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Hatam N, Donuru S, Musetti G, Lotfi SH, Spetsotaki K, Steffen H, Autschbach R, Zayat R. P1574 Variation in myocardial work performance after surgical and transcather aortic valve replacement: A pilot echocardiographic study. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
none
Objective
Perioperative myocardial injury occurs after surgical aortic valve replacement (SAVR) as well as after transcather aortic valve replacement (TAVR). The novel non-invasive method for regional LV pressure– strain corresponds well with invasively measured myocardial work (MW) and is independent of afterload compared to ejection fraction and global longitudinal strain (GLS) . In this pilot study, we aimed to compare changes of LV-MW index (MWI) between SAVR and TAVR in the early postoperative period.
Methods
25 TAVR (Corevalve & Symetis) and 25 SAVR (Perimount) patients, scheduled for elective procedures received transthoracic echocardiography studies pre- and 7 days postoperatively. Besides routine measurements the following parameters were analyzed: MWI, global MW efficiency (MWE), global wasted myocardial work (GWMW), GLS and global strain rate (GSR).
Results
In the TAVR group, 17 patients received transfermoral, 8 patients transapical TAVR. As expected, EuroSCORE II was significantly higher in the TAVR group (p = 0.015). GLS was significantly lower (better) in the SAVR group compared to the TAVR group preoperatively (-13.4 + 4.9 vs.-16.7 ± 4.2, p = 0.027). Postoperative GLS increased (worsened) in the SAVR group, though no significant difference was detected between the groups (-12.7 ± 5.1% vs. -10.4 ± 3.4%, p = 0.215) postoperatively. MWI was significantly lower in the TAVR group preoperatively (p = 0.033). Within the TAVR group MWI did not decrease significantly postoperatively (1242 mmHg% vs. 1108 mmHg%, p = 0.476). However, postoperative MWI decreased significantly in the SAVR group (1632 mmHg% vs. 1267mmHg%, p = 0.043). MWE and GWMW did not differ between the groups or within the groups comparing pre- and postoperative values.
Conclusion
Despite better GLS values in SAVR patients preoperatively, we could detect a better preservation of GMWI in TAVR Patients postoperatively. To evaluate the clinical impact of MWI, further studies with larger cohort and correlation with biomarkers of myocardial injury and follow-up assessments are required.
Abstract P1574 Figure. Myocardial work changes after TAVI
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Affiliation(s)
- N Hatam
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
| | - S Donuru
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
| | | | - S H Lotfi
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
| | - K Spetsotaki
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
| | - H Steffen
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
| | - R Autschbach
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
| | - R Zayat
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
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Hatam N, Spetsostaki K, Musetti G, Steffen H, Autschbach R, Zayat R. P312 Early changes of left ventricular myocardial work performance in patients undergoing coronary artery bypass surgery: off-pump vs. on-pump. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Coronary-artery bypass grafting (CABG) without the use of cardio-pulmonary bypass (CPB) was introduced to avoid the potential damaging effects of fpreign surfaces. Nevertheless, the value of off-pump CABG (OPCAB) remains controversial. Regional myocardial work has been shown to reflect regional metabolic demand and provide a more comprehensive assessment of myocardial function. Recently a novel non-invasive method for assessing regional MW by LV pressure–strain loop analysis has been described.
Purpose
To detect changes of MW after CABG comparing off- and on-pump techniques.
Methods
We prospectively evaluated 93 patients undergoing CABG (50 on- vs. 43 off-pump). Patients underwent transthoracic echocardiography exams prior to and one week after surgery as well as concurrently systolic arterial blood pressure measurements at rest. Besides conventional echocardiography parameters, wemeasured global longitudinal strain (GLS), global work index (GWI) and global work efficiency (GWE).
