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Xiao X. Prediction scores for new onset atrial fibrillation in patients with acute coronary syndrome undergoing percutaneous coronary intervention: Two sides of the same coin. Int J Cardiol 2023; 389:131221. [PMID: 37517781 DOI: 10.1016/j.ijcard.2023.131221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/26/2023] [Indexed: 08/01/2023]
Affiliation(s)
- Xiaoxia Xiao
- Department of Cardiology, The Third Hospital of Changsha, Changsha 410001, China.
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Molnár AÁ, Merkely B. The Added Value of Atrial Strain Assessment in Clinical Practice. Diagnostics (Basel) 2022; 12:diagnostics12040982. [PMID: 35454030 PMCID: PMC9025202 DOI: 10.3390/diagnostics12040982] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/05/2022] [Accepted: 04/12/2022] [Indexed: 12/28/2022] Open
Abstract
Speckle tracking echocardiography has emerged as a sensitive tool to analyze myocardial function with improved diagnostic accuracy and prognostic value. Left atrial strain assessment has become a novel imaging method in cardiology with superior prognostic value compared to conventional left atrial volume indices. Left atrial function is divided into three phases, reservoir function being the most important. This review summarizes the added value of speckle tracking echocardiography derived left atrial strain assessment in clinical practice. Recently published data suggest the prognostic value of left atrial reservoir function in heart failure, atrial fibrillation, stroke and valvular heart disease. Furthermore, left atrial reservoir strain proved to be a predictor of cardiovascular morbidity and mortality in the general population. Thus, routine assessment of left atrial function can be an optimal strategy to improve cardiovascular risk prediction and supplement the current risk prediction models.
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3
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Khurrami L, Møller JE, Lindholt JS, Dahl JS, Fredgart MH, Obel LM, Steffensen FH, Urbonaviciene G, Lambrechtsen J, Diederichsen ACP. Aortic valve calcification among elderly males from the general population, associated echocardiographic findings, and clinical implications. Eur Heart J Cardiovasc Imaging 2021; 23:177-184. [PMID: 34491310 DOI: 10.1093/ehjci/jeab182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Abstract
AIMS Aortic valve calcification (AVC) detected by non-contrast computed tomography (NCCT) associates with morbidity and mortality in patients with aortic valve stenosis. However, the importance of AVC in the general population is sparsely evaluated. We intend to describe the associations between AVC score on NCCT and echocardiographic findings as left atrial (LA) dilatation, left ventricular (LV) hypertrophy, aortic valve area (AVA), peak velocity, mean gradient, and aortic valve replacement (AVR) in a population with AVC scores ≥300 AU. METHODS AND RESULTS Of 10 471 males aged 65-74 years from the Danish Cardiovascular Screening trial (DANCAVAS), participants with AVC score ≥300 AU were invited for transthoracic echocardiography and 828 (77%) of 1075 accepted the invitation. AVC scores were categorized (300-599, 600-799, 800-1199, and ≥1200 AU). AVR was obtained from registries. AVC was significantly associated with a steady increase in LA dilation (10.5%, 16.3%, 15.8%, 19.6%, P = 0.031), LV hypertrophy (3.9%, 6.6%, 8.9%, 10.1%, P = 0.021), peak velocity (1.7, 1.9, 2.1, 2.8 m/s, P = 0001), mean gradient (6, 8, 11, 19 mmHg, P = 0.0001), and a decrease in AVA (2.0, 1.9, 1.7, 1.3 cm2, P = 0.0001). The area under the curve was 0.79, 0.93, and 0.92 for AVA ≤1.5 cm2, peak velocity ≥3.0 m/s, and mean gradient ≥20 mmHg, respectively, and the associated optimal AVC score thresholds were 734, 1081, and 1019 AU. AVC > 1200 AU was associated with AVR (P < 0.0001). CONCLUSION Among males from the background population, increasing AVC scores were associated with LA dilatation, LV hypertrophy, AVA, peak aortic velocity, mean aortic gradient, and AVR.
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Affiliation(s)
- Lida Khurrami
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - Jacob Eifer Møller
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark.,Department of Cardiology, Copenhagen University Hospital, Blegdamsvej 9, 2100 København, Denmark
| | - Jes Sanddal Lindholt
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - Jordi Sancez Dahl
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - Maise Hoeigaard Fredgart
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - Lasse M Obel
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | | | - Grazina Urbonaviciene
- Department of Cardiology, Regional Hospital Central Jutland, Falkevej 1A, 8600 Silkeborg, Denmark
| | - Jess Lambrechtsen
- Department of Cardiology, Odense University Hospital, Baagøes Alle 31, 5700 Svendborg, Denmark
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Chew NW, Ngiam JN, Tan BY, Sia C, Sim H, Kong WK, Tay EL, Yeo TC, Poh KK. Differences in Clinical and Echocardiographic Profiles and Outcomes of Patients With Atrial Fibrillation Versus Sinus Rhythm in Medically Managed Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction. Heart Lung Circ 2020; 29:1773-81. [DOI: 10.1016/j.hlc.2020.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 10/01/2019] [Accepted: 02/26/2020] [Indexed: 11/19/2022]
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5
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Tufano A, Galderisi M. Can echocardiography improve the prediction of thromboembolic risk in atrial fibrillation? Evidences and perspectives. Intern Emerg Med 2020; 15:935-943. [PMID: 32124208 DOI: 10.1007/s11739-020-02303-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 02/20/2020] [Indexed: 01/28/2023]
Abstract
Atrial fibrillation is the most common arrhythmia and its prevalence is expected to further increase. Patients with atrial fibrillation have an increased risk of stroke (fivefold increased risk), heart failure, and death. In patients with non-valvular atrial fibrillation, the most recent guidelines recommend the use of the CHA2DS2-VASc (congestive heart failure, arterial hypertension, age > 75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65-74 years, sex category) scoring system to identify those who may benefit from oral anticoagulant treatment. Guidelines recommend initiation of oral anticoagulation with vitamin K antagonists or direct oral anticoagulants in men with a score ≥ 2 and in women with a score ≥ 3, while oral anticoagulation in individuals with a score of 0 is not recommended. Accordingly, men with CHA2DS2VASc score = 1 (and women with CHA2DS2VASc = 2) represent a grey zone where guidelines do not provide a definite oral anticoagulant indication. Implementation of risk stratification with transthoracic echocardiography could be extremely useful. Both prospective and observational studies using transthoracic echocardiography prediction of events and studies utilizing transesophageal echocardiographic parameters as surrogate markers of thromboembolic events make sustainable the hypothesis that echocardiography could improve thromboembolism prediction in non-valvular atrial fibrillation. However, because of some controversial results of different studies, determination of the best echocardiographic parameter predicting thromboembolic events in atrial fibrillation remains uncertain. The combination of left atrial enlargement with left atrial function (in particular assessing left atrial strain) appears to be very valuable, but needs to be confirmed in large-scale multi-center trials.
