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151. Pregnancy in women with hypertrophic cardiomyopathy: Data from the European Society of Cardiology initiated Registry of Pregnancy and Cardiac disease (ROPAC)

Author

Goland, S. (Sorel), Hagen, I.M. (Iris) van, Elbaz-Greener, G. (G.), Elkayam, U. (Uri), Shotan, A. (A.), Merz, W.M. (Waltraut M.), Enar, S.C. (S. C.), Gaisin, I.R. (Ilshat R.), Pieper, P.G. (Petronella), Johnson, M.R. (Mark), Hall, R. (Ruth), Blatt, A. (A.), Roos-Hesselink, J.W. (Jolien), Goland, S. (Sorel), Hagen, I.M. (Iris) van, Elbaz-Greener, G. (G.), Elkayam, U. (Uri), Shotan, A. (A.), Merz, W.M. (Waltraut M.), Enar, S.C. (S. C.), Gaisin, I.R. (Ilshat R.), Pieper, P.G. (Petronella), Johnson, M.R. (Mark), Hall, R. (Ruth), Blatt, A. (A.), and Roos-Hesselink, J.W. (Jolien)

Abstract

We report the maternal and foetal outcomes at birth and after 6 months in a cohort of pregnant women with hypertrophic cardiomyopathy (HCM). Although most women with HCM tolerate pregnancy well, there is an increased risk of obstetric and cardiovascular complications. Methods and results All pregnant women with HCM entered into the prospective worldwide Registry of Pregnancy and Cardiac disease (ROPAC) were included in this analysis. The primary endpoint was a major adverse cardiovascular event (MACE), which included death, heart failure (HF), thrombo-embolic event, and arrhythmia. Baseline and outcome data were analysed and compared for patients with MACE vs. without MACE and for patients with obstructive HCM vs. nonobstructive HCM. Sixty pregnant women (mean age 30.4 ± 6.0 years) with HCM (41.7% obstructive) were included. No maternal mortality occurred in this cohort. In 14 (23%) patients at least one MACE occurred: 9 (15.0%) HF and 7 (12%) an arrhythmia (6 ventricular and 1 atrial fibrillation). MACE occurred most commonly during the 3rd trimester and postpartum period. In total, 3 (5.0%) women experienced foetal loss. Women with MACE had a higher rate of emergency Caesarean delivery for cardiac reasons (21.4% vs. 0%, P = 0.01). No significant differences in pregnancy outcome were found between women with obstructive and non-obstructive HCM. NYHA functional class of >-II and signs of HF before pregnancy, were associated with MACE. Conclusion Although most women with HCM tolerated pregnancy well, cardiovascular complications were not uncommon and predicted by pre-pregnancy status facilitating pre-pregnancy counselling and targeted antenatal care.

Published
2017
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152. Corrigendum to 'Ventricular tachyarrhythmia during pregnancy in women with heart disease: Data from the ROPAC, a registry from the European Society of Cardiology' [Int. J. Cardiol. 220 (2016) 131-136]

Author

Ertekin, E. (Ebru), Hagen, I.M. (Iris) van, Salam, A.M. (Amar M.), Ruys, T.P.E. (Titia), Johnson, M.R. (Mark), Popelová, J. (Jana), Parsonage, W.A. (William A.), Ashour, Z. (Zeinab), Shotan, A. (Avraham), Oliver, J.M. (José M.), Veldtman, G.R. (Gruschen R.), Hall, R. (Ruth), Roos-Hesselink, J.W. (Jolien), Ertekin, E. (Ebru), Hagen, I.M. (Iris) van, Salam, A.M. (Amar M.), Ruys, T.P.E. (Titia), Johnson, M.R. (Mark), Popelová, J. (Jana), Parsonage, W.A. (William A.), Ashour, Z. (Zeinab), Shotan, A. (Avraham), Oliver, J.M. (José M.), Veldtman, G.R. (Gruschen R.), Hall, R. (Ruth), and Roos-Hesselink, J.W. (Jolien)

Abstract

The authors regret that some dates of sponsor's involvement in the program were incorrectly reported in the initial published paper, therefore please consider the below corrected information: Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011–2014), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2017), Bayer (2009–2018), Boehringer Ingelheim (2009–2016), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011–2017), Gedeon Richter Plc. (2014–2017), Menarini Int. Op. (2009–2012), MSD-Merck & Co. (2011–2014), Novartis Pharma AG (2014–2017), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2009–2018). The authors would like to apologise for any inconvenience caused.

Published
2017
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153. Corrigendum to ‘Ventricular tachyarrhythmia during pregnancy in women with heart disease: Data from the ROPAC, a registry from the European Society of Cardiology’ [Int. J. Cardiol. 220 (2016) 131–136]

Author

Ertekin, Ebru, van Hagen, Iris M., Salam, Amar M., Ruys, Titia P.E., Johnson, Mark R., Popelova, Jana, Parsonage, William A., Ashour, Zeinab, Shotan, Avraham, Oliver, José M., Veldtman, Gruschen R., Hall, Roger, Roos-Hesselink, Jolien W., Ertekin, Ebru, van Hagen, Iris M., Salam, Amar M., Ruys, Titia P.E., Johnson, Mark R., Popelova, Jana, Parsonage, William A., Ashour, Zeinab, Shotan, Avraham, Oliver, José M., Veldtman, Gruschen R., Hall, Roger, and Roos-Hesselink, Jolien W.

