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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian 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Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Vacarescu C, Luca CT, Gaita D, Crisan S, Mornos C, Goanta EV, Lazar MA, Ionac I, Arnautu DA, Cozma D. Fusion CRT pacing: septal flash significance in super responder patients. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.999] [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
LV only CRT pacing is an option that may be considered to maximize response to CRT and at least as an alternative in non-responders to biventricular (BiV) pacing. However, criteria to best titrate therapy on an individual basis are lacking in fusion pacing. On the other hand, septal flash (SF) is a strong predictor of favorable response for patients (pts) with BiV pacing.
Purpose
To analyze the relationship between SF and the response to fusion CRT pacing.
Methods
Consecutive pts with exclusive fusion CRT-P were included. Right atrium/left ventricle leads DDD CRT pacing system were used in all patients. Prospective data were collected at every 6 months follow-up visits: device interrogation, exercise test, echocardiographic parameters. Exercise tests, device reprogramming and medication optimization were performed regular in order to maximize CRT response. Patients were divided in 2 groups: super-responders (SR) and responders (R). SRs were defined those with left ventricular end-systolic volume (LVESV) improvement ≥30% and stable ejection fraction (LVEF) ≥45%.
Results
69 pts with NYHA II–III heart failure and non-ischemic dilated cardiomyopathy were initially included. 5 pts were non responders and excluded (non LBBB, spontaneous QRS <149 ms). Final analyzed group had 64 pts (35 male) aged 60±12 y.o. The mean follow-up was 54±19 months; 22 pts (34%) were SRs. At baseline, SF was found in all SR pts and in 55% of R pts. SF was corrected post CRT in all patients, except one. For this patient (LV lead in a posterior branch of the coronary sinus – CS) the strategy included an upgrade to triple chamber device with a second lead in a lateral branch of the CS and became SR from R. Mitral regurgitation decreased in 38 patients (all SR, 40% R). Interesting, baseline left atrium volume and pulmonary sistolic artery pressure were smaller in SR versus R group, however SF did not corelate with LA volume/diastolic dysfunction.
Conclusions
Septal flash seems to be a strong predictor of super-response in patients with fusion CRT pacing. This finding could improve the selection of candidates for fusion CRT-P, however larger studies are needed to assess SF in this categories of patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- C Vacarescu
- University of Medicine Victor Babes , Timisoara , Romania
| | - C T Luca
- University of Medicine Victor Babes , Timisoara , Romania
| | - D Gaita
- University of Medicine Victor Babes , Timisoara , Romania
| | - S Crisan
- University of Medicine Victor Babes , Timisoara , Romania
| | - C Mornos
- University of Medicine Victor Babes , Timisoara , Romania
| | - E V Goanta
- University of Medicine Victor Babes , Timisoara , Romania
| | - M A Lazar
- University of Medicine Victor Babes , Timisoara , Romania
| | - I Ionac
- University of Medicine Victor Babes , Timisoara , Romania
| | - D A Arnautu
- University of Medicine Victor Babes , Timisoara , Romania
| | - D Cozma
- University of Medicine Victor Babes , Timisoara , Romania
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Gurgu A, Petrescu L, Vacarescu C, Luca CT, Mornos C, Crisan S, Lazar MA, Cozma D. Diastolic dyssynchrony in patients with LV only fusion pacing CRT without RV lead. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
CRT improves both systolic and diastolic function, thus increasing cardiac output. However, less data is available concerning diastolic dyssynchrony and fusion pacing CRT. The aim of our study was to assess the outcome of LV diastolic asynchrony in a population of fusion pacing CRT without right ventricular (RV) lead.
Methods
Prospective data were collected from a cohort of patients (pts) with right atrium/left ventricle leads (RA/LV CRT). Baseline and every 6 months follow-up included standard ETT and classical dyssynchrony parameter measurements. Diastolic dyssynchrony was done by offline speckle-tracking derived TDI timing assesment of the simultaneity of E" and A" basal septal and lateral wall 4 chamber view. New parameters were introduced: E" and respectively A" time (E"T / A"T) as the time difference between E" (respectively A" ) peaks septal and lateral wall. Exercise tests, drugs optimization and device individual programmimg were systematically performed in order to maintain constant fusion and improve CRT response. Patients were divided in three groups: super-responders (SR), responders (R) and non responders (NR).
Results
Sixty-two pts (35 male) aged 62 ± 11 y.o. with idiopathic DCM implanted with a RA/LV CRT were analyzed: 34%SR / 61%R / 5%NR. Baseline initial characteristics: QRS 164 ± 18 ms; EF 27 ± 5.2; 29% had type III diastolic dysfunction (DD), 63% type II DD, 8% type I DD. Average follow-up was 45 ± 19 months; mean LVEF at the last follow-up was 37 ± 7.9%. The E"T decreased from 90 ± 20 ms to 25 ± 10 ms in SR with significant LV reverse remodelling (LV end-diastolic volume 193.7 ± 81 vs 243.2 ± 82 ml at baseline, p < 0.0028) and lower LV filling pressures (E/E" 13.2 ± 4.6 vs 11.4 ± 4.5, p =0.0295). DD profile improved in 65% of R with a reduction in E/A ratio (1.46 ± 5.3 vs. 0.82 ± 3.9 at baseline, p= 0.4453). Non-sudden cardiac death occurred in 3 NR pts (2%) with type III DD, severe LA volume and larger E" T /A"T (E"T> 85 msec A"T > 30 msec). Significant cut off value calculated by ROC curve for LV diastolic dyssynchrony is E"T > 80 ms and A"T of > 25 msec.
