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1. 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

2. P210Long- term outcome of primary mitral valve prolapse: results from a population of 250 patients referred to a tertiary cardiovascular center.P211Rheumatic Heart Disease in Uganda - Results from more than 600 echocardiograms in a no-profit hospitalP212Higher ventricular ectopy burden in asymptomatic severe Barlows mitral valve disease compared to similar patients with mitral valve prolapseP213Surgical mitral valve repair for severe secondary mitral regurgitation: prognostic implications of left ventricular forward flowP214Multicentre trial results of a transfemoral annuloplasty system for mitral valve reconstruction -P215Comparative assessment of paravalvular leaks with 3D-transesophageal echocardiography and cardiac computed tomographyP216Failing surgical aortic bioprosthetic valves: redo aortic valve surgery versus percutaneous valve-in-valve replacementP217Mitral annular calcification and infective endocarditisP218Infective endocarditis - a changing diseaseP219Staphilococcus aureus bacteremia: application of the ESC proposed diagnostic echocardiographic algorithm in clinical practiceP220ESC proposed diagnostic echocardiographic algorithm in elective patients with clinical suspicion of infective endocarditis and negative blood cultures: diagnostic yield and prognostic implicationsP221Three-dimensional transesophageal echocardiography versus multidetector computed tomography for aortic annulus sizing in TAVI: a worthy alternativeP222Early and mid-term improvement in left ventricular function after transcatheter aortic valve replacement as assessed by myocardial strain imagingP223Dynamic of aortic root as predictor of paravalvular regurgitation after transcatheter aortic valve implantationP224Short term effect of heart rate reduction by Ivabradine on left ventricular function and remodeling in systolic heart failure patientsP225Global longitudinal strain and regional longitudinal strain in patients with hypertrophic cardiomyopathy: are they associated with the presence of myocardial fibrosis?P226Investigation of mitral leaflet elongation in patients with non-obstructive versus latent-obstructive hypertrophic cardiomyopathyP227Hypertrophic cardiomyopathy: to what degree have the new ESC guidelines been implemented in routine clinical practice? A retrospective audit assessing current practice in a large general UK hospitalP228New genotype-phenotype associations in hypertrophic cardiomyopathy patients studied with cardiac magnetic resonance with feature-trackingP229How many are too many - frequent premature ventricular contractions and left ventricular functionP230Two-dimensional global longitudinal strain and strain rate for evaluation of inflammatory cardiomyopathy as proven by endomyocardial biopsyP231The echocardiographic features of young asymptomatic screening population with left ventricular hypertrabeculationP232Use of amlodipine to decrease myocardial iron in thalassemia major (AMIT trial): comparison of T2* CMR and echocardiography for assessment of cardiac volumes and functionP233Echocardiographic comparison of Fabry cardiomyopathy and light-chain amyloid heart diseaseP234Early detection of left atrial enlargement using 3D echocardiography in patients undergoing breast cancer treatment

