435 results on '"Barbara J.M. Mulder"'
Search Results
402. Determinants of adverse in-hospital outcome after cardiac surgery in adults with congenital heart disease
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A.C.M.J. van Riel, D.R. Koolbergen, B.J. Bouma, Wim K. Lagrand, Mark J. Schuuring, Mark G. Hazekamp, and Barbara J.M. Mulder
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Inotrope ,medicine.medical_specialty ,Heart disease ,business.industry ,Renal function ,medicine.disease ,Logistic regression ,Jugular venous pressure ,Cardiac surgery ,medicine.anatomical_structure ,Ventricle ,Internal medicine ,Intensive care ,medicine ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Purpose: Patients with congenital heart disease (CHD) often undergo right-sided surgery, and contribution of the right ventricle (RV) to their cardiac pump function is essential. We aimed to identify determinants of adverse outcome after cardiac surgery. Methods: 503 consecutive adults (56% male, median age 36 years) with CHD operated between January 2001 and January 2011 in the Academic Medical Center in Amsterdam were studied. RV function was considered normal for levels of TAPSE and TDI S' above 15mm and 11 cm/s respectively. RV failure was defined as combination of (1) elevated jugular venous pressure, (2) impaired RV function on transthoracic echocardiography and (3) diagnosis of RV failure was documented in the medical charts. Intensive care stay was prolonged if it exceeded four days. The composite end point of an adverse in-hospital outcome was operative mortality, RV failure, inotropes on intensive care, a prolonged intensive care stay, or all. Determinants of adverse outcome were evaluated by logistic regression analysis. Results: Nine patients (1,8%) died peri-operatively, 19 had RV failure, 83 needed inotropic therapy on intensive care and 21 had prolonged intensive care stay. The composite end point was reached in 91 patients (18,1%). Significant pre-operative determinants are shown in the Table. View this table: Table 1. Pre operative determinants of adverse outcome after congenital cardiac surgery Conclusion: Supraventricular arrhythmia, renal function and ventricular function were determinants of adverse in-hospital outcome after congenital cardiac surgery. more...
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- 2013
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403. Nt-proBNP predicts cardiovascular complications in pregnant women with congenital heart disease
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D.J. Van Veldhuisen, M. Ludwig-Ruitenberg, A.P.J. van Dijk, Petronella G. Pieper, J.P. van Melle, Krystyna M. Sollie-Szarynska, Ali Balci, Barbara J.M. Mulder, M. A. M. Kampman, and J.W. Roos-Hesselink more...
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Cardiovascular event ,Pregnancy ,medicine.medical_specialty ,Heart disease ,business.industry ,Brain natriuretic peptide ,medicine.disease ,Internal medicine ,Cardiac complication ,Area under curve ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business - Published
- 2013
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404. Sudden cardiac death in adult congenital heart disease: can we predict the unpredictable?
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Erwin Oechslin, Werner Budts, Louise Harris, Candice K. Silversides, J. R. de Groot, Berto J. Bouma, Barbara J.M. Mulder, Zeliha Koyak, A. H. Zwinderman, and I. C. Van Gelder
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medicine.medical_specialty ,Ejection fraction ,Heart disease ,Ventricular function ,business.industry ,medicine.disease ,Sudden death ,Sudden cardiac death ,QRS complex duration ,Qt dispersion ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Published
- 2013
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405. PATIENTS WITH A SYSTEMIC RIGHT VENTRICLE: WHO ARE AT RISK OF CLINICAL EVENTS?
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Petronella G. Pieper, Barbara J.M. Mulder, Michiel M. Winter, Arie P.J. van Dijk, Jolien W. Roos-Hesselink, Aeilko H. Zwinderman, Gertjan Tj. Sieswerda, Maarten Groenink, Teun van der Bom, Hubert W. Vliegen, and Berto J. Bouma more...
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medicine.medical_specialty ,medicine.anatomical_structure ,Ventricle ,business.industry ,Clinical events ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Published
- 2013
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406. IN-HOSPITAL ARRHYTHMIAS AFTER CONGENITAL HEART SURGERY FOR ADULTS: INCIDENCE AND RISK FACTORS
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Mark G. Hazekamp, Felix Berger, Zeliha Koyak, David R. Koolbergen, Joris R. de Groot, Barbara J.M. Mulder, Roel C.A. Achterbergh, Nico A. Blom, and Berto J. Bouma
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medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,Internal medicine ,Emergency medicine ,medicine ,Cardiology ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business - Published
- 2013
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407. CONGENITAL HEART DISEASE PATIENTS ARE AT HIGHEST RISK OF RIGHT-SIDED COMPLICATIONS AFTER CARDIAC SURGERY, REGARDLESS THE SIDE OF SURGERY
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David R. Koolbergen, Mark J. Schuuring, Wim K. Lagrand, Petr Symersky, Barbara J.M. Mulder, Mark G. Hazekamp, and Berto J. Bouma
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medicine.medical_specialty ,Heart disease ,business.industry ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Cardiac surgery ,Surgery - Published
- 2013
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408. Severe Cardiovascular Features of Marfan Syndrome in Childhood: Just Another Manifestation or a Specific Entity?
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Maarten Groenink, Barbara J.M. Mulder, Cardiology, and Radiology and Nuclear Medicine
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Marfan syndrome ,Pediatrics ,medicine.medical_specialty ,Text mining ,business.industry ,Severity of illness ,MEDLINE ,medicine ,medicine.disease ,business ,Cardiac imaging - Published
- 2004
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409. 1095-206 Pregnancy in women with corrected tetralogy of fallot
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Barbara J.M. Mulder, Tjark Ebels, Adriaan A. Voors, Jolien W. Roos-Hesselink, Arie P.J. van Dijk, Dirk J. van Veldhuisen, Els P.G. Pieper, and Jiska M Meijer
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medicine.medical_specialty ,Pregnancy ,Obstetrics ,business.industry ,medicine ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,eye diseases ,Tetralogy of Fallot - Published
- 2004
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410. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010)
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Pascal Vouhé, Philip J. Kilner, Harald Kaemmerer, Folkert J. Meijboom, Helmut Baumgartner, Natasja M.S. de Groo, Nazzareno Galiè, Christa Gohlke-Baerwolf, Barbara J.M. Mulder, Fokko de Haan, Michael A. Gatzoulis, Erwin Oechslin, Philipp Bonhoeffer, Erik Thaulow, Alain Serraf, András Szatmári, John Deanfield, Edmond Walma, and José M. Oliver more...
