6 results on '"Mota Carmo, M"'
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2. Rapid Fire Abstract session: usefulness of CT and radionuclide imaging in different clinical scenarios
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Lagan, J, Meah, M, Hasleton, J, Mcshane, J, Trent, R, Rio, P, Abreu, A, Santos, V, Santa-Clara, H, Oliveira, L, Martins Oliveira, M, Silva Cunha, P, Moura Branco, L, Mota Carmo, M, Cruz Ferreira, R, Barone-Rochette, G, Zoreka, FZ, Calizzano, A, Vautrin, E, Quesada, JL, Broisat, A, Riou, L, Baguet, JP, Fagret, D, Ghezzi, C, Limeres Freire, J, Rodriguez, J, Oristrell, G, Quiroga, X, Pizzi, N, Perez-Rodon, J, Galve, E, Aguade, S, Abreu, A, Santa Clara, H, Santos, V, Oliveira, L, Oliveira, M, Rio, P, Cunha, P, Portugal, G, Ferreira, R, Mota Carmo, M, BETTER-HF, Clerc, O F, Kaufmann, B P, Possner, M, Liga, R, Vontobel, J, Mikulicic, F, Graeni, C, Benz, D C, Kaufmann, P A, Buechel, R R, Iriart, X, Selmi, W, Jalal, Z, Thambo, JB, Van Den Hoven, AT, Saru-Chelu, RG, Duijnhouwer, AL, Van Hagen, IM, and Roos-Hesselink, JW
- Abstract
Purpose: The National Institute for Health and Care Excellence (NICE) and the European Society of Cardiology (ESC) support the use of different cardiac imaging modalities in patients with suspected ischaemic heart disease (IHD). The cost of single photon emission computed tomography (SPECT) and invasive coronary angiography (ICA) in UK is estimated at £293 and £1052 respectively. Following positive SPECT, a large number of patients at our institution progressed to ICA which did not confirm significant coronary artery disease. As a result, a new SPECT scanner was acquired with ECG gating and in-built CT to correct for diaphragm / breast attenuation. Methods: We calculated cumulative cost of SPECT +/- ICA per patient before and after the scanner change. We screened patients with fixed / no defects on SPECT for acute coronary syndromes and cardiac related deaths in one year after the scan. Results: See Table 1. The new scanner detected significantly more fixed perfusion defects (p=0.0007, Fisher's exact test) and less reversible defects necessitating progression to ICA (p=0.001, Chi-square test). The cost of SPECT +/- ICA per patient was £713.8 in the old scanner group (£57,104 in total) and £468.3 in the new scanner group (£44,460 in total). Patients with normal SPECT or fixed defects did not have cardiac related deaths or acute coronary syndromes during following 12 months. Conclusions: The new scanner allowed for significant cost savings in our institution reducing the cost of SPECT +/- ICA from £713.8 to £468.3 per patient without compromising patients' safety. This is crucial in current climate of financial austerity. Our study was limited by the small number of patients and by the fact that many patients with reversible ischaemia were not referred for ICA due to different reasons: minor symptoms / ischaemia on SPECT (n=15), patients not attending follow up (n=3), non cardiac death (n=1), other imaging modalities chosen (n=2).
Old Scanner New Scanner Number of SPECT 80 96 Reversible defect on SPECT 42 (52.5%) 27 (28.1%) Fixed defect on SPECT 3 (3.75%) 20 (20.8%) Number of ICA 32 (40%) 16 (16.7%) Cost of SPECT +/- ICA per patient £713.8 £468.3 SPECT/ICA results - Published
- 2015
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3. Poster session 2