Author

Mecarocci, V., primary, Mapelli, M., primary, Johnson, K., primary, Kamperidis, V., primary, Treede, H., primary, Alonso Fernandez De Gatta, M., primary, Mameri, A., primary, Pressman, G., primary, Coutinho Cruz, M., primary, Bartolacelli, Y., primary, Gillebert, C., primary, Lozano-Granero, VC., primary, Boretti, I., primary, Son, JW., primary, Carvalho, JF., primary, Zuo, L., primary, Basu, J., primary, Gomes, AC., primary, Lie, OH., primary, Aleksandrov, AS., primary, Tang, HC., primary, Alvi, N., primary, Marek, J., primary, Rascon Sabido, R., primary, Mori, F., additional, Fusini, L., additional, Zagni, P., additional, Muratori, M., additional, Agostoni, P., additional, Gripari, P., additional, Ghulam Ali, S., additional, Tamborini, G., additional, Pepi, M., additional, Fiorentini, C., additional, Abdel-Rahman, ST., additional, Dobson, L., additional, Kidambi, A., additional, Gatenby, K., additional, Schlosshan, D., additional, Van Wijngaarden, SE., additional, Van Rosendael, PJ., additional, Kong Kok Fai, W., additional, Leung, M., additional, Sianos, G., additional, Ajmone Marsan, N., additional, Bax, JJ., additional, Delgado, V., additional, Nickenig, G., additional, Kuck, KH., additional, Baldus, S., additional, Vahanian, A., additional, Colombo, A., additional, Alfieri, O., additional, Topilsky, Y., additional, Grayburn, P., additional, Maisano, F., additional, Barreiro Perez, M., additional, Arribas Jimenez, A., additional, Martin Garcia, A., additional, Diaz Pelaez, E., additional, Rodriguez Collado, J., additional, Cruz Gonzalez, I., additional, Sanchez Fernandez, PL., additional, Urena Alcazar, M., additional, Cimadevilla, C., additional, Himbert, D., additional, Raffoul, R., additional, Verdonk, C., additional, Nataf, P., additional, Messika-Zeitoun, D., additional, Gartman, CH., additional, Obasare, E., additional, Melendres, E., additional, Malik, M., additional, Slipczuk, L., additional, Figueredo, V., additional, Ilhao Moreira, R., additional, Moura Branco, L., additional, Galrinho, A., additional, Coutinho Miranda, L., additional, Timoteo, AT., additional, Abreu, J., additional, Pinto Teixeira, P., additional, Fragata, J., additional, Cruz Ferreira, R., additional, Barbieri, A., additional, Bursi, F., additional, Mantovani, F., additional, Lugli, R., additional, Fabbri, M., additional, Mussini, C., additional, Boriani, G., additional, Perry, R., additional, Hecker, T., additional, Szpytma, M., additional, Joseph, M., additional, Fernandez-Santos, S., additional, Plaza-Martin, M., additional, Lopez-Fernandez, T., additional, De La Hera, JM., additional, Martinez-Monzonis, A., additional, La Canna, G., additional, Mesa, D., additional, Swaans, M., additional, Murzilli, R., additional, Echevarria, T., additional, Habib, G., additional, Zamorano, JL., additional, Fernandez-Golfin Loban, C., additional, Salido, L., additional, Gonzalez Gomez, A., additional, Garcia Martin, A., additional, Hinojar Baides, R., additional, Pardo, A., additional, Moya Mur, JL., additional, Ruiz Leria, S., additional, Hernandez Antolin, R., additional, Jimenez Nacher, JJ., additional, Zamorano Gomez, JL., additional, Kim, HJ., additional, Kim, BJ., additional, Choi, KW., additional, Lee, CH., additional, Kim, W., additional, Park, JS., additional, Shin, DG., additional, Kim, YJ., additional, Choi, JH., additional, Congo, K., additional, Neves, D., additional, Pais, J., additional, Guerreiro, R., additional, Picarra, B., additional, Santos, AR., additional, Bento, A., additional, Aguiar, J., additional, Wang, J., additional, Ta, SJ., additional, Kang, N., additional, Zhou, MY., additional, Guo, RQ., additional, Liu, L., additional, Thorsen, L., additional, Thomas, K., additional, Shabbir, A., additional, Balkhausen, K., additional, Bull, S., additional, Lopes, LR., additional, Cruz, I., additional, Almeida, AR., additional, Pereira, H., additional, Saberniak, J., additional, Dejgaard, LA., additional, Anfinsen, OG., additional, Hegbom, F., additional, Edvardsen, T., additional, Haugaa, KH., additional, Kasner, M., additional, Tschoepe, C., additional, Ho, JS., additional, Goh, LK., additional, Ding, ZP., additional, Tipoo, FA., additional, Chowdhury, D., additional, Colan, S., additional, Imran, A., additional, Raza, U., additional, Ashiqali, S., additional, Hasan, BS., additional, Mohty, D., additional, Palecek, T., additional, Golan, L., additional, Jaccard, A., additional, Lenhart, A., additional, Garcia Mendez Rosalba, RGM, additional, Martinez Hernandez Carlos, MHC, additional, Ibarra Quevedo David, DIQ, additional, and Almeida Gutierrez Eduardo, EAG, additional