Results
All patients survived surgery. Patients in the OPCAB group had significantly higher EuroSCORE II (3.3% vs. 1.1%, p < 0.001). Preoperatively, OPCABgroup had significantly lower EF (50.1 vs. 55.7%, p = 0.004), lower GWI (1411 vs. 1650mmHg%, p = 0.039) and lower GWE (86.7 vs. 91.6%, p = 0.017). GLS did not differ significantly between off- and on-pump groupspreoperatively. However, postoperatively GLS, MWI, MWE and EF decreased significantly within the on-pump group (p < 0.001, p < 0.001, p < 0.001 and p = 0.002, respectively). In the OPCAB group only GWI and GLSdecreased significantly (p = 0.028 and p = 0.017, respectively). Due to the fact, that mean differences between all pre- and postoperative values were higher in the on-pump group, no significant differences in systolic LV-function (sLVF) could be detected between on- and off-pump patients postoperatively. During the early postoperative phase, no correlation between GWI and GWE and clinical outcomes could be detected, onlylower preoperative-GWI values showed a weak correlation with the incidence of postoperative cardiogenic shock (r= -0.27, p = 0.029).
Conclusion
Despite having worse preoperative sLVF in the off-pump group determined by EF, GLS, GWI and GWE, the decrease in sLVF parameters was significantly higher in the on-pump group, leading to an equal distribution of LV-function parameters between off- and on-pump patients postoperatively. Our results suggest that off-pump CABG provides a better preservation of LV-function.
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Affiliation(s)
- N Hatam
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
| | - K Spetsostaki
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
| | | | - H Steffen
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
| | - R Autschbach
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
| | - R Zayat
- RWTH University Hospital Aachen, Department of Thoracic and Cardiovascular surgery, Aachen, Germany
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Piraccini E, Biondi G, Byrne H, Calli M, Bellantonio D, Musetti G, Maitan S. Ultrasound Guided Transversus Thoracic Plane block, Parasternal block and fascial planes hydrodissection for internal mammary post thoracotomy pain syndrome. Eur J Pain 2018; 22:1673-1677. [PMID: 29770535 DOI: 10.1002/ejp.1249] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2018] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Pectoral Nerves Block (PECS) and Serratus Plane Block (SPB) have been used to treat persistent post-surgical pain after breast and thoracic surgery; however, they cannot block the internal mammary region, so a residual pain may occur in that region. Parasternal block (PSB) and Thoracic Transversus Plane Block (TTP) anaesthetize the anterior branches of T2-6 intercostal nerves thus they can provide analgesia to the internal mammary region. METHODS We describe a 60-year-old man suffering from right post-thoracotomy pain syndrome with residual pain located in the internal mammary region after a successful treatment with PECS and SPB. We performed a PSB and TTP and hydrodissection of fascial planes with triamcinolone and Ropivacaine. RESULTS Pain disappeared and the result was maintained 3 months later. DISCUSSION This report suggests that PSB and TTP with local anaesthetic and corticosteroid with hydrodissection of fascial planes might be useful to treat a post thoracotomy pain syndrome located in the internal mammary region. SIGNIFICANCE The use of Transversus Thoracic Plane and Parasternal Blocks and fascial planes hydrodissection as a novel therapeutic approach to treat a residual post thoracotomy pain syndrome even when already treated with Pectoral Nerves Block and Serratus Plane Block.
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Affiliation(s)
- E Piraccini
- Department of Surgery, Anesthesia and Intensive, Care Section "G.B. Morgagni-Pierantoni" Hospital, Forlì, Italy
| | - G Biondi
- Anesthesia and Intensive Care, University of Ferrara, Italy
| | - H Byrne
- Medical Diagnostic Department, Kingsbridge Private Hospital, Belfast, UK
| | - M Calli
- Department of Surgery, Anesthesia and Intensive, Care Section "G.B. Morgagni-Pierantoni" Hospital, Forlì, Italy
| | - D Bellantonio
- Department of Surgery, Anesthesia and Intensive, Care Section "G.B. Morgagni-Pierantoni" Hospital, Forlì, Italy
| | - G Musetti
- Department of Emergency, Anesthesia and Intensive Care Section, "M. Bufalini Hospital", Cesena, Italy
| | - S Maitan
