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3. 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, Rudina, Shuperka, Eritinka, Lleshi, Erviola, Rustemaj, Joana, Qordja, Marsjon, Gina, Mirald, Husi, Senada, Basic, Daniel, Steringer-Mascherbauer, Regina, Huber, Charlotte, Ebner, Christian, Sigmund, Elisabeth, Ploechl, Andrea, Sturmberger, Thomas, Eder, Veronica, Koppler, Tanja, Heger, Maria, Kammerlander, Andreas, Duca, Franz, Binder, Christina, Koschutnik, Matthias, Perschy, Leonard, Puskas, Lisa, Ho, Chen-Yu, Aliyev, Farid, Guluzada, Vugar, Imanov, Galib, Ibrahimov, Firdovsi, Abbasaliyev, Abbasali, Ahmedov, Tahir, Muslumova, Fargana, Babayev, Jamil, Rustamova, Yasmin, Jahangirov, Tofig, Samadov, Rauf, Museyibov, Muxtar, Isayev, Elnur, Musayev, Oktay, Xalilov, Shahin, Huseynov, Saleh, Yuzbashova, Madina, Zamanov, Vuqar, Mammadov, Vusal, Van Camp, Gery, Penicka, Martin, Batjoens, Hedwig, Debonnaire, Philippe, Dendooven, Daniel, Knecht, Sebastien, Duytschaever, Mattias, Vandekerckhove, Yves, Missault, Luc, Muyldermans, Luc, Tavernier, René, De Grande, Tineke, Coussement, Patrick, DeTroyer, Joyce, Derycker, Katrien, De Jaegher, Kelly, Bondue, Antoine, Beauloye, Christophe, Goffinet, Céline, Mirica, Daniela Corina, Eynden, Frédéric Vanden, Van de Borne, Philippe, Van Frachen, Béatrice, Vancraeynest, David, Vanoverschelde, Jean Louis, Pierard, Sophie, Malanca, Mihaela, Sinnaeve, Florence, Tahon, Séverine, De Clippel, Marie, Gayet, Frederic, Loiseau, Jacques, Van de Veire, Nico, Moerman, Veronique, Willems, Anne-Marie, Cosyns, Bernard, Droogmans, Steven, Motoc, Andreea, Kerkhove, Dirk, Plein, Daniele, Roosens, Bram, Weytjens, Caroline, Lancellotti, Patrizio, Dulgheru, Elena Raluca, Parenicova, Ilona, Bedanova, Helena, Tousek, Frantisek, Sindelarova, Stepanka, Canadyova, Julia, Taborsky, Milos, Ostransky, Jiri, Ivona simkova, Vicha, Marek, Jelinek, Libor, Opavska, Irena, Homza, Miroslav, Kvrayola, Miriam, Brat, Radim, Mrozek, Dan, Lichnerova, Eva, Docekalova, Iveta, Zarybnicka, Marta, Peskova, Marketa, Roucka, Patrik, Stastna, Vlasta, Vondrackova, Dagmar Jungwirtova, Hornig, Alfred, Niznansky, Matus, Branny, Marian, Vodzinska, Alexandra, Dorda, Miloslav, Snkouril, Libor, Kluz, Krystyna, Kypusova, Jana, Nezvalova, Radka, Olsen, Niels Thue, Ali, Hosam Hasan, Taha, Salma, Hassan, Mohamed, Afifi, Ahmed, Kabil, Hamza, Mady, Amr, Ebaid, Hany, Ahmed, Yasser, Nour, Mohammad, Talaat, Islam, Sayed, CairoMaiy El, Mostafa, Ahmad Elsayed, Sadek, CairoYasser, Eltobgi, CairoSherif, Bakhoum, Sameh, Doss, Ramy, Sheashea, Mahmoud, Elasry, Abd Allah, Fouad, Ahmed, Baraka, Mahmoud, Samir, Sameh, Roshdy, Alaa, AbdelRazek, Yasmin, Abd Rabou, Mostafa M., Abobakr, Ahmed, Moaaz, Moemen, Mokhtar, Mohamed, Ashry, Mohamed, Elkhashab, Khaled, Ghareeb, Haytham Soliman, Kamal, Mostafa, AbdelRazek, Gomaa, Farag, GizaNabil, Elbarbary, Giza:Ahmed, Wahib, Evette, Kazamel, Ghada, Kamal, Diaa, Tantawy, Mahmoud, Alansary, Adel, Yahia, Mohammed, Mahmoud, Raouf, El Banna, Tamer, Atef, Mohamed, Nasr, Gamela, Ahmed, Salah, El Hefny, Ehab E., Saifelyazal, Islam, El Ghany, Mostafa Abd, El Rahman El Hadary, Abd, Khairy, Ahmed, Lommi, Jyri, Laine, Mika, Kylmala, Minna, Kankanen, Katja, Turpeinen, Anu, Hartikainen, Juha, Kujanen, Lari, Airaksinen, Juhani, Vasankari, Tuija, Szymanski, Catherine, Bohbot, Yohann, Gun, Mesut, Rousseaux, Justine, Biere, Loic, Mateus, Victor, Audonnet, Martin, Rautureau, Jérémy, Cornet, Charles, Sorbets, Emmanuel, Mear, BourgesKarine, Issa, Adi, Jobic, Yannick, Le Ven, Florent, Pouliquen, Marie-Claire, Gilard, Martine, Ohanessian, Alice, Farhat, Ali, Vlase, Alina, Said, Fkhar, Lasgi, Caroline, Sanchez, Carlos, Breil, Romain, Peignon, Marc, Elkaim, Jean-Philippe, Jan-Blin, Virginie, BertrandM'Ban, Sylvain