Conclusions
Fusion pacing CRT without RV lead showed a positive outcome; improving LV diastolic dyssynchrony in responders and super-responders patients is obvious. Larger randomized studies are needed to define the role of diastolic asynchronism as a predictor of favorable response in fusion pacing.
Abstract Figure. Typical TDI patterns in LV fusion pacing
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Affiliation(s)
- A Gurgu
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - L Petrescu
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - C Vacarescu
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - CT Luca
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - C Mornos
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - S Crisan
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - MA Lazar
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - D Cozma
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
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Vacarescu C, Luca C, Petrescu L, Ionac A, Mornos C, Goanta E, Crisan S, Lazar M, Cozma D. AV delay optimisation in LV only CRT: constant fusion pacing is easier in patients with first degree AV block. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0810] [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: 11/14/2022] Open
Abstract
Abstract
Background
LV only pacing is non-inferior to BiV pacing, and recent publications showed that DDD CRT without RV lead is safe in patients with normal atrioventricular (AV) conduction, although there are no device algorithms available for fusion pacing and PR interval variability is understudied in this population.
Purpose
To analyse AV behaviour in patients with DDD CRT and the impact to effective fusion maintenance.
Methods
Consecutive patients with right atrium/left ventricle leads DDD CRT pacing system were included. Prospective data were collected at every 6 months follow-up visits: device interrogation, exercise test (ET), echocardiography. CRT assessment during ET analysed loss of LV capture with special focus on maintaining constant fusion pacing during exercise. We defined 2 groups of patients: longer PR interval patients (200–250 ms) and normal PR interval patients (<200 ms). In case of LV loss of capture or unsatisfactory LV fusion pacing, device reprogramming was performed individualised for each patient and BB/ivabradine dose titration was done to achieve stability of PR spontaneous interval. Patients were rescheduled in no later one month to be reassessed by ET.
Results
55 patients (29 male) aged 62±11 y.o. were included, 36 patients with normal PR and 19 patients with longer PR. During follow-up (45±19 months), a total of 235 ETs were performed with mean exercise load 118±35 watts. In the normal PR group, 14 patients (39%) had inadequate pacing or loss of LV capture during ET due to physiological shortening of PR interval vs. 4 patients (21%) in the longer PR group. Loss of LV capture by exceeding maximum tracking rate (MTR) was noted in 6 patients (17%) with normal PR vs. 2 patients (11%) with long PR. Post ET device optimisation included: reprogramming rate adaptive AV interval (23±8 ms decrease in normal PR patients vs. 12±7 ms in longer PR patients, p<0.0001) and individualised programming of MTR. BB/ivabradine optimisation was performed in 32% of patients with normal PR vs. 13% of patients with longer PR.
Conclusions
A lower rate of optimisations after ET was needed in patients with a slightly longer AV conduction to achieve stability of fusion pacing DDD CRT, without device algorithms. Larger studies are needed to assess AV conduction variability and the benefits of fusion pacing CRT in patients with longer PR interval.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): University of Medicine and Pharmacy “Victor Babes”, Timisoara; Timisoara Institute of Cardiovascular Diseases
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Affiliation(s)
- C Vacarescu
- University of Medicine Victor Babes, Timisoara, Romania
| | - C.T Luca
- University of Medicine Victor Babes, Timisoara, Romania
| | - L Petrescu
- University of Medicine Victor Babes, Timisoara, Romania
| | - A Ionac
- University of Medicine Victor Babes, Timisoara, Romania
| | - C Mornos
- University of Medicine Victor Babes, Timisoara, Romania
| | - E.V Goanta
- University of Medicine Victor Babes, Timisoara, Romania
| | - S Crisan
- University of Medicine Victor Babes, Timisoara, Romania
| | - M.A Lazar
- University of Medicine Victor Babes, Timisoara, Romania
| | - D Cozma
- University of Medicine Victor Babes, Timisoara, Romania
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Abstract
Abstract
Background
We have previously demonstrated that patients with neurally mediated syncope (NMS) who have an isolated QRS complex, of very low voltage (≤0.3mV cutoff), in one of the frontal leads on the 12-lead electrocardiogram have a threefold increase in the risk of syncope recurrence. The potential relationship between isolated low voltage (ILV) in precordial leads (Figure A) and recurrent NMS has not been yet explored.
Purpose
To prospectively evaluate whether the presence of ILV in the precordial leads predicts recurrence of NMS.
Methods
We included 135 patients with NMS (age 49±20) years, with a median of 4 syncopal episodes. During a median period of 15 months, 43 patients (32%) experienced recurrent syncope. The lowest QRS voltage (QRSmin) was determined separately for the frontal and precordial leads. The cutoff for precordial QRSmin that best discriminated between patients with recurrent and no recurrent syncope was ≤0.7mV (ROC curve AUC=0.65).