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Affiliation(s)
- Antonella Tufano
- Department of Clinical Medicine and Surgery, Federico II University Hospital, Via S. Pansini, 5, 80131, Naples, Italy.
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
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Witt CT, Kronborg MB, Sommer A, Hansen PB, Nohr EA, Nørgaard BL, Nielsen JC. Left Atrial Function Determined by Cardiac Computed Tomography Predicts Device-Detected Atrial High-Rate Episodes in Patients Treated With Cardiac Resynchronization Therapy. J Comput Assist Tomogr 2020; 44:784-9. [PMID: 32558773 DOI: 10.1097/RCT.0000000000001038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to examine whether left atrial (LA) volumes and function were associated with atrial high-rate episodes (AHREs) in patients with cardiac resynchronization therapy (CRT). METHODS Ninety-two consecutive patients without prior atrial fibrillation underwent clinical evaluation, echocardiograms, and cardiac computed tomography (CT) before CRT implantation and after 6 months. Left atrial volumes and LA emptying fraction (LAEF) were derived by CT images reconstructed at 5% phase increments of the cardiac cycle. Cox regression was used to assess associations between AHRE and LA anatomical and functional variables. RESULTS Twenty-two patients (24%) developed AHRE during 1.9 years (SD, 1 year) At baseline, higher LAEF was associated with a lower risk of AHRE (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.91-0.98; P = 0.003), and large LA minimal (LAmin) volume was related to higher risk of AHRE (HR, 1.03; 95% CI, 1.00-1.06; P = 0.04). When combining LAEF and LAmin volume, only LAEF remained associated with occurrence of AHRE. Higher passive LAEF was associated with lower risk of AHRE (HR, 0.95; 95% CI, 0.91-0.98; P = 0.003). CONCLUSIONS In patients with CRT, low preimplant LAEF measured by cardiac CT was independently associated with device-detected AHRE.
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Gulsen K, Ince O, Akgun T, Demir S, Uslu A, Kup A, Ocal L, Emiroglu MY, Kargin R, Sahin I, Kepez A, Okuyan E, Ozdemir N, Kaymaz C. The effect of P wave indices on new onset atrial fibrillation after trans-catheter aortic valve replacement. J Electrocardiol 2020; 61:71-76. [PMID: 32554159 DOI: 10.1016/j.jelectrocard.2020.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/26/2020] [Accepted: 06/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Data is scarce regarding the relation between P wave indices and new onset atrial fibrillation (NOAF) after trans-catheter aortic valve replacement (TAVR). AIMS The present study aimed to find out certain characteristics of P wave that may predict NOAF after TAVR procedure. METHOD Patients with severe calcific aortic stenosis who had undergone TAVR procedure between 2013 and 2019 in two centers were investigated. P wave abnormalities that have been resumed to reflect impaired atrial conduction; partial and advanced inter atrial block (IAB), P-wave terminal force in lead V1, P wave dispersion, reduced amplitude of P- wave in lead I, P wave peak time in D2 and V1 were evaluated on pre- procedural 12 derivation surface electrocardiography (ECG). The relationship between these parameters and incidence of NOAF during index hospitalization was evaluated. RESULTS A total of 227 consecutive patients (median age 79 [74-83]; 134 [59%] female) were included in the study. NOAF occurred in 46 (20.3%) patients. P wave duration, P wave dispersion, number of patients with partial and advanced IAB, left atrium diameter, STS score were higher in NOAF patients. Use of general anesthesia and history of prior open heart surgery were also more frequent in NOAF group. In multivariable logistic regression analysis; advanced IAB (OR 6.413 [2.555-16.095] p < 0.01), P wave dispersion (OR 3.544 [1.431-8.780] p = 0.006) and use of general anesthesia (OR 2.736 [1.225-6.109] p = 0.014) were independent predictors of NOAF. CONCLUSION Among P wave abnormalities evaluated on pre-procedural 12-derivation surface ECG, advanced IAB and P wave dispersion may predict NOAF after TAVR procedure.
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Affiliation(s)
- Kamil Gulsen
- Kartal Kosuyolu Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
| | - Orhan Ince
- Bagcilar Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Taylan Akgun
- Kartal Kosuyolu Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Serdar Demir
- Kartal Kosuyolu Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Abdulkadir Uslu
- Kartal Kosuyolu Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Ayhan Kup
- Kartal Kosuyolu Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Lutfi Ocal
- Kartal Kosuyolu Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Mehmet Y Emiroglu
- Kartal Kosuyolu Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Ramazan Kargin
- Kartal Kosuyolu Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Irfan Sahin
- Bagcilar Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Alper Kepez
- Marmara University School of Medicine, Department of Cardiology, Istanbul, Turkey
| | - Ertugrul Okuyan
- Bagcilar Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Nihal Ozdemir
- Kartal Kosuyolu Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Cihangir Kaymaz
- Kartal Kosuyolu Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
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Hodges G, Bang CN, Torp-Pedersen C, Hansen ML, Schjerning AM, Hansen J, Johannessen A, Gislason GH, Pallisgaard J. Significance of early recurrence of atrial fibrillation after catheter ablation: a nationwide Danish cohort study. J Interv Card Electrophysiol 2021; 60:271-8. [PMID: 32253599 DOI: 10.1007/s10840-020-00741-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/26/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Recurrence of atrial tachyarrhythmias after ablation of atrial fibrillation (AF) is common, although consensus guidelines advise against immediate re-ablation of "early recurrences" (occurring ≤ 90 days after ablation). However, recent studies show early recurrence is associated with "late recurrence" (occurring > 90 days) and question the duration of this "blanking period." We investigated incidence and timing of early recurrence in relation to late recurrence in a large nationwide cohort. METHODS From Danish nationwide registers, we included all patients aged 18 and older who underwent first-time ablation for AF between January 2005 and April 2017 and followed them for up to 2 years. RESULTS Of the total 7339 patients included (72% male; median age 62 years), 2801 (38%) experienced early recurrence. The odds of late recurrence were 2.34 times higher (95% confidence interval, 2.09-2.63; P < 0.001) given early recurrence, compared with those without early recurrence. In particular, both timing and frequency of early recurrences were associated with a significantly higher odds of late recurrence in a graded relationship: odds ratio (OR) 2.08/4.96/6.25 for early recurrences in the first/second/third month respectively (all P < 0.001); and OR 1.64/2.83/5.14 for those experiencing one/two/more than two episodes respectively (all P < 0.001); compared with those without early recurrence. CONCLUSION In patients undergoing first-time ablation for AF, both the frequency and later onset of early recurrence are significantly associated with higher odds of late recurrence. This suggests the arbitrary blanking period should be abandoned in favor of a case-by-case assessment when evaluating candidates for re-ablation.