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lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Heart disease ,lcsh:RC666-701 ,business.industry ,Internal medicine ,Cardiology ,General Earth and Planetary Sciences ,Medicine ,business ,medicine.disease ,General Environmental Science - Published
- 2012
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411. DETERMINANTS OF MORTALITY IN ADULTS WITH PULMONARY ARTERIAL HYPERTENSION DUE TO CONGENITAL HEART DISEASE AFTER INITIATION OF ADVANCED THERAPY
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Annelieke C.M.J. van Riel, Barbara J.M. Mulder, Mark J. Schuuring, Berto J. Bouma, Jeroen C. Vis, and Marielle G. J. Duffels
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medicine.medical_specialty ,Heart disease ,business.industry ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease - Published
- 2012
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412. INFLAMMATORY GENES ARE ASSOCIATED WITH SEVERITY OF AORTIC ROOT ANEURYSM PROGRESSION IN PATIENTS WITH MARFAN SYNDROME
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Ynte M. Ruigrok, Barbara J.M. Mulder, Romy Franken, Aeilko H. Zwinderman, Maarten Groenink, Gerard Pals, Janneke Timmermans, Piet de Witte, Teodora Radonic, Alexander den Hartog, Arthur J.H.A. Scholte, and Maarten P. van den Berg more...
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Marfan syndrome ,medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiology ,Medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Aortic root aneurysm ,Inflammatory genes - Published
- 2012
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413. Effect of age on exercise capacity and cardiac reserve in patients with pulmonary atresia with intact ventricular septum after biventricular repair
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Nico A. Blom, Mart N. van der Plas, Maarten Groenink, Soha Romeih, Barbara J.M. Mulder, Anje M. Spijkerboer, ACS - Amsterdam Cardiovascular Sciences, Radiology and Nuclear Medicine, Cardiology, Pulmonology, Paediatric Cardiology, and Other Research more...
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Cardiac function curve ,Medicine(all) ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Diastole ,Cardiac reserve ,Magnetic resonance imaging ,Stroke volume ,medicine.disease ,Hypoplasia ,lcsh:RC666-701 ,Internal medicine ,Poster Presentation ,Cardiology ,cardiovascular system ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Pulmonary atresia ,Angiology - Abstract
OBJECTIVESIn patients with pulmonary atresia with intact ventricular septum (PAIVS), biventricular repair is considered to be the optimal treatment option in the absence of significant right ventricular (RV) hypoplasia. However, long-term clinical outcome studies are limited. We evaluated exercise capacity and cardiac function during pharmacological stress in children and young adults with PAIVS after biventricular repair.METHODSTen PAIVS patients after biventricular repair, with a median age of 12 years (range 9-42 years), underwent a cardiopulmonary exercise test, dobutamine stress magnetic resonance imaging (DS-MRI) and delayed contrast enhancement (DCE) MRI.RESULTSThe patients' ages negatively correlated with exercise capacity (r = -0.72, P = 0.01) as well as left (LV) and RV stroke volume (SV) response to pharmacological stress (r = -0.72, P = 0.02; and r = -0.64, P = 0.04; respectively), Furthermore, older age was associated with decreased RV E/A volume ratio and increased pulmonary late diastolic forward flow percentage (r = 0-0.65, P = 0.04, r = 0.66, P = 0.03, respectively). RV E/A volume ratio positively correlated with RV-SV response to DS-MRI (r = 0.77, P = 0.009). and O(2)-pulse during physical stress correlated with biventricular SV response to DS-MRI. No RV or LV ventricular myocardial fibrosis was detected.CONCLUSIONSIn PAIVS patients after biventricular repair exercise capacity and cardiac reserve decrease with age. These findings appear to be related to impaired diastolic RV function and decreased RV filling, indicating that the function of the relatively small RV deteriorates with time more...
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- 2012
414. Is cardiac CT a reliable alternative for cardiac CMR in adult patients with a systemic right ventricle?
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Michiel M. Winter, Anje M. Spijkerboer, Maarten Groenink, Soha Romeih, Barbara J.M. Mulder, Nico A. Blom, Cardiology, Amsterdam Cardiovascular Sciences, Radiology and Nuclear Medicine, Other Research, and Paediatric Cardiology more...
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Medicine(all) ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Radiological and Ultrasound Technology ,Adult patients ,business.industry ,Gold standard (test) ,medicine.anatomical_structure ,Ventricle ,lcsh:RC666-701 ,Internal medicine ,Poster Presentation ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,In patient ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Angiology - Abstract
Our manuscript addresses the reliability of cardiac CT as an alternative for cardiac MRI in patients with a systemic right ventricle. Currently, cardiac MRI is considered the gold standard for volumes and function measurements of the systemic right ventricle. However, 20% of patients with a systemic right ventricle is pacemaker dependent, and therefore unsuitable to undergo MRI. To our knowledge, this is the first study to evaluate whether cardiac CT provides a reliable alternative for volumes and function measurements of the systemic RV, which is morphologically very different from the subpulmonary RV. We found that cardiac CT provides a reliable alternative for cardiac MRI for volumes and function measurements of the systemic RV, although larger variability between measurements should be taken into account. However, we recommend restrictive patient selection, to avoid unnecessary exposure to radiation and contrast agents. more...
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- 2012
415. Effects of low-dose aspirin (50-mg/day), low-dose aspirin plus dipyridamole, and oral anticoagulant agents after internal mammary artery bypass-grafting: Patency and clinical outcome at 1 year
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Hans L. Hillege, Kong I. Lie, A. Brutel De La Riviere, G. J. Kootstra, Matthias Pfisterer, P. H. J. M. Dunselman, W. H. Van Gilst, J. van der Meer, Barbara J.M. Mulder, and Faculteit Medische Wetenschappen/UMCG more...
