlight:200,\n\t\t\tregular:400,\n\t\t\tmedium:600,\n\t\t\tbold:800,\n\t\t\txbold:1000\n\t\t)\n\t\t),\n\tui: (\n\t\tname: 'Roboto Flex',\n\t\tshort-name: 'RF',\n\t\tstack: '\"Roboto Flex\",Roboto,\"Open Sans\",-apple-system, BlinkMacSystemFont, \"Segoe UI\", Helvetica, Arial, sans-serif',\n\t\tweight:(\n\t\t\tlight:200,\n\t\t\tregular:400,\n\t\t\tmedium:600,\n\t\t\tbold:800,\n\t\t\txbold:1000\n\t\t)\n\t),\n);\n\n\n\n\t\n// Reset Values of Utility-css.vars.scss\n$value-to-unit: map-deep-set($value-to-unit, font-family accent, unquote(map-deep-get($fonts, accent, stack)));\n$value-to-unit: map-deep-set($value-to-unit, font-family display, unquote(map-deep-get($fonts, display, stack)));\n$value-to-unit: map-deep-set($value-to-unit, font-family copy, unquote(map-deep-get($fonts, copy, stack)));\n$value-to-unit: map-deep-set($value-to-unit, font-family ui, unquote(map-deep-get($fonts, ui, stack)));\n\n\n\n$font_display: get-css-size(font-family, display);\n$font_accent: get-css-size(font-family, accent);\n$font_ui: get-css-size(font-family, ui);\n$font_copy: get-css-size(font-family, copy);\n$font_mono: get-css-size(font-family, mono);\n\n$global-radius-on: false;\n$global-border-radius: 3px;\n$value-to-unit: map-deep-set($value-to-unit, 'radius' 'radius', $global-border-radius);\n$global-border-round: 18px;\n$value-to-unit: map-deep-set($value-to-unit, 'radius' 'round', $global-border-round);\n$basicSizeMultiplier: 1rem;\n\n$h1-font-size: map-deep-get($value-to-unit, font-size, 5);\n$h2-font-size: map-deep-get($value-to-unit, font-size, 4);\n$h3-font-size: map-deep-get($value-to-unit, font-size, 3);\n$h4-font-size: map-deep-get($value-to-unit, font-size, 2);\n$h5-font-size: map-deep-get($value-to-unit, font-size, 1);\n$h6-font-size: map-deep-get($value-to-unit, font-size, 0);\n\n$font-size-base: $base-font-size-rem; // Assumes the browser default, typically `16px`\n$font-size-lg: map-deep-get($value-to-unit, font-size, 2);\n$font-size-sm: map-deep-get($value-to-unit, font-size, n1);\n\n\n$headline-color: get-theme-color(primary,-1);\n\n\n$usingFontAwesome:false;@function color-block($colorName, $modifier, $modifier-label, $font-color-class) {\n $return:\"

#{$colorName}-#{$modifier-label}

  • HEX: #{get-theme-color($colorName, $modifier)}
  • RGB: #{get-theme-color($colorName, $modifier, RGB)}
  • HSL: #{get-theme-color($colorName, $modifier, HSL)}
\";\n @return $return;\n}\n\n\n\n\n\n@each $colorName, $color in $theme-palette{\n\n/*\n\n#{$colorName}: Color Variations \n \nThe Modified versions of the #{$colorName} color from this theme\n \nMarkup:\n\n\n\t\t#{ color-block($colorName, -5,n5,c_white)}\n\t\t#{ color-block($colorName, -4,n4,c_white)}\n\t\t#{ color-block($colorName, -3,n3,c_white)}\n\t\t#{ color-block($colorName, -2,n2,c_white)}\n\t\t#{ color-block($colorName, -1,n1,c_white)}\n\t\t#{ color-block($colorName, 0,0,c_white)}\n\t\t#{ color-block($colorName, 1,1,c_black)}\n\t\t#{ color-block($colorName, 2,2,c_black)}\n\t\t#{ color-block($colorName, 3,3,c_black)}\n\t\t#{ color-block($colorName, 4,4,c_black)}\n\t\t#{ color-block($colorName, 5,5,c_black)}\n\n\n\n\n\n HideCodeBlock: display_none \n\nWeight:0\n \nStyleguide DesignBase.CrayonBox.#{$colorName}\n\n*/\n}\n\n/*\nCrayon Box\n \nThis is all of the colors of the theme broken out with its modifications written in hex code.\n \n\nWeight:0\n\nHideCodeBlock: display_none \n \nStyleguide DesignBase.CrayonBox\n*/\n$unitless: (\n\t\t0: 0,\n\t\tn5: -5,\n\t\tn4: -4,\n\t\tn3: -3,\n\t\tn2: -2,\n\t\tn1: -1,\n\t\t1: 1,\n\t\t2: 2,\n\t\t3: 3,\n\t\t4: 4,\n\t\t5: 5,\n\t);\n/*Adobe XD Color Map*/\n@each $colorName, $color in $theme-palette{\n @each $label, $value in $unitless{\n /* $xd-color_#{$colorName}-#{$label}: #{get-theme-color($colorName, $value)}*/\n }\n}/*\n\nBasic HTML\n\nThe Arches Design System, at its core, is a Utility Class Styling Design. It is built not to prescribe the design of the HTML and components but to paint with classes to create complicated UI without having to create more styles. Arches rely on the browser or branding defaults for basic HTML styling. Below is a kitchen sink of HTML elements so you can see how this variation look without further alteration from adding classes. There is No basic styling around the pure DOM with the utility class only, and there is improved styling as you add Bootstrap or Foundation. \n\nWeight: -100\n\nStyleguide HTML\n*/\n/*\n\nReading Typography\n\nReading typography is a container class to opt into an override of the basic typography from arches. Basic Typography is un-styled and rely on the most basic styles from the browser stylesheets so there is less overriding when making UI but it leaves reading typography lacking. Most ways typography content is added to a site is devoid of hooks to add styles to an element so work around that restriction and to unified styling across reading experiences the \"reading-typography\" class is used on the parent container. Please note that the reading typography can still look a bit different look depending on the brand or the framework.
modifier classcustomizationusage
.inherit_colorremoves all color rules from colored typography and sets it to inherit.inverting a block of typography where all text and headlines should be white.
.font-size_upshifts all typography up one font size stepintro blocks of text where the text. Or in articles where you can shift all text up a size.
`.font-size_down`shifts all typography down one font size step.citation blocks or boiler plate content where the text should be smaller and less impactful.
.links_darkturns all links to the dark color standard.this is used in junction with the .inherit_color class.
.links_lightturns all links to the light color standard.this is used in junction with the .inherit_color class when text is on a dark background.
* there are further advanced features if you want to apply CSS Property Overrides. \n\nMarkup:\n
\n
\n\t\n\t\t\n\t\t\n\t\t\n\t\t \n\t\t\"\"\n\t\n
\n
\n User Name\n Log Out \n
\n
\n
\n

This is the primary heading and there should only be one of these per page

\n
sub heading
\n

A small paragraph to emphasis and show important bits.