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9
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Argento LV, Travetto CM, de Las M Colicigno M, Gentile S, Salvati A, Lax J, Cianciulli T. Tissue Doppler imaging of the atrial lateral wall: Correlation with atrial strain rate and parameters of diastolic function. Echocardiography 2019; 36:1282-1289. [PMID: 31162740 DOI: 10.1111/echo.14394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To evaluate the velocity profile of the lateral wall of the left atrium (LA) using pulsed-wave color tissue Doppler imaging (TDI) on line and its correlation with two-dimensional strain rate imaging (SRI) by speckle tracking, of equal segments and phases, and other parameters of diastolic function in a population of individuals without known cardiovascular disease. MATERIALS AND METHODS A total of 91 adults aged 18-74 years, without cardiovascular history, hypertension, diabetes, dyslipidemia or obesity, were evaluated. A Doppler echocardiogram was performed. The lateral wall of the LA was divided subjectively into three portions, the atrial roof was excluded; the peak velocities of the basal and midportions, and their average, were measured with pulsed-wave TDI on line and SRI. Using both techniques, a first positive wave (S'la and SRS-reservoir phase) and two negative waves (E'la and SRE-conduit phase-and A'la and SRA-atrial systole-respectively) were obtained. E'la/A'la ratio and SRE/SRA ratio were analyzed. RESULTS The median age was 42 years, and 54.9% of the subjects were female. S'la presented moderate correlation with S' lateral mitral annulus. Both E'la and the E'la/A'la relationships showed moderate to good correlation with various diastolic dysfunction parameters evaluated and SRI. A'la did not present a statistically significant correlation with any of the variables evaluated. CONCLUSION Evaluation of the lateral wall of the LA by pulsed-wave color TDI on line is feasible in the vast majority of patients. In the conduit phase, E'la and the E'la/A'la relationship showed correlation with the parameters that evaluate diastolic function and SRI.
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Affiliation(s)
- Laura V Argento
- Hospital General de Agudos Dr. Cosme Argerich, Capital Federal, Argentina.,Sanatorio Clínica Modelo de Morón, Buenos Aires, Argentina
| | | | | | - Silvia Gentile
- Sanatorio Clínica Modelo de Morón, Buenos Aires, Argentina
| | - Ana Salvati
- Sanatorio Clínica Modelo de Morón, Buenos Aires, Argentina
| | - Jorge Lax
- Hospital General de Agudos Dr. Cosme Argerich, Capital Federal, Argentina
| | - Tomás Cianciulli
- Hospital General de Agudos Dr. Cosme Argerich, Capital Federal, Argentina.,Sanatorio Clínica Modelo de Morón, Buenos Aires, Argentina
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Olsen FJ, Møgelvang R, Jensen GB, Jensen JS, Biering-Sørensen T. Relationship Between Left Atrial Functional Measures and Incident Atrial Fibrillation in the General Population. JACC Cardiovasc Imaging 2019; 12:981-989. [DOI: 10.1016/j.jcmg.2017.12.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 12/12/2017] [Accepted: 12/28/2017] [Indexed: 10/18/2022]
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Tarantini G, Mojoli M, Urena M, Vahanian A. Atrial fibrillation in patients undergoing transcatheter aortic valve implantation: epidemiology, timing, predictors, and outcome. Eur Heart J 2018; 38:1285-1293. [PMID: 27744287 DOI: 10.1093/eurheartj/ehw456] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 09/11/2016] [Indexed: 12/31/2022] Open
Abstract
Atrial fibrillation (AF) is a common arrhythmia in patients with aortic stenosis. When these patients are treated medically or by surgical aortic valve replacement, AF is associated with increased risk of adverse events including death. Growing evidence suggests a significant impact of AF on outcomes also in patients with aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI). Conversely, limited evidence is available regarding the optimal management of this condition. This review aims to summarize prevalence, pathophysiology, prognosis, and treatment of AF in patients undergoing TAVI.
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Affiliation(s)
- Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Marco Mojoli
- Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padova, Via Giustiniani 2, 35128 Padova, Italy
| | - Marina Urena
- Cardiology Department, Hospital Bichat-Claude Bernard, 46 Rue Henri Huchard, 75018 Paris, France
| | - Alec Vahanian
- Cardiology Department, Hospital Bichat-Claude Bernard, 46 Rue Henri Huchard, 75018 Paris, France
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13
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Wu VCC, Takeuchi M, Nagata Y, Izumo M, Akashi YJ, Lin FC, Otsuji Y. Prognostic value of area of calcified aortic valve by 2-dimensional echocardiography in asymptomatic severe aortic stenosis patients with preserved left ventricular ejection fraction. Medicine (Baltimore) 2018; 97:e0246. [PMID: 29561453 PMCID: PMC5895302 DOI: 10.1097/md.0000000000010246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We hypothesized that area of calcified aortic valve (ACAV) measured by 2D echocardiography (2DE) can predict future cardiovascular events in asymptomatic severe aortic stenosis (AS).Multidetector computed tomography determined aortic valve calcification load is strongly associated with AS severity but has risks for radiation exposure. Quantification of ACAV by transthoracic 2DE is simple and convenient but its clinical utility has not been extensively studied.We measured ACAV in 124 asymptomatic severe AS patients (80 ± 9 years, 45 males) with preserved left ventricular ejection fraction. ACAV was measured by planimetry from 2D zoomed long axis view of the AV at end-diastole. Patients were followed to record cardiac death (CD) and major adverse cardiovascular events (MACEs).During a median follow-up of 232 days, 17 patients had MACE, including 8 CD. ACAV was significantly larger in patients with event compared to those without (1.14 ± 0.35 cm vs 0.87 ± 0.34 cm, P=.0032). Using receiver operating characteristics derived ACAV of 0.79 cm as cutoff value, Kaplan-Meyer analysis showed it could discriminate high-risk group from low-risk group for future CD (P=.0223, χ = 5.22) and MACE (P = .0054, χ = 7.74).2DE determined ACAV is straightforward and has potential to predict future cardiac events in asymptomatic severe AS patients.
