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2. Heart rate variability and stroke or systemic embolism in patients with atrial fibrillation

Author

Aeschbacher, Stefanie, Bhend, Katalin, Blum, Steffen, Bonati, Leo H., Carmine, Désirée, Conen, David, Eken, Ceylan, Fischer, Urs, Girroy, Corinne, Hennings, Elisa, Krisai, Philipp, Kühne, Michael, Mäder, Nina, Meyer-Zürn, Christine, Meyre, Pascal B., Monsch, Andreas U., Mosher, Luke, Müller, Christian, Osswald, Stefan, Paladini, Rebecca E., Peter, Raffaele, Schweigler, Adrian, Sticherling, Christian, Szucs, Thomas, Völlmin, Gian, Aujesky, Drahomir, Fuhrer, Juerg, Roten, Laurent, Jung, Simon, Mattle, Heinrich, Netzer, Seraina, Adam, Luise, Aubert, Carole Elodie, Feller, Martin, Loewe, Axel, Moutzouri, Elisavet, Schneider, Claudio, Flückiger, Tanja, Groen, Cindy, Ehrsam, Lukas, Hellrigl, Sven, Nuoffer, Alexandra, Rakovic, Damiana, Schwab, Nathalie, Wenger, Rylana, Zarrabi Saffari, Tu Hanh, Rodondi, Nicolas, Reichlin, Tobias, Beynon, Christopher, Dillier, Roger, Deubelbeiss, Michèle, Eberli, Franz, Franzini, Christine, Juchli, Isabel, Liedtke, Claudia, Murugiah, Samira, Nadler, Jacqueline, Obst, Thayze, Roth, Jasmin, Schlomowitsch, Fiona, Schneider, Xiaoye, Studerus, Katrin, Tynan, Noreen, Weishaupt, Dominik, Müller, Andreas, Friedli, Corinne, Kuest, Silke, Scheuch, Karin, Hischier, Denise, Bonetti, Nicole, Grau, Alexandra, Villinger, Jonas, Laube, Eva, Baumgartner, Philipp, Filipovic, Mark, Frick, Marcel, Montrasio, Giulia, Leuenberger, Stefanie, Rutz, Franziska, Beer, Jürg-Hans, Auricchio, Angelo, Anesini, Adriana, Camporini, Cristina, Caputo, Maria Luce, Peronaci, Rebecca, Regoli, Francois, Ronchi, Martina, Conte, Giulio, Brenner, Roman, Altmann, David, Fink, Karin, Gemperle, Michaela, Ammann, Peter, Firmann, Mathieu, Foucras, Sandrine, Rime, Martine, Hayoz, Daniel, Berte, Benjamin, Bühler, Kathrin, Justi, Virgina, Kellner-Weldon, Frauke, Koch, Melanie, Mehmann, Brigitta, Meier, Sonja, Roth, Myriam, Ruckli-Kaeppeli, Andrea, Russi, Ian, Schmidt, Kai, Young, Mabelle, Kobza, Richard, Rigamonti, Elia, Cereda, Carlo, Cianfoni, Alessandro, De Perna, Maria Luisa, Frangi-Kultalahti, Jane, Mayer Melchiorre, Patrizia Assunta, Pin, Anica, Terrot, Tatiana, Vicari, Luisa, Moschovitis, Giorgio, Ehret, Georg, Gallet, Hervé, Guillermet, Elise, Lazeyras, Francois, Lovblad, Karl-Olof, Perret, Patrick, Tavel, Philippe, Teres, Cheryl, Shah, Dipen, Lauriers, Nathalie, Méan, Marie, Salzmann, Sandrine, Schläpfer, Jürg, Porretta, Alessandra Pia, Grêt, Andrea, Novak, Jan, Vitelli, Sandra, Stephan, Frank-Peter, Gallino, Augusto, Di Valentino, Marcello, Aebersold, Helena, Foster, Fabienne, Schwenkglenks, Matthias, Düring, Marco, Sinnecker, Tim, Altermatt, Anna, Amann, Michael, Huber, Petra, Hürbin, Manuel, Ruberte, Esther, Thöni, Alain, Würfel, Jens, Zuber, Vanessa, Coslovsky (Head), Michael, Neuschwander, Pia, Simon, Patrick, Wunderlin, Olivia, Schmid, Ramun, Baumann, Christian, Hämmerle, Peter, Schlageter, Vincent, Coslovsky, Michael, Coduri, Federica, Blum, Manuel R., Stauber, Annina, Beer, Jürg, and Zuern, Christine S.

Published
2024
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4. Impact of the 2022 pulmonary hypertension definition on haemodynamic classification and mortality in patients with aortic stenosis undergoing valve replacement.

