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4. Cardiopoietic cell therapy for advanced ischemic heart failure : results at 39 weeks of the prospective, randomized, double blind, sham-controlled CHART-1 clinical trial

Author

Bartunek, Jozef, Terzic, Andre, Davison, Beth A, Filippatos, Gerasimos S, Radovanovic, Slavica, Beleslin, Branko, Merkely, Bela, Musialek, Piotr, Wojakowski, Wojciech, Andreka, Peter, Horvath, Ivan G, Katz, Amos, Dolatabadi, Dariouch, El Nakadi, Badih, Arandjelovic, Aleksandra, Edes, Istvan, Seferovic, Petar M, Obradovic, Slobodan, Vanderheyden, Marc, Jagic, Nikola, Petrov, Ivo, Atar, Shaul, Halabi, Majdi, Gelev, Valeri L, Shochat, Michael K, Kasprzak, Jaroslaw D, Sanz Ruiz, Ricardo, Heyndrickx, Guy R, Nyolczas, Noémi, Legrand, Victor, Guédès, Antoine, Heyse, Alex, Moccetti, Tiziano, Fernandez Aviles, Francisco, Jimenez Quevedo, Pilar, Bayes Genis, Antoni, Hernandez Garcia, Jose Maria, Ribichini, Flavio, Gruchala, Marcin, Waldman, Scott A, Teerlink, John R, Gersh, Bernard J, Povsic, Thomas J, Henry, Timothy D, Metra, Marco, Hajjar, Roger J, Tendera, Michal, Behfar, Atta, Alexandre, Bertrand, Seron, Aymeric, Stough, Wendy Gattis, Sherman, Warren, Cotter, Gad, Wijns, W. i. l. l. i. a. m. Collaborators Clinical investigators, Dens, sites Belgium: Ziekenhuis Oost Limburg: J., Dupont, M., Mullens, W., Janssens, M., Dolatabadi, Hoˆpital Civil de Charleroi: D., De Bruyne, Y., Lalmand, J., Dubois, P., El Nakadi, B., Aminian, A., De Vuyst, E., Gurnet, P., Gujic, M., Blankoff, I., Guedes, CHU Mont Godinne UCL: A., Gabriel, L., Seldrum, S., Doyen, C., Andre´, M., Heyse, AZ Glorieux: A., Van Durme, F., Verschuere, J., Legrand, Domaine Universitaire du Sart Tilman: V., Gach, O., D’Orio, V., Davin, L., Lancellotti, P., Baudoux, E., Ancion, A., Dulgheru, R., Vanderheyden, OLV Ziekenhuis Aalst – Cardiologie: M., Bartunek, J., Wijns, W., Verstreken, S., Penicka, . M., Gelev, P. Meeus Bulgaria: Tokuda Hospital Sofia: V., Zheleva Kichukova, I., Parapunova, R., Melamed, R., Sardovski, S., Radev, O., Yordanov, A., Radinov, A., Nenov, D., Amine, I., Petrov, City Hospital Clinic Cardiology Center: I., Kichukov, K., Nikitasov, L., Stankov, Z., Stoyanov, H., Tasheva Dimitrova, I., Angelova, M., Dimitrov, E., Minchev, M., Garvanski, I., Botev, C., Polomski, P., Alexandrovska University Hospital, Vassilev, Sofia: D., Karamfiloff, K., Tarnovska Kadreva, R., Vladimirova, L., Dimitrov, G., Hadzhiev, E., Tzvetkova, G., Andreka, . M. Atanasova Hungary: Gottsegen Gyo¨ rgy Orszagos Kardiologiai Inte´zet: P., Fontos, G., Fabian, J., Csepregi, A., Uzonyi, G., Gelei, A., Edes, Debreceni Egyetem Orvos e´s Ege´szse´gtudomanyi Centrum Altalanos Orvostudomanyi Kar Kardiologia Inte´zet: I., Balogh, L., Vajda, G., Darago, A., Gergely, S., Fulop, T., Jenei, C., Horvath, Pe´csi Tudomanyegyetem Klinikai Ko¨zpont Szıvgyogyaszati Klinika: I., Magyari, B., Nagy, A., Cziraki, A., Faludi, R., Kittka, B., Alizadeh, H., Merkely, Semmelweis Egyetem Varosmajori Szıv e´s Ergyogyaszati Klinika: B., Geller, L., Farkas, P., Szombath, G., Foldes, G., Skopal, J., Kovacs, A., Kosztin, A., Gara, E., Sydo, N., Nyolczas, MH Ege´szse´gu¨gyi Ko¨zpont Kardiologiai Osztaly: N., Kerecsen, G., Korda, A., Kiss, . M., Borsanyi, T., Polgar, B., Muk, B., Sharif, Z. Bari Ireland: HRB Clinical Research Facility: F., Atar, Y. M. Smyth Israel:Western Galilee Hospital: S., Shturman, A., Akria, L., Kilimnik, M., Brezins, M., Halabi, Ziv Medical Center: M., Dally, N., Goldberg, A., Aehab, K., Rosenfeld, I., Levinas, T., Saleem, D., Katz, Barzilai Medical Center: A., Plaev, T., Drogenikov, T., Nemetz, A., Barshay, Y., Jafari, J., Orlov, I., Nazareth Hospital EMMS: M. Omory, N. Kogan Nielsen, Shochat, Hillel Yaffe Medical Center: M., Shotan, A., Frimerman, A., Meisel, S., Asif, A., Sofer, O., Blondheim, D. S., Vazan, A., Metra, L. Arobov