\n
    \n
  • This is a list item
    • \n
  • So is this - there could be more
    • \n
  • Make sure to style list items to:\n
      \n
    • Not forgetting child list items
      • \n
    • Not forgetting child list items
      • \n
    • Not forgetting child list items
      • \n
    • Not forgetting child list items
      • \n
    \n
    • \n
  • A couple more
    • \n
  • top level list items
    • \n
\n

Don't forget Ordered lists:

\n
    \n
  1. Lorem ipsum dolor sit amet, consectetuer adipiscing elit.
    2. \n
  2. Aliquam tincidunt mauris eu risus.\n
      \n
    1. Lorem ipsum dolor sit amet, consectetuer adipiscing elit.
      2. \n
    2. Aliquam tincidunt mauris eu risus.
      3. \n
    \n
    3. \n
  3. Lorem ipsum dolor sit amet, consectetuer adipiscing elit.
    4. \n
  4. Aliquam tincidunt mauris eu risus.\n
\n

A sub heading which is not as important as the first, but is quite imporant overall

\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.

\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n
Table HeadingTable Heading
table datatable data
table datatable data
table datatable data
table datatable data
\t\n

A sub heading which is not as important as the second, but should be used with consideration

\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.

\n

“Ooh - a blockquote! Lorem ipsum dolor sit amet, consectetur adipiscing elit. Vivamus magna. Cras in mi at felis aliquet congue. Ut a est eget ligula molestie gravida. Curabitur massa. Donec eleifend, libero at sagittis mollis, tellus est malesuada tellus, at luctus turpis elit sit amet quam. Vivamus pretium ornare est.”

\n

A sub heading which is not as important as the second, but should be used with consideration

\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.

\n 
\n#header h1 a { \n    display: block; \n    width: 300px; \n    height: 80px; \n}\n
\n
A sub heading which is not as important as the second, but should be used with consideration
\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.

\n
\n
Definition list
\n
Consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna \n\taliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea \n\tcommodo consequat.
\n\t
Lorem ipsum dolor sit amet
\n\t
Consectetur adipisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna \n\taliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea \n\tcommodo consequat.
\n\t
\n\t
This heading plays a relatively small bit part role, if you use it at all
\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Donec eu libero sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo.

\n
\n\nWeight: -9\n\nHideCodeBlock: display_none \n\nStyleguide HTML.Typography\n\n*/\n\n/*\n\nSample Typography\n\nThis text is used as a lorem content in many of our containers. \n\n.p_4 - This is the basic typogrpahy from the browser.\n.reading-typography.p_4 - this is the standard styling for typography of reading content\n.reading-typography.font-size_up.p_4 - This font increased their sizes across all typography in the container.\n.reading-typography.font-size_down.p_4 - This font decreses their sizes across all typography in the container.\n.reading-typography.color_inherit.bg_acc.c_white.p_4.links_light - This removes all color defining styles to make it easer to reverse colors. This sets all typography and borders to inherit their colors.\n\nMarkup:\n
\n

Lorem Ipsum

\n

Pellentesque habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas. Vestibulum tortor quam, feugiat vitae, ultricies eget, tempor sit amet, ante. Pellentesque sit amet quam egestas semper. Aenean ultricies mi vitae est. Mauris placerat eleifend leo. Quisque sit amet est et sapien ullamcorper pharetra. Vestibulum erat wisi, condimentum sed, commodo vitae, ornare sit amet, wisi. Aenean fermentum, elit eget tincidunt condimentum, eros ipsum rutrum orci, sagittis tempus lacus enim ac dui. Donec non enim in turpis pulvinar facilisis. Ut felis.

\n

Header Level 2

\n
    \n
  1. Lorem ipsum dolor sit amet, consectetuer adipiscing elit.
    2. \n
  2. Aliquam tincidunt mauris eu risus.
    3. \n
\n

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Vivamus magna. Cras in mi at felis aliquet congue. Ut a est eget ligula molestie gravida. Curabitur massa. Donec eleifend, libero at sagittis mollis, tellus est malesuada tellus, at luctus turpis elit sit amet quam. Vivamus pretium ornare est.

\n

Header Level 3

\n
    \n
  • Lorem ipsum dolor sit amet, consectetuer adipiscing elit.
    • \n
  • Aliquam tincidunt mauris eu risus.
    • \n
\n \n
\n\nWeight: -9\n\nHideCodeBlock: display_none \n\nMarkupWrapperClasses: br_solid br_radius br_black-1 br_1 m_3 max-w_50\n\nStyleguide HTML.Typography.Sample\n\n*/\n\n/*\n\nBasic Typography\n\nBasic Typography is unstyled and relys on the most basic styles from the browser stylesheets so there is less overriding when making UI but it leaves the reading of content text lacking. The overriding styles that are applied to Basic typography is a consistent font treatment (font sizing, font family, and font-weight) and what comes from the baseline frameworks that build the brand. \n\n\nMarkup:\n

Basic Typography: Lorem ipsum dolor sit amet, consectetuer adipiscing \nelit.

\n

Aenean commodo ligula eget dolor aenean massa

\n

Cut sociis natoque penatibus et magnis dis \nparturient montes nascetur ridiculus mus

\n

Donec quam felis ultricies nec pellentesque eu \npretium quis sem nlla consequat massa quis enim

\n
Donec pede justo fringilla vel aliquet nec vulputate \neget arcu
\n
In enim justo rhoncus ut imperdiet a venenatis vitae \njusto
\n

Lorem ipsum dolor sit amet, consectetuer adipiscing \nelit. Aenean commodo ligula eget dolor. Aenean massa. \nCum sociis natoque penatibus et magnis dis parturient \nmontes, nascetur ridiculus mus. Donec quam felis, \nultricies nec, pellentesque eu, pretium quis, sem.