Published
2016
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3. HIT Poster session 1P154Preclinical diastolic dysfunction is related to impaired endothelial function in patients with chronic kidney diseaseP155Early detection of left atrial and left ventricular abnormalities in hypertensive and obese womenP156Right ventricle preserved systolic function irrespective of right ventricular hypertrophy and disease severity in anderson fabry diseaseP157Left atrial volume and function in patients undergoing percutaneous mitral valve repairP158Impact of left ventricular dysfunction on outcomes of patients undergoing direct TAVI with a self-expanding bioprosthesisP159Anatomic Doppler spectrum – retrospective spectral tissue Doppler from ultra high frame rate tissue Doppler imaging for evaluation of tissue deformationP160Phasic dynamics of ischaemic mitral regurgitation after primary coronary intervention in acute myocardial infarction: serial echocardiographic assessment from emergency room to long-term follow-upP161Reproducibility of 3DE RV volumes - novel insights at a regional levelP162Pulmonary vascular capacitance as assessed by echocardiography in pulmonary arterial hypertensionP163Three-dimensional endocardial area strain: a novel parameter for quantitative assessment of global left ventricular systolic functionP164Role of exercise hemodynamics assessed by echocardiography on symptom reduction after MitraClipP165Early identification of ventricular dysfunction in patients with juvenile systemic sclerosisP166Heart failure with and without preserved ejection fraction - the role of biomarkers in the aspect of global longitudinal strainP167Complex systolic deformation of aortic root: insights from two dimensional speckle tracking imageP168Volumetric and deformational imaging usind 2d strain and 3d echocardiography in patients with pulmonary hypertensionP169Influence of pressure load and right ventricular morphology and function on tricuspid regurgitation in pulmonary arterial hypertensionP170Left ventricular myocardial diastolic deformation analysis by 2D speckle tracking echocardiography and relationship with conventional diastolic parameters in chronic aortic regurgitationP171Extracellular volume, and not native T1 time, distinguishes diffuse fibrosis in dilated or hypertrophic cardiomyopathy at 3TP172Left atrial strain is significantly reduced in arterial hypertensionP173Symptomatic severe secondary mitral regurgitation: LV enddiastolic diameter (LVEDD) as preferable parameter for risk stratificationP174Left ventricular mechanics in isolated left bundle branch block at rest and when exercising: exploration of the concept of conductive cardiomyopathyP175Assessment of myocardial scar by 2D contrast echocardiographyP176Chronic pericarditis - expression of a rare disease: Erdheim Chester diseaseP177Aortic arch mechanics with two-dimensional speckle tracking echocardiography to estimate the left ventricular remodelling in hypertensive patientsP178Strain analysis by tissue doppler imaging: comparison of conventional manual measurement with a semi-automated approachP179Distribution of extravascular lung water in heart failure patients assessed by lung ultrasoudP180Surrogate markers for obstructive coronary artery diseaseP181LA deformation and LV longitudinal strain by two-dimensional speckle tracking echocardiography as predictors of postoperative AF development after aortic valve replacement in ASP182Left ventricular diastolic dysfunction in type 2 diabetic patients with non alcoholic fatty liver diseaseP183Myocardial strain by speckle-tracking and evaluation of 3D ejection fraction in drug-induced cardiotoxicity's approach in breast cancer

Author

Gevaert, AB, primary, Borizanova, A, primary, Graziani, F, primary, Galuszka, O M, primary, Stathogiannis, K, primary, Lervik Nilsen, L C, primary, Nishino, S, primary, Willis, J, primary, Venner, C, primary, Luo, XX, primary, Van De Heyning, C M, primary, Castaldi, B, primary, Michalski, BW, primary, Wang, TL, primary, Aktemur, T, primary, Dorlet, S, primary, Verseckaite, R, primary, Amzulescu, MS, primary, Brecht, A, primary, Brand, M, primary, Galli, E, primary, Murzilli, R, primary, Bica, R, primary, Teixeira, R, primary, Schmid, J, primary, Miglioranza, MH, primary, Cherneva, ZH, primary, Gheghici, S, primary, Pernigo, M, primary, Rafael, D, primary, Van Craenenbroeck, AH, additional, Shivalkar, B, additional, Lemmens, K, additional, Vrints, CJ, additional, Van Craenenbroeck, EM, additional, Somleva, D, additional, Zlatareva- Gronkova, N, additional, Kinova, E, additional, Goudev, A, additional, Camporeale, A, additional, Pieroni, M, additional, Pedicino, D, additional, Laurito, MP, additional, Verrecchia, E, additional, Lanza, GA, additional, Manna, R, additional, Crea, F, additional, Reinthaler, M, additional, Rutschow, S, additional, Gross, M, additional, Landmesser, U, additional, Kasner, M, additional, Toutouzas, K, additional, Drakopoulou, M, additional, Latsios, G, additional, Synetos, A, additional, Kaitozis, O, additional, Trantalis, G, additional, Mastrokostopoulos, A, additional, Kotronias, R, additional, Tousoulis, D, additional, Brekke, BB, additional, Aase, SA, additional, Lonnebakken, MT, additional, Stensvag, D, additional, Amundsen, B, additional, Torp, H, additional, Stoylen, A, additional, Watanabe, N, additional, Kimura, T, additional, Nakama, T, additional, Furugen, M, additional, Koiwaya, H, additional, Ashikaga, K, additional, Kuriyama, N, additional, Shibata, Y, additional, Augustine, DX, additional, Knight, D, additional, Sparey, J, additional, Coghlan, G, additional, Easaw, J, additional, Huttin, O, additional, Voilliot, D, additional, Mercy, M, additional, Villemin, T, additional, Olivier, A, additional, Mandry, D, additional, Chaouat, A, additional, Juilliere, Y, additional, Selton-Suty, C, additional, Fang, F, additional, Li, S, additional, Zhang, ZH, additional, Yu, CM, additional, Bertrand, PB, additional, De Maeyer, C, additional, De Bock, D, additional, Paelinck, BP, additional, Claeys, MJ, additional, Reffo, E, additional, Balzarin, M, additional, Zulian, F, additional, Milanesi, O, additional, Miskowiec, D, additional, Kupczynska, K, additional, Peczek, L, additional, Nawrot, B, additional, Lipiec, P, additional, Kasprzak, JD, additional, Li, H, additional, Jin, XY, additional, Poci, N, additional, Kaymaz, C, additional, Venner, C, additional, Manenti, V, additional, Carillo, S, additional, Chabot, F, additional, Mizariene, V, additional, Rimkeviciute, D, additional, Bieseviciene, M, additional, Jonkaitiene, R, additional, Jurkevicius, R, additional, Roy, C, additional, Slimani, A, additional, Boileau, L, additional, De Meester, C, additional, Vancraeynest, D, additional, Pasquet, A, additional, Vanoverschelde, JL, additional, Pouleur, AC, additional, Gerber, BL, additional, Oertelt-Prigione, S, additional, Seeland, U, additional, Ruecke, M, additional, Regitz-Zagrosek, V, additional, Stangl, V, additional, Knebel, F, additional, Laux, D, additional, Roeing, J, additional, Butz, T, additional, Christ, M, additional, Grett, M, additional, Wennemann, R, additional, Trappe, H- J, additional, Fournet, M, additional, Leclercq, C, additional, Samset, E, additional, Daubert, J-C, additional, Donal, E, additional, Leo, LA, additional, Pasotti, E, additional, Klersy, C, additional, Moccetti, T, additional, Faletra, FF, additional, Dobre, D, additional, Darmon, S, additional, Dumitrescu, S, additional, Calistru, P, additional, Monteiro, R, additional, Ribeiro, M, additional, Garcia, J, additional, Cardim, N, additional, Goncalves, L, additional, Kaufmann, R, additional, Grubler, MR, additional, Verheyen, N, additional, Weidemann, F, additional, Binder, JS, additional, Santanna, RT, additional, Rover, MM, additional, Leiria, T, additional, Kalil, R, additional, Picano, E, additional, Gargani, L, additional, Kuneva, ZK, additional, Vasilev, DV, additional, Ianula, R, additional, Dasoveanu, M, additional, Calin, C, additional, Homentcovsci, C, additional, Siliste, R, additional, Bergamini, C, additional, Mantovani, A, additional, Bonapace, S, additional, Lipari, P, additional, Barbieri, E, additional, Bonora, E, additional, Targher, G, additional, Camarozano, AC, additional, Pereira Da Cunha, CL, additional, Padilha, SL, additional, Souza, AM, additional, and Freitas, AKE, additional