Italy: A. O. Spedali Civili di Brescia: M., Bonadei, I., Inama, L., Chiari, E., Lombardi, C., Magatelli, M., Russo, D., Lazzarini, V., Carubelli, V., Vassanelli, AOUI Verona – Borgo Trento Hospital: C., Ribichini, Flavio Luciano, Bergamini, C., Krampera, Mauro, Cicoria, M. A., Zanolla, L., Dalla Mura, D., Gambaro, A., Rossi, A., Pesarini Poland: Jagiellonian University Department of Cardiac, G., Musialek, Vascular Diseases at John Paul II Hospital in Krakow: P., Mazurek, A., Drabik, L., Ka˛dzielski, A., Walter, Z., Dzieciuch Rojek, M., Rubis, P., Plazak, . W., Tekieli, L., Podolec, J., Orczyk, W., Sutor, U., Zmudka, K., Olszowska, M., Podolec, P., Gruchala, Uniwersyteckie Centrum Kliniczne: M., Ciecwierz, D., Mielczarek, M., Burakowski, S., Chmielecki, M., Zielinska, M., Frankiewicz, A., Wdowczyk, J., Stopczynska, I., Bellwon, J., Mosakowska, K., Nadolna, R., Wroblewska, J., Rozmyslowska, M., Rynkiewicz, M., Marciniak, I., Raczak, G., Tarnawska, M., Taszner, M., Kasprzak, Bieganski Hospital: J., Plewka, M., Fiutowska, D., Rechcinski, T., Lipiec, P., Sobczak, M., Weijner Mik, P., Wraga, M., Krecki, R., Markiewicz, M., Haval Qawoq, D., Wojakowski, Gornosla˛skie Centrum Medyczne Sla˛skie j. Akademii Medycznej: W., Ciosek, J., Dworowy, S., Gaszewska Zurek, E., Ochala, A., Cybulski, W., Jadczyk, T., Wanha, W., Parma, Z., Kozlowski, M., Dzierzak, M., Markiewicz Serbia: Clinical Hospital Center Zvezdara, M., Arandjelovic, Cardiology Clinic: A., Sekularac, N., Boljevic, D., Bogdanovic, A., Zivkovic, S., Cvetinovic, N., Loncar, G., Clinical Centre of Serbia, Beleslin, Cardiology Clinic: B., Nedeljkovic, M., Trifunovic, D., Giga, V., Banovic, M., Nedeljkovic, I., Stepanovic, J., Vukcevic, V., Djordjevic Dikic, A., Dobric, M., Obrenovic Kircanski, B., Seferovic, Cardiology Clinic: P., Orlic, D., Tesic, M., Petrovic, O., Milinkovic, I., Simeunovic, D., Jagic, Clinical Center of Kragujevac: N., Tasic, M., Nikolic, D., Miloradovic, V., Djurdjevic, P., Sreckovic, M., Zornic, N., Clinical Hospital Center Bezanijska Kosa, Radovanovic, Cardiology Department: S., Saric, J., Hinic, S., Djokovic, A., Ðordevic, S., Bisenic, V., Markovic, O., Stamenkovic, S., Malenkovic, V., Tresnjak, J., Misic, G., Cotra, D., Tomovic, L., Vuckovic, V., Clinic of Emergency Internal Medicine, Obradovic, Military Medical Academy: S., Jovic, Z., Vukotic, S., Markovic, D., Djenic, N., Ristic Andjelkov, A., Bayes Genis, D. Ljubinka Spain: Hospital Universitario Germans Trias I. Pujol: A., Rodriguez Leor, O., Labata, C., Vallejo, N., Ferrer, E., Batlle, M., Fernandez Aviles, Hospital General Universitario Gregorio Mara~non: F., Sanz Ruiz, R., Casado, A., Loughlin, G., Zatarain, E., Anguita, J., Ferna ndez Santos, M. E., Pascual, C., Bermejo, J., Hernandez Garcia, Hospital Clinico Universitario Virgen de la Victoria: J. M., Jimenez Navarro, M., Dominguez, A., Carrasco, F., Mu~noz, A., Garcia Pinilla, J. M., Ruiz, J., Queipo de Llano, M. P., Hernandez, A., Fernandez, A., Jimenez Quevedo, Hospital Clinico San Carlos: P., Guerra, R., Biagioni, C., Gonzalez, R. A., Gomez deDiego, J. J., Mansson Broberg, L. Perez de Isla Sweden: Karolinska University Hospital: A., Sylve´n, C., Leblanc, K., Winter, R., Blomberg, P., Gunyeli, E., Ruck, A., Silva, C., Fo¨rstedt Switzerland: CardioCentro Ticino, J., Moccetti, Switzerland: T., Rossi, M., Pasotti, E., Petrova, I., Crljenica, C., Monti, C., Murzilli, R., Su¨rder, D., Moccetti, M., Turchetto, L., Locicero, V., Chiumiento, L., Maspoli, S., Mombelli, M., Anesini, A., Biggiogero, M., Ponti, G., Camporini, C., Polledri, S., Hill, G. Dolci United Kingdom: Kings College Hospital: J., Plymen, C., Amin Youssef, G., Mcdonagh, T., Drasar, E., Mijovic, A., Jouhra, F., Mcloman, D., Dworakowski, R., Webb, I., Byrne, J., and Potter, V.