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medicine.medical_specialty ,OCCLUSION ,SURGERY ,THERAPY ,Coronary artery bypass surgery ,Antithrombotic ,medicine ,Myocardial infarction ,Prospective cohort study ,Prothrombin time ,Aspirin ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Thrombosis ,PREVENTION ,Surgery ,Dipyridamole ,Anesthesia ,SAPHENOUS-VEIN GRAFTS ,SURVIVAL ,OPERATION ,TRIAL ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Objectives. This study was performed to compare the efficacy and safety of aspirin, aspirin plus dipyridamole, and oral anti coagulant agents in the prevention of internal mammary artery graft occlusion.Background. Antithrombotic drugs increase vein graft patency after coronary artery bypass surgery. Their benefit after internal mammary artery grafting has not been established.Methods. Angiographic internal mammary artery graft patency at 1 year was assessed in 494 patients who received both internal mammary artery and vein grafts. These patients were a subgroup of a prospective, randomized vein graft patency study in 948 patients assigned to treatment with aspirin, aspirin plus dipyri- damole, or oral anticoagulant agents. The design was double blind for both aspirin groups and open for oral anticoagulant treatment. Dipyridamole (5 mg/kg body weight per 24 h intravenously, followed by 200 mg twice daily) and oral anticoagulant agents (prothrombin time target range 2.8 to 4.8 international normalized ratio) were started before operation, and low dose aspirin (50 mg/day) after operation. Clinical outcome was assessed by the incidence of myocardial infarction, thrombosis, major bleeding or death.Results. Occlusion rates of distal anastomoses were 4.6% in the aspirin plus dipyridamole group and 6.8% in the oral anticoagulant group versus 5.3% in the aspirin group (p = NS). Overall clinical event rates were 23.3% and 13.3% in the aspirin plus dipyridamole group and the aspirin group, respectively (relative risk 1.75, 95% confidence interval 1.09 to 2.81, p = 0.025), and 17.1% in the oral anticoagulant group.Conclusions. Internal mammary artery graft patency at 1 year is not improved by aspirin plus dipyridamole or oral anticoagulant agents over that obtained with low dose aspirin alone. However, there is evidence that the overall clinical event rate increases if dipyridamole is added to aspirin. more...
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- 1994
416. CRITICAL APPRAISAL OF THE REVISED MARFAN NOSOLOGY IN CARDIOLOGICAL PRACTICE
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Maarten P. van den Berg, Piet de Witte, Aeilko H. Zwinderman, Peter van Tintelen, Maarten Groenink, Marlies Kempers, Barbara J.M. Mulder, Teodora Radonic, Rianne H. A. C. M. de Bruin Bon, Marieke J.H. Baars, Arthur J.H.A. Scholte, and Janneke Timmermans more...
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musculoskeletal diseases ,Nosology ,congenital, hereditary, and neonatal diseases and abnormalities ,Critical appraisal ,medicine.medical_specialty ,business.industry ,Medicine ,cardiovascular diseases ,skin and connective tissue diseases ,Cardiology and Cardiovascular Medicine ,business ,Psychiatry - Published
- 2011
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417. The Authors' reply
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Barbara J.M. Mulder, Alex V. Postma, Klaartje van Engelen, and Marieke J.H. Baars
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congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Internal medicine ,cardiovascular system ,Cardiology ,medicine ,Deletion syndrome ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,Pulmonary atresia ,business ,Tetralogy of Fallot ,Genetic testing - Abstract
We thank Digilio et al for their interest in our paper, showing that 22q11.2 deletion syndrome (22q11.2DS) is underrecognised in adults with tetralogy of Fallot (TOF) and with pulmonary atresia (PA)/ventricular septal defect (VSD).1 Digilio et al disagree with our recommendation to consider genetic testing for the syndrome in all adults with TOF and PA/VSD. Rather they propose to reserve this for patients with associated ‘classic’ or ‘subtle’ extracardiac anomalies and to … more...
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- 2011
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418. Guía de práctica clínica de la ESC para el manejo de cardiopatías congénitas en el adulto (nueva versión 2010)
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Erik Thaulow, Christa Gohlke-Baerwolf, Harald Kaemmerer, Pascal Vouhé, Nazzareno Galiè, Helmut Baumgartner, Edmond P. Walma, Erwin Oechslin, Philip J. Kilner, András Szatmári, Barbara J.M. Mulder, Fokko de Haan, Folkert J. Meijboom, Natasja M.S. de Groot, Michael A. Gatzoulis, Philipp Bonhoeffer, José M. Oliver, Alain Serraf, and John Deanfield more...
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business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Humanities - Abstract
Responsabilidad: Las Guias de Practica Clinica recogen la opinion de la ESC y se han elaborado tras una consideracion minuciosa de las evidencias disponibles en el momento en que fueron escritas. Se anima a los profesionales de la sanidad a que las tengan en plena consideracion cuando ejerzan su juicio clinico. No obstante, las Guias de Practica Clinica no deben invalidar la responsabilidad individual de los profesionales de la salud a la hora de tomar decisiones adecuadas a las circunstancias individuales de cada paciente, consultando con el propio paciente y, cuando sea necesario y pertinente, con su tutor o representante legal. Tambien es responsabilidad del profesional de la salud verificar las normas y los reglamentos que se aplican a los farmacos o dispositivos en el momento de la prescripcion. El contenido de las Guias de Practica Clinica de la Sociedad Europea de Cardiologia (ESC) ha sido publicado para uso exclusivamente personal y educacional. No esta autorizado su uso comercial. No se autoriza la traduccion o reproduccion en ningun formato de las Guias de la ESC ni de ninguna de sus partes sin un permiso escrito de la ESC. El permiso puede obtenerse enviando una solicitud por escrito a Oxford University Press, la empresa editorial de European Heart Journal y representante autorizada de la ESC para gestionar estos permisos. © The European Society of Cardiology 2010. Reservados todos los derechos. Para la solicitud de permisos dirijase por correo electronico a: journals. permissions@oxfordjournals.org Los comentarios-anotaciones (*) incluidos en esta traduccion de la Guia han sido realizados por el Dr. Jose M. Oliver Ruiz (Madrid, Espana). more...