\n

This paragraph is nested inside an article. It contains many different, sometimes useful, HTML5 tags. Of course there are classics like emphasis, strong, and small but there are many others as well. Hover the following text for abbreviation tag: abbr. Similarly, you can use acronym tag like this: ftw. You can define deleted text which often gets replaced with inserted text.

You can also use keyboard text, which sometimes is styled similarly to the <code> or samp tags. Even more specifically, there is a tag just for variables. Not to be mistaken with blockquotes below, the quote tag lets you denote something as quoted text. Lastly don't forget the sub (H2O) and sup (E = MC2) tags.

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Tricuspid regurgitation (TR) is a common valvular disease estimated to affect >1.5 million people in the U.S., with a yearly incidence of about 200,000 and >300,000 patients in the U.S and Europe, respectively.1 Stated another way, a clinically significant form of this valvular disease affects 4% (or 1 in 25) of patients ages 75 and older.2

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Despite the current guidelines favoring early tricuspid valve repair, especially when undergoing concomitant left-sided cardiac surgery, most patients with TR receive lifetime medical therapy until intractable right-sided heart failure (HF) and end-organ dysfunction appear.1 In recent years, multiple studies have drawn attention to the poor prognosis of untreated TR, and demonstrated a clear tendency of excess mortality in patients with increasing severity of TR, highlighting the need for interventional options to improve outcomes.3

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\n\t\t\t\t\tThe future of medicine is increasingly in the hands of those who are effective users of clinical data.\n\t\t\t\t\t– Bill Weintraub, MD, MACC\n\t\t\t\t
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TR associated with left-sided valvular or myocardial disease is often a marker for late-stage chronic HF with limited treatment options and an unfavorable overall prognosis. However, isolated TR is also independently associated with excess mortality if left untreated. Thus, TR represents an important public health problem with an unmet clinical need.

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Surgical approaches, either repair or replacement, have been shown to carry a high risk of in-hospital mortality, reaching 10%, without significant improvement over the past 10 years.4 As transcatheter interventional options for valvular heart disease continue to expand, transcatheter tricuspid valve repair through leaflet approximation or annuloplasty has been investigated.

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Despite studies showing promising results with greater survival and freedom from HF rehospitalization compared with conservative management, its use can be limited by anatomical infeasibility such as large leaflet coaptation gap, perforation, significant leaflet tethering with dense chordae, and leaflet impingement with a cardiac implantable electronic device lead.

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A myriad of investigational transcatheter tricuspid valve replacement (TTVR) devices have emerged as an alternative to surgery and to address this outstanding need, with promising early results related to safety, efficacy and improvements in patients' functional status and quality of life.

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Orthotopic Valve Replacement

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Orthotopic TTVR is a form of valve replacement performed by implanting a bioprosthetic valve on an existing tricuspid annulus, in a fashion similar to how it is performed in transcatheter aortic or mitral valve replacement. Several investigational devices are available with a variety of access and anchoring systems.

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EVOQUE

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The EVOQUE system (Edwards Lifesciences, Irvine, CA) is a self-expanding bovine pericardial valve mounted on a nitinol frame with a fabric skirt delivered through a transfemoral approach. The perimeter is surrounded by nine anchors that allow stabilization through anchoring to the annulus, leaflets and chords of the tricuspid apparatus. Its compassionate use in 27 patients with severe symptomatic TR at inoperable or high surgical risk has demonstrated 92% success with no periprocedural mortality.5

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The reduction in TR remained excellent at one year (≤moderate in 96% and ≤mild in 87%) with sustained symptomatic improvement (NYHA I/II in 69% compared with 11% at baseline).5 All-cause death and HF hospitalization at one year were both at 7% without any deaths being identified as device-related. An early feasibility trial of this device, TRISCEND, is ongoing with an early report of 56 patients demonstrating a similar success rate, reduction in TR and symptomatic improvement.6

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Lux-Valve

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The Lux-Valve (Jenscare Biotechnology Co., Ningbo, China) is a bovine pericardium valve with a self-expanding nitinol atrial disc, self-adaptive fabric skirt, two graspers and an interventricular septal anchor. It is deployed via a minimally invasive right thoracotomy and transatrial approach. First-in-human experience including 31 patients reported a 100% technical success rate with TR reduction to ≤moderate and ≤mild in 100% and 85.2%, respectively at one year. Symptomatic improvement has persisted at one year with 82.8% maintaining NYHA I/II and a 96.8% survival rate.7 A study investigating the second-generation LuX-Valve Plus delivered through transjugular access is currently underway (NCT05436028).

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GATE

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The GATE (NaviGate Cardiac Structures, Inc., Lake Forest, CA) device was the first TTVR performed and is composed of an equine pericardium tricuspid valve mounted on a nitinol alloy stent. Twelve right ventricular tines grasp the native leaflets and 12 right atrial winglets covered by microfiber polyester cloth provide a seal. It is delivered through a right thoracotomy and transatrial access. An early study including five patients reported 100% technical success, with all patients demonstrating TR reduction to ≤mild; however, one patient died before discharge.8

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Prominent Stressors For CVD Among LGBTQIA+ Adults

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Excess cardiovascular disease risk is associated with three categories of stressors, as described by the Minority Stress Model: psychosocial (depression, anxiety, stress); behavioral (diet quality, physical activity, substance use); and physiological (hypothalamic-pituitary-adrenal axis, chronic inflammation, autonomic nervous system dysfunction).4

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Structural/institutional stressors are also in place. The Behavioral Risk Factor Surveillance System survey 2014-2017 found a higher rate of poverty in LGBT people compared with cisgender heterosexual people vs. 15.7%, respectively).9

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In 2018, a large portion of LGBTQIA+ individuals lived in states that did not have public accommodation (hospitals and schools) and employment nondiscrimination laws.10

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For many transgender individuals, employee-sponsored health insurance is often not an option. Many employee-sponsored health insurance programs do not acknowledge partners or spouses with gender identities that align with the insured. More than two-thirds of gender minority adults report having experienced some form of discrimination from clinicians (including the use of abusive language). Roughly a quarter of transgender individuals have been denied health care by clinicians.11