Subjects
0301 basic medicine, Male, Cardiopoiesis, Cardiovascular disease, Disease severity, Marker, Precision medicine, Regenerative medicine, Stem cell, Target population, Adult, Aged, Double-Blind Method, Female, Heart Failure, Humans, Mesenchymal Stem Cell Transplantation, Middle Aged, Myocardial Ischemia, Prospective Studies, Treatment Outcome, Young Adult, Cardiology and Cardiovascular Medicine, Cell- and Tissue-Based Therapy, mesenchymal stem-cells, 030204 cardiovascular system & hematology, Cardiorespiratory Medicine and Haematology, outcomes, Fast-Track Clinical Research, Sudden cardiac death, 0302 clinical medicine, Ischemia, cardiovascular disease, Clinical endpoint, target population, CHART Program, Ejection fraction, bone-marrow, Heart Failure/Cardiomyopathy, 3. Good health, Cohort, Cardiology, Fast Track, disease severity, delivery, medicine.medical_specialty, precision medicine, Clinical Sciences, regenerative medicine, 03 medical and health sciences, cardiopoiesis, Internal medicine, medicine, Adverse effect, marker, disease, business.industry, medicine.disease, mortality, Confidence interval, Clinical trial, stem cell, Editor's Choice, 030104 developmental biology, predictors, Cardiovascular System & Hematology, Heart failure, business
Abstract

Altres ajuts: This work was supported by Celyad, SA (Mont-Saint-Guibert, Belgium). Celyad has received research grants from the Walloon Region (Belgium, DG06 funding). Cardiopoietic cells, produced through cardiogenic conditioning of patients' mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort. This multinational, randomized, double-blind, sham-controlled study was conducted in 39 hospitals. Patients with symptomatic ischaemic heart failure on guideline-directed therapy (n = 484) were screened; n = 348 underwent bone marrow harvest and mesenchymal stem cell expansion. Those achieving > 24 million mesenchymal stem cells (n = 315) were randomized to cardiopoietic cells delivered endomyocardially with a retention-enhanced catheter (n = 157) or sham procedure (n = 158). Procedures were performed as randomized in 271 patients (n = 120 cardiopoietic cells, n = 151 sham). The primary efficacy endpoint was a Finkelstein–Schoenfeld hierarchical composite (all-cause mortality, worsening heart failure, Minnesota Living with Heart Failure Questionnaire score, 6-min walk distance, left ventricular end-systolic volume, and ejection fraction) at 39 weeks. The primary outcome was neutral (Mann–Whitney estimator 0.54, 95% confidence interval [CI] 0.47–0.61 [value > 0.5 favours cell treatment], P = 0.27). Exploratory analyses suggested a benefit of cell treatment on the primary composite in patients with baseline left ventricular end-diastolic volume 200–370 mL (60% of patients) (Mann–Whitney estimator 0.61, 95% CI 0.52–0.70, P = 0.015). No difference was observed in serious adverse events. One (0.9%) cardiopoietic cell patient and 9 (5.4%) sham patients experienced aborted or sudden cardiac death. The primary endpoint was neutral, with safety demonstrated across the cohort. Further evaluation of cardiopoietic cell therapy in patients with elevated end-diastolic volume is warranted.

