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Spartera M, Stracquadanio A, Pessoa-Amorim G, Harston G, Mazzucco S, Young V, Von Ende A, Hess AT, Ferreira VM, Kennedy J, Neubauer S, Casadei B, Wijesurendra RS. Reduced Left Atrial Rotational Flow Is Independently Associated With Embolic Brain Infarcts. JACC Cardiovasc Imaging 2023; 16:1149-1159. [PMID: 37204381 DOI: 10.1016/j.jcmg.2023.03.006] [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: 11/23/2022] [Revised: 02/22/2023] [Accepted: 03/10/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Up to 25% of embolic strokes occur in individuals without atrial fibrillation (AF) or other identifiable mechanisms. OBJECTIVES This study aims to assess whether left atrial (LA) blood flow characteristics are associated with embolic brain infarcts, independently of AF. METHODS The authors recruited 134 patients: 44 with a history of ischemic stroke and 90 with no history of stroke but CHA2DS2VASc score ≥1. Cardiac magnetic resonance (CMR) evaluated cardiac function and LA 4-dimensional flow parameters, including velocity and vorticity (a measure of rotational flow), and brain magnetic resonance imaging (MRI) was performed to detect large noncortical or cortical infarcts (LNCCIs) (likely embolic), or nonembolic lacunar infarcts. RESULTS Patients (41% female; age 70 ± 9 years) had moderate stroke risk (median CHA2DS2VASc = 3, Q1-Q3: 2-4). Sixty-eight (51%) had diagnosed AF, of whom 58 (43%) were in AF during CMR. Thirty-nine (29%) had ≥1 LNCCI, 20 (15%) had ≥1 lacunar infarct without LNCCI, and 75 (56%) had no infarct. Lower LA vorticity was significantly associated with prevalent LNCCIs after adjustment for AF during CMR, history of AF, CHA2DS2VASc score, LA emptying fraction, LA indexed maximum volume, left ventricular ejection fraction, and indexed left ventricular mass (OR: 2.06 [95% CI: 1.08-3.92 per SD]; P = 0.027). By contrast, LA flow peak velocity was not significantly associated with LNCCIs (P = 0.21). No LA parameter was associated with lacunar infarcts (all P > 0.05). CONCLUSIONS Reduced LA flow vorticity is significantly and independently associated with embolic brain infarcts. Imaging LA flow characteristics may aid identification of individuals who would benefit from anticoagulation for embolic stroke prevention, regardless of heart rhythm.
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Affiliation(s)
- Marco Spartera
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom.
| | - Antonio Stracquadanio
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Guilherme Pessoa-Amorim
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom; CTSU Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - George Harston
- Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Sara Mazzucco
- Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom; Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, Oxford, United Kingdom
| | - Victoria Young
- Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Adam Von Ende
- CTSU Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Aaron T Hess
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom
| | - Vanessa M Ferreira
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - James Kennedy
- Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Barbara Casadei
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom
| | - Rohan S Wijesurendra
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; University of Oxford Centre for Clinical Magnetic Resonance Research, Oxford, United Kingdom; Oxford University Hospital NHS Foundation Trust, Oxford, United Kingdom; CTSU Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Hewitson LJ, Cadiz S, Al-Sayed S, Fellows S, Amin A, Asimakopoulos G, Barnes E, Beale A, Browne S, Chandrasekaran B, Dalby M, Foley P, Hawkins M, Haynes D, Heng EL, Hyde T, Kabir T, Khavandi A, Mirsadraee S, McCrea W, Petrou M, Senior R, Smith D, Smith R, Spartera M, Wamil M, Panoulas V, Rahbi H. Time to TAVI: streamlining the pathway to treatment. Open Heart 2023; 10:e002170. [PMID: 37666643 PMCID: PMC10481834 DOI: 10.1136/openhrt-2022-002170] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 07/27/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION Severe aortic stenosis is a major cause of morbidity and mortality. The existing treatment pathway for transcatheter aortic valve implantation (TAVI) traditionally relies on tertiary Heart Valve Centre workup. However, this has been associated with delays to treatment, in breach of British Cardiovascular Intervention Society targets. A novel pathway with emphasis on comprehensive patient workup at a local centre, alongside close collaboration with a Heart Valve Centre, may help reduce the time to TAVI. METHODS The centre performing local workup implemented a novel TAVI referral pathway. Data were collected retrospectively for all outpatients referred for consideration of TAVI to a Heart Valve Centre from November 2020 to November 2021. The main outcome of time to TAVI was calculated as the time from Heart Valve Centre referral to TAVI, or alternative intervention, expressed in days. For the centre performing local workup, referral was defined as the date of multidisciplinary team discussion. For this centre, a total pathway time from echocardiographic diagnosis to TAVI was also evaluated. A secondary outcome of the proportion of referrals proceeding to TAVI at the Heart Valve Centre was analysed. RESULTS Mean±SD time from referral to TAVI was significantly lower at the centre performing local workup, when compared with centres with traditional referral pathways (32.4±64 to 126±257 days, p<0.00001). The total pathway time from echocardiographic diagnosis to TAVI for the centre performing local workup was 89.9±67.6 days, which was also significantly shorter than referral to TAVI time from all other centres (p<0.003). Centres without local workup had a significantly lower percentage of patients accepted for TAVI (49.5% vs 97.8%, p<0.00001). DISCUSSION A novel TAVI pathway with emphasis on local workup within a non-surgical centre significantly reduced both the time to TAVI and rejection rates from a Heart Valve Centre. If adopted across the other centres, this approach may help improve access to TAVI.
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Affiliation(s)
| | - Suzane Cadiz
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | | | - Sarah Fellows
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alaaeldin Amin
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | | | - Edward Barnes
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Andrew Beale
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Suzy Browne
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | | | - Miles Dalby
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Paul Foley
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Mark Hawkins
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Douglas Haynes
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Ee Ling Heng
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Tom Hyde
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Tito Kabir
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Ali Khavandi
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | | | - William McCrea
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Mario Petrou
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Roxy Senior
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - David Smith
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Robert Smith
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | - Marco Spartera
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Vasileios Panoulas
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
- Cardiovascular Sciences, Imperial College London National Heart and Lung Institute, London, UK
| | - Hazim Rahbi
- Great Western Hospitals NHS Foundation Trust, Swindon, UK
- Royal Brompton & Harefield NHS Foundation Trust, London, UK
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3
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Orsborne C, Bhatia RT, Li ZC, MacLachlan H, Spartera M, Stoll VM. British Cardiovascular Society Young Investigator Award 2022. Heart 2023; 109:884-885. [PMID: 37028927 DOI: 10.1136/heartjnl-2023-322582] [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: 04/09/2023] Open
Affiliation(s)
- Chris Orsborne
- Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Raghav T Bhatia
- Cardiovascular Clinical Academic Group and Cardiology Research Centre, St George's, University of London, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Ziwen C Li
- Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Hamish MacLachlan
- Cardiovascular Clinical Academic Group and Cardiology Research Centre, St George's, University of London, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Marco Spartera
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- Great Western Hospital NHS Foundation Trust, Swindon, UK
| | - Victoria M Stoll
- Adult Congenital Heart Disease, Royal Papworth Hospital Foundation Trust, Cambridge, UK
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4
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Ancona F, Mangieri A, Spartera M, Taramasso M. Editorial: Open issues in the diagnosis and management of tricuspid regurgitation. Front Cardiovasc Med 2023; 10:1189956. [PMID: 37139118 PMCID: PMC10150317 DOI: 10.3389/fcvm.2023.1189956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/05/2023] [Indexed: 05/05/2023] Open
Affiliation(s)
- Francesco Ancona
- Cardiovascular Imaging Unit, Cardiothoracic Department, San Raffaele Scientific Institute, Milan, Italy
- Correspondence: Francesco Ancona
| | | | - Marco Spartera
- Cardiothoracic Department, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, OCMR, Oxford, United Kingdom
| | - Maurizio Taramasso
- HerzZentrum Hirslanden Zurich, Switzerland and University of Zurich, Switzerland
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Deal O, Rayner J, Stracquadanio A, Wijesurendra RS, Neubauer S, Rider O, Spartera M. Effect of Weight Loss on Early Left Atrial Myopathy in People With Obesity But No Established Cardiovascular Disease. J Am Heart Assoc 2022; 11:e026023. [PMID: 36346054 PMCID: PMC9750071 DOI: 10.1161/jaha.122.026023] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background Obesity is associated with left atrial (LA) remodeling (ie, dilatation and dysfunction) which is an independent determinant of future cardiovascular events. We aimed to assess whether LA remodeling is present in obesity even in individuals without established cardiovascular disease and whether it can be improved by intentional weight loss. Methods and Results Forty-five individuals with severe obesity without established cardiovascular disease (age, 45±11 years; body mass index; 39.1±6.7 kg/m2; excess body weight, 51±18 kg) underwent cardiac magnetic resonance for quantification of LA and left ventricular size and function before and at a median of 373 days following either a low glycemic index diet (n=28) or bariatric surgery (n=17). Results were compared with those obtained in 27 normal-weight controls with similar age and sex. At baseline, individuals with obesity displayed reduced LA reservoir function (a marker of atrial distensibility), and a higher mass and LA maximum volume (all P<0.05 controls) but normal LA emptying fraction. On average, weight loss led to a significant reduction of LA maximum volume and left ventricular mass (both P<0.01); however, significant improvement of the LA reservoir function was only observed in those at the upper tertile of weight loss (≥47% excess body weight loss). Following weight loss, we found an average residual increase in left ventricular mass compared with controls but no residual significant differences in LA maximum volume and strain function (all P>0.05). Conclusions Obesity is linked to subtle LA myopathy in the absence of overt cardiovascular disease. Only larger volumes of weight loss can completely reverse the LA myopathic phenotype.