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- 2010
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419. Sexuality in Adult Patients With Congenital Heart Disease and Their Partners
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Barbara J.M. Mulder, Arie P.J. van Dijk, Hubert W. Vliegen, Berto J. Bouma, Harald Kedde, Jeroen C. Vis, Claire Reisma, Michiel M. Winter, Paul Luijendijk, Petronella G. Pieper, A. H. Zwinderman, Piet de Witte, Cardiovascular Centre (CVC), Amsterdam Cardiovascular Sciences, General Internal Medicine, Cardiology, Amsterdam Public Health, and Epidemiology and Data Science more...
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Adult ,Heart Defects, Congenital ,Male ,Marfan syndrome ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Heart disease ,Sexual Behavior ,NETHERLANDS ,Coarctation of the aorta ,Human sexuality ,Young Adult ,of-the-literature erectile dysfunction reproductive health failure netherlands people life ,Quality of life ,PEOPLE ,Surveys and Questionnaires ,ERECTILE DYSFUNCTION ,medicine ,Humans ,FAILURE ,Young adult ,Aged ,Cardiovascular diseases [NCEBP 14] ,business.industry ,Middle Aged ,medicine.disease ,LIFE ,Sexual Partners ,OF-THE-LITERATURE ,Great arteries ,Eisenmenger syndrome ,Quality of Life ,Female ,REPRODUCTIVE HEALTH ,Cardiology and Cardiovascular Medicine ,business ,Sexuality ,Follow-Up Studies - Abstract
Contains fulltext : 89274.pdf (Publisher’s version ) (Closed access) Data on relational and sexuality issues in adult patients with congenital heart disease (CHD) are scarce. The present study aimed to evaluate relational and sexual behaviors, satisfaction, and functioning in a representative sample of patients with CHD and their partners. In addition, we aimed to evaluate the relation between sexuality parameters and quality of life. Relational and sexuality issues were assessed using a sexuality questionnaire in 133 patients (52% men, 37 +/- 13 years old) with CHD (43 with coarctation of the aorta, 42 with transposition of great arteries, 36 with Marfan syndrome, and 12 with Eisenmenger syndrome), and 74 partners. Quality of life was assessed using the Dutch translation of the Medical Outcomes Study Short Form 36-Item Health Survey. Data were compared to an age- and gender-matched control group (n = 3,642). Seventy-one percent of patients with CHD were involved in a relationship, which was significantly less compared to controls (79%, p < 0.05). Nonetheless, patients perceived their relationship as more satisfactory compared to controls (p < 0.05). Overall, sexual satisfaction was equal in patients compared to controls, although they perceived lower body esteem (p < 0.001), decreased sexual esteem (p < 0.05), and more distress during sex (p < 0.001). Patients reported no more erectile and lubrication problems compared to partners and to controls. We found significant associations between most relational and sexual parameters and quality of life. In conclusion, many aspects of sexuality are affected in adult patients with CHD, whereas their partners remain relatively unaffected. Moreover, sexuality is an important aspect of quality of life in these patients. We advise physicians to be receptive to discuss sexuality issues and provide patients with adequate therapy. more...
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- 2010
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420. Right ventricular function declines after cardiac surgery in adult patients with congenital heart disease
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Mark J. Schuuring, Berto J. Bouma, Barbara J.M. Mulder, Mark G. Hazekamp, Pauline P. M. Bolmers, Dave R. Koolbergen, Wim K. Lagrand, Stefan De Hert, E. M. F. H. de Beaumont, Rianne H.A.C.M. de Bruin-Bon, Amsterdam Cardiovascular Sciences, Cardiology, Cardiothoracic Surgery, Amsterdam institute for Infection and Immunity, Intensive Care Medicine, Anesthesiology, and Other Research more...
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Adult ,Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Time Factors ,Heart disease ,Ventricular Dysfunction, Right ,Doppler echocardiography ,Risk Assessment ,law.invention ,Young Adult ,Troponin T ,law ,Risk Factors ,Internal medicine ,Cardiopulmonary bypass ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Cardiac Surgical Procedures ,Creatine Kinase ,Cardiac imaging ,Netherlands ,Congenital heart disease ,Academic Medical Centers ,Original Paper ,Tricuspid valve ,Chi-Square Distribution ,medicine.diagnostic_test ,business.industry ,Recovery of Function ,Cardiac surgery ,medicine.disease ,Intensive care unit ,Right ventricular function ,Echocardiography, Doppler ,medicine.anatomical_structure ,Treatment Outcome ,Echocardiography ,Radiology Nuclear Medicine and imaging ,Cardiology ,Linear Models ,Ventricular Function, Right ,Female ,business ,Cardiology and Cardiovascular Medicine ,Biomarkers - Abstract
Right ventricular function (RVF) is often selectively declined after coronary artery bypass graft surgery. In adult patients with congenital heart disease (CHD) the incidence and persistence of declined RVF after cardiac surgery is unknown. The current study aimed to describe RVF after cardiac surgery in these patients. Adult CHD patients operated between January 2008 and December 2009 in the Academic Medical Centre in Amsterdam were studied. Clinical characteristics, laboratory tests, surgical data and intensive care unit outcome were obtained from medical records. RVF was measured by trans-thoracic echocardiography (TTE) and expressed by tricuspid annular plane systolic excursion (TAPSE), tissue Doppler imaging (RV S') and myocardial performance index (MPI) pre-operatively and direct, at intermediate and late follow up. Of a total of 185 operated, 86 patients (mean age 39 +/- A 13 years, 54% male) had echo data available. There was a significant fall in RVF after cardiac surgery. TAPSE and RV S' were significantly higher and MPI was significantly lower pre-operatively compared to direct post-operative values (TAPSE 22 +/- A 5 versus 13 +/- A 3 mm (P more...