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Cardiovascular Disease Risk Factors

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The data on cardiovascular health in LGBTQIA+ adults are limited because of a lack of research and challenges with study design. In terms of cardiovascular disease risk factors, the use of tobacco products is more likely among LGBTQIA+ adults than cisgender heterosexual adults.12 Alcohol and illicit drug use disorder, poor mental health and elevated body mass index are greater risk factors among sexual minority women than heterosexual women.13 Current studies also suggest that decreased sleep duration, which has been associated with higher rates of hypertension, diabetes and cardiovascular disease, was higher among sexual minority women compared with heterosexual women.14

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Cardiovalve

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The Cardiovalve (Venus Medtech Inc., Hangzhou, China) is deployed through transfemoral access and consists of a bovine pericardial leaflet mounted on a dual nitinol atrial and ventricular frame creating 24 grasping points for anchoring. The atrial portion of the frame has a covered flange to allow sealing to prevent paravalvular leak. Its compassionate use has been reported in 15 patients demonstrating significant reduction in TR to ≤moderate in 100% and ≤mild in 8% at 30 days.9 An early feasibility study is currently underway (NCT04100720).

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Intrepid

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The Intrepid (Medtronic Plc, Minneapolis, MN) is a transfemoral system with a bovine pericardial valve housed within a nitinol dual stent frame. Early experience with three patients reported technical success in all, and an early feasibility study is currently recruiting patients with a goal to include 15 patients (NCT04433065).10

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This article was authored by Hiroki Ueyama, MD, and Isida Byku, MD, FACC, from the Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, in Atlanta, GA.