- Department of Surgery, Anesthesia and Intensive, Care Section "G.B. Morgagni-Pierantoni" Hospital, Forlì, Italy
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Zayat R, Lee J, Musetti G, Kang H, Goetzenich A, Jansen-Park SH, Hatam N, Tewarie L, Autschbach R. Radial Artery Tonometry to Determine Cardiac Output in Left Ventricular Assist Device Patients: A Comparison with Transthoracic Echocardiography. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- R. Zayat
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - J. Lee
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, Helmholtz Institute, Aachen, Germany
| | - G. Musetti
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - H. Kang
- Research Department, DAEYOMEDI Co. Ltd., Gyeonggi-Do, Republic of Korea
| | - A. Goetzenich
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - S.-H. Jansen-Park
- Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, RWTH Aachen University, Helmholtz Institute, Aachen, Germany
| | - N. Hatam
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - L. Tewarie
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - R. Autschbach
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
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Aljalloud A, Zayat R, Musetti G, Arias-Pinilla J, Haushofer M, Lotfi S, Hatam N, Autschbach R. The Fluttering Cusps of the Perceval: A Transthoracic and Transesophageal Echocardiography Study. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- A. Aljalloud
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - R. Zayat
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - G. Musetti
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - J. Arias-Pinilla
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - M. Haushofer
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - S. Lotfi
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - N. Hatam
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
| | - R. Autschbach
- Department of Thoracic and Cardiovascular Surgery, RWTH University Hospital Aachen, Aachen, Germany
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Kanda T, Borizanova A, Borizanova A, Zayat R, Bianco F, Hajdu M, Cherata DA, Ariani R, Sanchez J, Surkova E, Kalcik M, Demkina AE, Di Meglio M, Luszczak JM, Filipiak D, Sanz Sanchez J, Kolesnyk MY, Cersit S, Chokesuwattanaskul R, De Lepper AGW, Hubert A, Tavares Da Silva M, Svetlin Nedkov Tsonev ST, Ahmed A, Fujita M, Iida O, Masuda M, Okamoto S, Ishihara T, Nanto K, Uematsu M, Kinova E, Goudev A, Kinova E, Goudev A, Aljalloud A, Musetti G, Kang HJ, Jansen-Park SH, Goetzenich A, Autschbach R, Hatam N, Cicchitti V, Bucciarelli V, Di Girolamo E, Tonti G, De Caterina R, Gallina S, Vertes V, Meiszterics ZS, Szabados S, Simor T, Faludi R, Muraru D, Palermo C, Romeo G, Aruta P, Binotto G, Semenzato G, Carstea D, Iliceto S, Badano LP, Soesanto AM, Ruiz M, Mesa D, Delgado M, Gutierrez G, Aristizabal CH, Fernandez J, Ferreiro C, Duran E, Anguita M, Castillo JC, Pan M, Arizon JM, Suarez De Lezo J, Bidviene J, Brunello G, Veronesi F, Cavalli G, Sokalskis V, Aruta P, Badano LP, Muraru D, Yesin M, Bayam E, Gunduz S, Gursoy MO, Karakoyun S, Astarcioglu MA, Cersit S, Candan O, Ozkan M, Krylova NS, Poteshkina NG, Kovalevskaya EA, Hashieva FM, Venner C, Huttin O, Guillaumot A, Chaouat A, Chabot F, Juilliere Y, Selton-Suty C, Williams CA, Stuart AG, Pieles GE, Kasprzak JD, Lipiec P, Osa Saez A, Arnau Vives MA, Buendia Fuentes F, Ferre Valverdu M, Quesada Carmona A, Serrano Martinez F, Montero Argudo A, Martinez Dolz L, Rueda Soriano J, Nikitjuk OV, Dzyak GV, Gunduz S, Tabakci M, Gursoy O, Karakoyun S, Bayam E, Kalcik M, Yesin M, Ozkan M, Satitthummanid S, Boonyaratavej S, Herold IHF, Saporito S, Bouwman RA, Mischi M, Korsten HHM, Reesink KD, Houthuizen P, Galli E, Bouzille G, Samset E, Donal E, Pestana G, De Sousa C, Pinto R, Ribeiro V, Vasconcelos M, Almeida PB, Macedo F, Maciel MJ, Manov E, Runev N, Shabani R, Gartcheva M, Donova T, Petrov I, Al-Mallah M. HIT Poster session 1P161E/e'*SV is a better predictor of outcome than E/e' in patients with heart failure with preserved left ventricular ejection fractionP162Subclinical left atrial and left ventricular structural and functional abnormalities in postmenopausal women with abdominal obesityP163Central obesity and hypertension: double burden to the left atrium of postmenopausal womenP164Comparison between 3-D blood pressure pulse analyser and pulsed-wave doppler echocardiography derived hemodynamic parameters in cardiac