Published
2015
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6. HIT Poster session 1

Author

Gevaert, AB, Van Craenenbroeck, AH, Shivalkar, B, Lemmens, K, Vrints, CJ, Van Craenenbroeck, EM, Borizanova, A, Somleva, D, Zlatareva- Gronkova, N, Kinova, E, Goudev, A, Graziani, F, Camporeale, A, Pieroni, M, Pedicino, D, Laurito, MP, Verrecchia, E, Lanza, GA, Manna, R, Crea, F, Galuszka, O M, Reinthaler, M, Rutschow, S, Gross, M, Landmesser, U, Kasner, M, Stathogiannis, K, Toutouzas, K, Drakopoulou, M, Latsios, G, Synetos, A, Kaitozis, O, Trantalis, G, Mastrokostopoulos, A, Kotronias, R, Tousoulis, D, Lervik Nilsen, L C, Brekke, BB, Aase, SA, Lonnebakken, MT, Stensvag, D, Amundsen, B, Torp, H, Stoylen, A, Nishino, S, Watanabe, N, Kimura, T, Nakama, T, Furugen, M, Koiwaya, H, Ashikaga, K, Kuriyama, N, Shibata, Y, Willis, J, Augustine, DX, Knight, D, Sparey, J, Coghlan, G, Easaw, J, Venner, C, Huttin, O, Voilliot, D, Mercy, M, Villemin, T, Olivier, A, Mandry, D, Chaouat, A, Juilliere, Y, Selton-Suty, C, Luo, XX, Fang, F, Li, S, Zhang, ZH, Yu, CM, Van De Heyning, C M, Bertrand, PB, De Maeyer, C, De Bock, D, Paelinck, BP, Vrints, CJ, Claeys, MJ, Castaldi, B, Reffo, E, Balzarin, M, Zulian, F, Milanesi, O, Michalski, BW, Miskowiec, D, Kupczynska, K, Peczek, L, Nawrot, B, Lipiec, P, Kasprzak, JD, Wang, TL, Li, H, Jin, XY, Aktemur, T, Poci, N, Kaymaz, C, Dorlet, S, Huttin, O, Voilliot, D, Venner, C, Villemin, T, Manenti, V, Carillo, S, Chabot, F, Juilliere, Y, Selton-Suty, C, Verseckaite, R, Mizariene, V, Rimkeviciute, D, Bieseviciene, M, Jonkaitiene, R, Jurkevicius, R, Amzulescu, MS, Roy, C, Slimani, A, Boileau, L, De Meester, C, Vancraeynest, D, Pasquet, A, Vanoverschelde, JL, Pouleur, AC, Gerber, BL, Brecht, A, Oertelt-Prigione, S, Seeland, U, Ruecke, M, Regitz-Zagrosek, V, Stangl, V, Knebel, F, Brand, M, Laux, D, Roeing, J, Butz, T, Christ, M, Grett, M, Wennemann, R, Trappe, H- J, Galli, E, Fournet, M, Leclercq, C, Samset, E, Daubert, J-C, Donal, E, Murzilli, R, Leo, LA, Pasotti, E, Klersy, C, Moccetti, T, Faletra, FF, Bica, R, Dobre, D, Darmon, S, Dumitrescu, S, Calistru, P, Teixeira, R, Monteiro, R, Ribeiro, M, Garcia, J, Cardim, N, Goncalves, L, Schmid, J, Kaufmann, R, Grubler, MR, Verheyen, N, Weidemann, F, Binder, JS, Miglioranza, MH, Santanna, RT, Rover, MM, Leiria, T, Kalil, R, Picano, E, Gargani, L, Cherneva, ZH, Kuneva, ZK, Vasilev, DV, Gheghici, S, Ianula, R, Dasoveanu, M, Calin, C, Homentcovsci, C, Siliste, R, Pernigo, M, Bergamini, C, Mantovani, A, Bonapace, S, Lipari, P, Barbieri, E, Bonora, E, Targher, G, Rafael, D, Camarozano, AC, Pereira Da Cunha, CL, Padilha, SL, Souza, AM, and Freitas, AKE

