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2. Contemporary Management of Severe Symptomatic Aortic Stenosis
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Iung, Bernard, Bax, Jeroen, De Bonis, Michele, Delgado, Victoria, Haude, Michael, Hindricks, Gerhard, Maggioni, Aldo P., Pierard, Luc, Popescu, Bogdan A., Prendergast, Bernard, Price, Susanna, Rosenhek, Raphael, Ruschitzka, Frank, Vahanian, Alec, Wendler, Olaf, Windecker, Stephan, Mekhaldi, Souad, Lemaitre, Katell, Authier, Sébastien, Laroche, Cécile, Abdelhamid, Magdy, Apor, Astrid, Bajraktari, Gani, Beleslin, Branko, Bogachev-Prokophiev, Alexander, Demarco, Daniela Cassar, Pasquet, Agnes, Dogan, Sait Mesut, Erglis, Andrejs, Evangelista, Arturo, Goda, Artan, Ihlemann, Nikolaj, Ince, Huseyin, Katsaros, Andreas, Linhartova, Katerina, Mascherbauer, Julia, Mirrakhimov, Erkin, Mizariene, Vaida, Rahman-Haley, Shelley, Ribeiras, Regina, Samadov, Fuad, Saraste, Antti, Simkova, Iveta, Kostovska, Elizabeta Srbinovska, Tomkiewicz-Pajak, Lidia, Tribouilloy, Christophe, Zera, Eliverta, Metalla, Mimoza, Shirka, Ervina, Dado, Elona, Bica, Loreta, Aleksi, Jorida, Knuti, Gerti, Gjyli, Lidra, Pjeci, 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Nicolas, Molina-Mora, Ma Jose, Paton, Ramon Rubio, Martinez Diaz, Juan Jose, Ruiz, Pablo Ramos, Valle, Alfonso, Rodriguez, Ana, Alania, Edgardo, Galcera, Emilio, Seller, Julia, Valenzuela, Gonzalo de la Morena, Espin, Daniel Saura, Garcia, Dolores Espinosa, Oliva Sandoval, Maria Jose, Gonzalez, Josefa, Navarro, Miguel Garcia, Perez-Martinez, Maria Teresa, Ortega Trujillo, Jose Ramon, Gallego, Irene Menduina, San Roman, Daniel, Perez Nogales, Eliu David, Medina, Olga, Montiel Quintero, Rodolfo Antonio, Bujanda Morun, Pablo Felipe, Perez, Marta Lopez, Huaripata, Jimmy Plasencia, Morales Gonzalez, Juan Jose, Nelson, Veronica Quevedo, Zamorano, Jose Luis, Gomez, Ariana Gonzalez, Fraile, Alfonso, Alberca, Maria Teresa, Martin, Joaquin Alonso, Fernandez-Golfin, Covadonga, Ramos, Javier, Jimenez, Sergio Hernandez, Mitroi, Cristina, Sanchez Fernandez, Pedro L., Diaz-Pelaez, Elena, Garde, Beatriz, Caballero, Luis, Garcia, Fermin Martinez, Cambronero, Francisco, Castro, Noelia, Castro, Antonio, De La Rosa, Alejandro, Gallego, Pastora, Mendez, Irene, Villegas, David Villagomez, Correa, Manuel Gonzalez, Calvo, Roman, Florian, Francisco, Paya, Rafael, Esteban, Esther, Buendia, Francisco, Cubillos, Andrés, Fernandez, Carmen, Cárdenas, Juan Pablo, Pérez-Boscá, José Leandro, Vano, Joan, Belchi, Joaquina, Iglesia-Carreno, Cristina, Iglesias, Francisco Calvo, Escudero-Gonzalez, Aida, Zapateria-Lucea, Sergio, Duarte, Juan Sterling, Perez-Davila, Lara, Cobas-Paz, Rafael, Besada-Montenegro, Rosario, Fontao-Romeo, Maribel, Lopez-Rodriguez, Elena, Paredes-Galan, Emilio, Caneiro-Queija, Berenice, Gonzalez, Alba Guitian, Bozkurt, Abdi, Demir, Serafettin, Unlu, Durmus, Cagliyan, Caglar Emre, Ikikardes, Muslum Firat, Tangalay, Mustafa, Kuloglu, Osman, Ozer, Necla, Canpolat, Ugur, Kemaloglu, Melek Didem, Demirtas, Abdullah Orhan, Akgün, Didar Elif, Avci, Eyup, Taylan, Gokay, Yilmaztepe, Mustafa Adem, Ucar, Fatih Mehmet, Altay, Servet, Gurdogan, Muhammet, Gudul, Naile Eris, Aktas, Mujdat, Buyuklu, Mutlu, Degirmenci, Husnu, Turan, Mehmet Salih, Mert, Kadir Ugur, Mert, Gurbet Ozge, Dural, Muhammet, Arslan, Sukru, Sayar, Nurten, Kanar, Batur, Sadic, Beste Ozben, Sahin, Ahmet Anil, Buyuk, Ahmet, Kilicarslan, Onur, Bostan, Cem, Yildirim, Tarik, Yildirim, Seda Elcim, Cosansu, Kahraman, Varim, Perihan, Ilguz, Ersin, Demirbag, Recep, Yesilay, Asuman, Cirit, Abdullah, Tusun, Eyyup, Erkus, Emre, Sayin, Muhammet Rasit, Kazaz, Zeynep, Kul, Selim, Karabag, Turgut, Kalayci, Belma, Eugène, Marc, and Bax, Jeroen J.
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- 2021
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3. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction: TRANSITION Study
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Gniot, Jacek, Mozheiko, Maria, Lelonek, Malgorzata, Dominguez, Antonio Reyes, Horacek, Thomas, Garcia del Rio, Enrique, Kobalava, Zhanna, Mueller, Christian Eugen, Cavusoglu, Yuksel, Straburzynska-Migaj, Ewa, Slanina, Miroslav, vom Dahl, Juergen, Senni, Michele, Ryding, Alisdair, Moriarty, Andrew, Robles, Manuel Beltran, Villota, Julio Nunez, Quintana, Antonio Garcia, Nitschke, Thorsten, Garcia Pinilla, Jose Manuel, Bonet, Luis Almenar, Chaaban, Said, Filali zaatari, Samia, Spinar, Jindrich, Musial, Wlodzimierz, Abdelbaki, Khaled, Belohlavek, Jan, Fehske, Wolfgang, Bott, Michael Carlos, Hoegalmen, Geir, Leiro, Marisa Crespo, Ozcan, Ismail Turkay, Mullens, Wilfried, Kryza, Radim, Al-Ani, Riadh, Loboz-Grudzien, Krystyna, Ermoshkina, Lyudmila, Hojerova, Silvia, Fernandez, Alberto Alfredo, Spinarova, Lenka, Lapp, Harald, Bulut, Efraim, Almeida, Filipa, Vishnevsky, Alexander, Belicova, Margita, Pascual, Domingo, Witte, Klaus, Wong, Kenneth, Droogne, Walter, Delforge, Marc, Peterka, Martin, Olbrich, Hans-Georg, Carugo, Stefano, Nessler, Jadwiga, McGill, Thao Huynh, Huegl, Burkhard, Akin, Ibrahim, Moreira, Ilidio, Baglikov, Andrey, Thambyrajah, Jeetendra, Hayes, Chris, Barrionuevo, Marcelo Raul, Yigit, Zerrin, Kaya, Hakki, Klimsa, Zdenek, Radvan, Martin, Kadel, Christoph, Landmesser, Ulf, Di Tano, Giuseppe, Lisik, Malgorzata Buksinska, Fonseca, Candida, Oliveira, Luis, Marques, Irene, Santos, Luis Miguel, Lenner, Egon, Letavay, Peter, Bueno, Manuel Gomez, Mota, Paula, Wong, Aaron, Bailey, Kristian, Foley, Paul, Hasbani, Eduardo, Virani, Sean, Massih, Tony Abdel, Al-Saif, Shukri, Taborsky, Milos, Kaislerova, Marta, Motovska, Zuzana, Cohen, Aron Ariel, Logeart, Damien, Endemann, Dierk, Ferreira, Daniel, Brito, Dulce, Kycina, Peter, Bollano, Entela, Basilio, Enrique Galve, Rubio, Lorenzo Facila, Aguado, Marcos Garcia, Schiavi, Lilia Beatriz, Zivano, Daniel Francisco, Lonn, Eva, El Sayed, Ali, Pouleur, Anne-Catherine, Heyse, Alex, Schee, Alexandr, Polasek, Rostislav, Houra, Marek, Tribouilloy, Christophe, Seronde, Marie France, Galinier, Michel, Noutsias, Michel, Schwimmbeck, Peter, Voigt, Ingo, Westermann, Dirk, Pulignano, Giovanni, Vegsundvaag, Johnny, Da Silva Antunes, Jose Alexandre, Monteiro, Pedro, Stevlik, Jan, Goncalvesova, Eva, Hulkoova, Beata, Castro Fernandez, Antonio Juan, Davies, Ceri, Squire, Iain, Meyer, Philippe, Sheppard, Richard, Sahin, Tayfun, Sochor, Karel, De Geeter, Guillaume, Wachter, Rolf, Schmeisser, Alexander, Weil, Joachim, Soares, Ana Oliveira, Vasilevna, Olga Bulashova, Oshurkov, Andrey, Sunderland, Shahid Junejo, Glover, Jason, Exequiel, Tomas, Decoulx, Eric, Meyer, Sven, Muenzel, Thomas, Frioes, Fernando, Arbolishvili, Georgy, Tokarcikova, Anna, Karlstrom, Patric, Trullas Vila, Joan Carles, Perez, Gonzalo Pena, Sankaranarayanan, Rajiv, Nageh, Thuraia, Alasia, Diego Cristian, Refaat, Marwan, Demirkan, Burcu, Al-Buraiki, Jehad, Karabsheh, Shadi, Pascual-Figal, Domingo, Bao, Weibin, Noè, Adele, Schwende, Heike, Butylin, Dmytro, and Prescott, Margaret F.
