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Abou Kamar S, Andrzejczyk K, Petersen TB, Chin JF, Aga YS, de Bakker M, Akkerhuis KM, Geleijnse M, Brugts JJ, Sorop O, de Boer RA, Rizopoulos D, Asselbergs FW, Boersma E, den Ruijter H, van Dalen BM, Kardys I. The plasma proteome is linked with left ventricular and left atrial function parameters in patients with chronic heart failure. Eur Heart J Cardiovasc Imaging 2024:jeae098. [PMID: 38597740 DOI: 10.1093/ehjci/jeae098] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/27/2023] [Revised: 02/26/2024] [Accepted: 03/30/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Examining the systemic biological processes in the heterogeneous syndrome of heart failure with reduced ejection fraction (HFrEF), as reflected by circulating proteins, in relation to echocardiographic characteristics, may provide insights into HF pathophysiology. OBJECTIVE We investigated the link of 4210 repeatedly measured circulating proteins with repeatedly measured echocardiographic parameters, as well as with elevated left atrial pressure (LAP), in HFrEF patients, to provide insights into underlying mechanisms. METHODS In 173 HFrEF patients, we performed six-monthly echocardiography and trimonthly blood sampling during a median follow-up of 2.7(IQR:2.5-2.8) years. We investigated circulating proteins in relation to echocardiographic parameters of left ventricular (left ventricular ejection fraction[LVEF], global longitudinal strain[GLS]), and left atrial function (left atrial reservoir strain[LASr]) and elevated LAP(E/e' ratio >15), and used gene enrichment analyses to identify underlying pathophysiological processes. RESULTS We found 723, 249, 792 and 427 repeatedly measured proteins, with significant associations with LVEF, GLS, LASr and E/e' ratio, respectively. Proteins associated with LASr reflected pathophysiological mechanisms mostly related to the extracellular matrix (ECM). Proteins associated with GLS reflected cardiovascular biological processes and diseases, whereas those associated with LVEF reflected processes involved in the sympathetic nervous system. Moreover, 49 proteins were associated with elevated LAP; after correction for LVEF, three proteins remained: Cystatin-D, Fibulin-5 and HSP40. CONCLUSION Circulating proteins show varying associations with different echocardiographic parameters in HFrEF patients. These findings suggest that pathways involved in atrial and ventricular dysfunction, as reflected by the plasma proteome, are distinct.
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Affiliation(s)
- S Abou Kamar
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
- The Netherlands Heart Institute, Utrecht, The Netherlands
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - K Andrzejczyk
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
| | - T B Petersen
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
- Department of Biostatistics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J F Chin
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Y S Aga
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - M de Bakker
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
| | - K M Akkerhuis
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
| | - M Geleijnse
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
| | - J J Brugts
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
| | - O Sorop
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
| | - R A de Boer
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
| | - D Rizopoulos
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
- Department of Biostatistics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - F W Asselbergs
- Department of Cardiology, Amsterdam Medical Center, The Netherlands
| | - E Boersma
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
| | - H den Ruijter
- Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - B M van Dalen
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - I Kardys
- Erasmus MC, Cardiovascular Institute, Thorax Center, Department of Cardiology, Rotterdam, the Netherlands
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Pelosi C, Kauling RM, Cuypers JAAE, Utens EMWJ, van den Bosch AE, Kardys I, Bogers AJJC, Helbing WA, Roos-Hesselink JW, Legerstee JS. Executive functioning of patients with congenital heart disease: 45 years after surgery. Clin Res Cardiol 2023; 112:1417-1426. [PMID: 37031447 PMCID: PMC10562274 DOI: 10.1007/s00392-023-02187-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/28/2022] [Indexed: 04/10/2023]
Abstract
BACKGROUND Nowadays, more than 90% of patients with congenital heart disease (CHD) reach adulthood. However, long-term impact on neurodevelopment and executive functioning in adults with CHD are not completely understood. PURPOSE To investigate the self- and informant-reported executive functioning in adults with CHD operated in childhood. MATERIAL AND METHODS Longitudinal study of a cohort of patients (n = 194, median age: 49.9 [46.1-53.8]) who were operated in childhood (< 15 years old) between 1968 and 1980 (median follow-up time: 45 [40-53] years) for one of the following diagnoses: atrial septal defect (ASD), ventricular septal defect (VSD), pulmonary stenosis (PS), tetralogy of Fallot (ToF) or transposition of the great arteries (TGA). Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A) questionnaire was used to assess self- and informant-reported executive functioning. RESULTS 40-53 years after surgery, the CHD group did show significantly better executive functioning compared to the norm data. No significant difference was found between mild CHD (ASD, VSD and PS) and moderate/severe CHD (ToF and TGA). Higher education, NYHA class 1 and better exercise capacity were associated with better self-reported executive functioning, whereas females or patients taking psychiatric or cardiac medications reported worse executive functioning. CONCLUSIONS Our findings suggest favorable outcomes (comparable to normative data) regarding executive functioning in adults with CHD, both self- and informant-reported. However, further study is warranted to explore more in detail the different cognitive domains of executive functioning in these patients.
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Affiliation(s)
- C Pelosi
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - R M Kauling
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - J A A E Cuypers
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - E M W J Utens
- Academic Center for Child Psychiatry Levvel, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | - I Kardys
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - A J J C Bogers
- Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - W A Helbing
- Division of Cardiology, Department of Pediatrics, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | | | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
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Abou Kamar S, Aga YS, de Bakker M, van den Berg VJ, Strachinaru M, Bowen D, Frowijn R, Akkerhuis KM, Brugts JJ, Manintveld O, Umans V, Geleijnse M, de Boer RA, Boersma E, Kardys I, van Dalen BM. Prognostic value of temporal patterns of left atrial reservoir strain in patients with heart failure with reduced ejection fraction. Clin Res Cardiol 2023:10.1007/s00392-023-02244-x. [PMID: 37311973 DOI: 10.1007/s00392-023-02244-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/24/2023] [Accepted: 06/02/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND We investigated whether repeatedly measured left atrial reservoir strain (LASr) in heart failure with reduced ejection fraction (HFrEF) patients provides incremental prognostic value over a single baseline LASr value, and whether temporal patterns of LASr provide incremental prognostic value over temporal patterns of other echocardiographic markers and NT-proBNP. METHODS In this prospective observational study, 153 patients underwent 6-monthly echocardiography, during a median follow-up of 2.5 years. Speckle tracking echocardiography was used to measure LASr. Hazard ratios (HRs) were calculated for LASr from Cox models (baseline) and joint models (repeated measurements). The primary endpoint (PEP) comprised HF hospitalization, left ventricular assist device, heart transplantation, and cardiovascular death. RESULTS Mean age was 58 ± 11 years, 76% were men, 82% were in NYHA class I/II, mean LASr was 20.9% ± 11.3%, and mean LVEF was 29% ± 10%. PEP was reached by 50 patients. Baseline and repeated measurements of LASr (HR per SD change (95% CI) 0.20 (0.10-0.41) and (0.13 (0.10-0.29), respectively) were both significantly associated with the PEP, independent of both baseline and repeated measurements of other echo-parameters and NT-proBNP. Although LASr was persistently lower over time in patients with PEP, temporal trajectories did not diverge in patients with versus without the PEP as the PEP approached. CONCLUSION LASr was associated with adverse events in HFrEF patients, independent of baseline and repeated other echo-parameters and NT-proBNP. Temporal trajectories of LASr showed decreased but stable values in patients with the PEP, and do not provide incremental prognostic value for clinical practice compared to single measurements of LASr.
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Affiliation(s)
- S Abou Kamar
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- The Netherlands Heart Institute, Utrecht, The Netherlands
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Y S Aga
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - M de Bakker
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - V J van den Berg
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Cardiology, Northwest Clinics, Alkmaar, The Netherlands
- Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands
| | - M Strachinaru
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - D Bowen
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - R Frowijn
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - K M Akkerhuis
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - J J Brugts
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - O Manintveld
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - V Umans
- Department of Cardiology, Northwest Clinics, Alkmaar, The Netherlands
| | - M Geleijnse
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - R A de Boer
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - E Boersma
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - I Kardys
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - B M van Dalen
- Department of Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Room Na-316, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
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Klimczak-Tomaniak D, Baart S, Van Boven N, Akkerhuis KM, Constantinescu A, Kaliskan C, Simsek S, Germans T, Van Ramshorst J, Kuch M, Umans V, Boersma E, Kardys I. Temporal evolution of liver function parameters predicts clinical outcome in chronic heart failure patients (Bio-SHiFT Study). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1076] [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: 11/12/2022] Open
Abstract
Abstract
Background
Liver dysfunction contributes to worse clinical outcome in heart failure (HF) patients, and cholestatic enzymes are associated with mortality in the setting of chronic HF (CHF). However, the temporal evolutions of liver function parameters in stable CHF patients, and their associations with clinical outcome, have not yet been investigated.
Purpose
We aimed to investigate in detail the temporal patterns of alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGTP), total bilirubin (TBIL) and albumin (ALB), and their relation with clinical outcome, in patients with stable CHF with reduced ejection fraction (HFrEF).
Methods
During 2.2 (1.4–2.5) years of follow-up, we collected 1984 tri-monthly plasma samples in 263 patients. We selected 749 samples in the 250 HFrEF patients included in the study - all baseline samples, the last two samples before censoring in event-free patients, and the last two samples preceding the primary endpoint (PEP; composite of cardiac death, heart transplantation, LVAD implantation, and hospitalization for the management of acute or worsened HF). In these samples ALP, GGTP, and ALB were measured using colorimetric assays, TBIL using diazomethod, all by Roche/Hitachi Cobas c analyser. The relationship between repeatedly measured biomarker levels and the PEP was evaluated by joint models.
Results
Mean age was 68±18 years; 74% were men, 25% in NYHA class III or IV. 66 patients (26%) reached the PEP.
Repeatedly measured levels of TBIL, ALP, GGTP and ALB were associated with the PEP in a model adjusted for NT-proBNP and hs-TnT (hazard ratio (HR) [95% confidence interval] per doubling of biomarker level: 1.98 [1.32; 2.95], p=0.002; 1.84 [1.09; 3.05], p=0.018, 1.33 [1.08; 1.63], p=0.006 and 1.14 [1.09; 1.20], p<0.001, respectively). Serially measured ALP and GGTP remained significantly associated with the PEP after adjustment for clinical covariates (HR [95% CI]: 1.13 [1.07; 1.19], p=0.018; 1.03 [1.01; 1.06], p=0.006, respectively).