Results
Isolated low voltage in precordial leads was present in 49 (36%) of patients. The lead which displayed QRSmin in the precordial leads was V1 in 35 (71%) patients. The actuarial total syncope recurrence rate at 1 year was 26% (95% CI 16–42%) in patients with ILV in precordial leads, and 21% (95% CI 6–39%) in patients without ILV (log rank test P=0.043; Figure B). The significant relationship between the presence of ILV in precordial leads and syncope recurrence was retained in Cox multivariate analysis that included isolated very low voltage in frontal leads (≤0.3mV cutoff), as well as the number of syncopal episodes.
Conclusions
Isolated low QRS voltage in the precordial leads predicts recurrence of NMS independent of isolated low QRS voltage in the frontal leads.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- D Blendea
- University of Medicine and Pharmacy of Cluj Napoca, Cluj Napoca, Romania
| | - M Cimpeanu
- University of Medicine and Pharmacy of Cluj Napoca, Cluj Napoca, Romania
| | - M Jelnean
- University of Medicine and Pharmacy of Cluj Napoca, Cluj Napoca, Romania
| | - R Chiorescu
- University of Medicine and Pharmacy of Cluj Napoca, Cluj Napoca, Romania
| | - S Crisan
- University of Medicine and Pharmacy of Cluj Napoca, Cluj Napoca, Romania
| | - S Pop
- Clinic Medical I of Cluj-Napoca, Medicine, Cluj-Napoca, Romania
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6
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Vacarescu C, Luca CT, Petrescu L, Mornos C, Goanta EV, Crisan S, Lazar MA, Cozlac RA, Cozma D. P1168Redefining first degree AV block: constant fusion pacing CRT is easier in longer PR interval patients. Europace 2020. [DOI: 10.1093/europace/euaa162.217] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
LV only pacing is non-inferior to BiV pacing, and recent publications showed that DDD CRT without RV lead is safe in patients with normal atrioventricular (AV) conduction, although there are no device algorithms available for fusion pacing and PR interval variability is understudied in this population. Purpose: To analyse AV behaviour in pts with DDD CRT and the impact to effective fusion maintenance.
Methods
Consecutive pts with right atrium/left ventricle (RA/LV) DDD CRT pacing system were included. Prospective data were collected at every 6 months follow-up visits: device interrogation, exercise test (ET), echocardiography. CRT assessment during ET analysed loss of LV capture with special focus on maintaining constant fusion pacing during exercise. We defined 2 groups of pts: longer PR interval pts (200-250 ms) and normal PR interval pts (˂200 ms). In case of LV loss of capture or unsatisfactory LV fusion pacing, device reprogramming was performed individualised for each patient and BB/ivabradine dose titration was done to achieve stability of PR spontaneous interval. Patients were rescheduled in no later one month to be reassessed by ET.
Results
55 pts (29 male) aged 62 ± 11 y.o. were included, 36 pts with normal PR and 19 pts with longer PR. During follow-up (45 ± 19 months), a total of 235 ETs were performed with mean exercise load 118 ± 35 watts. In the normal PR group 14 pts (39%) had inadequate pacing or loss of LV capture during ET due to physiological shortening of PR interval vs. 4 pts (21%) in the long PR group. Loss of LV capture by exceeding maximum tracking rate (MTR) was noted in 6 pts (17%) with normal PR vs. 2 pts (11%) with longer PR. Post ET device optimisation included: reprogramming rate adaptive AV interval (23 ± 8 ms decrease in normal PR pts vs. 12 ± 7 ms in longer PR pts, p < 0.0001) and individualised programming of MTR. BB/ivabradine optimisation was performed in 32% of pts with normal PR vs. 13% of pts with longer PR.
Conclusions
A lower rate of optimisations after exercise test was needed in pts with a slightly longer AV conduction to achieve stability of fusion pacing DDD CRT without device algorithms. Larger studies are needed to assess AV conduction variability and the benefits of fusion pacing CRT in pts with longer PR interval.
Abstract Figure.
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Affiliation(s)
- C Vacarescu
- University of Medicine Victor Babes, Timisoara, Romania
| | - C T Luca
- Timisoara Institute of Cardiovascular Medicine, Timisoara, Romania
| | - L Petrescu
- University of Medicine Victor Babes, Cardiology Department, Timisoara, Romania
| | - C Mornos
- Timisoara Institute of Cardiovascular Medicine, Timisoara, Romania
| | - E V Goanta
- University of Medicine Victor Babes, Timisoara, Romania
| | - S Crisan
- Timisoara Institute of Cardiovascular Medicine, Timisoara, Romania
| | - M A Lazar
- University of Medicine Victor Babes, Cardiology Department, Timisoara, Romania
| | - R A Cozlac
- University of Medicine Victor Babes, Cardiology Department, Timisoara, Romania
| | - D Cozma
- Timisoara Institute of Cardiovascular Medicine, Timisoara, Romania
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Vacarescu C, Petrescu L, Luca CT, Mornos C, Gurgu A, Goanta EV, Crisan S, Lazar MA, Cozlac RA, Cozma D. 416 LV only fusion pacing CRT without RV lead induces size and shape LA reverse remodelling. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.230] [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
Adaptive CRT pacing induces significant left atrium (LA) reverse remodelling comparing to biventricular (BiV) pacing, although the algorithm delivers compulsory BiV pacing in heart rate over 100/min! Purpose: to assess LA remodelling in LV only pacing without RV lead in a real-life situation of permanent CRT fusion pacing.
