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1. Early integration of palliative care versus standard cardiac care for patients with heart failure (EPCHF): a multicentre, parallel, two-arm, open-label, randomised controlled trial

Author

Balata, Mahmoud, Radbruch, Lukas, Hesse, Michaela, Westenfeld, Ralf, Neukirchen, Martin, Pfister, Roman, Batzler, Yann-Nicolas, Öztürk, Can, Kavsur, Refik, Tiyerili, Vedat, Weltermann, Birgitta, Pölsler, Robert, Standl, Thomas, Nickenig, Georg, and Becher, Marc Ulrich

Published
2024
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5. Sex-Related Differences in Clinical Characteristics and Outcome Prediction Among Patients Undergoing Transcatheter Tricuspid Valve Intervention

Author

Fortmeier, Vera, Lachmann, Mark, Körber, Maria I., Unterhuber, Matthias, Schöber, Anne R., Stolz, Lukas, Stocker, Thomas J., Kassar, Mohammad, Gerçek, Muhammed, Rudolph, Tanja K., Praz, Fabien, Windecker, Stephan, Pfister, Roman, Baldus, Stephan, Laugwitz, Karl-Ludwig, Hausleiter, Jörg, Lurz, Philipp, and Rudolph, Volker

Published
2023
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6. Early Outcomes of 2 Mitral Valve Transcatheter Leaflet Approximation Devices: A Propensity Score–Matched Multicenter Comparison

Author

Mauri, Victor, Sugiura, Atsushi, Spieker, Max, Iliadis, Christos, Horn, Patrick, Öztürk, Can, Besler, Christian, Riebisch, Matthias, Al-Hammadi, Osamah, Ruf, Tobias, Gerçek, Muhammed, Grothusen, Christina, Mehr, Michael, Becher, Marc Ulrich, Mues, Christoph, Boeder, Niklas, Kreidel, Felix, Friedrichs, Kai, Westenfeld, Ralf, Braun, Daniel, Baldus, Stephan, Rassaf, Tienush, Thiele, Holger, Nickenig, Georg, Hausleiter, Jörg, Möllmann, Helge, Kelm, Malte, Rudolph, Volker, von Bardeleben, Ralph Stephan, Nef, Holger M., Luedike, Peter, Lurz, Philipp, and Pfister, Roman

Published
2022
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7. Transcatheter Mitral Valve Repair in Patients With Atrial Functional Mitral Regurgitation

Author

Doldi, Philipp, Stolz, Lukas, Orban, Mathias, Karam, Nicole, Praz, Fabien, Kalbacher, Daniel, Lubos, Edith, Braun, Daniel, Adamo, Marianna, Giannini, Cristina, Melica, Bruno, Näbauer, Michael, Higuchi, Satoshi, Wild, Mirjam, Neuss, Michael, Butter, Christian, Kassar, Mohammad, Petrescu, Aniela, Pfister, Roman, Iliadis, Christos, Unterhuber, Matthias, Thiele, Holger, Baldus, Stephan, von Bardeleben, Ralph Stephan, Schofer, Niklas, Hagl, Christian, Petronio, Anna Sonia, Massberg, Steffen, Windecker, Stephan, Lurz, Philipp, Metra, Marco, and Hausleiter, Jörg

Published
2022
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9. Outcomes Stratified by Adapted Inclusion Criteria After Mitral Edge-to-Edge Repair

Author

Koell, Benedikt, Orban, Mathias, Weimann, Jessica, Kassar, Mohammad, Karam, Nicole, Neuss, Michael, Petrescu, Aniela, Iliadis, Christos, Unterhuber, Matthias, Adamo, Marianna, Giannini, Cristina, Melica, Bruno, Ludwig, Sebastian, Massberg, Steffen, Praz, Fabien, Pfister, Roman, Thiele, Holger, von Bardeleben, Ralph Stephan, Baldus, Stephan, Butter, Christian, Lurz, Philipp, Windecker, Stephan, Metra, Marco, Petronio, Anna Sonia, Hausleiter, Jörg, Lubos, Edith, and Kalbacher, Daniel

Published
2021
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10. Impact of Residual Mitral Regurgitation on Survival After Transcatheter Edge-to-Edge Repair for Secondary Mitral Regurgitation

Author

Higuchi, Satoshi, Orban, Mathias, Stolz, Lukas, Karam, Nicole, Praz, Fabien, Kalbacher, Daniel, Ludwig, Sebastian, Braun, Daniel, Näbauer, Michael, Wild, Mirjam G., Neuss, Michael, Butter, Christian, Kassar, Mohammad, Petrescu, Aniela, Pfister, Roman, Iliadis, Christos, Unterhuber, Matthias, Park, Sang-Don, Thiele, Holger, Baldus, Stephan, von Bardeleben, Stephan, Schofer, Niklas, Massberg, Steffen, Windecker, Stephan, Lurz, Philipp, and Hausleiter, Jörg

Published
2021
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11. Sex-Related Clinical Characteristics and Outcomes of Patients Undergoing Transcatheter Edge-to-Edge Repair for Secondary Mitral Regurgitation

Author

Park, Sang-Don, Orban, Mathias, Karam, Nicole, Lubos, Edith, Kalbacher, Daniel, Braun, Daniel, Stolz, Lukas, Neuss, Michael, Butter, Christian, Praz, Fabien, Kassar, Mohammad, Petrescu, Aniela, Pfister, Roman, Iliadis, Christos, Unterhuber, Matthias, Lurz, Philipp, Thiele, Holger, Baldus, Stephan, von Bardeleben, Stephan, Blankenberg, Stefan, Massberg, Steffen, Windecker, Stephan, and Hausleiter, Jörg

Published
2021
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12. TRI-SCORE and benefit of intervention in patients with severe tricuspid regurgitation