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- 2020
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4. The association of mechanical dyssynchrony and resynchronization therapy with survival in heart failure with a wide QRS complex: a two-world study
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Stankovic, Ivan, Stefanovic, Milica, Prinz, Christian, Ciarka, Agnieszka, Daraban, Ana Maria, Kotrc, Martin, Aarones, Marit, Szulik, Mariola, Winter, Stefan, Kukulski, Tomasz, Aakhus, Svend, Willems, Rik, Fehske, Wolfgang, Penicka, Martin, Faber, Lothar, Neskovic, Aleksandar N., and Voigt, Jens-Uwe
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- 2020
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5. Expert consensus document on the assessment of the severity of aortic valve stenosis by echocardiography to provide diagnostic conclusiveness by standardized verifiable documentation
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Hagendorff, Andreas, Knebel, Fabian, Helfen, Andreas, Knierim, Jan, Sinning, Christoph, Stöbe, Stephan, Fehske, Wolfgang, and Ewen, Sebastian
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- 2020
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6. Assessment of aortic valve tract dynamics using automatic tracking of 3D transesophageal echocardiographic images
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Queirós, Sandro, Morais, Pedro, Fehske, Wolfgang, Papachristidis, Alexandros, Voigt, Jens-Uwe, Fonseca, Jaime C., D’hooge, Jan, and Vilaça, João L.
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- 2019
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7. The association of volumetric response and long-term survival after cardiac resynchronization therapy
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Stankovic, Ivan, Belmans, Ann, Prinz, Christian, Ciarka, Agnieszka, Maria Daraban, Ana, Kotrc, Martin, Aarones, Marit, Szulik, Mariola, Winter, Stefan, Neskovic, Aleksandar N, Kukulski, Tomasz, Aakhus, Svend, Willems, Rik, Fehske, Wolfgang, Penicka, Martin, Faber, Lothar, and Voigt, Jens-Uwe
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- 2017
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8. Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT)
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Stankovic, Ivan, Prinz, Christian, Ciarka, Agnieszka, Daraban, Ana Maria, Kotrc, Martin, Aarones, Marit, Szulik, Mariola, Winter, Stefan, Belmans, Ann, Neskovic, Aleksandar N., Kukulski, Tomasz, Aakhus, Svend, Willems, Rik, Fehske, Wolfgang, Penicka, Martin, Faber, Lothar, and Voigt, Jens-Uwe
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- 2016
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9. Clinical performance of a novel bioprosthetic surgical aortic valve in a German high‐volume center.
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El‐Sayed Ahmad, Ali, Giammarino, Sabrina, Salamate, Saad, Fehske, Wolfgang, Sirat, Sami, Amer, Mohamed, Bramlage, Peter, Bakhtiary, Farhad, and Doss, Mirko
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AORTIC valve ,BIOPROSTHETIC heart valves ,AORTIC valve transplantation ,CHRONIC obstructive pulmonary disease ,HEART valves ,HEART valve prosthesis implantation - Abstract
Background and Aim: Bioprosthetic surgical aortic valve replacement (SAVR) is increasingly adopted in younger patients. We aimed to analyze mid‐term follow‐up data after SAVR to assess the performance of the prosthesis. Methods: Data were collected from a single‐center series of 154 patients, who underwent SAVR with a bioprosthetic heart valve with the RESILIA tissue at our Heart Centre in Siegburg. All procedural and midterm patient outcomes were documented. Results: Patients had a mean age of 56.8 ± 9.9 years, 35.7% were female, and the mean logistic European system for cardiac operative risk evaluation (EuroSCORE) was 3.4 ± 3.6%. Diabetes (12.3%), atrial fibrillation (10.4%), and chronic obstructive pulmonary disease (COPD) (5.8%) were common comorbidities. The mean surgery duration was 163.8 ± 73.4 min, with the 23 mm (34.4%) and 25 mm (33.8%) heart valves being most frequently implanted. At 3‐year follow‐up, mean pressure gradient was 13.9 ± 5.9 mmHg, peak gradient was 23.6 ± 7.7 mmHg, and effective orifice area (EOA) was 1.9 ± 0.4 cm². No patient died during the operation, 3 (2.1%) patients within 30 days, and 4 (2.7%) thereafter with an overall mortality of n = 7. Of the surviving patients, 97.8% were in New York Heart Association (NYHA) class I/II and none had structural valve deterioration (SVD). Conclusion: Results of our single‐center study indicate favorable procedural outcomes. The safety outcomes confirm preliminary earlier results of this novel bioprosthesis but include more patients and a longer midterm follow‐up. [ABSTRACT FROM AUTHOR]
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- 2022
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10. Is there an association between left atrial outpouching structures and recurrence of atrial fibrillation after catheter ablation?
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Celik, Erkan, Hokamp, Nils Große, Goertz, Lukas, Fehske, Wolfgang, Nguyen, Dinh Quang, Lichtenberg, Lutz, Reimer, Robert Peter, Maintz, David, Düber, Christoph, and Achenbach, Tobias
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LEFT heart atrium ,ATRIAL fibrillation ,CATHETER ablation ,CARDIOVASCULAR diseases risk factors ,PULMONARY veins ,MEDICAL lasers - Abstract
Objective: The aim of this study was to investigate the impact of left atrial diverticula (LADs), left sided septal pouches (LSSPs) and middle right pulmonary veins (MRPVs) on recurrent atrial fibrillation (rAF) in patients undergoing laser pulmonary vein isolation procedure (PVI). Material and methods: This retrospective study enrolled 139 patients with pre-procedural multiple detector computed tomography (MDCT) imaging and 12 months follow-up examination. LADs, LSSPs and MRPV were identified by two radiologists on a dedicated workstation using multiplanar reconstructions and volume rendering technique. Univariate and bivariate regression analyses with patient demographics and cardiovascular risk factors as covariates were performed to reveal independent factors associated with rAF. Results: LADs were recorded in 41 patients (29%), LSSPs in 20 (14%) and MRPVs in 15 (11%). The right anterosuperior wall of the left atrium was the most prevalent location of LADs (68%). rAF occured in 20 patients, thereof, 15 exhibited an outpouching structure of the left atrium (LAD: 9, LSSP: 2 and MRPV: 3). Presence of an LAD (HR: 2.7, 95%CI: 1.0–8.4, p = 0.04) and permanent AF (HR: 4.8, 95%CI: 1.5–16.3, p = 0.01) were independently associated with rAF. Conclusions: LAD, LSSP and MRPV were common findings on pre-procedural cardiac computed tomography. LADs were revealed as potential independent risk factor of rAF, which might be considered for treatment planning and post-treatment observation. [ABSTRACT FROM AUTHOR]
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- 2022
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11. Acute re-distribution of regional left ventricular work by cardiac resynchronization therapy determines long-term remodelling (*)
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Voigt, Jens-Uwe, Winter, Stefan, Hopp, Einar, Galli, Elena, Fehske, Wolfgang, Unlu, SERKAN, Donal, Erwan, Bezy, Stephanie, Beela, Ahmed, Aalen, John, Duchenne, Jurgen, Kongsgard, Erik, Larsen, Camilla, and Smiseth, Otto
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- 2020
12. Use of an automatic application for wall motion classification based on longitudinal strain: is it affected by operator expertise in echocardiography? A multicentre study by the Israeli Echocardiography Research Group
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Blondheim, David S., Friedman, Zvi, Lysyansky, Peter, Kuperstein, Rafael, Hay, Ilan, Feinberg, Micha S., Beeri, Ronen, Vaturi, Mordehay, Sagie, Alik, Shimoni, Sarah, Fehske, Wolfgang, Deutsch, Lisa, Leitman, Marina, Gilon, Dan, Agmon, Yoram, Tsadok, Yossi, Rosenmann, David, and Liel-Cohen, Noah
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- 2012
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13. Reliability of Visual Assessment of Global and Segmental Left Ventricular Function: A Multicenter Study by the Israeli Echocardiography Research Group