The levels of ALP and GGTP were higher in patients who experienced the PEP than in event-free patients long before the PEP occurred (>2 years), and as the PEP approached, levels diverged slightly between those with and without the PEP (Figure 1). Conversely, levels of ALB were higher in those with subsequent PEP, >2 years before the PEP, and subsequently fell; while TBIL levels rose less than 1 year before the PEP in those with subsequent PEP. The slopes of the temporal evolution of ALB and TBIL, adjusted for clinical variables, were also significantly associated with the PEP (HR [95% CI] per 20% decrease in the slope for albumin and increase in the slope of TBIL per year: 1.61 [1.43; 1.84], p<0.001 and 1.72 [1.28; 2.55], p<0.001, respectively).
Conclusions
Changes in serum levels of TBIL, ALP, GGTP and ALB precede adverse cardiovascular events in patients with CHF. These routine liver function parameters may provide additional prognostic information in HFrEF patients in clinical practice.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Jaap Schouten Foundation (Rotterdam, the Netherlands)Noordwest Academie (Alkmaar, the Netherlands)
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Affiliation(s)
- D Klimczak-Tomaniak
- Erasmus MC, University Medical Center Rotterdam, Netherlands (The), Medical University of Warsaw , Warsaw , Poland
| | - S Baart
- Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - N Van Boven
- Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - K M Akkerhuis
- Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - A Constantinescu
- Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - C Kaliskan
- Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - S Simsek
- Northwest Clinics , Alkmaar , The Netherlands
| | - T Germans
- Northwest Clinics , Alkmaar , The Netherlands
| | | | - M Kuch
- Medical University of Warsaw , Warsaw , Poland
| | - V Umans
- Northwest Clinics , Alkmaar , The Netherlands
| | - E Boersma
- Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
| | - I Kardys
- Erasmus MC, University Medical Center Rotterdam , Rotterdam , The Netherlands
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Pelosi C, Kauling RM, Cuypers JAAE, Utens EMWJ, Van Den Bosch AE, Kardys I, Bogers AJJC, Helbing WA, Roos-Hesselink JW, Legerstee JS. Executive functioning of patients with congenital heart disease: 45 years after surgery. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1840] [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
For children with congenital heart disease (CHD), subtle neuropsychological deficits have been reported. However, very little is known about executive functioning in their adulthood.
Purpose
To investigate the self- and informant-reported executive functioning in adults with CHD operated in childhood (<15 years old).
Material and methods
A cohort study of 194 patients (age 50 [46–54] years), operated in childhood between 1968 and 1980 for one of the following diagnosis: atrial septal defect (ASD), ventricular septal defect (VSD), pulmonary stenosis (PS), tetralogy of Fallot (ToF) or transposition of the great arteries (TGA), were evaluated 40–53 years after surgery. The “Behavior Rating Inventory of Executive Functions – Adult version” (BRIEF-A) questionnaire was used to assess self- and informant-reported executive functioning and compared to the general population.
Results
The CHD group did not show worse executive functioning compared to normative data. In addition, no significant difference was found between simple CHD (ASD, VSD and PS) and moderate/complex CHD (ToF and TGA).
Higher education and NYHA class 1 were associated with better self-reported executive functioning, while male patients and patients taking psychiatric or cardiac medications reported worse executive functioning.
Conclusions
Overall, our findings suggest reassuring outcomes regarding executive functioning in adults with CHD. However, these findings should be confirmed with neuropsychological assessment studies.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Thorax Foundation
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Affiliation(s)
- C Pelosi
- Erasmus University Rotterdam, Department of Cardiology , Rotterdam , The Netherlands
| | - R M Kauling
- Erasmus University Rotterdam, Department of Cardiology , Rotterdam , The Netherlands
| | - J A A E Cuypers
- Erasmus University Rotterdam, Department of Cardiology , Rotterdam , The Netherlands
| | - E M W J Utens
- Amsterdam UMC, Academic Center for Child Psychiatry Levvel , Amsterdam , The Netherlands
| | - A E Van Den Bosch
- Erasmus University Rotterdam, Department of Cardiology , Rotterdam , The Netherlands
| | - I Kardys
- Erasmus University Rotterdam, Department of Cardiology , Rotterdam , The Netherlands
| | - A J J C Bogers
- Erasmus University Rotterdam, Department of Cardiothoracic Surgery , Rotterdam , The Netherlands
| | - W A Helbing
- Erasmus University Medical Centre, Department of Pediatrics, Division of Cardiology , Rotterdam , The Netherlands
| | - J W Roos-Hesselink
- Erasmus University Rotterdam, Department of Cardiology , Rotterdam , The Netherlands
| | - J S Legerstee
- Erasmus University Medical Centre, Department of Child and Adolescent Psychiatry/Psychology , Rotterdam , The Netherlands
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Vriesendorp PA, Wilschut JM, Diletti R, Daemen J, Kardys I, Zijlstra F, Van Mieghem NM, Bennett J, Esposito G, Sabate M, den Dekker WK. Immediate versus staged revascularisation of non-culprit arteries in patients with acute coronary syndrome: a systematic review and meta-analysis. Neth Heart J 2022; 30:449-456. [PMID: 35536483 PMCID: PMC9474746 DOI: 10.1007/s12471-022-01687-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Accepted: 02/21/2022] [Indexed: 12/02/2022] Open
Abstract
Although there is robust evidence that revascularisation of non-culprit vessels should be pursued in patients presenting with an acute coronary syndrome (ACS) and multivessel coronary artery disease (MVD), the optimal timing of complete revascularisation remains disputed. In this systematic review and meta-analysis our results suggest that outcomes are comparable for immediate and staged complete revascularisation in patients with ACS and MVD. However, evidence from randomised controlled trials remains scarce and cautious interpretation of these results is recommended. More non-biased evidence is necessary to aid future decision making on the optimal timing of complete revascularisation.
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Affiliation(s)
- P A Vriesendorp
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
- The Heart Centre, The Alfred Hospital, Melbourne, Australia
| | - J M Wilschut
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - R Diletti
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - J Daemen
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - I Kardys
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - F Zijlstra
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - N M Van Mieghem
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - J Bennett
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium
| | - G Esposito
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - M Sabate
- Cardiovascular Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - W K den Dekker
- Department of Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands.
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7
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Kimenai DM, Anand A, De Bakker M, Shipley M, Fujisawa T, Strachan F, Shah ASV, Kardys I, Boersma E, Brunner E, Mills NL. Trajectories of high-sensitivity cardiac troponin I in the two decades before cardiovascular death in Whitehall II. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2508] [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
High-sensitivity cardiac troponin may be a promising biomarker that could be used for personalised cardiovascular risk prediction and monitoring in the general population. Temporal changes in high-sensitivity cardiac troponin before cardiovascular death are largely unexplored.
Purpose
Using the longitudinal Whitehall II cohort, we evaluated whether three serial high-sensitivity cardiac troponin I measurements over 15 years improved prediction of cardiovascular death when compared to a single time point at baseline.
Methods
Whitehall II is an ongoing longitudinal observation cohort study of 10,308 civil servants, and we included participants who had at least one cardiac troponin measurement and outcome data available. We constructed time trajectories to evaluate the temporal pattern of cardiac troponin I in those who died from cardiovascular disease as compared to those who did not. Cox regression and joint models were used to investigate the association of cardiac troponin I in relation to cardiovascular death using single time point (at baseline) and repeated measurements (at baseline, 10 and 15 years), respectively. The discriminative ability was assessed by the concordance index.
Results
In total, we included 7,293 individuals (mean age of 58 years [SD 7] at baseline, 29.4% women). Of these, 5,818 (79.8%) and 4,045 (55.5%) individuals had a second and third cardiac troponin I concentration measured, respectively. Cardiovascular death occurred in 281 (3.9%) individuals during a median follow-up of 21.4 [IQR, 15.8 to 21.8] years. In the 21-year trajectories of cardiac troponin I, we observed higher baseline concentrations in those who died due to cardiovascular disease as compared to those who did not (median 5 [IQR, 2 to 9] ng/L versus 3 [IQR, 2 to 5] ng/L respectively, Figure). Cardiac troponin I was an independent predictor of cardiovascular death, and the hazard ratio (HR) derived from the joint model that included serial cardiac troponin measurements was higher than the HR derived from the single time point model (single time point model: adjusted HR 1.53, 95% Confidence Interval [CI] 1.37 to 1.70 per naturally log transformed unit of cardiac troponin I, versus repeated measurements model: adjusted HR 1.79, 95% CI 1.58 to 2.02). The discriminative ability of the cardiac troponin model improved when using repeated measurements (concordance index of unadjusted cardiac troponin models, single time point: 0.668 versus repeated measurements: 0.724).
Conclusions
Our study shows that cardiac troponin I trajectories were persistently higher among individuals who died from cardiovascular disease. Cardiac troponin I is a strong independent predictor of cardiovascular death, and incorporating repeated measurements of cardiac troponin improves cardiovascular risk prediction in the general population.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Cardiac troponin I measurements and analysis were supported by were supported by Siemens Healthineers. The study was supported by Health Data Research UK which receives its funding from HDR UK Ltd (HDR-5012) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation and the Wellcome Trust. NLM is supported by the British Heart Foundation through a Senior Clinical Research Fellowship (FS/16/14/32023), Programme Grant (RG/20/10/34966) and a Research Excellence Award (RE/18/5/34216). The funders had no role in the study and the decision to submit this work to be considered for publication.