Methods
Prospective data were analysed from a cohort of patients with CRT-P indication implanted with right atrium/left ventricle (RA/LV) DDD pacing system. Complete follow-up at every 6 months included device interrogation, exercise test, transthoracic echocardiography (TE) and individualised drug optimisation. LA evaluation included: parasternal dimension (LAd), 4 chambers view: mid-LA transverse diameter (LAt), basal LA maximal transverse diameter (LAb); volume (LA vol) and shape assessment: trapezoidal LA shape was defined by LAt less than Lab, the reverse situation was considered ellipsoidal shape.
Results
55 pts (30 males) with idiopathic DCM aged 62 ± 11 y.o. were included. Baseline characteristic: QRS 164 ± 18 ms; EF 27 ± 5.2%; mitral regurgitation was severe in 22 pts, moderate in 27 pts and mild in 6 pts; 15 pts had type III diastolic dysfunction, 37 pts with type II diastolic dysfunction, 3 pts with type I diastolic dysfunction. Average follow-up was 42 ± 18 months: all patients were responders, EF increased at 37 ± 7.9%; mitral regurgitation decreased in 38 pts (69%), diastolic profile improved in 36 pts (65%). Trapezoidal LA shape was documented in 31 (56%) patients. Atrial fibrillation was noted in 4 pts (7%) and cardioversion was needed. Non-sudden cardiac death occurred in 5 patients (9%), all deaths were noted in pts with severe LA vol, trapezoidal shape and type III diastolic dysfunction. Statistically significative LA reverse remodelling was noted regarding LA volume, but not shape.
Conclusions
RA/LV fusion CRT pacing was associated with important LA reverse remodelling and a low incidence of AF. Larger randomised studies are needed to validate these results and assess the role of LA shape remodelling in CRT.
before RA/LV CRT-P Follow-up 42 ± 18 months p LV EF, %, mean ± SD 27 ± 5.2 37 ± 7.9 <0.0001 LA diameter (mm), mean ± SD 50 ± 4.9 44 ± 2.8 <0.0001 LA area (cm2), mean ± SD 24 ± 5.6 22 ± 0.7 0.0138 LA volume (ml), mean ± SD 104.9 ± 34 80 ± 28.2 0.0001
Abstract 416 Figure.
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Affiliation(s)
- C Vacarescu
- University of Medicine Victor Babes, Cardiology , Timisoara, Romania
| | - L Petrescu
- University of Medicine Victor Babes, Cardiology Department, Timisoara, Romania
| | - C T Luca
- Timisoara Institute of Cardiovascular Medicine, Timisoara, Romania
| | - C Mornos
- University of Medicine Victor Babes, Cardiology Department, Timisoara, Romania
| | - A Gurgu
- Timisoara Institute of Cardiovascular Medicine, Timisoara, Romania
| | - E V Goanta
- University of Medicine Victor Babes, Cardiology , Timisoara, Romania
| | - S Crisan
- University of Medicine Victor Babes, Cardiology , Timisoara, Romania
| | - M A Lazar
- University of Medicine Victor Babes, Cardiology , Timisoara, Romania
| | - R A Cozlac
- University of Medicine Victor Babes, Cardiology , Timisoara, Romania
| | - D Cozma
- University of Medicine Victor Babes, Cardiology , Timisoara, Romania
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Buzdugan EC, Goidescu C, Nemeti G, Goidescu I, Procopciuc LM, Crisan S, Radulescu D, Muresan D, Caracostea G. P5360Cardiovascular adaptation characteristics in women with preeclampsia. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0325] [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
Introduction
Even in normal pregnancies, physiologic functional and structural cardiovascular adjustments are required for progression of a successful pregnancy. In preeclamptic patients, these pregnancy-induced adaptive processes are intensified. It has been suggested that preeclampsia should be regarded as a failed stress test, a marker for increased later life cardiovascular risk.
Purpose
To differentiate between cardiovascular remodelling patterns in preeclamptic vs. normal pregnancies, using echocardiography and digital photoplethysmography.
Material
We conducted a single-center case–control study, performing cardiovascular assessment during last trimester of pregnancy in 56 pregnant women with preeclamsia (PE) and 62 healthy pregnant women, without CV risk factors.
Echocardiography was performed to characterize left ventricular (LV) remodelling patterns and to assess LV systolic and dyastolic function. Also, digital photoplethysmography was used to determine stiffness index (SI) and vascular age (VA). Data between groups were compared.
Results
The two groups were matched by age (30.42±6.37 vs 29.96±5.18 y/o, p=0.74), body mass index (29.84±5.31 vs. 28.53±5.33g, p=0.30), and parity (primiparous 33 vs. 25, p=0.47, multiparous 23 vs. 27, p=0.78). The prevalence of LV hypertrophy, expressed as LV mass (185.75±39.61 vs. 144.85±28.81 g, p=0.0023) and LV relative wall thickness (0.49±0.08 vs. 0.42±0.069), was higher in preeclamptic women, corresponding to higher blood pressure values (systolic blood pressure 164.27±20.09 vs 114±18.04 mmHg, p=0.0014, dyastolic blood pressure 103.22±14.13 vs. 72.83±11.34 mmHg, p=0.0015). The most common remodeling type in preeclamptic group was concentric hypertrophy (28/56, 50%), while in normal pregnancy group, normal geometry (21/62, 34%) and concentric remodeling (21/62, 34%), were more frequently encountered. No significant differences between groups were found in terms of LV ejection fraction, while dyastolic LV function, depicted through transmitral flow parameters, varied only when E/A ratio was measured (1.38±0.34 vs. 1.62±0.46, p=0.03). In preeclamptic women, SI was increased (9.27±1.86 vs. 7.13±1.86 m/s, p=0.0091), with a significantly higher VA also (47.44±21.61 vs. 28.75±7.51y/o, p=0.0001), for a similar maternal age of the study groups.