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Blondheim, David S., Beeri, Ronen, Feinberg, Micha S., Vaturi, Mordehay, Shimoni, Sarah, Fehske, Wolfgang, Sagie, Alik, Rosenmann, David, Lysyansky, Peter, Deutsch, Lisa, Leitman, Marina, Kuperstein, Rafael, Hay, Ilan, Gilon, Dan, Friedman, Zvi, Agmon, Yoram, Tsadok, Yossi, and Liel-Cohen, Noah
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- 2010
14. Acute re-distribution of myocardial work by cardiac resynchronization therapy determines long-term remodelling of the left ventricle
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aalen, John, Voigt, Jens-Uwe, smiseth, OA, donal, erwan, Fehske, Wolfgang, Hopp, Einar, Winter, Stefan, Pagourelias, Efstathios D, Beela, Ahmed S, Bézy, Stéphanie, Galli, Elena, larsen, arne K, Cvijic, Marta, Duchenne, Jürgen, and ÜNLÜ, SERKAN
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- 2019
15. Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study
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Wachter, Rolf, Senni, Michele, Belohlavek, Jan, Straburzynska‐Migaj, Ewa, Witte, Klaus K., Kobalava, Zhanna, Fonseca, Candida, Goncalvesova, Eva, Cavusoglu, Yuksel, Fernandez, Alberto, Chaaban, Said, Bøhmer, Ellen, Pouleur, Anne‐Catherine, Mueller, Christian, Tribouilloy, Christophe, Lonn, Eva, A.L. Buraiki, Jehad, Gniot, Jacek, Mozheiko, Maria, Lelonek, Malgorzata, Noè, Adele, Schwende, Heike, Bao, Weibin, Butylin, Dmytro, Pascual‐Figal, Domingo, Dominguez, Antonio Reyes, Horacek, Thomas, del Rio, Enrique Garcia, Mueller, Christian Eugen, Straburzynska-Migaj, Ewa, Slanina, Miroslav, vom Dahl, Juergen, Ryding, Alisdair, Moriarty, Andrew, Robles, Manuel Beltran, Villota, Julio Nunez, Quintana, Antonio Garcia, Nitschke, Thorsten, Manuel Garcia Pinilla, Jose, Bonet, Luis Almenar, Filali zaatari, MD, Samia, Spinar, Jindrich, Musial, Wlodzimierz, Abdelbaki, Khaled, Fehske, Wolfgang, Bott, Michael Carlos, Hoegalmen, Geir, Leiro, Marisa Crespo, Ozcan, Ismail Turkay, Mullens, Wilfried, Kryza, Radim, Al-Ani, Riadh, Loboz-Grudzien, Krystyna, Ermoshkina, Lyudmila, Hojerova, Silvia, Fernandez, Alberto Alfredo, Spinarova, Lenka, Lapp, Harald, Bulut, Efraim, Almeida, Filipa, Vishnevsky, Alexander, Belicova, Margita, Pascual, Domingo, Witte, Klaus, Wong, Kenneth, Droogne, Walter, Delforge, Marc, Peterka, Martin, Olbrich, Hans‐Georg, Carugo, Stefano, Nessler, Jadwiga, McGill, Thao Huynh, Huegl, Burkhard, Akin, Ibrahim, Moreira, Ilidio, Baglikov, Andrey, Thambyrajah, Jeetendra, Hayes, Chris, Barrionuevo, Marcelo Raul, Yigit, Zerrin, Kaya, Hakki, Klimsa, Zdenek, Radvan, Martin, Kadel, Christoph, Landmesser, Ulf, Di Tano, Giuseppe, Lisik, Malgorzata Buksinska, Oliveira, Luis, Marques, Irene, Santos, Luis Miguel, Lenner, Egon, Letavay, Peter, Bueno, Manuel Gomez, Mota, Paula, Wong, Aaron, Bailey, Kristian, Foley, Paul, Hasbani, Eduardo, Virani, Sean, Massih, Tony Abdel, Al‐Saif, Shukri, Taborsky, Milos, Kaislerova, Marta, Motovska, Zuzana, Praha, Cohen, Aron Ariel, Logeart, Damien, Endemann, Dierk, Ferreira, Daniel, Brito, Dulce, Kycina, Peter, Bollano, Entela, Basilio, Enrique Galve, Rubio, Lorenzo Facila, Aguado, Marcos Garcia, Schiavi, Lilia Beatriz, Zivano, Daniel Francisco, Sayed, Ali El, Heyse, Alex, Schee, Alexandr, Polasek, Rostislav, Houra, Marek, Seronde, Marie France, Galinier, Michel, Noutsias, Michel, Schwimmbeck, Peter, Voigt, Ingo, Westermann, Dirk, Pulignano, Giovanni, Vegsundvaag, Johnny, Alexandre Da Silva Antunes, Jose, Monteiro, Pedro, Stevlik, Jan, Hulkoova, Beata, Juan Castro Fernandez, Antonio, Davies, Ceri, Squire, Iain, Meyer, Philippe, Sheppard, Richard, Sahin, Tayfun, Sochor, Karel, De Geeter, Guillaume, Schmeisser, Alexander, Weil, Joachim, Soares, Ana Oliveira, Vasilevna, Olga Bulashova, Oshurkov, Andrey, Sunderland, Shahid Junejo, Glover, Jason, Exequiel, Tomas, Decoulx, Eric, Meyer, Sven, Muenzel, Thomas, Frioes, Fernando, Arbolishvili, Georgy, Tokarcikova, Anna, Karlstrom, Patric, Carles Trullas Vila, Joan, Perez, Gonzalo Pena, Sankaranarayanan, Rajiv, Nageh, Thuraia, Alasia, Diego Cristian, Refaat, Marwan, Demirkan, Burcu, Al-Buraiki, Jehad, Karabsheh, Shadi, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Wachter, R, Senni, M, Belohlavek, J, Straburzynska-Migaj, E, Witte, K, Kobalava, Z, Fonseca, C, Goncalvesova, E, Cavusoglu, Y, Fernandez, A, Chaaban, S, Bøhmer, E, Pouleur, A, Mueller, C, Tribouilloy, C, Lonn, E, A L Buraiki, J, Gniot, J, Mozheiko, M, Lelonek, M, Noè, A, Schwende, H, Bao, W, Butylin, D, Pascual-Figal, D, and Transition, I
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Male ,medicine.medical_specialty ,Acute decompensated heart failure ,Tetrazoles ,Heart failure ,030204 cardiovascular system & hematology ,Sacubitril ,03 medical and health sciences ,Angiotensin Receptor Antagonists ,0302 clinical medicine ,Internal medicine ,medicine ,Clinical endpoint ,Hospitalisation ,Humans ,Sacubitril/valsartan ,Aged ,Angiotensin receptor–neprilysin inhibitor ,Heart Failure ,Ejection fraction ,Dose-Response Relationship, Drug ,business.industry ,Aminobutyrates ,Biphenyl Compounds ,Hemodynamics ,medicine.disease ,Angiotensin receptor-neprilysin inhibitor ,Patient Discharge ,3. Good health ,Discontinuation ,Drug Combinations ,Treatment Outcome ,Valsartan ,Tolerability ,Female ,Neprilysin ,business ,Cardiology and Cardiovascular Medicine ,Sacubitril, Valsartan ,medicine.drug ,Follow-Up Studies - Abstract
AIMS: To assess tolerability and optimal time point for initiation of sacubitril/valsartan in patients stabilised after acute heart failure (AHF). METHODS AND RESULTS: TRANSITION was a randomised, multicentre, open-label study comparing two treatment initiation modalities of sacubitril/valsartan. Patients aged ≥ 18 years, hospitalised for AHF were stratified according to pre-admission use of renin-angiotensin-aldosterone system inhibitors and randomised (n = 1002) after stabilisation to initiate sacubitril/valsartan either ≥ 12-h pre-discharge or between Days 1-14 post-discharge. Starting dose (as per label) was 24/26 mg or 49/51 mg bid with up- or down-titration based on tolerability. The primary endpoint was the proportion of patients attaining 97/103 mg bid target dose after 10 weeks. Median time of first dose of sacubitril/valsartan from the day of discharge was Day -1 and Day +1 in the pre-discharge group and the post-discharge group, respectively. Comparable proportions of patients in the pre- and post-discharge initiation groups met the primary endpoint [45.4% vs. 50.7%; risk ratio (RR) 0.90; 95% confidence interval (CI) 0.79-1.02]. The proportion of patients who achieved and maintained for ≥ 2 weeks leading to Week 10, either 49/51 or 97/103 mg bid was 62.1% vs. 68.5% (RR 0.91; 95% CI 0.83-0.99); or any dose was 86.0% vs. 89.6% (RR 0.96; 95% CI 0.92-1.01). Discontinuation due to adverse events occurred in 7.3% vs. 4.9% of patients (RR 1.49; 95% CI 0.90-2.46). CONCLUSIONS: Initiation of sacubitril/valsartan in a wide range of heart failure with reduced ejection fraction patients stabilised after an AHF event, either in hospital or shortly after discharge, is feasible with about half of the patients achieving target dose within 10 weeks. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02661217. © 2019 The Authors. European Journal of Heart Failure published by John Wiley & Sons peerReviewed
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- 2019
16. Aortic Valve Endocarditis with Bartonella Quintana—a Rare Entity
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Christiansen, Stefan, Fehske, Wolfgang, and Autschbach, Rüdiger
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- 2005
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17. Relation between symptoms and profiles of coronary artery blood flow velocities in patients with aortic valve stenosis: a study using transoesophageal Doppler echocardiography
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Omran, Heyder, Fehske, Wolfgang, Rabahieh, Rami, Hagendorff, Andreas, and Luderitz, Berndt
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- 1996
18. Influence of captopril on nitroglycerin-mediated vasodilation and development of nitrate tolerance in arterial and venous circulation
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Pizzulli, Luciano, Hagendorff, Andreas, Zirbes, Markus, Fehske, Wolfgang, Ewig, Santiago, Jung, Werner, and Luderitz, Berndt
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- 1996
19. Acute redistribution of regional left ventricular work by cardiac resynchronization therapy determines long-term remodelling.