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Affiliation(s)
- Oscar Deal
- Division of Cardiovascular MedicineRadcliffe Department of Medicine, University of OxfordUnited Kingdom
| | - Jennifer Rayner
- Division of Cardiovascular MedicineRadcliffe Department of Medicine, University of OxfordUnited Kingdom
- The University of Oxford Centre for Clinical Magnetic Resonance ResearchOxfordUnited Kingdom
| | - Antonio Stracquadanio
- Division of Cardiovascular MedicineRadcliffe Department of Medicine, University of OxfordUnited Kingdom
- The University of Oxford Centre for Clinical Magnetic Resonance ResearchOxfordUnited Kingdom
| | - Rohan S. Wijesurendra
- Division of Cardiovascular MedicineRadcliffe Department of Medicine, University of OxfordUnited Kingdom
| | - Stefan Neubauer
- Division of Cardiovascular MedicineRadcliffe Department of Medicine, University of OxfordUnited Kingdom
| | - Oliver Rider
- Division of Cardiovascular MedicineRadcliffe Department of Medicine, University of OxfordUnited Kingdom
- The University of Oxford Centre for Clinical Magnetic Resonance ResearchOxfordUnited Kingdom
| | - Marco Spartera
- Division of Cardiovascular MedicineRadcliffe Department of Medicine, University of OxfordUnited Kingdom
- The University of Oxford Centre for Clinical Magnetic Resonance ResearchOxfordUnited Kingdom
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Lodge J, Pitcher A, Srivastava V, Spartera M. Thrombotic mechanisms in low-thrombogenicity mechanical mitral valve prostheses. Eur Heart J Cardiovasc Imaging 2022; 24:e24. [PMID: 36352493 PMCID: PMC9910275 DOI: 10.1093/ehjci/jeac221] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Jeorghino Lodge
- Cardiology, Great Western Hospital NHS Foundation Trust, Marlborough Road, Swindon, SN3 6BB, UK
| | - Alex Pitcher
- Cardiothoracic Department, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Vivek Srivastava
- Cardiothoracic Department, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
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Spartera M, Stracquadanio A, Von Ende A, Pessoa-Amorim G, Hess A, Young V, Mazzucco S, Kennedy J, Ferreira V, Neubauer S, Casadei B, Wijesurendra R. Left atrial vorticity is independently associated with embolic brain infarcts and represents a promising imaging biomarker of cardioembolism in sinus rhythm and atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.274] [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
Atrial fibrillation (AF) is associated with embolic stroke, but risk scores such as CHA2DS2-VASc perform only modestly (C statistics 0.6–0.7). Meanwhile, up to 25% of embolic strokes in patients without AF have no identifiable cause, and occult left atrial (LA) thromboembolism may be a relevant mechanism in such cases.
Purpose
We hypothesised that imaging of left atrial blood flow could improve embolic risk prediction in patients with and without AF. We used 4D flow magnetic resonance imaging (MRI) to identify a biomarker that is: (a) independently associated with embolic brain infarction by brain MRI, (b) able to stratify blood flow characteristics both during AF and in sinus rhythm (SR), and (c) reproducible.
Methods
We recruited 3 patient cohorts to respectively address each aim. Firstly, to assess the association between LA flow parameters and embolic brain infarcts, we recruited cohort A, consisting of 134 patients (41% female; age 70±9 years) with a history of ischaemic stroke (N=44) or no history of stroke but with CHA2DS2VASc score ≥1 (N=90). Next, the sensitivity of 4D flow parameters to rhythm change was assessed in cohort B: 37 patients with persistent AF studied before and after cardioversion, whose results were compared with those of 23 healthy controls in SR [CHA2DS2-VASc = 0.0 (0.0–0.0)]. Finally, scan-rescan coefficients of variation (CV) and interval-scan CV at 30 days were determined in Cohort C (86 subjects; 64 in SR, 22 in AF). Brain MRI was used to identify large non-cortical or cortical brain infarcts (LNCCI) – i.e. infarcts likely to be embolic in origin.
Results
At least one LNCCI was present in 39 of 134 patients in cohort A. Lower LA vorticity was significantly associated with higher risk of prevalent LNCCIs (Figure 1), after adjustment for AF, age, and CHA2DS2VASc score [OR=2.10 (95% CI 1.12–3.92) per SD, P=0.02]. This association remained significant after further adjustment for other cardiac parameters (all P<0.05, Figure 1). By contrast, there was no significant association between peak velocity and LNCCIs (P=0.21).
LA vorticity was sensitive to rhythm change, improving significantly in patients in cohort B in SR at ≥4 weeks after cardioversion (CV) of persistent AF (Figure 2A, paired P<0.001 vs pre-CV), but remained impaired compared to healthy controls (Figure 2B, P<0.01).
Finally, reproducibility studies in cohort C showed that LA vorticity had a same-day scan-rescan CV of 7% without significant differences between SR and AF subjects (P>0.05), and also showed no significant temporal variability on interval scanning (P>0.05).
Conclusions
LA vorticity is reproducible, sensitive to changes in heart rhythm, and independently associated with embolic brain infarcts, suggesting a promising imaging biomarker of cardioembolism in SR and AF. LA blood flow imaging could improve stroke prediction and the personalisation of decisions about anticoagulation, regardless of heart rhythm.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Oxford BRC, BHF
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Affiliation(s)
- M Spartera
- University of Oxford , Oxford , United Kingdom
| | | | - A Von Ende
- University of Oxford , Oxford , United Kingdom
| | | | - A Hess
- University of Oxford , Oxford , United Kingdom
| | - V Young
- University of Oxford , Oxford , United Kingdom
| | - S Mazzucco
- University of Oxford , Oxford , United Kingdom
| | - J Kennedy
- University of Oxford , Oxford , United Kingdom
| | - V Ferreira
- University of Oxford , Oxford , United Kingdom
| | - S Neubauer
- University of Oxford , Oxford , United Kingdom
| | - B Casadei
- University of Oxford , Oxford , United Kingdom
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Spartera M, Stracquadanio A, Pessoa-Amorim G, Von Ende A, Fletcher A, Manley P, Ferreira VM, Hess AT, Hopewell JC, Neubauer S, Wijesurendra RS, Casadei B. The impact of atrial fibrillation and stroke risk factors on left atrial blood flow characteristics. Eur Heart J Cardiovasc Imaging 2021; 23:115-123. [PMID: 34687541 PMCID: PMC8685601 DOI: 10.1093/ehjci/jeab213] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/06/2021] [Indexed: 12/03/2022] Open
Abstract
AIMS Altered left atrial (LA) blood flow characteristics account for an increase in cardioembolic stroke risk in atrial fibrillation (AF). Here, we aimed to assess whether exposure to stroke risk factors is sufficient to alter LA blood flow even in the presence of sinus rhythm (SR). METHODS AND RESULTS We investigated 95 individuals: 37 patients with persistent AF, who were studied before and after cardioversion [Group 1; median CHA2DS2-VASc = 2.0 (1.5-3.5)]; 35 individuals with no history of AF but similar stroke risk to Group 1 [Group 2; median CHA2DS2-VASc = 3.0 (2.0-4.0)]; and 23 low-risk individuals in SR [Group 3; median CHA2DS2-VASc = 0.0 (0.0-0.0)]. Cardiac function and LA flow characteristics were evaluated using cardiac magnetic resonance. Before cardioversion, Group 1 displayed impaired left ventricular (LV) and LA function, reduced LA flow velocities and vorticity, and a higher normalized vortex volume (all P < 0.001 vs. Groups 2 and 3). After restoration of SR at ≥4-week post-cardioversion, LV systolic function and LA flow parameters improved significantly (all P < 0.001 vs. pre-cardioversion) and were no longer different from those in Group 2. However, in the presence of SR, LA flow peak and mean velocity, and vorticity were lower in Groups 1 and 2 vs. Group 3 (all P < 0.01), and were associated with impaired LA emptying fraction (LAEF) and LV diastolic dysfunction. CONCLUSION Patients at moderate-to-high stroke risk display altered LA flow characteristics in SR in association with an LA myopathic phenotype and LV diastolic dysfunction, regardless of a history of AF.
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Affiliation(s)
- Marco Spartera
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 6, West Wing, Headley Way, Oxford OX3 9DU, UK
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK
| | - Antonio Stracquadanio
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 6, West Wing, Headley Way, Oxford OX3 9DU, UK
| | - Guilherme Pessoa-Amorim
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 6, West Wing, Headley Way, Oxford OX3 9DU, UK
| | - Adam Von Ende
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Alison Fletcher
- Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Peter Manley
- Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Vanessa M Ferreira
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 6, West Wing, Headley Way, Oxford OX3 9DU, UK
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK
| | - Aaron T Hess
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK
| | - Jemma C Hopewell
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 6, West Wing, Headley Way, Oxford OX3 9DU, UK
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK
| | - Rohan S Wijesurendra
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 6, West Wing, Headley Way, Oxford OX3 9DU, UK
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK
| | - Barbara Casadei
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Level 6, West Wing, Headley Way, Oxford OX3 9DU, UK
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Deal O, Rayner J, Stracquadanio A, Wijesurendra R, Neubauer S, Casadei B, Rider O, Spartera M. Effect of weight loss on early left atrial myopathy in obese patients without known cardiovascular disease. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.053] [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: Foundation. Main funding source(s): BHF & NIHR BRC
Introduction
Obesity is strongly associated with increased risk of heart failure and ischaemic stroke independently of associated co-morbidities. Left atrial (LA) reservoir dysfunction, a marker of atrial distensibility and compliance, is an early pathophysiological change which precedes the onset of cardiovascular disease in patients with obesity. It is unclear whether a weight loss intervention may be sufficient to reverse LA reservoir dysfunction.
Purpose
To longitudinally assess whether a weight loss intervention normalizes LA reservoir function by cardiac magnetic resonance (CMR) feature-tracking in patients with obesity and only subclinical cardiovascular disease and compared this age and sex matched non-obese normal weight controls.
Methods
A total of 45 patients with severe obese (age = 45 ± 11 years, body mass index = 39.1 ± 6.7 kg/m2, 51 ± 18 kg of excess body weight [EBW], 67% female) underwent CMR for quantification of LA and left ventricular (LV) size and function before and a median of 373 days following weight loss intervention. Weight loss was achieved by means of a very-low calorie diet (N = 28; 800 kcal/day) or by bariatric surgery (N = 17). A total of N = 27 non-obese healthy controls (age = 41 ± 12 years, body mass index = 22.3 ± 2.4 kg/m2, 75% female) underwent the same CMR protocol once.
Results
At baseline, patients with obesity displayed signs of atrial myopathy with increased LA volume and reduced LA reservoir function as compared to normal-weight controls (both P < 0.05, Figure 1) alongside increased LV mass and hyper-normal LV ejection fraction [LVEF] (both p < 0.01). As expected, weight loss led to a significant reduction of LA volume and LV mass with normalization of LVEF regardless of the degree of weight loss achieved (all P < 0.05, Figure 2). By contrast, only a large weight loss (>46.6% EBW, in red in Figure 2) was sufficient to improve and normalize the LA reservoir function (P < 0.05, Figure 2). On the other hand, moderate or milder weight loss (in orange and red) had no significant effect on LA reservoir function (both P > 0.05).
Conclusion
Successful weight loss can completely revert early LA myopathic phenotype in obese patients without known cardiovascular disease although this can be achieved only with larger weight loss targets.