Conclusions
We documented a higher prevalence of LV hypertrophy, with the concentric remodelling pattern predominance, as well as a significantly advanced vascular age due to an increased arterial stiffness, among preeclamptic group. Follow-up of these patients may reveal features, or cut-off values, useful to early identify a population that may benefit from early interventions to prevent cardiovascular disease.
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Affiliation(s)
- E C Buzdugan
- University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - C Goidescu
- University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - G Nemeti
- University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - I Goidescu
- University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - L M Procopciuc
- University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - S Crisan
- University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - D Radulescu
- University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - D Muresan
- University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - G Caracostea
- University of Medicine and Pharmacy, Cluj Napoca, Romania
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Tong L, Huang C, Ramalli A, Tortoli P, Luo J, D'hooge J, Tzemos N, Mordi I, Bishay T, Bishay T, Negishi T, Hristova K, Kurosawa K, Bansal M, Thavendiranathan P, Yuda S, Popescu B, Vinereanu D, Penicka M, Marwick T, Hamed W, Kamel M, Yaseen R, El-Barbary H, Nemes A, Kis O, Gavaller H, Kanyo E, Forster T, Angelis A, Vlachopoulos C, Ioakimidis N, Felekos I, Chrysohoou C, Aznaouridis K, Abdelrasoul M, Terentes D, Ageli K, Stefanadis C, Kurnicka K, Domienik-Karlowicz J, Lichodziejewska B, Goliszek S, Grudzka K, Krupa M, Dzikowska-Diduch O, Ciurzynski M, Pruszczyk P, Gual Capllonch F, Lopez Ayerbe J, Teis A, Ferrer E, Vallejo N, Junca G, Pla R, Bayes-Genis A, Schwaiger J, Knight D, Gallimore A, Schreiber B, Handler C, Coghlan J, Bruno RM, Giardini G, Malacrida S, Catuzzo B, Armenia S, Brustia R, Ghiadoni L, Cauchy E, Pratali L, Kim K, Lee K, Cho J, Yoon H, Ahn Y, Jeong M, Cho J, Park J, Cho S, Nastase O, Enache R, Mateescu A, Botezatu D, Popescu B, Ginghina C, Gu H, Sinha M, Simpson J, Chowienczyk P, Fazlinezhad A, Tashakori Behesthi A, Homaei F, Mostafavi H, Hosseini G, Bakaeiyan M, Boutsikou M, Petrou E, Dimopoulos A, Dritsas A, Leontiadis E, Karatasakis G, Sahin ST, Yurdakul S, Yilmaz N, Cengiz B, Cagatay Y, Aytekin S, Yavuz S, Karlsen S, Dahlslett T, Grenne B, Sjoli B, Smiseth O, Edvardsen T, Brunvand H, Nasr G, Nasr A, Eleraki A, Elrefai S, Mordi I, Sonecki P, Tzemos N, Gustafsson U, Naar J, Stahlberg M, Cerne A, Capotosto L, Rosato E, D'angeli I, Azzano A, Truscelli G, De Maio M, Salsano F, Terzano C, Mangieri E, Vitarelli A, Renard S, Najih H, Mancini J, Jacquier A, Haentjens J, Gaubert J, Habib G, Caminiti G, D'antoni V, D'antoni V, Cardaci V, Cardaci V, Conti V, Conti V, Volterrani M, Volterrani M, Ahn J, Kim D, Lee H, Iliuta L, Lo Iudice F, Esposito R, Lembo M, Santoro C, Ballo P, Mondillo S, De Simone G, Galderisi M, Hwang Y, Kim J, Kim J, Moon K, Yoo K, Kim C, Tagliamonte E, Rigo F, Cirillo T, Caruso A, Astarita C, Cice G, Quaranta G, Romano C, Capuano N, Calabro' R, Zagatina A, Zhuravskaya N, Guseva O, Huttin O, Benichou M, Voilliot D, Venner C, Micard E, Girerd N, Sadoul N, Moulin F, Juilliere Y, Selton-Suty C, Baron T, Christersson C, Johansson K, Flachskampf F, Lee S, Lee J, Hur S, Park J, Yun J, Song S, Kim W, Ko J, Nyktari E, Bilal S, Ali S, Izgi C, Prasad S, Aly M, Kleijn S, Kandil H, Kamp O, Beladan C, Calin A, Rosca M, Craciun A, Gurzun M, Calin C, Enache R, Mateescu A, Ginghina C, Popescu B, Mornos C, Mornos A, Ionac A, Cozma D, Crisan S, Popescu I, Ionescu G, Petrescu L, Camacho S, Gamaza Chulian S, Carmona R, Diaz E, Giraldez A, Gutierrez A, Toro R, Benezet J, Antonini-Canterin F, Vriz O, La Carrubba S, Poli S, Leiballi E, Zito C, Careri S, Caruso R, Pellegrinet M, Nicolosi G, Kong