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Martins Fernandes, S, Teixeira, R, Roussin, I, Lynch, M, Badano, L, Muraru, D, Romeo, G, Ermacora, D, Marotta, C, Aruta, P, Cucchini, U, Iliceto, S, Garcia Campos, A, Martin-Fernandez, M, De La Hera Galarza, JM, Corros-Vicente, C, Colunga Blanco, S, Velasco-Alonso, E, Leon-Aguero, V, Rodriguez-Suarez, ML, Moris De La Tassa, C, Erdei, T, Edwards, J, Braim, D, Price, C, Fraser, AG, Cardiff, Investigators, MEDIA, Mehdipoor, G, Salmani, F, Arjmand Shabestari, A, Hanboly, N, Michalski, BW, Szymczyk, E, Kupczynska, K, Peczek, L, Nawrot, B, Lipiec, P, Kasprzak, JD, Vriz, O, Driussi, C, Ferrara, F, Brosolo, G, Antonini-Canterin, F, Magne, J, Aboyans, V, Bossone, E, Mo, VY, Bellucci, BM, Fisher, JM, Balekian, AA, Le, T T, Idapalapati, S, Huang, F, Wong, JI, Tan, RS, Ribeiro, JM, Teixeira, R, Madeira, M, Almeida, I, Reis, L, Siserman, A, Dinis, P, Dias, L, Ramos, AP, Goncalves, L, Ternacle, J, Wan, FW, Sawaki, DS, Dubois-Rande, JLDR, Adnot, SA, Czibik, GC, Derumeaux, GD, Yurdakul, SELEN, Ercan, G, Tekkesin, ILKER, Sahin, ST, Cengiz, B, Celik, G, Demircan, S, Aytekin, SAIDE, Shetye, A, Razvi, NA, Nazir, SA, Price, N, Khan, JN, Kanagala, P, Singh, A, Squire, I, Mccann, GP, Stoebe, S, Langel, M, Pfeiffer, D, Hagendorff, A, Lisowska, A, Ptaszynska-Kopczynska, K, Marcinkiewicz-Siemion, M, Knapp, M, Witkowski, M, Musial, WJ, Kaminski, K, Chinali, M, Natali, B, D' Anna, C, Leonardi, B, Secinaro, A, Pongiglione, G, Rinelli, G, Orabona, M, Renard, S, Michel, N, Mancini, J, Haentjens, J, Sitbon, O, Habib, G, Contaldi, C, Imbriaco, M, Alcidi, G, Santoro, C, Buonauro, A, Lo Iudice, F, Lembo, M, Cuocolo, A, Trimarco, B, Galderisi, M, De La Chica, JA, Mora Robles, J, Roldan Jimenez, MA, Mancisidor, MA, De Mora, MA, Codolosa, JN, Alnabelsi, T, Goykhman, I, Koshkelashvili, N, Romero-Corral, A, Pressman, GS, Trzcinski, P, Michalski, BW, Kupczynska, K, Miskowiec, D, Lipiec, P, Kasprzak, JD, Prado Diaz, S, Montoro Lopez, N, Refoyo Salicio, E, Valbuena Lopez, SC, Gonzalez, O, Alvarez, C, Moreno Yanguela, M, Bartha Rasero, JL, De La Calle, M, Guzman Martinez, G, Morales Portano, J D, Suarez-Cuenca, JA, Merino, JA, Gomez Alvarez, E B, Delgado, LG, Ha, SJ, Woo, YM, Bang, WD, Sohn, GH, Cheong, SS, Yoo, SY, Valente, F, Rodriguez Palomares, JF, Gutierrez, L, Maldonado, G, Pineda, V, Galian, L, Teixido, G, Gonzalez Allujas, MT, Evangelista, A, Garcia Dorado, D, Joseph, G, Zaremba, T, Ekeloef, S, Heiberg, E, Engblom, H, Jensen, SE, Sogaard, P, Valente, F, Rodriguez Palomares, JF, Gutierrez, L, Garcia, G, Pineda, V, Galian, L, Teixido, G, Gonzalez Allujas, MT, Evangelista, A, Garcia Dorado, D, Scali, MC, Dini, FL, Galli, F, Lattanzi, F, Picano, E, Marzilli, M, Cordeiro, F, Leao, S, Moz, M, Magalhaes, P, Trigo, J, Mateus, PS, Ferreira, A, Moreira, JI, Duchateau, N, De Craene, M, Legallois, D, Labombarda, F, Pellissier, A, Sermesant, M, Saloux, E, Fabris, E, Merlo, M, Moretti, M, Barbati, G, Stolfo, D, Gigli, M, Pinamonti, B, Sinagra, G, Costantino, MF, Dores, E, Matera, A, Innelli, P, Innelli, P, Lopizzo, A, Violini, R, Fiorilli, R, Cappabianca, G, Picano, E, Tarsia, G, Cho, I J, Seo, J, Chang, HJ, Heo, R, Kim, IC, Shim, CY, Hong, GR, Chung, N, Goublaire, C, Melissopoulou, MM, Nguyen, V, Brochet, E, Cimadevilla, C, Codogno, I, Vahanian, A, Messika-Zeitoun, D, Lam, W, Pontana, F, Vassiliou, V, Prasad, S, Galli, E, Leclercq, C, Samset, E, Donal, E, Kim, KH, Lim, DS, Mariani, M, Bianchi, G, Rossi, F, Gianetti, J, Marchi, F, Cerone, E, Nardelli, A, Terrazzi, M, Solinas, M, Maffei, S, Malev, E, Pshepiy, A, Vasina, L, Timofeev, E, Reeva, S, Zemtsovsky, E, Zuercher, F, Brugger, N, Jahren, S, De Marchi, SF, Seiler, C, Tang, Z, Jin, CN, Tang, H, Fan, K, Kam, K, Yan, BP, Yu, CM, Lee, PW, Cimino, S, Reali, M, Silvetti, E, Salatino, T, Mancone, M, Pennacchi, M, Giordano, A, Sardella, G, Agati, L, Mahia, P, Tirado, G, Nogales-Romo, MT, Marcos-Alberca, P, De Agustin, A, Almeria, C, Rodrigo, JL, Garcia Fernandez, MA, Macaya, C, Perez De Isla, L, De La Chica, JA, Mancisidor, M, Lara Garcia, C, Vivancos, R, De