Abstract

Background: Preclinical diastolic dysfunction is highly prevalent in the aging population, but mechanisms for progression into heart failure with preserved ejection fraction (HFpEF) are still obscure. Recently, microvascular endothelial inflammation and endothelial dysfunction (ED) were advocated as primum movens in the development of HFpEF. Purpose: We aimed to evaluate whether ED and arterial stiffness relate to diastolic and other structural and functional cardiac parameters. This was studied in patients with chronic kidney disease (CKD), known to be prone to diastolic dysfunction and left ventricular hypertrophy. Methods: Consecutive CKD patients, without concomitant cardiovascular disease, were included. Diastolic parameters were assessed by cardiac ultrasound using E/e´ ratio and left atrial volume index (LAVi). Also, left ventricular mass index (LVMi) and interventricular septum thickness (IVSd) were included. Endothelial function was evaluated by flow-mediated dilation (FMD) of the brachial artery induced by hyperaemia. Arterial stiffness was assessed by measuring carotid-femoral pulsed wave velocity (PWV). Results: After exclusion of patients with normal diastolic function (n=11), 52 patients (age 53.9 ± 12.8 years, 53.2% male) were assessed, of whom 36 underwent a second analysis after 3 months (total measurements 88). Mean creatinin clearance (eGFR) was 42.9 ± 23.2 ml/min/1.73m2. Comorbidities included arterial hypertension (90.4%) and diabetes mellitus (9.6%). Mean Framingham Heart score was 18.9% ± 18.7. Endothelial function was impaired (FMD 4.64% ± 2.61), and patients showed increased arterial stiffness (PWV 8.96 m/s ± 2.18). Ratio of E/e´ was elevated (>12) in 36.4% of measurements. LVMi was raised in 28.4%, and LAVi was elevated in 45.1%. Patients with E/e´>12 had impaired FMD (p=0.005) and elevated PWV (p=0.047). In bivariate correlation analysis, FMD correlated with E/e´ (r=-0.289, p=0.010) and with IVSd (r=-0.315, p=0.005). PWV did not show a relation with any of the diastolic indices (all p>0.05). In a multiple linear regression model, accounting for age, sex, smoking, eGFR, and PWV, FMD remained independently associated to E/e´ (ß=-0.279, p=0.011) and IVSd (ß=-0.232, p=0.026). Conclusions: In CKD patients with preclinical diastolic dysfunction, impaired endothelial function correlates with higher filling pressures and structural cardiac changes. This observation supports the paradigm that ED plays a role in the pathophysiology of diastolic dysfunction, even in an asymptomatic stage.

Published
2015
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7. Speckle-Tracking Layer-Specific Analysis of Myocardial Deformation and Evaluation of Scar Transmurality in Chronic Ischemic Heart Disease.