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References

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  1. Asmarats L, Puri R, Latib A, Navia JL, Rodés-Cabau J. Transcatheter tricuspid valve interventions: Landscape, challenges, and future directions. J Am Coll Cardiol 2018;71:2935-56.
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  2. Topilsky Y, Maltais S, Medina Inojosa J, et al. Burden of Tricuspid regurgitation in patients diagnosed in the community setting. JACC Cardiovasc Imaging 2019;12:433-42.
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  3. Taramasso M, Benfari G, van der Bijl P, et al. Transcatheter versus medical treatment of patients with symptomatic severe tricuspid regurgitation. J Am Coll Cardiol 2019;74:2998-3008.
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  4. Dreyfus J, Flagiello M, Bazire B, et al. Isolated tricuspid valve surgery: Impact of aetiology and clinical presentation on outcomes. Eur Heart J 2020;41:4304-17.
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  5. Webb JG, Chuang AM, Meier D, et al. Transcatheter Tricuspid valve replacement with the evoque system: 1-year outcomes of a multicenter, first-in-human experience. JACC Cardiovasc Interv 2022;15:481-91.
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  6. Kodali S, Hahn RT, George I, et al. Transfemoral tricuspid valve replacement in patients with tricuspid regurgitation: TRISCEND study 30-Day results. JACC Cardiovasc Interv 2022;15:471-80.
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  7. Modine T. Transcatheter tricuspid valve replacement with the LuX-Valve system 1-Year results of a multicenter FIH experience. Presented at TVT 2022, June 8, 2022.
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  8. Hahn RT, George I, Kodali SK, et al. Early Single-site experience with transcatheter tricuspid valve replacement. JACC Cardiovasc Imaging 2019;12:416-29.
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  9. Fam NP. Cardiovalve TTVR update. Presented at TVT 2022, June 8, 2022.
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  10. Bapat VN. The INTREPID Valve for severe tricuspid regurgitation: First-in-man case experience. Presented at TCT 2020.
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  11. Lauten A, Figulla HR, Unbehaun A, et al. Interventional treatment of severe tricuspid regurgitation: Early clinical experience in a multicenter, observational, first-in-man study. Circ Cardiovasc Interv 2018;11:e006061.
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  12. Dreger H, Mattig I, Hewing B, et al. Treatment of severe tricuspid regurgitation in patients with advanced heart failure with CAval Vein Implantation of the Edwards Sapien XT VALve (TRICAVAL): a randomised controlled trial. EuroIntervention 2020;15:1506-13.
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  13. Lauten A, Doenst T, Hamadanchi A, Franz M, Figulla HR. Percutaneous bicaval valve implantation for transcatheter treatment of tricuspid regurgitation: clinical observations and 12-month follow-up. Circ Cardiovasc Interv 2014;7:268-72.
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  14. Wild MG, Lubos E, Cruz-Gonzalez I, et al. Early clinical experience with the TRICENTO bicaval valved stent for treatment of symptomatic severe tricuspid regurgitation: A multicenter registry. Circ Cardiovasc Interv 2022;15:e011302.
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  15. Lurz P, von Bardeleben R, Weber M, et al. Transcatheter edge-to-edge repair for treatment of tricuspid regurgitation. J Am Coll Cardiol 2021;77:229-39.
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  16. Hahn RT. Transcatheter tricuspid valve repair:CLASP TR study one-year results. . Presented at EuroPCR 2022.
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  17. Kodali S, Hahn RT, Eleid MF, et al. Feasibility study of the transcatheter valve repair system for severe tricuspid regurgitation. J Am Coll Cardiol 2021;77:345-56.
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  18. Zack CJ, Fender EA, Chandrashekar P, et al. National trends and outcomes in isolated tricuspid valve surgery. J Am Coll Cardiol 2017;70:2953-60.
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All of these color codes are used universally through out the college and have an associated meaning. All of these colors are just used for reference and have no associated decorator classes. You must include the the associated color-code_x.css have access to utlity classes that will color using the bellow colors. \n\nStyleguide DesignBase.Colors.ColorCoding\n\n */\n/*\n\nCOR Colors \n\n(COR) Class of Recommendation is a color collect used in Guideline recommendations.\n\n$cor-green \t- #{$cor-green}; I\n$cor-yellow \t- #{$cor-yellow}; IIA\n$cor-yellow-orange - #{$cor-yellow-orange}; IIA\n$cor-orange \t- #{$cor-orange};III and III-NoHarm\n$cor-red \t\t- #{$cor-red}; III-harm\n\nWeight: 10\n\nStyleguide DesignBase.Colors.ColorCoding.COR\n\n */\n\n/*\n\nLOE Colors \n\n(LOE) level of Evidence is a color collect used in Guideline recommendations.\n\n$loe-dark-blue \t- #{$loe-dark-blue};LOE A\n$loe-mid-blue \t\t- #{$loe-mid-blue };LOE B-R\n$loe-light-blue \t- #{$loe-light-blue };LOE B-NR\n$loe-pale-blue \t- #{$loe-pale-blue }; LOE C\n\nWeight: 10\n\nStyleguide DesignBase.Colors.ColorCoding.LOE\n\n */\n/*\n\nCredit Type Color Coding \n\nCredit Types in the ACC have a specific color coding.