Abstract

The authors regret that some dates of sponsor's involvement in the program were incorrectly reported in the initial published paper, therefore please consider the below corrected information: Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011–2014), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2017), Bayer (2009–2018), Boehringer Ingelheim (2009–2016), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011–2017), Gedeon Richter Plc. (2014–2017), Menarini Int. Op. (2009–2012), MSD-Merck & Co. (2011–2014), Novartis Pharma AG (2014–2017), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2009–2018). The authors would like to apologise for any inconvenience caused.

Published
2017

154. Two-dimensional strain echocardiography for diagnosing chest pain in the emergency room: a multicentre prospective study by the Israeli echo research group

Author

David Rosenmann, David S. Blondheim, Mohamed Jabarren, Sara Shimoni, Avraham Shotan, Salim Adawi, David Leibowitz, Sorel Goland, Noah Liel-Cohen, Ronen Beeri, Lev Bloch, Sergio L. Kobal, Avinoam Shiran, Micha S. Feinberg, Marina Leitman, and Alex Sagie

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, Chest Pain, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, Chest pain, Risk Assessment, Severity of Illness Index, Cohort Studies, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Odds Ratio, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Prospective Studies, Systole, Acute Coronary Syndrome, Israel, Prospective cohort study, Aged, biology, business.industry, General Medicine, Emergency department, Middle Aged, medicine.disease, Troponin, Surgery, Survival Rate, ROC Curve, Echocardiography, Cardiology, biology.protein, Female, medicine.symptom, Symptom Assessment, Cardiology and Cardiovascular Medicine, business, Emergency Service, Hospital, Mace, Follow-Up Studies
Abstract

Aims Left ventricular (LV) two-dimensional longitudinal strain (2DLS) analysis by echocardiography has been suggested as a useful tool for the detection of acute coronary syndromes (ACS). Our aim was to determine whether 2DLS analysis could assist in triage of patients with chest pain (CP) in the emergency department (ED). Methods and results We prospectively enrolled patients presenting to the ED with CP and suspected ACS but without a diagnostic ECG or elevated troponin. An echocardiogram was performed within 24 h of CP. For each patient, a histogram of LV myocardial peak systolic strain (PSS) was generated and the value identifying the 20% worst strain values (PSS20%) was determined. A predefined value of greater than −17% was considered abnormal. 2DLS analysis was available for 605 patients (mean age 58 ± 9 years, 70% males), of which 74 (12.2%) had ACS. During a 6-month follow-up, MACE occurred in 4 (5.8%) patients with and in 3 (0.6%) without ACS. An abnormal PSS20% was present in 60/74 patients with ACS (sensitivity 81%, negative predictive value 91%), but also in 391/531 patients without ACS (specificity 26%, positive predictive value 13%). Similar results were found for global longitudinal strain (GLS). Receiver-operating characteristic curves showed an area under curve of 0.59 for PSS20% and 0.6 for GLS ( P = 0.3). Independent predictors of abnormal 2DLS were male gender, body mass index, heart rate, and mean tissue Doppler e ′, but not ACS. Conclusion In this large multicentre prospective study, 2DLS was not a useful tool to rule out ACS in the ED. Clinical trial registration . Unique identifier NCT01163019.

Published
2016

155. Rapid microscopy measurement of very large spectral images

Author

Moshe Lindner, Yuval Garini, and Zav Shotan

Subjects
medicine.medical_specialty, Microscope, Materials science, business.industry, Hyperspectral imaging, Field of view, 02 engineering and technology, 021001 nanoscience & nanotechnology, 01 natural sciences, Atomic and Molecular Physics, and Optics, Spectral imaging, law.invention, 010309 optics, Optical axis, Optics, law, 0103 physical sciences, Microscopy, medicine, Spectral resolution, 0210 nano-technology, business, Image resolution
Abstract

The spectral content of a sample provides important information that cannot be detected by the human eye or by using an ordinary RGB camera. The spectrum is typically a fingerprint of the chemical compound, its environmental conditions, phase and geometry. Thus measuring the spectrum at each point of a sample is important for a large range of applications from art preservation through forensics to pathological analysis of a tissue section. To date, however, there is no system that can measure the spectral image of a large sample in a reasonable time. Here we present a novel method for scanning very large spectral images of microscopy samples even if they cannot be viewed in a single field of view of the camera. The system is based on capturing information while the sample is being scanned continuously ‘on the fly’. Spectral separation implements Fourier spectroscopy by using an interferometer mounted along the optical axis. High spectral resolution of ~5 nm at 500 nm could be achieved with a diffraction-limited spatial resolution. The acquisition time is fairly high and takes 6-8 minutes for a sample size of 10mm x 10mm measured under a bright-field microscope using a 20X magnification.

Published
2016

156. Novel Method for Real Time Co-Registration of IVUS and Coronary Angiography

Author

Aharon, Frimerman, Eitan, Abergel, David S, Blondheim, Avraham, Shotan, Simcha, Meisel, Michael, Shochat, Pritesh, Punjabi, and Ariel, Roguin

Subjects
Male, Phantoms, Imaging, Image Processing, Computer-Assisted, Humans, Reproducibility of Results, Female, Pilot Projects, Stents, Middle Aged, Coronary Angiography, Coronary Vessels, Ultrasonography, Interventional, Aged
Abstract

We present our experience with a novel method for real time co-registration of intravascular ultrasound (IVUS) and coronary angiography.A major limitation of the current practice of concomitant use of coronary angiography and IVUS is that the locations of the acquired IVUS images are not correlated with their exact locations on the vessel roadmap obtained by coronary angiography.Phantoms simulating the coronary tree were used to test the accuracy and potential of co-registration. Subsequently we examined patients who underwent IVUS during cardiac catheterization. Analysis and feasibility were performed in 42 arteries of 36 patients.The statistical validation in phantoms resulted in a co-registration accuracy of 1.12 mm. The length measurement on an angiogram resulted in an accuracy of 0.38 mm. Co-registration in patients was successful in all cases and four categories were assisted by 1(bad) to 5 (good) grading. Accuracy (the co-registration precision in pointing at the exact corresponding location): 4.8±0.41; Ease of use and workflow: 4.74±0.44; Stent landing zone detection and evaluation: 4.58±0.5; Stent landing zone length and diameter measurement: 4.94±0.23. The co-registration error was estimated as no more than 1 mm.In this pilot study, we found that the novel IVUS and coronary angiography co-registration method is accurate, easy to use, fast and user-friendly. This method precludes the need to use motorized automated pull back device.