Author

Tarascio M, Leo LA, Klersy C, Murzilli R, Moccetti T, and Faletra FF

Subjects
Case-Control Studies, Chronic Disease, Contrast Media, Female, Humans, Image Interpretation, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Retrospective Studies, Cicatrix diagnostic imaging, Cicatrix physiopathology, Echocardiography methods, Myocardial Ischemia diagnostic imaging, Myocardial Ischemia physiopathology
Abstract

Background: Identification of the extent of scar transmurality in chronic ischemic heart disease is important because it correlates with viability. The aim of this retrospective study was to evaluate whether layer-specific two-dimensional speckle-tracking echocardiography allows distinction of scar presence and transmurality., Methods: A total of 70 subjects, 49 with chronic ischemic cardiomyopathy and 21 healthy subjects, underwent two-dimensional speckle-tracking echocardiography and late gadolinium-enhanced cardiac magnetic resonance. Scar extent was determined as the relative amount of hyperenhancement using late gadolinium-enhanced cardiac magnetic resonance in an 18-segment model (0% hyperenhancement = normal; 1%-50% = subendocardial scar; 51%-100% = transmural scar). In the same 18-segment model, peak systolic circumferential strain and longitudinal strain were calculated separately for the endocardial and epicardial layers as well as the full-wall myocardial thickness., Results: All strain parameters showed cutoff values (area under the curve > 0.69) that allowed the discrimination of normal versus scar segments but not of transmural versus subendocardial scars. This was true for all strain parameters analyzed, without differences in efficacy between longitudinal and circumferential strain and subendocardial, subepicardial, and full-wall-thickness strain values. Circumferential and longitudinal strain in normal segments showed transmural and basoapical gradients (greatest values at the subendocardial layer and apex). In segments with scar, transmural gradient was maintained, whereas basoapical gradient was lost because the reduction of strain values in the presence of the scar was greater at the apex., Conclusions: The two-dimensional speckle-tracking echocardiographic values distinguish scar presence but not transmurality; thus, they are not useful predictors of scar segment viability. It remains unclear why there is a greater strain value reduction in the presence of a scar at the apical level., (Copyright © 2017 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)

Published
2017
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8. Echocardiography-X-Ray Image Fusion.

Author

Faletra FF, Pedrazzini G, Pasotti E, Murzilli R, Leo LA, and Moccetti T

Subjects
Cardiac Catheterization, Fluoroscopy, Heart Diseases therapy, Humans, Predictive Value of Tests, Radiography, Interventional, Echocardiography, Three-Dimensional, Echocardiography, Transesophageal, Heart Diseases diagnostic imaging, Multimodal Imaging methods, Radiographic Image Interpretation, Computer-Assisted
Published
2016
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9. Predictors of disagreement between prospectively ECG-triggered dual-source coronary computed tomography angiography and conventional coronary angiography.

Author

Muzzarelli S, Suerder D, Murzilli R, Donato L, Pedrazzini G, Pasotti E, Moccetti T, Klersy C, and Faletra FF

Subjects
Female, Heart Rate, Humans, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Severity of Illness Index, Computed Tomography Angiography methods, Coronary Angiography methods, Coronary Artery Disease diagnostic imaging, Electrocardiography methods
Abstract

Aims: To identify causes of misinterpretation in second generation, dual-source coronary computed tomography angiography (CCTA)., Methods: A retrospective re-interpretation was performed on 100 consecutive CCTA studies, previously performed with a 2×128 slice dual-source CT. Results were compared with coronary angiography (CA). CCTA and CA images were interpreted by 2 independent readers. At CCTA vessel diameter, image quality, plaque characteristics and localization (bifurcation vs. non) were described for all segments. Finally, aortic contrast-to-noise ratio (CNR) and the total Agatston calcium score were quantified. Agreement between CCTA and CA was assessed with the Kappa statistic after categorizing the stenosis severity at significant (≥50%) and critical (≥70%) cut-offs, and independent predictors of disagreement were determined by multivariable logistic regression, including patient characteristics such as body mass index (BMI), heart rate (HR), age and gender., Results: Per-segment sensitivity and specificity at ≥50% and ≥70% stenosis was of 83-95%, and 73-97%, respectively. There was a substantial agreement between CCTA and CA (kappa-50%=0.78, SE=0.03; kappa-70%=0.72, SE=0.03). Worse motion-related quality score, smaller vessel diameter, calcification within the segment of interest and LAD location were independent predictors of disagreement at 50% stenosis. The same factors, excluded LAD location, in addition to bifurcation-location of the coronary lesion predicted misdiagnosis at 70% stenosis. HR per se and BMI did not predict disagreement., Conclusion: According to the literature a substantial agreement between CCTA and CA was found. However, discrepancies exist and are mainly related with motion-related degradation of image quality, specific vessel anatomy and plaque characteristics. Awareness of such potential limitations may help guiding interpretation of CCTA., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Published
2016
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10. [The emerging role of three-dimensional transesophageal echocardiography in guiding the MitraClip procedure].