Published
2017

6. HIT Poster session 3

Author

Stella, S, Rosa, I, Marini, C, Ancona, F, Spagnolo, P, Latib, A, Romano, V, Colombo, A, Margonato, A, Agricola, E, Li, H, Yuan, L, Xie, MX, Jin, XY, Stathogiannis, K, Toutouzas, K, Drakopoulou, M, Latsios, G, Synetos, A, Sanidas, E, Kaitozis, O, Trantalis, G, Gerckens, U, Tousoulis, D, Stojkovic, S, Tesic, M, Stojkovic, S, Stepanovic, J, Trifunovic, D, Beleslin, B, Giga, V, Nedeljkovic, I, Djordjevic Dikic, A, Ondrus, T, Bartunek, J, Vanderheyden, M, Stockman, B, Mirica, C, Kotrc, M, Van Praet, F, Van Camp, G, Penicka, M, Plaza Lopez, D, Igual Munoz, B, Sanchez Lacuesta, ME, Lopez Vilella, R, Domenech Tort, MD, Sepulveda Sanchis, P, Ten Morro, F, Calvillo Batlles, P, Montero Argudo, JA, Martinez Dolz, LV, Jinno, S, Yamada, A, Sugimoto, K, Ito, S, Kato, M, Inuzuka, H, Sugiyama, H, Takada, K, Ozaki, Y, Ishii, J, Verseckaite, R, Mizariene, V, Gaileviciute, K, Bieseviciene, M, Jonkaitiene, R, Jurkevicius, R, Oliveira Da Silva, C, Gunyeli, E, Winter, R, Back, M, Settergren, M, Manouras, A, Shahgaldi, K, Altin, C, Ozsoy, HM, Gezmis, E, Yilmaz, M, Tunc, E, Sade, LE, Muderrisoglu, H, Krestjyaninov, MV, Gimaev, RH, Melnikova, MA, Olezov, NV, Ruzov, VI, Izci, S, Dogan, C, Acar, R, Cetin, G, Bakal, RB, Unkun, T, Cap, M, Erdogan, E, Kaymaz, C, Ozdemir, N, Santos, M, Leite, L, Martins, R, Baptista, R, Barbosa, A, Ribeiro, N, Oliveira, A, Castro, G, Pego, M, Urbano-Moral, JA, Gutierrez-Garcia-Moreno, L, Rodriguez-Palomares, JF, Galuppo, V, Maldonado-Herrera, G, Teixido-Tura, G, Gruosso, D, Gonzalez-Alujas, T, Evangelista-Massip, A, Spartera, M, Stella, S, Rosa, I, Ancona, F, Marini, C, Latib, A, Giannini, F, Colombo, A, Margonato, A, Agricola, E, Gonzalvez-Garcia, A, Urbano-Moral, JA, Matabuena-Gomez-Limon, J, Grande-Trillo, A, Rojas-Bermudez, C, Rodriguez-Puras, MJ, Martinez-Martinez, A, Lopez-Pardo, F, Lopez-Haldon, JE, Miskowiec, D, Kupczynska, K, Kasprzak, JD, Lipiec, P, Hagrass, MUHAMMAD, Abdelrahman Sharaf El Dein, AHMED, Shawky El Serafy, AHMED, Rajan, RAJESH, Rady, M, Sveric, K, Kvakan, H, Strasser, RH, Reskovic Luksic, V, Cekovic, S, Veceric, S, Separovic Hanzevacki, J, Castaldi, B, Romanato, S, Callegari, A, Bernardinello, V, Reffo, E, Milanesi, O, Silva, T, Agapito, A, Sousa, L, Oliveira, JA, Branco, LM, Timoteo, AT, Galrinho, A, Thomas, B, Tavares, NJ, Cruz Ferreira, R, Silva, T, Agapito, A, Sousa, L, Oliveira, JA, Branco, LM, Timoteo, AT, Galrinho, A, Thomas, B, Tavares, NJ, Cruz Ferreira, R, Silva, T, Agapito, A, Sousa, L, Oliveira, JA, Soares, R, Aguiar Rosa, SA, Morais, L, Thomas, B, Tavares, NJ, Cruz Ferreira, R, Kolossvary, M, Szilveszter, B, Elzomor, H, Karolyi, M, Raaijmakers, R, Benke, K, Celeng, C, Bagyura, Z, Merkely, B, Maurovich-Horvat, P, Basuoni, A, Shaheen, S, Abdelkader, M, Rasheed, T, Miskowiec, D, Kasprzak, JD, Lipiec, P, Peovska Mitevska, I, Srbinovska, E, Pop Gorceva, D, Zdravkovska, M, Aguiar Rosa, S, Galrinho, A, Moura Branco, L, Timoteo, AT, Agapito, A, Sousa, L, Oliveira, JA, Rodrigues, I, Viveiros Monteiro, A, and Cruz Ferreira, R

Abstract

Purpose: the assessment of aortic annular size in TAVI patients, is critical and inappropriate sizing is a main reason of paravalvular aortic regurgitation (PVR). Data on aortic annulus measures assessed by 3D-Transesophageal Echocardiography (3D-TEE) compared to Multislice Computed Tomography (MSCT), are limited and discordant. The aim was to compare aortic annulus measurements obtained by 3D-TEE with MSCT, evaluating the impact on prosthesis size selection and their ability to predict PVR ≥ mild. Materials and Methods: 53 consecutive TAVI patients (mean age 81.5 ± 5.2 years, 22 women) underwent both 3D-TEE and MSCT. The 3D volume dataset was acquired containing the LVOT, aortic annulus/valve and aortic root. 3D-echocardiographic reconstruction for measurement of the aortic annulus was performed with a dedicated software (EchoPac). This allowed for precise identification of the annular plane from orthogonal views, to accurately perform mid-systole measurements. MSCT measurements were obtained in diastole. The final valve sizing was based on MSCT measurements. Then 3D-TEE data were submitted to one TAVI operator for blinded definition of prosthesis sizing, in order to test the agreement between the two modalities. Finally, Cover Index (CI) and absolute difference (Δ) between prosthesis size and 3D-TEE and MSCT annulus measures, were assessed for estimation of PVR ≥ mild predictivity. Results: although absolute differences were small, 3D-TEE measurements were statistically significantly smaller than MDCT ones: for major (coronal) diameter a mean difference=−2.3 mm (range, −2.1 to 6.7 mm, p= 0.0001), mean perimeter difference=−3.9 mm (range, −8.0 to 15,9 mm, p=0.006) and a mean area difference=−2.8 cm2 (range, −6.6 to 12.3 cm2, p=0.05), with the exception of minor (sagittal) diameter (mean difference= 0.02 ± 3 mm, p= 0.9), with a very good correlation for minor (sagittal) diameter and area (r= 0.76 and 0.79, respectively, p=0.0001). We found a 68% of concordance between 3D-TEE and MSCT for the implanted prosthesis size. Among the 32% of discordance, 3D-TEE lead to prosthesis underestimation in most of cases. Only MSCT perimeter measurement had statistically higher predictive value for the presence of ≥ mild PVR (AUC for Δ Perimeter and CI Perimeter=0.77 and 0.72, respectively). Conclusion: 3D-TEE annulus measurements of sagittal diameter and area evaluated in mid-systole well correlate to MDCT measurements in diastole. Moreover there is a moderate concordance between the two modalities, for final prosthesis sizing. Only MSCT perimeter measurement, predict post-TAVI PVR with good accuracy.