Author

Dreyfus, J, Galloo, X, Taramasso, M, Heitzinger, G, Benfari, G, Kresoja, K, Juarez-Casso, F, Omran, H, Bohbot, Y, Iliadis, C, Russo, G, Topilsky, Y, Weber, M, Nombela-Franco, L, Sala, A, Eixerés-Esteve, A, Iung, B, Obadia, J, Estevez Loureiro, R, Riant, E, Donal, E, Hausleiter, J, Badano, L, Le Tourneau, T, Coisne, A, Modine, T, Latib, A, Praz, F, Windecker, S, Zamorano, J, von Bardeleben, R, Tang, G, Hahn, R, Webb, J, Muraru, D, Nejjari, M, Chan, V, De Bonis, M, Carnero-Alcazar, M, Nickenig, G, Pfister, R, Tribouilloy, C, Rudolph, V, Crestanello, J, Lurz, P, Bartko, P, Maisano, F, Bax, J, Enriquez-Sarano, M, Messika-Zeitoun, D, Dreyfus, Julien, Galloo, Xavier, Taramasso, Maurizio, Heitzinger, Gregor, Benfari, Giovanni, Kresoja, Karl-Patrick, Juarez-Casso, Fernando, Omran, Hazem, Bohbot, Yohann, Iliadis, Christos, Russo, Giulio, Topilsky, Yan, Weber, Marcel, Nombela-Franco, Luis, Sala, Alessandra, Eixerés-Esteve, Andrea, Iung, Bernard, Obadia, Jean-François, Estevez Loureiro, Rodrigo, Riant, Elisabeth, Donal, Erwan, Hausleiter, Jörg, Badano, Luigi, Le Tourneau, Thierry, Coisne, Augustin, Modine, Thomas, Latib, Azeem, Praz, Fabien, Windecker, Stephan, Zamorano, Jose Luis, von Bardeleben, Ralph Stephan, Tang, Gilbert H L, Hahn, Rebecca, Webb, John, Muraru, Denisa, Nejjari, Mohammed, Chan, Vincent, De Bonis, Michele, Carnero-Alcazar, Manuel, Nickenig, Georg, Pfister, Roman, Tribouilloy, Christophe, Rudolph, Volker, Crestanello, Juan, Lurz, Philipp, Bartko, Philipp, Maisano, Francesco, Bax, Jeroen, Enriquez-Sarano, Maurice, Messika-Zeitoun, David, Dreyfus, J, Galloo, X, Taramasso, M, Heitzinger, G, Benfari, G, Kresoja, K, Juarez-Casso, F, Omran, H, Bohbot, Y, Iliadis, C, Russo, G, Topilsky, Y, Weber, M, Nombela-Franco, L, Sala, A, Eixerés-Esteve, A, Iung, B, Obadia, J, Estevez Loureiro, R, Riant, E, Donal, E, Hausleiter, J, Badano, L, Le Tourneau, T, Coisne, A, Modine, T, Latib, A, Praz, F, Windecker, S, Zamorano, J, von Bardeleben, R, Tang, G, Hahn, R, Webb, J, Muraru, D, Nejjari, M, Chan, V, De Bonis, M, Carnero-Alcazar, M, Nickenig, G, Pfister, R, Tribouilloy, C, Rudolph, V, Crestanello, J, Lurz, P, Bartko, P, Maisano, F, Bax, J, Enriquez-Sarano, M, Messika-Zeitoun, D, Dreyfus, Julien, Galloo, Xavier, Taramasso, Maurizio, Heitzinger, Gregor, Benfari, Giovanni, Kresoja, Karl-Patrick, Juarez-Casso, Fernando, Omran, Hazem, Bohbot, Yohann, Iliadis, Christos, Russo, Giulio, Topilsky, Yan, Weber, Marcel, Nombela-Franco, Luis, Sala, Alessandra, Eixerés-Esteve, Andrea, Iung, Bernard, Obadia, Jean-François, Estevez Loureiro, Rodrigo, Riant, Elisabeth, Donal, Erwan, Hausleiter, Jörg, Badano, Luigi, Le Tourneau, Thierry, Coisne, Augustin, Modine, Thomas, Latib, Azeem, Praz, Fabien, Windecker, Stephan, Zamorano, Jose Luis, von Bardeleben, Ralph Stephan, Tang, Gilbert H L, Hahn, Rebecca, Webb, John, Muraru, Denisa, Nejjari, Mohammed, Chan, Vincent, De Bonis, Michele, Carnero-Alcazar, Manuel, Nickenig, Georg, Pfister, Roman, Tribouilloy, Christophe, Rudolph, Volker, Crestanello, Juan, Lurz, Philipp, Bartko, Philipp, Maisano, Francesco, Bax, Jeroen, Enriquez-Sarano, Maurice, and Messika-Zeitoun, David

Abstract

BACKGROUND AND AIMS: Benefit of tricuspid regurgitation (TR) correction and timing of intervention are unclear. This study aimed to compare survival rates after surgical or transcatheter intervention to conservative management according to a TR clinical stage as assessed using the TRI-SCORE. METHODS: A total of 2,413 patients with severe isolated functional TR were enrolled in TRIGISTRY (1217 conservatively managed, 551 isolated tricuspid valve surgery, and 645 transcatheter valve repair). The primary endpoint was survival at 2 years. RESULTS: The TRI-SCORE was low (≤3) in 32%, intermediate (4-5) in 33%, and high (≥6) in 35%. A successful correction was achieved in 97% and 65% of patients in the surgical and transcatheter groups, respectively. Survival rates decreased with the TRI-SCORE in the three treatment groups (all P < .0001). In the low TRI-SCORE category, survival rates were higher in the surgical and transcatheter groups than in the conservative management group (93%, 87%, and 79%, respectively, P = .0002). In the intermediate category, no significant difference between groups was observed overall (80%, 71%, and 71%, respectively, P = .13) but benefit of the intervention became significant when the analysis was restricted to patients with successful correction (80%, 81%, and 71%, respectively, P = .009). In the high TRI-SCORE category, survival was not different to conservative management in the surgical and successful repair group (61% and 68% vs 58%, P = .26 and P = .18 respectively). CONCLUSIONS: Survival progressively decreased with the TRI-SCORE irrespective of treatment modality. Compared to conservative management, an early and successful surgical or transcatheter intervention improved 2-year survival in patients at low and, to a lower extent, intermediate TRI-SCORE, while no benefit was observed in the high TRI-SCORE category.

Published
2024

13. German Multicenter Experience With a New Leaflet-Based Transcatheter Mitral Valve Repair System for Mitral Regurgitation

Author

Mauri, Victor, Besler, Christian, Riebisch, Matthias, Al-Hammadi, Osamah, Ruf, Tobias, Gerçek, Muhammed, Horn, Patrick, Grothusen, Christina, Mehr, Michael, Becher, Marc Ulrich, Mues, Christoph, Boeder, Niklas, Kreidel, Felix, Friedrichs, Kai, Westenfeld, Ralf, Braun, Daniel, Öztürk, Can, Baldus, Stephan, Rassaf, Tienush, Thiele, Holger, Nickenig, Georg, Hausleiter, Jörg, Möllmann, Helge, Kelm, Malte, Rudolph, Volker, von Bardeleben, Ralph-Stephan, Nef, Holger M., Luedike, Peter, Lurz, Philipp, and Pfister, Roman

Published
2020
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14. Profiles of Geriatric Syndromes and Resources in Older Patients with Atrial Fibrillation.