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Affiliation(s)
- O Deal
- University of Oxford, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - J Rayner
- University of Oxford, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - A Stracquadanio
- University of Oxford, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - R Wijesurendra
- University of Oxford, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - S Neubauer
- University of Oxford, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - B Casadei
- University of Oxford, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - O Rider
- University of Oxford, Oxford, United Kingdom of Great Britain & Northern Ireland
| | - M Spartera
- University of Oxford, Oxford, United Kingdom of Great Britain & Northern Ireland
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Spartera M. Features of a covert cardiomyopathy are present in patients with unexplained syncope and incident ventricular tachycardia. Int J Cardiovasc Imaging 2021; 37:2621-2623. [PMID: 34146205 DOI: 10.1007/s10554-021-02313-0] [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: 11/25/2022]
Affiliation(s)
- Marco Spartera
- University of Oxford, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
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11
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Spartera M, Pessoa-Amorim G, Stracquadanio A, Von Ende A, Fletcher A, Manley P, Neubauer S, Ferreira VM, Casadei B, Hess AT, Wijesurendra RS. Left atrial 4D flow cardiovascular magnetic resonance: a reproducibility study in sinus rhythm and atrial fibrillation. J Cardiovasc Magn Reson 2021; 23:29. [PMID: 33745457 PMCID: PMC7983287 DOI: 10.1186/s12968-021-00729-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 02/03/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) allows sophisticated quantification of left atrial (LA) blood flow, and could yield novel biomarkers of propensity for intra-cardiac thrombus formation and embolic stroke. As reproducibility is critically important to diagnostic performance, we systematically investigated technical and temporal variation of LA 4D flow in atrial fibrillation (AF) and sinus rhythm (SR). METHODS Eighty-six subjects (SR, n = 64; AF, n = 22) with wide-ranging stroke risk (CHA2DS2VASc 0-6) underwent LA 4D flow assessment of peak and mean velocity, vorticity, vortex volume, and stasis. Eighty-five (99%) underwent a second acquisition within the same session, and 74 (86%) also returned at 30 (27-35) days for an interval scan. We assessed variability attributable to manual contouring (intra- and inter-observer), and subject repositioning and reacquisition of data, both within the same session (same-day scan-rescan), and over time (interval scan). Within-subject coefficients of variation (CV) and bootstrapped 95% CIs were calculated and compared. RESULTS Same-day scan-rescan CVs were 6% for peak velocity, 5% for mean velocity, 7% for vorticity, 9% for vortex volume, and 10% for stasis, and were similar between SR and AF subjects (all p > 0.05). Interval-scan variability was similar to same-day scan-rescan variability for peak velocity, vorticity, and vortex volume (all p > 0.05), and higher for stasis and mean velocity (interval scan CVs of 14% and 8%, respectively, both p < 0.05). Longitudinal changes in heart rate and blood pressure at the interval scan in the same subjects were associated with significantly higher variability for LA stasis (p = 0.024), but not for the remaining flow parameters (all p > 0.05). SR subjects showed significantly greater interval-scan variability than AF patients for mean velocity, vortex volume, and stasis (all p < 0.05), but not peak velocity or vorticity (both p > 0.05). CONCLUSIONS LA peak velocity and vorticity are the most reproducible and temporally stable novel LA 4D flow biomarkers, and are robust to changes in heart rate, blood pressure, and differences in heart rhythm.
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Affiliation(s)
- Marco Spartera
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, West Wing, Headley Way, Oxford, UK.
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK.
| | - Guilherme Pessoa-Amorim
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, West Wing, Headley Way, Oxford, UK
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Antonio Stracquadanio
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, West Wing, Headley Way, Oxford, UK
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Adam Von Ende
- Department of Population Health, CTSU Nuffield University of Oxford, Oxford, UK
| | - Alison Fletcher
- The University of Oxford Acute Vascular Imaging Centre (AVIC), Oxford, UK
| | - Peter Manley
- The University of Oxford Acute Vascular Imaging Centre (AVIC), Oxford, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, West Wing, Headley Way, Oxford, UK
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Vanessa M Ferreira
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, West Wing, Headley Way, Oxford, UK
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Barbara Casadei
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, West Wing, Headley Way, Oxford, UK
| | - Aaron T Hess
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, West Wing, Headley Way, Oxford, UK
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
| | - Rohan S Wijesurendra
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, West Wing, Headley Way, Oxford, UK
- The University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Oxford, UK
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12
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Raman B, Ariga R, Spartera M, Sivalokanathan S, Chan K, Dass S, Petersen SE, Daniels MJ, Francis J, Smillie R, Lewandowski AJ, Ohuma EO, Rodgers C, Kramer CM, Mahmod M, Watkins H, Neubauer S. Progression of myocardial fibrosis in hypertrophic cardiomyopathy: mechanisms and clinical implications. Eur Heart J Cardiovasc Imaging 2019; 20:157-167. [PMID: 30358845 PMCID: PMC6343081 DOI: 10.1093/ehjci/jey135] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/05/2018] [Indexed: 11/23/2022] Open
Abstract
Aims Myocardial fibrosis as detected by late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) is a powerful prognostic marker in hypertrophic cardiomyopathy (HCM) and may be progressive. The precise mechanisms underlying fibrosis progression are unclear. We sought to assess the extent of LGE progression in HCM and explore potential causal mechanisms and clinical implications. Methods and results Seventy-two HCM patients had two CMR (CMR1-CMR2) at an interval of 5.7 ± 2.8 years with annual clinical follow-up for 6.3 ± 3.6 years from CMR1. A combined endpoint of heart failure progression, cardiac hospitalization, and new onset ventricular tachycardia was assessed. Cine and LGE imaging were performed to assess left ventricular (LV) mass, function, and fibrosis on serial CMR. Stress perfusion imaging and cardiac energetics were undertaken in 38 patients on baseline CMR (CMR1). LGE mass increased from median 4.98 g [interquartile range (IQR) 0.97–13.48 g] to 6.30 g (IQR 1.38–17.51 g) from CMR1 to CMR2. Substantial LGE progression (ΔLGE ≥ 4.75 g) occurred in 26% of patients. LGE increment was significantly higher in those with impaired myocardial perfusion reserve (<MPRI 1.40) and energetics (phosphocreatine/adenosine triphosphate <1.44) on baseline CMR (P ≤ 0.01 for both). Substantial LGE progression was associated with LV thinning, increased cavity size and reduced systolic function, and conferred a five-fold increased risk of subsequent clinical events (hazard ratio 5.04, 95% confidence interval 1.85–13.79; P = 0.002). Conclusion Myocardial fibrosis is progressive in some HCM patients. Impaired energetics and perfusion abnormalities are possible mechanistic drivers of the fibrotic process. Fibrosis progression is associated with adverse cardiac remodelling and predicts an increased risk of subsequent clinical events in HCM.
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Affiliation(s)
- Betty Raman
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Rina Ariga
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Marco Spartera
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Sanjay Sivalokanathan
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Kenneth Chan
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Sairia Dass
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK.,Barts Heart Centre, St Bartholomew's hospital, Barts Health NHS Trust, West Smithfield, London, UK
| | - Matthew J Daniels
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Jane Francis
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Robert Smillie
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Adam J Lewandowski
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Eric O Ohuma
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Old Road Campus, Oxford, UK.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, UK
| | - Christopher Rodgers
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK.,Department of Clinical Neurosciences, Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Christopher M Kramer
- Cardiology and Radiology, University of Virginia Health System, Charlottesville, VA, USA
| | - Masliza Mahmod
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Headley Way, Oxford, UK
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Spartera M, Ancona F, Barletta M, Rosa I, Stella S, Marini C, Italia L, Montorfano M, Latib A, Alfieri O, Margonato A, Colombo A, Agricola E. Echocardiographic features of post−transcatheter aortic valve implantation thrombosis and endocarditis. Echocardiography 2017; 35:337-345. [DOI: 10.1111/echo.13777] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Marco Spartera
- Echocardiography Laboratory; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Francesco Ancona
- Echocardiography Laboratory; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Marta Barletta
- Echocardiography Laboratory; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Isabella Rosa
- Echocardiography Laboratory; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Stefano Stella
- Echocardiography Laboratory; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Claudia Marini
- Echocardiography Laboratory; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Leonardo Italia
- Echocardiography Laboratory; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Matteo Montorfano
- Unit of Cardiovascular Interventions; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Azeem Latib
- Unit of Cardiovascular Interventions; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Ottavio Alfieri
- Unit of Cardiovascular Interventions; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Alberto Margonato
- Unit of Cardiovascular Interventions; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Antonio Colombo
- Unit of Cardiovascular Interventions; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Eustachio Agricola
- Echocardiography Laboratory; IRCCS San Raffaele Scientific Institute; Milan Italy
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Spartera M, Ancona F, Barletta M, Rosa I, Stella S, Marini C, Pavon A, Montorfano M, Latib A, Alfieri O, Colombo A, Agricola E. P4225Echocardiographic signs of post-TAVI thrombosis and endocarditis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4225] [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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Spartera M, Jabbour RJ, Chiarito M, De Bonis M, Pappalardo F. Stepwise use of circulatory support devices in a patient refractory to cardiopulmonary resuscitation. Cardiovasc Revasc Med 2017; 18:447-449. [PMID: 28432006 DOI: 10.1016/j.carrev.2017.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 04/05/2017] [Indexed: 11/26/2022]
Abstract
This case describes the management of a patient admitted to an emergency department with general malaise, who deteriorated into cardiac arrest and refractory to advanced life support measures. After extracorporeal cardiopulmonary resuscitation (eCPR) with veno-arterial extracorporeal membrane oxygenation in association with an Impella 2.5 device, the patient underwent cardiac surgery (tissue aortic valve replacement, coronary artery bypass grafting and implantation of short-term paracorporeal left ventricular assist device). Subsequently a long-term LVAD was implanted and the patient was successfully discharged shortly afterwards. This report illustrates the challenges of 'clinical decision making' in a complex patient utilising a wide range of left ventricular support mechanical devices with varying degrees of invasiveness, whilst also reflecting on the current financial and economic considerations in utilizing this type of care pathway.
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Affiliation(s)
- Marco Spartera
- Cardiovascular Department, San Raffaele Scientific Institute, Milan, Italy.
| | | | - Mauro Chiarito
- Cardiovascular Department, San Raffaele Scientific Institute, Milan, Italy
| | - Michele De Bonis
- Cardiovascular Department, San Raffaele Scientific Institute, Milan, Italy
| | - Federico Pappalardo
- Cardiac Intensive Care Unit, San Raffaele Scientific Institute, Milan, Italy
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Agricola E, Ancona F, Stella S, Rosa I, Marini C, Spartera M, Denti P, Margonato A, Hahn RT, Alfieri O, Colombo A, Latib A. Use of Echocardiography for Guiding Percutaneous Tricuspid Valve Procedures. JACC Cardiovasc Imaging 2017; 10:1194-1198. [PMID: 28330659 DOI: 10.1016/j.jcmg.2016.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 10/04/2016] [Accepted: 10/07/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Eustachio Agricola
- Echocardiography Laboratory, San Raffaele Scientific Institute, Milan, Italy.