Published
2016

157. Pre-admission NT-proBNP improves diagnostic yield and risk stratification – the NT-proBNP for EValuation of dyspnoeic patients in the Emergency Room and hospital (BNP4EVER) study

Author

Michael Shochat, Avraham Shotan, Michael Glikson, James L. Januzzi, Shmuel Bar Haim, Jalal Ashkar, Moshe Sharist, Simcha R. Meisel, Pavel Peschansky, David S. Blondheim, and Margarita Medvedovski

Subjects
medicine.medical_specialty, Discharge diagnosis, Pediatrics, Blinding, Acute decompensated heart failure, business.industry, medicine.drug_class, General Medicine, Emergency department, Critical Care and Intensive Care Medicine, medicine.disease, Acute Heart Failure, Heart failure, Emergency medicine, Risk stratification, Natriuretic peptide, Medicine, Medical diagnosis, Cardiology and Cardiovascular Medicine, business
Abstract

Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) level is useful to diagnose or exclude acutely decompensated heart failure (ADHF) in dyspnoeic patients presenting to the emergency department (ED).To evaluate the impact of ED NT-proBNP testing on admission, length of stay (LOS), discharge diagnosis and long-term outcome.Dyspnoeic patients were randomized in the ED to NT-proBNP testing. Admission and discharge diagnoses, and outcomes were examined.During 17 months, 470 patients were enrolled and followed for 2.0±1.3 years. ADHF likelihood, determined at study conclusion by validated criteria, established ADHF diagnosis as unlikely in 86 (17%), possible in 120 (24%), and likely in 293 (59%) patients. The respective admission rates in these subgroups were 80, 91, and 96%, regardless of blinding, and 61.9% of blinded vs. 74.5% of unblinded ADHF-likely patients were correctly diagnosed at discharge (p=0.029), with similar LOS. 2-year mortality within subgroups was unaffected by test, but was lower in ADHF-likely patients with NT-proBNP levels below median (5000 pg/ml) compared with those above median (p=0.002). Incidence of recurrent cardiac events tracked NT-proBNP levels.ED NT-proBNP testing did not affect admission, LOS, 2-year survival, or recurrent cardiac events among study patients but improved diagnosis at discharge, and allowed risk stratification even within the ADHF-likely group. (ClinicalTrials.gov#NCT00271128).

Published
2012
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159. Use of intravenous morphine for acute decompensated heart failure in patients with and without acute coronary syndromes

Author

Zaza Iakobishvili, Avraham Shotan, David Hasdai, Eytan Cohen, Amir Sandach, Aviv Mager, Solomon Behar, Alexander Battler, Moshe Garty, and Shmuel Gottlieb

Subjects
Aspirin, medicine.medical_specialty, Acute coronary syndrome, Acute decompensated heart failure, Exacerbation, business.industry, medicine.disease, Internal medicine, Diabetes mellitus, Heart failure, Heart rate, Emergency Medicine, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business, Dyslipidemia, medicine.drug
Abstract

Background: Current guidelines regarding the use of intravenous morphine (IM) in the management of patients with acute decompensated heart failure (ADHF) are discordant; whereas the American guidelines reserve IM for terminal patients, the European guidelines recommend its use in the early stage of treatment. Our aim was to determine the impact of IM on outcomes of ADHF patients. Methods: Stepwise logistic regression and propensity score analysis of ADHF patients with and without use of IM was performed in a national heart failure survey. Results: Of the 4102 enrolled patients, we identified 2336 ADHF patients, of whom 218 (9.3%) received IM. IM patients were more likely to have acute coronary syndromes, acute rather than exacerbation of chronic heart failure, and diabetes mellitus and dyslipidemia. They had higher heart rate, were less likely to receive diuretics and more likely to receive aspirin and statins. Unadjusted in-hospital mortality rates were 11.5% versus 5.0% for patients who did or did not r...

Published
2011
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160. Outcomes of acute heart failure associated with acute coronary syndrome versus other causes

Author

Shmuel Gottlieb, Moshe Garty, Solomon Behar, David Hasdai, Zaza Iakobishvili, Amir Sandach, Aviv Mager, Avraham Shotan, Alexander Battler, Gabriel Greenberg, and Eytan Cohen

Subjects
Inotrope, Coronary angiography, medicine.medical_specialty, Acute coronary syndrome, business.industry, medicine.medical_treatment, Mortality rate, Revascularization, medicine.disease, law.invention, Randomized controlled trial, law, Internal medicine, Heart failure, Emergency Medicine, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, Prospective cohort study, business
Abstract

Background: By and large, prior registries and randomized trials have not distinguished between acute heart failure (AHF) associated with acute coronary syndrome (ACS) versus other causes.Aims: To examine whether the treatments and outcomes of ACS-associated AHF are different from non-ACS-associated AHF.Methods: We examined in a prospective, nationwide hospital-based survey the adjusted outcomes of AHF patients with and without ACS as its principal cause.Results: Of the 4102 patients in our national heart failure survey, 2336 (56.9%) had AHF, of whom 923 (39.5%) had ACS-associated AHF. These patients were more likely to receive intravenous inotropes and vasodilators and to undergo coronary angiography and revascularization, but less likely to receive intravenous diuretics. The unadjusted in-hospital, 30-day, one-year, and four-year mortality rates for AHF patients with or without ACS were 6.5% versus 5.0% (P = 0.13), 10.3% versus 7.5% (P = 0.02), 26.6% versus 31.0% (P = 0.02), and 55.3% versus 63.3% (P = ...