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Duchenne, Jürgen, Aalen, John M, Cvijic, Marta, Larsen, Camilla K, Galli, Elena, Bézy, Stéphanie, Beela, Ahmed S, Ünlü, Serkan, Pagourelias, Efstathios D, Winter, Stefan, Hopp, Einar, Kongsgård, Erik, Donal, Erwan, Fehske, Wolfgang, Smiseth, Otto A, and Voigt, Jens-Uwe
- Subjects
MYOCARDIUM physiology ,BUNDLE-branch block ,CARDIAC pacing ,ELECTROCARDIOGRAPHY ,HEART failure ,LONGITUDINAL method ,MEDICAL cooperation ,MULTIVARIATE analysis ,CARDIOMYOPATHIES ,REGRESSION analysis ,RESEARCH ,VENTRICULAR remodeling ,PRE-tests & post-tests ,VENTRICULAR ejection fraction - Abstract
Aims Investigating the acute impact of cardiac resynchronization therapy (CRT) on regional myocardial work distribution in the left ventricle (LV) and to which extent it is related to long-term reverse remodelling. Methods and results One hundred and thirty heart failure patients, referred for CRT implantation, were recruited in our prospective multicentre study. Regional myocardial work was calculated from non-invasive segmental stress–strain loop area before and immediately after CRT. The magnitude of volumetric reverse remodelling was determined from the change in LV end-systolic volume, 11 ± 2 months after implantation. CRT caused acute redistribution of myocardial work across the LV, with an increase in septal work, and decrease in LV lateral wall work (all P < 0.05). Amongst all LV walls, the acute change in work in the septum and lateral wall of the four-chamber view correlated best and significantly with volumetric reverse remodelling (r = 0.62, P < 0.0001), with largest change seen in patients with most volumetric reverse remodelling. In multivariate linear regression analysis, including conventional parameters, such as pre-implant QRS morphology and duration, LV ejection fraction, ischaemic origin of cardiomyopathy, and the redistribution of work across the septal and lateral walls, the latter appeared as the strongest determinant of volumetric reverse remodelling after CRT (model R
2 = 0.414, P < 0.0001). Conclusion The acute redistribution of regional myocardial work between the septal and lateral wall of the LV is an important determinant of reverse remodelling after CRT implantation. Our data suggest that the treatment of the loading imbalance should, therefore, be the main aim of CRT. [ABSTRACT FROM AUTHOR]- Published
- 2020
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20. Improvement in the Assessment of Aortic Valve and Aortic Aneurysm Repair by 3-Dimensional Echocardiography.
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Hagendorff, Andreas, Evangelista, Arturo, Fehske, Wolfgang, and Schäfers, Hans-Joachim
- Abstract
Reconstructive surgery of the aortic valve is being increasingly used in patients with aortic regurgitation and/or aortic aneurysm. Its success depends on restoring normal aortic valve and root form. Echocardiography is the most reliable and precise imaging technique because it defines abnormal morphology and function, essential for selecting appropriate substrates and guiding the surgical strategy. Despite technical advances in echocardiography, aortic valve and aortic root morphology and function are still assessed mainly using 2-dimensional echocardiography in clinical practice. This review focuses on the need to use 3-dimensional echocardiography to characterize different forms of aortic valve and root abnormalities and attempts to define echocardiographic predictors of successful valve-root complex repair. • Reconstructive surgery of the aortic valve has currently received increasing attention in patients with aortic regurgitation and/or aortic aneurysm. • The use of 3D echocardiography is a powerful tool to objectively characterize different forms of aortic valve and root abnormalities and to define echocardiographic predictors of successful valve/root complex repair. • The systematic analysis of the aortic root by 3D echocardiography enables correct planning of surgical procedures in reconstructive surgery in patients with aortic regurgitation and aortic valve/root abnormalities. • Automatic quantification of the aortic root complex and image optimization by further technical improvements will facilitate the dynamic analysis of the aortic root complex by echocardiography in the future. [ABSTRACT FROM AUTHOR]
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- 2019
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21. Sex-specific difference in outcome after cardiac resynchronization therapy.
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Beela, Ahmed S, Duchenne, Jürgen, Petrescu, Aniela, Ünlü, Serkan, Penicka, Martin, Aakhus, Svend, Winter, Stefan, Aarones, Marit, Stefanidis, Evangelos, Fehske, Wolfgang, Willems, Rik, Szulik, Mariola, Kukulski, Tomasz, Faber, Lothar, Ciarka, Agnieszka, Neskovic, Aleksandar N, Stankovic, Ivan, and Voigt, Jens-Uwe
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HEART ventricle diseases ,ATRIAL fibrillation ,BUNDLE-branch block ,CARDIAC pacing ,ECHOCARDIOGRAPHY ,LEFT heart ventricle ,HEART beat ,HEART failure ,MULTIVARIATE analysis ,CARDIOMYOPATHIES ,SEX distribution ,SURVIVAL ,TREATMENT effectiveness ,RETROSPECTIVE studies ,DESCRIPTIVE statistics ,LOG-rank test ,VENTRICULAR ejection fraction - Abstract
Aims Observation of better outcome in women after cardiac resynchronization therapy (CRT) has led to controversies about a potential sex-specific response. In this study, we investigated to which extent this sex-specific difference in CRT outcome could be explained by differences in baseline characteristics between both sexes. Methods and results We retrospectively analysed data from a multicentre registry of 1058 patients who received CRT. Patients were examined by echocardiography before and 12 ± 6 months after implantation. Response was defined as ≥15% reduction of left ventricular end-systolic volume at follow-up. Patient's characteristics at baseline, including New York Heart Association class, ejection fraction, QRS width and morphology, ischaemic aetiology of cardiomyopathy (ICM), number of scarred segments, age at implantation, atrial fibrillation, and mechanical dyssynchrony (Dyss) were analysed. Patients were followed for a median duration of 59 months. Primary end point was all-cause mortality. Women (24% of the population) had less ICM (23% vs. 49%, P < 0.0001), less scarred segments (0.4 ± 1.3 vs. 1.0 ± 2.1, P < 0.0001), more left bundle branch block (LBBB; 87% vs. 80%, P = 0.01), and more Dyss at baseline (78% vs. 57%, P < 0.0001). Without matching baseline differences, women showed better survival (log rank P < 0.0001). After matching, survival was similar (log rank P = 0.58). In multivariable analysis, female sex was no independent predictor of neither volumetric response (P = 0.06) nor survival (P = 0.31). Conclusion Our data suggest that the repeatedly observed better outcome in women after CRT is mainly due to the lower rate ICM and smaller scars. When comparing patients with similar baseline characteristics, the response of both sexes to CRT is similar. [ABSTRACT FROM AUTHOR]
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- 2019
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22. Anxiety, depression and quality of life in acute high risk cardiac disease patients eligible for wearable cardioverter defibrillator: Results from the prospective multicenter CRED-registry.
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Weiss, Michael, Michels, Guido, Eberhardt, Frank, Fehske, Wolfgang, Winter, Stefan, Baer, Frank, Choi, Yeong-Hoon, Albus, Christian, Steven, Daniel, Baldus, Stephan, and Pfister, Roman
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IMPLANTABLE cardioverter-defibrillators ,DEFIBRILLATORS ,QUALITY of life ,HEART diseases - Abstract
Background: Psychological distress is common in patients with cardiovascular disease and negatively impacts outcome. Hypothesis: Psychological distress is high in acute high risk cardiac patients eligible for a WCD, and associated with low quality of life. Distress is aggravated by WCD. Methods: Consecutive patients eligible for a WCD were included in the prospective, multicenter “Cologne Registry of External Defibrillator” registry. Quality of life (Short Form-12), depressive symptoms (Beck-Depression Inventory II) and anxiety (State Trait Anxiety Inventory) were assessed at enrollment and 6-weeks, and associations with WCD prescription were analyzed. Results: 123 patients (mean [SD] age 59 [± 14] years, 75% male) were included, 85 (69%) of whom received a WCD. At enrollment 21% showed clinically significant depressive symptoms and 52% anxiety symptoms, respectively. At 6 weeks, depressive and anxious symptoms significantly decreased to 7% and 25%, respectively. Depressive symptoms at enrollment and changes at 6 weeks showed significant associations with health-related quality of life, whereas anxious symptoms did not. There was a trend for better improvement of depression scores in patients with WCD (mean [SD] change in score points: -4.1 [6.1] vs -1.8 [3.9]; p = 0.09), whereas change of the anxiousness score was not different (-4.6 [9.5]) vs -3.7 [9.1], p = 0.68). Conclusion: In patients eligible for a WCD, depressive and anxiety symptoms were initially common and depressive symptoms showed a strong association with reduced health-related quality of life contributing to their clinical relevance. WCD recipients showed at least similar improvement of depression and anxiety at 6 weeks when compared to non recipients. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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23. Assessment of mechanical dyssynchrony can improve the prognostic value of guideline-based patient selection for cardiac resynchronization therapy.