Author

Verleysdonk, Joshua, Noetzel, Nicolas, Becker, Ingrid, Pickert, Lena, Benzing, Thomas, Pfister, Roman, Polidori, Maria Cristina, and Affeldt, Anna Maria

Subjects
OLDER patients, AGE, SEX (Biology), FRAILTY, ATRIAL fibrillation
Abstract

Objective: Older patients with nonvalvular atrial fibrillation (AF) are at high risk for frailty and geriatric syndromes (GSs), which modulate their individual prognosis and are therefore relevant for further management. Because few studies have evaluated the geriatric profile of older AF patients, this secondary analysis aims to further characterize the patterns of GSs and geriatric resources (GRs) in AF patients and their association with anticoagulation use. Methods: Data from 362 hospitalized patients aged 65 years and older with AF (n = 181, 77.8 ± 5.8 years, 38% female) and without AF (non-AF [NAF]; n = 181, 77.5 ± 5.9 years, 40% female) admitted to an internal medicine and nephrology ward of a large university hospital in Germany were included. All patients underwent usual care plus a comprehensive geriatric assessment (CGA) including calculation of the Multidimensional Prognostic Index (MPI) and collection of 17 GSs and 10 GRs. Patients were followed up by telephone 6 and 12 months after discharge to collect data on their health status. Results: The mean MPI score of 0.47 indicated an average risk of poor outcome, and patients with AF had a significantly higher MPI than those without AF (p = 0.040). After adjustment for chronological age, biological sex, Cumulative Illness Rating Scale (CIRS) for relevant chronic diagnoses and MPI as a proxy for biological age, AF patients had significantly more mnestic resources (63.5% vs. 33.1%, p < 0.001), a tendency for less age-appropriate living conditions (56.4% vs. 72.9%, p = 0.051) and more sensory impairment (78.5% vs. 52.5%, p < 0.001) than NAF patients. They also had a higher number of GSs (p = 0.046). AF patients on oral anticoagulants (OACs, n = 91) had less age-appropriate living conditions (48.4% vs. 64.4%, p < 0.05) and mnestic resources (36.3% vs. 54.4%, p < 0.01), but more emotional resources (80.2% vs. 65.6%, p < 0.05) and chronic pain (56% vs. 40%, p < 0.05) than patients without OACs (n = 90). Overall, mortality at 1 year was increased in patients with a higher MPI (p < 0.009, adjusted for age, sex and CIRS), with a diagnosis of AF (p = 0.007, adjusted for age, sex, CIRS and MPI), with of male sex (p = 0.008, adjusted for age, CIRS and MPI) and those with AF and treated with hemodialysis (p = 0.022, compared to AF patients without dialysis treatment). Conclusions: Patients with AF and patients with AF and OACs show differences in their multidimensional frailty degree as well as GR and GS profiles compared to patients without AF or with AF not treated with OACs. Mortality after 1 year is increased in AF patients with a higher MPI and dialysis, independently from OAC use and overall burden of chronic disease as assessed per CIRS. GRs and GSs, especially age-appropriate living conditions, emotional resources, sensory impairment and chronic pain, can be considered as factors that may modify the individual impact of frailty, underscoring the relevance of these parameters in the management of older patients. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Multiparametric Monitoring of Disease Progression in Contemporary Patients with Wild-Type Transthyretin Amyloid Cardiomyopathy Initiating Tafamidis Treatment

Author

Ney, Svenja, primary, Gertz, Roman Johannes, additional, Pennig, Lenhard, additional, Nies, Richard J., additional, Holtick, Udo, additional, Völker, Linus A., additional, Wunderlich, Gilbert, additional, Seuthe, Katharina, additional, Hohmann, Christopher, additional, Metze, Clemens, additional, Nähle, Claas Philip, additional, von Stein, Jennifer, additional, Brüwer, Monique, additional, ten Freyhaus, Henrik, additional, and Pfister, Roman, additional

Published
2024
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16. One‐Year Outcomes According to Mitral Regurgitation Etiology Following Transcatheter Edge‐to‐Edge Repair With the PASCAL System: Results From a Multicenter Registry

Author

von Stein, Philipp, primary, Besler, Christian, additional, Riebisch, Matthias, additional, Al‐Hammadi, Osamah, additional, Ruf, Tobias, additional, Gerçek, Muhammed, additional, Grothusen, Christina, additional, Mehr, Michael, additional, Becher, Marc Ulrich, additional, Friedrichs, Kai, additional, Öztürk, Can, additional, Baldus, Stephan, additional, Guthoff, Henning, additional, Rassaf, Tienush, additional, Thiele, Holger, additional, Nickenig, Georg, additional, Hausleiter, Jörg, additional, Möllmann, Helge, additional, Horn, Patrick, additional, Kelm, Malte, additional, Rudolph, Volker, additional, von Bardeleben, Ralph‐Stephan, additional, Nef, Holger M., additional, Luedike, Peter, additional, Lurz, Philipp, additional, Pfister, Roman, additional, and Mauri, Victor, additional

Published
2023
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17. “Artificial Intelligence-Enabled Assessment of Right Ventricular to Pulmonary Artery Coupling in Patients Undergoing Transcatheter Tricuspid Valve Intervention”

Author

Fortmeier, Vera, primary, Lachmann, Mark, additional, Stolz, Lukas, additional, von Stein, Jennifer, additional, Unterhuber, Matthias, additional, Kassar, Mohammad, additional, Gerçek, Muhammed, additional, Schöber, Anne R, additional, Stocker, Thomas J, additional, Omran, Hazem, additional, Körber, Maria I, additional, Hesse, Amelie, additional, Harmsen, Gerhard, additional, Friedrichs, Kai Peter, additional, Yuasa, Shinsuke, additional, Rudolph, Tanja K, additional, Joner, Michael, additional, Pfister, Roman, additional, Baldus, Stephan, additional, Laugwitz, Karl-Ludwig, additional, Windecker, Stephan, additional, Praz, Fabien, additional, Lurz, Philipp, additional, Hausleiter, Jörg, additional, and Rudolph, Volker, additional

Published
2023
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18. Congestion patterns in severe tricuspid regurgitation and transcatheter treatment: Insights from a multicentre registry.