Published
2015
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7. Poster session 4: Friday 5 December 2014, 08:30-12:30 * Location: Poster area

Author

Orii, M, Tanimoto, T, Yokoyama, M, Ota, S, Kubo, T, Hirata, K, Tanaka, A, Imanishi, T, Akasaka, T, Michelsen, MM, Pena, A, Mygind, ND, Hoest, NB, Prescott, E, Abd El Dayem, SOHA, Battah, AHMED, Abd El Azzez, FATEN, Ahmed, AZZA, Fattoh, AYA, Ismail, REEM, Andjelkovic, K, Kalimanovska Ostric, D, Nedeljkovic, I, Andjelkovic, I, Rashid, HESHAM, Abuel Enien, HESHAM, Ibraheem, MAHER, work, Tissue Doppler echocardiography research, Vago, H, Toth, A, Csecs, I, Czimbalmos, CS, Suhai, F I, Kecskes, K, Becker, D, Simor, T, Merkely, B, D'ascenzi, F, Pelliccia, A, Natali, BM, Cameli, M, Lisi, M, Focardi, M, Corrado, D, Bonifazi, M, Mondillo, S, Zaha, VG, Kim, GE, Su, KN, Zhang, J, Mikush, N, Ross, J, Palmeri, M, Young, LH, Tadic, M, Ilic, SI, Celic, VC, Jaimes, C, Gonzalez Mirelis, J, Gallego, M, Goirigolzarri, J, Pellegrinet, M, Poli, S, Prati, G, Vriz, O, Di Bello, V, Carerj, S, Zito, C, Mateescu, A, Popescu, BA, Antonini-Canterin, F, Chatzistamatiou, E, Moustakas, G, Memo, G, Konstantinidis, D, Mpampatzeva Vagena, I, Manakos, K, Traxanas, K, Vergi, N, Feretou, A, Kallikazaros, I, Hewing, B, Theres, L, Dreger, H, Spethmann, S, Stangl, K, Baumann, G, Knebel, F, Uejima, T, Itatani, K, Nakatani, S, Lancellotti, P, Seo, Y, Zamorano, JL, Ohte, N, Takenaka, K, group, VFM international collaboration, Naar, J, Mortensen, L, Johnson, J, Winter, R, Shahgaldi, K, Manouras, A, Braunschweig, F, Stahlberg, M, Coisne, D, Al Arnaout, A-M, Tchepkou, C, Raud Raynier, P, Diakov, C, Degand, B, Christiaens, L, Barbier, P, Mirea, O, Cefalu, C, Savioli, G, Guglielmo, M, Maltagliati, A, O'neill, L, Walsh, K, Hogan, J, Manzoor, T, Ahern, B, Owens, P, Savioli, G, Guglielmo, M, Mirea, O, Cefalu, C, Barbier, P, Sengelov, M, Biering-Sorensen, T, Jorgensen, PG, Bruun, NE, Fritz-Hansen, T, Bech, J, Olsen, FJ, Sivertsen, J, Jensen, JS, Marta, L, Abecasis, J, Reis, C, Ribeiras, R, Andrade, MJ, Mendes, M, D'andrea, A, Stanziola, A, Di Palma, E, Martino, M, Lanza, M, Betancourt, V, Maglione, M, Calabro', R, Russo, MG, Bossone, E, Vogt, M O, Meierhofer, CH, Rutz, TH, Fratz, S, Ewert, P, Roehlig, CH, Kuehn, A, Storsten, P, Eriksen, M, Remme, EW, Boe, E, Smiseth, OA, Skulstad, H, Ereminiene, E, Ordiene, R, Ivanauskas, V, Vaskelyte, J, Stoskute, N, Kazakauskaite, E, Benetis, R, Marketou, M, Parthenakis, F, Kontaraki, J, Zacharis, E, Maragkoudakis, S, Logakis, J, Roufas, K, Vougia, D, Vardas, P, Dado, E, Dado, E, Knuti, G, Djamandi, J, Shota, E, Sharka, I, Saka, J, Halmai, L, Nemes, A, Kardos, A, Neubauer, S, Kurnicka, K, Domienik-Karlowicz, J, Lichodziejewska, B, Goliszek, S, Grudzka, K, Krupa, M, Dzikowska-Diduch, O, Ciurzynski, M, Pruszczyk, P, Chung, H, Kim, JY, Yoon, YW, Min, PK, Lee, BK, Hong, BK, Rim, SJ, Kwon, HM, Choi, EY, Soya, OV, Kuryata, OV, Kakihara, R, Naruse, C, Inayoshi, A, El Sebaie, MAHA, Frer, ABDEL, Abdelsamie, MAGDY, Eldamanhory, AHMED, Ciampi, Q, Cortigiani, L, Simioniuc, A, Manicardi, C, Villari, B, Picano, E, Sicari, R, Ferferieva, V, Deluyker, D, Lambrichts, I, Rigo, JM, Bito, V, Kuznetsov, VA, Yaroslavskaya, EI, Krinochkin, DV, Pushkarev, GS, Gorbatenko, EA, Trzcinski, P, Michalski, BW, Lipiec, P, Szymczyk, E, Peczek, L, Nawrot, B, Chrzanowski, L, Kasprzak, JD, Todaro, MC, Zito, C, Khandheria, BK, Cusma-Piccione, M, La Carrubba, S, Antonini-Canterin, F, Di Bello, V, Oreto, G, Di Bella, G, Carerj, S, Gunyeli, E, Oliveira