Mora, M, Petrovic, J, Petrovic, M, Vujisic-Tesic, B, Trifunovic, D, Boricic-Kostic, M, Petrovic, I, Draganic, G, Petrovic, O, Tomic-Dragovic, M, Ciobotaru, V, Remsey- Semmelweiss, E, Kogoj, P, Furlan, T, Ambrozic, J, Mohorko Pleskovic, PN, Bunc, M, Guerreiro, S, Ribeiras, R, Abecasis, J, Andrade, MJ, Mendes, M, Saxena, A, Ramakrishnan, S, Gupta, SK, Juneja, R, Kothari, SS, Mozenska, O, Zaleska, M, Segiet, A, Chwesiuk, S, Kroc, A, Kosior, DA, Pontone, G, Andreini, D, Solbiati, A, Guglielmo, M, Mushtaq, S, Baggiano, A, Beltrama, V, Rota, C, Guaricci, AI, Pepi, M, Macaya Ten, F, Pons Llinares, J, Asmarats Serra, L, Pericas Ramis, P, Caldes Llull, O, Grau Sepulveda, A, Frontera, G, Vaquer Segui, A, Noris, M, Bethencourt Gonzalez, A, Caballero, L, Climent Paya, V, Martinez Moreno, M, Saura, D, Oliva, MJ, Sanchez Quinones, J, Garcia Honrubia, A, Valdes, M, De La Morena, G, Avegliano, G, Terricabras, M, Costabel, JP, Ronderos, R, Evangelista, A, Venturini, C, Galve, E, Halmai, L, Nemes, A, Neubauer, S, Rahman Haley, S, Banner, N, Reis, L, Teixeira, R, Caetano, F, Almeida, I, Trigo, J, Botelho, A, Silva, J, Nascimento, J, Goncalves, L, Trifunovic, D, Tesic, M, Jovanovic, I, Petrovic, O, Boricic-Kostic, M, Dragovic, M, Petrovic, M, Stepanovic, J, Banovic, M, Vujisic-Tesic, B, Gospodinova, M, Guergelcheva, V, Chamova, T, Sarafov, S, Tournev, I, Denchev, S, Makavos, G, Ikonomidis, I, Psarogiannakopoulos, P, Tsirigotis, P, Paraskevaidis, I, Lekakis, J, D'ascenzi, F, Pelliccia, A, Natali, BM, Cameli, M, Focardi, M, Bonifazi, M, Mondillo, S, Dantas Tavares De Melo, M, Lima, C, Assed, L, Kalil Filho, R, Mady, C, Bochi, E A, Salemi, V M C, Bonapace, S, Targher, G, Valbusa, F, Rossi, A, Lanzoni, L, Lipari, P, Zenari, L, Molon, G, Canali, G, Barbieri, E, Kulkarni, A, Li, L, Craft, M, Nanda, M, Lorenzo, JM, Kutty, S, Cameli, M, Bombardini, T, Sparla, S, Di Tommaso, C, Losito, M, Incampo, E, Maccherini, M, Mondillo, S, Ingvarsson, A, Werther Evaldsson, A, Radegran, G, Stagmo, M, Waktare, J, Roijer, A, Meurling, CJ, Driessen, MMP, Hui, W, Meijboom, FJ, Bijnens, B, Dragulescu, A, Mertens, L, Friedberg, MK, Tufekcioglu, O, Sensoy, B, Suleymanoglu, M, Akin, Y, Sahan, E, Sasmaz, H, Radulescu, D, Pasca, L, Buzdugan, E, Chis, B, Stoicescu, L, Barac, A, Lynce, FC, Smith, KL, Mete, M, Isaacs, C, Cioffi, G, Viapiana, O, Di Nora, C, Ognibeni, F, Fracassi, E, Giollo, A, Mazzone, C, Faganello, G, Di Lenarda, A, Rossini, M, Almeida Morais, L, Galrinho, A, Branco, L, Timoteo, A T, Rodrigues, I, Daniel, P, Rosa, S, Ferreira, L, Ferreira, R, Ledakowicz-Polak, A, Polak, L, Krauza, G, Stokfisz, K, Zielinska, M, Portugal, G, Branco, L M, Galrinho, A, Mota Carmo, M, Teresa Timoteo, A, Aguiar Rosa, S, Abreu, J, Pinto Teixeira, P, Viveiros Monteiro, A, Cruz Ferreira, R, Naksuk, N, Peeraphatdit, T, Chaiteerakij, R, Klarich, KW, Parato, V M, Masia, S, Kovalova, S, Necas, J, Cherubini, A, Nistri, S, Negri, F, Barbati, G, Cioffi, G, Russo, G, Mazzone, C, Faganello, G, Pandullo, C, Di Lenarda, A, Corrado, G, Durante, A, Rovelli, E, Genchi, V, Trabattoni, L, Zerboni, SC, Cattaneo, L, Butti, E, Ferrari, G, Malev, E, Luneva, E, Mitrofanova, L, Uspensky, V, Zemtsovsky, E, Wierzbowska-Drabik, K, Kasprzak, JD, Lesevic, H, Rosner, S, Karl, M, Ott, I, Sonne, C, Laredj, N, Ali Lahmar, HM, Hammou, L, Pieles, G E, Forsey, J, Gowing, L, Miller, F, Ramanujam, P, Stuart, AG, Williams, CA, Generati, G, Bandera, F, Pellegrino, M, Carbone, F, Labate, V, Alfonzetti, E, Guazzi, M, Van Zalen, JJ, Patel, NR, Raju, P, Beale, L, Brickley, G, Lloyd, GW, Aquila, I, Fernandez-Golfin, C, Gonzalez, A, Rincon, LM, Hinojar, R, Garcia, A, Megias, A, Jimenez-Nacher, JJ, Moya, JL, Zamorano, JL, Cheng, H-L, Lanzoni, L, Molon, G, Canali, G, Bonapace, S, Chiampan, A, Albrigi, L, Barbieri, E, Asmarats Serra, L, Noris