Author

Rommel, Karl‐Philipp, Bonnet, Guillaume, Fortmeier, Vera, Stolz, Lukas, Schöber, Anne R., von Stein, Jennifer, Kassar, Mohammad, Gerçek, Muhammed, Rosch, Sebastian, Stocker, Thomas J., Körber, Maria I., Kresoja, Karl‐Patrik, Rudolph, Tanja K., Pfister, Roman, Baldus, Stephan, Windecker, Stephan, Thiele, Holger, Praz, Fabien, Hausleiter, Jörg, and Rudolph, Volker

Subjects
TRICUSPID valve insufficiency, HEART failure, TRICUSPID valve, TRICUSPID valve surgery, PULMONARY artery, CARDIAC catheterization, PROGNOSIS
Abstract

Aims: While invasively determined congestion holds mechanistic and prognostic significance in acute heart failure (HF), its role in patients with tricuspid regurgitation (TR)‐related right‐ heart failure (HF) undergoing transcatheter tricuspid valve intervention (TTVI) is less well established. A comprehensive understanding of congestion patterns might aid in procedural planning, risk stratification, and the identification of patients who may benefit from adjunctive therapies before undergoing TTVI. The aim of this study was to investigate the role of congestion patterns in patients with severe TR and its implications for TTVI. Methods and results: Within a multicentre, international TTVI registry, 813 patients underwent right heart catheterization (RHC) prior to TTVI and were followed up to 24 months. The median age was 80 (interquartile range 76–83) years and 54% were women. Both mean right atrial pressure (RAP) and pulmonary capillary wedge pressure (PCWP) were associated with 2‐year mortality on Cox regression analyses with Youden index‐derived cut‐offs of 17 mmHg and 19 mmHg, respectively (p < 0.01 for all). However, RAP emerged as an independent predictor of outcomes following multivariable adjustments. Pre‐interventionally, 42% of patients were classified as euvolaemic (RAP <17 mmHg, PCWP <19 mmHg), 23% as having left‐sided congestion (RAP <17 mmHg, PCWP ≥19 mmHg), 8% as right‐sided congestion (RAP ≥17 mmHg, PCWP <19 mmHg), and 27% as bilateral congestion (RAP ≥17 mmHg, PCWP ≥19 mmHg). Patients with right‐sided or bilateral congestion had the lowest procedural success rates and shortest survival times. Congestion patterns allowed for discerning specific patient's physiology and specifying prognostic implications of right ventricular to pulmonary artery coupling surrogates. Conclusion: In this large cohort of invasively characterized patients undergoing TTVI, congestion patterns involving right‐sided congestion were associated with low procedural success and higher mortality rates after TTVI. Whether pre‐interventional reduction of right‐sided congestion can improve outcomes after TTVI should be established in dedicated studies. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Artificial intelligence–enabled assessment of right ventricular to pulmonary artery coupling in patients undergoing transcatheter tricuspid valve intervention.

Author

Fortmeier, Vera, Lachmann, Mark, Stolz, Lukas, Stein, Jennifer von, Unterhuber, Matthias, Kassar, Mohammad, Gerçek, Muhammed, Schöber, Anne R, Stocker, Thomas J, Omran, Hazem, Körber, Maria I, Hesse, Amelie, Harmsen, Gerhard, Friedrichs, Kai Peter, Yuasa, Shinsuke, Rudolph, Tanja K, Joner, Michael, Pfister, Roman, Baldus, Stephan, and Laugwitz, Karl-Ludwig

Subjects
PULMONARY artery physiology, TRICUSPID valve surgery, PEARSON correlation (Statistics), RESEARCH funding, ARTIFICIAL intelligence, MULTIVARIATE analysis, HEART valve prosthesis implantation, RESEARCH, RIGHT ventricular dysfunction, ECHOCARDIOGRAPHY, CARDIAC catheterization, REGRESSION analysis
Abstract

Aims Right ventricular to pulmonary artery (RV-PA) coupling has been established as a prognostic marker in patients with severe tricuspid regurgitation (TR) undergoing transcatheter tricuspid valve interventions (TTVI). RV-PA coupling assesses right ventricular systolic function related to pulmonary artery pressure levels, which are ideally measured by right heart catheterization. This study aimed to improve the RV-PA coupling concept by relating tricuspid annular plane systolic excursion (TAPSE) to mean pulmonary artery pressure (mPAP) levels. Moreover, instead of right heart catheterization, this study sought to employ an extreme gradient boosting (XGB) algorithm to predict mPAP levels based on standard echocardiographic parameters. Methods and results This multicentre study included 737 patients undergoing TTVI for severe TR; among them, 55 patients from one institution served for external validation. Complete echocardiography and right heart catheterization data were available from all patients. The XGB algorithm trained on 10 echocardiographic parameters could reliably predict mPAP levels as evaluated on right heart catheterization data from external validation (Pearson correlation coefficient R : 0.68; P value: 1.3 × 10−8). Moreover, predicted mPAP (mPAPpredicted) levels were superior to echocardiographic systolic pulmonary artery pressure (sPAPechocardiography) levels in predicting 2-year mortality after TTVI [area under the curve (AUC): 0.607 vs. 0.520; P value: 1.9 × 10−6]. Furthermore, TAPSE/mPAPpredicted was superior to TAPSE/sPAPechocardiography in predicting 2-year mortality after TTVI (AUC: 0.633 vs. 0.586; P value: 0.008). Finally, patients with preserved RV-PA coupling (defined as TAPSE/mPAPpredicted > 0.617 mm/mmHg) showed significantly higher 2-year survival rates after TTVI than patients with reduced RV-PA coupling (81.5% vs. 58.8%, P < 0.001). Moreover, independent association between TAPSE/mPAPpredicted levels and 2-year mortality after TTVI was confirmed by multivariate regression analysis (P value: 6.3 × 10−4). Conclusion Artificial intelligence–enabled RV-PA coupling assessment can refine risk stratification prior to TTVI without necessitating invasive right heart catheterization. A comparison with conservatively treated patients is mandatory to quantify the benefit of TTVI in accordance with RV-PA coupling. [ABSTRACT FROM AUTHOR]

Published
2024
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20. TCT-163 Artificial Intelligence-Enabled Assessment of Right Ventricular to Pulmonary Artery Coupling Refines Mortality Prediction in Patients With Severe Tricuspid Regurgitation Undergoing Transcatheter Tricuspid Valve Intervention

Author

Fortmeier, Vera, primary, Lachmann, Mark, additional, Stolz, Lukas, additional, Unterhuber, Matthias, additional, Kassar, Mohammad, additional, Gerçek, Muhammed, additional, Körber, Isabel, additional, Pfister, Roman, additional, Baldus, Stephan, additional, Laugwitz, Karl-Ludwig, additional, Windecker, Stephan, additional, Praz, Fabien, additional, Lurz, Phillip, additional, Hausleiter, Jörg, additional, and Rudolph, Volker, additional

Published
2023
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22. Machine learning‐based prediction of in‐hospital death for patients with takotsubo syndrome: The InterTAK‐ML model