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Affiliation(s)
- Victor Chien-Chia Wu
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu
| | - Yasufumi Nagata
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
| | - Masaki Izumo
- Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshihiro J. Akashi
- Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Fen-Chiung Lin
- Division of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Yutaka Otsuji
- Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
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14
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Galderisi M, Donal E, Magne J, Lo Iudice F, Agricola E, Sade LE, Cameli M, Schwammenthal E, Cardim N, Cosyns B, Hagendorff A, Neskovic AN, Zamorano JL, Lancellotti P, Habib G, Edvardsen T, Popescu BA. Rationale and design of the EACVI AFib Echo Europe Registry for assessing relationships of echocardiographic parameters with clinical thrombo-embolic and bleeding risk profile in non-valvular atrial fibrillation. Eur Heart J Cardiovasc Imaging 2018; 19:245-252. [DOI: 10.1093/ehjci/jex322] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
- Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, via S. Pansini 5, 80131 Naples, Italy
| | - Erwan Donal
- CHU Rennes, Service de Cardiologie et Maladies Vasculaires, Université Rennes, 2 rue Henri Le Guilloux, Rennes, France
| | - Julien Magne
- Service Cardiologie, CHU Limoges, Hospital Dupuytren, 2, avenue Martin Luther King, 87042 Limoges, France
| | - Francesco Lo Iudice
- Department of Advanced Biomedical Sciences, Federico II University Hospital, via S. Pansini 5, 80131 Naples, Italy
| | - Eustachio Agricola
- Cardiothoracic Department, Echocardiography Laboratory, Clinical Cardiology Unit, San Raffaele Hospital of Milan (IRCCS), via Olgettina 60, 20132 Milano, Italy
| | - Leyla Elif Sade
- Department of Cardiology, Baskent University, Faculty of Medicine, Fevzi okmak Cad. 10. Sok. Bahcelievler, 06490 Ankara, Turkey
| | - Matteo Cameli
- Department of Cardiovascular Diseases, University of Siena, Policlinico ‘S. Maria alle Scotte’, viale M. Bracci, 16, 53100 Siena, Italy
| | - Ehud Schwammenthal
- Department of Cardiology, Heart Center, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Emek HaEla St 1, Ramat Gan, Israel
| | - Nuno Cardim
- Cardiac Imaging Department, Hospital Da Luz, Av. Lusíada 100, 1500-650 Lisbon, Portugal
| | - Bernard Cosyns
- CHVZ (Centrum voor Hart en Vaatziekten)-Universitair ziekenhuis and ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, 101 Laarbeeklaan, 1090 Jette, Brussels, Belgium
| | - Andreas Hagendorff
- Department of Cardiology, Echokardiographie-Labore des Universitätsklinikums AöR, University of Leipzig, Liebigstr. 20, 04103 Leipzig, Germany
| | - Alexandar N Neskovic
- Department of Cardiology, Clinic of Internal Medicine/Interventional Cardiology Clinical Hospital Center Zemun-Belgrade, Faculty of Medicine, University of Belgrade, Vukova 9, 11070 Beograd, Serbia
| | - Josè Luis Zamorano
- Department of Cardiology, University Alcala de Henares, Hospital Ramon y Cajal, CIBERCV, Ctra. De Colmenar Viejo, km. 9100, 28034 Madrid, Spain
| | - Patrizio Lancellotti
- Department of Cardiology, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Domaine Universitaire du Sart Tilman, Bâtiment B 35, B-4000 Liège Belgium
- Gruppo Villa Maria Care and Research, Anthea Hospital, via C. Rosalba, 35/37, 70124 Bari, Italy
| | - Gilbert Habib
- URMITE, Aix Marseille Universite, UM63, CNRS 7278, IRD 198, INSERM 1095 IHU—Méditerranée Infection, 58, bd Charles Livon, 13284 Marseille, France
- Cardiology Department, APHM, La Timone Hospital, 264 Rue Saint-Pierre, 13385 Marseille, France
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, University of Oslo, 4950 Nydalen, 0424 Oslo, Norway
| | - Bogdan A Popescu
- University of Medicine and Pharmacy ‘Carol Davila’-Euroecolab, Institute of Cardiovascular Diseases, Sos. Fundeni 258, Sector 2, 022328 Bucharest, Romania
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15
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Schnell F, Claessen G, La Gerche A, Claus P, Bogaert J, Delcroix M, Carré F, Heidbuchel H. Atrial volume and function during exercise in health and disease. J Cardiovasc Magn Reson 2017; 19:104. [PMID: 29254488 PMCID: PMC5735907 DOI: 10.1186/s12968-017-0416-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although atrial function has prognostic significance in many cardiovascular conditions, changes during exercise have not previously been assessed. The aim of this study was to evaluate left atrial (LA) and right atrial (RA) volume and function during incremental exercise, both in normal individuals, healthy athletes, and in patients with chronic thromboembolic pulmonary hypertension (CTEPH). METHODS Fifteen healthy non-athletes, 15 athletes and 15 CTEPH patients underwent multi-slice real-time cardiovascular magnetic resonance imaging at rest and during supine bicycle exercise with simultaneous invasive hemodynamic measurements. RESULTS At rest, athletes had larger indexed maximal RA and LA volumes (iRAVmax, iLAVmax) than CTEPH patients and non-athletes, the latter two groups having similar values. CTEPH patients had lower RA and LA emptying functions (EmF) at rest. During exercise, RA volumes (maximum and minimum) increased in CTEPH patients, whilst decreasing in athletes and non-athletes (P < 0.001). The exercise-induced change in iLAVmax was similar between groups, but iLAVmin did not decrease in CTEPH patients. Thus exercise-induced increases in RAEmF and LAEmF, as seen in normal physiology, were significantly impaired in CTEPH patients. At peak exercise, RA volumes (maximum and minimum) and EmF correlated strongly with RA pressure (R = 0.70; P = 0.005; R = 0.83; P < 0.001; R = -0.87; P < 0.001). On multivariate analysis, peak exercise RAEmF and iLAVmin were independent predictors of VO2peak in CTEPH patients and together explained 72% of the variance in VO2peak (ß =0.581 and ß = -0.515, respectively). CONCLUSIONS In normal physiology, RAEmF and LAEmF increase with exercise, whereas CTEPH patients have impaired LAEmF and RAEmF, which becomes more apparent during exercise. Therefore, the changes in atrial volumes and function during exercise enable a far better distinction between physiological and pathological atrial remodeling than resting measures of volumes which are prone to confounding factors (e.g. endurance training). Peak exercise RAEmF is a good marker of poor functional state in CTEPH patients.