Author

Murzilli R, Pedrazzini G, Pasotti E, Moccetti T, Faletra FF, and Leo LA

Subjects
Echocardiography methods, Humans, Mitral Valve Insufficiency physiopathology, Patient Selection, Severity of Illness Index, Echocardiography, Three-Dimensional methods, Echocardiography, Transesophageal methods, Mitral Valve Insufficiency surgery
Abstract

Percutaneous edge-to-edge mitral valve repair with the MitraClip device has been shown to be a safe and effective procedure in selected patients with moderate-to-severe mitral regurgitation. Two-dimensional transesophageal echocardiography (2D TEE) is the primary imaging modality for guidance of the procedure. Real-time three-dimensional (3D) TEE has recently been used as additional imaging modality during the MitraClip procedure. In comparison with 2D TEE, 3D TEE provides additional information in several steps of the procedure, including precise positioning of the clip delivery system into the left atrium, correct alignment of the clip arms perpendicular to the coaptation line and confirmation of the correct grasping location. This review describes the relevant role of 3D TEE imaging during the procedure, but also its limitations.

Published
2015
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11. An in-silico analysis of the effect of heart position and orientation on the ECG morphology and vectorcardiogram parameters in patients with heart failure and intraventricular conduction defects.

Author

Nguyên UC, Potse M, Regoli F, Caputo ML, Conte G, Murzilli R, Muzzarelli S, Moccetti T, Caiani EG, Prinzen FW, Krause R, and Auricchio A

Subjects
Aged, Arrhythmias, Cardiac complications, Arrhythmias, Cardiac diagnosis, Computer Simulation, Diagnosis, Computer-Assisted methods, Electrocardiography methods, Female, Heart Failure complications, Heart Failure diagnosis, Humans, Male, Middle Aged, Patient-Specific Modeling, Posture, Reproducibility of Results, Sensitivity and Specificity, Arrhythmias, Cardiac physiopathology, Heart Conduction System physiopathology, Heart Failure physiopathology, Models, Cardiovascular, Patient Positioning methods, Vectorcardiography methods
Abstract

Aim: The aim of this study was to investigate the influence of geometrical factors on the ECG morphology and vectorcardiogram (VCG) parameters., Methods: Patient-tailored models based on five heart-failure patients with intraventricular conduction defects (IVCDs) were created. The heart was shifted up to 6 cm to the left, right, up, and down and rotated ±30° around the anteroposterior axis. Precordial electrodes were shifted 3 cm down., Results: Geometry modifications strongly altered ECG notching/slurring and intrinsicoid deflection time. Maximum VCG parameter changes were small for QRS duration (-6% to +10%) and QRS-T angle (-6% to +3%), but considerable for QRS amplitude (-36% to +59%), QRS area (-37% to +42%), T-wave amplitude (-41% to +36%), and T-wave area (-42% to +33%)., Conclusion: The position of the heart with respect to the electrodes is an important factor determining notching/slurring and voltage-dependent parameters and therefore must be considered for accurate diagnosis of IVCDs., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Published
2015
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12. In vivo electromechanical assessment of heart failure patients with prolonged QRS duration.

Author

Kroon W, Lumens J, Potse M, Suerder D, Klersy C, Regoli F, Murzilli R, Moccetti T, Delhaas T, Krause R, Prinzen FW, and Auricchio A

Subjects
Aged, Computer Simulation, Electrocardiography, Heart Ventricles physiopathology, Humans, Magnetic Resonance Spectroscopy, Myocardial Contraction physiology, Heart Failure physiopathology
Abstract

Background: Combined measurement of electrical activation and mechanical dyssynchrony in heart failure (HF) patients is scarce but may contain important mechanistic and diagnostic clues., Objective: The purpose of this study was to characterize the electromechanical (EM) coupling in HF patients with prolonged QRS duration., Methods: Ten patients with QRS width >120 ms underwent left ventricular (LV) electroanatomic contact mapping using the Noga® XP system (Biosense Webster). Recorded voltages during the cardiac cycle were converted to maps of depolarization time (TD). Electrode positions were tracked and converted into maps of time-to-peak shortening (TPS) using custom-made deformation analysis software. Correlation analysis was performed between the 2 maps to quantify EM coupling. Simulations with the CircAdapt cardiovascular system model were performed to mechanistically unravel the observed relation between TD and TPS., Results: The delay between earliest LV electrical activation and peak shortening differed considerably between patients (TPSmin-TDmin = 360 ± 73 ms). On average, total mechanical dyssynchrony exceeded total electrical activation (ΔTPS = 177 ± 47 ms vs ΔTD = 93 ± 24 ms, P <.001), but a large interpatient variability was observed. The TD and TPS maps correlated strongly in all patients (median R = 0.87, P <.001). These correlations were similar for regions with unipolar voltages above and below 6mV (Mann-Whitney U test, P = .93). Computer simulations revealed that increased passive myocardial stiffness decreases ΔTPS relative to ΔTD and that lower contractility predominantly increases TPSmin-TDmin., Conclusion: EM coupling in HF patients is maintained, but the relationship between TD and TPS differs strongly between patients. Intra-individual and inter-individual differences may be explained by local and global differences in passive and contractile myocardial properties., (Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Published
2015
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13. Three-dimensional transesophageal echocardiography in degenerative mitral regurgitation.