Author

Maeder, Micha T, Weber, Lukas, Pohle, Susanne, Chronis, Joannis, Baty, Florent, Rigger, Johannes, Brutsche, Martin, Haager, Philipp, Rickli, Hans, and Brenner, Roman

Subjects
AORTIC stenosis, PULMONARY hypertension, HEART valve prosthesis implantation, AORTIC valve transplantation, HEMODYNAMICS, PULMONARY artery
Abstract

Aims With the 2022 pulmonary hypertension (PH) definition, the mean pulmonary artery pressure (mPAP) threshold for any PH was lowered from ≥25 to >20 mmHg, and the pulmonary vascular resistance (PVR) value to differentiate between isolated post-capillary PH (IpcPH) and combined pre- and post-capillary PH (CpcPH) was reduced from >3 Wood units (WU) to >2 WU. We assessed the impact of this change in the PH definition in aortic stenosis (AS) patients undergoing aortic valve replacement (AVR). Methods and results Severe AS patients (n = 503) undergoing pre-AVR cardiac heart catheterization were classified according to both the 2015 and 2022 definitions. The post-AVR mortality [median follow-up 1348 (interquartile range 948–1885) days] was assessed. According to the 2015 definition, 219 (44% of the entire population) patients had PH: 63 (29%) CpcPH, 125 (57%) IpcPH, and 31 (14%) pre-capillary PH. According to the 2022 definition, 321 (+47%) patients were diagnosed with PH, and 156 patients (31%) were re-classified: 26 patients from no PH to IpcPH, 38 from no PH to pre-capillary PH, 38 from no PH to unclassified PH, 4 from pre-capillary PH to unclassified PH, and 50 from IpcPH to CpcPH (CpcPH: +79%). With both definitions, only the CpcPH patients displayed increased mortality (hazard ratios ≈ 4). Among the PH-defining haemodynamic components, PVR was the strongest predictor of death. Conclusion In severe AS, the application of the 2022 PH definition results in a substantially higher number of patients with any PH as well as CpcPH. With either definition, CpcPH patients have a significantly increased post-AVR mortality. [ABSTRACT FROM AUTHOR]

Published
2024
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5. ECG left ventricular hypertrophy in aortic stenosis: Relationship with cardiac structure, invasive hemodynamics, and long‐term mortality.

Author

Sager, Patrizia, Rusch, Andreas, Weber, Lukas, Breuss, Alexander, Appert, Sharon, Brenner, Roman, Buser, Marc, Ammann, Peter, Rickli, Hans, and Maeder, Micha T.

Subjects
LEFT ventricular hypertrophy, AORTIC stenosis, AORTIC valve transplantation, HEMODYNAMICS, ELECTROCARDIOGRAPHY, VASCULAR resistance
Abstract

Background: In aortic stenosis (AS), left ventricular hypertrophy (LVH) is the response to pressure overload and represents the substrate for a maladaptive cascade, the so‐called AS‐related cardiac damage. We hypothesized that in AS patients electrocardiogram (ECG) LVH not only predicts echocardiography LVH but also other noninvasive and invasive markers of cardiac damage and prognosis after aortic valve replacement (AVR). Methods: In 279 patients with severe AS undergoing ECG, echocardiography, and cardiac catheterization before AVR, the Sokolow‐Lyon index, the Cornell product, the Romhilt‐Estes score, and the Peguero‐Lo Presti score were assessed. Results: The mean left ventricular mass index was 109 ± 34 g/m2, and 131 (47%) patients had echocardiography LVH. The areas under the receiver operator characteristics curve (AUC) for the Sokolow‐Lyon index, the Cornell product, the Romhilt‐Estes score, and the Peguero‐Lo Presti score for the prediction of echocardiography LVH were 0.59, 0.70, 0.63, and 0.65. The Peguero‐Lo Presti score had the numerically greatest AUC for the prediction of left ventricular end‐diastolic pressure >15 mmHg, mean pulmonary artery wedge pressure >15 mmHg, pulmonary vascular resistance >3 Wood units, mean right atrial pressure >14 mmHg, and stroke volume index <31 mL/m2. After a median follow‐up of 1365 (interquartile range: 931–1851) days after AVR only the Peguero‐Lo Presti score was significantly associated with all‐cause mortality [hazard ratio: 1.24 (95% confidence interval: 1.01–1.54); per 1 mV increase; p =.045]. Conclusions: Among severe AS patients, the Peguero‐Lo Presti score is associated with abnormalities in cardiac structure including LVH, invasive measures of cardiac damage, and long‐term mortality after AVR. [ABSTRACT FROM AUTHOR]

Published
2024
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