Author

De Filippo, Ovidio, primary, Cammann, Victoria L., additional, Pancotti, Corrado, additional, Di Vece, Davide, additional, Silverio, Angelo, additional, Schweiger, Victor, additional, Niederseer, David, additional, Szawan, Konrad A., additional, Würdinger, Michael, additional, Koleva, Iva, additional, Dusi, Veronica, additional, Bellino, Michele, additional, Vecchione, Carmine, additional, Parodi, Guido, additional, Bossone, Eduardo, additional, Gili, Sebastiano, additional, Neuhaus, Michael, additional, Franke, Jennifer, additional, Meder, Benjamin, additional, Jaguszewski, Miłosz, additional, Noutsias, Michel, additional, Knorr, Maike, additional, Jansen, Thomas, additional, Dichtl, Wolfgang, additional, von Lewinski, Dirk, additional, Burgdorf, Christof, additional, Kherad, Behrouz, additional, Tschöpe, Carsten, additional, Sarcon, Annahita, additional, Shinbane, Jerold, additional, Rajan, Lawrence, additional, Michels, Guido, additional, Pfister, Roman, additional, Cuneo, Alessandro, additional, Jacobshagen, Claudius, additional, Karakas, Mahir, additional, Koenig, Wolfgang, additional, Pott, Alexander, additional, Meyer, Philippe, additional, Roffi, Marco, additional, Banning, Adrian, additional, Wolfrum, Mathias, additional, Cuculi, Florim, additional, Kobza, Richard, additional, Fischer, Thomas A., additional, Vasankari, Tuija, additional, Airaksinen, K.E. Juhani, additional, Napp, L. Christian, additional, Dworakowski, Rafal, additional, MacCarthy, Philip, additional, Kaiser, Christoph, additional, Osswald, Stefan, additional, Galiuto, Leonarda, additional, Chan, Christina, additional, Bridgman, Paul, additional, Beug, Daniel, additional, Delmas, Clément, additional, Lairez, Olivier, additional, Gilyarova, Ekaterina, additional, Shilova, Alexandra, additional, Gilyarov, Mikhail, additional, El‐Battrawy, Ibrahim, additional, Akin, Ibrahim, additional, Poledniková, Karolina, additional, Toušek, Petr, additional, Winchester, David E., additional, Massoomi, Michael, additional, Galuszka, Jan, additional, Ukena, Christian, additional, Poglajen, Gregor, additional, Carrilho‐Ferreira, Pedro, additional, Hauck, Christian, additional, Paolini, Carla, additional, Bilato, Claudio, additional, Kobayashi, Yoshio, additional, Kato, Ken, additional, Ishibashi, Iwao, additional, Himi, Toshiharu, additional, Din, Jehangir, additional, Al‐Shammari, Ali, additional, Prasad, Abhiram, additional, Rihal, Charanjit S., additional, Liu, Kan, additional, Schulze, P. Christian, additional, Bianco, Matteo, additional, Jörg, Lucas, additional, Rickli, Hans, additional, Pestana, Gonçalo, additional, Nguyen, Thanh H., additional, Böhm, Michael, additional, Maier, Lars S., additional, Pinto, Fausto J., additional, Widimský, Petr, additional, Felix, Stephan B., additional, Braun‐Dullaeus, Ruediger C., additional, Rottbauer, Wolfgang, additional, Hasenfuß, Gerd, additional, Pieske, Burkert M., additional, Schunkert, Heribert, additional, Budnik, Monika, additional, Opolski, Grzegorz, additional, Thiele, Holger, additional, Bauersachs, Johann, additional, Horowitz, John D., additional, Di Mario, Carlo, additional, Bruno, Francesco, additional, Kong, William, additional, Dalakoti, Mayank, additional, Imori, Yoichi, additional, Münzel, Thomas, additional, Crea, Filippo, additional, Lüscher, Thomas F., additional, Bax, Jeroen J., additional, Ruschitzka, Frank, additional, De Ferrari, Gaetano Maria, additional, Fariselli, Piero, additional, Ghadri, Jelena R., additional, Citro, Rodolfo, additional, D'Ascenzo, Fabrizio, additional, and Templin, Christian, additional

Published
2023
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23. Long-Term Prognosis of Patients With Takotsubo Syndrome

Author

Ghadri, Jelena R., Kato, Ken, Cammann, Victoria L., Gili, Sebastiano, Jurisic, Stjepan, Di Vece, Davide, Candreva, Alessandro, Ding, Katharina J., Micek, Jozef, Szawan, Konrad A., Bacchi, Beatrice, Bianchi, Rahel, Levinson, Rena A., Wischnewsky, Manfred, Seifert, Burkhardt, Schlossbauer, Susanne A., Citro, Rodolfo, Bossone, Eduardo, Münzel, Thomas, Knorr, Maike, Heiner, Susanne, D’Ascenzo, Fabrizio, Franke, Jennifer, Sarcon, Annahita, Napp, L. Christian, Jaguszewski, Milosz, Noutsias, Michel, Katus, Hugo A., Burgdorf, Christof, Schunkert, Heribert, Thiele, Holger, Bauersachs, Johann, Tschöpe, Carsten, Pieske, Burkert M., Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Hasenfuß, Gerd, Karakas, Mahir, Koenig, Wolfgang, Rottbauer, Wolfgang, Said, Samir M., Braun-Dullaeus, Ruediger C., Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K.E. Juhani, Opolski, Grzegorz, Dworakowski, Rafal, MacCarthy, Philip, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Crea, Filippo, Dichtl, Wolfgang, Empen, Klaus, Felix, Stephan B., Delmas, Clément, Lairez, Olivier, El-Battrawy, Ibrahim, Akin, Ibrahim, Borggrefe, Martin, Horowitz, John, Kozel, Martin, Tousek, Petr, Widimský, Petr, Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, Winchester, David E., Ukena, Christian, Bax, Jeroen J., Prasad, Abhiram, Böhm, Michael, Lüscher, Thomas F., Ruschitzka, Frank, and Templin, Christian

Published
2018
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24. Acute chest pain—diagnostic accuracy and pre-hospital use of anticoagulants and platelet aggregation inhibitors

Author

Braumann, Simon, primary, Faber-Zameitat, Christian, additional, Macherey-Meyer, Sascha, additional, Tichelbäcker, Tobias, additional, Meertens, Max, additional, Heyne, Sebastian, additional, Nießen, Franz, additional, Nies, Richard Julius, additional, Nettersheim, Felix, additional, Reuter, Hannes, additional, Pfister, Roman, additional, Hellmich, Martin, additional, Burst, Volker, additional, Baldus, Stephan, additional, Lee, Samuel, additional, and Adler, Christoph, additional

Published
2023
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28. Intraventricular Thrombus Formation and Embolism in Takotsubo Syndrome: Insights From the International Takotsubo Registry