Da Silva, C, Sahlen, A, Manouras, A, Winter, R, Shahgaldi, K, Spampinato, RA, Tasca, M, Roche E Silva, JG, Strotdrees, E, Schloma, V, Dmitrieva, Y, Dobrovie, M, Borger, MA, Mohr, FW, Einarsen, E, Cramariuc, D, Lonnebakken, MT, Boman, K, Gohlke-Barwolf, C, Chambers, JB, Gerdts, E, Calin, A, Rosca, M, Beladan, CC, Mirescu Craciun, A, Gurzun, MM, Mateescu, A, Enache, R, Ginghina, C, Popescu, BA, Antova, E, Georgievska Ismail, LJ, Srbinovska, E, Andova, V, Peovska, I, Davceva, J, Otljanska, M, Vavulkis, M, Tsuruta, H, Kohsaka, S, Murata, M, Yasuda, R, Dan, M, Yashima, F, Inohara, T, Maekawa, Y, Hayashida, K, Fukuda, K, Migliore, R, 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Sanchez, PSS, Cervera Zamora, ACZ, Piquer Gil Marina, MPG, Montero- Argudo, AMA, Naka, KK, Evangelou, D, Lakkas, L, Kalaitzidis, R, Bechlioulis, A, Gkirdis, I, Tzeltzes, G, Nakas, G, Pappas, K, Michalis, LK, Mansencal, N, Bagate, F, Arslan, M, Siam-Tsieu, V, Deblaise, J, El Mahmoud, R, Dubourg, O, Wierzbowska-Drabik, K, Plewka, M, Kasprzak, JD, Bandera, F, Generati, G, Pellegrino, M, Alfonzetti, E, Labate, V, Villani, S, Gaeta, M, Guazzi, M, Bandera, F, Generati, G, Pellegrino, M, Labate, V, Alfonzetti, E, Guazzi, M, Generati, G, Bandera, F, Pellegrino, M, Labate, V, Alfonzetti, E, Guazzi, M, Grycewicz, T, Szymanska, K, Grabowicz, W, Lubinski, A, Sotaquira, M, Pepi, M, Tamborini, G, Caiani, EG, Bochard Villanueva, B, Chacon-Hernandez, N, Fabregat-Andres, O, Garcia-Gonzalez, P, Cubillos-Arango, A, De La Espriella-Juan, R, Albiach-Montanana, C, Berenguer-Jofresa, A, Perez-Bosca, JL, Paya-Serrano, R, Cheng, H-L, Huang, C-H, Wang, Y-C, Chou, W-H, Kuznetsov, VA, Melnikov, NN, Krinochkin, 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Vascular, University, Semmelweis, Budapest, Hungary, and Group, MTA-SE Lendület Cardiovascular Imaging Research

Abstract

Purpose: Although delayed-enhancement magnetic resonance imaging (DEMRI) is essential for diagnosis of cardiac sarcoidosis (CS), the test was not available when pacemaker was implamted. Recently, MR-conditional pacemaker has become avilable and we hypothesized that this device would be useful for diagnosis and management of CS. The aim of this study was to assess the diagnostic ability of MR-conditional pacemaker about CS in patients with advanced A-V nodal block (AAVB). Methods: Twenty-seven AAVB patients (14 men, 13 women; mean age, 69 ± 11 years) who were implanted MR-conditional pacemaker were studied. DEMRI was performed 6 weeks after implantation of permanent pacemaker. In patients with positive for DE, additional examinations like echocardiography, radioisotope imaging, biopsy, and coronary computed-tomography were performed due to confirm the diagnosis of CS and exclude coronary artery disease. Results: DE was observed in 12 patients (44 %). Out of 12 patients, 2 patients were excluded for having prior myocardial infarction. Seven of 10 (70 %) patients were diagnosed of CS by the consensus criteria. Compared with non-CS group, CS group had significantly lower age (61 ± 12 years vs. 72 ± 9 years p = 0.017). There was no significant difference about sex, angiotensin-converting enzyme, brain natriuretic peptide, and left ventricular ejection fraction between 2 groups. Six patients had started corticosteroid therapy and 5 patients (83%) recovered A-V nodal conduction. Conclusion: MR-conditional pacemaker was useful for diagnosis and management of patients with AAVB caused by CS. Figure Cardiac MRI in patient with AV block