Published
2011
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161. A novel radiological score to assess lung fluid content during evolving acute heart failure in the course of acute myocardial infarction

Author

Avraham Shotan, Michael Shochat, David S. Blondheim, Aya Asif, Yoseph Rozenman, Victoria Trachtengerts, Simcha R. Meisel, Ilia Shochat, Mark Kazatsker, and Vladimir Gurovich

Subjects
medicine.medical_specialty, Lung, medicine.diagnostic_test, business.industry, medicine.disease, medicine.anatomical_structure, Radiological weapon, Heart failure, Edema, Internal medicine, Emergency Medicine, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, Myocardial infarction, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Chest radiograph, Lung impedance
Abstract

Background: Monitoring of lung fluid content (LFC) in order to predict acute heart failure (AHF) during acute myocardial infarction (AMI) is an unmet challenge.Aim: To evaluate in AMI patients the ability of proposed radiological score (RS), which is the sum of selected radiological signs of congestion, to reflect correctly LFC, as assessed with repeat physical examinations and lung impedance (LI) measurements.Methods: Chest X-rays were taken at baseline, when rales were detected, whenever indicated, and at conclusion of monitoring. RS grading for LFC assessment was: RS = 0–1 for normal X-ray, RS = 2–4 for interstitial congestion, and RS values of 5–6, 7–8 and 9–10 signified mild, moderate and severe alveolar edema, respectively.Results: 624 AMI patients without AHF at baseline were monitored (94 ± 42 h). 476 patients (76%) with baseline RS of 0.3 ± 0.5 did not develop AHF. Overt AHF developed in 148 patients (24%) during monitoring; baseline RS (0.6 ± 0.8) reached 5.4 ± 0.7, 7.0 ± 0.8, and 9.8 ± 0.5 at t...

Published
2011
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162. Abstracts