Author

Ding, Katharina J., Cammann, Victoria L., Szawan, Konrad A., Stähli, Barbara E., Wischnewsky, Manfred, Di Vece, Davide, Citro, Rodolfo, Jaguszewski, Milosz, Seifert, Burkhardt, Sarcon, Annahita, Knorr, Maike, Heiner, Susanne, Gili, Sebastiano, D’Ascenzo, Fabrizio, Neuhaus, Michael, Napp, L. Christian, Franke, Jennifer, Noutsias, Michel, Burgdorf, Christof, Koenig, Wolfgang, Kherad, Behrouz, Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Karakas, Mahir, Pott, Alexander, Meyer, Philippe, Arroja, Jose D., Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K.E. Juhani, Paolini, Carla, Bilato, Claudio, Carrilho-Ferreira, Pedro, Opolski, Grzegorz, Dworakowski, Rafal, MacCarthy, Philip, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Dichtl, Wolfgang, Chan, Christina, Bridgman, Paul, Delmas, Clément, Lairez, Olivier, El-Battrawy, Ibrahim, Akin, Ibrahim, Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, Kozel, Martin, Tousek, Petr, Widimský, Petr, Winchester, David E., Galuszka, Jan, Ukena, Christian, Horowitz, John D., Di Mario, Carlo, Prasad, Abhiram, Rihal, Charanjit S., Pinto, Fausto J., Crea, Filippo, Borggrefe, Martin, Braun-Dullaeus, Ruediger C., Rottbauer, Wolfgang, Bauersachs, Johann, Katus, Hugo A., Hasenfuß, Gerd, Tschöpe, Carsten, Pieske, Burkert M., Thiele, Holger, Schunkert, Heribert, Böhm, Michael, Felix, Stephan B., Münzel, Thomas, Bax, Jeroen J., Lüscher, Thomas F., Ruschitzka, Frank, Ghadri, Jelena R., Bossone, Eduardo, and Templin, Christian

Published
2020
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29. Epiphenomenon or Prognostically Relevant Interventional Target? A Novel Proportionality Framework for Severe Tricuspid Regurgitation

Author

Fortmeier, Vera, primary, Lachmann, Mark, additional, Unterhuber, Matthias, additional, Stolz, Lukas, additional, Kassar, Mohammad, additional, Ochs, Laurin, additional, Gerçek, Muhammed, additional, Schöber, Anne R., additional, Stocker, Thomas J., additional, Omran, Hazem, additional, Körber, Maria I., additional, Hesse, Amelie, additional, Friedrichs, Kai Peter, additional, Yuasa, Shinsuke, additional, Rudolph, Tanja K., additional, Joner, Michael, additional, Pfister, Roman, additional, Baldus, Stephan, additional, Laugwitz, Karl‐Ludwig, additional, Praz, Fabien, additional, Windecker, Stephan, additional, Hausleiter, Jörg, additional, Lurz, Philipp, additional, and Rudolph, Volker, additional

Published
2023
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30. CHARACTERIZATION OF SCREEN FAILURES IN PATIENTS EVALUATED FOR TRANSCATHETER TRICUSPID VALVE INTERVENTION (TRISELECT-STUDY)

Author

Gerçek, Muhammed, primary, Narang, Akhil, additional, Koerber, Maria Isabel, additional, Friedrichs, Kai, additional, Puthumana, Jyothy J., additional, Baldridge, Abigail, additional, Meng, Zhiying, additional, Davidson, Laura, additional, Malaisrie, S. Chris, additional, Thomas, James D., additional, Rudolph, Tanja, additional, Pfister, Roman, additional, Rudolph, Volker, additional, and Davidson, Charles J., additional

Published
2023
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33. Epidemiology of cardiac amyloidosis in Germany: a retrospective analysis from 2009 to 2018

Author

Ney, Svenja, Ihle, Peter, Ruhnke, Thomas, Gunster, Christian, Michels, Guido, Seuthe, Katharina, Hellmich, Martin, Pfister, Roman, Ney, Svenja, Ihle, Peter, Ruhnke, Thomas, Gunster, Christian, Michels, Guido, Seuthe, Katharina, Hellmich, Martin, and Pfister, Roman

Abstract

Background Improved imaging modalities contributed to increasing awareness of cardiac amyloidosis. Contemporary data on frequency trends in Germany are lacking. Methods In a retrospective study using health claims data of a German statutory health insurance, patients with diagnostic codes of amyloidosis and concomitant heart failure between 2009 and 2018 were identified. Results Prevalence increased from 15.5 to 47.6 per 100,000 person-years, and incidence increased from 4.8 to 11.6 per 100,000 person-years, with a continuous steepening in the slope of incidence trend. In patients with amyloidosis and heart failure age and proportion of men significantly increased, whereas the frequency of myeloma and nephrotic syndrome significantly decreased over time. Median (IQR) survival time after first diagnosis was 2.5 years (0.5-6 years), with a 9% (95% CI 2-15%, p = 0.008) reduced risk of death in the second compared to the first 5 years of observation. In the 2 years prior and 1 year after diagnosis, mean total health care costs were 6568 euro, 11,872 euro and 21,955 euro per person and year. Conclusion The rise in cardiac amyloidosis has continuously accelerated in the last decade. Considering the adverse outcome and high health care burden, further effort should be put on early detection of the disease to implement available treatment.

Published
2023

34. Outcomes Associated With Cardiogenic Shock in Takotsubo Syndrome: Results From the International Takotsubo Registry

Author

Di Vece, Davide, Citro, Rodolfo, Cammann, Victoria L., Kato, Ken, Gili, Sebastiano, Szawan, Konrad A., Micek, Jozef, Jurisic, Stjepan, Ding, Katharina J., Bacchi, Beatrice, Schwyzer, Moritz, Candreva, Alessandro, Bossone, Eduardo, D’Ascenzo, Fabrizio, Sarcon, Annahita, Franke, Jennifer, Napp, L. Christian, Jaguszewski, Milosz, Noutsias, Michel, Münzel, Thomas, Knorr, Maike, Heiner, Susanne, Katus, Hugo A., Burgdorf, Christof, Schunkert, Heribert, Thiele, Holger, Bauersachs, Johann, Tschöpe, Carsten, Pieske, Burkert M., Rajan, Lawrence, Michels, Guido, Pfister, Roman, Cuneo, Alessandro, Jacobshagen, Claudius, Hasenfuβ, Gerd, Karakas, Mahir, Koenig, Wolfgang, Rottbauer, Wolfgang, Said, Samir M., Braun-Dullaeus, Ruediger C., Banning, Adrian, Cuculi, Florim, Kobza, Richard, Fischer, Thomas A., Vasankari, Tuija, Airaksinen, K.E. Juhani, Opolski, Grzegorz, Dworakowski, Rafal, MacCarthy, Philip, Kaiser, Christoph, Osswald, Stefan, Galiuto, Leonarda, Crea, Filippo, Dichtl, Wolfgang, Empen, Klaus, Felix, Stephan B., Delmas, Clément, Lairez, Olivier, El-Battrawy, Ibrahim, Akin, Ibrahim, Borggrefe, Martin, Gilyarova, Ekaterina, Shilova, Alexandra, Gilyarov, Mikhail, Horowitz, John, Kozel, Martin, Tousek, Petr, Widimský, Petr, Winchester, David E., Ukena, Christian, Di Mario, Carlo, Prasad, Abhiram, Böhm, Michael, Bax, Jeroen J., Lüscher, Thomas F., Ruschitzka, Frank, Ghadri, Jelena R., and Templin, Christian