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Affiliation(s)
- D M Kimenai
- University of Edinburgh, Usher Institute, Edinburgh, United Kingdom
| | - A Anand
- University of Edinburgh, BHF Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - M De Bakker
- Erasmus University Medical Centre, Department of Cardiology, Rotterdam, Netherlands (The)
| | - M Shipley
- University College London, Department of Epidemiology and Public Health, London, United Kingdom
| | - T Fujisawa
- University of Edinburgh, BHF Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - F Strachan
- University of Edinburgh, BHF Centre for Cardiovascular Science, Edinburgh, United Kingdom
| | - A S V Shah
- London School of Hygiene and Tropical Medicine, Department of non-communicable disease, London, United Kingdom
| | - I Kardys
- Erasmus University Medical Centre, Department of Cardiology, Rotterdam, Netherlands (The)
| | - E Boersma
- Erasmus University Medical Centre, Department of Cardiology, Rotterdam, Netherlands (The)
| | - E Brunner
- University College London, Department of Epidemiology and Public Health, London, United Kingdom
| | - N L Mills
- University of Edinburgh, BHF Centre for Cardiovascular Science, Edinburgh, United Kingdom
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8
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Feyz L, Nannan Panday R, Henneman M, Verzijlbergen F, Constantinescu AA, van Dalen BM, Brugts JJ, Caliskan K, Geleijnse ML, Kardys I, Van Mieghem NM, Manintveld O, Daemen J. Endovascular renal sympathetic denervation to improve heart failure with reduced ejection fraction: the IMPROVE-HF-I study. Neth Heart J 2021; 30:149-159. [PMID: 34609726 PMCID: PMC8881518 DOI: 10.1007/s12471-021-01633-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction The aim of the present study was to assess the safety and efficacy of renal sympathetic denervation (RDN) in patients with heart failure with reduced ejection fraction (HFrEF). Methods We randomly assigned 50 patients with a left ventricular ejection fraction (LVEF) ≤ 35% and NYHA class ≥ II, in a 1:1 ratio, to either RDN and optimal medical therapy (OMT) or OMT alone. The primary safety endpoint was the occurrence of a combined endpoint of cardiovascular death, rehospitalisation for heart failure, and acute kidney injury at 6 months. The primary efficacy endpoint was the change in iodine-123 meta-iodobenzylguanidine (123I‑MIBG) heart-to-mediastinum ratio (HMR) at 6 months. Results Mean age was 60 ± 9 years, 86% was male and mean LVEF was 33 ± 8%. At 6 months, the primary safety endpoint occurred in 8.3% vs 8.0% in the RDN and OMT groups, respectively (p = 0.97). At 6 months, the mean change in late HMR was −0.02 (95% CI: −0.08 to 0.12) in the RDN group, versus −0.02 (95% CI: −0.09 to 0.12) in the OMT group (p = 0.95) whereas the mean change in washout rate was 2.34 (95% CI: −6.35 to 1.67) in the RDN group versus −2.59 (95% CI: −1.61 to 6.79) in the OMT group (p-value 0.09). Conclusion RDN with the Vessix system in patients with HFrEF was safe, but did not result in significant changes in cardiac sympathetic nerve activity at 6 months as measured using 123I‑MIBG. Supplementary Information The online version of this article (10.1007/s12471-021-01633-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L Feyz
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - R Nannan Panday
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - M Henneman
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - F Verzijlbergen
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A A Constantinescu
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - B M van Dalen
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Cardiology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - J J Brugts
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - K Caliskan
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - M L Geleijnse
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - I Kardys
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - N M Van Mieghem
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - O Manintveld
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - J Daemen
- University Medical Center, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
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9
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Van Der Velde N, Janus CPM, Bowen DJ, Hassing HC, Kardys I, Van Leeuwen FE, So-Osman C, Nout RA, Manintveld OC, Hirsch A. Cardiovascular magnetic resonance for early detection of late cardiotoxicity in asymptomatic survivors of hodgkin and non-hodgkin lymphoma. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.130] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Long-term survivors of Hodgkin (HL) and non-Hodgkin (NHL) lymphomas experience late adverse effects of mediastinal radiotherapy and/or anthracycline containing chemotherapy, which lead to premature cardiovascular morbidity and mortality. It is unknown whether early stages of myocardial dysfunction and heart failure in these survivors can be detected by cardiovascular magnetic resonance imaging (CMR).
Purpose
To identify early sensitive markers for the detection of subclinical late cardiotoxicity using CMR in asymptomatic survivors of HL and (primary mediastinal large B-cell lymphoma) NHL.
Methods
For this prospective observational study, we included 80 HL or selected NHL survivors, who have been free of disease for ≥5 years and were treated with mediastinal radiotherapy (RT) with/without chemotherapy. Patients with known cardiac disease were excluded. Included patients were compared to 40 age- and sex matched healthy controls. CMR included 1) cine imaging for assessment of left ventricular (LV) and right ventricular (RV) dimensions, systolic function and strain; 2) 2-dimensional late gadolinium enhancement (LGE) imaging; 3) T2 mapping and 4) pre- and post-contrast T1 mapping (MOLLI) for assessment of native T1 values and extracellular volume (ECV).
Results
Of the 80 patients, 78 (98%) had a history of HL and 2 (2%) of NHL with a mean age of 47 ± 11 years (46% male). All patients were treated with mediastinal RT which was combined with anthracycline containing chemotherapy in 68 (85%) patients. The median interval between diagnosis and CMR was 20 [14 – 26] years. Differences in CMR characteristics between patients and healthy controls are shown in the table. LV end-systolic volume was statistically significantly higher, but LV ejection fraction and mass were significantly lower in patients compared to healthy controls. RV volumes were significantly lower in patients, but RV ejection fraction was preserved. Strain parameters of the LV, i.e. global longitudinal strain, global circumferential strain and global radial strain, were slightly but significantly reduced in patients. No significant differences were found in myocardial T2 times and ECV; however, native myocardial T1 time was significantly higher in patients compared to healthy controls. LGE was detected in 25% of the patients and in the majority of patients with LGE this was classified as hinge point fibrosis.
Conclusion
Asymptomatic survivors of HL and NHL are not exempt of late cardiotoxicity, which can be detected by subtle changes in LV myocardial function, strain and native T1 value with CMR. Furthermore, late gadolinium enhancement was present in 25% of the patients. Further longitudinal studies are needed to assess the implication of these changes in relation to clinical outcome.
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Affiliation(s)
- N Van Der Velde
- Erasmus University Medical Centre, Cardiology and Radiology, Rotterdam, Netherlands (The)
| | - CPM Janus
- Erasmus University Medical Centre, Radiation Oncology, Rotterdam, Netherlands (The)
| | - DJ Bowen
- Erasmus University Medical Centre, Cardiology, Rotterdam, Netherlands (The)
| | - HC Hassing
- Erasmus University Medical Centre, Cardiology and Radiology, Rotterdam, Netherlands (The)
| | - I Kardys
- Erasmus University Medical Centre, Cardiology, Rotterdam, Netherlands (The)
| | - FE Van Leeuwen
- Netherlands Cancer Institute, Psychosocial Research and Epidemiology, Amsterdam, Netherlands (The)
| | - C So-Osman
- Erasmus University Medical Centre, Hematology, Rotterdam, Netherlands (The)
| | - RA Nout
- Erasmus University Medical Centre, Radiation Oncology, Rotterdam, Netherlands (The)
| | - OC Manintveld
- Erasmus University Medical Centre, Cardiology, Rotterdam, Netherlands (The)
| | - A Hirsch
- Erasmus University Medical Centre, Cardiology and Radiology, Rotterdam, Netherlands (The)
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10
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Schreuder MM, Schuurman A, Akkerhuis KM, Constantinescu AA, Caliskan K, van Ramshorst J, Germans T, Umans VA, Boersma E, Roeters van Lennep JE, Kardys I. Sex-specific temporal evolution of circulating biomarkers in patients with chronic heart failure with reduced ejection fraction. Int J Cardiol 2021; 334:126-134. [PMID: 33940096 DOI: 10.1016/j.ijcard.2021.04.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/08/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND We aimed to assess differences in clinical characteristics, prognosis, and the temporal evolution of circulating biomarkers in male and female patients with HFrEF. METHODS We included 250 patients (66 women) with chronic heart failure (CHF) between 2011 and 2013 and performed trimonthly blood sampling during a median follow-up of 2.2 years [median (IQR) of 8 (5-10) urine and 9 (5-10) plasma samples per patient]. After completion of follow-up we measured 8 biomarkers. The primary endpoint (PE) was the composite of cardiac death, cardiac transplantation, left ventricular assist device implantation, and hospitalization due to acute or worsened CHF. Joint models were used to determine whether there were differences in the temporal patterns of the biomarkers between men and women as the PE approached. RESULTS A total of 66 patients reached the PE of which 52 (78.8%) were male and 14 (21.2%) were female. The temporal patterns of all studied biomarkers were associated with the PE, and overall showed disadvantageous changes as the PE approached. For NT-proBNP, HsTnT, and CRP, women showed higher levels over the entire follow-up duration and concomitant numerically higher hazard ratios [NT-proBNP: women: HR(95%CI) 7.57 (3.17-21.93), men: HR(95%CI) 3.14 (2.09-4.79), p for interaction = 0.104, HsTnT: women: HR(95%CI) 6.38 (2.18-22.46), men: HR(95%CI) 4.91 (2.58-9.39), p for interaction = 0.704, CRP: women: HR(95%CI) 7.48 (3.43-19.53), men: HR(95%CI) 3.29 [2.27-5.44], p for interaction = 0.106). In contrast, temporal patterns of glomerular and tubular renal markers showed similar associations with the PE in men and women. CONCLUSION Although interaction terms are not statistically significant, the associations of temporal patterns of NT-proBNP, HsTnT, and CRP appear more outspoken in women than in men with HFrEF, whereas associations seem similar for temporal patterns of creatinine, eGFR, Cystatin C, KIM-1 and NAG. Larger studies are needed to confirm these potential sex differences.
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Affiliation(s)
- M M Schreuder
- Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - A Schuurman
- Department of Cardiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - K M Akkerhuis
- Department of Cardiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - A A Constantinescu
- Department of Cardiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - K Caliskan
- Department of Cardiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - J van Ramshorst
- Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands
| | - T Germans
- Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands
| | - V A Umans
- Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands
| | - E Boersma
- Department of Cardiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | | | - I Kardys
- Department of Cardiology, Erasmus Medical Centre, Rotterdam, the Netherlands.