Published
2014
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8. Poster session 3: Thursday 4 December 2014, 14:00-18:00 * Location: Poster area

Author

Shahgaldi, K, Hegner, T, Da Silva, C, Fukuyama, A, Takeuchi, M, Uema, A, Kado, Y, Nagata, Y, Hayashi, A, Otani, K, Fukuda, S, Yoshitani, H, Otsuji, Y, Morhy, S, Lianza, AC, Afonso, TR, Oliveira, WA, Tavares, GP, Rodrigues, AC, Vieira, MC, Warth, AN, Deutsch, AD, Fischer, CH, Tezynska-Oniszk, I, Turska-Kmiec, A, Kawalec, W, Dangel, J, Maruszewski, B, Bokiniec, R, Burczynski, P, Borszewska-Kornacka, K, Ziolkowska, L, Zuk, M, Mazowsza, eSUM Dzieciaki, Troshina, A, Dzhalilova, DA, Poteshkina, NG, Hamitov, FF, Warita, S, Kawasaki, M, Tanaka, R, Yagasaki, H, Minatoguchi, S, Wanatabe, T, Ono, K, Noda, T, Wanatabe, S, Minatoguchi, S, Angelis, A, Ageli, K, Vlachopoulos, C, Felekos, I, Ioakimidis, N, Aznaouridis, K, Vaina, S, Abdelrasoul, M, Tsiamis, E, Stefanadis, C, Cameli, M, Sparla, S, D'ascenzi, F, Fineschi, M, Favilli, R, Pierli, C, Henein, M, Mondillo, S, Lindqvist, P, Tossavainen, E, Gonzalez, M, Soderberg, S, Henein, M, Holmgren, A, Strachinaru, M, Catez, E, Jousten, I, Pavel, O, Janssen, C, Morissens, M, Chatzistamatiou, E, Moustakas, G, Memo, G, Konstantinidis, D, Mpampatzeva Vagena, I, Manakos, K, Traxanas, K, Vergi, N, Feretou, A, Kallikazaros, I, Tsai, W-C, Sun, Y-T, Lee, W-H, Yang, L-T, Liu, Y-W, Lee, C-H, Li, W-T, Mizariene, V, Bieseviciene, M, Karaliute, R, Verseckaite, R, Vaskelyte, J, Lesauskaite, V, Chatzistamatiou, E, Mpampatseva Vagena, I, Manakos, K, Moustakas, G, Konstantinidis, D, Memo, G, Mitsakis, O, Kasakogias, A, Syros, P, Kallikazaros, I, Hristova, K, Cornelissen, G, Singh, RB, Shiue, I, Coisne, D, Madjalian, A-M, Tchepkou, C, Raud Raynier, P, Degand, B, Christiaens, L, Baldenhofer, G, Spethmann, S, Dreger, H, Sanad, W, Baumann, G, Stangl, K, Stangl, V, Knebel, F, Azzaz, S, Kacem, S, Ouali, S, Risos, L, Dedobbeleer, C, Unger, P, Sinem Cakal, SC, Elif Eroglu, EE, Baydar, O, Beytullah Cakal, BC, Mehmet Vefik Yazicioglu, MVY, Mustafa Bulut, MB, Cihan Dundar, CD, Kursat Tigen, KT, Birol Ozkan, BO, Ali Metin Esen, AME, Tournoux, F, Chequer, R, 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Shin, S, Shim, CY, Hong, GR, and Chung, N

Abstract

Objective:  We aimed to investigate the reproducibility of vena contracta (VC) in mitral regurgitation (MR) of different etiology between an inexperienced and an experienced echocardiographer. Background: MR is the second most common valvular heart disease in Europe that requires surgery.  Echocardiography is the principal modality of investigation when MR is suspected. In European and American guidelines VC is described as one of the most feasible echocardiographic measurements in the assessment of MR. There is a lack of publications regarding intra-observer variability and studies comparing inexperienced and experienced echocardiographers for the assessment of VC. Method/Material: VC of 55 recorded 2D echocardiograms with known MR of different degree and etiology were analyzed from parasternal long axis view, 4- and 3 chamber view. The mean value of the different plane measurements of each exam was used for statistical analysis. Analyses were made by an inexperienced (A) fellow echocardiographer (<100 studies) and a level 3 experienced (B) echocardiographer. Measurements of VC by the 2 echocardiographers were performed blinded to clinical data. Measurements were performed with at least 2 weeks apart, blinded to the first measurement. Results: Three exams were excluded (feasibility 95%) from statistical analysis because adequate color Doppler images from all tree planes was not available. The inter class correlation (ICC) between the first and second analysis was (r=0.75; 95% CI -1.1 to 1.7mm) for A and (r=0.94; 95% CI -0.76 to 0.84mm) for B. There was good ICC between the 2 echocardiographers (r=0.78; 95% CI -1.5 to 1.3mm). The intra observer variability was 11.1% for A and 6.1% for B. The inter observer variability was 11.7% (p>0.05 for all). Conclusion: Measurement of vena contracta in mitral regurgitation is a feasible semi-quantitative parameter. Good correlation and narrow limits of agreement between a novice and an experienced echocardiographer was demonstrated in our study.