Mora, M, Rodriguez Fernandez, A, Exposito Pineda, C, Grande, C, Gonzalez Colino, R, Macaya Ten, F, Fernandez Vazquez, X, Fortuny Frau, E, Bethencourt Gonzalez, A, Kadrabulatova, S, Ranjbar, S, Karvandi, M, Szczesniak-Stanczyk, D, Blaszczyk, R, Zarczuk, R, Brzozowski, W, Janowski, M, Wysokinski, A, Stanczyk, B, Consortium, ReMeDi, Sharka, I, Myftiu, S, Teferici, D, Quka, A, Dado, E, Djamandi, J, Kresto, L, Duka, A, Kristo, A, Balla, I, Di Salvo, G, Issa, Z, Moiduddin, N, Siblini, G, Bulbul, Z, Ben Kahla, S, Abid, L, Abid, D, Kammoun, S, Li, L, Rush, E, Craft, M, Goodwin, J, Kreikemeier, R, Cantinotti, M, Kutty, S, Hadeed, HA, Zolaly, M A, Khoshhal, SQ, El-Harbi, K, Tarawah, A, Al-Hawsawi, Z, Al-Mozainy, I, Habeeb, H A, Bakhoum, S W G, Nabil, M N, Elebrashy, I N, Toscano, A, Chinali, M, Albanese, S, Carotti, A, Iacobelli, R, Esposito, C, Secinaro, A, Moscogiuri, G, Pasquini, L, Granata, F, Malvezzi Caracciolo, M, Bianchi, RM, Caso, P, Arenga, F, Riegler, L, Scarafile, R, D'andrea, A, Russo, MG, Calabro', P, Djikic, D, Simic, DS, Peric, VP, Mujovic, NM, Marinkovic, MM, Jankovic, NJ, Wdowiak-Okrojek, K, Shim, A, Wejner-Mik, P, Kasprzak, JD, Lipiec, P, Girgis, H Y A, Sharma, A, Jain, N, Kharwar, R, Saran, RK, Narain, VS, Dwivedi, SK, Sethi, R, Chandra, S, Pradhan, A, Safal, S, Soro, C, Marchetti, MF, Cacace, C, Congia, M, Nissardi, V, Ruscazio, M, Meloni, L, Montisci, R, Gallego Page, J C, Gallego Sanchez, G, Calero, S, Portero, JJ, Tercero, A, Garcia, JC, Barambio, M, Martinez Lazaro, R, Corneli, M, Meretta, AH, Perea, GO, Belcastro, F, Aguirre, E, De Luca, I, Henquin, R, and Masoli, O
- Abstract
Introduction: The relationship between the appropriateness of the transthoracic echocardiography (TTE) and its clinical impact is still a matter of debate. Objective: The aim of this study was to assess the degree of adherence to the appropriate use criteria for echocardiography, in a tertiary public hospital in the United Kingdom, as well as the clinical impact of the exam on patient management. Methods: 859 TTE’s performed consecutively during January 2014 were reviewed to assess its appropriateness, and were classified as appropriate, uncertain or inappropriate using the 2011 guidelines. Subsequently, patient’s files were examined to determine the clinical impact of the TTE which was assigned to one of the following three categories: (1) active change in care, (2) continuation of current care, or (3) no change in care. Patients which files were not available were excluded (259). All classifications were evaluated by two independent cardiologists, with no direct relation to the study. Results: Our sample had a mean age of 63 ± 17 years with a gender balance. The majority of the exams were requested at the outpatient (81.4%) clinic, by cardiologists (50.3%) and general practitioners (13.4%). Regarding the main findings, in 7.6% of the studies there were moderate to severe systolic dysfunction; 4.0% showed severe valvular heart disease and 5.1% had significant pulmonary hypertension. Relatively to the appropriateness of the TTE requests, 76.5% were considered appropriate, 7.1% inappropriate and 12.6% uncertain. With respect to the clinical impact of the TTE’s, 42.7% of the exams led to an active change in care, 15.6% to a continuation of the care and 11.5% revealed no change in care. Age (β0.90, P=0.05) and outpatient setting (β4.4, P<0.01) were the most important predictors of an active change of care exam. On the contrary, the appropriateness of the TTE’s requests (β1.1, P=0.56) and the specialist ordering the exams (β0.81, P=0.26) were not independently associated. Conclusion: Our data showed that almost 8 out of 10 TTE were considered appropriate, and 4 out of 10 exams had an active clinical impact.