| | - Francesco Ancona
- Echocardiography Laboratory, San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Stella
- Echocardiography Laboratory, San Raffaele Scientific Institute, Milan, Italy
| | - Isabella Rosa
- Echocardiography Laboratory, San Raffaele Scientific Institute, Milan, Italy
| | - Claudia Marini
- Echocardiography Laboratory, San Raffaele Scientific Institute, Milan, Italy
| | - Marco Spartera
- Echocardiography Laboratory, San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Denti
- Cardiac Surgery Department, San Raffaele Scientific Institute, Milan, Italy
| | - Alberto Margonato
- Echocardiography Laboratory, San Raffaele Scientific Institute, Milan, Italy
| | - Rebecca T Hahn
- Columbia University Medical Center/New York Presbyterian Hospital, New York, New York
| | - Ottavio Alfieri
- Cardiac Surgery Department, San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Colombo
- Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy
| | - Azeem Latib
- Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy
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Spartera M, Damascelli A, Mozes F, De Cobelli F, La Canna G. Three-dimensional speckle tracking longitudinal strain is related to myocardial fibrosis determined by late-gadolinium enhancement. Int J Cardiovasc Imaging 2017; 33:1351-1360. [DOI: 10.1007/s10554-017-1115-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 03/09/2017] [Indexed: 01/09/2023]
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Spartera M, Godino C, Baldissera E, Campochiaro C, La Spina K, Aiello P, Salerno A, Cera M, Magni V, Jabbour RJ, Dagna L, Tresoldi M, Cappelletti A, Alfieri O, Colombo A, Sabbadini MG, Margonato A. Long-term clinical outcomes of patients with rheumatoid arthritis and concomitant coronary artery disease. Am J Cardiovasc Dis 2017; 7:9-18. [PMID: 28337386 PMCID: PMC5344967] [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] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 01/22/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is associated with high morbidity and mortality predominately due to increased cardiovascular risk. Few reports are available regarding the management of coronary artery disease (CAD) in RA patients and the long-term clinical outcomes after coronary revascularization. METHODS AND RESULTS All consecutive patients with RA were identified by retrospective review at a rheumatology tertiary center in Milan, Italy between 2001 and 2013. RA patients affected by significant CAD (RA-CAD+) were prospectively followed for major adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary revascularization (RA-PCI), coronary artery bypass grafting (RA-CABG) or medical therapy (RA-MT). Among 936 patients with RA, the presence of clinically significant CAD was found in 5.6% (53 patients, RA-CAD+). Of these, 32 patients (60%) underwent PCI (RA-PCI), 10 patients (19%) underwent CABG (RA-CABG) and 11 patients (21%) treated with MT (RA-MT). After a mean follow-up of 9±7 years, the rate of MACCE was 56% in RA-PCI patients, 50% in RA-CABG and 27% in RA-MT patients (P=0.184). The high MACCE rate was mainly driven by repeat coronary revascularization (47%) in the RA-PCI group and high rate of strokes (30%) in RA-CABG patients. CONCLUSION In patients with rheumatoid arthritis and concomitant coronary artery disease (RA-CAD+), we observed at long-term follow-up a high MACCE rate, predominantly in those who underwent coronary revascularization.
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Affiliation(s)
- Marco Spartera
- Department of Cardiovascular, San Raffaele Scientific InstituteMilan, Italy
| | - Cosmo Godino
- Department of Cardiovascular, San Raffaele Scientific InstituteMilan, Italy
| | - Elena Baldissera
- Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific InstituteMilan, Italy
| | - Corrado Campochiaro
- Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific InstituteMilan, Italy
| | - Ketty La Spina
- Department of Cardiovascular, San Raffaele Scientific InstituteMilan, Italy
| | - Patrizia Aiello
- Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific InstituteMilan, Italy
| | - Anna Salerno
- Department of Cardiovascular, San Raffaele Scientific InstituteMilan, Italy
| | - Michela Cera
- Department of Cardiovascular, San Raffaele Scientific InstituteMilan, Italy
| | - Valeria Magni
- Department of Cardiovascular, San Raffaele Scientific InstituteMilan, Italy
| | | | - Lorenzo Dagna
- Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific InstituteMilan, Italy
| | - Moreno Tresoldi
- Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific InstituteMilan, Italy
| | | | - Ottavio Alfieri
- Department of Cardiovascular, San Raffaele Scientific InstituteMilan, Italy
| | - Antonio Colombo
- Department of Cardiovascular, San Raffaele Scientific InstituteMilan, Italy
- EMO-GVM Centro Cuore ColumbusMilan, Italy
| | - Maria Grazia Sabbadini
- Unit of Internal Medicine and Clinical Immunology, San Raffaele Scientific InstituteMilan, Italy
| | - Alberto Margonato
- Department of Cardiovascular, San Raffaele Scientific InstituteMilan, Italy
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Spampinato RA, Kammerlander A, Ondrus T, Cho SW, Gillis K, Italia L, Zito C, Ancona F, Jahnke C, Paetsch I, Hilbert S, Schloma V, Dmitrieva Y, Strotdrees E, Hindricks G, Mohr FW, Wiesinger M, Duca F, Aschauer S, Zotter-Tufaro C, Schwaiger ML, Marzluf BA, Bartko PE, Bonderman D, Mascherbauer J, Mirica DC, Kotrc M, Kockova R, Van Camp G, Mo Y, Praveckova A, Penicka M, Park SJ, Kim SM, Hwang JW, Chang SA, Jeong DS, Lee SC, Park SW, Choe YH, Park PW, Bala G, Roosens B, Hernot S, Remory I, Droogmans S, Cosyns B, Geremia G, Stella S, Marini C, Rosa I, Ancona F, Latib A, Montorfano M, Colombo A, Margonato A, Agricola E, Bracco A, Baldi E, Di Bella G, Cusma Piccione M, Di Nunzio D, Donato R, Manganaro R, Terrizzi A, Pizzino F, Carerj ML, Rivetti L, Bitto R, Sergi M, Carerj S, Agricola E, Stella S, Rosa I, Marini C, Spartera M, Denti P, Margonato A, Hahn R, Alfieri O, Latib A, Colombo A. Rapid Fire Abstract: Multimodality imaging valvular heart disease742Quantification of aortic regurgitation by pulsed Doppler examination of the left subclavian artery velocity contour: a validation study with cardiac magnetic resonance imaging743Diastolic retrograde flow in the descending aorta by cardiovascular magnetic resonance imaging for the quantification of aortic regurgitation744Native T1 relaxation time can accurately identify limited left ventricular contractile reserve in patients with aortic stenosis745The validation and assessment of myocardial fibrosis by using cardiac magnetic resonance and speckle-tracking echocardiography in severe aortic stenosis746Clinical validation of a semi-automatic quantification score of aortic valve calcification with ultrasound747A comparison among conventional 3D-transesophageal echocardiography manual analysis, 3D automatic software analysis and computed tomography for the aortic annulus sizing in TAVI patients748New insights from a multimodality imaging evaluation of LV remodeling in patients with chronic ischemic mitral regurgitation: a combined magnetic resonance and speckle tracking analysis749Multimodality imaging monitoring during percutaneous tricuspid valve repair procedures. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew251] [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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Ilhao Moreira R, Cambronero Cortinas E, Giannakopoulos G, Wong CY, Maria Joao Vieira MJV, Neves Pestana G, Andjelkovic K, Pavon AG, Nunes A, Portero Portaz JJ, Stefan C, Namitokov A, Chivulescu M, Wojtkowska A, Gomes AC, Jurko T, Cazzoli I, Valente F, Moura Branco L, Coutinho Cruz M, Pinto Teixeira P, Almeida Morais L, Viveiros Monteiro A, Oliveira M, Ramos R, Agapito A, Cruz Ferreira R, Racugno P, Escribano D, Mendez J, Paya A, Bonanad C, Valle Munoz A, Corbi Pascual MJ, Chorro FJ, Bodi V, Mueller H, Catia Costa CC, Beatriz Saldanha Santos BSS, Kevin Domingues KD, Nuno Craveiro NC, Maria Luz Pitta MLP, Miguel Alves MA, Margarida Leal ML, Bernardo-Almeida P, Sousa C, Tavares-Silva M, Almeida R, Lima R, Amorim MJ, Almeida J, Macedo F, Maciel MJ, Kalimanovska Ostric D, Boricic Kostic M, Petrovic O, Petrovic M, Vujisic Tesic B, Mikic A, Kalangos A, Marini C, Rosa I, Stella S, Ancona F, Spartera M, Margonato A, Colombo A, Agricola E, Nascimento H, Maia Araujo P, Ferreira A, Pinho T, Andre Rodrigues R, Bernardo Almeida P, Campelo M, Dias P, Julia Maciel M, Tercero Martinez A, Corbi Pascual MJ, Prieto Mateos D, Urraca Espejel C, Calero Nunez S, Fuentes Manso R, Gallego Page JC, Garcia Lopez JC, Barambio Ruiz MJ, Iancovici S, Ianovici E, Zamfir D, Dorobantu M, Kizhvatova N, Kolodina M, Skaletsky K, Soroka N, Mayngart S, Kosmacheva E, Barbukhatti K, Porhanov V, Jurcut C, Enache R, Popescu BA, Ginghina C, Spirito P, Jurcut R, Tomaszewski A, Czekajska-Chehab E, Tomaszewski M, Stettner D, Wysokinski A, Fazendas P, Carvalho J, Ferreira F, Sousa L, Fiarresga A, Martins JD, Pereira H, Jurko A, Krsiakova J, Jurko AJR, Matasova K, Zibolen M, Babu-Narayan S, Senior R, Gatzoulis MA, Li W, Maldonado G, Cuellar H, Marti G, Roque A, Teixido G, Gonzalez-Alujas MT, Garcia-Dorado D, Evangelista A, Rodriguez-Palomares JF. Clinical Case Poster session 4P1046An unexpected findingP1047Coronary artery ectasia in the setting of subacute Inferior STEMIP1048Diagnosis through the back door: the utility of the subscapular acoustic windowP1049A challenging case of paravalvular leakage closureP1050A life-threatning asymptomatic incidental findingP1051Acute heart failure due to intermittent aortic prosthesis regurgitation - case reportP1052Role of echocardiography in a patient with sequels after surgical treatment of infective endocarditis on a bicuspid aortic valveP1053MitraClip to treat systolic anterior motion-induced outflow tract obstruction in hypertrophic obstructive cardiomyopathyP1054Acute heart failure by parvovirus B19P1055Multimodality assessment of myocardial involvement in female carriers of the Duchenne diseaseP1056Cardiovascular complications in hypereosinophilic syndrom-a case reportP1057Giant false left ventricle aneurysm in the myocardial infarction outcomeP1058From syncope to the diagnosis of systemic disease: the importance of a high index of suspicionP1059A total anomalous pulmonary venous return in 60-year-old patientP1060Atrial septal defect occluder fracture - diagnostic challenge in asymptomatic patientP1061Marfan syndrome in two newborn infantsP1062Isolated pulmonary valve regurgitation as a cause of severe right heart dilatation in an adult patientP1063Multimodality imaging - how to find the missing leak. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew261] [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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Cambronero Cortinas E, Marini C, Sorrentino R, Hassan Y, Badea RG, Heseltine TD, Laymouna R, Santoro C, Sawicka K, Gonzalez Garcia AE, Bret Zurita M, Garcia Hamilton D, Corbi Pascual MJ, Ruiz Cantador J, Oliver Ruiz JM, Ancona F, Stella S, Rosa I, Spartera M, Melisurgo G, Pappalardo F, Margonato A, Agricola E, Lo Iudice F, Niglio T, Stabile E, Galderisi M, Trimarco B, Elsharkawy E, Laymouna R, Elgowelly M, Almaghraby A, Enache R, Serban M, Gherasim D, Platon P, Ginghina C, Lima E, Cino-Polla JM, Elsharkawy E, Hassan Y, Elgowelly M, Almaghraby A, Ilardi F, Lembo M, Lo Iudice F, Cirillo P, Esposito G, Trimarco B, Galderisi M, Prasal M, Tomaszewski M, Wojtkowska A, Tomaszewski A. Clinical Cases: Ischaemic heart disease899Asymptomatic very late presentation of ALCAPA900Usefulness of 3-dimensional contrast echocardiography in the diagnosis of a left ventricular pseudoaneurysm after acute myocardial infarction901Peri-procedural jailing of septal perforator branch retrospectively identified using speckle tracking echocardiography902Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA)903Coronary artery compression by aneurysmal pulmonary artery904A rare complication of myocardial infarction: pseudoaneurysm leading to ischaemic VSD905Single coronary ostium from the right aortic sinus of valsalva906Incremental value of regional longitudinal strain upon visual assessment for detection of ischemia during dobutamine stress echocardiography907One serious complication after myocardial infarction, isn't that enough? Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew257] [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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Spartera M, Alfieri O, La Canna G. Transient severe tricuspid regurgitation during atrioventricular block. J Echocardiogr 2016; 14:87-8. [DOI: 10.1007/s12574-016-0284-6] [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] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 02/16/2016] [Accepted: 03/02/2016] [Indexed: 11/30/2022]
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Rosa I, Marini C, Stella S, Ancona F, Spartera M, Margonato A, Agricola E. Mechanical dyssynchrony and deformation imaging in patients with functional mitral regurgitation. World J Cardiol 2016; 8:146-162. [PMID: 26981211 PMCID: PMC4766266 DOI: 10.4330/wjc.v8.i2.146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 10/06/2015] [Accepted: 12/08/2015] [Indexed: 02/06/2023] Open
Abstract
Chronic functional mitral regurgitation (FMR) is a frequent finding of ischemic heart disease and dilated cardiomyopathy (DCM), associated with unfavourable prognosis. Several pathophysiologic mechanisms are involved in FMR, such as annular dilatation and dysfunction, left ventricle (LV) remodeling, dysfunction and dyssynchrony, papillary muscles displacement and dyssynchrony. The best therapeutic choice for FMR is still debated. When optimal medical treatment has already been set, a further option for cardiac resynchronization therapy (CRT) and/or surgical correction should be considered. CRT is able to contrast most of the pathophysiologic determinants of FMR by minimizing LV dyssynchrony through different mechanisms: Increasing closing forces, reducing tethering forces, reshaping annular geometry and function, correcting diastolic MR. Deformation imaging in terms of two-dimensional speckle tracking has been validated for LV dyssynchrony assessment. Radial speckle tracking and three-dimensional strain analysis appear to be the best methods to quantify intraventricular delay and to predict CRT-responders. Speckle-tracking echocardiography in patients with mitral valve regurgitation has been usually proposed for the assessment of LV and left atrial function. However it has also revealed a fundamental role of intraventricular dyssynchrony in determining FMR especially in DCM, rather than in ischemic cardiomyopathy in which MR severity seems to be more related to mitral valve deformation indexes. Furthermore speckle tracking allows the assessment of papillary muscle dyssynchrony. Therefore this technique can help to identify optimal candidates to CRT that will probably demonstrate a reduction in FMR degree and thus will experience a better outcome.
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Spartera M, Galderisi M, Mele D, Cameli M, D'Andrea A, Rossi A, Mondillo S, Novo G, Esposito R, D'Ascenzi F, Montisci R, Gallina S, Margonato A, Agricola E. Role of cardiac dyssynchrony and resynchronization therapy in functional mitral regurgitation. Eur Heart J Cardiovasc Imaging 2016; 17:471-80. [DOI: 10.1093/ehjci/jev352] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 12/14/2015] [Indexed: 12/28/2022] Open
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Stella S, Li H, Stathogiannis K, Stojkovic S, Ondrus T, Plaza Lopez D, Jinno S, Verseckaite R, Oliveira Da Silva C, Altin C, Krestjyaninov MV, Izci S, Santos M, Urbano-Moral JA, Spartera M, Gonzalvez-Garcia A, Miskowiec D, Hagrass MUHAMMAD, Rady M, Reskovic Luksic V, Castaldi B, Silva T, Silva T, Silva T, Kolossvary M, Basuoni A, Miskowiec D, Peovska Mitevska I, Aguiar Rosa S, Rosa I, Marini C, Ancona F, Spagnolo P, Latib A, Romano V, Colombo A, Margonato A, Agricola E, Yuan L, Xie MX, Jin XY, Toutouzas K, Drakopoulou M, Latsios G, Synetos A, Sanidas E, Kaitozis O, Trantalis G, Gerckens U, Tousoulis D, Tesic M, Stojkovic S, Stepanovic J, Trifunovic D, Beleslin B, Giga V, Nedeljkovic I, Djordjevic Dikic A, Bartunek J, Vanderheyden M, Stockman B, Mirica C, Kotrc M, Van Praet F, Van Camp G, Penicka M, Igual Munoz B, Sanchez Lacuesta ME, Lopez Vilella R, Domenech Tort MD, Sepulveda Sanchis P, Ten Morro F, Calvillo Batlles P, Montero Argudo JA, Martinez Dolz LV, Yamada A, Sugimoto K, Ito S, Kato M, Inuzuka H, Sugiyama H, Takada K, Ozaki Y, Ishii J, Mizariene V, Gaileviciute K, Bieseviciene M, Jonkaitiene R, Jurkevicius R, Gunyeli E, Winter R, Back M, Settergren M, Manouras A, Shahgaldi K, Ozsoy HM, Gezmis E, Yilmaz M, Tunc E, Sade LE, Muderrisoglu H, Gimaev RH, Melnikova MA, Olezov NV, Ruzov VI, Dogan C, Acar R, Cetin G, Bakal RB, Unkun T, Cap M, Erdogan E, Kaymaz C, Ozdemir N, Leite L, Martins R, Baptista R, Barbosa A, Ribeiro N, Oliveira A, Castro G, Pego M, Gutierrez-Garcia-Moreno L, Rodriguez-Palomares JF, Galuppo V, Maldonado-Herrera G, Teixido-Tura G, Gruosso D, Gonzalez-Alujas T, Evangelista-Massip A, Stella S, Rosa I, Ancona F, Marini C, Latib A, Giannini F, Colombo A, Margonato A, Agricola E, Urbano-Moral JA, Matabuena-Gomez-Limon J, Grande-Trillo A, Rojas-Bermudez C, Rodriguez-Puras MJ, Martinez-Martinez A, Lopez-Pardo F, Lopez-Haldon JE, Kupczynska K, Kasprzak JD, Lipiec P, Abdelrahman Sharaf El Dein AHMED, Shawky El Serafy AHMED, Rajan RAJESH, Sveric K, Kvakan H, Strasser RH, Cekovic S, Veceric S, Separovic Hanzevacki J, Romanato S, Callegari A, Bernardinello V, Reffo E, Milanesi O, Agapito A, Sousa L, Oliveira JA, Branco LM, Timoteo AT, Galrinho A, Thomas B, Tavares NJ, Cruz Ferreira R, Agapito A, Sousa L, Oliveira JA, Branco LM, Timoteo AT, Galrinho A, Thomas B, Tavares NJ, Cruz Ferreira R, Agapito A, Sousa L, Oliveira JA, Soares R, Aguiar Rosa SA, Morais L, Thomas B, Tavares NJ, Cruz Ferreira R, Szilveszter B, Elzomor H, Karolyi M, Raaijmakers R, Benke K, Celeng C, Bagyura Z, Merkely B, Maurovich-Horvat P, Shaheen S, Abdelkader M, Rasheed T, Kasprzak JD, Lipiec P, Srbinovska E, Pop Gorceva D, Zdravkovska M, Galrinho A, Moura Branco L, Timoteo AT, Agapito A, Sousa L, Oliveira JA, Rodrigues I, Viveiros Monteiro A, Cruz Ferreira R. HIT Poster session 3Transcatheter procedures (TAVI/MitralClip)P937Comparison between 3d transesophageal echocardiography and multislice computed tomography for the aortic annulus sizing in tavi patients: implication for prosthesis sizingP938Left ventricular remodelling in chronic mitral regurgitation: from geometry to mechanics by speckle tracing imageP939Direct TAVI of a self-expanding bioprosthesis: long-term clinical outcomes.P940Prognostic value of coronary flow reserve in the culprit artery following previous myocardial infarctionP941Both MitraClip and heartport surgery prevent progressive left ventricular remodeling in very severe systolic heart failureP942Predictors for the development of microvascular obstruction in patients with acute myocardial infarction treated with primary percutaneous coronary intervention.P943Usefulness of exercise stress echocardiography in asymptomatic or mildly symptomatic patients with chronic degenerative mitral regurgitationP944Left ventricular myocardial deformation changes after aortic valve repair and replacement for aortic regurgitationP945Transcatheter aortic valve implantation: a view of the right side.P946Assessment of epicardial fat thickness and carotid intima media thickness in preeclemsiaP947Gender differences in the remodelling of left and right chambers of the heart in patients with uncontrolled hypertensionP948The five-year course of the left ventricular conventional and advanced echocardiographic parameters in patients with anterior and inferior myocardial infarction revascularized by percutaneouslyP949Aortic regurgitation and 2D derived-speckle tracking left ventricle global longitudinal strain: a connection with symptoms beyond ejection fractionP950Hypertrophic cardiomyopathy: structural abnormalities beyond hypertrophy from a prospective echocardiographic evaluationP952Echocardiographic findings of thrombosis vs endocarditis in tavi patients: a single centre experienceP953Prospective examination of the prevalence and significance of causal mechanisms of low gradient aortic valve stenosisP954Echocardiographic assessment of regional left atrial longitudinal strain by tissue Doppler and speckle tracking method - a comparison studyP955Pattern of atherosclerosis in extracranial and intracranial vessles in non diabetic, non stroke patient with atherosclerotic CADP9563D volume time curves of the left ventricle and exercise capacity testing in patients with dilated cardiomyopathy- old parameters revisedP957Left ventricular longitudinal function in hypertensive patients with septal bulgeP958Integrated imaging to evaluate cardiac performance in Fontan patientsP959The value of right ventricular global longitudinal strain in the evaluation of adult patients with repaired tetralogy of FallotP960Accurate transthoracic echocardiography parameters for the evaluation of adult patients with repaired tetralogy of Fallot: validation with cardiac magnetic resonance imagingP961Cardiac magnetic resonance imaging and cardiopulmonary exercise testing in the functional evaluation of adult patients with repaired tetralogy of FallotP962Model based iterative reconstruction techniques cause modest change in calcium scoresP963Assesment of diastolic heart function by using multi detector computed tomography ( MDCT) in comparison with tissue dopplerP964Bicuspid aortic valve morphology and its impact on aortic diameter - a meta-analysisP965Prognostic value of moderate and severe myocardial ischemia in patients with suspected coronary artery disease and normal coronary angiogramsP966Predictors of aortic dilation in patients with bicuspid aortic valve. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev274] [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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Colunga Blanco S, Gonzalez Matos C, Angelis A, Dinis PG, Chinali M, Toth A, Andreassi MG, Rodriguez Munoz D, Reid AB, Park JH, Shetye A, Novo G, De Marchi SF, Cikes M, Smarz K, Illatopa V, Peluso D, Wellnhofer E, De La Rosa Riestra A, Sattarzadeh Badkoubeh R, Mandour Ali M, Azoz A, Pontone G, Krljanac G, Acar R, Nucifora G, Sirtautas A, Roos ST, Qasem MS, Marini C, Fabiani I, Gillis K, Bandera F, Borowiec A, Lim YJ, Chalbia TE, Santos M, Gao SA, Zilberszac R, Farrag AAM, Palmiero G, Aruta P, De Diego Soler O, Fasano D, Tamborini G, Ancona F, Raafat DM, Marchel M, De Gregorio C, Gommans DHF, Godinho AR, Mielczarek M, Bandera F, Kubik M, Cho JY, Tarando F, Lourenco Marmelo BF, Reis L, Domingues K, Krestjyaninov MV, Mesquita J, Ikonomidis I, Ferferieva V, Peluso D, Peluso D, King GJ, D'ascenzi F, Ferrera Duran C, Sormani P, Gonzalez Fernandez O, Tereshina O, Cambronero Cortinas E, Kupczynska K, Carvalho JF, Shivalkar B, Aghamohammadzadeh R, Cifra B, Cifra B, Bandera F, Kuznetsov VA, Van Zalen JJ, Kochanowski J, Goebel B, Ladeiras-Lopes R, Goebel B, Karvandi M, Karvandi M, Alonso Salinas G, Unkun T, Ranjbar S, Hubert A, Enescu OA, Liccardo M, Cameli M, Ako E, Lembo M, Goffredo C, Enache R, Novo G, Wdowiak-Okrojek K, Nemes A, Nemes A, Di Salvo G, Capotosto L, Caravaca P, Maceira Gonzalez AM, Iriart X, Jug B, Garcia Campos A, Capin Sampedro E, Corros Vicente C, Martin Fernandez M, Leon Arguero V, Fidalgo Arguelles A, Velasco Alonso E, Lopez Iglesias F, De La Hera Galarza JM, Chaparro-Munoz M, Recio-Mayoral A, Vlachopoulos C, Ioakeimidis N, Felekos I, Abdelrasoul M, Aznaouridis K, Chrysohoou C, Rousakis G, Aggeli K, Tousoulis D, Faustino AC, Paiva L, Fernandes A, Costa M, Cachulo MC, Goncalves L, Emma F, Rinelli G, Esposito C, Franceschini A, Doyon A, Raimondi F, Schaefer F, Pongiglione G, Mateucci MC, Vago H, Juhasz C, Janosa C, Oprea V, Balint OH, Temesvari A, Simor T, Kadar K, Merkely B, Bruno RM, Borghini A, Stea F, Gargani L, Mercuri A, Sicari R, Picano E, Lozano Granero C, Carbonell San Roman A, Moya Mur JL, Fernandez-Golfin C, Moreno Planas J, Fernandez Santos S, Casas Rojo E, Hernandez-Madrid A, Zamorano Gomez JL, Pearce K, Gamlin W, Miller C, Schmitt M, Seong IW, Kim KH, Kim MJ, Jung HO, Sohn IS, Park SM, Cho GY, Choi JO, Park SW, Nazir SA, Khan JN, Singh A, Kanagala P, Squire I, Mccann GP, Di Lisi D, Meschisi MC, Brunco V, Badalamenti G, Bronte E, Russo A, Novo S, Von Tscharner M, Urheim S, Aakhus S, Seiler C, Schmalholz S, Biering-Sorensen T, Cheng S, Oparil S, Izzo J, Pitt B, Solomon SD, Zaborska B, Jaxa-Chamiec T, Tysarowski M, Budaj A, Cordova F, Aguirre O, Sanabria S, Ortega J, Romeo G, Perazzolo Marra M, Tona F, Famoso G, Pigatto E, Cozzi F, Iliceto S, Badano LP, Kriatselis C, Gerds-Li JH, Kropf M, Pieske B, Graefe M, Martinez Santos P, Batlle Lopez E, Vilacosta I, Sanchez Sauce B, Espana Barrio E, Jimenez Valtierra J, Campuzano Ruiz R, Alonso Bello J, Martin Rios MD, Farrashi M, Abtahi H, Sadeghi H, Sadeghipour P, Tavoosi A, Abdel Rahman TA, Mohamed LA, Maghraby HM, Kora IM, Abdel Hameed FR, Ali MN, Al Shehri A, Youssef A, Gad A, Alsharqi M, Alsaikhan L, Andreini D, Rota C, Guglielmo M, Mushtaq S, Baggiano A, Beltrama V, Solbiati A, Guaricci AI, Pepi M, Trifunovic D, Sobic Saranovic D, Savic L, Grozdic Milojevic I, Asanin M, Srdic M, Petrovic M, Zlaic N, Mrdovic I, Dogan C, Izci S, Gecmen C, Unkun T, Cap M, Erdogan E, Onal C, Yilmaz F, Ozdemir N, Muser D, Tioni C, Zanuttini D, Morocutti G, Spedicato L, Bernardi G, Proclemer A, Pranevicius R, Zapustas N, Briedis K, Valuckiene Z, Jurkevicius R, Juffermans LJM, Enait V, Van Royen N, Van Rossum AC, Kamp O, Khalaf HASSEN, Hitham SAKER, Osama AS, Abazid RAMI, Guall RAHIM, Durdan SHAFAT, Mohammed ZYAD, Stella S, Rosa I, Ancona F, Spartera M, Italia L, Latib A, Colombo A, Margonato A, Agricola E, Scatena C, Mazzanti C, Conte L, Pugliese N, Barletta V, Bortolotti U, Naccarato AG, Di Bello V, Bala G, Roosens B, Hernot S, Remory I, Droogmans S, Cosyns B, Generati G, Labate V, Donghi V, Pellegrino M, Carbone F, Alfonzetti E, Guazzi M, Dabrowski R, Kowalik I, Firek B, Chwyczko T, Szwed H, Kawamura A, Kawano S, Zaroui A, Ben Said R, Ben Halima M, Kheder N, Farhati A, Mourali S, Mechmech R, Leite L, Martins R, Baptista R, Barbosa A, Ribeiro N, Oliveira A, Castro G, Pego M, Polte CL, Lagerstrand K, Johnsson ÅA, Janulewicz M, Bech-Hanssen O, Gabriel H, Wisser W, Maurer G, Rosenhek R, El Aroussy W, Abdel Ghany M, Al Adeeb K, Ascione L, Carlomagno G, Sordelli C, Ferro A, Ascione R, Severino S, Caso P, Muraru D, Janei C, Haertel Miglioranza M, Cavalli G, Romeo G, Peluso D, Cucchini U, Iliceto S, Badano L, Armario Bel X, Garcia-Garcia C, Ferrer Sistach E, Rueda Sobella F, Oliveras Vila T, Labata Salvador C, Serra Flores J, Lopez-Ayerbe J, Bayes-Genis A, Conte E, Gonella A, Morena L, Civelli D, Losardo L, Margaria F, Riva L, Tanga M, Carminati C, Muratori M, Gripari P, Ghulam Ali S, Fusini L, Vignati C, Bartorelli AL, Alamanni F, Pepi M, Rosa I, Stella S, Marini C, Spartera M, Latib A, Montorfano M, Colombo A, Margonato A, Agricola E, Ismaiel A, Ali N, Amry S, Serafin A, Kochanowski J, Filipiak KJ, Opolski G, Speranza G, Ando' G, Magaudda L, Cramer GE, Bakker J, Michels M, Dieker HJ, Fouraux MA, Marcelis CLM, Timmermans J, Brouwer MA, Kofflard MJM, Vasconcelos M, Araujo V, Almeida P, Sousa C, Macedo F, Cardoso JS, Maciel MJ, Voilliot D, Huttin O, Venner C, Olivier A, Villemin T, Deballon R, Manenti V, Juilliere Y, Selton-Suty C, Generati G, Pellegrino M, Labate V, Carbone F, Alfonzetti E, Guazzi M, Dabrowska-Kugacka A, Dorniak K, Lewicka E, Szalewska D, Kutniewska-Kubik M, Raczak G, Kim KH, Yoon HJ, Park HJ, Ahn Y, Jeong MH, Cho JG, Park JC, Kim JH, Galli E, Habib G, Schnell F, Lederlin M, Daubert JC, Mabo P, Donal E, Faria R, Magalhaes P, Marques N, Domingues K, Lourenco C, Almeida AR, Teles L, Picarra B, Azevedo O, Lourenco C, Oliveira M, Magalhaes P, Domingues K, Marmelo B, Almeida A, Picarra B, Faria R, Marques N, Bento D, Lourenco C, Magalhaes P, Cruz I, Marmelo B, Reis L, Picarra B, Faria R, Azevedo O, Gimaev RH, Melnikova MA, Olezov NV, Ruzov VI, Goncalves P, Almeida MS, Branco P, Carvalho MS, Dores H, Gaspar MA, Sousa H, Andrade MJ, Mendes M, Makavos G, Varoudi M, Papadavid E, Andreadou I, Gravanis K, Liarakos N, Pavlidis G, Rigopoulos D, Lekakis J, Deluyker D, Bito V, Pigatto E, Romeo G, Muraru D, Cozzi F, Punzi L, Iliceto S, Badano LP, Pigatto E, Romeo G, Muraru D, Cozzi F, Iliceto S, Badano LP, Neilan T, Coen K, Gannon S, Bennet K, Clarke JG, Solari M, Cameli M, Focardi M, Corrado D, Bonifazi M, Henein M, Mondillo S, Gomez-Escalonilla C, De Agustin A, Egido J, Islas F, Simal P, Gomez De Diego JJ, Luaces M, Macaya C, Perez De Isla L, Zancanella M, Rusconi C, Musca F, Santambrogio G, De Chiara B, Vallerio P, Cairoli R, Giannattasio G, Moreo A, Alvarez Ortega C, Mori Junco R, Caro Codon J, Meras Colunga P, Ponz De Antonio I, Lopez Fernandez T, Valbuena Lopez S, Moreno Yanguela M, Lopez-Sendon JL, Surkova E, Bonanad-Lozano C, Lopez-Lereu MP, Monmeneu-Menadas JV, Gavara J, De Dios E, Paya-Chaume A, Escribano-Alarcon D, Chorro-Gasco FJ, Bodi-Peris V, Michalski BW, Miskowiec D, Kasprzak JD, Lipiec P, Morgado G, Caldeira D, Cruz I, Joao I, Almeida AR, Lopes L, Fazendas P, Cotrim C, Pereira H, De Block C, Buys D, Salgado R, Vrints C, Van Gaal L, Mctear C, Irwin RB, Dragulescu A, Friedberg M, Mertens L, Dragulescu A, Friedberg M, Mertens L, Carbone F, Generati G, Pellegrino M, Labate V, Alfonzetti E, Guazzi M, Krinochkin DV, Yaroslavskaya EI, Zaharova EH, Pushkarev GS, Sugihara C, Patel NR, Sulke AN, Lloyd GW, Piatkowski R, Scislo P, Grabowski M, Marchel M, Opolski G, Roland H, Hamadanchi A, Otto S, Jung C, Lauten A, Figulla HC, Poerner TC, Sampaio F, Fonseca P, Fontes-Carvalho R, Pinho M, Campos AS, Castro P, Fonseca C, Ribeiro J, Gama V, Heck R, Hamdanchi A, Otto S, Jung C, Lauten A, Figulla HR, Poerner TC, Ranjbar S, Ghaffaripour Jahromi M, Ranjbar S, Hinojar R, Fernandez Golfin C, Esteban A, Pascual-Izco M, Garcia-Martin A, Casas Rojo E, Jimenez-Nacher JJ, Zamorano JL, Gecmen C, Cap M, Izci S, Erdogan E, Onal C, Acar R, Bakal RB, Kaymaz C, Ozdemir N, Karvandi M, Ghaffaripour Jahromi M, Galand V, Schnell F, Matelot D, Martins R, Leclercq C, Carre F, Suran BC, Margulescu AD, Rimbas RC, Siliste C, Vinereanu D, Nocerino P, Urso AC, Borrino A, Carbone C, Follero P, Ciardiello C, Prato L, Salzano G, Marino F, Ruspetti A, Sparla S, Di Tommaso C, Loiacono F, Focardi M, D'ascenzi F, Henein M, Mondillo S, Porter J, Walker M, Lo Iudice F, Esposito R, Santoro C, Cocozza S, Izzo R, De Luca N, De Simone G, Trimarco B, Galderisi M, Gervasi F, Patti G, Mega S, Bono M, Di Sciascio G, Buture A, Badea R, Platon P, Ghiorghiu I, Jurcut R, Coman IM, Popescu BA, Ginghina C, Lunetta M, Spoto MS, Lo Vi AM, Pensabene G, Meschisi MC, Carita P, Coppola G, Novo S, Assennato P, Shim A, Wejner-Mik P, Kasprzak JD, Lipiec P, Havasi K, Domsik P, Kalapos A, Forster T, Piros GA, Domsik P, Kalapos A, Lengyel C, Orosz A, Forster T, Bulbul Z, Issa Z, Al Sehly A, Pergola V, Oufi S, Conde Y, Cimino E, Rinaldi E, Ashurov R, Ricci S, Pergolini M, Vitarelli A, Lujan Valencia JE, Chaparro M, Garcia-Guerrero A, Cristo Ropero MJ, Izquierdo Bajo A, Madrona L, Recio-Mayoral A, Monmeneu JV, Igual B, Lopez Lereu P, Garcia MP, Selmi W, Jalal Z, Thambo