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421. Rare Variants in NR2F2 Cause Congenital Heart Defects in Humans
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Kerry Setchfield, Sebastian S. Gerety, Catherine Cosgrove, Shoumo Bhattacharya, Okan Toka, Hashim Abdul-Khaliq, David I. Wilson, Anne-Karin Arndt, Jamie Bentham, Bernard Thienpont, Ashok K. Manickaraj, Koen Devriendt, G. Jawahar Swaminathan, Seema Mital, Ita O'Kelly, Javier T. Granados-Riveron, Catherine L. Mercer, Anneke Lucassen, Marc-Phillip Hitz, Hans-Heiner Kramer, Jacoba Low, Kirstin Hoff, Sabine Klaassen, Stephan Schubert, Reiner Siebert, Lisa C.A. D'Alessandro, Christine Harnack, Hugh Watkins, David R. FitzPatrick, Marc Gewillig, Saeed Al Turki, Barbara J.M. Mulder, J. David Brook, Sarah J. Lindsay, Jeroen Breckpot, Matthew E. Hurles, Frances A. Bu'Lock, Anthony P. Salmon, Chris Thornborough, ACS - Amsterdam Cardiovascular Sciences, and Cardiology more...
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Heart Defects, Congenital ,Male ,0301 basic medicine ,Transcription, Genetic ,Balanced Chromosomal Translocation ,Mutation, Missense ,Biology ,030105 genetics & heredity ,Bioinformatics ,Article ,Cell Line ,COUP Transcription Factor II ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Gene duplication ,Genetics ,Missense mutation ,Animals ,Humans ,Medicine ,Exome ,Genetics(clinical) ,Prospective Studies ,Gene ,Exome sequencing ,Genetics (clinical) ,Binding Sites ,business.industry ,Correction ,Promoter ,Pedigree ,3. Good health ,Cardiovascular and Metabolic Diseases ,030220 oncology & carcinogenesis ,embryonic structures ,030211 gastroenterology & hepatology ,Female ,Erratum ,business ,Comparative genomic hybridization - Abstract
Congenital heart defects (CHDs) are the most common birth defect worldwide and are a leading cause of neonatal mortality. Nonsyndromic atrioventricular septal defects (AVSDs) are an important subtype of CHDs for which the genetic architecture is poorly understood. We performed exome sequencing in 13 parent-offspring trios and 112 unrelated individuals with nonsyndromic AVSDs and identified five rare missense variants (two of which arose de novo) in the highly conserved gene NR2F2, a very significant enrichment (p = 7.7 × 10(-7)) compared to 5,194 control subjects. We identified three additional CHD-affected families with other variants in NR2F2 including a de novo balanced chromosomal translocation, a de novo substitution disrupting a splice donor site, and a 3 bp duplication that cosegregated in a multiplex family. NR2F2 encodes a pleiotropic developmental transcription factor, and decreased dosage of NR2F2 in mice has been shown to result in abnormal development of atrioventricular septa. Via luciferase assays, we showed that all six coding sequence variants observed in individuals significantly alter the activity of NR2F2 on target promoters. more...
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422. Advanced therapy for pulmonary arterial hypertension due to congenital heart disease: a clinical perspective in a new therapeutic era
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Berto J. Bouma, Dave R. Koolbergen, Nico A. Blom, S. M. Boekholdt, M. Keijzers, Barbara J.M. Mulder, A. Windhausen, M. Groenink, Mark J. Schuuring, R. J. de Winter, Amsterdam Cardiovascular Sciences, Cardiology, Radiology and Nuclear Medicine, Cardiothoracic Surgery, and Paediatric Cardiology more...
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medicine.medical_specialty ,Heart disease ,business.industry ,Sildenafil ,medicine.medical_treatment ,medicine.disease ,Tadalafil ,Bosentan ,Cardiac surgery ,respiratory tract diseases ,Special Article ,chemistry.chemical_compound ,medicine.anatomical_structure ,chemistry ,Eisenmenger syndrome ,Internal medicine ,medicine ,Vascular resistance ,Cardiology ,cardiovascular system ,Lung transplantation ,business ,Cardiology and Cardiovascular Medicine ,medicine.drug - Abstract
IntroductionPulmonary arterial hypertension (PAH) is a progressivedisease with poor survival. PAH is classified by the 2009updated clinical classification of pulmonary hypertensionand a major subgroup is PAH due to congenital heartdisease (CHD) with systemic-to-pulmonary shunt [1]. Thisshunting may lead to extensive histological changes in thedistal pulmonary arteries resulting in an irreversibleincrease in pulmonary vascular resistance (PVR). Theclassification of CHD-PAH includes four categories: (1)Eisenmenger syndrome, (2) PAH associated with systemic-to-pulmonary shunts, (3) PAH with small septal defects,and (4) PAH after corrective cardiac surgery [2]. In thesepatients advanced pharmacological therapy should beconsidered.Three classes of advanced therapy for PAH are currentlyin use: prostanoids such as epoprostenol, endothelin-1receptor antagonists such as bosentan, and phosphodiester-ase 5 inhibitors such as sildenafil [3]. Bosentan has beenshown to improve 6-min walking distance (6MWD) and todecrease PVR in patients with Eisenmenger syndrome [4].Anecdotal experience with the phosphodiesterase type-5inhibitors sildenafil and tadalafil show favourable function-al and haemodynamic results in patients with CHD-PAH[5, 6]. We present three patients treated with advancedpharmacological therapy for CHD-PAH: a patient withEisenmenger syndrome receiving standard care, a patientwith atrial septal defect receiving advanced therapy as abridge to surgery, and a patient with segmental PAH whowas started on advanced therapy empirically.Case 1: an Eisenmenger patientThe first case describes a 38-year-old male patient with adouble inlet left ventricle, hypoplastic aortic arch and patentductus arteriosus. He was deemed ineligible for a Fontancirculation and developed PAH in childhood. He wasseverely symptomatic (NYHA functional class III-IV) andcould only live a sedentary lifestyle. He had been on thewaiting list for combined heart and lung transplantation for2 years. He was cyanotic with a peripheral saturation of80%. His haemoglobin level was 13.4 mmol/L. Onauscultation, normal heart sounds were heard, as well as asystolic murmur grade II/VI. Trans-thoracic echocardiogra-phy (TTE) showed a moderate systolic ventricular function,mild mitral regurgitation, and moderate tricuspid regurgita more...