\n\n$credit-AAPA - #{$credit-AAPA }; AAPA: American Academy of Physician Assistants (AAPA) Category 1 CME Credit \n$credit-ABP - #{$credit-ABP }; ABP-MOC: American Board of Pediatrics \n$credit-ABPMOCII - #{$credit-ABPMOCII }; ABP-MOC 2: American Board of Pediatrics MOC 2 \n$credit-ABPMOCIV - #{$credit-ABPMOCIV }; ABP-MOC 4: American Board of Pediatrics MOC 4 \n$credit-ATCEU - #{$credit-ATCEU }; ATCEU: Athletic Trainer Continuing Education Unit \n$credit-CE - #{$credit-CE }; CE: Continuing CCA\\Tech Education \n$credit-CME - #{$credit-CME }; CME: AMA PRA Category 1TM Credit(s)  \n$credit-CNE - #{$credit-CNE }; CNE: Continuing Nurse Education \n$credit-CNErx - #{$credit-CNErx }; CNErx: Continuing Nursing Education Pharmaceutical \n$credit-COP - #{$credit-COP }; COP: Certificate of Participation  \n$credit-CPE - #{$credit-CPE }; CPE: Continuing Pharmacy Education \n$credit-ECME - #{$credit-ECME }; ECME: European Board for Accreditation in Cardiology (EBAC) External CME Credit\n$credit-IPCE - #{$credit-IPCE }; IPCE: Interprofessional Continuing Education Credit\n$credit-MOCII - #{$credit-MOCII }; MOC II: ABIM MOC Part II \n$credit-MOCIV - #{$credit-MOCIV }; MOC IV: ABIM MOC Part IV \n\nWeight: 0\n\nStyleguide DesignBase.Colors.ColorCoding.Credits\n\n*/\n/*\n\nClinical Pathway Colors \n\nEach of the clinical pathways has a distinctive color. These colors are used to give a distinct theme to our clinical apps, marketing, pdf's and tools.\n\n$pathway-acute-coronary-syndromes \t\t\t\t\t\t- #{$pathway-acute-coronary-syndromes}; Acute Coronary Syndromes\n$pathway-arrhythmias-EP \t\t\t\t\t\t\t\t- #{$pathway-arrhythmias-EP}; arrhythmias and Clinical EP\n$pathway-congenital-heart-disease \t\t\t\t\t\t- #{$pathway-congenital-heart-disease}; Congenital Heart Disease\n$pathway-ecg-stress-test \t\t\t\t\t\t\t\t- #{$pathway-ecg-stress-test}; Standard ECG, Stress Test\n$pathway-heart-failure \t\t\t\t\t\t\t\t\t- #{$pathway-heart-failure}; Heart Failure and Cardiomyopathies\n$pathway-invasive-cardiology \t\t\t\t\t\t\t- #{$pathway-invasive-cardiology}; Invasive Cardiology Angiography and Intervention\n$pathway-noninvasive-cardiology \t\t\t\t\t\t- #{$pathway-noninvasive-cardiology}; Noninvasive Cardiology\n$pathway-pandemic \t\t\t\t\t\t\t\t\t\t- #{$pathway-pandemic}; Pandemic \"Covid\"\n$pathway-pericardial \t\t\t\t\t\t\t\t\t- #{$pathway-pericardial}; pericardial Disease\n$pathway-prevention \t\t\t\t\t\t\t\t\t- #{$pathway-prevention}; Prevention\n$pathway-pulmonary-hypertension \t\t\t\t\t\t- #{$pathway-pulmonary-hypertension}; Pulmonary Hypertension and Venous Thromboembolic Disease\n$pathway-special \t\t\t\t\t\t\t\t\t\t- #{$pathway-special}; Special\n$pathway-stable-ischemic-heart-disease \t\t\t\t- #{$pathway-stable-ischemic-heart-disease}; Stable ischemic Heart Disease\n$pathway-valvular-heart-disease \t\t\t\t\t\t- #{$pathway-valvular-heart-disease}; Valvular Heart Disease\n$pathway-vascular-medicine \t\t\t\t\t\t\t\t- #{$pathway-vascular-medicine}; Vascular Medicine\n\nWeight: -1\n\nStyleguide DesignBase.Colors.ColorCoding.Pathways\n\n*/\n/*\n\nRegistry CC\n\nCredit Type Color codes in the ACC have a specific color coding.\n\n$registry-cpmi - #{$registry-cpmi }; Chest Pain MI Registry\n$registry-afib - #{$registry-afib }; AFib Ablation Registry\n$registry-cathpci - #{$registry-cathpci }; CathPCI Registry\n$registry-icd - #{$registry-icd }; ICD Registry\n$registry-impact - #{$registry-impact }; IMPACT Registry\n$registry-pinnacle-primary - #{$registry-pinnacle-primary }; PINNACLE Registry (Primary)\n$registry-pinnacle-accent - #{$registry-pinnacle-accent }; PINNACLE Registry (Accent)\n$registry-focus - #{$registry-focus }; Patient Navigator Focus MI\n$registry-pcibleeding - #{$registry-pcibleeding }; Reducing Risk PCI Bleeding\n$registry-laao - #{$registry-laao }; LAAO Registry\n$registry-pvi - #{$registry-pvi }; PVI Registry\n$registry-auxdata - #{$registry-auxdata }; Auxiliar Data Collection\n$registry-ststvt - #{$registry-ststvt }; STS ACC TVT Registry\n$registry-diabetes - #{$registry-diabetes }; Diabetes Collaborative \n\nWeight: 2000\n\nStyleguide DesignBase.Colors.ColorCoding.Registry\n\n*/\n/*\n\nJournal\n\nJournals of JACC have specific branding colors.\n\n$journal-jc - #002e5a; Journal of the American College of Cardiology: (JC)\n$journal-adv - #0000FF; JACC: Advances: (JC-ADV)\n$journal-asia - #ec2939; JACC: Asia: (JC-ASIA)\n$journal-tran - #1788c2; JACC: Basic to Translational Science: (JC-TRAN)\n$journal-cvonc - #00ae81; JACC: CardioOncology: (JC-CVONC)\n$journal-case - #f37321; JACC: Case Reports: (JC-CASE)\n$journal-ep - #8a5e96; JACC: Clinical Electrophysiology: (JC-EP)\n$journal-hf - #991326; JACC: Heart Failure: (JC-HF)\n$journal-invt - #038e92; JACC: Cardiovascular Interventions: (JC-INVT)\n$journal-imag - #c18a0e; JACC: Cardiovascular Imaging: (JC-IMAG)\n\n\nWeight: 2000\n\nStyleguide DesignBase.Colors.ColorCoding.Journals\n\n*/\n/*\n\nSocial Network Colors \n\nEach of the social networks has a distinctive color. These colors are used to give a distinct theme to the social nav that is in different locations.\n\n$twitter - #000; \t\ttwitter \n$facebook - #3b5998; \tfacebook \n$linkedin - #007bb6; \tlinkedin \n$apple-store - #ea4cc0; \tapple-store \n$google-play - #689f38; \tgoogle-play \n$youtube - #bb0000; \tyoutube \n\n\n\nWeight: 100\n\nStyleguide DesignBase.Colors.ColorCoding.Social Networks\n\n*/\n\n/*\n\tTextures\n\n\tAll textures in the Arches design are a subtle variation of transparent. Allowing for colors to bleed through from behind. Different textures have intentions or are reserved for certain usagaes. \n\n\t.texture_light \t\t- Light textures is reserved for the base of a page where it can gve a soft area for text or cards to live on top of. \n\t.texture_medium \t\t\t\t\t- medium texture are used for area that are hidden away. Collapsable navs, areas, or sidebars ususaly use the medium texture.\n\t.texture_dust \t\t\t\t\t- Dust is the most transparent texture allowing for the color of the background to show through the most. This is used for the painted tops of cards, or score bars.\n\t.texture_dark \t\t\t\t\t- This texture predominatly used on the footer. Its rich black will alway requrie reversed text and buttons to be readable. \n\t.texture_cross \t\t\t\t\t- A mostly transparent cross texture used for alternating rows of content when a little extra texture is needed.\n\t.texture_disabled \t\t\t\t- This texture is used to paint disabled buttons and ui items giving it a greyed and X'ed out appearand. \n\n\tMarkup:\n\t