Author

O. Barthelemy, J. Silvain, D. Brieger, A. Bellemain-Appaix, G. Cayla, F. Beygui, R. Lancar, J. P. Collet, A. Mercadier, G. Montalescot, K. S. Cha, Y. H. Nam, J. H. Kim, S. Y. Park, T. H. Park, M. H. Kim, Y. D. Kim, H. C. Lee, M. S. Ahn, T. J. Hong, R. Blanco, F. Blanco, J. Szarfer, A. Garcia Escudero, G. Gigena, J. Gagliardi, A. Rodriguez, R. Sarmiento, S. Affatatto, M. Riccitelli, A. Petris, M. D. Datcu, C. Pop, M. Radoi, C. Arsenescu-Georgescu, I. Petrescu, L. Petrescu, L. Serban, E. Nechita, G. Tatu-Chitoiu, M. Dorobantu, I. Benedek, E. Craiu, C. Sinescu, D. D. Ionescu, C. Ginghina, B. Minescu, A. Izzo, P. Mantovani, L. Tomasi, L. Dall'oglio, S. Bonatti, R. Rosiello, M. Romano, F. Agostini, R. Zanini, Z. Y. Zhao, Y. J. Wu, J. J. Li, Y. J. Yany, H. Y. Qian, Y. D. Tang, A. T. Timoteo, A. Toste, A. Lousinha, R. Ramos, J. A. Oliveira, M. L. Ferreira, R. C. Ferreira, C. Cabades, J. L. Diez Gil, P. Aguar, D. Sanmiguel, A. Lopez-March, R. Marmol, L. Guerra, V. Girbes, J. Ferrando, A. Rincon De Arellano, L. Patricio, M. Blondal, T. Ainla, T. Marandi, J. Eha, M. M. Oliveira, M. N. Silva, P. S. Cunha, J. Feliciano, S. Silva, J. Kanovsky, P. Kala, J. Parenica, M. Poloczek, K. Prymusova, L. Kubkova, J. Spinar, D. Olinic, C. Homorodean, M. Ober, M. Olinic, C. Andrioaia, A. Condac, M. Masmoudi, B. Berdaoui, S. Labidi, C. Tapia Ballesteros, C. Hernandez Luis, M. G. Sandin, J. M. Vegas, R. Andion, N. Martinez, I. A. Gonzalez, M. Alvarado, I. J. Amat, J. A. San Roman, M. J. Garcia Gonzalez, E. Arroyo Ucar, C. Hernandez Garcia, M. Dorta Martin, F. Marrero Rodriguez, R. Dragu, M. Kapeliovich, H. Hammerman, D. Silva, N. Cortez-Dias, C. Jorge, J. Silva Marques, P. Carilho Ferreira, S. Robalo Martins, M. Almeida Ribeiro, C. Calisto, M. Fiuza, M. G. Lopes, P. Milicevic, M. Panic, I. Stankovic, D. Milicevic, T. Kalezic, S. Kafedzic, I. Ilic, M. Cerovic, B. Putnikovic, A. Neskovic, D. Rott, D. Leibowitz, Z. Monhart, J. Reissigova, H. Grunfeldova, P. Jansky, B. Valente, I. Villanueva Benito, I. Solla, E. Paredes, O. Diaz Castro, F. Calvo, J. A. Baz, A. Iniguez, A. Aleksova, R. Gerloni, R. Belfiore, C. Carriere, G. Barbati, E. Fabris, F. Possa, D. Nait, M. Milo, G. Sinagra, N. Marques, J. Mimoso, V. Gomes, R. M. Agra Bermejo, E. A. A. Emad Abu Assi, S. R. R. Sergio Raposeiras Roubin, P. C. G. Pilar Cabanas Grandio, C. P. G. Carlos Pena Gil, J. M. G. A. Jose Maria Garcia Acuna, J. R. G. J. Jose Ramon Gonzalez Juanatey, M. J. Daly, P. Scott, C. G. Owens, A. Tomlin, B. Smith, A. A. J. Adgey, L. R. Alvarez-Contreras, U. Juarez, A. Altamirano, A. Arias, A. Alvarez-San Gabriel, H. Gonzalez-Pacheco, C. Martinez-Sanchez, M. Rahnavardi, M. Keshtkar-Jahromi, H. Vakili, S. Gholamin, S. M. Razavi, T. Gilis-Januszewski, K.- P. Mellwig, M. Wiemer, J. Gilis-Januszewski, A. Peterschroeder, J. Koerfer, D. Horstkotte, M. Vrsalovic, B. Getaldic, N. Vrkic, H. Pintaric, S. Khan, B. Wasan, L. Moretti, P. Grossi, S. Silenzi, M. Testa, L. Candelori, L. N. Clementi, M. Forlini, L. Lando, M. L. Pezzuoli, P. Corradetti, G. Leurent, P. Y. Pennec, E. Filippi, B. Moquet, J. P. Hacot, P. Druelles, A. Rialan, G. Rouault, I. Coudert, H. Le Breton, S. Gevaert, F. Tromp, E. Vandecasteele, F. De Somer, Y. Van Belleghem, S. Bouchez, F. Martens, I. Herck, M. De Pauw, O. Ludka, M. Sepsi, R. Miklik, L. Dusek, D. Tomcikova, J. M. Garcia-Acuna, P. Aguiar-Souto, S. Raposeiras Roubin, R. Agra-Bermejo, M. Jacquet, E. Abu-Assi, J. R. Gonzalez-Juanatey, A. Ibatov, R. Labrova, R. Karlik, P. Lokaj, Q. She, S. B. Deng, S. H. Huang, L. J. Gu, J. I. A. N. Rong, Z. K. Wu, Y. Li, J. Zhang, L. Parascan, A. Campanile, L. Spinelli, G. Santulli, M. Ciccarelli, S. De Gennaro, E. Assante Di Panzillo, B. Trimarco, G. Iaccarino, E. Bobescu, G. Datcu, D. Dobreanu, B. Doka, J.- C. Charniot, C. Cosson, J. P. Albertini, R. Bittar, P. Giral, C. Cherfils, E. Guillerm, D. Bonnefont-Rousselot, A. Rusali, L. Cojocaru, I. Parepa, T. Koizumi, S. Iida, J. Sato, T. Kikutani, T. Muramatsu, S. Nishimura, N. Komiyama, W. P. Lee, B. B. Ong, K. Haralambos, D. Townsend, J. A. E. Rees, E. J. Williams, J. P. Halcox, I. Mcdowell, M. Damjanovic, G. Koracevic, D. Djordjevic-Radojkovic, M. Pavlovic, N. Krstic, S. Ciric-Zdravkovic, A. Stojkovic, Z. Perisic, S. Apostolovic, A. Faustino, L. Seca, S. Barra, F. Caetano, R. Providencia, J. Silva, P. Gomes, G. Costa, M. Costa, A. Leitao-Marques, A. L. Volkova, G. P. Arutyunov, N. A. Bylova, I. I. Dayter, Y. T. F. N. Jao, C. C. Fang, Y. Chen, C. L. Yu, S. P. Wang, J. Valencia, P. Perez-Berbel, J. M. Ruiz-Nodar, J. Pineda, P. Bordes, M. Quintanilla, V. Mainar, F. Sogorb, N. Santos, M. Serrao, H. Cafe, B. Silva, R. Oliveira, G. Caires, A. Drumond, J. Araujo, R. A. Providencia, P. L. Gomes, J. R. Pais, P. Mota, A. M. Leitao-Marques, S. Farhan, R. Jarai, I. Tentzeris, B. Vogel, M. K. Freynhofer, J. Wojta, K. Huber, M. Poli, P. Trambaiolo, F. Corsi, M. De