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423. Worse clinical outcome but similar graft patency in women versus men one year after coronary artery bypass graft surgery owing to an excess of exposed risk factors in women
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Barbara J.M. Mulder, Matthias Pfisterer, Peter H.J.M. Dunselman, C. A. P. L. Ascoop, Pieter Jan de Kam, Kong I. Lie, Eng-Shiong Tan, and Jan van der Meer
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Retrospective cohort study ,Odds ratio ,medicine.disease ,Revascularization ,Surgery ,Angina ,Internal medicine ,Heart failure ,Occlusion ,medicine ,Cardiology ,Myocardial infarction ,Risk factor ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES This retrospective study sought to assess differences in graft patency and clinical outcome between women and men after coronary artery bypass graft surgery (CABG). BACKGROUND A less favorable clinical outcome has been reported in women as compared with men. Its relation to graft patency has not been studied. METHODS We analyzed one-year follow-up data of 912 patients (120 women) who entered a randomized clinical drug trial. All patients received vein grafts; in 494 patients (56 women) internal mammary artery (IMA) grafts were also used. Graft patency was assessed by coronary angiography at one year. Primary clinical end points were myocardial infarction, revascularization procedures and death; secondary clinical end points included recurrent angina, heart failure and arrhythmias. RESULTS Occlusion rates of vein grafts were 16.7% in women and 12.4% in men (odds ratio [OR] 1.62, 95% confidence interval [CI] 0.88 to 3.00, p = 0.12); occlusion rates of IMA grafts were 3.4% and 5.7% in women and men, respectively (OR 0.56, 95% CI 0.08 to 3.96, p = 0.56). Primary clinical end points were observed in 16.7% of women and 9.2% of men (OR 1.97, 95% CI 1.10 to 3.34, p = 0.022), and any clinical end point in 41.7% of women and 25.8% of men (OR 2.06, 95% CI 1.39 to 3.04, p = 0.0004). Myocardial infarction (15% vs. 7.6%, OR 2.15, 95% CI 1.24 to 3.75, p = 0.013) and recurrent angina (26.7% vs. 15.4%, OR 2.00, 95% CI 1.28 to 3.11, p = 0.004) occurred most frequently. Multivariate regression analysis did not identify gender as an independent risk factor for graft occlusion or the clinical end points. Graft occlusion was an independent predictor of the composite primary clinical end point (OR 2.75, 95% CI 1.59 to 4.75, p = 0.0003) and each of the secondary clinical end points. The observed differences were due to an imbalance of risk factors at baseline and to surgical and graft characteristics. CONCLUSIONS One-year occlusion rates of vein and IMA grafts were comparable in women and men. Clinical outcome was related to graft patency and was less favorable in women owing to their uneven distribution of risk factors among both groups. more...
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424. Per-operative stent placement in the right pulmonary artery; a hybrid technique for the management of pulmonary artery branch stenosis at the time of pulmonary valve replacement in adult Fallot patients
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F. Windhausen, Mark G. Hazekamp, S. M. Boekholdt, R. J. de Winter, Dave R. Koolbergen, A. P. C. M. Backx, M. Groenink, Berto J. Bouma, Barbara J.M. Mulder, Cardiology, Amsterdam Cardiovascular Sciences, Radiology and Nuclear Medicine, Paediatric Cardiology, and Cardiothoracic Surgery more...
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medicine.medical_specialty ,business.industry ,Pulmonary Artery Branch ,medicine.disease ,Pulmonary artery stenting ,Right pulmonary artery ,Surgery ,Stenosis ,Stent placement ,Special Article ,Internal medicine ,Pulmonary Valve Replacement ,medicine.artery ,Pulmonary artery ,Cardiology ,Tetralogy of Fallot ,Medicine ,business ,Cardiology and Cardiovascular Medicine ,Peripheral pulmonary stenosis ,Pulmonary homograft - Abstract
After having undergone surgical correction at an early age, many patients with tetralogy of Fallot develop long-term complications including progressive pulmonary regurgitation and peripheral pulmonary stenosis. A high percentage of these patients need to undergo a second operation in their adolescence or early adulthood. If simultaneous treatment of both pulmonary regurgitation and peripheral pulmonary stenosis is warranted, a complete surgical approach has several disadvantages. We describe four cases of Fallot patients with severe pulmonary regurgitation and peripheral pulmonary stenosis who were treated using a hybrid approach involving surgical implantation of a pulmonary homograft and peroperative stenting of the pulmonary artery. more...
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425. Adults with Down syndrome have reduced cardiac response after light exercise testing
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K. van den Brink, Jeroen C. Vis, Barbara J.M. Mulder, Luc Imschoot, Sylvia A. Huisman, H A C M De Bruin-Bon, B.J. Bouma, Cardiology, Amsterdam Cardiovascular Sciences, and Graduate School
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Cardiac response ,Down syndrome ,medicine.medical_specialty ,business.industry ,Exercise testing ,Light Exercise ,Physical fitness ,Cardiac index ,Stroke volume ,Bioinformatics ,medicine.disease ,Echocardiography ,medicine ,Physical therapy ,Original Article ,business ,Cardiology and Cardiovascular Medicine - Abstract
Objective Physical fitness is reduced in adults with Down syndrome (DS). The present study was conducted to elucidate the exercise response in adults with DS. Design Case controlled before-after trial. Setting Residential centre for people with intellectual disabilities. Participants 96 Adults with DS, 25 non-DS adults with an intellectual disability, 33 controls. Interventions Echocardiography to exclude heart defects and to measure cardiac index (CI) in the supine position, supine position with raised legs, and following ten knee bends. Main outcome measure Exercise testing Results At rest, mean CI was not significantly different between persons with DS and controls (2.3 vs. 2.4 l/min/m2, p = 0.3). However, mean CI after exercise was significantly lower in DS (2.9 vs. 3.7 l/min/m2, p more...