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Affiliation(s)
- Frédéric Schnell
- Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
- Department of Sport Medicine, University Hospital Pontchaillou, Rennes 1 University, Rennes, France
| | - Guido Claessen
- Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
| | - André La Gerche
- Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Piet Claus
- Department of Cardiovascular Imaging and Dynamics, University of Leuven, Leuven, Belgium
| | - Jan Bogaert
- Department of Imaging and Pathology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
| | - Marion Delcroix
- Department of Pneumology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
| | - François Carré
- Department of Sport Medicine, University Hospital Pontchaillou, Rennes 1 University, Rennes, France
| | - Hein Heidbuchel
- Department of Cardiology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
- Department of Cardiology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
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16
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Bang CN, Greve AM, Rossebø AB, Ray S, Egstrup K, Boman K, Nienaber C, Okin PM, Devereux RB, Wachtell K. Antihypertensive Treatment With β-Blockade in Patients With Asymptomatic Aortic Stenosis and Association With Cardiovascular Events. J Am Heart Assoc 2017; 6:JAHA.117.006709. [PMID: 29180457 PMCID: PMC5779004 DOI: 10.1161/jaha.117.006709] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Patients with aortic stenosis (AS) often have concomitant hypertension. Antihypertensive treatment with a β‐blocker (Bbl) is frequently avoided because of fear of depression of left ventricular function. However, it remains unclear whether antihypertensive treatment with a Bbl is associated with increased risk of cardiovascular events in patients with asymptomatic mild to moderate AS. Methods and Results We did a post hoc analysis of 1873 asymptomatic patients with mild to moderate AS and preserved left ventricular ejection fraction in the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) study. Propensity‐matched Cox regression and competing risk analyses were used to assess risk ratios for all‐cause mortality, sudden cardiac death, and cardiovascular death. A total of 932 (50%) patients received Bbl at baseline. During a median follow‐up of 4.3±0.9 years, 545 underwent aortic valve replacement, and 205 died; of those, 101 were cardiovascular deaths, including 40 sudden cardiovascular deaths. In adjusted analyses, Bbl use was associated with lower risk of all‐cause mortality (hazard ratio 0.5, 95% confidence interval 0.3‐0.7, P<0.001), cardiovascular death (hazard ratio 0.4, 95% confidence interval 0.2‐0.7, P<0.001), and sudden cardiac death (hazard ratio 0.2, 95% confidence interval 0.1‐0.6, P=0.004). This was confirmed in competing risk analyses (all P<0.004). No interaction was detected with AS severity (all P>0.1). Conclusions In post hoc analyses Bbl therapy did not increase the risk of all‐cause mortality, sudden cardiac death, or cardiovascular death in patients with asymptomatic mild to moderate AS. A prospective study may be warranted to determine if Bbl therapy is in fact beneficial. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00092677.
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Affiliation(s)
- Casper N Bang
- Department of Cardiology, Zealand University Hospital Roskilde, Roskilde, Denmark .,Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Anders M Greve
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - Anne B Rossebø
- Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - Simon Ray
- Department of Cardiology, Manchester Academic Health Sciences Centre, Manchester, United Kingdom
| | - Kenneth Egstrup
- Department of Cardiology, Odense University Hospital, Svendborg, Denmark
| | - Kurt Boman
- Institution of Public Health and Clinical Medicine, Medicine Skellefteå, Umeå University, Skellefteå, Sweden
| | | | - Peter M Okin
- Department of Medicine, Weill Cornell Medicine, New York, NY
| | | | - Kristian Wachtell
- Department of Medicine, Weill Cornell Medicine, New York, NY.,Department of Cardiology, Oslo University Hospital, Oslo, Norway
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17
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Borgeat K, Stern J, Meurs KM, Fuentes VL, Connolly DJ. The influence of clinical and genetic factors on left ventricular wall thickness in Ragdoll cats. J Vet Cardiol 2016; 17 Suppl 1:S258-67. [PMID: 26776584 DOI: 10.1016/j.jvc.2015.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 06/25/2015] [Accepted: 06/26/2015] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To investigate the effect of various genetic and environmental modifiers on left ventricular (LV) wall thickness in a cohort of cats genotyped for the myosin binding protein C3 mutation (MYBPC3). ANIMALS Sixty-four Ragdoll cats. METHODS All cats were screened for HCM with echocardiography and genotyping for the HCM-associated MYBPC3:R820W mutation. Cats were also genotyped for previously identified variant polymorphisms of the angiotensin-converting enzyme (ACE) and cardiac beta-adrenergic receptor (ADRB1) genes. Plasma N-terminal pro-B-type natriuretic peptide and cardiac troponin I were also measured. Associations were evaluated between genotype (MYBPC3 negative/positive, and ACE and ADRB1 negative/heterozygous/homozygous), patient factors (body weight, age and sex) and echocardiographic measurements of LV wall thickness. RESULTS Male cats had greater maximum wall thickness (LVmax; 5.8 mm, IQR 5.1-6.4 mm) than females (4.7 mm, IQR 4.4-5.3 mm, p = 0.002). Body weight positively correlated with LVmax (ρ = 0.604, p < 0.001). The MYBPC3:R820W-positive cats had a greater LVmax (5.44 mm, IQR 4.83-6.28 mm) than the negative cats (4.76 mm, IQR 4.36-5.32 mm, p = 0.001). Also, the ACE polymorphism genotype was associated with LVmax: the homozygous cats (5.37 mm, IQR 5.14-6.4 mm) had greater LVmax than the heterozygous cats (4.73 mm, IQR 4.41-5.55 mm, p = 0.014). Only the MYBPC3 genotype and body weight were independently associated with wall thickness in multivariable analysis. CONCLUSIONS This study provides evidence that the MYBPC3:R820W mutation is independently associated with LV wall thickness in Ragdoll cats. Body weight is also independently associated with maximum LV wall thickness, but is not currently accounted for in HCM screening. In addition, other genetic modifiers may be associated with variation in LV wall thickness in Ragdolls.