JB, Kosuta D, Fras Z. Poster session 5The imaging examinationP1097Correlation between visual and quantitative assessment of left ventricle: intra- and inter-observer agreementP1099Incremental prognostic value of late gadolinium-enhanced by cardiac magnetic resonance in patients with heart failureAnatomy and physiology of the heart and great vesselsP1100Left ventricular geometry and diastolic performance in erectile dysfunction patients; a topic of differential arterial stiffness influenceAssessment of diameters, volumes and massP1101Impact of the percutaneous closure of atrial septal defect on the right heart "remodeling"P1102Left Ventricular Mass Indexation in Infants, Children and Adolescents: a Simplified Approach for the Identification of Left Ventricular Hypertrophy in Clinical PracticeP1103Impact of trabecules while quantifying cardiac magnetic resonance exams in patients with systemic right ventricleP1104Detection of subclinical atherosclerosis by carotid intima-media thickness: correlation with leukocytes telomere shorteningAssessments of haemodynamicsP1105Flow redirection towards the left ventricular outflow tract: vortex formation is not affected by variations in atrio-ventricular delayAssessment of systolic functionP1106Reproducibility and feasibility of cardiac MRI feature tracking in Fabry diseaseP1107Normal left ventricular strain values by two-dimensional strain echocardiography; result of normal (normal echocardiographic dimensions and functions in korean people) studyP1108Test-retest repeatability of global strain following st-elevation myocardial infarction - a comparison of tagging and feature trackingP1109Cardiotoxicity induced by tyrosine kinase inhibitors in patients with gastrointestinal stromal tumors (GIST)P1110Finite strain ellipses for the analysis of left ventricular principal strain directions using 3d speckle tracking echocardiographyP1111Antihypertensive therapy reduces time to peak longitudinal strainP1112Right ventricular systolic function as a marker of prognosis after inferior myocardial infarction - 5-year follow-upP1113Is artery pulmonary dilatation related with right but also early left ventricle dysfunction in pulmonary artery hypertension?P1114Right ventricular mechanics changes according to pressure overload increasing, a 2D-speckle tracking echocardiographic evaluationAssessment of diastolic functionP1115Paired comparison of left atrial strain from P-wave to P-wave and R-wave to R-waveP1116Diagnostic role of Tissue Doppler Imaging echocardiographic criteria in obese heart failure with preserved ejection fraction patientsP1117Evaluation of diastolic function of right ventricle in idiopathic pulmonary arterial hypertensionP1118Severity and predictors of diastolic dysfunction in a non-hypertensive non-ischemic cohort of Egyptian patients with documented systemic autoimmune disease; pilot reportP1119correlation between ST segment shift and cardiac diastolic function in patients with acute myocardial infarctionIschemic heart diseaseP1120Computed tomography coronary angiography verSus sTRess cArdiac magneTic rEsonance for the manaGement of sYmptomatic revascularized patients: a cost effectiveness study (STRATEGY study)P1121Utility of transmural myocardial mechanic for early infarct size prediction after primary percutaneous coronary intervention in STEMI patientsP1122Progressive Improvements of the echocardiographic deformation parameters in ST Elevation Myocardial Infarction after five years follow-upP1123Long-term prognostic value of left ventricular dyssynchrony as assessed by cardiac magnetic resonance feature-tracking imaging after a first st-segment elevation myocardial infarctionP1124Differences in mitral annulus remodeling in acute anterior ST elevation and acute inferior ST elevation myocardial infarctionP1125Reduction of microvascular injury using a novel theragnostic ultrasound strategy: a first in men feasibility and safety studyP1126Impact of focused echocardiography in clinical decision of patient presented with st elevation myocardial infarction underwent primary angioplastyHeart valve DiseasesP1127Aortic valve area calculation in aortic stenosis: a comparison among conventional and 3D-transesophageal echocardiography and computed tomographyP1128Myocardial fibrosis and microRNA-21 expression in patients with severe aortic valve stenosis and preserved ejection fraction: a 2D speckle tracking echocardiography, tissutal and plasmatic studyP1129Quantification of calcium amount in a new experimental model: a comparison between calibrated integrated backscatter of ultrasound and computed tomographyP1130Altered diffusion capacity in aortic stenosis: role of the right heartP1131Osteoprotegerin predicts all-cause mortality in calcific aortic stenosis patients with preserved left ventricle ejection fraction in long term observationP1132Mitral regurgitation as a risk factor for pulmonary hypertension in patients with aortic stenosisP1133The relationship between the level of plasma B-type natriuretic peptide and mitral stenosisP1134Aortic regurgitation, left ventricle mechanics and vascular load: a single centre 2d derived-speckle tracking studyP1135Feasibility and reproducibility issues limit the usefulness of quantitative colour Doppler parameters in the assessment of chronic aortic and mitral regurgitation severityP1136Predictors of postoperative outcome in degenerative mitral regurgitationP1137Left ventricular mechanical dyssynchrony in patients with severe mitral regurgitation of rheumatic etiology; three dimensional echocardiography studyP1138Functional mitral regurgitation and left atrial dysfunction concur in determining pulmonary hypertension and functional status in subjects with left ventricular systolic dysfunctionP11393D echocardiography allows more effective quantitative assessment of the severity of functional tricuspid regurgitation than conventional 2D/Doppler echocardiographyP1140Prosthetic valve thrombosis: still a severe disease? 10-years experience in a university hospitalP1141Validity of echocardiography in the hospital course of patients with feverP1142Do baseline 3DTEE characteristics of mitral valve apparatus predict long term result in patients undergoing percutaneous valve repair for degenerative regurgitation?P1143Influence of baseline aortic regurgitation on mitral regurgitation change after transcatheter aortic valve replacement for aortic stenosisP1144Prevalence of echocardiography detected significant valvular regurge in subclinical rheumatic carditis in assiut childrenCardiomyopathiesP1145Can we early detect left ventricular systolic dysfunction in patients with Duchenne muscular dystrophy using global longitudinal strain assessment?P1146Prevalence of isolated papillary muscle hypertrophy in young competitive athletesP1147Troponin release after exercise in patients with hypertrophic cardiomyopathy: associations with clinical and mr imaging characteristicsP1148Atrial fibrillation in hypertrophic cardiomyopathy: can we score the risk?P1149Impact of hypertrophy on multiple layer longitudinal deformation in hypertrophy cardiomyopathy and cardiac amyloidosis compared to controlsP1150Functional evaluation in hypertrophic cardiomyopathy combining cardiopulmonary exercise testing combined with exercise-echocardiographyP1151Refinement of the old diagnostic criteria of left ventricular noncompaction cardiomyopathy (LVNC) based on cardiac magnetic resonance (CMR)P1152Differences of clinical characteristics and outcomes between acute myocarditis with preserved and reduced left ventricular systolic functionP1153Value of longitudinal strain for distinguishing left ventricular non-compaction from idiopathic dilated cardiomyopathyP1154Speed of recovery of left ventricular function is not related to the prognosis of Takotsubo cardiomyopathy. A Portuguese multicentre studyP1155Predictors of in-hospital left ventricular systolic function recovery after admission with takotsubo cardiomyopathy. Portuguese multicentre studyP1156Mid-ventricular takotsubo detected by initial echocardiogram associates with recurrence of takotsubo cardiomyopathy - a portuguese multicentre studySystemic diseases and other conditionsP1157Relations between left ventricle remodelling and expression of angiotensin 2 AT2R1 geneP1158Impact of renal denervation on long-term blood pressure variability and surrogate markers of target organ damage in individuals with drug-resistant arterial hypertensionP1159Greater improvement of coronary artery function, left ventricular deformation and twisting by IL12/23 compared to TNF-a inhibition in psoriasisP1160Advanced glycation end products play a role in adverse LV remodeling following MIP1161Incidence of subclinical myocardial dysfunction in patients with systemic sclerosis and normal left ventricular systolic and diastolic functionP1162Left atrial remodeling and dysfunction occur early in patients with systemic sclerosis and normal left ventricular functionP1163Intrinsic vortex formation : a unique performance indicatorP1164P-wave morphology is unaffected by training-induced biatrial dilatation: a prospective, longitudinal study in healthy athletesP1165Usefulness of transthoracic echocardiography in diagnosis of young patients with ischemic strokeP1166Primary cardiac lymphoma: role of echocardiography in the clinical managementP1167Abnormal echocardiographic findings in cancer patients before chemotherapyMasses, tumors and sources of embolismP1168Three-dimensional transesophageal echocardiography of the left atrial appendage reduces rate of postpone electrical cardioversionP1169Detection of ventricular thrombus by cmr after reperfused st-segment elevation myocardial infarction correlated with echocardiographyP1170Clinical and transthoracic echocardiographic predictors of left atrial appendage thrombus in patients with atrial fibrillationStress echocardiographyP1171Pharmacological stress echocardiography complications: a 4-year single center experienceP1172Myocardial functional and perfusion reserve in type I diabetesP1173Feasibility of incorporating 3D Dobutamine stress echocardiography into routine clinical practiceP1174Right ventricular isovolumic acceleration at rest and during exercise in children after heart transplantP1175Right ventricular systolic and diastolic response to exercise in children after heart transplant -a bicycle exercise studyP1176Determinants of functional capacity in heart failure patients with reduced ejection fractionP1177Handgrip stress echocardiography