Luca, M. Mustilli, V. Lukic, M. Simonetti, G. Ferraiuolo, M. Lettino, G. Casella, M. R. Conte, L. De Luca, G. Geraci, R. Ceravolo, A. Pani, G. Fradella, A. Schratter, H. Thiele, T. Klemm, K. Demmin, D. Lehmann, M. Mende, G. Schuler, U. Pittl, A. Chernova, S. U. Nikulina, T. Naruke, T. Inomata, T. Yanagisawa, E. Maekawa, T. Mizutani, H. Shinagawa, M. Nishii, I. Takeuchi, H. Takehana, T. Izumi, C. Paulo, J. Mascarenhas, M. Patacho, J. Pimenta, P. Bettencourt, S. Nardai, G. Y. Szabo, B. Berta, I. Edes, B. Merkely, J. Delgado Silva, R. Baptista, R. Faria, J. Trigo, P. Gago, G. Gheorghe, I. T. Nanea, A. Cristea, S. Almarichi, H. Martins, F. Saraiva, E. Jorge, P. L. Mendes, P. Monteiro, S. Costa, F. Franco, L. A. Providencia, T. Nanea, G. S. Gheorghe, S. Visan, N. Paun, R. Gaber, R. Delewi, R. Nijveldt, H. A. De Bruin, A. Hirsch, A. Van Der Laan, B. J. Bouma, J. P. G. Tijssen, A. C. Van Rossum, F. Zijlstra, J. J. Piek, H. Rus, M. Donea, C. Ciurea, G. Ifteni, G. Casolo, M. Chioccioli, M. Magnacca, J. Del Meglio, A. Comella, M. Baratto, J. Lera, L. Salvadori, C. Tessa, C. 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Shpektor, E. Conti, M. B. Musumeci, F. M. Lauri, E. Dito, M. De Giusti, A. Lallo, D. Fusco, M. Davoli, M. Volpe, C. Autore, H. Gamra, Z. Dridi, M. Hassine, F. Addad, I. Gherissi, A. Reda, M. Mahjoub, S. Bouraoui, M. Abdennadher, F. Betbout, P. M. F. P. Mota, J. D. Silva, R. Jankovic Tomasevic, V. Djordjevic, D. Djordjevic Radojkovic, A. Scafa Udriste, A. Fruntelata, E. Gainoiu, S. Bogdan, D. Zamfir, C. Teodorescu, M. Guran, D. Constantinescu, A. Konopka, M. Banaszewski, I. Wojtkowska, J. Stepinska, J. V. Vidergold, I. V. Osipova, T. V. Tavrovskaya, J. V. Galkina, A. V. Timofeev, R. I. Vorobyov, E. N. Vorobyova, L. Matos, A. C. C. Carvalho, W. Oliveira, F. Cintra, D. Poyares, M. Andersen, R. Martins, S. Tufik, P. Ostadal, J. Brada, S. Horakova, M. Mlcek, V. Hrachovina, O. Kittnar, I. V. Gorudko, I. V. Buko, S. N. Cherenkevich, L. Z. Polonetsky, V. Y. Plotkin, M. A. Timoshina, S. V. Azanchevskaya, N. N. Chromov-Borisov, A. Vorlat, L. Snoep, M. J. Claeys, C. J. Vrints, A. Palazzuoli, M. Caputo, I. Quatrini, A. Calabro, G. Antonelli, M. S. Campagna, B. Franci, R. Nuti, A. Maisel, M. Negrini, T. Minora, P. Marino, R. Seregni, E. Tavlueva, O. Barbarash, L. Barbarash, T. Janota, J. Kudlicka, K. Malik, D. Wichterle, J. Hradec, R. Body, S. D. Carley, G. Mcdowell, M. Nuttall, C. Wibberley, M. France, J. K. Cruickshank, K. Mackway-Jones, M. Leon, C. Cozma, F. Mitu, D. R. Almeida, C. B. Dias, I. Burazor, M. Burazor, M. Krstic, M. Lazovic, M. Vukmanovic, J. Djordjevic, Z. Radovanovic, D. Ilic, P. Bosnjakovic, A. C. Ferreira, P. S. Mateus, P. Fontes, T. Teixeira, G. Conte, A. Menozzi, E. Solinas, M. G. Bolognesi, I. Tadonio, F. Mantovani, A. Cattabiani, L. Vignali, D. Ardissino, O. Tautu, A. Alexandrescu, R. Niculescu, R. Jankovic, N. Bozinovic, C. Santos, F. Costa, G. Cardoso, I. Correia, K. Fountoulaki, S. Kastellanos, E. Voltirakis, A. Kokotos, C. Michalakeas, K. Kontsas, K. Hasioti, E. T. Iliodromitis, M. G. Sandin Fuentes, E. Zatarain Nicolas, N. Martinez Uruena, M. Alvarado Montes De Oca, V. Dytrych, T. Kovarnik, O. Smid, A. Kral, A. G. Aroutunov, S. Intwala, I. Jegere, H. S. H. Shaalan, Z. Pagava, R. Agladze, R. Shakarishvili, N. Sharashidze, L. Gujejiani, G. Saatashvili, T. Z. Katova, V. Kostova, Y. Simova, S. Vukotic, S. Rafajlovski, R. Romanovic, N. Antonijevic, B. Gligic, M. Hutyra, T. Skala, D. Horak, D. Vindis, M. Taborsky, A. Contine, M. Del Pinto, F. Angeli, P. Verdecchia, F. Borgognoni, E. Grikstaite, P. Pantano, G. Ambrosio, C. Cavallini, C. Bonanad, J. Sanchis, V. Bodi, J. Nunez, X. Bosch, M. Heras, M. Pellicer, A. Llacer, L. Adao, M. Oliveira, H. Goncalves, J. Primo, V. Gama, C. Lombardi, M. Metra, S. Bugatti, E. Pasotti, F. Quinzani, M. Adamo, C. Villa, R. Rovetta, A. Manerba, M. Mariani, A. Dushpanova, M. Baroni, E. Cerone, A. Nardelli, J. Gianetti, S. Berti, F. Feliciano, R. Soares, S. Santos, A. Kruger, D. Vondrakova, J. Herget, C. Navarro, N. A. Cromie, J. A. A. Adgey, D. Caeiro Pereira, P. Braga, R. Fontes Carvalho, A. Rodrigues, M. Goncalves, L. Simoes, and K. V. Borisov