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Affiliation(s)
- Kieran Borgeat
- Royal Veterinary College, Hatfield, AL9 7TA, United Kingdom; Highcroft Veterinary Referrals, Bristol, BS14 9BE, United Kingdom.
| | - Joshua Stern
- School of Veterinary Medicine, University of California Davis, Davis, CA 95616, United States
| | - Kathryn M Meurs
- North Carolina State College of Veterinary Medicine, Raleigh, NC 27607, United States
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18
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Finocchiaro G, Haddad F, Kobayashi Y, Lee D, Pavlovic A, Schnittger I, Sinagra G, Magavern E, Myers J, Froelicher V, Knowles JW, Ashley E. Impact of Septal Reduction on Left Atrial Size and Diastole in Hypertrophic Cardiomyopathy. Echocardiography 2016; 33:686-94. [DOI: 10.1111/echo.13158] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Gherardo Finocchiaro
- Department of Medicine; Division of Cardiovascular Medicine; Stanford University School of Medicine; Stanford California
- Cardiovascular Sciences Research Centre; St. George's University of London; London UK
| | - Francois Haddad
- Department of Medicine; Division of Cardiovascular Medicine; Stanford University School of Medicine; Stanford California
- Stanford Cardiovascular Institute; Stanford California
| | - Yukari Kobayashi
- Department of Medicine; Division of Cardiovascular Medicine; Stanford University School of Medicine; Stanford California
| | - David Lee
- Department of Medicine; Division of Cardiovascular Medicine; Stanford University School of Medicine; Stanford California
- Stanford Cardiovascular Institute; Stanford California
| | - Aleksandra Pavlovic
- Department of Medicine; Division of Cardiovascular Medicine; Stanford University School of Medicine; Stanford California
| | - Ingela Schnittger
- Department of Medicine; Division of Cardiovascular Medicine; Stanford University School of Medicine; Stanford California
- Stanford Cardiovascular Institute; Stanford California
| | - Gianfranco Sinagra
- Cardiovascular Department; Ospedali Riuniti and University of Trieste; Trieste Italy
| | - Emma Magavern
- Department of Medicine; Division of Cardiovascular Medicine; Stanford University School of Medicine; Stanford California
| | - Jonathan Myers
- Veterans Affairs Palo Alto Health Care System; Palo Alto California
| | | | - Joshua W. Knowles
- Department of Medicine; Division of Cardiovascular Medicine; Stanford University School of Medicine; Stanford California
- Stanford Cardiovascular Institute; Stanford California
| | - Euan Ashley
- Department of Medicine; Division of Cardiovascular Medicine; Stanford University School of Medicine; Stanford California
- Stanford Cardiovascular Institute; Stanford California
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Abstract
OBJECTIVES To examine the risk of atrial fibrillation (AF) at the time of first diagnosis of gout compared with matched controls and to follow incident gout patients and their matched controls after diagnosis to compare their subsequent risk of AF. METHODS From the UK Clinical Practice Research Data-link, 45 378 incident gout patients and 45 378 age-, sex-, practice-, registration year- and index year-matched controls were identified. Index dates were initial diagnosis date for gout patients and their matched controls. The risk of AF at diagnosis [odds ratios (ORs), using conditional logistic regression] and after the diagnosis of gout [hazard ratios (HRs), using Cox proportional models] were estimated, adjusted for BMI, smoking, alcohol consumption, ischaemic heart disease, heart failure, heart valve disease, hyperthyroidism and other comorbidities and medications. RESULTS The prevalence of AF at index date in gout patients (male, 72.3%; mean age, 62.4 ± 15.1 years) was 7.42% (95% CI 7.18, 7.66%) and in matched controls 2.83% (95% CI 2.67, 2.98%). The adjusted OR (95% CI) was 1.45 (1.29, 1.62). The cumulative probability of AF at 1, 2, 5 and 10 years after index date was 1.08, 2.03, 4.77 and 9.68% in gout patients and 0.43, 1.08, 2.95 and 6.33% in controls, respectively (log-rank test, P < 0.001). The adjusted HR (95% CIs) was 1.09 (1.03, 1.16). CONCLUSION This population-based study indicates that gout is independently associated with a higher risk of AF at diagnosis and the risk is also higher after the diagnosis.
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Affiliation(s)
- Chang-Fu Kuo
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK, Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Matthew J Grainge
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham and
| | - Christian Mallen
- Arthritis Research UK Primary Care Centre, Keele University, Keele, UK
| | - Weiya Zhang
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK,
| | - Michael Doherty
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
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20
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Levy F, Rusinaru D, Maréchaux S, Charles V, Peltier M, Tribouilloy C. Determinants and prognosis of atrial fibrillation in patients with aortic stenosis. Am J Cardiol 2015; 116:1541-6. [PMID: 26410605 DOI: 10.1016/j.amjcard.2015.08.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 11/18/2022]
Abstract
Atrial fibrillation (AF) is frequently encountered in patients with aortic stenosis (AS) and its incidence also increases with age. In the general population, AF is known to increase cardiovascular risk. We sought to investigate the prognostic importance of AF associated with AS in the context of routine clinical practice. This analysis was based on 809 patients (75 ± 12 years) diagnosed with AS (aortic valve area <2 cm(2)) and normal (≥50%) ejection fraction (EF). Patients were grouped according to the presence of sinus rhythm (SR) or AF at study enrollment. The AF group comprised 141 patients (17.5%) with AF, whereas 668 patients (82.5%) were in SR at inclusion. Four-year estimates of all-cause mortality with medical and surgical management were 60 ± 5% for the AF group compared with 24 ± 2% for the SR group (p = 0.0001). On multivariate analysis, the risk of all-cause mortality was higher in the AF group than in the SR group (adjusted hazard ratio [HR] 2.47 [1.83 to 3.33], p = 0.0001). AF remained associated with excess mortality risk when the analysis was limited to asymptomatic patients (adjusted HR 2.31 [1.38 to 3.89], p = 0.002) and, respectively, patients with severe AS (adjusted HR 2.22 [1.41 to 3.49], p = 0.001). Among patients managed medically, AF was independently associated with increased risk of death in the overall study population (adjusted HR 2.52 [1.81 to 3.51], p = 0.0001), in asymptomatic AS (adjusted HR 2.12 [1.19 to 3.76], p = 0.01), and in severe AS (adjusted HR 2.23 [1.30 to 3.81], p = 0.004). In conclusion, AF is a major predictor of mortality, in both medically and surgically managed patients with AS, irrespective of the functional status and the severity. AF is, therefore, a strong marker of risk in AS and should be considered for clinical decision making.