Ropars, Bardet, Hélène, Sawadogo, Samuel, Muschoot, Aurélie, Tchatchoua, Dieudonné, Elhadad, Simon, Maubert, Aline, Lazizi, Tahar, Ourghi, Kais, Bonnet, Philippe, Menager-Gangloff, Clarisse, Gafsi, Sofiene, Mansouri, Djidjiga, Aboyans, Victor, Magne, Julien, Martins, Elie, Karm, Sarah, Mohty, Dania, Briday, Guillaume, David, Amandine, Marechaux, Sylvestre, Le Goffic, Caroline, Binda, Camille, Menet, Aymeric, Delelis, Francois, Ringlé, Anne, Castel, Anne-Laure, Appert, Ludovic, Tristram, Domitille, Trouillet, Camille, Nacer, Yasmine, Ngoy, Lucas, Habib, MarseilleGilbert, Thuny, Franck, Haentjens, Julie, Cautela, Jennifer, Lavoute, Cécile, Robin, Floriane, Armangau, Pauline, Vergeylen, Ugo, Sanhadji, Khalil, Abdallah, Nessim Hamed, Kerzazi, Hassan, Perianu, Mariana, Plurien, François, Oueslati, Chaker, Debauchez, Mathieu, Monin, Jean-Luc, Konstantinos, Zannis, Berrebi, Alain, Dibie, Alain, Lansac, Emmanuel, Veugeois, Aurélie, Diakov, Christelle, Caussin, Christophe, Czitrom, Daniel, Salvi, Suzanna, Amabile, Nicolas, Dervanian, Patrice, Lejeune, Stéphanie, Bagdadi, Imane, Mokrane, Yemmi, Rouault, Gilles, Abalea, Jerome, Leledy, Marion, Horen, Patrice, Donal, Erwan, Bosseau, Christian, Paven, Elise, Galli, Elena, Collette, Edouard, Urien, Jean-Marie, Bridonneau, Valentin, Gervais, Renaud, Bauer, Fabrice, Chopra, Houzefa, Charbonnier, Arthur, Attias, David, Dahouathi, Nesrine, Khounlaboud, Moukda, Daudin, Magalie, Thebault, Christophe, Hamon, Cécile, Couffon, Philippe, Bellot, Catherine, Vomscheid, Maelle, Bernard, Anne, Dion, Fanny, Naudin, Djedjiga, Mouzouri, Mohammed, Rudelin, Mathilde, Berenfeld, Alain, Vanzwaelmen, Thibault, Alloui, Tarik, Radovikj, Marija Gjerakaroska, Jordanova, Slavica, Scholtz, Werner, Liberda-Knoke, Eva, Wiemer, Melanie, Mugge, Andreas, Nickenig, Georg, Sinning, Jan-Malte, Sedaghat, Alexander, Heintzen, Matthias, Ballof, Jan, Frenk, Daniel, Hambrecht, Rainer, Wienbergen, Harm, Seidel, Annemarie, Osteresch, Rico, Kramer, Kirsten, Ziemann, Janna, Schulze, Ramona, Fehske, Wolfgang, Eifler, Clarissa, Wafaisade, Bahram, Kuhn, Andreas, Fischer, Sören, Lichtenberg, Lutz, Brunold, Mareike, Simons, Judith, Balling, Doris, Buck, Thomas, Plicht, Bjoern, Schols, Wolfgang, Ebelt, Henning, Chamieh, Marwan, Anacker, Jelena, Rassaf, Tienush, Janosi, Alexander, Lind, Alexander, Lortz, Julia, Lüdike, Peter, Kahlert, Philipp, Rittger, Harald, Eichinger, Gabriele, Kuhls, Britta, Felix, Stephan B., Lehnert, Kristin, Pedersen, Ann-Louise, Dorr, Marcus, Empen, Klaus, Kaczmarek, Sabine, Busch, Mathias, Baly, Mohammed, Er, Fikret, Duman, Erkan, Gabriel, Linda, Weinbrenner, Christof, Bauersachs, Johann, Wider, Julian, Kempf, Tibor, Bohm, Michael, Schulze, Paul-Christian, Poerner, C. Tudor, Möbius-Winkler, Sven, Lenk, Karsten, Heitkamp, Kerstin, Franz, Marcus, Krauspe, Sabine, Schumacher, Burghard, Windmuller, Volker, Kurwitz, Sarah, Thiele, Holger, Kurz, Thomas, Meyer-Saraei, Roza, Akin, Ibrahim, Fastner, Christian, Lossnitzer, Dirk, Hoffmann, Ursula, Borggrefe, Martin, Baumann, Stefan, Kircher, Brigitte, Foellinger, Claudia, Dietz, Heike, Schieffer, Bernhard, Niroomand, Feraydoon, Mudra, Harald, Maier, Lars, Camboni, Daniele, Birner, Christoph, Debl, Kurt, Paulus, Michael, Seither, Benedikt, El Mokhtari, Nour Eddine, Oner, Alper, Caglayan, Evren, Sherif, Mohammed, Yucel, Seyrani, Custodis, Florian, Schwinger, Robert, Vorpahl, Marc, Seyfarth, Melchior, Nover, Ina, Koehler, Till, Christiani, Sarah, Sanchez, David Calvo, Schanze, Barbel, Sigusch, Holger, Salman, Athir, Hancock, Jane, Chambers, John, Demetrescue, Camelia, Prendergast, Claire, Dalby, Miles, Smith, Robert, Rogers, Paula, Riley, Cheryl, Tousoulis, Dimitris, Kanakakis, Ioannis, Spargias, Konstantinos, Lampropoulos, Konstantinos, Panagiotis, Tolis, Koutsoukis, Athanasios, Michalis, Lampros, Goudevenos, Ioannis, Bellos, Vasileios, Papafaklis, Michail, Lakkas, Lampros, Hahalis, George, Makris, Athanasios, Karvounis, Haralampos, Kamperidis, Vasileios, Ninios, Vlasis, Sachpekidis, Vasileios, Rouskas, Pavlos, Poulimenos, Leonidas, Charalampidis, Georgios, Hamodraka, Eftihia, Manolis, Athanasios, Kiss, Robert