Subjects
Cardiology and Cardiovascular Medicine
Published
2010
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163. Near-deterministic activation of room-temperature quantum emitters in hexagonal boron nitride

Author

Nicholas V. Proscia, Zav Shotan, Harishankar Jayakumar, Prithvi Reddy, Charles Cohen, Michael Dollar, Audrius Alkauskas, Marcus Doherty, Carlos A. Meriles, and Vinod M. Menon

Subjects
Materials science, business.industry, Resonance, 02 engineering and technology, Quantum entanglement, 010402 general chemistry, 021001 nanoscience & nanotechnology, 01 natural sciences, Atomic and Molecular Physics, and Optics, 0104 chemical sciences, Electronic, Optical and Magnetic Materials, symbols.namesake, Delocalized electron, Lattice (order), symbols, Optoelectronics, Photonics, van der Waals force, 0210 nano-technology, business, Quantum, Plasmon
Abstract

Cooperative phenomena stemming from radiation-field-mediated coupling between individual quantum emitters are presently attracting broad interest for on-chip photonic quantum memories and long-range entanglement. Common to these applications is the generation of electromagnetic modes over macroscopic distances. Much research, however, is still needed before such systems can be deployed in the form of practical devices, starting with the investigation of alternate physical platforms. Quantum emitters in two-dimensional (2D) systems provide an intriguing route because these materials can be adapted to arbitrarily shaped substrates to form hybrid systems where emitters are near-field-coupled to suitable optical modes. Here, we report a scalable coupling method allowing color center ensembles in a van der Waals material - hexagonal boron nitride - to couple to a delocalized high quality plasmonic surface lattice resonance. This type of architecture is promising for photonic applications, especially given the ability of the hexagonal boron nitride emitters to operate as single-photon sources at room temperature.

Published
2018
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164. Predictors of long-term (4-year) mortality in elderly and young patients with acute heart failure

Author

Basil S. Lewis, Ilan Goldenberg, Alon Barsheshet, Eyal Zimlichman, Solomon Behar, Eytan Cohen, Amir Sandach, Shmuel Gottlieb, Avraham Shotan, Investigators, and Moshe Garty

Subjects
Male, medicine.medical_specialty, Time Factors, Renal function, Kaplan-Meier Estimate, Risk Assessment, Ventricular Function, Left, Diabetes mellitus, Internal medicine, Confidence Intervals, Prevalence, medicine, Humans, Hospital Mortality, Prospective Studies, Registries, Israel, Prospective cohort study, Aged, Aged, 80 and over, Heart Failure, Ejection fraction, business.industry, Age Factors, Stroke Volume, Stroke volume, Middle Aged, medicine.disease, Health Surveys, Surgery, Blood pressure, Heart failure, Multivariate Analysis, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Risk assessment, Glomerular Filtration Rate
Abstract

Aims The present study was designed to identify and compare predictors of short- and long-term mortality in elderly and young patients hospitalized with acute heart failure (HF). Methods and results The risk of in-hospital, 1- and 4-year mortality was assessed among 2336 acute HF patients in a prospective national survey. Interaction-term analysis was utilized to identify and compare independent risk factors between elderly (>75 years [n = 1182]) and younger (≤75 years [n = 1154]) study patients. Elderly patients exhibited a 1.8-fold (P = 0.004), 1.4-fold (P < 0.001), and 1.7-fold (P < 0.001) increase in the adjusted risk of in-hospital, 1-year, and 4-year mortality, respectively, as compared with younger patients. Independent risk factors for 4-year mortality among elderly patients included NYHA functional Class III–IV before admission (HR = 1.46, P < 0.001), systolic blood pressure

Published
2010
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165. Collateral pressure and flow in acute myocardial infarction with total coronary occlusion correlate with angiographic collateral grade and creatine kinase levels

Author

Aaron Frimerman, Simcha R. Meisel, Yoseph Rozenman, Avraham Shotan, David S. Blondheim, Michael Shochat, Jacob Shani, and Aya Asif

Subjects
medicine.medical_specialty, medicine.medical_treatment, Population, Myocardial Infarction, Collateral Circulation, Coronary Angiography, Leukocyte Count, Coronary circulation, Coronary Circulation, Internal medicine, Angioplasty, medicine, Humans, Ventricular Function, Myocardial infarction, education, Creatine Kinase, education.field_of_study, biology, business.industry, Collateral circulation, medicine.disease, Coronary arteries, medicine.anatomical_structure, Coronary Occlusion, Coronary occlusion, biology.protein, Cardiology, Creatine kinase, Cardiology and Cardiovascular Medicine, business
Abstract

The validity of angiographic collateral grade according to the Rentrop classification during acute myocardial infarction (AMI) and its relation to flow in occluded coronary arteries before angioplasty have never been evaluated.We assessed the validity of the angiographic collateral grade according to Rentrop classification in relation to collateral pressure and flow beyond occluded coronary arteries during AMI. Pressure distal to coronary artery occlusions before balloon dilatation was measured in 111 patients undergoing angioplasty for AMI. We calculated the collateral flow index (CFI) and compared it to observed Rentrop grade and measured creatine kinase sum.The values of pressure distal to coronary artery occlusions with respect to collateral grades 0 to 3 were 33 +/- 12, 37 +/- 13, 42 +/- 10, and 60 +/- 14 mm Hg (P.0001). Overall CFI was 0.35 +/- 0.13 (median 0.33), with CFI values of 0.3 +/- 0.13, 0.33 +/- 0.13, 0.39 +/- 0.1, and 0.57 +/- 0.2 for collateral grades 0 to 3, respectively (P.0001). Larger creatine kinase elevation (P.016) and higher white blood cell count (P.022) were recorded in the lowest tertile CFI compared with highest tertile CFI group; but no difference in the global, regional, or infarct-related regional left ventricular contraction was found.These observations demonstrate that the Rentrop classification is valid in AMI patients with occluded coronary arteries and that collaterals are recruited acutely. These collaterals, whose pressure-derived CFI during AMI was shown for the first time to be higher than its value reported in chronic conditions, may limit the immediate myocardial damage or the systemic inflammatory response. No impact on global or regional cardiac contraction was detected in a population where most patients were treated early.