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Affiliation(s)
- Franck Levy
- Department of Cardiology, University Hospital Amiens, Amiens, France; INSERM U-1088, Jules Verne University of Picardie, Amiens, France
| | - Dan Rusinaru
- Department of Cardiology, University Hospital Amiens, Amiens, France; Department of Cardiology, Hospital of Saint Quentin, Saint Quentin, France
| | - Sylvestre Maréchaux
- INSERM U-1088, Jules Verne University of Picardie, Amiens, France; Groupement des Hôpitaux de l'Institut Catholique de Lille/Faculté libre de médecine, Université Lille Nord de France, Lille, France
| | - Vincent Charles
- Department of Cardiology, University Hospital Amiens, Amiens, France
| | - Marcel Peltier
- Department of Cardiology, University Hospital Amiens, Amiens, France
| | - Christophe Tribouilloy
- Department of Cardiology, University Hospital Amiens, Amiens, France; INSERM U-1088, Jules Verne University of Picardie, Amiens, France.
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21
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Bang CN, Okin PM. The long and short of the PR-interval: relation to cardiovascular outcome in patients with coronary heart disease. Europace 2015; 17:838-9. [DOI: 10.1093/europace/euu284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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22
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Borgeat K, Dudhia J, Luis Fuentes V, Connolly DJ. Circulating concentrations of a marker of type I collagen metabolism are associated with hypertrophic cardiomyopathy mutation status in ragdoll cats. J Small Anim Pract 2015; 56:360-5. [DOI: 10.1111/jsap.12332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 12/03/2014] [Accepted: 12/08/2014] [Indexed: 11/27/2022]
Affiliation(s)
- K. Borgeat
- Clinical Science and Services; Royal Veterinary College; Hatfield AL9 7TA
- Highcroft Veterinary Referrals; Bristol BS14 9BE
| | - J. Dudhia
- Clinical Science and Services; Royal Veterinary College; Hatfield AL9 7TA
| | - V. Luis Fuentes
- Clinical Science and Services; Royal Veterinary College; Hatfield AL9 7TA
| | - D. J. Connolly
- Clinical Science and Services; Royal Veterinary College; Hatfield AL9 7TA
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Maan A, Heist EK, Passeri J, Inglessis I, Baker J, Ptaszek L, Vlahakes G, Ruskin JN, Palacios I, Sundt T, Mansour M. Impact of atrial fibrillation on outcomes in patients who underwent transcatheter aortic valve replacement. Am J Cardiol 2015; 115:220-6. [PMID: 25465936 DOI: 10.1016/j.amjcard.2014.10.027] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 10/14/2014] [Accepted: 10/14/2014] [Indexed: 11/23/2022]
Abstract
Transcatheter aortic valve replacement (TAVR) has emerged as an alternative treatment for surgical high-risk patients with severe aortic stenosis. The aim of this study was to determine the impact of atrial fibrillation (AF) on procedural outcomes. Data from 137 patients who underwent TAVR using Edwards SAPIEN valve were reviewed. The predictors of new-onset atrial fibrillation (NOAF) after the procedure were analyzed. In addition, the post-TAVR clinical outcomes and adverse events were compared according to the presence and absence of preprocedural and postprocedural AF. Previous AF was present in 49% of the patients who underwent TAVR. After the procedure, NOAF was detected in 21% of patients, and the cumulative incidence of post-TAVR AF was 60%. After TAVR, 50% of all the episodes of NOAF occurred in the initial 24 hours after the procedure. Transapical approach was observed to an important predictor of NOAF (adjusted odds ratio [OR] 5.05, 95% confidence interval [CI] 1.40 to 18.20, p = 0.013). The composite outcome of all-cause mortality, stroke, vascular complications, and repeat hospitalization in 1 month after TAVR was significantly higher in patients with previous AF (33 of 67 vs 19 of 70, adjusted OR 2.60, 95% CI 1.22 to 5.54, p = 0.013) compared with patients who did not have previous AF. The presence of post-TAVR AF led to a prolongation in the duration of intensive care unit stay by an average of 70 hours (95% CI 25 to 114.7 hours, p = 0.002). Similarly, post-TAVR AF also led to the prolongation in the hospital stay by an average of 6.7 days (95% CI 4.69 to 8.73 days, p <0.0005). In conclusion, our study demonstrates that the presence of AF before TAVR is an important predictor of the composite end point of all-cause mortality, stroke, vascular complications, and repeat hospitalization in 1 month after the procedure. AF after TAVR is more likely to be encountered with the transapical approach and is associated with a prolongation of intensive care unit and hospital stay.