W, Kyu K, Wong R, Tay E, Yip J, Yeo T, Poh K, Correia M, Delgado A, Marmelo B, Correia E, Abreu L, Cabral C, Gama P, Santos O, Rahman M, Borges IP, Peixoto E, Peixoto R, Peixoto R, Marcolla V, Okura H, Kanai M, Murata E, Kataoka T, Stoebe S, Tarr A, Pfeiffer D, Hagendorff A, Generati G, Bandera F, Pellegrino M, Alfonzetti E, Labate V, Guazzi M, Kuznetsov V, Yaroslavskaya E, Pushkarev G, Krinochkin D, Zyrianov I, Carigi S, Baldazzi F, Bologna F, Amati S, Venturi P, Grosseto D, Biagetti C, Fabbri E, Arlotti M, Piovaccari G, Rahbi H, Bin Abdulhaq A, Tleyjeh I, Santoro C, Galderisi M, Costantino M, Tarsia G, Innelli P, Dores E, Esposito G, Matera A, De Simone G, Trimarco B, Capotosto L, Azzano A, Mukred K, Ashurov R, Tanzilli G, Mangieri E, Vitarelli A, Merlo M, Gigli M, Stolfo D, Pinamonti B, Antonini Canterin F, Muca M, D'angelo G, Scapol S, Di Nucci M, Sinagra G, Behaghel A, Feneon D, Fournet M, Thebault C, Martins R, Mabo P, Leclercq C, Daubert C, Donal E, Davinder Pal S, Prakash Chand N, Sanjeev A, Rajeev M, Ankur D, Ram Gopal S, Mzoughi K, Zairi I, Jabeur M, Ben Moussa F, Ben Chaabene A, Kamoun S, Mrabet K, Fennira S, Zargouni A, Kraiem S, Demkina A, Hashieva F, Krylova N, Kovalevskaya E, Potehkina N, Zaroui A, Ben Said R, Smaali S, Rekik B, Ben Hlima M, Mizouni H, Mechmeche R, Mourali M, Malhotra A, Sheikh N, Dhutia H, Siva A, Narain R, Merghani A, Millar L, Walker M, Sharma S, Papadakis M, Siam-Tsieu V, Mansencal N, Arslan M, Deblaise J, Dubourg O, Zaroui A, Rekik B, Ben Said R, Boudiche S, Larbi N, Tababi N, Hannachi S, Mechmeche R, Mourali M, Mechmeche R, Zaroui A, Chalbia T, Ben Halima M, Rekik B, Boussada R, Mourali M, Lipari P, Bonapace S, Valbusa F, Rossi A, Zenari L, Lanzoni L, Targher G, Canali G, Molon G, Barbieri E, Novo G, Giambanco S, Sutera M, Bonomo V, Giambanco F, Rotolo A, Evola S, Assennato P, Novo S, Budnik M, Piatkowski R, Kochanowski J, Opolski G, Chatzistamatiou E, Mpampatseva Vagena I, Manakos K, Moustakas G, Konstantinidis D, Memo G, Mitsakis O, Kasakogias A, Syros P, Kallikazaros I, Marketou M, Parthenakis F, Kalyva N, Pontikoglou C, Maragkoudakis S, Zacharis E, Patrianakos A, Maragoudakis F, Papadaki H, Vardas P, Rodrigues A, Perandini L, Souza T, Sa-Pinto A, Borba E, Arruda A, Furtado M, Carvalho F, Bonfa E, Andrade J, Hlubocka Z, Malinova V, Palecek T, Danzig V, Kuchynka P, Dostalova G, Zeman J, Linhart A, Chatzistamatiou E, Konstantinidis D, Memo G, Mpampatzeva Vagena I, Moustakas G, Manakos K, Trachanas K, Vergi N, Feretou A, Kallikazaros I, Corut H, Sade L, Ozin B, Atar I, Turgay O, Muderrisoglu H, Ledakowicz-Polak A, Polak L, Krauza G, Zielinska M, Szulik M, Streb W, Wozniak A, Lenarczyk R, Sliwinska A, Kalarus Z, Kukulski T, Nogueira M, Branco L, Agapito A, Galrinho A, Borba A, Teixeira P, Monteiro A, Ramos R, Cacela D, Cruz Ferreira R, Guala A, Camporeale C, Tosello F, Canuto C, Ridolfi L, Chatzistamatiou E, Moustakas G, Memo G, Konstantinidis D, Mpampatzeva Vagena I, Manakos K, Traxanas K, Vergi N, Feretou A, Kallikazaros I, Hristova K, Marinov R, Stamenov G, Mihova M, Persenska S, Racheva A, Plaskota K, Trojnarska O, Bartczak A, Grajek S, Ramush Bejiqi R, Retkoceri R, Bejiqi H, Beha A, Surdulli S, Dreyfus J, Durand-Viel G, Cimadevilla C, Brochet E, Vahanian A, Messika-Zeitoun D, Jin C, Fang F, Meng F, Kam K, Sun J, Tsui G, Wong K, Wan S, Yu C, Lee A, Cho IJ, Chung H, Heo R, Ha S, Hong G, Shim C, Chang H, Ha J, Chung N, Moral S, Gruosso D, Galuppo V, Teixido G, Rodriguez-Palomares J, Gutierrez L, Evangelista A, Moral S, Gruosso D, Galuppo V, Teixido G, Rodriguez-Palomares J, Gutierrez L, Evangelista A, Moral S, Gruosso D, Galuppo V, Teixido G, Rodriguez-Palomares J, Gutierrez L, Evangelista A, Alexopoulos A, Dawson D, Nihoyannopoulos P, Zainal Abidin HA, Ismail J, Arshad K, Ibrahim Z, Lim C, Abd Rahman E, Kasim S, Peteiro J, Barrio A, Escudero A, Bouzas-Mosquera A, Yanez J, Martinez D, Castro-Beiras A, Scali M, Simioniuc A, Mandoli G, Lombardo A, Massaro F, Di Bello V, Marzilli