Published
2019
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35. Staging Heart Failure Patients With Secondary Mitral Regurgitation Undergoing Transcatheter Edge-to-Edge Repair

Author

Stolz, Lukas, primary, Doldi, Philipp M., additional, Orban, Mathias, additional, Karam, Nicole, additional, Puscas, Tania, additional, Wild, Mirjam G., additional, Popescu, Aniela, additional, von Bardeleben, Ralph Stephan, additional, Iliadis, Christos, additional, Baldus, Stephan, additional, Adamo, Marianna, additional, Thiele, Holger, additional, Besler, Christian, additional, Unterhuber, Matthias, additional, Ruf, Tobias, additional, Pfister, Roman, additional, Higuchi, Satoshi, additional, Koell, Benedikt, additional, Giannini, Christina, additional, Petronio, Anna, additional, Kassar, Mohammad, additional, Weckbach, Ludwig T., additional, Butter, Christian, additional, Stocker, Thomas J., additional, Neuss, Michael, additional, Melica, Bruno, additional, Braun, Daniel, additional, Windecker, Stephan, additional, Massberg, Steffen, additional, Praz, Fabien, additional, Näbauer, Micheal, additional, Kalbacher, Daniel, additional, Lurz, Philipp, additional, Metra, Marco, additional, Bax, Jeroen J., additional, and Hausleiter, Jörg, additional

Published
2023
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37. Invasive Right Ventricular to Pulmonary Artery Coupling in Patients Undergoing Transcatheter Edge-to-Edge Tricuspid Valve Repair

Author

Stolz, Lukas, primary, Weckbach, Ludwig T., additional, Karam, Nicole, additional, Kalbacher, Daniel, additional, Praz, Fabien, additional, Lurz, Philipp, additional, Omran, Hazem, additional, Iliadis, Christos, additional, Hausleiter, Jörg, additional, Näbauer, Michael, additional, Stocker, Thomas J., additional, Doldi, Philipp M., additional, Ludwig, Sebastian, additional, Koell, Benedikt, additional, Kassar, Mohammad, additional, Besler, Christian, additional, Unterhuber, Matthias, additional, Rommel, Karl-Philipp, additional, Pfister, Roman, additional, Eatemadi, Jennifer, additional, and Rudolph, Volker, additional

Published
2022
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38. Impact of right ventricular-pulmonary arterial coupling on clinical outcomes of tricuspid regurgitation

Author

Sugiura, Atsushi, primary, Kavsur, Refik, additional, Spieker, Maximilian, additional, Iliadis, Christos, additional, Mauri, Victor, additional, Tanaka, Tetsu, additional, Goto, Tadahiro, additional, Weber, Marcel, additional, Kelm, Malte, additional, Baldus, Stephan, additional, Nickenig, Georg, additional, Westenfeld, Ralf, additional, Pfister, Roman, additional, and Becher, Marc Ulrich, additional

Published
2022
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39. Guideline-directed medical treatment in patients undergoing transcatheter edge-to-edge repair for secondary mitral regurgitation

Author

Higuchi, Satoshi, Orban, Mathias, Adamo, Marianna, Giannini, Cristina, Melica, Bruno, Karam, Nicole, Praz, Fabien, Kalbacher, Daniel, Koell, Benedikt, Stolz, Lukas, Braun, Daniel, Näbauer, Michael, Wild, Mirjam, Doldi, Philipp, Neuss, Michael, Butter, Christian, Kassar, Mohammad, Ruf, Tobias, Petrescu, Aniela, Ludwig, Sebastian, Pfister, Roman, Iliadis, Christos, Unterhuber, Matthias, Sampaio, Francisco, Ferreira, Diogo, Thiele, Holger, Baldus, Stephan, von Bardeleben, Ralph Stephan, Massberg, Steffen, Windecker, Stephan, Lurz, Philipp, Petronio, Anna Sonia, Lindenfeld, JoAnn, Abraham, William T, Metra, Marco, and Hausleiter, Jörg

Subjects
Secondary mitral regurgitation, Guideline-directed medical therapy, 610 Medicine & health, Comorbidities, Heart failure with reduced ejection fraction, Residual mitral regurgitation, Transcatheter edge-to-edge-repair, Cardiology and Cardiovascular Medicine
Abstract

INTRODUCTION Guideline-directed medical therapy (GDMT), based on the combination of beta blockers (BB), renin-angiotensin system inhibitors (RAS-I), and mineralocorticoid-receptor antagonists (MRA), is known to have a major impact on the outcome of the patients with heart failure with reduced ejection fraction (HFrEF). Although GDMT is recommended prior to M-TEER, not all patients tolerate it. We studied the association of GDMT prescription with survival in HFrEF patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) for secondary mitral regurgitation (SMR). METHODS AND RESULTS EuroSMR, a European multicenter registry, included SMR patients with left ventricular ejection fraction of less than fifty percent. The outcome was 2-year all-cause mortality. Of 1344 patients, BB, RAS-I, and MRA were prescribed in 1169 (87%), 1012 (75%), and 765 (57%) patients at the time of M-TEER, respectively. Triple GDMT prescription was associated with a lower 2-year all-cause mortality compared to non-triple GDMT (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.60-0.91). The association persisted in patients with glomerular filtration rate of

Published
2022

40. Invasive Right Ventricular to Pulmonary Artery Coupling in Patients Undergoing Transcatheter Edge-to-Edge Tricuspid Valve Repair

Author

Näbauer, Michael, Stocker, Thomas J., Doldi, Philipp M., Ludwig, Sebastian, Koell, Benedikt, Kassar, Mohammad, Besler, Christian, Unterhuber, Matthias, Rommel, Karl-Philipp, Pfister, Roman, Eatemadi, Jennifer, Rudolph, Volker, Stolz, Lukas, Weckbach, Ludwig T., Karam, Nicole, Kalbacher, Daniel, Praz, Fabien, Lurz, Philipp, Omran, Hazem, Iliadis, Christos, and Hausleiter, Jörg

Published
2023
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43. TCT-532 Systolic Pulmonary Artery Derived From Echocardiography Is Not a Reliable Parameter in the Right Ventricular–Pulmonary Arterial Coupling in Patients Undergoing Transcatheter Tricuspid Valve Annuloplasty

Author

Gerçek, Muhammed, primary, Körber, Isabel, additional, Narang, Akhil, additional, Friedrichs, Kai, additional, Puthumana, Jyothy, additional, Thomas, James, additional, Pfister, Roman, additional, Davidson, Charles, additional, and Rudolph, Volker, additional

Published
2022
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44. Deep sedation vs. general anesthesia for transcatheter tricuspid valve repair