Gabor, Borsanyi, Tunde, Jarai, Zoltan, Zsary, Andras, Bartha, Elektra, Kosztin, Annamaria, Doronina, Alexandra, Kovacs, Attila, Imre, Barabas Janos, Chao, Chun, Benke, Kalman, Karoczkai, Istvan, Keltai, Kati, Förchécz, Zsolt, Pozsonyi, Zoltán, Jenei, Zsigmond, Patthy, Adam, Sallai, Laszlo, Majoros, Zsuzsanna, Pál, Tamás, Bencze, Jusztina, Sagi, Ildiko, Molnar, Andrea, Kurczina, Anita, Kolodzey, Gabor, Edes, Istvan, Szatmari, Valeria, Zajacz, Zsuzsanna, Cziraki, Attila, Nemeth, Adam, Faludi, Reka, Vegh, Laszlone, Jebelovszki, Eva, Lupkovics, Geza Karoly, Kovacs, Zsofia, Horvath, Andras, Berisha, Gezim, Ibrahimi, Pranvera, Percuku, Luan, Arapova, Rano, Laahunova, Elmira, Neronova, Kseniia, Zhakypova, Zarema, Naizabekova, Gulira, Muratova, Gulnazik, Sime, Iveta, Sorokins, Nikolajs, Kamzola, Ginta, Cgojeva-Sproge, Irina, Rancane, Gita, Valentinaviciene, Ramune, Rudiene, Laima, Raugaliene, Rasa, Bardzilauske, Aiste, Jonkaitiene, Regina, Petrauskaite, Jurate, Bieseviciene, Monika, Verseckaite, Raimonda, Zvirblyte, Ruta, Kalibatiene, Danute, Radauskaite, Greta, Janaviciute-Matuzeviciene, Gabija, Jancauskaite, Dovile, Balkute, Deimile, Maneikyte, Juste, Mileryte, Ingrida, Vaisvilaite, Monika, Gedvilaite, Lina, Biliukas, Mykolas, Karpaviciene, Vaiva, Xuereb, Robert George, Pllaha, Elton, Djaberi, Roxana, Komor, Klaudiusz, Gorgon-Komor, Agnieszka, Loranc, Beata, Myszor, Jaroslaw, Mizia-Stec, Katarzyna, Berger-Kucza, Adrianna, Mizia, Magdalena, Polak, Mateusz, Bogacki, Piotr, Podolec, Piotr, Komar, Monika, Sedziwy, Ewa, Sliwiak, Dorota, Sobien, Bartosz, Rog, Beata, Hlawaty, Marta, Gancarczyk, Urszula, Libiszewska, Natasza, Sorysz, Danuta, Gackowski, Andrzej, Cieply, Malgorzata, Misiuda, Agnieszka, Racibor, Franciszek, Nytko, Anna, Widenka, Kazimierz, Kolowca, Maciej, Bak, Janusz, Curzytek, Andrzej, Regulski, Mateusz, Kamela, Malgorzata, Wisniowski, Mateusz, Hryniewiecki, Tomasz, Szymanski, Piotr, Rozewicz, Monika, Grabowski, Maciej, Duchnowski, Piotr, Budaj, Andrzej, Zaborska, Beata, Pilichowska-Paskiet, Ewa, Sikora-Frac, Malgorzata, Slomski, Tomasz, Joao, Isabel, Cruz, Ines, Pereira, Hélder, Cale, Rita, Marques, Ana, Pereira, Ana Rita, Morais, Carlos, Freitas, Antonio, Roque, David, Antunes, Nuno, Pereira, Antonio Costeira, Vieira, Catarina, Salome, Nuno, Martins, Juliana, Campos, Isabel, Cardoso, Goncalo, Silva, Claudia, Oliveira, Afonso, Goncalves, Mariana, Martins, Rui, Quintal, Nuno, Mendes, Bruno, Silva, Joseline, Ferreira, Joao, Milner, James, Alves, Patricia, Marinho, Vera, Gago, Paula, Amado, Jose, Bispo, Joao, Bento, Dina, Machado, Inocencia, Oliveira, Margarida, Calvo, Lucy, von Hate, Pedro, Faria, Bebiana, Galrinho, Ana, Branco, Luisa, Goncalves, Antonio, Mendonca, Tiago, Selas, Mafalda, Macedo, Filipe, Sousa, Carla, Cabral, Sofia, Oliveira, Filomena, Trepa, Maria, Fontes-Oliveira, Marta, Nunes, Alzira, Araújo, Paulo, Ribeiro, Vasco Gama, Almeida, Joao, Rodrigues, Alberto, Braga, Pedro, Dias, Sonia, Carvalho, Sofia, Ferreira, Catarina, Ferreira, Alberto, Mateus, Pedro, Moz, Miguel, Leao, Silvia, Margato, Renato, Moreira, Ilidio, Guimanaes, Jose, Ribeiro, Joana, Goncalves, Fernando, Cabral, Jose, Almeida, Ines, Goncalves, Luisa, Tarusi, Mariana, Pop, Calin, Matei, Claudia, Tint, Diana, Barbulescu, Sanziana, Micu, Sorin, Pop, Ioana, Baba, Costica, Dimulescu, Doina, Dorobantu, Maria, Ginghina, Carmen, Onut, Roxana, Popescu, Andreea, Zamfirescu, Brandusa, Aflorii, Raluca, Popescu, Mihaela, Ghilencea, Liviu, Rachieru, Andreeea, Stoian, Monica, Oprescu, Nicoleta, Iancovici, Silvia, Petre, Iona, Mateescu, Anca Doina, Calin, Andreea, Botezatu, Simona, Enache, Roxana, Rosca, Monica, Ciuperca, Daniela, Babalac, Evelyn, Beyer, Ruxandra, Cadis, Laura, Rancea, Raluca, Tomoaia, Raluca, Rosianu, Adela, Kovacs, Emese, Militaru, Constantin, Craciun, Alina, Mirea, Oana, Florescu, Mihaela, Grigorica, Lucica, Dragusin, Daniela, Nechita, Luiza, Marinescu, Mihai, Chiscaneanu, Teodor, Botezatu, Lucia, Corciova, Costela, Petris, Antoniu