M, Dini F, Adachi H, Tomono J, Oshima S, Merchan Ortega G, Bravo Bustos D, Lazaro Garcia R, Sanchez Espino A, Macancela Quinones J, Ikuta I, Ruiz Lopez M, Valencia Serrano F, Bonaque Gonzalez J, Gomez Recio M, Romano G, D'ancona G, Pilato G, Di Gesaro G, Clemenza F, Raffa G, Scardulla C, Sciacca S, Lancellotti P, Pilato M, Addetia K, Takeuchi M, Maffessanti F, Weinert L, Hamilton J, Mor-Avi V, Lang R, Sugano A, Seo Y, Watabe H, Kakefuda Y, Aihara H, Nishina H, Ishizu T, Fumikura Y, Noguchi Y, Aonuma K, Luo X, Fang F, Lee A, Shang Q, Yu C, Sammut EC, Chabinok R, Jackson T, Siarkos M, Lee L, Carr-White G, Rajani R, Kapetanakis S, Byrne D, Walsh J, Ellis L, Mckiernan S, Norris S, King G, Murphy R, Hristova K, Katova T, Simova I, Kostova V, Shuie I, Ferferieva V, Bogdanova V, Castelon X, Nemes A, Sasi V, Domsik P, Kalapos A, Lengyel C, Orosz A, Forster T, Grapsa J, Demir O, Dawson D, Sharma R, Senior R, Nihoyannopoulos P, Pilichowska E, Zaborska B, Baran J, Stec S, Kulakowski P, Budaj A, Kosmala W, Kaye G, Saito M, Negishi K, Marwick T, Maceira Gonzalez AM, Ripoll C, Cosin-Sales J, Igual B, Salazar J, Belloch V, Dulai RS, Taylor A, Gupta S. Poster session 1: Wednesday 3 December 2014, 09:00-16:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2014; 15:ii25-ii51. [DOI: 10.1093/ehjci/jeu248] [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: 09/02/2023] Open
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Bilgic A, Sezer S, Ozdemir N, Kurita N, Hosokawa N, Nomura S, Maeda Y, Uchihara H, Fukuhara S, Gascon LD, Karohl C, Smith AL, Wilson RO, Raggi P, Ignace S, Loignon RC, Couture V, Marquis K, Utescu M, Lariviere R, Agharazii M, Zahalkova J, Marsova M, Nikorjakova I, vestak M, amboch K, Bellasi A, Gamboa C, Ferramosca E, Ratti C, Block G, Muntner P, Raggi P, Makino J, Makino K, Ito T, Kato S, Yuzawa Y, Yasuda Y, Tsuruta Y, Itoh A, Maruyama S, Karasavvidou D, Kalaitzidis R, Spanos G, Pappas K, Pappas E, Kountouris S, Tatsioni A, Siamopoulos K, Staffolani E, Galli D, Nicolais R, Magliano G, Forleo GB, Santini L, Romano V, Sgueglia M, Romeo F, Di Daniele N, Freercks R, Swanepoel C, Carrara H, Raggi P, Rayner B, Freercks R, Swanepoel C, Carrara H, Raggi P, Rayner B, Fedak D, Kuzniewski M, Galicka-Latala D, Kusnierz-Cabala B, Dumnicka P, Pasowicz M, Solnica B, Sulowicz W, Kuzniewski M, Fedak D, Kapusta M, Kusnierz-Cabala B, Janda K, Pasowicz M, Solnica B, Sulowicz W, Ozcan M, Calayoglu R, Sengul S, Ensari A, Hazinedaroglu S, Tuzuner A, Nergizoglu G, Erbay B, Keven K, Gross T, Floege J, Leon S, Markus K, Vincent B, Ulrich G, Zitt E, Koenig M, Vychytil A, Auinger M, Wallner M, Lingenhel G, Schilcher G, Lhotta K, Csiky B, Toth G, Sulyok E, Melegh B, Vas T, Wittmann I, Martens-Lobenhoffer J, Awiszus F, Bode-Boger SM, Staffolani E, Nicolais R, Miani N, Galli D, Borzacchi MS, Cipriani S, Sturniolo A, Di Daniele N, Abouseif K, Bichari W, Elewa U, Buimistriuc LD, Badarau S, Stefan A, Leanca E, Covic A, Kimura H, Mukai H, Miura S, Maeda A, Takeda K, Sikole A, Trajceska L, Selim G, Amitov V, Dzekova P, Gelev S, Severova G, Trajceski T, Abe Y, Watanabe M, Ito K, Ogahara S, Nakashima H, Saito T, Oleniuc M, Secara IF, Nistor I, Onofriescu M, Covic A, Papagianni A, Kasimatis E, Stavrinou E, Pliakos K, Spartalis M, Dimitriadis C, Belechri AM, Giamalis P, Economidou D, Efstratiadis G, Memmos D, Chen R, Xing C, Bi G, Ito S, Oyake N, Tanabe K, Shimada T, Capurro F, De Mauri A, Brustia M, Navino C, David P, De Leo M, Usvyat L, Bayh I, Etter M, Lam M, Levin NW, Marcelli D, Raimann JG, Schuh E, Thijssen S, Kotanko P, Sipahioglu M, Unal A, Kocyigit I, Karakurt M, Oguzhan N, Cilan H, Kavuncu F, Tokgoz B, Oymak O, Utas C, Canas L, Galan A, Ferrer E, Filella A, Fernandez M, Bayes B, Bonet J, Bonal J, Romero R, Amore A, Puccinelli MP, Petrillo G, Albiani R, Bonaudo R, Camilla R, Steckiph D, Grandi F, Bracco G, Coppo R, Chen X, Zhu P, Chen Y, Xu Y, Chen N, Tatar E, Kircelli F, Asci G, Carrero JJ, Gungor O, Demirci MS, Ozkahya M, Toz H, Ok