Author

Haurand, Jean Marc, primary, Kavsur, Refik, additional, Ochs, Laurin, additional, Tanaka, Tetsu, additional, Iliadis, Christos, additional, Sugiura, Atsushi, additional, Kelm, Malte, additional, Nickenig, Georg, additional, Baldus, Stephan, additional, Westenfeld, Ralf, additional, Becher, Marc Ulrich, additional, Pfister, Roman, additional, and Horn, Patrick, additional

Published
2022
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46. Left atrial volume index and outcome after transcatheter edge‐to‐edge valve repair for secondary mitral regurgitation

Author

Iliadis, Christos, primary, Kalbacher, Daniel, additional, Lurz, Philipp, additional, Petrescu, Aniela Monica, additional, Orban, Mathias, additional, Puscas, Tania, additional, Lupi, Laura, additional, Stazzoni, Laura, additional, Pires‐Morais, Gustavo, additional, Koell, Benedikt, additional, Besler, Christian, additional, Ruf, Tobias Friedrich, additional, Stolz, Lukas, additional, Tence, Noemie, additional, Adamo, Marianna, additional, Giannini, Cristina, additional, Guerreiro, Cláudio, additional, Hellmich, Martin, additional, Baldus, Stephan, additional, Schofer, Niklas, additional, Thiele, Holger, additional, von Bardeleben, Ralph Stephan, additional, Hausleiter, Jörg, additional, Karam, Nicole, additional, Metra, Marco, additional, Petronio, Anna Sonia, additional, Melica, Bruno, additional, and Pfister, Roman, additional

Published
2022
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48. A staging classification of right heart remodelling for patients undergoing transcatheter edge-to-edge mitral valve repair

Author

Shamekhi, Jasmin, primary, Sugiura, Atsushi, additional, Spieker, Maximilian, additional, Iliadis, Christos, additional, Weber, Marcel, additional, Öztürk, Can, additional, Becher, Marc Ulrich, additional, Tiyerili, Vedat, additional, Zimmer, Sebastian, additional, Horn, Patrick, additional, Westenfeld, Ralf, additional, Pfister, Roman, additional, Mauri, Victor, additional, Sinning, Jan-Malte, additional, Kelm, Malte, additional, Baldus, Stephan, additional, and Nickenig, Georg, additional

Published
2022
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49. Atrial fibrillation: a geriatric perspective on the 2020 ESC guidelines

Author

Polidori, M. Cristina, Alves, Mariana, Bahat, Gulistan, Boureau, Anne Sophie, Ozkok, Serdar, Pfister, Roman, Pilotto, Alberto, Veronese, Nicola, Bo, Mario, Polidori, M. Cristina, Alves, Mariana, Bahat, Gulistan, Boureau, Anne Sophie, Ozkok, Serdar, Pfister, Roman, Pilotto, Alberto, Veronese, Nicola, and Bo, Mario

Abstract

Background The Task Force for the diagnosis and management of atrial fibrillation (AF) of the European Society of Cardiology (ESC) published in 2020 the updated Guidelines for the Diagnosis and Management of Atrial Fibrillation with the contribution of the European Heart Rhythm Association (EHRA) of the ESC and the European Association for Cardiothoracic Surgery (EACTS). Methods and results In this narrative viewpoint, we approach AF from the perspective of aging medicine and try to provide the readers with information usually neglected in clinical routine, mainly due to the fact that while the large majority of AF patients in real life are older, frail and cognitively impaired, these are mostly excluded from clinical trials, and physicians' attitudes often prevail over standardized algorithms. Conclusions On the basis of existing evidence, (1) opportunistic AF screening by pulse palpation or ECG rhythm strip is cost-effective, and (2) whereas advanced chronological age by itself is not a contraindication to AF treatment, a Comprehensive Geriatric Assessment (CGA) including frailty, cognitive impairment, falls and bleeding risk may assist in clinical decision making to provide the best individualized treatment. Key Summary PointsAim To provide a geriatric perspective on the 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Findings While the large majority of AF patients in real life are older, frail and cognitively impaired, these are mostly excluded from clinical trials, and physicians' attitudes often prevail over standardized algorithms. On the basis of existing evidence, we suggest that (1) opportunistic AF screening by pulse palpation or ECG rhythm strip is cost-effective, and (2) whereas advanced chronological age by itself is not a contraindication to AF treatment, a Comprehesive Geriatric Assessment (CGA) including frailty, cognitive impair

Published
2022

50. Guideline-directed medical therapy after transcatheter edge-to-edge mitral valve repair

Author

Tanaka, Tetsu, Kavsur, Refik, Spieker, Maximilian, Iliadis, Christos, Metze, Clemens, Brachtendorf, Birthe M., Horn, Patrick, Zachoval, Christian, Sugiura, Atsushi, Kelm, Malte, Baldus, Stephan, Nickenig, Georg, Westenfeld, Ralf, Pfister, Roman, Becher, Marc Ulrich, Tanaka, Tetsu, Kavsur, Refik, Spieker, Maximilian, Iliadis, Christos, Metze, Clemens, Brachtendorf, Birthe M., Horn, Patrick, Zachoval, Christian, Sugiura, Atsushi, Kelm, Malte, Baldus, Stephan, Nickenig, Georg, Westenfeld, Ralf, Pfister, Roman, and Becher, Marc Ulrich

Abstract

Objective A sizeable proportion of patients with secondary mitral regurgitation (SMR) do not receive guideline-directed medical therapy (GDMT) for heart failure (HF). We investigated the association between the use of GDMT and mortality in patients with SMR who underwent transcatheter edge-to-edge repair (TEER). Methods We retrospectively analysed patients with SMR and a left ventricular ejection fraction of <50% who underwent TEER at three centres. According to current HF guidelines, GDMT was defined as triple therapy consisting of beta-blockers, renin-angiotensin system (RAS) inhibitors and mineralocorticoid receptor antagonists (MRAs). Patients were divided into two groups: GDMT and non-GDMT groups. We calculated the propensity scores and carried out inverse probability of treatment weighting (IPTW) analyses to compare 2-year mortality between the two groups. Results Of 463 patients, 228 (49.2%) were treated with GDMT upon discharge. IPTW-adjusted Kaplan-Meier curve showed patients with GDMT had a lower incidence of mortality than those without GDMT (19.8% vs 31.1%, p=0.011). In IPTW-adjusted Cox proportional hazards analysis, GDMT was associated with a reduced risk of 2-year mortality (HR: 0.58; 95% CI: 0.35 to 0.95; p=0.030), which was consistent among clinical subgroups. Moreover, patients with GDMT had a higher rate of left ventricular reverse remodelling at 1 year after TEER than those without GDMT. Conclusion GDMT, defined as triple therapy consisting of beta-blockers, RAS inhibitors and MRAs, was associated with a reduced risk of 2-year mortality after TEER for SMR. Optimisation of medical therapy is crucial to improve clinical outcomes in patients undergoing TEER for SMR.

Published
2022

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