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Beela, Ahmed S, Ünlü, Serkan, Duchenne, Jürgen, Ciarka, Agnieszka, Daraban, Ana Maria, Kotrc, Martin, Aarones, Marit, Szulik, Mariola, Winter, Stefan, Penicka, Martin, Neskovic, Aleksandar N, Kukulski, Tomasz, Aakhus, Svend, Willems, Rik, Fehske, Wolfgang, Faber, Lothar, Stankovic, Ivan, and Voigt, Jens-Uwe
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CARDIAC pacing ,HEART ventricle diseases ,DEATH ,ECHOCARDIOGRAPHY ,EVALUATION of medical care ,LEFT heart ventricle ,MEDICAL protocols ,SURVIVAL ,PATIENT selection ,DESCRIPTIVE statistics ,LOG-rank test ,PROGNOSIS ,DIAGNOSIS - Abstract
Aim To determine if incorporation of assessment of mechanical dyssynchrony could improve the prognostic value of patient selection based on current guidelines. Methods and results Echocardiography was performed in 1060 patients before and 12 ± 6 months after cardiac resynchronization therapy (CRT) implantation. Mechanical dyssynchrony, defined as the presence of apical rocking or septal flash was visually assessed at the baseline examination. Response was defined as ≥15% reduction in left ventricular end-systolic volume at follow-up. Patients were followed for a median of 59 months (interquartile range 37–86 months) for the occurrence of death of any cause. Applying the latest European guidelines retrospectively, 63.4% of the patients had been implanted with a Class I recommendation, 18.2% with Class IIa, 9.4% with Class IIb, and in 9% no clear therapy recommendation was present. Response rates were 65% in Class I, 50% in IIa, 38% in IIb patients, and 40% in patients without a clear guideline-based recommendation. Assessment of mechanical dyssynchrony improved response rates to 77% in Class I, 75% in IIa, 62% in IIb, and 69% in patients without a guideline-based recommendation. Non-significant difference in survival among guideline recommendation classes was found (Log-rank P = 0.2). Presence of mechanical dyssynchrony predicted long-term outcome better than guideline Classes I, IIa, IIb (Log-rank P < 0.0001, 0.006, 0.004, respectively) and in patients with no guideline recommendation (P = 0.02). Comparable results were observed using the latest American Guidelines. Conclusion Our data suggest that current guideline criteria for CRT candidate selection could be improved by incorporating assessment of mechanical asynchrony. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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24. Timing of myocardial shortening determines left ventricular regional myocardial work and regional remodelling in hearts with conduction delays.
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Cvijic, Marta, Duchenne, Jürgen, Ünlü, Serkan, Michalski, Blazej, Aarones, Marit, Winter, Stefan, Aakhus, Svend, Fehske, Wolfgang, Stankovic, Ivan, and Voigt, Jens-Uwe
- Subjects
HEART physiology ,LEFT heart ventricle ,MYOCARDIUM physiology ,BLOOD pressure ,CARDIAC pacing ,CARDIOVASCULAR system physiology ,ECHOCARDIOGRAPHY ,ELECTROCARDIOGRAPHY ,HEART beat ,HEART conduction system ,HEART failure ,ISCHEMIA ,CARDIOMYOPATHIES - Abstract
Aims The interaction between asynchronous regional myocardial activation and left ventricular (LV) wall remodelling has not been well established. We investigated the relationship between time of onset of longitudinal shortening (T
onset ), regional myocardial work, and segmental LV wall thickness (SWT) in patients treated with cardiac resynchronization therapy (CRT). Methods and results We analysed 26 patients with sinus rhythm, non-ischaemic cardiomyopathy (63 ± 9 years, 69% male, QRS duration 174 ± 18 ms) and positive response to CRT (15% reduction in end-systolic volume). Longitudinal strain was obtained by 2D speckle-tracking echocardiography before and after [14.5 (7–29) months] CRT. Tonset and SWT were measured in 18 segments per LV. Segmental myocardial work was calculated from non-invasive segmental stress–strain loop area. Before CRT, Tonset was the shortest in septal and anteroseptal and the longest in lateral and posterior walls (P < 0.001) and not different after CRT (P = 0.733). Before CRT, septal and anteroseptal walls were significantly thinner than lateral and posterior. After CRT, reverse remodelling increased thickness in septal and anteroseptal and thinned lateral and posterior segments (P < 0.001). Before CRT, non-uniformity in work distribution with reduced work in septal and anteroseptal and increased work in lateral and posterior walls (P < 0.001) was observed. After CRT, distribution of myocardial work was uniform (P = 0.215). Conclusion Dys-synchronous myocardial shortening is related to thinning of early and thickening of late activated segments in heart failure with conduction delay. Correction of dys-synchrony leads to regression of inhomogeneity towards more evenly distributed wall thickness. Regional differences in myocardial work load that are homogenized by successful CRT are considered as the underlying pathophysiological mechanism. [ABSTRACT FROM AUTHOR]- Published
- 2018
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25. Long-Term Outcome After CRT in the Presence of Mechanical Dyssynchrony Seen With Chronic RV Pacing or Intrinsic LBBB.
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Stankovic, Ivan, Prinz, Christian, Ciarka, Agnieszka, Daraban, Ana Maria, Mo, Yujing, Aarones, Marit, Szulik, Mariola, Winter, Stefan, Neskovic, Aleksandar N., Kukulski, Tomasz, Aakhus, Svend, Willems, Rik, Fehske, Wolfgang, Penicka, Martin, Faber, Lothar, and Voigt, Jens-Uwe
- Abstract
Objectives The aim of this study was to compare the volumetric response and the long-term survival after cardiac resynchronization therapy (CRT) in patients with intrinsic left bundle branch block (LBBB) versus chronic right ventricular pacing (RVP) with respect to the presence of mechanical dyssynchrony (MD). Background Chronic RVP induces an iatrogenic LBBB and asynchronous left ventricular contraction that is potentially reversible by upgrading to CRT. Methods A total of 914 patients eligible for CRT (117 with conventional pacemakers and 797 with intrinsic LBBB) were included in the study. MD was visually assessed before CRT and was defined as the presence of either apical rocking and/or septal flash on baseline echocardiograms. Patients with a left ventricular end-systolic volume decrease of ≥15% during the follow-up were considered responders. Patients were followed for all-cause mortality during the median follow-up of 48 months (interquartile range: 29 to 66 months). Results MD was observed in 51% of patients with RVP versus 77% in patients with intrinsic LBBB (p < 0.001). Patients with RVP and MD had a similar likelihood of volumetric response as did patients with intrinsic LBBB and MD (adjusted odds ratio: 0.71; 95% confidence interval: 0.33 to 1.53; p = 0.385). There was no significant difference in long-term survival between patients with RVP and intrinsic LBBB (adjusted hazard ratio: 1.101; 95% confidence interval: 0.658 to 1.842; p = 0.714). Patients with visual MD and either intrinsic LBBB or RVP had a more favorable survival than those without MD (p < 0.001). Conclusions The likelihood of volumetric response and a favorable long-term survival of patients with RVP was similar to those of patients with intrinsic LBBB and were mainly determined by the presence of MD and not by the nature of LBBB. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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26. Clinical and Experimental Evidence for a Strain-Based Classification of Left Bundle Branch Block-Induced Cardiac Remodeling.
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Calle, Simon, Duchenne, Jürgen, Beela, Ahmed S., Stankovic, Ivan, Puvrez, Alexis, Winter, Stefan, Fehske, Wolfgang, Aarones, Marit, De Buyzere, Marc, De Pooter, Jan, Voigt, Jens-Uwe, and Timmermans, Frank
- Abstract
Background: Septal strain patterns measured by echocardiography reflect the severity of left bundle branch block (LBBB)-induced left ventricular (LV) dysfunction. We investigated whether these LBBB strain stages predicted the response to cardiac resynchronization therapy in an observational study and developed a sheep model of LBBB-induced cardiomyopathy. Methods: The clinical study enrolled cardiac resynchronization therapy patients who underwent echocardiographic examination with speckle-tracking strain analysis before cardiac resynchronization therapy implant. In an experimental sheep model with pacing-induced dyssynchrony, LV remodeling and strain were assessed at baseline, at 8 and 16 weeks. Septal strain curves were classified into 5 patterns (LBBB-0 to LBBB-4). Results: The clinical study involved 250 patients (age 65 [58; 72] years; 79% men; 89% LBBB) with a median LV ejection fraction of 25 [21; 30]%. Across the stages, cardiac resynchronization therapy resulted in a gradual volumetric response, ranging from no response in LBBB-0 patients (ΔLV end-systolic volume 0 [−12; 15]%) to super-response in LBBB-4 patients (ΔLV end-systolic volume −44 [−64; −18]%) (P< 0.001). LBBB-0 patients had a less favorable long-term outcome compared with those in stage LBBB≥1 (log-rank P =0.003). In 13 sheep, acute right ventricular pacing resulted in LBBB-1 (23%) and LBBB-2 (77%) patterns. Over the course of 8−16 weeks, continued pacing resulted in progressive LBBB-induced dysfunction, coincident with a transition to advanced strain patterns (92% LBBB-2 and 8% LBBB-3 at week 8; 75% LBBB-3 and 25% LBBB-4 at week 16) (P =0.023). Conclusions: The strain-based LBBB classification reflects a pathophysiological continuum of LBBB-induced remodeling over time and is associated with the extent of reverse remodeling in observational cardiac resynchronization therapy-eligible patients. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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27. Impact of the Type of First Medical Contact within a Guideline-Conform ST-Elevation Myocardial Infarction Network: A Prospective Observational Registry Study.