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11
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Kroon HG, van Gils L, Ziviello F, van Wiechen MPH, Ooms JFW, Rahhab Z, El Faquir N, Maugenest AM, Goudzwaard JA, Cummins P, Lenzen M, Kardys I, Daemen J, Mattace-Raso F, de Jaegere PPT, Van Mieghem NM. Clinical consequences of consecutive self-expanding transcatheter heart valve iterations. Neth Heart J 2021; 30:140-148. [PMID: 33914259 PMCID: PMC8881514 DOI: 10.1007/s12471-021-01568-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Accepted: 03/24/2021] [Indexed: 11/25/2022] Open
Abstract
Objective To compare early clinical outcomes after transcatheter aortic valve implantation (TAVI) with three consecutive generations of self-expanding valves (SEVs). Methods Clinical endpoints of consecutive patients who underwent TAVI with CoreValve, Evolut R or Evolut PRO were included in a prospective database. Results TAVI was performed with CoreValve (n = 116), Evolut R (n = 160) or Evolut PRO (n = 92). Evolut R and Evolut PRO showed a tendency towards lower permanent pacemaker implantation (PPI) rates compared to CoreValve (CoreValve 27% vs Evolut R 16% vs Evolut PRO 18%, p = 0.091). By multivariable regression analysis CoreValve had a significantly higher risk for PPI (odds ratio (OR) 2.79, 95% confidence interval (CI) 1.31–5.94, p = 0.008) compared to Evolut R, while Evolut R and PRO were similar. Severe paravalvular leakage (PVL) occurred only with CoreValve, but no significant difference was observed in moderate PVL (10% vs 8% vs 6%, p = 0.49). CoreValve had a tendency towards a higher risk for more-than-mild PVL as compared with the Evolut platform (R + PRO) (OR 2.46, 95% CI 0.98–6.16, p = 0.055). No significant differences in all-cause mortality (7% vs 4% vs 1%, p = 0.10), stroke (6% vs 3% vs 2%, p = 0.21) or major vascular complications (10% vs 12% vs 4%, p = 0.14) were observed. Conclusions TAVI with self-expanding valves was safe, and device iterations may result in a lower need for PPI. More-than-mild PVL seemed to occur less often with repositionable technology. Supplementary Information The online version of this article (10.1007/s12471-021-01568-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- H G Kroon
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - L van Gils
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - F Ziviello
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M P H van Wiechen
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J F W Ooms
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Z Rahhab
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - N El Faquir
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A-M Maugenest
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J A Goudzwaard
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - P Cummins
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Lenzen
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - I Kardys
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Daemen
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - F Mattace-Raso
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - P P T de Jaegere
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - N M Van Mieghem
- Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
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12
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Minderhoud SCS, Hirsch A, Marin F, Kardys I, Roos-Hesselink JW, Wentzel JJ, Helbing WA, Akyildiz AC. Serial MRI-based right ventricular mechanical wall stress measurements and their association with right ventricle function in patients with repaired Tetralogy of Fallot. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.414] [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: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Stichting Hartekind en Thorax Foundation
Background
Optimal timing of pulmonary valve replacement (PVR) in Tetralogy of Fallot (TOF) patients remains challenging. Wall stress is considered to be a possible early marker of right ventricular (RV) dysfunction. With patient-specific computational models, wall stress can be determined regionally and with high accuracy, especially in complex shaped ventricles such as in TOF patients. We aimed to 1) develop patient-specific computational models to assess RV diastolic wall stresses and 2) investigate the association of wall stresses and their change over time with functional parameters in TOF patients.
Methods
Repaired TOF patients with at least moderate pulmonary regurgitation (PR) and prior to PVR were included. MRI-based patient-specific computational ventricular models were created (figure). The ventricular geometry was created by stacking endo- and epicardial contours traced on short axis SSFP cine images. Pressure in the right ventricle was estimated from echocardiography. Mid-diastolic wall stress in the RV free wall was analysed globally and regionally (basal, mid, apical, anterior, lateral and posterior) at two time points. RV ejection fraction (RVEF), NT-proBNP and exercise tests (% maximum predicted workload) were used as outcomes for RV function. Associations between wall stresses and outcomes were investigated using linear mixed models adjusted for follow-up duration.
Results
Five males and five females were included with an age at baseline of 24 (IQR 16-28) years and RV end-diastolic volume of 140 (IQR 127-144) ml/m2. The period between the two time points was 7.0 (IQR 5.8-7.3) years. Global wall stress of the RV free wall combining both time points was 5.8 kPa (IQR 5.2-7.2). There was no statistical difference between baseline and follow-up global wall stress. The mean wall stresses in the mid region was 1.69 kPa (p < 0.01) higher than in the basal region and was 1.05 kPa (p = 0.03) higher than in the apical region cross-sectionally. The wall stress also increased more in the mid region compared to basal and apical region, corrected for duration of follow-up. Patients with more severe PR at baseline demonstrated a higher increase of global wall stress over time (p = 0.02), especially in lateral free wall. Higher global free wall stresses were cross-sectionally independently associated with lower RVEF, adjusted for LVEF and RVEDV (β=-1.29 % RVEF per kPa increase in wall stress, p = 0.01). This association was most prominent in the anterior, basal and mid part. No statistically significant association was found between wall stress, NT-proBNP, and exercise capacity.
Conclusions
This study generated a novel MRI-based method to calculate wall stress in geometrically complex ventricles. Wall stress associated negatively with RVEF in patients with TOF and PR. This promising tool for RV wall stress analysis can be used in future larger studies to validate these preliminary findings and to assess the predictive value of wall stress in TOF.
Abstract Figure.
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Affiliation(s)
- SCS Minderhoud
- Erasmus University Medical Centre, Cardiology and Radiology and Nuclear Medicine, Rotterdam, Netherlands (The)
| | - A Hirsch
- Erasmus University Medical Centre, Cardiology and Radiology and Nuclear Medicine, Rotterdam, Netherlands (The)
| | - F Marin
- Politecnico di Milano, Chemistry, Materials and Chemical Engineering “Giulio Natta”, Milan, Italy
| | - I Kardys
- Erasmus University Medical Centre, Cardiology, Rotterdam, Netherlands (The)
| | - JW Roos-Hesselink
- Erasmus University Medical Centre, Cardiology, Rotterdam, Netherlands (The)
| | - JJ Wentzel
- Erasmus University Medical Centre, Cardiology, Rotterdam, Netherlands (The)
| | - WA Helbing
- Erasmus University Medical Centre, Paediatrics and Radiology and Nuclear Medicine, Rotterdam, Netherlands (The)
| | - AC Akyildiz
- Erasmus University Medical Centre, Cardiology, Rotterdam, Netherlands (The)
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13
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Bouwens E, Schuurman A, Akkerhuis K, Baart S, Caliskan K, Brugts J, Van Ramshorst J, Germans T, Umans V, Boersma H, Kardys I. Serially measured cytokines and cytokine receptors in relation to clinical outcome in patients with stable heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0994] [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
Activation of the inflammatory response in heart failure (HF) may initially serve as a compensatory mechanism. However, on the longer term, this physiological phenomenon can become disadvantageous. Temporal patterns of inflammatory proteins other than CRP have not yet been investigated in patients with stable HF.
Purpose
We aimed to evaluate the association of 17 serially measured cytokines and cytokine receptors with clinical outcome in patients with stable heart failure.
Methods
In 263 patients, 1984 serial, tri-monthly blood samples were collected during a median follow-up of 2.2 (IQR: 1.4–2.5) years. The primary endpoint (PE) composed of cardiovascular mortality, HF-hospitalization, heart transplantation, and LVAD. We selected baseline blood samples in all patients, as well as the two samples closest to the primary endpoint, and the last sample available in event-free patients. Thus, in 567 samples we measured 17 cytokines and cytokine receptors using the Olink Proteomics Cardiovascular III multiplex assay. Associations between biomarkers and PE were investigated by joint modelling.
Results
Median age was 68 (IQR: 59–76) years, with 72% men, 74% NYHA class I-II and a median ejection fraction of 30% (23–38%). 70 patients reached a PE. After adjustment for clinical characteristics (age, sex, diabetes, atrial fibrillation, NYHA class at baseline, diuretics and systolic blood pressure), 7 biomarkers were associated with the PE (Figure). Interleukin-1 receptor type 1 (IL1RT1) showed the strongest association: HR 2.65 [95% CI: 1.78–4.21]) per standard deviation change in level (NPX) at any point in time during follow-up, followed by Tumor necrosis factor receptor 1 (TNF-R1): 2.25 [1.66–3.08], and C-X-C motif chemokine 16 (CXCL16): 2.18 [1.59–3.04]. After adjustment for baseline N-terminal pro–B-type natriuretic peptide, high-sensitive troponin T and C-reactive protein however, only IL1RT1 and TNF-R1 remained significantly associated with the PE.
Conclusion
Repeatedly measured levels of several cytokines and cytokine receptors are independently associated with clinical outcome in stable HF patients. These results suggest that repeated measurements of these biomarkers, in addition to established cardiac biomarkers, may contribute to personalized risk assessment and herewith better identify high-risk patients.
Figure 1. Associations between levels of cytokines and cytokine receptors and the primary endpoint.
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): This work was supported by the Jaap Schouten Foundation and the Noordwest Academie.
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Affiliation(s)
- E Bouwens
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - A Schuurman
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - K.M Akkerhuis
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - S.J Baart
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - K Caliskan
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - J.J Brugts
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | | | - T Germans
- Northwest Clinics, Cardiology, Alkmaar, Netherlands (The)
| | - V.A.W.M Umans
- Northwest Clinics, Cardiology, Alkmaar, Netherlands (The)
| | - H Boersma
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - I Kardys
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
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14
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Hoes MF, Te Riele ASJM, Gladka MM, Westenbrink BD, van Hout GPJ, van den Hoogenhof MMG, Ghigo A, Bollini S, Purcell NH, Sohaib SMA, Kardys I, Kuster DWD. Young@Heart: empowering the next generation of cardiovascular researchers. Neth Heart J 2020; 28:25-30. [PMID: 32780328 PMCID: PMC7418282 DOI: 10.1007/s12471-020-01454-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
In recognition of the increasing health burden of cardiovascular disease, the Dutch CardioVascular Alliance (DCVA) was founded with the ambition to lower the cardiovascular disease burden by 25% in 2030. To achieve this, the DCVA is a platform for all stakeholders in the cardiovascular field to align policies, agendas and research. An important goal of the DCVA is to guide and encourage young researchers at an early stage of their careers in order to help them overcome challenges and reach their full potential. Young@Heart is part of the DCVA that supports the young cardiovascular research community. This article illustrates the challenges and opportunities encountered by young cardiovascular researchers in the Netherlands and highlights Young@Heart’s vision to benefit from these opportunities and optimise collaborations to contribute to lowering the cardiovascular disease burden together as soon as possible.
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Affiliation(s)
- M F Hoes
- Young@Heart, the Dutch CardioVascular Alliance, Utrecht, The Netherlands
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A S J M Te Riele
- Young@Heart, the Dutch CardioVascular Alliance, Utrecht, The Netherlands
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M M Gladka
- Young@Heart, the Dutch CardioVascular Alliance, Utrecht, The Netherlands
- Hubrecht Institute, Royal Netherlands Academy of Arts and Science, Utrecht, The Netherlands
- European Society of Cardiology, Scientists of Tomorrow, Biot, France
| | - B D Westenbrink
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - G P J van Hout
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
- Junior Chamber Board of the Netherlands Society of Cardiology, Utrecht, The Netherlands
| | - M M G van den Hoogenhof
- Institute of Experimental Cardiology, University of Heidelberg, Heidelberg, Germany
- Partner Site Heidelberg/Mannheim, DZHK (German Center for Cardiovascular Research), Heidelberg/Mannheim, Germany
| | - A Ghigo
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Torino, Torino, Italy
- International Society of Heart Research, Durham, NC, USA
| | - S Bollini
- European Society of Cardiology, Scientists of Tomorrow, Biot, France
- Department of Experimental Medicine (DIMES), Regenerative Medicine Laboratory, University of Genova, Genova, Italy
| | - N H Purcell
- Basic Cardiovascular Sciences Early Career Committee, American Heart Association, Dallas, TX, USA
- Department of Pharmacology, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - S M A Sohaib
- European Society of Cardiology Board Committee for Young Cardiovascular Professionals, Biot, France
- King George Hospital, Essex, UK
- St Bartholomew's Hospital, London, UK
| | - I Kardys
- Young@Heart, the Dutch CardioVascular Alliance, Utrecht, The Netherlands
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - D W D Kuster
- Young@Heart, the Dutch CardioVascular Alliance, Utrecht, The Netherlands.
- Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
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15
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Van Der Velde N, Huurman R, Yamasaki Y, Kardys I, Galema T, Budde R, Zijlstra F, Schinkel A, Michels M, Hirsch A. P1825 Myocardial bridging and coronary artery disease in hypertrophic cardiomyopathy: a matched case control study. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1170] [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
Funding Acknowledgements
None.
Introduction
The etiology of chest pain in hypertrophic cardiomyopathy (HCM) is diverse and includes coronary artery disease (CAD) as well as HCM-specific causes. Myocardial bridging (MB) has been associated with HCM, chest pain, and accelerated atherosclerosis. To investigate differences in the presence of MB and CAD, we compared HCM patients with age-, gender- and CAD pre-test probability (PTP)-matched outpatients presenting with chest pain.
Methods
We studied 84 HCM patients who underwent cardiac computed tomography and compared these with 168 matched controls (age 54 ± 11 years, 70% men, PTP 12% [5%–32%]). MB, calcium score, plaque morphology and presence and extent of CAD were assessed for each patient. Linear mixed models were used to assess differences between cases and controls.
Results
Differences between HCM patients and controls are described in the table. In summary, MB was more often seen in HCM patients (50% vs. 25%, p < 0.001), who were also more likely to have >1 segment affected (14% vs. 2%, p < 0.05). In the HCM group, MB was associated with pathogenic mutation status. Calcium score and the presence of obstructive CAD were similar in both groups (9 [0-225] vs. 4 [0-82] and 18% vs. 19%; p > 0.05 for both).
Conclusion
MB was twice as prevalent in the HCM group. However, in a matched analysis, the prevalence and extent of CAD was equal among patients with and without HCM. These finding illustrate that despite a higher prevalence of MB, the prevalence of CAD is similar between groups, also demonstrating satisfactory performance of pre-test risk prediction in HCM patients.
Assessment of CAD by CT HCM group(n = 84) Control group (n = 168) p-value Agatston score 9 [0-225] 4 [0-82] 0.22 No. of pts with score* 0.07 0-399 31 (89%) 149 (91%) >400 8 (11%) 15 (9%) Obstructive CAD 15 (18%) 32 (19%) 0.82 No. of pts with MB 42 (50%) 42 (25%) <0.001 No. of vessels with MB <0.001 1 34 (40%) 39 (23%) 2 8 (10%) 3 (2%) No. of pts with >1 segment with MB 12 (14%) 4 (2%) <0.001 Abbreviations CAD = Coronary artery disease, MB = Myocardial bridging, pts = patients *Only measured in 73/84 HCM patients and in 164/168 control patients
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Affiliation(s)
- N Van Der Velde
- Erasmus University Medical Center, Rotterdam, Netherlands (The)
| | - R Huurman
- Erasmus University Medical Center, Rotterdam, Netherlands (The)
| | - Y Yamasaki
- Kyushu University, Clinical Radiology, Fukuoka, Japan
| | - I Kardys
- Erasmus University Medical Center, Rotterdam, Netherlands (The)
| | - T Galema
- Erasmus University Medical Center, Rotterdam, Netherlands (The)
| | - R Budde
- Erasmus University Medical Center, Rotterdam, Netherlands (The)
| | - F Zijlstra
- Erasmus University Medical Center, Rotterdam, Netherlands (The)
| | - A Schinkel
- Erasmus University Medical Center, Rotterdam, Netherlands (The)
| | - M Michels
- Erasmus University Medical Center, Rotterdam, Netherlands (The)
| | - A Hirsch
- Erasmus University Medical Center, Rotterdam, Netherlands (The)
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16
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Bouwens E, Van Den Berg VJ, Akkerhuis KM, Baart S, Caliskan K, Brugts JJ, Mouthaan H, Van Ramshorst J, Germans T, Umans VA, Boersma H, Kardys I. 5948Circulating biomarkers of cell adhesion in relation to clinical outcomes in patients with chronic heart failure: the Bio-SHiFT study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0098] [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
Background
Cardiovascular inflammation and vascular endothelial dysfunction are present in chronic heart failure (CHF), and cellular adhesion molecules are considered to play a key role in these mechanisms. The temporal patterns of the blood biomarkers involved could provide further insights into these processes.
Purpose
We aimed to evaluate the prognostic value of the temporal patterns of blood biomarkers of cell adhesion in stable patients with CHF.
Methods
In 263 patients, a median of 9 (IQR: 5–10) serial, tri-monthly blood samples were collected during a median follow-up of 2.2 (IQR: 1.4–2.5) years. The composite primary endpoint (PE) of cardiovascular mortality, HF-hospitalization, heart transplantation and LVAD was reached in 70 patients. For efficiency, we selected all baseline samples, the two samples closest to a PE, and the last sample available for event-free patients. Thus, in 567 samples we measured twelve biomarkers of cell adhesion using the Olink Proteomics Cardiovascular III multiplex assay. Associations between biomarkers and first PE were investigated by combining linear mixed effect models and Cox regression (so-called joint model).
Results
Median age was 68 (IQR: 59–76) years, with 72% men and 74% NYHA class I-II. Levels of CD93 (Complement component C1q receptor), CDH5 (VE cadherin), CHI3L1 (Chitinase-3-like protein 1), EPHB4 (Ephrin type-B receptor 4) and JAM-A (Junctional adhesion molecule A) differed at baseline already. The average biomarker evolutions of these markers, and additionally of ICAM-2 (Intercellular adhesion molecule-2), showed different patterns in patients approaching the PE versus those who remained event-free (Figure 1). Repeatedly measured levels of these biomarkers were independently associated with the PE. Corresponding HRs [95% CI] per 1SD increase in log2 level (arbitrary unit) were: CD93: 1.85 [1.29–2.70], CDH5: 1.72 [1.23–2.44], CHI3L1: 2.45 [1.73–3.56], EPHB4: 1.83 [1.33–2.55], ICAM2: 1.74 [1.24–2.46] and JAM-A: 2.07 [1.39–3.18], adjusted for clinical characteristics (age, sex, diabetes, atrial fibrillation, baseline NYHA class, diuretics, systolic blood pressure and eGFR).
Figure 1. Average temporal patterns of cell adhesion biomarkers during follow-up.
Conclusion
CD93, CDH5, CHI3L1, EPHB4, ICAM2 and JAM-A show different patterns as adverse events approach in CHF patients, and their temporal patterns strongly predict clinical outcome. These findings demonstrate the incremental value of repeated measurements of biomarkers of cell adhesion in stable patients with CHF.
Acknowledgement/Funding
This work was supported by the Jaap Schouten Foundation and the Noordwest Academie.
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Affiliation(s)
- E Bouwens
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - V J Van Den Berg
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - K M Akkerhuis
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - S Baart
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - K Caliskan
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - J J Brugts
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | | | - J Van Ramshorst
- Medical Center Alkmaar, Cardiology, Alkmaar, Netherlands (The)
| | - T Germans
- Medical Center Alkmaar, Cardiology, Alkmaar, Netherlands (The)
| | - V A Umans
- Medical Center Alkmaar, Cardiology, Alkmaar, Netherlands (The)
| | - H Boersma
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - I Kardys
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
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17
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Schuurman AS, Tomer A, Akkerhuis KM, Brugts JJ, Constantinescu AA, Van Ramshorst J, Umans VA, Boersma H, Rizopoulos D, Kardys I. P1644Personalized screening intervals for measurement of n-terminal pro-b-type natriuretic peptide improve efficiency of prognostication in patients with chronic heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0403] [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: 11/12/2022] Open
Abstract
Abstract
Background
Predefined screening intervals and target levels do not account for variations in temporal patterns of biomarkers between individuals, which may hamper their potential use for therapy guidance. Conversely, a personalized screening approach with screening intervals and target levels based on the evolution of biomarkers in individual patients may further improve risk assessment and therapy guidance.
Purpose
We hypothesize that personalized screening intervals for N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements in patients with chronic heart failure (CHF) maximize information gain on the individual patient's disease progression, while minimizing the number of necessary measurements. We aim to compare such personalized scheduling of NT-proBNP measurements to a predefined fixed scheduling approach.
Methods
In 263 CHF patients from the Bio-SHiFT study, NT-proBNP was measured trimonthly according to a prespecified, fixed schedule [median: 9 (IQR: 5–10) measurements per patient].The primary composite endpoint (PE) comprised cardiac death, cardiac transplantation, left ventricular assist device implantation or heart failure hospitalization, and occurred in 70 patients (26.6%). Using joint models for time-to-event and longitudinal data, we modelled the association between repeated NT-proBNP measurements and the PE. Using the fitted joint model, for each patient at each follow-up visit, we determined the optimal time point of the next NT-proBNP measurement based on the patient's individual risk profile and the maximum information gain on the patient's prognosis as assessed by the Kullback-Leibler divergence. Personalized scheduling was compared to fixed (trimonthly) scheduling by means of a realistic simulation study, based on a replica of the study population included in the Bio-SHiFT study. In this simulation study, we stopped monitoring NT-proBNP to potentially enable appropriate timely intervention if the cumulative risk of PE exceeded an arbitrary risk threshold of 7.5% within 3-months. We compared personalized scheduling with fixed scheduling in terms of capability of identification of high-risk intervals (whether timely intervention was enabled before occurrence of PE), number of measurements needed, and costs.
Results
Compared to fixed scheduling, personalized scheduling saved on average 2 measurements [personalized; median: 7 (IQR: 7–8) vs. fixed; 9 (IQR: 8–10) measurements], while the start of the time-window identified for therapeutic intervention to avoid the occurrence of PE was similar in both approaches [personalized; median: 6.6 (IQR: 4.5–11.3) vs. fixed; 6.3 (IQR: 4.2–10.3) months before occurrence of PE]. Costs saved were €165 per patient per year.