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24
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Hayashi S, Yamada H, Bando M, Saijo Y, Nishio S, Hirata Y, Klein AL, Sata M. Optimal Analysis of Left Atrial Strain by Speckle Tracking Echocardiography: P-wave versus R-wave Trigger. Echocardiography 2014; 32:1241-9. [DOI: 10.1111/echo.12834] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Shuji Hayashi
- Ultrasound Examination Center; Tokushima University Hospital; Tokushima Japan
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine; Tokushima University Hospital; Tokushima Japan
| | - Mika Bando
- Department of Cardiovascular Medicine; Tokushima University Hospital; Tokushima Japan
| | - Yoshihito Saijo
- Department of Cardiovascular Medicine; Tokushima University Hospital; Tokushima Japan
| | - Susumu Nishio
- Ultrasound Examination Center; Tokushima University Hospital; Tokushima Japan
| | - Yukina Hirata
- Ultrasound Examination Center; Tokushima University Hospital; Tokushima Japan
| | - Allan L. Klein
- Department of Cardiovascular Medicine, Heart and Vascular Institute; Cleveland Clinic; Cleveland Ohio
| | - Masataka Sata
- Department of Cardiovascular Medicine; Tokushima University Hospital; Tokushima Japan
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25
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Borgeat K, Sherwood K, Payne JR, Luis Fuentes V, Connolly DJ. Plasma cardiac troponin I concentration and cardiac death in cats with hypertrophic cardiomyopathy. J Vet Intern Med 2014; 28:1731-7. [PMID: 25319115 PMCID: PMC4895638 DOI: 10.1111/jvim.12459] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 07/28/2014] [Accepted: 08/21/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The use of cardiac biomarkers to assist in the diagnosis of occult and symptomatic hypertrophic cardiomyopathy (HCM) in cats has been established. There is limited data describing their prognostic utility in cats with HCM. HYPOTHESIS Circulating concentrations of N-terminal B-type natriuretic peptide (NTproBNP) and cardiac troponin I (cTnI) predict cardiac death in cats with HCM. ANIMALS Forty-one cats diagnosed with HCM at a veterinary teaching hospital, between February 2010 and May 2011. METHODS Prospective investigational study. Plasma samples were collected from cats diagnosed with HCM and concentrations of NTproBNP and cTnI were analyzed at a commercial laboratory. Echocardiographic measurements from the day of blood sampling were recorded. Long-term outcome data were obtained. Associations with time to cardiac death were analyzed using Cox proportional hazards models. RESULTS When controlling for the presence/absence of heart failure and echocardiographic measures of left atrial size and function, cTnI > 0.7 ng/mL was independently associated with time to cardiac death. In univariable analysis, NTproBNP > 250 pmol/L was associated with cardiac death (P = .023), but this did not remain significant (P = .951) when controlling for the effect of clinical signs or left atrial size/function. CONCLUSIONS AND CLINICAL IMPORTANCE Plasma concentration of cTnI (cutoff >0.7 ng/mL) is a predictor of cardiac death in cats with HCM that is independent of the presence of heart failure or left atrial dilatation.
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Affiliation(s)
- K Borgeat
- Royal Veterinary College, Hatfield, UK; Highcroft Veterinary Referrals, Bristol, UK
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26
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Bang CN, Devereux RB, Okin PM. Regression of electrocardiographic left ventricular hypertrophy or strain is associated with lower incidence of cardiovascular morbidity and mortality in hypertensive patients independent of blood pressure reduction – A LIFE review. J Electrocardiol 2014; 47:630-5. [DOI: 10.1016/j.jelectrocard.2014.07.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Indexed: 11/28/2022]
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Maffè S, Paffoni P, Dellavesa P, Cucchi L, Zenone F, Bergamasco L, Paino AM, Franchetti Pardo N, Signorotti F, Baduena L, Parravicini U. Prognostic Value of Total Atrial Conduction Time Measured with Tissue Doppler Imaging to Predict the Maintenance of Sinus Rhythm after External Electrical Cardioversion of Persistent Atrial Fibrillation. Echocardiography 2014; 32:420-7. [DOI: 10.1111/echo.12702] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Stefano Maffè
- Division of Cardiology; SS Trinità Borgomanero Hospital; ASL No Novara Italy
| | - Paola Paffoni
- Division of Cardiology; SS Trinità Borgomanero Hospital; ASL No Novara Italy
| | | | - Lorenzo Cucchi
- Division of Cardiology; SS Trinità Borgomanero Hospital; ASL No Novara Italy
| | - Franco Zenone
- Division of Cardiology; SS Trinità Borgomanero Hospital; ASL No Novara Italy
| | - Luca Bergamasco
- Division of Cardiology; SS Trinità Borgomanero Hospital; ASL No Novara Italy
| | - Anna Maria Paino
- Division of Cardiology; SS Trinità Borgomanero Hospital; ASL No Novara Italy
| | | | - Fabiana Signorotti
- Division of Cardiology; SS Trinità Borgomanero Hospital; ASL No Novara Italy
| | - Lara Baduena
- Division of Cardiology; SS Trinità Borgomanero Hospital; ASL No Novara Italy
| | - Umberto Parravicini
- Division of Cardiology; SS Trinità Borgomanero Hospital; ASL No Novara Italy
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Payne J, Borgeat K, Connolly D, Boswood A, Dennis S, Wagner T, Menaut P, Maerz I, Evans D, Simons V, Brodbelt D, Luis Fuentes V. Prognostic Indicators in Cats with Hypertrophic Cardiomyopathy. J Vet Intern Med 2013; 27:1427-36. [DOI: 10.1111/jvim.12215] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 07/31/2013] [Accepted: 09/03/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
- J.R. Payne
- Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire UK
| | - K. Borgeat
- Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire UK
| | - D.J. Connolly
- Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire UK
| | - A. Boswood
- Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire UK
| | - S. Dennis
- School of Veterinary Medicine; University of Pennsylvania; Philadelphia PA
| | - T. Wagner
- Southern Counties Veterinary Specialists LLP; Ringwood Hampshire UK
| | - P. Menaut
- Clinique Vétérinaire; Aquivet; Eysines France
| | - I. Maerz
- Klinik fur Kleintiere (Innere Medizin); Justus-Liebig-University Giessen; Giessen Germany
| | - D. Evans
- Ash Tree Veterinary Practice; Market Harborough Leicestershire UK
| | - V.E. Simons
- Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire UK
| | - D.C. Brodbelt
- Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire UK
| | - V. Luis Fuentes
- Clinical Sciences and Services; Royal Veterinary College; Hatfield Hertfordshire UK
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Gohlke-Bärwolf C, Minners J, Jander N, Gerdts E, Wachtell K, Ray S, Pedersen TR. Natural History of Mild and of Moderate Aortic Stenosis—New Insights From a Large Prospective European Study. Curr Probl Cardiol 2013; 38:365-409. [DOI: 10.1016/j.cpcardiol.2013.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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