- Author
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Pfister, Roman, Lee, Samuel, Kuhr, Kathrin, Baer, Frank, Fehske, Wolfgang, Hoepp, Hans-Wilhelm, Baldus, Stephan, and Michels, Guido
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MYOCARDIAL infarction ,PERCUTANEOUS coronary intervention ,ELECTROCARDIOGRAPHY ,EMERGENCY medical services ,MORTALITY ,HOSPITAL care - Abstract
Aims: The impact of type of first medical contact (FMC) in the setting of a guideline conform metropolitan ST-elevation myocardial infarction (STEMI) network providing obligatory primary percutaneous coronary intervention (PCI) is unclear. Methods and Results: 3,312 patients were prospectively included between 2006 and 2012 into a registry accompanying the “Cologne Infarction Model” STEMI network, with 68.4% primarily presenting to emergency medical service (EMS), 17.6% to non-PCI-capable hospitals, and 14.0% to PCI-capable hospitals. Median contact-to-balloon time differed significantly by FMC with 89 minutes (IQR 72–115) for EMS, 107 minutes (IQR 85–148) for non-PCI- and 65 minutes (IQR 48–91) for PCI-capable hospitals (p < 0.001). TIMI-flow grade III and in-hospital mortality were 75.7% and 10.4% in EMS, 70.3% and 8.6% in non-PCI capable hospital and 84.4% and 5.6% in PCI-capable hospital presenters, respectively (p both < 0.01). The association of FMC with in-hospital mortality was not significant after adjustment for baseline characteristics, but risk of TIMI-flow grade < III remained significantly increased in patients presenting to non-PCI capable hospitals. Conclusion: Despite differences in treatment delay by type of FMC in-hospital mortality did not differ significantly. The increased risk of TIMI-flow grade < III in patients presenting to non PCI-capable hospitals needs further study. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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28. Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT).
- Author
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Ciarka, Agnieszka, Daraban, Ana Maria, Willems, Rik, Voigt, Jens-Uwe, Stankovic, Ivan, Neskovic, Aleksandar N., Prinz, Christian van, Faber, Lothar, Kotrc, Martin, Penicka, Martin, Aarones, Marit, Aakhus, Svend, Szulik, Mariola, Kukulski, Tomasz, Winter, Stefan, Fehske, Wolfgang, and Belmans, Ann
- Subjects
CARDIAC pacing ,COMPUTER terminals ,CONFIDENCE intervals ,CAUSES of death ,ELECTROCARDIOGRAPHY ,STATISTICS ,SURVIVAL ,DATA analysis ,HEART assist devices ,DESCRIPTIVE statistics - Abstract
AIMS: Apical rocking (ApRock) and septal flash (SF) are often observed phenomena in asynchronously contracting ventricles. We investigated the relationship of visually assessed ApRock and SF, reverse remodelling, and long-term survival in cardiac resynchronization therapy (CRT) candidates. METHODS AND RESULTS: A total of 1060 patients eligible for CRT underwent echocardiographic examinations before and 12 ± 6 months after device implantation. Three blinded physicians were asked to visually assess the presence of ApRock and SF before device implantation and also their correction by CRT 12 ± 6 months post-implantation. Patients with a left ventricular (LV) end-systolic volume decrease of ≥15% during the first year of follow-up were regarded as responders. Patients were followed for a median period of 46 months (interquartile range: 27-65 months) for the occurrence of death of any cause. If corrected by CRT, visually assessed ApRock and SF were associated with reverse remodelling with a sensitivity of 84 and 79%, specificity of 79 and 74%, and accuracy of 82 and 77%, respectively. ApRock (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.30-0.53, P < 0.0001) and SF (HR 0.45 [CI 0.34-0.61], P < 0.001) were independently associated with lower all-cause mortality after CRT and had an incremental value over clinical variables and QRS width for identifying CRT responders. Both the absence of ApRock/SF and unsuccessful correction of ApRock/SF despite CRT were associated with a high risk for non-response and an unfavourable long-term survival. CONCLUSION: A specific LV mechanical dyssynchrony pattern, characterized by ApRock and SF, is associated with a more favourable long-term survival after CRT. Both parameters are also indicators of an effective therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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29. A New Tool for Automatic Assessment of Segmental Wall Motion Based on Longitudinal 2D Strain: A Multicenter Study by the Israeli Echocardiography Research Group.
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Liel-Cohen, Noah, Tsadok, Yossi, Been, Ronen, Lysyansky, Peter, Agmon, Yoram, Feinberg, Micha S., Fehske, Wolfgang, Gilon, Dan, Hay, Ilan, Kuperstein, Rafael, Leitman, Marina, Deutsch, Lisa, Rosenmann, David, Sagie, Alik, Shimoni, Sarah, Vaturi, Mordehay, Friedman, Zvi, and Blondheim, David S.
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SEGMENTAL analysis technique (Biomechanics) ,ELECTRONIC data processing ,CORONARY disease ,CARDIOMYOPATHIES ,CARDIAC contraction ,MEDICAL equipment ,MEDICAL equipment reliability - Abstract
The article presents a study which examines the practical use of an automatic tool for the assessment of segmental wall motion (WM) abnormalities based on longitudinal two dimensional strain. It states that an automated analysis with conventional visual method was used in comparing the segmental scoring of normal subjects and patients with ischemic heart disease or cardiomyopathy. Results show that the two dimensional longitudinal strain WM scoring tool can be used to assess WM contraction.
- Published
- 2010
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30. Multiplane transesophageal echocardiographic evaluation of transvenous defibrillation leads.
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Fehske, Wolfgang, Jung, Werner, Omran, Heyder, Manz, Matthias, Moosdorf, Rainer, Lüderitz, Berndt, Fehske, W, Jung, W, Omran, H, Manz, M, Moosdorf, R, and Lüderitz, B
- Published
- 1995
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31. Diagnosis of a posterior left ventricular pseudoaneurysm by multiplane transesophageal echocardiography.
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Fehske, Wolfgang, Kranidis, Athanasios, Kirchhoff, Paul Gerhard, Omran, Heyder, Lauck, Gerhard, Lüderitz, Berndt, Fehske, W, Kranidis, A, Kirchhoff, P G, Omran, H, Lauck, G, and Lüderitz, B
- Published
- 1995
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32. Angiographic Results and Elastic Recoil Following Coronary Excimer Laser Angioplasty with Saline Perfusion.
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PIZZULLI, LUCIANO, JUNG, WERNER, PFEIFFER, DIETRICH, FEHSKE, WOLFGANG, and LÜDERITZ, BERNDT
- Published
- 1996
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33. Radiofrequency catheter ablation of septal accessory pathways.
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PFEIFFER, DIETRICH, TEBBENJOHANNS, JÜRGEN, SCHUMACHER, BURGHARD, OMRAN, HEYDER, FEHSKE, WOLFGANG, LÜDERITZ, BERNDT, Pfeiffer, D, Tebbenjohanns, J, Schumacher, B, Omran, H, Fehske, W, and Lüderitz, B
- Published
- 1995
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34. Echocardiographic Imaging of Coronary Sinus Diverticula and Middle Cardiac Veins in Patients with Preexcitation Syndrome: Impact on Radiofrequency Catheter Ablation of Posteroseptal Accessory Pathways.
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Omran, Heyder, Pfeiffer, Dietrich, Tebbenjohanns, Jürgen, Schumacher, Burghard, Manz, Matthias, Lauck, Gerhard, Hagendorff, Andreas, Jung, Werner, Fehske, Wolfgang, and Lüderitz, Berndt
- Subjects
ECHOCARDIOGRAPHY ,MEDICAL imaging systems ,CATHETER ablation ,RADIO frequency ,BLOOD vessels ,ANGIOGRAPHY - Abstract
To determine the value of echocardiography for identifying coronary sinus (CS) diverticula and middle cardiac veins (MGVs) in patients with posteroseptal accessory pathways (PAPs), transthoracic (TTE) and transesophageal echocardiography (TEE) were performed in 18 consecutive patients with PAP and in 15 control subjects with left lateral accessory pathway before CS angiography. The size, shape, and location of CS diverticula and MCV were described and compared to angiography. TEE and angiography were concordant for the identification of diverticula (n = 5) and agreed for depicting MCV in 22 of the 27 cases. TTE revealed 4 of 5 diverticula and identified 4 of 27 MCV (P < 0.001). Fourteen MCV but no diverticula were found in the control subjects. There was no significant difference between transesophageal and angiographic measurements for the width (23.5 ± 4.9 vs 26.8 ± 6.6 mm) and height (13.5 ± 3.8 vs 15.7 ± 3.4 mm) of the diverticula, and the width (3.5 ± 0.7 vs 3.7 ± 0.6 mm) of MCV. TEE underestimated the length of the MCV (12.0 ± 1.8 vs 27.2 ± 6.0, P < 0.001). Delivery of radiofrequency energy within the neck of a diverticulum or within an MCV was successful in 5 of 5, and 6 of 13 cases in patients with PAPs, respectively. In conclusion, echocardiography was as reliable as angiography for detecting and describing CS diverticula and MCV in patients with preexcitation syndrome. Echocardiography is recommended prior to electrophysiological study because it may simplify radiofrequency catheter ablation. [ABSTRACT FROM AUTHOR]
- Published
- 1995
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35. A Simplified, Practical Echocardiographic Approach for 3-Dimensional Surfacing and Quantitation of the Left Ventricle: Clinical Application in Patients with Abnormally Shaped Hearts
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Mele, Donato, Fehske, Wolfgang, Mæhle, Jørgen, Cittanti, Corrado, von Smekal, Alexander, Lüderitz, Berndt, Alboni, Paolo, and Levine, Robert A.