Figure 1
Conclusion
Personalized scheduling of NT-proBNP measurements in CHF patients shows similar prognostic performance as fixed scheduling, but requires fewer NT-proBNP measurements. This may improve efficiency of natriuretic guided therapy, if the latter were to be installed.
Acknowledgement/Funding
Funding for this study was provided by the Jaap Schouten Foundation and Erasmus MC Efficiency Research grant
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Affiliation(s)
- A.-S Schuurman
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - A Tomer
- Erasmus Medical Center, Biostatistics, Rotterdam, Netherlands (The)
| | - K M Akkerhuis
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - J J Brugts
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | | | | | - V A Umans
- Northwest Clinics, Cardiology, Alkmaar, Netherlands (The)
| | - H Boersma
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
| | - D Rizopoulos
- Erasmus Medical Center, Biostatistics, Rotterdam, Netherlands (The)
| | - I Kardys
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands (The)
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18
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van Toorenburg M, van den Berg V, van der Ploeg T, Heestermans A, Dirksen M, Hautvast R, Drexhage O, Boersma E, Kardys I, Umans V. Addition of routinely measured blood biomarkers significantly improves GRACE risk stratification in patients with myocardial infarction. Int J Cardiol 2018; 273:237-242. [DOI: 10.1016/j.ijcard.2018.07.100] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/28/2018] [Accepted: 07/20/2018] [Indexed: 12/13/2022]
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19
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Van Den Berg VJ, Vroegindewey MM, Umans VAWM, Buljubasic N, Kardys I, Oude Ophuis T, Lenderink T, Asselbergs FW, Akkerhuis KM, Boersma E. P2724Washout and long-term stabilization of cholesterols after acute coronary syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2724] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- V J Van Den Berg
- Erasmus Medical Center, Clinical epidemiology of Cardiology, Rotterdam, Netherlands
| | - M M Vroegindewey
- Erasmus Medical Center, Clinical epidemiology of Cardiology, Rotterdam, Netherlands
| | | | - N Buljubasic
- Erasmus Medical Center, Clinical epidemiology of Cardiology, Rotterdam, Netherlands
| | - I Kardys
- Erasmus Medical Center, Clinical epidemiology of Cardiology, Rotterdam, Netherlands
| | - T Oude Ophuis
- Canisius Wilhelmina Ziekenhuis, Cardiology, Nijmegen, Netherlands
| | - T Lenderink
- Zuyderland, Cardiology, Heerlen, Netherlands
| | - F W Asselbergs
- University Medical Center Utrecht, Cardiology, Utrecht, Netherlands
| | - K M Akkerhuis
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | - E Boersma
- Erasmus Medical Center, Clinical epidemiology of Cardiology, Rotterdam, Netherlands
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20
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Vroegindewey MM, Van Den Berg VJ, Oemrawsingh RM, Kardys I, Asselbergs FW, Van Der Harst P, Kietselaer B, Lenderink T, Akkerhuis KM, Boersma E. P6245High frequency metabolite profiling and the incidence of recurrent coronary events in post-acute coronary syndrome patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6245] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | - I Kardys
- Erasmus Medical Center, Rotterdam, Netherlands
| | | | | | - B Kietselaer
- Maastricht University Medical Centre (MUMC), Maastricht, Netherlands
| | | | | | - E Boersma
- Erasmus Medical Center, Rotterdam, Netherlands
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21
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Masdjedi K, Van Zandvoort LJC, Ligthart J, Tovar Forero NM, Lemmert ME, Diletti R, Witberg K, Zijlstra F, Kardys I, Van Mieghem NM, Daemen J. P4198The predictive value of Pd/pa and resting diastolic pressure ratio (DPR) on 1-year adverse cardiovascular event following contemporary percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4198] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Masdjedi
- Erasmus Medical Centre, Cardiology, Rotterdam, Netherlands
| | | | - J Ligthart
- Erasmus Medical Centre, Cardiology, Rotterdam, Netherlands
| | | | - M E Lemmert
- Erasmus Medical Centre, Cardiology, Rotterdam, Netherlands
| | - R Diletti
- Erasmus Medical Centre, Cardiology, Rotterdam, Netherlands
| | - K Witberg
- Erasmus Medical Centre, Cardiology, Rotterdam, Netherlands
| | - F Zijlstra
- Erasmus Medical Centre, Cardiology, Rotterdam, Netherlands
| | - I Kardys
- Erasmus Medical Centre, Cardiology, Rotterdam, Netherlands
| | | | - J Daemen
- Erasmus Medical Centre, Cardiology, Rotterdam, Netherlands
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22
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Van Den Berg VJ, Bouwens E, Umans VAWM, Manintveld OC, Caliskan K, Constantinescu AA, Cornel JH, Akkerhuis KM, Boersma E, Kardys I. P5665Coagulation biomarkers and clinical outcomes in patients with chronic heart failure - The bio-shift study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5665] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V J Van Den Berg
- Erasmus Medical Center, Clinical epidemiology of Cardiology, Rotterdam, Netherlands
| | - E Bouwens
- Erasmus Medical Center, Clinical epidemiology of Cardiology, Rotterdam, Netherlands
| | | | - O C Manintveld
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | - K Caliskan
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | | | - J H Cornel
- Northwest clinics, Cardiology, Alkmaar, Netherlands
| | - K M Akkerhuis
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | - E Boersma
- Erasmus Medical Center, Clinical epidemiology of Cardiology, Rotterdam, Netherlands
| | - I Kardys
- Erasmus Medical Center, Clinical epidemiology of Cardiology, Rotterdam, Netherlands
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23
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Brankovic M, Kardys I, Van Den Berg V, Oemrawsingh R, Asselbergs F, Kietselaer B, Lenderink T, Ophuis T, Umans V, De Winter R, Akkerhuis K, Boersma E. P3653Evolution of renal function after acute coronary syndrome and prognostic impact of serial renal assessments in patients with normal-to-moderately reduced glomerular filtration rates: BIOMArCS study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3653] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M. Brankovic
- Erasmus Medical Center, Department of Cardiology, Rotterdam, Netherlands
| | - I. Kardys
- Erasmus Medical Center, Department of Cardiology, Rotterdam, Netherlands
| | - V. Van Den Berg
- Erasmus Medical Center, Department of Cardiology, Rotterdam, Netherlands
| | - R. Oemrawsingh
- Erasmus Medical Center, Department of Cardiology, Netherlands Heart Institute,, Rotterdam, Netherlands
| | - F.W. Asselbergs
- University Medical Center Utrecht, Division Heart & Lungs, Department of Cardiology, Durrer Center for Cardiovascular Research, Utrecht, Netherlands
| | - B. Kietselaer
- Maastricht University Medical Centre (MUMC), Maastricht, Netherlands
| | | | - T.O. Ophuis
- Canisius Wilhelmina Ziekenhuis, Working Group on Cardiovascular Research the Netherlands (WCN), Nijmegen, Netherlands
| | - V. Umans
- Noordwest Ziekenhuisgroep, Department of Cardiology, Alkmaar, Netherlands
| | - R. De Winter
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands
| | - K.M. Akkerhuis
- Erasmus Medical Center, Department of Cardiology, Rotterdam, Netherlands
| | - E. Boersma
- Erasmus Medical Center, Department of Cardiology, Rotterdam, Netherlands
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24
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Anroedh S, Oemrawsingh R, Cheng J, Garcia-Garcia H, Regar E, Van Geuns R, Serruys P, Daemen J, Van Mieghem N, Boersma E, Kardys I, Akkerhuis K. 2211Serum PCSK9 in relation to coronary near-infrared spectroscopy-derived lipid core burden index and long-term cardiovascular outcome [ATHEROREMO-NIRS substudy]. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.2211] [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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25
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Schuurman A, Vroegindewey M, Kardys I, Oemrawsingh R, Garcia-Garcia H, Van Geuns R, Regar E, Van Mieghem N, Koenig W, Serruys P, Boersma E, Akkerhuis K. P6035The long-term prognostic value of radiofrequency intravascular ultrasound for major adverse cardiovascular events in patients with coronary artery disease during 4.7-years follow-up. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6035] [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: 11/12/2022] Open
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26
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Akin S, Soliman O, Muslem R, Dos Reis Miranda D, Den Uil C, Constantinescu A, Kardys I, Bogers A, Zijlstra F, Brugts J, Caliskan K. 4993Preoperative right heart hemodynamics predict right heart failure and early ICU mortality following LVAD implantation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.4993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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27
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Anroedh S, Akkerhuis K, Oemrawsingh R, Garcia-Garcia H, Brankovic M, Regar E, Van Geuns R, Serruys P, Daemen J, Van Mieghem N, Boersma E, Kardys I. P660Associations of 26 circulating inflammatory and renal biomarkers with near-infrared spectroscopy and long term cardiovascular outcome in patients undergoing coronary angiography [ATHEROREMO study]. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p660] [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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28
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Brankovic M, Akkerhuis K, Van Boven N, Manintveld O, Germans T, Brugts J, Caliskan K, Boersma E, Umans V, Constantinescu A, Kardys I. P6174Serial biomarker measurements show that down-titration of RAAS inhibitors and up-titration of diuretics mark progression towards end stage heart failure: Analysis of Bio-SHIFT study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6174] [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: 11/12/2022] Open