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426. Recent progress in treatment of pulmonary arterial hypertension due to congenital heart disease
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A.C.M.J. van Riel, Mark J. Schuuring, Barbara J.M. Mulder, Berto J. Bouma, Amsterdam Cardiovascular Sciences, Cardiology, Graduate School, and Faculteit der Geneeskunde
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medicine.medical_specialty ,Heart disease ,business.industry ,Volume overload ,Disease ,medicine.disease ,Bosentan ,Surgery ,Cardiac surgery ,Stenosis ,Blood pressure ,medicine.anatomical_structure ,Editorial ,Internal medicine ,medicine ,Cardiology ,sense organs ,business ,Cardiology and Cardiovascular Medicine ,medicine.drug ,Artery - Abstract
IntroductionPulmonary arterial hypertension (PAH) is a severe, progres-sive disease, which can present idiopathically or secondary toconditions such as systemic sclerosis or congenital heartdisease(CHD)[1]. In the setting of CHD-PAH a systemic-to-pulmonary shunt and increased volume overload ultimatelylead to adaptations of pulmonary vasculature and endothelialdysfunction. The classification of CHD-PAH has recentlybeen updated to include four categories: (1) Eisenmengersyndrome, (2) PAH associated with systemic-to-pulmonaryshunts, (3) PAH with small septal defects and (4) PAH aftercorrective cardiac surgery or intervention. Three classes ofadvanced therapy for PAH are currently in use: prostanoidssuch as epoprostenol, endothelin-1 receptor antagonists suchas bosentan and phosphodiesterase 5 inhibitors such assildenafil.Eisenmenger syndromeNowadays, all patients with class III Eisenmengersyndrome should be treated according to the currentguidelines, based on a class IC recommendation [2]. Inour nationwide study with a standardised treatment protocolwe observed a prolonged beneficial effect of bosentantreatment on exercise capacity, echocardiographic strokevolume and quality of life in CHD-PAH patients (79%Eisenmenger syndrome) [3]. In Eisenmenger patients withDown syndrome a stabilisation of clinical parameters wasseen.Expanding indicationsIndications for advanced therapy are expanding. In NYHAfunctionalclassIIPAHpatients,short-termefficacyofbosentanhas been demonstrated. Moreover, prevention of clinicaldeteriorationshouldbeconsideredanimportanttreatmentgoal.Some patients with complex CHD have peripheralpulmonary artery stenosis resulting in local variation ofpulmonary artery arterial pressure. Consequently, somesegments of pulmonary tissue have higher pressures thanothers; therefore, the term segmental PAH has beensuggested to describe this situation [4]. Our group hasreported a case series with segmental PAH demonstratingimprovement of NYHA functional class and exercisecapacity after 12 months of bosentan treatment.Surgical patientsPatients with septal defects and severe or irreversible PAHare by convention ineligible for cardiac surgery. However, anumber of these patients can benefit from advanced therapyas a bridge to surgical intervention. In the literature a fewcases have been reported on CHD-PAH patients whobecame eligible for cardiac surgery after bosentan treatment[5]. more...
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427. Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: executive summary
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David S. Celermajer, Marla Kiess, Folkert J. Meijboom, Gary D. Webb, Helmut Baumgartner, Nancy Poirier, Ariane Marelli, Timothy J. Bradley, Carole A. Warnes, Louise Harris, Paul Khairy, Judith Therrien, Dylan A. Taylor, Koichiro Niwa, Jack M. Colman, Seema Mital, Barbara J.M. Mulder, Isabelle Vonder Muhll, Candice K. Silversides, Erwin Oechslin, Omid Salehian, Lee N. Benson, Markus Schwerzmann, Matthias Greutmann, Luc M. Beauchesne, Michael S. Connelly, Mike Landzberg, Annie Dore, Eric Horlick, ACS - Amsterdam Cardiovascular Sciences, and Cardiology more...
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Heart Defects, Congenital ,Male ,education.field_of_study ,medicine.medical_specialty ,Canada ,Executive summary ,Heart disease ,business.industry ,Consensus Development Conferences as Topic ,Population ,Psychological intervention ,Disease ,Canadian Cardiovascular Society ,medicine.disease ,Cardiac surgery ,Special Article ,Heart failure ,medicine ,Humans ,Female ,Cardiology and Cardiovascular Medicine ,education ,business ,Intensive care medicine ,Societies, Medical - Abstract
With advances in pediatric cardiology and cardiac surgery, the population of adults with congenital heart disease (CHD) has increased. In the current era, there are more adults with CHD than children. This population has many unique issues and needs. They have distinctive forms of heart failure, and their cardiac disease can be associated with pulmonary hypertension, thromboemboli, complex arrhythmias and sudden death. Medical aspects that need to be considered relate to the long-term and multisystemic effects of single-ventricle physiology, cyanosis, systemic right ventricles, complex intracardiac baffles and failing subpulmonary right ventricles. Since the 2001 Canadian Cardiovascular Society Consensus Conference report on the management of adults with CHD, there have been significant advances in the understanding of the late outcomes, genetics, medical therapy and interventional approaches in the field of adult CHD. Therefore, new clinical guidelines have been written by Canadian adult CHD physicians in collaboration with an international panel of experts in the field. The present executive summary is a brief overview of the new guidelines and includes the recommendations for interventions. The complete document consists of four manuscripts that are published online in the present issue of The Canadian Journal of Cardiology, including sections on genetics, clinical outcomes, recommended diagnostic workup, surgical and interventional options, treatment of arrhythmias, assessment of pregnancy and contraception risks, and follow-up requirements. The complete document and references can also be found at www.ccs.ca or www.cachnet.org. more...