with emotional component compared to conventional isometric exercise in coronary artery disease diagnosisP1178The relationship between resting transthoracic echocardiography and exercise capacity in patients with paroxysmal atrial fibrillationP1179Correlation between NT-proBNP and selected echocardiography parameters at rest and after exercise in patients with functional ischemic mitral regurgitation qualified for cardiosurgical treatmentReal-time three-dimensional TEEP1180Vena contracta area for severity grading in functional and degenerative mitral regurgitation: A study based on transesophageal 3D colour Doppler in 419 patientsP1181Proximal flow convergence by 3D echocardiography in the evaluation of mitral valve area in rheumatic mitral stenosisP1182Quantification of valve dimensions by transesophageal 3D echocardiography in patients with functional and degenerative mitral regurgitationTissue Doppler and speckle trackingP1183Automatic calculation of left ventricular volume changes over a cardiac cycle from echocardiography images by nonlinear dimensionality reductionP1184Effect of the mitral valve repairs on the left ventricular blood flow formationP1185Quantification of left atrial strain using cardiovascular magnetic resonance. a comparison between hypertrophic cardiomyopathy and healthy controlsP1186The role of early systolic lengthening in patients with non-ST elevation acute coronary syndrome and its relation to syntax scoreP1187Different standard two dimensional strain methods to quantity left ventricular mechanicsP1188Atrial function and electrocardiography caracteristics in sportsmen with or without paroxysmal atrial fibrillationP1189Right ventricular outflow premature contractions induce regional left ventricular dysfunctionP1190Ultrasound guided venous access for pacemaker and defibrillators. Randomized TrialP1191Atrial function analysis correlates with symptoms and quality of life of heart failure patientsP1192The use of tissue doppler echocardiography in myocardial iron overload in patients with thalassaemia majorP1193Independent association between pulse pressure and left ventricular global longitudinal strainP1194Global and regional longitudinal strain identifies the presence of coronary artery disease in patients with suspected reduction of coronary flow reserve and absence of wall motion abnormalitiesP1195Prognostic value of invasive and noninvasive parameters of right ventricular function in patients with pulmonary arterial hypertension receiving specific vasodilator therapyP1196Myocardial deformation analysis to improve arrhythmic risk stratificationP1197Quantitative assessment of regional systolic and diastolic function parameters for detecting prior transient ischemia in normokinetic segmentsP1198Left atrial function in patients with corrected tetralogy of Fallot - a three-dimensional speckle-tracking echocardiographic studyP1199Left atrial ejection force correlates with left atrial strain and volume-based functional properties as assessed by three-dimensional speckle tracking echocardiographyP1200Acute angulation of the aortic arch late after the arterial switch operation for transposition of the great arteries: impact on cardiac mechanicsP1201Circumferential deformation of the ascending thoracic aorta in hypertensive patients by three-dimensional speckle tracking echocardiographyCardiac Magnetic ResonanceP1202The incremental value of cardiac magnetic resonance on diagnosis myocardial infarction and non-obstructed coronary arteriesP1204Reference ranges of global and regional myocardial T1 values derived from MOLLI and shMOLLI at 3TComputed Tomography & Nuclear CardiologyP1205Deformation of the left atrial appendage after percutaneous closure with the Amplatzer cardiac plugP1206Prognostic impact of non-obstructive coronary artery disease on coronary computed tomographic angiography: A single-center study. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev275] [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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Rutten B, Maseri A, Cianflone D, Laricchia A, Cristell NA, Durante A, Spartera M, Ancona F, Limite L, Hu D, Li H, Uren NG, de Groot PG, Mannucci PM, Roest M. Plasma levels of active Von Willebrand factor are increased in patients with first ST-segment elevation myocardial infarction: a multicenter and multiethnic study. Eur Heart J Acute Cardiovasc Care 2014; 4:64-74. [PMID: 24833640 DOI: 10.1177/2048872614534388] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Von Willebrand factor (VWF), a key player in hemostasis and thrombosis, is released from endothelial cells during inflammation. Upon release, VWF is processed by ADAMTS13 into an inactive conformation. The aim of our study was to investigate whether plasma levels of active VWF, total VWF, ADAMTS13, osteoprotegerin (OPG) and the ratios between VWF and ADAMTS13 are risk factors for first ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS We assessed 1026 patients with confirmed first STEMI and 652 control subjects from China, Italy and Scotland, within six hours after their cardiovascular event. Median plasma levels of total VWF, active VWF, OPG and ratios VWF/ADAMTS13 were increased, while plasma levels of ADAMTS13 were decreased in patients compared to controls. The odds ratio (OR) of STEMI in patients with high plasma levels of active VWF was 2.3 (interquartile range (IQR): 1.8-2.9), total VWF was 1.8 (1.4-2.3), ADAMTS13 was 0.6 (05-0.8), OPG was 1.6 (1.2-2.0) and high VWF/ADAMTS13 ratios was 1.5 (1.2-2.0). The OR for total VWF, active VWF and ratios VWF/ADAMTS13 remained significant after adjustment for established risk factors, medical treatment, C-reactive protein, total VWF, ADAMTS13 and OPG. When we adjusted for levels of active VWF, the significance of the OR for VWF and ratios VWF/ADAMTS13 disappeared while the OR for active VWF remained significant. CONCLUSIONS We found evidence that plasma levels of active VWF are an independent risk factor for first STEMI in patients from three different ethnic groups. Our findings confirm the presence of VWF abnormalities in patients with STEMI and may be used to develop new therapeutic approaches.
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Affiliation(s)
- B Rutten
- Laboratory of Clinical Chemistry and Haematology, University Medical Center Utrecht, The Netherlands
| | - A Maseri
- Heart Care Foundation, Florence, Italy
| | - D Cianflone
- Clinical Cardiovascular Biology Centre, Universita Vita-Salute San Raffaele, Italy
| | - A Laricchia
- Clinical Cardiovascular Biology Centre, Universita Vita-Salute San Raffaele, Italy
| | - N A Cristell
- Clinical Cardiovascular Biology Centre, Universita Vita-Salute San Raffaele, Italy
| | - A Durante
- Clinical Cardiovascular Biology Centre, Universita Vita-Salute San Raffaele, Italy
| | - M Spartera
- Clinical Cardiovascular Biology Centre, Universita Vita-Salute San Raffaele, Italy
| | - F Ancona
- Clinical Cardiovascular Biology Centre, Universita Vita-Salute San Raffaele, Italy
| | - L Limite
- Clinical Cardiovascular Biology Centre, Universita Vita-Salute San Raffaele, Italy
| | - D Hu
- The Heart Center, People's Hospital of Peking University, China
| | - H Li
- The Heart Center, People's Hospital of Peking University, China
| | - N G Uren
- Department of Cardiology, Royal Infirmary of Edinburgh, UK
| | - P G de Groot
- Laboratory of Clinical Chemistry and Haematology, University Medical Center Utrecht, The Netherlands
| | - P M Mannucci
- A Bianchi Bonomi Hemophilia and Thrombosis Center, Ospedale Maggiore Policlinico, Italy
| | - M Roest
- Laboratory of Clinical Chemistry and Haematology, University Medical Center Utrecht, The Netherlands
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Godino C, Pavon AG, Mangieri A, Viani GM, Galaverna S, Spartera M, Chieffo A, Cappelletti A, Margonato A, Colombo A. PlaCor PRT measurement of shear-activated platelet aggregate formation in stable patients treated with single and dual antiplatelet therapy. Platelets 2013; 25:337-42. [PMID: 23971989 DOI: 10.3109/09537104.2013.825710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Shear forces play a key role in thrombus formation and shear-based tests may better reflect physiological conditions in vivo compared with agonist-based tests. We evaluated the PlaCor PRT®, a novel platelet reactivity test based on shear-induced platelet aggregation, in patients with stable coronary artery disease (CAD) treated with single (SAPT) and dual antiplatelet therapy (DAPT). We examined 100 patients with multiple risk factors for CAD and/or documented stable CAD: 38 treated with SAPT, aspirin 100 mg qd, 62 treated with DAPT, aspirin 100 mg + clopidogrel 75 mg qd, compared with age- and sex-matched healthy volunteers without antiplatelet therapy (HV, n = 35). Measures of shear-induced platelet aggregation were performed with the PlaCor PRT®. In 25 patients in SAPT, the PlaCor test was also performed before and after a 12-hour-loading dose of clopidogrel 600 mg. The mean ± SD PRT time (seconds) in HV was 78 ± 13 and was significantly lower compared with SAPT (118 ± 16, p = 0.030) and to DAPT patients (242 ± 11, p < 0.0001). A statistically significant difference was also reported between SAPT and DAPT patients (p < 0.0001). After a loading dose of clopidogrel, the PRT time of SAPT patients increased significantly from 112 ± 20 to 254 ± 17, p < 0.0001. 2.7 and 26% of patients were considered as "poor responders" to single and dual antiplatelet therapy, respectively. This study shows that in patients with multiple risk factors for CAD and/or documented stable CAD, SAPT and DAPT play an important role in reducing platelet aggregation mediated by shear forces as evaluated with the novel PlaCor PRT®. Further studies will be required to confirm and assess the extent of these findings in patients with acute coronary syndromes.
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Affiliation(s)
- Cosmo Godino
- Cardio-Thoracic-Vascular Department, San Raffaele Institute , Milan , Italy
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Durante A, Peretto G, Laricchia A, Ancona F, Spartera M, Mangieri A, Cianflone D. Role of the Renin-Angiotensin-Aldosterone System in the Pathogenesis of Atherosclerosis. Curr Pharm Des 2012; 18:981-1004. [DOI: 10.2174/138161212799436467] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 12/13/2011] [Indexed: 11/22/2022]
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