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29
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Vroegindewey M, Schuurman A, Kardys I, Anroedh S, Oemrawsingh R, Ligthart J, Garcia-Garcia H, Van Geuns R, Regar E, Van Mieghem N, Serruys P, Boersma H, Akkerhuis K. P2362SYNTAX score is positively correlated with intravascular ultrasound and near-infrared spectroscopy for the assessment of atherosclerotic burden in patients with stable coronary artery disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2362] [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: 11/13/2022] Open
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30
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Van Den Berg V, Umans V, Akkerhuis K, Oemrawsingh R, Asselbergs F, Kietselaer B, Lenderink T, Van Der Harst P, Maas A, Oude Ophuis A, De Winter R, Hoefer I, Van Schaik R, Kardys I, Boersma E. P3648Detailed temporal patterns of high-sensitivity-cardiac troponin I and T during long-term follow-up after acute coronary syndrome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3648] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | - K.M. Akkerhuis
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | | | - F.W. Asselbergs
- University Medical Center Utrecht, Cardiology, Utrecht, Netherlands
| | - B.L.J.H. Kietselaer
- Maastricht University Medical Centre (MUMC), Cardiology, Maastricht, Netherlands
| | | | | | - A. Maas
- Gelre Ziekenhuis, Cardiology, Zutphen, Netherlands
| | - A.J. Oude Ophuis
- Canisius Wilhelmina Ziekenhuis, Cardiology, Nijmegen, Netherlands
| | - R.J. De Winter
- Academic Medical Center of Amsterdam, Cardiology, Amsterdam, Netherlands
| | - I.E. Hoefer
- University Medical Center Utrecht, Cardiology, Utrecht, Netherlands
| | - R.H. Van Schaik
- Erasmus Medical Center, Clinical chemistry, Rotterdam, Netherlands
| | - I. Kardys
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
| | - E. Boersma
- Erasmus Medical Center, Cardiology, Rotterdam, Netherlands
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Ballantyne C, Cushman M, Psaty B, Furberg C, Khaw KT, Sandhu M, Oldgren J, Rossi GP, Maiolino G, Cesari M, Lenzini L, James SK, Rimm E, Collins R, Anderson J, Koenig W, Brenner H, Rothenbacher D, Berglund G, Persson M, Berger P, Brilakis E, McConnell JP, Koenig W, Sacco R, Elkind M, Talmud P, Rimm E, Cannon CP, Packard C, Barrett-Connor E, Hofman A, Kardys I, Witteman JCM, Criqui M, Corsetti JP, Rainwater DL, Moss AJ, Robins S, Bloomfield H, Collins D, Packard C, Wassertheil-Smoller S, Ridker P, Ballantyne C, Cannon CP, Cushman M, Danesh J, Gu D, Hofman A, Nelson JJ, Thompson S, Zalewski A, Zariffa N, Di Angelantonio E, Kaptoge S, Thompson A, Thompson S, Walker M, Watson S, Wood A. Collaborative meta-analysis of individual participant data from observational studies of Lp-PLA2 and cardiovascular diseases. ACTA ACUST UNITED AC 2016; 14:3-11. [PMID: 17301621 DOI: 10.1097/01.hjr.0000239464.18509.f1] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A large number of observational epidemiological studies have reported generally positive associations between circulating mass and activity levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) and the risk of cardiovascular diseases. Few studies have been large enough to provide reliable estimates in different circumstances, such as in different subgroups (e.g., by age group, sex, or smoking status) or at different Lp-PLA2 levels. Moreover, most published studies have related disease risk only to baseline values of Lp-PLA2 markers (which can lead to substantial underestimation of any risk relationships because of within-person variability over time) and have used different approaches to adjustment for possible confounding factors. OBJECTIVES By combination of data from individual participants from all relevant observational studies in a systematic 'meta-analysis', with correction for regression dilution (using available data on serial measurements of Lp-PLA2), the Lp-PLA2 Studies Collaboration will aim to characterize more precisely than has previously been possible the strength and shape of the age and sex-specific associations of plasma Lp-PLA2 with coronary heart disease (and, where data are sufficient, with other vascular diseases, such as ischaemic stroke). It will also help to determine to what extent such associations are independent of possible confounding factors and to explore potential sources of heterogeneity among studies, such as those related to assay methods and study design. It is anticipated that the present collaboration will serve as a framework to investigate related questions on Lp-PLA2 and cardiovascular outcomes. METHODS A central database is being established containing data on circulating Lp-PLA2 values, sex and other potential confounding factors, age at baseline Lp-PLA2 measurement, age at event or at last follow-up, major vascular morbidity and cause-specific mortality. Information about any repeat measurements of Lp-PLA2 and potential confounding factors has been sought to allow adjustment for possible confounding and correction for regression dilution. The analyses will involve age-specific regression models. Synthesis of the available observational studies of Lp-PLA2 will yield information on a total of about 15 000 cardiovascular disease endpoints.
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Van Boven N, Windecker S, Umans VA, Van Domburg RT, Kardys I, Akkerhuis KM, Van Geuns RJ, Raber L, Boersma E. Stent thrombosis in early-generation drug-eluting stents versus newer-generation everolimus-eluting stent assorted by left ventricular ejection fraction. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5484] [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: 11/12/2022] Open
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Cheng JM, Oemrawsingh RM, Akkerhuis KM, Garcia-Garcia HM, De Boer SPM, Lenzen MJ, Van Geuns RJ, Serruys PW, Kardys I, Boersma E. Circulating chemokines in relation to coronary plaque characteristics as measured by intravascular ultrasound and 1-year cardiovascular outcome in patients undergoing coronary angiography. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4178] [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: 11/12/2022] Open
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Oemrawsingh RM, Cheng JM, Garcia-Garcia HM, Van Geuns RJ, Regar E, Kardys I, Lenzen MJ, Serruys PW, Akkerhuis KM, Boersma E. Near-infrared spectroscopy predicts cardiovascular outcome in patients with coronary artery disease. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Totzeck M, Hendgen-Cotta U, Rammos C, Petrescu A, Stock P, Goedecke A, Shiva S, Kelm M, Rassaf T, Duerr GD, Heuft T, Klaas T, Suchan G, Roell W, Zimmer A, Welz A, Fleischmann BK, Dewald O, Luedde M, Carter N, Lutz M, Sosna J, Jacoby C, Floegel U, Hippe HJ, Adam D, Heikenwaelder M, Frey N, Sobierajski J, Luedicke P, Hendgen-Cotta U, Lue H, Totzeck M, Dewor M, Kelm M, Bernhagen J, Rassaf T, Cortez-Dias N, Costa M, Carrilho-Ferreira P, Silva D, Jorge C, Robalo Martins S, Fiuza M, Pinto FJ, Nunes Diogo A, Enguita FJ, Tsiachris D, Tsioufis C, Kasiakogias A, Flessas D, Antonakis V, Kintis K, Giakoumis M, Hatzigiannis P, Katsimichas T, Stefanadis C, Andrikou E, Tsioufis C, Thomopoulos C, Kasiakogias A, Tzamou V, Andrikou I, Bafakis I, Lioni L, Kintis K, Stefanadis C, Lazaros G, Tsiachris D, Tsioufis C, Vlachopoulos C, Brili S, Chrysohoou C, Tousoulis D, Stefanadis C, Santos De Sousa CI, Pires S, Nunes A, Cortez Dias N, Belo A, Cabrita I, Pinto FJ, Benova T, Radosinska J, Viczenczova C, Bacova B, Knezl V, Dosenko V, Navarova J, Zeman M, Tribulova N, Maceira Gonzalez AM, Cosin Sales J, Igual B, Ruvira J, Diago JL, Aguilar J, Lopez Lereu MP, Monmeneu JV, Estornell J, Choi JC, Cha KS, Lee HW, Yun EY, Ahn JH, Oh JH, Choi JH, Lee HC, Hong TJ, Manzano Fernandez S, Lopez-Cuenca A, Januzzi JL, Mateo-Martinez A, Sanchez-Martinez M, Parra-Pallares S, Orenes-Pinero E, Romero-Aniorte AI, Valdes-Chavarri M, Marin F, Bouzas Mosquera A, Peteiro J, Broullon FJ, Alvarez Garcia N, Couto Mallon D, Bouzas Zubeldia B, Martinez Ruiz D, Yanez Wonenburger JC, Fabregas Casal R, Castro Beiras A, Backus BE, Six AJ, Cullen L, Greenslade J, Than M, Kameyama T, Sato T, Noto T, Nakadate T, Ueno H, Yamada K, Inoue H, Albrecht-Kuepper B, Kretschmer A, Kast R, Baerfacker L, Schaefer S, Kolkhof P, Andersson C, Kober L, Christensen SB, Nguyen CD, Nielsen MB, Olsen AMS, Gislason GH, Torp-Pedersen C, Shigekiyo M, Harada K, Lieu H, Neutel J, Maddock S, Goldsmith S, Koren M, Antwerp BV, Burnett J, Christensen SB, Charlot MG, Madsen M, Andersson C, Kober L, Gustafsson F, Torp-Pedersen C, Gislason GH, Cavusoglu Y, Mert KU, Nadir A, Mutlu F, Gencer E, Ulus T, Birdane A, Lim HS, Tahk SJ, Yang HM, Kim JW, Seo KW, Choi BJ, Choi SY, Yoon MH, Hwang GS, Shin JH, Russ MA, Wackerl C, Hochadel M, Brachmann J, Mudra H, Zeymer U, Weber MA, Menozzi A, Saia F, Valgimigli M, Belotti LM, Casella G, Manari A, Cremonesi A, Piovaccari G, Guastaroba P, Marzocchi A, Kuramitsu S, Iwabuchi M, Haraguchi T, Domei T, Nagae A, Hyodo M, Takabatake Y, Yokoi H, Toyota F, Nobuyoshi M, Kaitani K, Hanazawa K, Izumi C, Nakagawa Y, Ando K, Arita T, Nobuyoshi M, Shizuta S, Kimura T, Isshiuki T, Trucco ME, Tolosana JM, Castel MA, Borras R, Sitges M, Khatib M, Arbelo E, Berruezo A, Brugada J, Mont L, Romanov A, Pokushalov E, Prokhorova D, Chernyavskiy A, Shabanov V, Goscinska-Bis K, Bis J, Bochenek A, Gersak B, Karaskov A, Linde C, Daubert C, Bergemann TL, Abraham WT, Gold MR, Van Boven N, Bogaard K, Ruiter JH, Kimman GP, Kardys I, Umans VA, Cipriani M, Lunati M, Landolina M, Vittori C, Vargiu S, Ghio S, Petracci B, Campo C, Bisetti S, Frigerio M, Bongiorni MG, Soldati E, Segreti L, Zucchelli G, Di Cori A, De Lucia R, Viani S, Paperini L, Boem A, Levorato D, Kutarski A, Malecka B, Zabek A, Czajkowski M, Chudzik M, Kutarski A, Mitkowski P, Maciag A, Kempa