- Published
- 2015
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4. Poster session 1
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Haberka, M, Banska, K, Gasior, Z, Garcia Martin, A, Moya-Mur, JL, Carbonell-San Roman, S-A, Rodriguez-Munoz, D, Garcia-Lledo, A, Casas-Rojo, E, Hinojar, R, Jimenez-Nacher, JJ, Fernandez-Golfin, C, Zamorano-Gomez, JL, Barbier, P, Ravani, A, Cefalu, C, Maltagliati, A, Frigerio, B, Sansaro, D, Amato, M, Baldassarre, D, Pellegrino, M, Bandera, F, Generati, G, Labate, V, Alfonzetti, E, Guazzi, M, Angelis, A, Aggeli, K, Ioakeimidis, N, Abdelrasoul, M, Felekos, I, Gourgouli, I, Aznaouridis, K, Rousakis, G, Vlachopoulos, C, Tousoulis, D, Howlett, PJ, Darasz, K, Mahmoudi, M, Shah, N, Jabr, RI, Hickman, M, Leatham, EW, Fry, CH, PREDICT-PAF, Madeira, M, Teixeira, R, Almeida, I, Caetano, F, Fernandes, A, Cassandra, M, Reis, L, Costa, M, Goncalves, L, Carrero, PJ, Nielsen, AJ, Carrero, MC, Saubidet, GL, Peralta, SP, Argentina, Aorta Abdominal, Hansen, KL, Moeller-Soerensen, H, Kjaergaard, J, Jensen, MB, Lund, JT, Pedersen, MM, Olesen, JB, Jensen, JA, Nielsen, MB, Trunina, I, Sharykin, AS, Karelina, EV, Telezhnikova, ND, Basar, C, Ozhan, H, Kayapinar, O, Albayrak, ES, Lie, OH, Saberniak, J, Dejgaard, L, Nestaas, E, Edvardsen, T, Haugaa, KH, Sade, LE, Bal, U, Eroglu, S, Pirat, B, Muderrisoglu, H, Gopal, A S, Muthukumar, L, Saha, SK, Toole, RS, Klug, G, Reinstadler, S, Feistritzer, HJ, Pernter, B, Mayr, A, Franz, WM, Mueller, S, Metzler, B, Rodriguez Gonzalez, E, Mingo Santos, S, Palomero Monivas, V, Gonzalez Mirelis, J, Goirigolzarri Artaza, J, Zorita Gil, B, Fernandez Diaz, JA, Goicolea Ruigomez, J, Restrepo Cordoba, MA, Alonso Pulpon, L, Ferrara, F, Gargani, L, D'alto, M, Ghio, S, Acri, E, Carannante, L, Argiento, P, D'andrea, A, Vriz, O, Bossone, E, Moustafa, S, Ho, TH, Shah, P, Murphy, K, Nelluri, BK, Lee, H, Wilansky, S, Mookadam, F, Naksuk, N, Peeraphatdit, T, Chaiteerakij, R, Klarich, KW, Cantinotti, M, Scalese, M, Melo, M, Assanta, N, Marotta, M, Crocetti, M, Spadoni, I, Giordano, R, Kutty, S, Iervasi, I, Michelsen, MM, Mygind, ND, Pena, A, Frestad, D, Hoest, N, Prescott, E, Fernandes, JMG, Romao, BO, Rivera, IR, Mendonca, MA, Carvalho, AC, Campos, O, Amato, A, Moises, VA, Demir, OM, Bashir, A, Marshall, K, Douglas, M, Wasan, B, Plein, S, Alfakih, K, Cano Carrizal, R, Casanova Rodriguez, C, Cadenas Chamorro, R, Iglesias Del Valle, D, Martin-Penato Molina, A, De Juan Baguda, J, Prieto Moriche, E, Garcia Garcia, A, De La Cruz Berlanga, E, Plaza Perez, I, Bouzas-Mosquera, A, Peteiro, J, Broullon, FJ, Alvarez-Garcia, N, Barbeito-Caamano, C, Larranaga-Moreira, JM, Maneiro-Melon, N, Martinez-Ruiz, D, Yanez, JC, Vazquez-Rodriguez, JM, Leao, S, Cordeiro, F, Magalhaes, P, Moz, M, Trigo, J, Mateus, P, Fontes, P, Moreira, I, Kuznetsov, VA, Krinochkin, DV, Plusnin, AV, Soldatova, AM, Nazir, S A, Shetye, A, Khan, JN, Singh, A, Kanagala, P, Swarbrick, DJ, Graham-Brown, M, Mccann, GP, Trifunovic, D, Krljanac, G, Savic, L, Asanin, M, Aleksandric, S, Lasica, R, Srdic, M, Zlatic, N, Petrovic, M, Mrdovic, I, Rodriguez Gonzalez, E, Mingo Santos, S, Monivas Palomero, V, Gonzalez Mirelis, J, Zorita Gil, B, Fernandez Diaz, JA, Restrepo Cordoba, MA, Goirigolzarri Artaza, J, Rivero Arribas, B, Goicolea Ruigomez, J, Spampinato, RA, Dobrovie, M, Da Rocha E Silva, JG, Bonamigo Thome, F, Kluttig, R, Schloma, V, Dmitrieva, Y, Strotdrees, E, Mohr, FW, Antonini-Canterin, F, Luzza, G, Caruso, R, Belfiore, R, Della Mattia, A, Poli, S, Vriz, O, Zito, C, La Carrubba, S, Carerj, S, Ribeiro, JM, Teixeira, R, Goncalves, L, Morgado, GJ, Carvalho, JF, Gomes, AC, Caldeira, D, Cruz, IR, Stuart, B, Maia, R, Fazendas, P, Pereira, H, Trifunovic, D, Rakocevic, I, Tutos, V, Petrovic, O, Petrovic, M, Boricic-Kostic, M, Stepanovic, J, Jovanovic, I, Banovic, M, Vujisic-Tesic, B, Reis, L, Teixeira, R, Leite, L, Fernandes, A, Cassandra, M, Madeira, M, Botelho, A, Santos, M, Nascimento, J, Goncalves, L, Naratrekoon, B, Yingchoncharoen, T, Vathesatogkit, P, Yamwong, S, Sritara, P, Soto-Ruiz, RM, Bonaque Gonzalez, J C, Abellan-Huerta, J, Rubio-Paton, R, Soria, F, Ramos, JL, Egea, S, Garcia-Gomez, J, Martinez Diaz, JJ, Castillo, JA, Penicka, M, Vecera, J, Mirica, C, Kotrc, M, Kockova, R, Zilberszac, R, Gabriel, H, Maurer, G, Rosenhek, R, De