Author

Faletra FF, Demertzis S, Pedrazzini G, Murzilli R, Pasotti E, Muzzarelli S, Siclari F, and Moccetti T

Subjects
Aged, Female, Humans, Male, Middle Aged, Reproducibility of Results, Sensitivity and Specificity, Treatment Outcome, Echocardiography, Three-Dimensional methods, Echocardiography, Transesophageal methods, Image Interpretation, Computer-Assisted methods, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery
Abstract

The morphology of mitral valve (MV) prolapse and flail may be extremely variable, with dominant and secondary dynamic lesions. Any pathologic valve appears unique and different from any other. Three-dimensional (3D) transesophageal echocardiography is a powerful tool to evaluate the geometry, dynamics, and function of the MV apparatus and may be of enormous value in helping surgeons perform valve repair procedures. Indeed, in contrast to the surgical view, 3D transesophageal echocardiography can visualize MV prolapse and flail in motion and from different perspectives. The purpose of this special article is not to provide a comprehensive review of degenerative MV disease but rather to illustrate different types of mitral prolapse and flail as they appear from multiple 3D transesophageal echocardiographic perspectives using a series of clinical scenarios. Because in everyday practice, 3D transesophageal echocardiographic images of MV prolapse and flail are usually observed in motion, each scenario is accompanied by several videos. Finally, the authors provide for each scenario a brief description of the surgical techniques that are usually performed at their institution., (Copyright © 2015 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)

Published
2015
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14. 3D real-time TEE during pulmonary vein isolation in atrial fibrillation.

Author

Acena M, Regoli F, Faletra FF, Tritto M, Klersy C, Murzilli R, Scopigni F, Penco M, Pasotti E, Moccetti T, and Auricchio A

Subjects
Catheter Ablation, Computer Systems, Humans, Prospective Studies, Pulmonary Veins surgery, Atrial Fibrillation surgery, Echocardiography, Three-Dimensional, Echocardiography, Transesophageal, Pulmonary Veins diagnostic imaging
Published
2014
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15. 3D TEE during catheter-based interventions.

Author

Faletra FF, Pedrazzini G, Pasotti E, Muzzarelli S, Dequarti MC, Murzilli R, Schlossbauer SA, Slater IP, and Moccetti T

Subjects
Heart Diseases diagnostic imaging, Humans, Image Interpretation, Computer-Assisted, Predictive Value of Tests, Punctures, Treatment Outcome, Cardiac Catheterization methods, Echocardiography, Three-Dimensional, Echocardiography, Transesophageal, Heart Diseases therapy, Ultrasonography, Interventional methods
Abstract

Guidance of catheter-based procedures is performed using fluoroscopy and 2-dimensional transesophageal echocardiography (TEE). Both of these imaging modalities have significant limitations. Because of its 3-dimensional (3D) nature, 3D TEE allows visualizing the entire scenario in which catheter-based procedures take place (including long segments of catheters, tips, and the devices) in a single 3D view. Despite these undeniable advantages, 3D TEE has not yet gained wide acceptance among most interventional cardiologists and echocardiographists. One reason for this reluctance is probably the absence of standardized approaches for obtaining 3D perspectives that provide the most comprehensive information for any single step of any specific procedure. Therefore, the purpose of this review is to describe what we believe to be the most useful 3D perspectives in the following catheter-based percutaneous interventions: transseptal puncture; patent foramen ovale/atrial septal defect closure; left atrial appendage occlusion; mitral valve repair; and closure of paravalvular leaks., (Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Published
2014
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16. Imaging-based right-atrial anatomy by computed tomography, magnetic resonance imaging, and three-dimensional transoesophageal echocardiography: correlations with anatomic specimens.

Author

Faletra FF, Muzzarelli S, Dequarti MC, Murzilli R, Bellu R, and Ho SY

Subjects
Echocardiography, Three-Dimensional methods, Female, Heart Atria diagnostic imaging, Humans, Magnetic Resonance Imaging, Cine methods, Male, Reference Values, Sensitivity and Specificity, Tomography, X-Ray Computed methods, Diagnostic Imaging methods, Echocardiography, Transesophageal methods, Heart Atria anatomy & histology, Image Processing, Computer-Assisted
Abstract

Nowadays computed tomography, cardiac magnetic resonance imaging, and tridimensional transoesophageal echocardiography provide anatomic images of right-atrial structures with an impressive richness of anatomical details. It is therefore surprising that these techniques are not routinely used as complementary tools in teaching anatomy. This review aims to fill this gap showing the normal anatomy of right atrium as displayed by these sophisticated imaging techniques. A better understanding of right-atrial anatomy is crucial for the treatment of primary right-atrium electrical disorders as well as for catheter-based interventions for structural heart disease. The success of these procedures is, in fact, related to an accurate anatomical pre-procedural assessment. In this review, we describe the normal anatomy and variants of those right-atrial structures relevant for both ablationists and interventionalists.

Published
2013
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