Octavian, Arsenescu-Georgescu, Catalina, Salaru, Delia, Alexandrescu, Dan Mihai, Plesoianu, Carmjen, Tanasa, Ana, Mitu, Ovidiu, Costache, Irina Iuliana, Tudorancea, Ionut, Usurelu, Catalin, Eminovici, Gabriela, Manitiu, Ioan, Stoia, Oana, Mitre, Adriana, Nistor, Dan-Octavian, Maier, Anca, Lupu, Silvia, Opris, Mihaela, Ionac, Adina, Popescu, Irina, Crisan, Simina, Mornos, Cristian, Goanta, Flavia, Gruescu, Liana, Voinescu, Oana, Petcu, Madalina, Cozlac, Ramona, Damrina, Elena, Khilova, Liliya, Ryazantseva, Irina, Kozmin, Dmitry, Kiseleva, Maria, Goncharova, Marina, Kitalaeva, Kamila, Demetskay, Victoria, Verevetinov, Artem, Fomenko, Mikhail, Skripkina, Elena, Tsoi, Viktor, Antipov, Georgii, Schneider, Yuri, Yazikov, Denis, Makarova, Marina, Cherkes, Aleksei, Ermakova, Natalya, Medvedev, Aleksandr, Sarosek, Anastasia, Isayan, Mikhail, Voronova, Tatyana, Kulumbegov, Oleg, Tuchina, Alina, Stefanov, Sergei, Klimova, Margarita, Smolyaninov, Konstantin, Dandarova, Zhargalma, Magamet, Victoriya, Spiropulos, Natalia, Boldyrev, Sergey, Barbukhatty, Kirill, Buyankov, Dmitrii, Yurin, Vladimir, Gross, Yuriy, Boronin, Maksim, Mikhaleva, Mariya, Shablovskaya, Mariya, Zotov, Alex, Borisov, Daniil, Tereshchenko, Vasily, Zubova, Ekaterina, Kuzmin, A., Tarasenko, Ivan, Gamzaev, Alishir, Borovkova, Natalya, Koroleva, Tatyana, Botova, Svetlana, Pochinka, Ilya, Dunaeva, Vera, Teplitskaya, Victoria, Semenova, Elena I., Korabel'Nikova, Olga V., Simonov, Denis S., Denisenko, Elena, Harina, Natalia, Yarohno, Natalia, Alekseeva, Svetlana, Abydenkova, Julia, Shabalkina, Lyubov, Mayorova, Olga, Tsechanovich, Valeriy, Medvedev, Igor, Lepilin, Michail, Nemchenko, PenzaEvgenii, Karnahin, Vadim, Safina, Vasilya, Slastin, Yaroslav, Gilfanova, Venera, Gorbunov, Roman, Jakubov, Ramis, Fazylova, Aigul, Poteev, Mansur, Vazetdinova, Laysan, Tarasova, Indira, Irgaliyev, Rishat, Moiseeva, Olga, Gordeev, Mikhail, Irtyuga, Olga, Moiseeva, Raisa, Ostanina, Nina, Zverev, Dmitry, Murtazalieva, Patimat, Kuznetsov, Dmitry, Skurativa, Mariya, Polyaeva, Larisa, Mihaiilov, Kirill, Obrenovic-Kircanski, Biljana, Putnik, Svetozar, Simic, Dragan, Petrovic, Milan, Nikolic, Natasa Markovic, Jovovic, Ljiljana, Ostric, Dimitra Kalimanovska, Brajovic, Milan, Manojlovic, Milica Dekleva, Novakovic, Vladimir, Zamaklar-Trifunovic, Danijela, Orbovic, Bojana, Petrovic, Olga, Boricic-Kostic, Marija, Andjelkovic, Kristina, Milanov, Marko, Despotovic-Nikolic, Maja, Budisavljevic, Sreten, Veljkovic, Sanja, Cvetinovic, Nataša, Lepojevic, Daniijela, Todorovic, Aleksandra, Nikolic, Aleksandra, Borzanovic, Branislava, Trkulja, Ljiljana, Tomic, Slobodan, Vukovic, Milan, Milosavljevic, Jelica, Milanovic, Mirjana, Stakic, Vladan, Cvetkovic, Aleksandra, Milutinovic, Suzana, Bozic, Olivera, Miladinovic, Miodrag, Nikolic, Zoran, Despotovic, Dinka, Jovanovic, Dimitrije, Stojsic-Milosavljevic, Anastazija, Ilic, Aleksandra, Sladojevic, Mirjana, Susak, Stamenko, Maletin, Srdjan, Pavlovic, Salvo, Kuzmanovic, Vladimir, Ivanovic, Nikola, Dejanovic, Jovana, Ruzicic, Dusan, Drajic, Dragana, Cvetanovic, Danijel, Mirkovic, Marija, Omoran, Jon, Margoczy, Roman, Sedminova, Katarina, Reptova, Adriana, Baranova, Eva, Valkovicova, Tatiana, Valocik, Gabriel, Kurecko, Marian, Vachalcova, Marianna, Kollarova, Alzbeta, Studencan, Martin, Alusik, Daniel, Kozlej, Marek, Macakova, Jana, Moral, Sergio, Cladellas, Merce, Luiso, Daniele, Calvo, Alicia, Palet, Jordi, Carballo, Juli, Tura, Gisela Teixido, Maldonado, Giuliana, Gutierrez, Laura, Gonzalez-Alujas, Teresa, Jose Fernando, Rodriguez Palomares, Villalva, 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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4. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction: TRANSITION Study