Chiara, B, Botta, L, Musca, F, Belli, O, Costetti, A, Trolese, I, Spano, F, Russo, C, Giannattasio, C, Moreo, A, Rifai, R, Berthelot, E, Le, MT, Hilpert, L, Montani, D, Sitbon, O, Jais, X, Humbert, M, Assayag, P, Gunduz, S, Yesin, M, Kalcik, M, Gursoy, MO, Cersit, S, Astarcioglu, MA, Karakoyun, S, Aykan, AC, Ozkan, M, Cersit, S, Gunduz, S, Tabakci, M, Kalcik, M, Yesin, M, Bayam, E, Ozkan, M, Devecchi, C, Degiovanni, A, Di Ruocco, MV, Marino, P, Ancona, F, Rosa, I, Stella, S, Barletta, M, Marini, C, Latib, A, Montorfano, M, Colombo, A, Margonato, A, Agricola, E, Smith, D, Ray, R, Gallagher, M, Nazir, M, Perreso, V, Sharma, R, Gargani, L, Pang, PS, Miglioranza, M, Landi, P, Dini, FL, Picano, E, Asmarats Serra, L, Pons Llinares, J, Macaya Ten, F, Pericas Ramis, P, Caldes Llull, O, Grau Sepulveda, A, Frontera, G, Bethencourt, A, 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Fernandez-Golfin, C, Zamorano Gomez, JL, Hoetink, A, Jansen Klomp, WW, Van 'T Hof, AWJ, Brandon Bravo Bruinsma, GJ, Spanjersberg, AJ, Grandjean, J, Nierich, AP, Ferreira, R, Ferreira, J, Lazaro Mendes, S, Martins, R, Monteiro, S, Pego, M, Rohani, A, Khamene Bagheri, R, Wierzbowska-Drabik, K, Peruga, JZ, Sobczak, M, Plewka, M, Wcislo, T, Krecki, R, Kasprzak, JD, Carvalho, J F, Morgado, G, Cruz, I, Caldeira, D, Almeida, AR, Joao, I, Lopes, L, Fazendas, P, Cotrim, C, Pereira, H, Cherubini, A, Cioffi, G, Mazzone, C, Faganello, G, Pandullo, C, Russo, G, Stefenelli, C, Furlanello, F, Tarantini, L, Di Lenarda, A, Teramoto, K, Suzuki, K, Satoh, Y, Minami, K, Mizukoshi, K, Kamijima, R, Kou, S, Takai, M, Izumo, M, Akashi, YJ, May, CJH, Ayuk, J, Geh, I, Shah, T, Edwards, NC, Steeds, RP, Wejner-Mik, P, Sobczak, M, Miskowiec, D, Wdowiak-Okrojek, K, Kasprzak, JD, Lipiec, P, Gurzun, M M, Rosca, M, Calin, A, Beladan, C, Serban, M, Ginghina, C, Popescu, BA, Perea, GO, Lombardero, M, Henquin, R, Corneli, M, Tinetti, M, Laveau, F, Hekimian, G, Achkar, M, Isnard, R, Combes, A, Hammoudi, N, Mahmoud, HM, Al-Ghamdi, M, Ghabashi, A, Ezzat, M H, Al-Amin, A, Sanz, M, Giraldeau, G, Sarvari, SI, Marin, J, Brambila, C, Gabrielli, L, Bijnens, B, Sitges, M, Sanchez-Martinez, S, Duchateau, N, Erdei, T, Fraser, A, Bijnens, B H, Piella, G, Montserrat, S, Sanchis, L, Borras, R, Vidal, B, Prat, S, Azqueta, M, Pare, C, Grazioli, G, Sanz, M, Sitges, M, Kowalczyk, E, Kasprzak, JD, Wejner-Mik, P, Wdowiak-Okrojek, K, Lipiec, P, Park, CS, Jung, MH, Ahn, HS, Kim, JH, Cho, JS, Jeon, HK, Youn, HJ, Hinojar, R, Fernandez-Golfin, C, Megias, A, Alonso, GL, Gonzalez-Gomez, A, Rincon, LM, Esteban, A, Fernandez Mendez, MA, Barrios, V, Zamorano, JL, Van Berendoncks, A M, Van Gaal, L, De Block, C, Salgado, R, Vrints, C, Shivalkar, B, Guedes, H, Pereira, A, Santos, R, Marques, L, Moreno, N, Carvalho, R, Pires, M, Sousa, R, Andrade, A, Pinto, P, Nestaas, E, Stoylen, A, Fugelseth, D, Onut, R, Tautu, O, Onciul, S, Marinescu, C, Zamfir, D, Dorobantu, M, Moran, L, Sanchez Sanchez, V, Navas, P, Garcia-Cosio, D, Diaz, B, Carballo-Alzola, L, Lombera, F, Delgado, J, Kisko, A, Babcak, M, Kishko, N, Agmon, Y, Eitan, A, Mutlak, D, Kehat, I, Corneli, M, Meretta, AH, Perea, GO, Belcastro, F, Aguirre, E, Rosa, D, Zaefferer, P, Masoli, O, Peovska Mitevska, IPM, Srbinovska, ES, Bosevski, MB, Antova, EA, Pop Gorceva, DPG, Barreiro Perez, M, Martin Fernandez, M, Costilla Garcia, SM, Diaz Pelaez, E, and Moris De La Tassa, C
- Abstract
Background: The attainment of the primary (low density lipoprotein cholesterol; LDL-C) and the secondary (non-high density lipoprotein cholesterol; non-HDL) lipid therapeutic targets may depend on several potential factors. Our aim was assess the associations between ultrasound fat indexes, lipid levels and the lipid goals attainment in high and very high cardiovascular (CV) risk patients. Methods: Four hundred twenty (n=420) patients (F/M=146/274; age=61 ± 7 y.o.) with high (43%) or very high (57%) cardiovascular risk and chronic statin treatment (³12 months) were enrolled into the study. Obesity measures (body-mass index, BMI; bioelectrical impedance body fat; BF, waist circumference, WC, body adiposity index; BAI), serum levels of lipids (total cholesterol–TC, LDL-C, HDL-C and triglycerides–TG) and goal lipid levels (LDL-C and non-HDL-C) according to the CV risk were determined