- Published
- 1998
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36. Left Atrial Chamber and Appendage Function After Internal Atrial Defibrillation: A Prospective and Serial Transesophageal Echocardiographic Study
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Omran, Heyder, Jung, Werner, Rabahieh, Rami, Schimpf, Rainer, Wolpert, Christian, Hagendorff, Andreas, Fehske, Wolfgang, and Lüderitz, Berndt
- Published
- 1997
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37. Diagnosis and follow-up of congenital heart disease in children with the use of two-dimensional Doppler echocardiography
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Redel, Dierk A. and Fehske, Wolfgang
- Published
- 1984
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38. Color-coded Doppler imaging of the vena contracta as a basis for quantification of pure mitral regurgitation
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Fehske, Wolfgang, Omran, Heyder, Manz, Matthias, Köhler, Josef, Hagendorff, Andreas, and Lüderitz, Berndt
- Published
- 1994
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39. Complications of pacemaker-defibrillator devices: Diagnosis and management
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Pfeiffer, Dietrich, Jung, Werner, Fehske, Wolfgang, Korte, Thomas, Manz, Matthias, Moosdorf, Rainer, and Lüderitz, Berndt
- Published
- 1994
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40. PREDICTORS OF ADVERSE CARDIAC EVENTS IN NONCOMPACTION CARDIOMYOPATHY: DATA FROM THE GERMAN NONCOMPACTION REGISTRY (ALKK).
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Engberding, Rolf, Stoellberger, Claudia, Fehske, Wolfgang, Gietzelt, Matthias, Haux, Reinhold, and Gerecke, Birgit J.
- Published
- 2014
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41. Which patients do benefit from an implantable atrial defibrillator?
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Jung, Werner, Pfeiffer, Dietrich, Wolpert, Christian, Pizzulli, Luciano, Fehske, Wolfgang, Schumacher, Burghard, Lewalter, Thorsten, Omran, Heyder, Korte, Thomas, and Lüderitz, Berndt
- Published
- 1996
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42. Spatial flow velocity distribution in mechanical mitral valve prostheses as detected by quantitative color flow imaging using multiplane transesophageal echocardiography
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Fehske, Wolfgang, Köhler, Josef, Rabahieh, Rami, and Lüderitz, Berndt
- Published
- 1996
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43. Effect of various atrio-ventricular intervals on coronary artery flow velocity profiles in dual chamber pacemakers
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Omran, Heyder, Lewalter, Thorsten, MacCarter, Dean, Jung, Werner, Rabahieh, Rami, Fehske, Wolfgang, and Lüderitz, Berndt
- Published
- 1996
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44. Transcatheter edge-to-edge valve repair versus minimally invasive beating-heart surgery of the tricuspid valve: an observational study.
- Author
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Wilde N, Silaschi M, Alirezaei H, Vogelhuber J, Sugiura A, Tanaka T, Sudo M, Kavsur R, Cattelaens F, El-Sayed Ahmad A, Doss M, Fehske W, Zimmer S, Nickenig G, Bakhtiary F, and Weber M
- Subjects
- Humans, Tricuspid Valve surgery, Treatment Outcome, Cardiac Catheterization, Tricuspid Valve Insufficiency surgery, Heart Valve Prosthesis Implantation
- Published
- 2023
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45. Acute redistribution of regional left ventricular work by cardiac resynchronization therapy determines long-term remodelling.
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Duchenne J, Aalen JM, Cvijic M, Larsen CK, Galli E, Bézy S, Beela AS, Ünlü S, Pagourelias ED, Winter S, Hopp E, Kongsgård E, Donal E, Fehske W, Smiseth OA, and Voigt JU
- Subjects
- Echocardiography, Humans, Prospective Studies, Treatment Outcome, Ventricular Function, Left, Ventricular Remodeling, Cardiac Resynchronization Therapy, Heart Failure diagnostic imaging, Heart Failure therapy, Ventricular Dysfunction, Left therapy
- Abstract
Aims: Investigating the acute impact of cardiac resynchronization therapy (CRT) on regional myocardial work distribution in the left ventricle (LV) and to which extent it is related to long-term reverse remodelling., Methods and Results: One hundred and thirty heart failure patients, referred for CRT implantation, were recruited in our prospective multicentre study. Regional myocardial work was calculated from non-invasive segmental stress-strain loop area before and immediately after CRT. The magnitude of volumetric reverse remodelling was determined from the change in LV end-systolic volume, 11 ± 2 months after implantation. CRT caused acute redistribution of myocardial work across the LV, with an increase in septal work, and decrease in LV lateral wall work (all P < 0.05). Amongst all LV walls, the acute change in work in the septum and lateral wall of the four-chamber view correlated best and significantly with volumetric reverse remodelling (r = 0.62, P < 0.0001), with largest change seen in patients with most volumetric reverse remodelling. In multivariate linear regression analysis, including conventional parameters, such as pre-implant QRS morphology and duration, LV ejection fraction, ischaemic origin of cardiomyopathy, and the redistribution of work across the septal and lateral walls, the latter appeared as the strongest determinant of volumetric reverse remodelling after CRT (model R2 = 0.414, P < 0.0001)., Conclusion: The acute redistribution of regional myocardial work between the septal and lateral wall of the LV is an important determinant of reverse remodelling after CRT implantation. Our data suggest that the treatment of the loading imbalance should, therefore, be the main aim of CRT., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
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46. Sex-specific difference in outcome after cardiac resynchronization therapy.
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Beela AS, Duchenne J, Petrescu A, Ünlü S, Penicka M, Aakhus S, Winter S, Aarones M, Stefanidis E, Fehske W, Willems R, Szulik M, Kukulski T, Faber L, Ciarka A, Neskovic AN, Stankovic I, and Voigt JU
- Subjects
- Aged, Cause of Death, Coronary Angiography, Electrocardiography, Female, Heart Function Tests, Humans, Male, Middle Aged, Registries, Retrospective Studies, Sex Factors, Cardiac Resynchronization Therapy methods, Echocardiography, Doppler, Outcome Assessment, Health Care
- Abstract
Aims: Observation of better outcome in women after cardiac resynchronization therapy (CRT) has led to controversies about a potential sex-specific response. In this study, we investigated to which extent this sex-specific difference in CRT outcome could be explained by differences in baseline characteristics between both sexes., Methods and Results: We retrospectively analysed data from a multicentre registry of 1058 patients who received CRT. Patients were examined by echocardiography before and 12 ± 6 months after implantation. Response was defined as ≥15% reduction of left ventricular end-systolic volume at follow-up. Patient's characteristics at baseline, including New York Heart Association class, ejection fraction, QRS width and morphology, ischaemic aetiology of cardiomyopathy (ICM), number of scarred segments, age at implantation, atrial fibrillation, and mechanical dyssynchrony (Dyss) were analysed. Patients were followed for a median duration of 59 months. Primary end point was all-cause mortality. Women (24% of the population) had less ICM (23% vs. 49%, P < 0.0001), less scarred segments (0.4 ± 1.3 vs. 1.0 ± 2.1, P < 0.0001), more left bundle branch block (LBBB; 87% vs. 80%, P = 0.01), and more Dyss at baseline (78% vs. 57%, P < 0.0001). Without matching baseline differences, women showed better survival (log rank P < 0.0001). After matching, survival was similar (log rank P = 0.58). In multivariable analysis, female sex was no independent predictor of neither volumetric response (P = 0.06) nor survival (P = 0.31)., Conclusion: Our data suggest that the repeatedly observed better outcome in women after CRT is mainly due to the lower rate ICM and smaller scars. When comparing patients with similar baseline characteristics, the response of both sexes to CRT is similar., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2019
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47. Assessment of mechanical dyssynchrony can improve the prognostic value of guideline-based patient selection for cardiac resynchronization therapy.