Author

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.

Published
2020
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6. The association of mechanical dyssynchrony and resynchronization therapy with survival in heart failure with a wide QRS complex: a two-world study

Author

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

Published
2020
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10. Clinical and Experimental Evidence for a Strain-Based Classification of Left Bundle Branch Block-Induced Cardiac Remodeling

Author

Calle, Simon, primary, Duchenne, Jürgen, additional, Beela, Ahmed S., additional, Stankovic, Ivan, additional, Puvrez, Alexis, additional, Winter, Stefan, additional, Fehske, Wolfgang, additional, Aarones, Marit, additional, De Buyzere, Marc, additional, De Pooter, Jan, additional, Voigt, Jens-Uwe, additional, and Timmermans, Frank, additional

Published
2022
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12. Is there an association between left atrial outpouching structures and recurrence of atrial fibrillation after catheter ablation?

Author

Celik, Erkan, Hokamp, Nils Grosse, Goertz, Lukas, Fehske, Wolfgang, Lichtenberg, Lutz, Reimer, Robert Peter, Maintz, David, Dueber, Christoph, Achenbach, Tobias, Celik, Erkan, Hokamp, Nils Grosse, Goertz, Lukas, Fehske, Wolfgang, Lichtenberg, Lutz, Reimer, Robert Peter, Maintz, David, Dueber, Christoph, and Achenbach, Tobias

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.

Published
2022

14. Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT)

Author

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

Published
2016
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15. Manual on indications and performance of specific echocardiographic applications

Author

Hagendorff, Andreas, Helfen, Andreas, Flachskampf, Frank A., Ewen, Sebastian, Kruck, Sebastian, La Rosee, Karl, Knierim, Jan, Voigt, Jens-Uwe, Kreidel, Felix, Fehske, Wolfgang, Brandt, Roland, Zahn, Ralf, Knebel, Fabian, Hagendorff, Andreas, Helfen, Andreas, Flachskampf, Frank A., Ewen, Sebastian, Kruck, Sebastian, La Rosee, Karl, Knierim, Jan, Voigt, Jens-Uwe, Kreidel, Felix, Fehske, Wolfgang, Brandt, Roland, Zahn, Ralf, and Knebel, Fabian

Abstract

The second manual on indications for and performance of echocardiography focusses on specific echocardiographic modalities and special problems in several patient cohorts. Practical aspects are discussed with priority. Established echocardiographic modalities are transesophageal, stress and contrast echocardiography. Modern technologies, such as 3D echocardiography and deformation imaging play an important role in nearly all scenarios of clinical echocardiography. This complete echocardiographic spectrum is incorporated into emergency and intensive care medicine, monitoring interventions of structural heart diseases, cardiac surgery, patients with cardiac assist devices, adult patients with congenital heart diseases and the care of highly infectious patients in pandemics. The diagnostic procedures of conventional and modern echocardiography are highlighted in this manual. The use of 3D echocardiography to characterize cardiac morphology and the application of deformation imaging to objectify cardiac function are already established in clinical practice. Stress echocardiography to detect myocardial ischemia and viability or to diagnose valvular heart diseases, assessment of coronary flow reserve to analyze myocardial perfusion and contrast echocardiography for left ventricular opacification and tumor characterization are increasingly being used to improve diagnostics. As mentioned for conventional echocardiography in the last manual of echocardiography in 2009, the modern features in echocardiography require standardized documentation and acquisition of certain images with optimized ultrasound settings, because conclusive and reproducible data analysis can only be performed if the image quality is sufficient.