in all patients. The following ultrasound fat parameters were used in the study: intraabdominal fat (IAT), preperitoneal fat thickness (PreFT), epicardial (EFT) and pericardial (PFT) fat thickness and were indexed to BMI. Results: Our study patients had 5.2 ± 1.7 CV risk factors (80% hypertension, 32% diabetes, 59% metabolic syndrome), 49% were obese, 63% had high BF% and 85% had increased waist circumference (F>80 or M>94cm). All the patients were on a long-term statin treatment (rosuvastatin, atorvastatin or simvastatin). The attainment of the target lipid levels in the study group was as follows: LDL-C–34%, non-HDL-C–39%, both LDL-C and non-HDL-C 31%. Mean fat parameters in the study group were as follows: IAT–76.4 ± 26mm, PreFT–23.3 ± 6.5mm, EFT–3.5 ± 1.5mm and PFT–8.6 ± 3.8mm. Patients with LDL-C goal attainment had significantly higher BAI (34.6 ± 33 vs 30.5 ± 7, p=0.04), but significantly lower IAT/BMI (2.35 ± 0.7 vs 2.51 ± 0.7, p<0.05) with no differences in other clinical (BMI, BF%, WC) and ultrasound (PreFT/BMI, EFT/BMI, PFT/BMI) indexes. The LDL-C goal achievement revealed inverse association with IAT/BMI (r=-0.15, p<0.05) and no associations with PreFT/BMI, EFT/BMI or PFT/BMI. Multivariable regression analysis revealed independent association between IAT/BMI and the LDL-C goal achievement. Conclusions: Intraabdominal fat thickness representing visceral adipose tissue is inversely associated with the LDL-C goal attainment independently from general obesity. It may help to identify individuals requiring more aggressive management of dylipidaemia.
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- 2015
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5. Moderated Posters session: complementary role of imaging techniques
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Pontone, G, Andreini, D, Annoni, A, Petulla, M, Russo, E, Innocenti, E, Guglielmo, M, Mushtaq, S, Tondo, C, Pepi, M, Demir, OM, Bashir, A, Marshall, K, Douglas, M, Wasan, B, Plein, S, Alfakih, K, Celeng, C, Kolossvary, M, Kovacs, A, Szilveszter, B, Molnar, A, Horvath, T, Jermendy, AL, Tarnoki, AD, Merkely, B, Maurovich-Horvat, P, Llao-Ferrando, JI, Castro, JC, Vilades-Medel, D, Mirabet, S, Pons-Llado, G, Roig, E, Leta, R, Kitsiou, A N, Papanikolaou, S, Griroriou, K, Antonopoulos, M, Mpouki, M, Moustakas, G, Giougi, A, Giannakopoulos, V, Gionakis, G, Balomenos, A, Portugal, G, Abreu, A, Rio, P, Santos, V, Martins Oliveira, M, Silva Cunha, P, Mota Carmo, M, Branco, L M, Morais, L, Cruz Ferreira, R, Becoulet, L, Guijarro, D, Pallardy, A, Mathieu, C, Valette, F, Gueffet, JP, Serfaty, JM, Kraeber-Bodere, F, Trochu, JN, Piriou, N, Demir, OM, Bashir, A, Marshall, K, Wasan, B, Plein, S, Alfakih, K, Marcos-Alberca Moreno, P, Perez-Isla, L, Palacios, J, Gomez De Diego, JJ, Islas, F, De Agustin, JA, Luaces, M, Arrazola, J, Garcia-Fernandez, MA, Macaya, C, Iriart, X, Selmi, W, Jalal, Z, and Thambo, JB
- Abstract
Background: The outcome of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) has improved thanks to left atrium (LA) anatomy reconstruction by computed tomography with adaptive statistical iterative reconstruction algorithm (CT-ASIR) before the procedure. However, CT-ASIR strategy is associated to an increase of cumulative effective radiation dose (ED) in these patients. Recently, a model-based iterative reconstruction algorithm (MBIR, GE Healthcare, Waukesha,Wisconsin) has been developed (CT-MBIR) for image noise reduction reducing the ED close to chest X-ray exposure. The aim of this study is to compare the CT and RFCA characteristics, AF recurrence after procedure and radiation exposure between RFCA guided by image integration with CT-ASIR versus CT-MBIR Methods and Materials: One-hundred twenty consecutive patients with drug-refractory paroxysmal or persistent AF were addressed to CT-ASIR (Group 1; N: 60; mean age 60.3 ± 10.1 yo; male: 46) or CT-MBIR protocol (Group 2; N: 60; mean age 59.7 ± 11.3 yo; male:45) for evaluation of LA before RFCA. All patients were subsequently treated by image integration-supported RFCA. Image noise, signal to noise ratio (SNR), contrast to noise ratio (CNR), RFCA procedural characteristics, rate of AF recurrence and CT radiation exposure were measured and compared between the two groups. Results: The two groups were homogeneous in terms of demographic characteristics, cardiovascular risk factors, prevalence of persistent AF, medical therapy and echocardiographic characteristics. The mean follow-up was similar (578 ± 284 vs. 591 ± 278 days, respectively, p:ns). Group 2 showed a higher signal to noise ratio (25.9 ± 7.1 vs. 13.8 ± 5.1) and contrast to noise ratio (22.7 ± 6.5 vs. and 14.08 ± 4.1) of left atrium as compared to Group 1 (p<0.001). No differences were found in terms of RFCA parameter [procedural duration (130.9 ± 130.6. vs. 143.8 ± 80.4 min); fluoroscopy time (27.9 ± 14.1.0 vs. 32.0 ± 16.4 min); pulmonary veins isolated (3.8 ± 0.4 vs. 3.9 ± 0.4)] and the rate of AF recurrence (31% vs. 29%) between Group 2 vs Group 1. Group 2 showed a 94% reduction of ED as compared to Group 1 (0.4 ± 0.04 mSv vs 6.4 ± 1.8 mSv, p<0.01). Conclusions: CT-MBIR allows accurate non-invasive reconstruction of LA anatomy in AF patients undergoing to RFCA with a submillisievert effective radiation and comparable success rate of RFCA with CT-ASIR technique.
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- 2015
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6. Moderated Posters session * Cardiovascular computed tomography, magnetic resonance and nuclear imaging: 13/12/2013, 08:30-12:30 * Location: Moderated Poster area
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Jung, HO, Kim, MJ, Youn, HJ, Wozniak-Skowerska, I, Skowerski, M, Skowerski, M, Hoffmann, A, Hoffmann, A, Kolasa, J, Kolasa, J, Skowerski, T, Skowerski, T, Sosnowski, M, Sosnowski, M, Wnuk-Wojnar, AM, Wnuk-Wojnar, AM, Gasior, Z, Gasior, Z, Mizia-Stec, K, Mizia-Stec, K, Schirmer, H, Forsdahl, SH, Sildnes, T, Trovik, T, Iqbal, A, Astrom Aneq, M, Engvall, JE, Abreu, A, Oliveira, L, Portugal, G, Goncalves, M, Mota Carmo, M, Santa Clara, H, Pereiro, T, Oliveira, M, Branco, L, Ferreira, R, Moody, WE, Sze Lin, L, Bloxham, N, Fraser, H, Taylor, RJ, Holloway, B, Edwards, NC, Ferro, CJ, Townend, JN, Steeds, RP, Group, Birmingham Cardio-Renal, Perea, GO, Corneli, M, Meretta, AH, Aguirre, ME, Rosa, D, Henquin, R, Ronderos, R, Perez Balino, N, Sunman, H, Yorgun, H, Sahiner, L, Kaya, B, Hazirolan, T, Ozer, N, Aytemir, K, Tokgozoglu, L, Kabakci, G, Oto, A, Peovska, I, Srbinovska, E, Hristova, E, Otljanska, M, Bosevski, M, Arnaudova, F, Andova, V, and Iwaki, T
- Abstract
Purpose: A left-bulging atrial septum (AS) in diastole is an abnormal sign indicating hemodynamic overloading of the right heart. Main hypothesis is computed tomography (CT)-derived AS bulging and ventricular septum (VS) bowing signs would be used to identify patients with acute pulmonary embolism (PE) and significant hemodynamic derangements. Methods: In the prospective registry, 221 consecutive patients with a first episode of acute PE diagnosed by chest CT were grouped by clinical hemodynamic assessment: massive or submassive PE (Group 1), and small PE (Group 2). The curvatures of the AS and VS, right ventricle (RV) and left ventricle (LV) diameters were measured on chest CT. Results: Group 1 showed higher degrees of RV dilatation, and abnormal VS and AS curvatures versus Group2. The sensitivity and specificity of a CT-derived RVD/LVD ratio >0.9 for predicting PE with clinically significant RV dysfunction were 60.8% and 69.7%, respectively. An abnormal VS bowing sign was observed in 33 (32.4%) and 7 (5.9%) patients in Groups 1 and 2, respectively (p<0.001). An abnormal AS bulging sign was observed in 62 (60.8%) and 35 (29.4%) patients in Groups 1 and 2, respectively (p<0.001). On the basis of the CT-derived RVD/LVD ratio, VS bowing, and AS bulging status, patients with acute PE were classified into three risk groups: higher risk, lower risk, and intermediate risk. An algorithm was designed to predict clinically significant hemodynamic abnormality based on these signs (Figure); patients deemed "higher risk" exhibited higher 90-day all-cause mortality than patients in the lower-risk group (p=0.028). Conclusions: Conventional chest CT-derived hemodynamic findings, including abnormal AS and VS signs, can be used to identify high-risk patients with acute PE and to predict early mortality.
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- 2013
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