E, Buzdugan E, Condor A, Crisan S, Radulescu D, Lucaciu D, Hakemi MS, Nassiri AA, Asadzadeh R, Faizei AM, Molsted S, Andersen JL, Eidemak I, Harrison AP, Rodriguez Gomez MA, Fernandez-Reyes Luis MJ, Molina Ordas A, Heras Benito M, Sanchez Hernandez R, Mortazavi Najafabadi M, Moinzadeh F, Saadatnia SM, Shahidi S, Davarpanah A, Farajzadegan Z, Rodriguez-Reimundes E, Rognant N, Jolivot A, Abdeljaouad A, Pelletier S, Juillard L, Laville M, Fouque D, Santoro A, Zuccala A, Cagnoli L, Bolasco PG, Panzetta O, Mercadal L, Fessy H, London G, Severi S, Domini R, Grandi F, Corsi C. Cardiovascular complications in CKD 5D (2). Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.55] [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: 11/14/2022] Open
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Crisan S, Pestrea C, Nita T, Herghea D, Vesa S, Pirloaga I, Crisan L. 106 Poster Testing the Knowledge of Risk Factors for Atherosclerosis in Women with Peripheral Arterial Disease. Eur J Cardiovasc Nurs 2010. [DOI: 10.1016/s1474-5151(10)60087-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/19/2022]
Affiliation(s)
- S. Crisan
- University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Cluj-Napoca, Romania
| | | | - T. Nita
- Heart Institute, Cluj-Napoca, Romania
| | | | - S. Vesa
- Municipal Hospital, Cluj-Napoca, Romania
| | | | - L.G. Crisan
- Babes Bolyai University Department of Psychology, Cluj-Napoca, Romania
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Crisan S, Tarnovan IG, Tebrean B, Crisan TE. Optical Multi-touch System for Patient Monitoring and Medical Data Analysis. IFMBE Proceedings 2009. [DOI: 10.1007/978-3-642-04292-8_61] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Blendea D, Duncea C, Bedreaga M, Crisan S, Zarich S. Abnormalities of left ventricular long-axis function predict the onset of hypertension independent of blood pressure: a 7-year prospective study. J Hum Hypertens 2007; 21:539-45. [PMID: 17361193 DOI: 10.1038/sj.jhh.1002181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Increased blood pressure and left ventricular (LV) mass predict the onset of the clinically manifest hypertension, but little is known regarding the possible predictive value of LV function. The present study was designed to evaluate the association between echocardiographic LV long-axis systolic, and diastolic function and hypertension onset. We prospectively followed 244 normotensive adults with a family history of hypertension (HTN), with echocardiography for 7 years. M-mode derived atrioventricular plane displacement of the mitral and tricuspid annuli (MAVPD and TAVPD respectively), and LV circumferential fractional shortening were calculated. Diastolic function of the left and right ventricle were assessed using Doppler indices of the mitral and tricuspid inflow. During follow-up, 79 subjects developed hypertension (H group) and 165 subjects remained normotensive (N group). H group subjects had diminished MAVPD (13.8+/-3.4 vs 15.0+/-3.1 mm; P=0.007), lower mitral E/A ratio, and longer mitral E-wave deceleration time as compared to N group. In multivariate Cox model MAVPD and mitral E/A ratio predicted the onset of hypertension independent of LV mass index, blood pressure, pre-hypertensive status at baseline, age, sex and body mass index. During follow-up, H subjects experienced a significant decline in MAVPD and mitral E/A ratio, whereas the indices of right ventricular function and LV circumferential shortening remained intact. In conclusion, alterations in LV long-axis systolic and diastolic function, as measured by MAVPD and E/A ratio predict the onset of hypertension. These parameters declined during the development of hypertension.
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Affiliation(s)
- D Blendea
- Department of Cardiology, Bridgeport Hospital, Yale University School of Medicine, 267 Grant Street, Bridgeport, CT 06610, USA.
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