{{modifier_class}} with a light primary color background
\n\n\tStyleguide DesignBase.Textures\n\n */\n@import './src/scss/recipes/base/_web-footer';\n@import './src/scss/recipes/journal/_journal._footer';/** SCSS DOC: __globalshame_uc.scss **/","/** SCSS DOC: _helpers.scss **/\n\n// @import \"fixes\";\n@import \"str-replace\";\n@import \"strip-unit\";\n@import \"class-name-constructor\";\n//@import \"clamp\";\n@import \"str-explode\";\n@import \"deep-map-check\";\n@import \"map-deep-get\";\n@import \"map-deep-set\";\n@import \"get\";\n\n@import \"make-shadow\";\n@import \"color-loop\";\n@import \"size-loop\";\n@import \"styleguide\"\n\n// Exsists in foundation\n\n\n\n","@use \"sass:map\";\n@use \"sass:selector\";\n@use \"sass:color\";\n@use \"sass:math\";\n\n/** SCSS DOC: _colors.scss **/\n\n$acc-blue: #004176 !default;\n$teal: #198dae !default;\n$green-blue: #24ccae !default;\n$dark-grey: #676a72 !default;\n$alt-grey: #a3988c !default;\n$green: #06a022 !default;\n$orange: #da8210 !default;\n$red: #dd1a1a !default;\n$blue: #2b58c0 !default;\n$purple: #976ad2 !default;\n$magenta: #c34198 !default;\n$white: rgb(251, 247, 247) !default;\n$black: rgb(19, 18, 18) !default;\n// Currently Un used in the design but part of bootstrap.\n$indigo: #6610f2 !default;\n$pink: #e83e8c !default;\n$yellow: #ffc107 !default;\n$cyan: #17a2b8 !default;\n$gray-100: mix($white, $black, 10%) !default;\n$gray-200: mix($white, $black, 20%) !default;\n$gray-300: mix($white, $black, 30%) !default;\n$gray-400: mix($white, $black, 40%) !default;\n$gray-500: mix($white, $black, 50%) !default;\n$gray-600: mix($white, $black, 60%) !default;\n$gray-700: mix($white, $black, 70%) !default;\n$gray-800: mix($white, $black, 80%) !default;\n$gray-900: mix($white, $black, 90%) !default;\n$grays: () !default;\n$grays: map-merge(\n\t(\n\t\t\"100\": $gray-100,\n\t\t\"200\": $gray-200,\n\t\t\"300\": $gray-300,\n\t\t\"400\": $gray-400,\n\t\t\"500\": $gray-500,\n\t\t\"600\": $gray-600,\n\t\t\"700\": $gray-700,\n\t\t\"800\": $gray-800,\n\t\t\"900\": $gray-900,\n\t),\n\t$grays\n);\n$colors: () !default;\n$colors: map-merge(\n\t(\n\t\t\"blue\": $blue,\n\t\t\"indigo\": $indigo,\n\t\t\"purple\": $purple,\n\t\t\"pink\": $pink,\n\t\t\"red\": $red,\n\t\t\"orange\": $orange,\n\t\t\"yellow\": $yellow,\n\t\t\"green\": $green,\n\t\t\"teal\": $teal,\n\t\t\"cyan\": $cyan,\n\t\t\"white\": $white,\n\t\t\"gray\": $gray-600,\n\t\t\"gray-dark\": $gray-800,\n\t),\n\t$colors\n);\n$theme-palette: () !default;\n\n$theme-palette: map-merge(\n\t(\n\t\tprimary: $teal,\n\t\tsecondary: $dark-grey,\n\t\tsuccess: $green,\n\t\tshade: $gray-500,\n\t\twarning: $orange,\n\t\talert: $red,\n\t\tnavigation: $blue,\n\t\taccent: $green-blue,\n\t\tinfo: $alt-grey,\n\t\thighlight: $purple,\n\t\tacc: $acc-blue,\n\t),\n\t$theme-palette\n);\n/** Setting link color variables in scss **/\n$link-color-light:\t\t\t\t\tget-theme-color(accent, 3) !default;\n$link-color-light--hover:\t\t\tget-theme-color(accent, 5) !default;\n$link-color-light--visited:\t\t\tcolor.scale( get-theme-color(accent, 2), $saturation: -70%) !default;\n$link-color-dark:\t\t\t\t\tget-theme-color(accent, -3) !default;\n$link-color-dark--hover:\t\t\tget-theme-color(accent, -5) !default;\n$link-color-dark--visited:\t\t\tcolor.scale( get-theme-color(accent, -2), $saturation: -70%) !default;\n\n\n\n\n\n$cor-green: #6fc284;\n$cor-yellow: #ffd44f;\n$cor-yellow-orange: #faa74b;\n$cor-orange: #f15d4c;\n$cor-red: #ed1c00;\n$cor-pale-pink:#fcdbd8;\n$COR: () !default;\n$COR: map-merge(\n\t(\n\t\tI: $cor-green,\n\t\tIIA: $cor-yellow,\n\t\tIIB: $cor-yellow-orange,\n\t\tIII: $cor-orange,\n\t\tIII-NOBENIFIT: $cor-orange,\n\t\tIII-HARM: $cor-red,\n\t\tIII-4: $cor-pale-pink\n\t),\n\t$COR\n);\n$loe-dark-blue: rgb(62, 111, 183);\n$loe-mid-blue: rgb(101, 156, 211);\n$loe-light-blue: rgb(161, 193, 230);\n$loe-pale-blue: rgb(181, 213, 229);\n$LOE: () !default;\n$LOE: map-merge(\n\t(\n\t\tA: $loe-dark-blue,\n\t\tB-NR: $loe-mid-blue,\n\t\tB-BR: $loe-light-blue,\n\t\tC-LD: $loe-pale-blue,\n\t\tC-EO: $loe-pale-blue,\n\t),\n\t$LOE\n);\n\n$credit-AAPA: #e8c536;\n$credit-ABP: #007a5b;\n$credit-ABPMOCII: #0b6d4c;\n$credit-ABPMOCIV: #105a3b;\n$credit-ATCEU: #775744;\n$credit-CE: #a8a8a8;\n$credit-CME: #00a15b;\n$credit-CNE: #198dae;\n$credit-AANP: #2667b2;\n$credit-CNErx: #52549e;\n$credit-COP: #775891;\n$credit-CPE: #992e2e;\n$credit-ECME: #d16528;\n$credit-IPCE:#6c36b3;\n$credit-MOC: #9a1267;\n$credit-MOCII: #9a1267;\n$credit-MOCIV: #d3248d;\n$credit-ACHE : #9733a5;\n\n$CreditColors: () !default;\n$CreditColors: map-merge(\n\t(\n\t\tAANP: $credit-AANP,\n\t\tAAPA: $credit-AAPA,\n\t\tABP: $credit-ABP,\n\t\tABPMOCII: $credit-ABPMOCII,\n\t\tABPMOCIV: $credit-ABPMOCIV,\n\t\tATCEU: $credit-ATCEU,\n\t\tCE: $credit-CE,\n\t\tCME: $credit-CME,\n\t\tCNE: $credit-CNE,\n\t\tCNErx: $credit-CNErx,\n\t\tCOP: $credit-COP,\n\t\tCPE: $credit-CPE,\n\t\tECME: $credit-ECME,\n\t\tIPCE:$credit-IPCE,\n\t\tMOC: $credit-MOCII,\n\t\tMOCII: $credit-MOCII,\n\t\tMOCIV: $credit-MOCIV,\n\t\tACHE: $credit-ACHE,\n\t),\n\t$CreditColors\n);\n$pathway-invasive-cardiology: #c8b02f;\n$pathway-congenital-heart-disease: #fdb918;\n$pathway-noninvasive-cardiology: #947b33;\n$pathway-ecg-stress-test: #d9691f;\n$pathway-vascular-medicine: #ae171c;\n$pathway-pulmonary-hypertension: #d60e7e;\n$pathway-prevention: #a01d51;\n$pathway-heart-failure: #410d49;\n$pathway-valvular-heart-disease: #4f4190;\n$pathway-arrhythmias-EP: #005b37;\n$pathway-pericardial: #0079ad;\n$pathway-acute-coronary-syndromes: #009974;\n$pathway-stable-ischemic-heart-disease: #0f3e65;\n$pathway-special: #00b6f1;\n$pathway-pandemic: #8e2582;\n$PathwayColors: () !default;\n$PathwayColors: map-merge(\n\t(\n\t\tinvasive: $pathway-invasive-cardiology,\n\t\tcongenital: $pathway-congenital-heart-disease,\n\t\tnoninvasive: $pathway-noninvasive-cardiology,\n\t\tecg: $pathway-ecg-stress-test,\n\t\tvascular: $pathway-vascular-medicine,\n\t\tpulmonary: $pathway-pulmonary-hypertension,\n\t\tprevention: $pathway-prevention,\n\t\thf: $pathway-heart-failure,\n\t\tvalvular: $pathway-valvular-heart-disease,\n\t\tarrhythmias: $pathway-arrhythmias-EP,\n\t\tpericardial: $pathway-pericardial,\n\t\tacute: $pathway-acute-coronary-syndromes,\n\t\tischemic: $pathway-stable-ischemic-heart-disease,\n\t\tspecial: $pathway-special,\n\t\tpandemic: $pathway-pandemic,\n\t),\n\t$PathwayColors\n);\n\n$pathwayV2-invt: #c8b02f;\n$pathwayV2-pchd: #fdb918;\n$pathwayV2-imag: #947b33;\n$pathwayV2-vasc: #ae171c;\n$pathwayV2-pulmvd: #d60e7e;\n$pathwayV2-valv: #4f4190;\n$pathwayV2-ep: #005b37;\n$pathwayV2-ischem: #0f3e65;\n$pathwayV2-special: #00b6f1;\n$pathwayV2-prev: #a01d51;\n$pathwayV2-hf: #410d49;\n\n$PathwayColorsV2: () !default;\n$PathwayColorsV2: map-merge(\n\t(\n\t\tinvt: $pathwayV2-invt,\n\t\tpchd: $pathwayV2-pchd,\n\t\timag: $pathwayV2-imag,\n\t\tvasc: $pathwayV2-vasc,\n\t\tpulmvd: $pathwayV2-pulmvd,\n\t\tprev: $pathwayV2-prev,\n\t\thf: $pathwayV2-hf,\n\t\tvalv: $pathwayV2-valv,\n\t\tep: $pathwayV2-ep,\n\t\tischem: $pathwayV2-ischem,\n\t\tspecial: $pathwayV2-special\n\t),\n\t$PathwayColorsV2\n);\n\n$pathwayV3-arr: #c73d53;\n$pathwayV3-prev: #9f1d51;\n$pathwayV3-chd: #006838;\n$pathwayV3-invt: #b2c83a;\n$pathwayV3-hf: #935ca6;\n$pathwayV3-ischem: #0c4166;\n$pathwayV3-imag: #fdb913;\n$pathwayV3-pulmvd: #d50e7e;\n$pathwayV3-special: #00b6f1;\n$pathwayV3-vasc: #f15a29;\n$pathwayV3-valv: #400d49;\n\n\n$PathwayColorsV3: () !default;\n$PathwayColorsV3: map-merge(\n\t(\n\t\tarr: $pathwayV3-arr,\n\t\tprev: $pathwayV3-prev,\n\t\tchd: $pathwayV3-chd,\n\t\tinvt: $pathwayV3-invt,\n\t\thf: $pathwayV3-hf,\n\t\tischem: $pathwayV3-ischem,\n\t\timag: $pathwayV3-imag,\n\t\tpulmvd: $pathwayV3-pulmvd,\n\t\tspecial: $pathwayV3-special,\n\t\tvasc: $pathwayV3-vasc,\n\t\tvalv: $pathwayV3-valv\n\n\t),\n\t$PathwayColorsV3\n);\n\n\n$twitter: #000;\n$facebook: #3b5998;\n$linkedin: #0077b5;\n$apple-store: #ea4cc0;\n$google-play: #ef6c00;\n$youtube: #bb0000;\n$instagram: #8134af;\n$SocialColors: () !default;\n$SocialColors: map-merge(\n\t(\n\t\ttwitter: $twitter,\n\t\tfacebook: $facebook,\n\t\tlinkedin: $linkedin,\n\t\tapple-store: $apple-store,\n\t\tgoogle-play: $google-play,\n\t\tyoutube: $youtube,\n\t\tinstagram: $instagram,\n\t),\n\t$SocialColors\n);\n\n\n$registry-cpmi: #f22418;\n$registry-afib:#ffb300;\n$registry-cathpci: #0086d5;\n$registry-icd: #80b800;\n$registry-impact:#4e1f73;\n$registry-pinnacle-primary:#0e4f1b;\n$registry-pinnacle-accent:#b3c4c4;\n$registry-focus:#d6560d;\n$registry-pcibleeding:#c0268e;\n$registry-laao:#00667a;\n$registry-pvi:#00947f;\n$registry-auxdata:#04adad;\n$registry-ststvt:#a20062;\n$registry-diabetes:#7893b8;\n\n$RegistryColors: () !default;\n$RegistryColors: map-merge(\n\t(\n\t\tcpmi: $registry-cpmi,\n\t\tafib: $registry-afib,\n\t\tcathpci:$registry-cathpci,\n\t\ticd:$registry-icd,\n\t\timpact:$registry-impact,\n\t\tpinnacle:$registry-pinnacle-primary,\n\t\tpinnacle-accent:$registry-pinnacle-accent,\n\t\tfocus:$registry-focus,\n\t\tpcibleeding:$registry-pcibleeding,\n\t\tlaao:$registry-laao,\n\t\tpvi:$registry-pvi,\n\t\tauxdata:$registry-auxdata,\n\t\tststvt:$registry-ststvt,\n\t\tdiabetes:$registry-diabetes\n\t),\n\t$RegistryColors\n);\n\n\n\n$journal-jc: #002e5a; \n$journal-adv:#0000FF;\t\n$journal-asia:#ec2939;\t\n$journal-tran:#1788c2;\t\n$journal-cvonc:#00ae81;\n$journal-case:#f37321;\n$journal-ep:#8a5e96;\t\n$journal-hf:#991326;\t\n$journal-invt:#038e92;\t\n$journal-imag:#c18a0e;\t\n\n$journal-label-jc: \"Journal of the American College of Cardiology\"; \n$journal-label-adv:\"JACC: Advances\";\t\n$journal-label-asia:\"JACC: Asia\";\t\n$journal-label-tran:\"JACC: Basic to Translational Science\";\t\n$journal-label-cvonc:\"JACC: CardioOncology\";\n$journal-label-case:\"JACC: Case Reports\";\n$journal-label-ep:\"JACC: Clinical Electrophysiology\";\t\n$journal-label-hf:\"JACC: Heart Failure\";\t\n$journal-label-invt:\"JACC: Cardiovascular Interventions\";\t\n$journal-label-imag:\"JACC: Cardiovascular Imaging\";\t\n\n$JournalsJACC: () !default;\n$JournalsJACC: map-merge(\n\t(\n\tjc:$journal-jc,\n\tjc-adv:$journal-adv,\n\tjc-asia:$journal-asia,\n\tjc-tran:$journal-tran,\n\tjc-cvonc:$journal-cvonc,\n\tjc-case:$journal-case,\n\tjc-ep:$journal-ep,\n\tjc-hf:$journal-hf,\n\tjc-invt:$journal-invt,\n\tjc-imag:$journal-imag,\n\n\t),\n\t$JournalsJACC\n);\n\n\n/*\n\nLink Colors: Light\n\nLink colors of a lighter shade in all of its states, default, hover, visited. 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\n © 2023 American College of Cardiology Foundation. All rights reserved.\n
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American College of Cardiology

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Heart House

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Stay Connected\n

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