surgery patients - a pilot studyP165Paced-induced heart electrical activation modifies the orientation of left ventricular flow momentum: novel insights from echocardiographic particle image velocimetryP166Correlations between echocardiographic and CMR-derived parameters of right ventricular size and function in patients with COPDP167Longitudinal strain analysis allows the identification of subclinical deterioration of right ventricular myocardial function in patients with cancer therapy-related left ventricular dysfunctionP168Effect of atrial fibrillation to pulmonary hypertension and right ventricular function in patient with severe mitral stenosisP169Evolution of etiologic spectrum and clinical features of mitral regurgitation since 2007 until 2015P170Tricuspid annulus area correlates more with right atrial than right ventricular volumes in patients with different mechanisms of functional tricuspid regurgitation: a 3D echocardiography studyP171The effect of hemolysis on serum lipid levels in patients suffering from severe paravalvular leakageP172Right ventricular dysfunction in patients with hypertrophic cardiomyopathyP173Interest of variations of echocardiographic parameters after initiation of specific therapy in the risk stratification of patients with pulmonary hypertensionP174Comparison of left and right atrial size and function in elite adolescent male football playersP175Do pocket-size imaging devices allow for reliable bedside vascular screening?P176Evolution of tricuspid regurgitation after pulmonary valve replacement for pulmonary regurgitation in repaired tetralogy of fallotP177Effect of perindopril/amlodipine combination on post-exercise E/e' in patients with arterial hypertensionP178Relationship between pulmonary venous flow and prosthetic mitral valve thrombosis P179Mitral valve parameters derived from 3-dimensional transesophageal echocardiography dataset: correlation between qlab and tomtec softwareP180Non-invasive pulmonary transit time: a new parameter for global cardiac performanceP181Assessment of the positive work and mechanical dispersion: new methods to quantify left ventricular function in aortic stenosisP182Atrial function in Takotsubo cardiomyopathy: deformation analysisP183Cardiac syndrome X- proven left ventricular perfusion and kinetic abnormalities by SPECT-CT and pharmacological dobutamine stress testP184Impact of frailty assessment on myocardial perfusion imaging results: a prospective cohort study. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pioli G, Basini G, Pedrazzoni M, Musetti G, Ulietti V, Bresciani D, Villa P, Bacchi A, Hughes D, Russell G. Spontaneous release of interleukin-I and interleukin-6 by peripheral blood mononuclear cells after oophorectomy. Clin Sci (Lond) 1992; 83:503-7. [PMID: 1330414 DOI: 10.1042/cs0830503] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
1. We studied the changes in interleukin-1 and interleukin-6 secretion by peripheral blood mononuclear cells from 12 premenopausal women after oophorectomy and seven premenopausal women who had undergone simple hysterectomy. 2. The results showed that 1 month after surgery interleukin-1 secretion increased by 414 +/- 171% (mean +/- SEM) and interleukin-6 secretion increased by 1354 +/- 481% in oophorectomized women, whereas only non-significant fluctuations in the secretion of both cytokines (-9% +/- 29% for interleukin-1 and -31% +/- 19% for interleukin-6) were seen in the women who had undergone simple hysterectomy. The difference between the two groups was significant (P = 0.035 for interleukin-1 and P = 0.003 for interleukin-6). In addition, oophorectomy, but not simple hysterectomy, was followed by significant increases in plasma ionized calcium concentration (P < 0.05), plasma alkaline phosphatase activity (P < 0.01) and plasma osteocalcin concentration (P < 0.02), and a reduction in plasma parathyroid hormone level (P < 0.01). 3. We conclude that ovary ablation may modify cytokine secretion by peripheral blood mononuclear cells. If this phenomenon occurs in the bone microenvironment, it could be important in the loss of bone observed after oophorectomy. However, the possibility of an independent alteration induced by the lack of gonadal hormones but unrelated to bone turnover cannot be excluded.
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Affiliation(s)
- G Pioli
- Istituto di Clinica Medica Generale e Terapia Medica, Università degli Studi di Parma, Italy
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