M, Golzio PG, Fanelli A, Vinci M, Pelissero E, Morello M, Grosso Marra W, Gaita F, Kutarski A, Czajkowski M, Pietura R, Golzio PG, Vinci M, Pelissero E, Fanelli A, Ferraris F, Gaita F, Cuypers JAAE, Menting ME, Opic P, Utens EMWJ, Van Domburg RT, Helbing WA, Witsenburg M, Van Den Bosch AE, Bogers AJJC, Roos-Hesselink JW, Van Der Linde D, Takkenberg JJM, Rizopoulos D, Heuvelman HJ, Witsenburg M, Budts W, Van Dijk APJ, Bogers AJJC, Oechslin EN, Roos-Hesselink JW, Diller GP, Kempny A, Liodakis E, Alonso-Gonzalez R, Orwat S, Dimopoulos K, Swan L, Li W, Gatzoulis MA, Baumgartner H, Andrade AC, Voges I, Jerosch-Herold M, Pham M, Hart C, Hansen T, Kramer HH, Rickers C, Kempny A, Wustmann K, Borgia F, Dimopoulos K, Uebing A, Piorkowski A, Yacoub MH, Gatzoulis MA, Swan L, Diller GP, Mueller J, Weber R, Pringsheim M, Hoerer J, Hess J, Hager A, Hu K, Liu D, Niemann M, Herrmann S, Cikes M, Stoerk S, Knob S, Ertl G, Bijnens B, Weidemann F, Mornos C, Cozma D, Dragulescu D, Ionac A, Mornos A, Petrescu L, Mingo S, Ruiz Bautista L, Monivas Palomero V, Prados C, Maiz L, Giron R, Martinez M, Cavero Gibanel MA, Segovia J, Pulpon L, Kato H, Kubota S, Takasawa Y, Kumamoto T, Iacoviello M, Puzzovivo A, Forleo C, Lattarulo MS, Monitillo F, Antoncecchi V, Malerba G, Marangelli V, Favale S, Ruiz Bautista L, Mingo S, Monivas V, Segovia J, Prados C, Maiz L, Giron R, Martinez MT, Gonzalez Estecha M, Alonso Pulpon LA, Ren B, De Groot-De Laat L, Mcghie J, Vletter W, Ten Cate F, Geleijnse M, Looi JL, Lam YY, Yu CM, Lee PW, Apor A, Sax B, Huttl T, Nagy A, Kovacs A, Merkely B, Vecera J, Bartunek J, Vanderheyden M, Mertens P, Bodea O, Penicka M, Biaggi P, Gaemperli O, Corti R, Gruenenfelder J, Felix C, Bettex D, Datta S, Jenni R, Tanner F, Herzog B, Fattouch K, Murana G, Castrovinci S, Sampognaro R, Bertolino EC, Caccamo G, Ruvolo G, Speziale G, Lancellotti P. Saturday, 25 August 2012. Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs280] [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: 11/13/2022] Open
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Burgess S, Thompson SG, Burgess S, Thompson SG, Andrews G, Samani NJ, Hall A, Whincup P, Morris R, Lawlor DA, Davey Smith G, Timpson N, Ebrahim S, Ben-Shlomo Y, Davey Smith G, Timpson N, Brown M, Ricketts S, Sandhu M, Reiner A, Psaty B, Lange L, Cushman M, Hung J, Thompson P, Beilby J, Warrington N, Palmer LJ, Nordestgaard BG, Tybjaerg-Hansen A, Zacho J, Wu C, Lowe G, Tzoulaki I, Kumari M, Sandhu M, Yamamoto JF, Chiodini B, Franzosi M, Hankey GJ, Jamrozik K, Palmer L, Rimm E, Pai J, Psaty B, Heckbert S, Bis J, Anand S, Engert J, Collins R, Clarke R, Melander O, Berglund G, Ladenvall P, Johansson L, Jansson JH, Hallmans G, Hingorani A, Humphries S, Rimm E, Manson J, Pai J, Watkins H, Clarke R, Hopewell J, Saleheen D, Frossard R, Danesh J, Sattar N, Robertson M, Shepherd J, Schaefer E, Hofman A, Witteman JCM, Kardys I, Ben-Shlomo Y, Davey Smith G, Timpson N, de Faire U, Bennet A, Sattar N, Ford I, Packard C, Kumari M, Manson J, Lawlor DA, Davey Smith G, Anand S, Collins R, Casas JP, Danesh J, Davey Smith G, Franzosi M, Hingorani A, Lawlor DA, Manson J, Nordestgaard BG, Samani NJ, Sandhu M, Smeeth L, Wensley F, Anand S, Bowden J, Burgess S, Casas JP, Di Angelantonio E, Engert J, Gao P, Shah T, Smeeth L, Thompson SG, Verzilli C, Walker M, Whittaker J, Hingorani A, Danesh J. Bayesian methods for meta-analysis of causal relationships estimated using genetic instrumental variables. Stat Med 2010; 29:1298-311. [PMID: 20209660 DOI: 10.1002/sim.3843] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Genetic markers can be used as instrumental variables, in an analogous way to randomization in a clinical trial, to estimate the causal relationship between a phenotype and an outcome variable. Our purpose is to extend the existing methods for such Mendelian randomization studies to the context of multiple genetic markers measured in multiple studies, based on the analysis of individual participant data. First, for a single genetic marker in one study, we show that the usual ratio of coefficients approach can be reformulated as a regression with heterogeneous error in the explanatory variable. This can be implemented using a Bayesian approach, which is next extended to include multiple genetic markers. We then propose a hierarchical model for undertaking a meta-analysis of multiple studies, in which it is not necessary that the same genetic markers are measured in each study. This provides an overall estimate of the causal relationship between the phenotype and the outcome, and an assessment of its heterogeneity across studies. As an example, we estimate the causal relationship of blood concentrations of C-reactive protein on fibrinogen levels using data from 11 studies. These methods provide a flexible framework for efficient estimation of causal relationships derived from multiple studies. Issues discussed include weak instrument bias, analysis of binary outcome data such as disease risk, missing genetic data, and the use of haplotypes.
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Kardys I, Vliegenthart R, Oudkerk M. The female advantage in cardiovascular disease: Do vascular beds contribute equally? J Vasc Surg 2008. [DOI: 10.1016/j.jvs.2007.12.019] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sie M, Mattace-Raso F, Kardys I, de Maat M, Uitterlinden A, Hofman A, Hoeks A, Reneman R, Asmar R, van Duijn C, Witteman J. Genetic variation in the C-reactive protein gene and arterial stiffness: The Rotterdam Study. Artery Res 2008. [DOI: 10.1016/j.artres.2008.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Danesh J, Erqou S, Walker M, Thompson SG, Tipping R, Ford C, Pressel S, Walldius G, Jungner I, Folsom AR, Chambless LE, Knuiman M, Whincup PH, Wannamethee SG, Morris RW, Willeit J, Kiechl S, Santer P, Mayr A, Wald N, Ebrahim S, Lawlor DA, Yarnell JWG, Gallacher J, Casiglia E, Tikhonoff V, Nietert PJ, Sutherland SE, Bachman DL, Keil JE, Cushman M, Psaty BM, Tracy RP, Tybjaerg-Hansen A, Nordestgaard BG, Frikke-Schmidt R, Giampaoli S, Palmieri L, Panico S, Vanuzzo D, Pilotto L, Simons L, McCallum J, Friedlander Y, Fowkes FGR, Lee AJ, Smith FB, Taylor J, Guralnik J, Phillips C, Wallace R, Blazer D, Khaw KT, Jansson JH, Donfrancesco C, Salomaa V, Harald K, Jousilahti P, Vartiainen E, Woodward M, D'Agostino RB, Wolf PA, Vasan RS, Pencina MJ, Bladbjerg EM, Jorgensen T, Moller L, Jespersen J, Dankner R, Chetrit A, Lubin F, Rosengren A, Wilhelmsen L, Lappas G, Eriksson H, Bjorkelund C, Cremer P, Nagel D, Tilvis R, Strandberg T, Rodriguez B, Bouter LM, Heine RJ, Dekker JM, Nijpels G, Stehouwer CDA, Rimm E, Pai J, Sato S, Iso H, Kitamura A, Noda H, Goldbourt U, Salomaa V, Salonen JT, Nyyssönen K, Tuomainen TP, Deeg D, Poppelaars JL, Meade T, Cooper J, Hedblad B, Berglund G, Engstrom G, Döring A, Koenig W, Meisinger C, Mraz W, Kuller L, Selmer R, Tverdal A, Nystad W, Gillum R, Mussolino M, Hankinson S, Manson J, De Stavola B, Knottenbelt C, Cooper JA, Bauer KA, Rosenberg RD, Sato S, Naito Y, Holme I, Nakagawa H, Miura H, Ducimetiere P, Jouven X, Crespo C, Garcia-Palmieri M, Amouyel P, Arveiler D, Evans A, Ferrieres J, Schulte H, Assmann G, Shepherd J, Packard C, Sattar N, Cantin B, Lamarche B, Després JP, Dagenais GR, Barrett-Connor E, Wingard D, Bettencourt R, Gudnason V, Aspelund T, Sigurdsson G, Thorsson B, Trevisan M, Witteman J, Kardys I, Breteler M, Hofman A, Tunstall-Pedoe H, Tavendale R, Lowe GDO, Ben-Shlomo Y, Howard BV, Zhang Y, Best L, Umans J, Onat A, Meade TW, Njolstad I, Mathiesen E, Lochen ML, Wilsgaard T, Gaziano JM, Stampfer M, Ridker P, Ulmer H, Diem G, Concin H, Rodeghiero F, Tosetto A, Brunner E, Shipley M, Buring J, Cobbe SM, Ford I, Robertson M, He Y, Ibanez AM, Feskens EJM, Kromhout D, Collins R, Di Angelantonio E, Kaptoge S, Lewington S, Orfei L, Pennells L, Perry P, Ray K, Sarwar N, Scherman M, Thompson A, Watson S, Wensley F, White IR, Wood AM. The Emerging Risk Factors Collaboration: analysis of individual data on lipid, inflammatory and other markers in over 1.1 million participants in 104 prospective studies of cardiovascular diseases. Eur J Epidemiol 2007; 22:839-69. [PMID: 17876711 DOI: 10.1007/s10654-007-9165-7] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Accepted: 07/02/2007] [Indexed: 01/22/2023]
Abstract
Many long-term prospective studies have reported on associations of cardiovascular diseases with circulating lipid markers and/or inflammatory markers. Studies have not, however, generally been designed to provide reliable estimates under different circumstances and to correct for within-person variability. The Emerging Risk Factors Collaboration has established a central database on over 1.1 million participants from 104 prospective population-based studies, in which subsets have information on lipid and inflammatory markers, other characteristics, as well as major cardiovascular morbidity and cause-specific mortality. Information on repeat measurements on relevant characteristics has been collected in approximately 340,000 participants to enable estimation of and correction for within-person variability. Re-analysis of individual data will yield up to approximately 69,000 incident fatal or nonfatal first ever major cardiovascular outcomes recorded during about 11.7 million person years at risk. The primary analyses will involve age-specific regression models in people without known baseline cardiovascular disease in relation to fatal or nonfatal first ever coronary heart disease outcomes. This initiative will characterize more precisely and in greater detail than has previously been possible the shape and strength of the age- and sex-specific associations of several lipid and inflammatory markers with incident coronary heart disease outcomes (and, secondarily, with other incident cardiovascular outcomes) under a wide range of circumstances. It will, therefore, help to determine to what extent such associations are independent from possible confounding factors and to what extent such markers (separately and in combination) provide incremental predictive value.
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