428. CIRCUMSTANCES OF DEATH IN ADULT CONGENITAL HEART DISEASE
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Diederick E. Grobbee, J.M. Ansink, Cuno S.P.M. Uiterwaal, Enno T. van der Velde, A. C. Zomer, Folkert J. Meiboom, Lambert F.M. van den Merkhof, Petronella G. Pieper, Luc Cozijnsen, Barbara J.M. Mulder, and L.H.B. Bauer more...
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Pediatrics ,medicine.medical_specialty ,Heart disease ,business.industry ,medicine ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease - Full Text
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429. Plasma neurohormones as markers of right ventricular overload and predictors of mortality in acute pulmonary embolism
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Ernst E. van der Wall, Harry R. Büller, Marye ten Wolde, Barbara J.M. Mulder, Igor I. Tulevski, Jasper W.M. Mulder, and Dirk J. van Veldhuisen
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medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiology ,cardiovascular system ,Medicine ,business ,Neurohormones ,medicine.disease ,Cardiology and Cardiovascular Medicine ,Pulmonary embolism - Full Text
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430. Prognostic value of brain natriuretic peptide and cardiac troponin T in patients with confirmed pulmonary embolism: Changes after treatment
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Dirk J. van Veldhuisen, Igor I. Tulevski, Ernst E. van der Wall, Harry R. Büller, Barbara J.M. Mulder, Marye ten Wolde, and Jasper W.M. Mulder
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medicine.medical_specialty ,Cardiac troponin ,business.industry ,Brain natriuretic peptide ,medicine.disease ,Pulmonary embolism ,Internal medicine ,Cardiology ,medicine ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Value (mathematics) ,After treatment - Full Text
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431. PROGNOSIS OF HEART FAILURE IN ADULTS WITH CONGENITAL HEART DISEASE
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D. E. Grobbee, E.T. van der Velde, F.L.J. Eerens, Barbara J.M. Mulder, Leo H. B. Baur, Wilfred F. Heesen, Lodewijk J. Wagenaar, Ilonca Vaartjes, A. C. Zomer, and T.C. Konings
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medicine.medical_specialty ,Heart disease ,business.industry ,Internal medicine ,Heart failure ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease - Full Text
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432. EFFICACY OF IMPLANTABLE CARDIOVERTER DEFIBRILLATORS IN ADULTS WITH CONGENITAL HEART DISEASE
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Arthur A.M. Wilde, Alexander H. Maass, Pascal F.H.M. van Dessel, Isabelle C. Van Gelder, Joep L.R.M. Smeets, P. G. Pieper, Joris R. de Groot, Lieselot van Erven, Arie Van Dijk, Barbara J.M. Mulder, Werner Budts, Zeliha Koyak, and Cardiovascular Centre (CVC) more...
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medicine.medical_specialty ,Heart disease ,business.industry ,Internal medicine ,medicine ,Cardiology ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,medicine.disease ,business ,Cardiology and Cardiovascular Medicine ,GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries) - Full Text
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433. Normal regional pulse wave velocity predicts absence of aortic luminal growth in patients with Marfan syndrome: a comprehensive MRI-study
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Hildo J. Lamb, Lucia J.M. Kroft, Eleanore S.J. Kröner, Barbara J.M. Mulder, Pieter J. van den Boogaard, Patrick J.H. de Koning, Ernst E. van der Wall, Maarten Groenink, Albert de Roos, Jeroen J. Bax, Jos J.M. Westenberg, Yvonne Hilhorst-Hofstee, Rob J. van der Geest, Teodora Radonic, Johan H. C. Reiber, Arthur J.H.A. Scholte, Amsterdam Cardiovascular Sciences, Cardiology, Radiology and Nuclear Medicine, and Other departments more...
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musculoskeletal diseases ,Marfan syndrome ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Wall stiffness ,medicine.artery ,Internal medicine ,Ascending aorta ,medicine ,Radiology, Nuclear Medicine and imaging ,In patient ,cardiovascular diseases ,Pulse wave velocity ,Angiology ,Aortic dissection ,Medicine(all) ,Aorta ,Radiological and Ultrasound Technology ,business.industry ,fungi ,food and beverages ,medicine.disease ,lcsh:RC666-701 ,Poster Presentation ,Cardiology ,cardiovascular system ,Cardiology and Cardiovascular Medicine ,business - Abstract
Summary By using a comprehensive MRI-approach in patients with Marfan syndrome, increased regional pulse wave velocity in the ascending aorta can predict in 42% of the cases aortic luminal growth in the ascending aorta, while normal PWV can predict in 89% absence of luminal growth. Background The leading cause of premature death in patients with Marfan syndrome (MFS) is aortic dissection after progressive dilatation due to local increased wall stiffness, occurring most prominently in the ascending aorta. Aortic pulse wave velocity (PWV) is a marker of wall stiffness [Nollen, et al. Eur Heart J 2004]. Regional PWV can be accurately determined from in-plane multi-directional velocity-encoded (VE) MRI [Westenberg, et al. JMRI 2010]. The study objective was to test whether regional PWV can predict regional aorta dilatation at 2year follow-up (FU) in MFS. more...
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434. ATHEROSCLEROSIS PROGRESSION IN ADULT POST-COARCTECTOMY PATIENTS
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Joris W.J. Vriend, Barbara J.M. Mulder, Paul Luijendijk, Eric de Groot, Johan Gort, and Berto J. Bouma
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medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,cardiovascular system ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business - Full Text
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435. THE EFFECT OF HIGH DOSE STATINS ON VASCULAR WALL DAMAGE AND CARDIOVASCULAR RISK IN AORTIC COARCTATION
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Joris W.J. Vriend, Hubert W. Vliegen, Paul Luiiendiik, Eric de Groot, Arie P.J. van Dijk, Aeilko H. Zwinderman, Berto J. Bouma, Petronella G. Pieper, Barbara J.M. Mulder, Gerrit Veen, Gertjan Tj. Sieswerda, and Maarten Groenink more...
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Vascular wall ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cardiology ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business - Full Text
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