Published
2014
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9. Does stress echocardiography add incremental value to baseline ejection fraction for the early identification of candidates for implantable defibrillators?

Author

Muhrbeck J, Gunyeli E, Andersson E, Alam M, Frykman V, and Sjoblom J

Abstract

Objective: A reduction in left ventricular ejection fraction (EF) remains the strongest indicator of increased risk of sudden cardiac death after an acute myocardial infarction (AMI). Guidelines recommend that patients with an EF ≤35%, 6-12 weeks after AMI should be considered for implantable cardioverter defibrillator (ICD) therapy. Stress echocardiography is a safe method to detect viability in a stunned myocardium. The purpose of this study was to investigate if stress echocardiography early after AMI could identify ICD candidates before discharge., Methods: Ninety-six patients with EF ≤40% early after AMI were prospectively included in a cohort study, and investigated by baseline and stress echocardiography before discharge. Follow-up echocardiography was performed after 3 months. EF, mitral annular plane systolic excursion (MAPSE) and peak systolic velocity (PSV) were determined for each examination., Results: There were 80 (83%) patients who completed the baseline, stress and follow-up echocardiography. Among them there were 32 (40%) patients who met the ICD criteria of EF ≤35% at 3 months. For these patients, EF, MAPSE and PSV were significantly lower than for those patients who recovered. The area under the receiver operating characteristic curve (AUC) was 85% (95% CI 0.74 to 0.94) for baseline EF to predict non-recovery. None of the other variables had a higher AUC., Conclusion: Patients who met the ICD criteria of EF ≤35% at 3 months after myocardial infarction had lower EF, MAPSE and PSV on baseline and stress echocardiograph before discharge. Stress echocardiography did not add additional value in predicting non-recovery., Competing Interests: Competing interests: None declared.

Published
2019
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10. The potential clinical value of contrast-enhanced echocardiography beyond current recommendations.

Author

Larsson MK, Da Silva C, Gunyeli E, Ilami AA, Szummer K, Winter R, and Bjällmark A

Subjects
Aged, Echocardiography, Stress standards, Europe, Feasibility Studies, Female, Humans, Image Enhancement standards, Image Interpretation, Computer-Assisted standards, Male, Observer Variation, Practice Guidelines as Topic, Reproducibility of Results, Sensitivity and Specificity, United States, Contrast Media, Echocardiography, Stress methods, Image Enhancement methods, Image Interpretation, Computer-Assisted methods, Stroke Volume, Ventricular Dysfunction, Left diagnostic imaging
Abstract

Background: Contrast agents are used in resting echocardiography to opacify the left ventricular (LV) cavity and to improve LV endocardial border delineation in patients with suboptimal image quality. If a wider use of contrast-enhanced echocardiography would be adopted instead of the current selective approach, diagnoses such as myocardial ischemia and LV structural abnormalities could potentially be detected earlier. The aim was therefore to retrospectively investigate if contrast-enhanced echocardiography beyond the current recommendations for contrast agent usage affects assessment of wall motion abnormalities, ejection fraction (EF) and detection of LV structural abnormalities. A secondary aim was to evaluate the user dependency during image analysis., Methods: Experienced readers (n = 4) evaluated wall motion score index (WMSI) and measured EF on greyscale and contrast-enhanced images from 192 patients without indications for contrast-enhanced echocardiography. Additionally, screening for LV structural abnormalities was performed. Repeated measurements were performed in 20 patients by the experienced as well as by inexperienced (n = 2) readers., Results: Contrast analysis resulted in significantly higher WMSI compared to greyscale analysis (p < 0.003). Of the 83 patients, classified as healthy by greyscale analysis, 55% were re-classified with motion abnormalities by contrast analysis. No significant difference in EF classification (≥55%, 45-54%, 30-44%, < 30%) was observed. LV structural abnormalities, such as increased trabeculation (n = 21), apical aneurysm (n = 4), hypertrophy (n = 1) and thrombus (n = 1) were detected during contrast analysis. Intra- and interobserver variability for experienced readers as well as the variability between inexperienced and experienced readers decreased for WMSI and EF after contrast analysis., Conclusions: Contrast-enhanced echocardiography beyond current recommendations for contrast agent usage increased the number of detected wall motion and LV structural abnormalities. Moreover, contrast-enhanced echocardiography increased reproducibility for assessment of WMSI and EF.

Published
2016
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