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Beela AS, Ünlü S, Duchenne J, Ciarka A, Daraban AM, Kotrc M, Aarones M, Szulik M, Winter S, Penicka M, Neskovic AN, Kukulski T, Aakhus S, Willems R, Fehske W, Faber L, Stankovic I, and Voigt JU
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- Aged, Echocardiography, Female, Heart Failure diagnostic imaging, Heart Failure mortality, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Treatment Outcome, Cardiac Resynchronization Therapy, Guideline Adherence, Heart Failure physiopathology, Heart Failure therapy, Patient Selection
- Abstract
Aim: To determine if incorporation of assessment of mechanical dyssynchrony could improve the prognostic value of patient selection based on current guidelines., Methods and Results: Echocardiography was performed in 1060 patients before and 12 ± 6 months after cardiac resynchronization therapy (CRT) implantation. Mechanical dyssynchrony, defined as the presence of apical rocking or septal flash was visually assessed at the baseline examination. Response was defined as ≥15% reduction in left ventricular end-systolic volume at follow-up. Patients were followed for a median of 59 months (interquartile range 37-86 months) for the occurrence of death of any cause. Applying the latest European guidelines retrospectively, 63.4% of the patients had been implanted with a Class I recommendation, 18.2% with Class IIa, 9.4% with Class IIb, and in 9% no clear therapy recommendation was present. Response rates were 65% in Class I, 50% in IIa, 38% in IIb patients, and 40% in patients without a clear guideline-based recommendation. Assessment of mechanical dyssynchrony improved response rates to 77% in Class I, 75% in IIa, 62% in IIb, and 69% in patients without a guideline-based recommendation. Non-significant difference in survival among guideline recommendation classes was found (Log-rank P = 0.2). Presence of mechanical dyssynchrony predicted long-term outcome better than guideline Classes I, IIa, IIb (Log-rank P < 0.0001, 0.006, 0.004, respectively) and in patients with no guideline recommendation (P = 0.02). Comparable results were observed using the latest American Guidelines., Conclusion: Our data suggest that current guideline criteria for CRT candidate selection could be improved by incorporating assessment of mechanical asynchrony.
- Published
- 2019
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48. Timing of myocardial shortening determines left ventricular regional myocardial work and regional remodelling in hearts with conduction delays.
- Author
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Cvijic M, Duchenne J, Ünlü S, Michalski B, Aarones M, Winter S, Aakhus S, Fehske W, Stankovic I, and Voigt JU
- Subjects
- Aged, Analysis of Variance, Cohort Studies, Databases, Factual, Electrocardiography methods, Female, Heart Failure etiology, Heart Failure therapy, Humans, Male, Middle Aged, Myocardial Contraction physiology, Prognosis, Stroke Volume physiology, Time Factors, Ventricular Dysfunction, Left complications, Ventricular Dysfunction, Left therapy, Cardiac Resynchronization Therapy methods, Echocardiography methods, Heart Failure diagnostic imaging, Image Interpretation, Computer-Assisted, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Remodeling physiology
- Abstract
Aims: The interaction between asynchronous regional myocardial activation and left ventricular (LV) wall remodelling has not been well established. We investigated the relationship between time of onset of longitudinal shortening (Tonset), regional myocardial work, and segmental LV wall thickness (SWT) in patients treated with cardiac resynchronization therapy (CRT)., Methods and Results: We analysed 26 patients with sinus rhythm, non-ischaemic cardiomyopathy (63 ± 9 years, 69% male, QRS duration 174 ± 18 ms) and positive response to CRT (15% reduction in end-systolic volume). Longitudinal strain was obtained by 2D speckle-tracking echocardiography before and after [14.5 (7-29) months] CRT. Tonset and SWT were measured in 18 segments per LV. Segmental myocardial work was calculated from non-invasive segmental stress-strain loop area. Before CRT, Tonset was the shortest in septal and anteroseptal and the longest in lateral and posterior walls (P < 0.001) and not different after CRT (P = 0.733). Before CRT, septal and anteroseptal walls were significantly thinner than lateral and posterior. After CRT, reverse remodelling increased thickness in septal and anteroseptal and thinned lateral and posterior segments (P < 0.001). Before CRT, non-uniformity in work distribution with reduced work in septal and anteroseptal and increased work in lateral and posterior walls (P < 0.001) was observed. After CRT, distribution of myocardial work was uniform (P = 0.215)., Conclusion: Dys-synchronous myocardial shortening is related to thinning of early and thickening of late activated segments in heart failure with conduction delay. Correction of dys-synchrony leads to regression of inhomogeneity towards more evenly distributed wall thickness. Regional differences in myocardial work load that are homogenized by successful CRT are considered as the underlying pathophysiological mechanism.
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- 2018
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49. Validation of a Novel Software Tool for Automatic Aortic Annular Sizing in Three-Dimensional Transesophageal Echocardiographic Images.
- Author
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Queirós S, Morais P, Dubois C, Voigt JU, Fehske W, Kuhn A, Achenbach T, Fonseca JC, Vilaça JL, and D'hooge J
- Subjects
- Aged, 80 and over, Aortic Valve Stenosis diagnosis, Female, Humans, Male, Reproducibility of Results, Retrospective Studies, Aortic Valve diagnostic imaging, Aortic Valve Stenosis surgery, Echocardiography, Three-Dimensional methods, Echocardiography, Transesophageal methods, Multidetector Computed Tomography methods, Software, Transcatheter Aortic Valve Replacement methods
- Abstract
Background: Accurate aortic annulus (AoA) sizing is crucial for transcatheter aortic valve implantation planning. Three-dimensional (3D) transesophageal echocardiography (TEE) is a viable alternative to the standard multidetector row computed tomography (MDCT) for such assessment, with few automatic software solutions available. The aim of this study was to present and evaluate a novel software tool for automatic AoA sizing by 3D TEE., Methods: One hundred one patients who underwent both preoperative MDCT and 3D TEE were retrospectively analyzed using the software. The automatic software measurements' accuracy was compared against values obtained using standard manual MDCT, as well as against those obtained using manual 3D TEE, and intraobserver, interobserver, and test-retest reproducibility was assessed. Because the software can be used as a fully automatic or as an interactive tool, both options were addressed and contrasted. The impact of these measures on the recommended prosthesis size was then evaluated to assess if the software's automated sizes were concordant with those obtained using an MDCT- or a TEE-based manual sizing strategy., Results: The software showed very good agreement with manual values obtained using MDCT and 3D TEE, with the interactive approach having slightly narrower limits of agreement. The latter also had excellent intra- and interobserver variability. Both fully automatic and interactive analyses showed excellent test-retest reproducibility, with the first having a faster analysis time. Finally, either approach led to good sizing agreement against the true implanted sizes (>77%) and against MDCT-based sizes (>88%)., Conclusions: Given the automated, reproducible, and fast nature of its analyses, the novel software tool presented here may potentially facilitate and thus increase the use of 3D TEE for preoperative transcatheter aortic valve implantation sizing., (Copyright © 2018 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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50. The association of volumetric response and long-term survival after cardiac resynchronization therapy.
- Author
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Stankovic I, Belmans A, Prinz C, Ciarka A, Maria Daraban A, Kotrc M, Aarones M, Szulik M, Winter S, Neskovic AN, Kukulski T, Aakhus S, Willems R, Fehske W, Penicka M, Faber L, and Voigt JU
- Subjects
- Aged, Analysis of Variance, Cohort Studies, Echocardiography methods, Europe, Female, Hemodynamics physiology, Humans, Internationality, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, Prognosis, Retrospective Studies, Risk Assessment, Severity of Illness Index, Survival Rate, Treatment Outcome, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Remodeling physiology, Cardiac Resynchronization Therapy methods, Cause of Death, Stroke Volume physiology, Ventricular Dysfunction, Left mortality, Ventricular Dysfunction, Left therapy
- Abstract
Aims: Clinical experience indicates that limited or no reverse left ventricular (LV) remodelling may not necessarily imply non-response to cardiac resynchronization therapy (CRT). We investigated the association of the extent of LV remodelling, mechanical dyssynchrony, and survival in patients undergoing CRT., Methods and Results: In 356 CRT candidates, three blinded readers visually assessed the presence of mechanical dyssynchrony (either apical rocking and/or septal flash) before device implantation and also its correction by CRT 12 ± 3 months post-implantation. To assess LV reverse remodelling, end-systolic volumes (ESV) were measured at the same time points. Patients were divided into four subgroups: no LV remodelling (ESV change 0 ± 5%), mild LV reverse remodelling (ESV reduction 5-15%), significant LV reverse remodelling (ESV reduction ≥15%), and LV volume expansion (ESV increase ≥5%). Patients were followed for all-cause mortality during the median follow-up of 36 months. Patients with LV remodelling as in the above defined groups showed 58, 54, and 84% reduction in all-cause mortality compared to patients with volume expansion. In multivariable analysis, LVESV change remained independently associated with survival, with an 8% reduction in mortality for every 10% decrease in LVESV (P = 0.0039), but an optimal cut-off point could not be established. In comparison, patients with corrected mechanical dyssynchrony showed 71% reduction in all-cause mortality (P < 0.001)., Conclusion: Volumetric response assessed at 1-year after CRT is strongly associated with long-term mortality. However, an optimal cut-off cannot be established. The association of the correction of mechanical dyssynchrony with survival was stronger than that of any volumetric cut-off., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2017
- Full Text
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