Published
2021

17. Manual on indications and performance of echocardiography-Update 2020 of the German Cardiac Society

Author

Hagendorff, Andreas, Fehske, Wolfgang, Flachskampf, Frank, Helfen, Andreas, Kreidel, Felix, Kruck, Sebastian, La Rosee, Karl, Tiemann, Klaus, Voigt, Jens-Uwe, von Bardeleben, Ralph Stephan, Zahn, Ralf, Knebel, Fabian, Hagendorff, Andreas, Fehske, Wolfgang, Flachskampf, Frank, Helfen, Andreas, Kreidel, Felix, Kruck, Sebastian, La Rosee, Karl, Tiemann, Klaus, Voigt, Jens-Uwe, von Bardeleben, Ralph Stephan, Zahn, Ralf, and Knebel, Fabian

Abstract

The new manual on indications for and performance of echocardiography focuses primarily on the transthoracic echocardiographic approach. The performance of a standardized documentation in transthoracic echocardiography includes the acquisition of several cineloops and Doppler spectra with consecutive measurements illustrated by figures and a scheme of an echocardiographic report. The extended documentation in transthoracic echocardiography is presented with respect to specific pathological alterations of the heart. This includes alterations of the left ventricular wall thickness, the global and regional reduction of left ventricular function, diastolic dysfunction with normal left ventricular systolic function, pressure and volume overload of the right ventricle and the reduction of right ventricular function and pathological alterations of the heart valves. Echocardiography performed in the presence of aortic valve stenosis and regurgitation, mitral valve stenosis and regurgitation, tricuspid valve regurgitation as well as less common heart valve diseases and endocarditis is presented in special sections. The manual ends with sections describing additional echocardiographic modalities, the reporting and the use of emergency echocardiography.

Published
2020
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18. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction

Author

Pascual-Figal, Domingo, primary, Wachter, Rolf, additional, Senni, Michele, additional, Bao, Weibin, additional, Noè, Adele, additional, Schwende, Heike, additional, Butylin, Dmytro, additional, Prescott, Margaret F., additional, Gniot, Jacek, additional, Mozheiko, Maria, additional, Lelonek, Malgorzata, additional, Dominguez, Antonio Reyes, additional, Horacek, Thomas, additional, Garcia del Rio, Enrique, additional, Kobalava, Zhanna, additional, Mueller, Christian Eugen, additional, Cavusoglu, Yuksel, additional, Straburzynska-Migaj, Ewa, additional, Slanina, Miroslav, additional, vom Dahl, Juergen, additional, Ryding, Alisdair, additional, Moriarty, Andrew, additional, Robles, Manuel Beltran, additional, Villota, Julio Nunez, additional, Quintana, Antonio Garcia, additional, Nitschke, Thorsten, additional, Garcia Pinilla, Jose Manuel, additional, Bonet, Luis Almenar, additional, Chaaban, Said, additional, Filali zaatari, Samia, additional, Spinar, Jindrich, additional, Musial, Wlodzimierz, additional, Abdelbaki, Khaled, additional, Belohlavek, Jan, additional, Fehske, Wolfgang, additional, Bott, Michael Carlos, additional, Hoegalmen, Geir, additional, Leiro, Marisa Crespo, additional, Ozcan, Ismail Turkay, additional, Mullens, Wilfried, additional, Kryza, Radim, additional, Al-Ani, Riadh, additional, Loboz-Grudzien, Krystyna, additional, Ermoshkina, Lyudmila, additional, Hojerova, Silvia, additional, Fernandez, Alberto Alfredo, additional, Spinarova, Lenka, additional, Lapp, Harald, additional, Bulut, Efraim, additional, Almeida, Filipa, additional, Vishnevsky, Alexander, additional, Belicova, Margita, additional, Pascual, Domingo, additional, Witte, Klaus, additional, Wong, Kenneth, additional, Droogne, Walter, additional, Delforge, Marc, additional, Peterka, Martin, additional, Olbrich, Hans-Georg, additional, Carugo, Stefano, additional, Nessler, Jadwiga, additional, McGill, Thao Huynh, additional, Huegl, Burkhard, additional, Akin, Ibrahim, additional, Moreira, Ilidio, additional, Baglikov, Andrey, additional, Thambyrajah, Jeetendra, additional, Hayes, Chris, additional, Barrionuevo, Marcelo Raul, additional, Yigit, Zerrin, additional, Kaya, Hakki, additional, Klimsa, Zdenek, additional, Radvan, Martin, additional, Kadel, Christoph, additional, Landmesser, Ulf, additional, Di Tano, Giuseppe, additional, Lisik, Malgorzata Buksinska, additional, Fonseca, Candida, additional, Oliveira, Luis, additional, Marques, Irene, additional, Santos, Luis Miguel, additional, Lenner, Egon, additional, Letavay, Peter, additional, Bueno, Manuel Gomez, additional, Mota, Paula, additional, Wong, Aaron, additional, Bailey, Kristian, additional, Foley, Paul, additional, Hasbani, Eduardo, additional, Virani, Sean, additional, Massih, Tony Abdel, additional, Al-Saif, Shukri, additional, Taborsky, Milos, additional, Kaislerova, Marta, additional, Motovska, Zuzana, additional, Cohen, Aron Ariel, additional, Logeart, Damien, additional, Endemann, Dierk, additional, Ferreira, Daniel, additional, Brito, Dulce, additional, Kycina, Peter, additional, Bollano, Entela, additional, Basilio, Enrique Galve, additional, Rubio, Lorenzo Facila, additional, Aguado, Marcos Garcia, additional, Schiavi, Lilia Beatriz, additional, Zivano, Daniel Francisco, additional, Lonn, Eva, additional, El Sayed, Ali, additional, Pouleur, Anne-Catherine, additional, Heyse, Alex, additional, Schee, Alexandr, additional, Polasek, Rostislav, additional, Houra, Marek, additional, Tribouilloy, Christophe, additional, Seronde, Marie France, additional, Galinier, Michel, additional, Noutsias, Michel, additional, Schwimmbeck, Peter, additional, Voigt, Ingo, additional, Westermann, Dirk, additional, Pulignano, Giovanni, additional, Vegsundvaag, Johnny, additional, Da Silva Antunes, Jose Alexandre, additional, Monteiro, Pedro, additional, Stevlik, Jan, additional, Goncalvesova, Eva, additional, Hulkoova, Beata, additional, Castro Fernandez, Antonio Juan, additional, Davies, Ceri, additional, Squire, Iain, additional, Meyer, Philippe, additional, Sheppard, Richard, additional, Sahin, Tayfun, additional, Sochor, Karel, additional, De Geeter, Guillaume, additional, Schmeisser, Alexander, additional, Weil, Joachim, additional, Soares, Ana Oliveira, additional, Vasilevna, Olga Bulashova, additional, Oshurkov, Andrey, additional, Sunderland, Shahid Junejo, additional, Glover, Jason, additional, Exequiel, Tomas, additional, Decoulx, Eric, additional, Meyer, Sven, additional, Muenzel, Thomas, additional, Frioes, Fernando, additional, Arbolishvili, Georgy, additional, Tokarcikova, Anna, additional, Karlstrom, Patric, additional, Trullas Vila, Joan Carles, additional, Perez, Gonzalo Pena, additional, Sankaranarayanan, Rajiv, additional, Nageh, Thuraia, additional, Alasia, Diego Cristian, additional, Refaat, Marwan, additional, Demirkan, Burcu, additional, Al-Buraiki, Jehad, additional, and Karabsheh, Shadi, additional

Published
2020
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19. Acute redistribution of regional left ventricular work by cardiac resynchronization therapy determines long-term remodelling

Author

Duchenne, Jürgen, primary, Aalen, John M, primary, Cvijic, Marta, primary, Larsen, Camilla K, primary, Galli, Elena, primary, Bézy, Stéphanie, primary, Beela, Ahmed S, primary, Ünlü, Serkan, primary, Pagourelias, Efstathios D, primary, Winter, Stefan, primary, Hopp, Einar, primary, Kongsgård, Erik, primary, Donal, Erwan, primary, Fehske, Wolfgang, primary, Smiseth, Otto A, primary, and Voigt, Jens-Uwe, primary

Published
2020
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24. Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study

Author

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

Subjects
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

Published
2019

25. 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

Author

Weiss, Michael, Michels, Guido, Eberhardt, Frank, Fehske, Wolfgang, Winter, Stefan, Baer, Frank, Choi, Yeong-Hoon, Albus, Christian, Steven, Daniel, Baldus, Stephan, Pfister, Roman, Weiss, Michael, Michels, Guido, Eberhardt, Frank, Fehske, Wolfgang, Winter, Stefan, Baer, Frank, Choi, Yeong-Hoon, Albus, Christian, Steven, Daniel, Baldus, Stephan, and Pfister, Roman

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.

Published
2019

26. 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

Author

Andò, Giuseppe, Weiss, Michael, Michels, Guido, Eberhardt, Frank, Fehske, Wolfgang, Winter, Stefan, Baer, Frank, Choi, Yeong-Hoon, Albus, Christian, Steven, Daniel, Baldus, Stephan, Pfister, Roman, Andò, Giuseppe, Weiss, Michael, Michels, Guido, Eberhardt, Frank, Fehske, Wolfgang, Winter, Stefan, Baer, Frank, Choi, Yeong-Hoon, Albus, Christian, Steven, Daniel, Baldus, Stephan, and Pfister, Roman

Published
2019

28. 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

Author

Weiss, Michael, primary, Michels, Guido, additional, Eberhardt, Frank, additional, Fehske, Wolfgang, additional, Winter, Stefan, additional, Baer, Frank, additional, Choi, Yeong-Hoon, additional, Albus, Christian, additional, Steven, Daniel, additional, Baldus, Stephan, additional, and Pfister, Roman, additional

Published
2019
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29. Sex-specific difference in outcome after cardiac resynchronization therapy

Author

Beela, Ahmed S, primary, Duchenne, Jürgen, additional, Petrescu, Aniela, additional, Ünlü, Serkan, additional, Penicka, Martin, additional, Aakhus, Svend, additional, Winter, Stefan, additional, Aarones, Marit, additional, Stefanidis, Evangelos, additional, Fehske, Wolfgang, additional, Willems, Rik, additional, Szulik, Mariola, additional, Kukulski, Tomasz, additional, Faber, Lothar, additional, Ciarka, Agnieszka, additional, Neskovic, Aleksandar N, additional, Stankovic, Ivan, additional, and Voigt, Jens-Uwe, additional

Published
2019
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31. Assessment of mechanical dyssynchrony can improve the prognostic value of guideline-based patient selection for cardiac resynchronization therapy

Author

Beela, Ahmed S, primary, Ünlü, Serkan, additional, Duchenne, Jürgen, additional, Ciarka, Agnieszka, additional, Daraban, Ana Maria, additional, Kotrc, Martin, additional, Aarones, Marit, additional, Szulik, Mariola, additional, Winter, Stefan, additional, Penicka, Martin, additional, Neskovic, Aleksandar N, additional, Kukulski, Tomasz, additional, Aakhus, Svend, additional, Willems, Rik, additional, Fehske, Wolfgang, additional, Faber, Lothar, additional, Stankovic, Ivan, additional, and Voigt, Jens-Uwe, additional

Published
2018
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34. Long-Term Outcome After CRT in the Presence of Mechanical Dyssynchrony Seen With Chronic RV Pacing or Intrinsic LBBB

Author

Stankovic, Ivan, primary, Prinz, Christian, additional, Ciarka, Agnieszka, additional, Daraban, Ana Maria, additional, Mo, Yujing, additional, Aarones, Marit, additional, Szulik, Mariola, additional, Winter, Stefan, additional, Neskovic, Aleksandar N., additional, Kukulski, Tomasz, additional, Aakhus, Svend, additional, Willems, Rik, additional, Fehske, Wolfgang, additional, Penicka, Martin, additional, Faber, Lothar, additional, and Voigt, Jens-Uwe, additional

Published
2017
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35. Assessment of mechanical dyssynchrony can improve the prognostic value of guideline-based patient selection for cardiac resynchronization therapy.

Author

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

Subjects
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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36. Impact of the Type of First Medical Contact within a Guideline-Conform ST-Elevation Myocardial Infarction Network: A Prospective Observational Registry Study

Author

Pfister, Roman, Lee, Samuel, Kuhr, Kathrin, Baer, Frank, Fehske, Wolfgang, Hoepp, Hans-Wilhelm, Baldus, Stephan, Michels, Guido, Pfister, Roman, Lee, Samuel, Kuhr, Kathrin, Baer, Frank, Fehske, Wolfgang, Hoepp, Hans-Wilhelm, Baldus, Stephan, and Michels, Guido

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.

Published
2016

37. New Automatic Tools to Identify Responders to Cardiac Resynchronization Therapy

Author

Mada, Razvan O., primary, Lysyansky, Peter, additional, Duchenne, Jürgen, additional, Beyer, Ruxandra, additional, Mada, Cristina, additional, Muresan, Lucian, additional, Rosianu, Horia, additional, Serban, Adela, additional, Winter, Stefan, additional, Fehske, Wolfgang, additional, Stankovic, Ivan, additional, and Voigt, Jens-Uwe, additional

Published
2016
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38. Mitralklappeninsuffizienz

Author

Fehske, Wolfgang, primary, DuQuoc, Bao, additional, Fischer, Sören, additional, Winter, Stefan, additional, and Perier, Patrick, additional

Published
2016
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41. Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT)

Author

Stankovic, Ivan, primary, Prinz, Christian, additional, Ciarka, Agnieszka, additional, Daraban, Ana Maria, additional, Kotrc, Martin, additional, Aarones, Marit, additional, Szulik, Mariola, additional, Winter, Stefan, additional, Belmans, Ann, additional, Neskovic, Aleksandar N., additional, Kukulski, Tomasz, additional, Aakhus, Svend, additional, Willems, Rik, additional, Fehske, Wolfgang, additional, Penicka, Martin, additional, Faber, Lothar, additional, and Voigt, Jens-Uwe, additional

Published
2015
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42. Timing of myocardial shortening determines left ventricular regional myocardial work and regional remodelling in hearts with conduction delays.

Author

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. T onset and SWT were measured in 18 segments per LV. Segmental myocardial work was calculated from non-invasive segmental stress–strain loop area. Before CRT, T onset 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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43. Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT).

Author

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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44. Transcatheter edge-to-edge valve repair versus minimally invasive beating-heart surgery of the tricuspid valve: an observational study.

Author

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.

Author

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.

Author

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.

Author

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

Subjects
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

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.

Published
2018
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49. The association of volumetric response and long-term survival after cardiac resynchronization therapy.

Author

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
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50. Relationship of visually assessed apical rocking and septal flash to response and long-term survival following cardiac resynchronization therapy (PREDICT-CRT).

Author

Stankovic I, Prinz C, Ciarka A, Daraban AM, Kotrc M, Aarones M, Szulik M, Winter S, Belmans A, Neskovic AN, Kukulski T, Aakhus S, Willems R, Fehske W, Penicka M, Faber L, and Voigt JU

Subjects
Echocardiography, Female, Heart Failure diagnostic imaging, Humans, Male, Middle Aged, Sensitivity and Specificity, Survival Rate, Treatment Outcome, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Remodeling, Cardiac Resynchronization Therapy, Heart Failure physiopathology, Heart Failure therapy, Ventricular Dysfunction, Left physiopathology, Ventricular Dysfunction, Left therapy
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., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)

Published
2016
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