Published
2010
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167. Optical control of room-temperature valley polaritons

Author

Sun, Zheng, primary, Gu, Jie, additional, Ghazaryan, Areg, additional, Shotan, Zav, additional, Considine, Christopher R., additional, Dollar, Michael, additional, Chakraborty, Biswanath, additional, Liu, Xiaoze, additional, Ghaemi, Pouyan, additional, Kéna-Cohen, Stéphane, additional, and Menon, Vinod M., additional

Published
2017
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168. Corrigendum to “Non-Invasive Lung Impedance-Guided Preemptive Treatment in Chronic Heart Failure Patients: A Randomized Controlled Trial (Impedance-HF Trial)”

Author

Shochat, Michael Kleiner, primary, Shotan, Avraham, additional, Blondheim, David S., additional, Kazatsker, Mark, additional, Dahan, Iris, additional, Asif, Aya, additional, Rozenman, Yoseph, additional, Kleiner, Ilia, additional, Weinstein, Jean Marc, additional, Frimerman, Aaron, additional, Vasilenko, Lubov, additional, and Meisel, Simcha R., additional

Published
2017
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169. Pregnancy in women with hypertrophic cardiomyopathy: data from the European Society of Cardiology initiated Registry of Pregnancy and Cardiac disease (ROPAC)

Author

Goland, S., primary, van Hagen, I.M., additional, Elbaz-Greener, G., additional, Elkayam, U., additional, Shotan, A., additional, Merz, W.M., additional, Enar, S.C., additional, Gaisin, I.R., additional, Pieper, P.G., additional, Johnson, M.R., additional, Hall, R., additional, Blatt, A., additional, and Roos-Hesselink, J.W., additional

Published
2017
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170. Corrigendum to ‘Ventricular tachyarrhythmia during pregnancy in women with heart disease: Data from the ROPAC, a registry from the European Society of Cardiology’ [Int. J. Cardiol. 220 (2016) 131–136]

Author

Ertekin, Ebru, primary, van Hagen, Iris M., additional, Salam, Amar M., additional, Ruys, Titia P.E., additional, Johnson, Mark R., additional, Popelova, Jana, additional, Parsonage, William A., additional, Ashour, Zeinab, additional, Shotan, Avraham, additional, Oliver, José M., additional, Veldtman, Gruschen R., additional, Hall, Roger, additional, and Roos-Hesselink, Jolien W., additional

Published
2017
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174. Non-Invasive Lung IMPEDANCE-Guided Preemptive Treatment in Chronic Heart Failure Patients: A Randomized Controlled Trial (IMPEDANCE-HF Trial)

Author

Aaron Frimerman, Simcha R. Meisel, Ilia Kleiner, Mark Kazatsker, Iris Dahan, Lubov Vasilenko, Yoseph Rozenman, Aya Asif, David S. Blondheim, Avraham Shotan, Jean Marc Weinstein, and Michael Shochat

Subjects
Male, medicine.medical_specialty, New York Heart Association Class, Pulmonary Edema, 030204 cardiovascular system & hematology, High-Density Lipoproteins, Pre-beta, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Reference Values, Internal medicine, Confidence Intervals, Electric Impedance, Medicine, Outpatient clinic, Humans, Single-Blind Method, 030212 general & internal medicine, Diuretics, Survival analysis, Aged, Heart Failure, Ejection fraction, business.industry, Stroke Volume, Stroke volume, Middle Aged, medicine.disease, Prognosis, Survival Analysis, Confidence interval, Respiratory Function Tests, Hospitalization, Treatment Outcome, Heart failure, Chronic Disease, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Previous investigations have suggested that lung impedance (LI)-guided treatment reduces hospitalizations for acute heart failure (AHF). A single-blind 2-center trial was performed to evaluate this hypothesis (ClinicalTrials.gov-NCT01315223).The study population included 256 patients from 2 medical centers with chronic heart failure and left ventricular ejection fraction ≤35% in New York Heart Association class II-IV, who were admitted for AHF within 12 months before recruitment. Patients were randomized to a control group treated by clinical assessment and a monitored group whose therapy was also assisted by LI, and followed for at least 12 months. Noninvasive LI measurements were performed with a new high-sensitivity device. Patients, blinded to their assignment group, were scheduled for monthly visits in the outpatient clinics. The primary efficacy endpoint was AHF hospitalizations; the secondary endpoints were all-cause hospitalizations and mortality.There were 67 vs 158 AHF hospitalizations during the first year (P .001) and 211 vs 386 AHF hospitalizations (P .001) during the entire follow-up among the monitored patients (48 ± 32 months) and control patients (39 ± 26 months, P = .01), respectively. During the follow-up, there were 42 and 59 deaths (hazard ratio 0.52, 95% confidence interval 0.35-0.78, P = .002) with 13 and 31 of them resulting from heart failure (hazard ratio 0.30, 95% confidence interval 0.15-0.58 P .001) in the monitored and control groups, respectively. The incidence of noncardiovascular death was similar.Our results seem to validate the concept that LI-guided preemptive treatment of chronic heart failure patients reduces hospitalizations for AHF as well as the incidence of heart failure, cardiovascular, and all-cause mortality.

Published
2015

176. Shortness of Breath During Pregnancy: Could a Cardiac Factor Be Involved?

Author

Sorel, Goland, Sharon, Perelman, Nardin, Asalih, Sara, Shimoni, Osnat, Walfish, Mordechai, Hallak, Zion, Hagay, Jacob, George, Avraham, Shotan, and David S, Blondheim

Subjects
Adult, Echocardiography, Doppler, Pulsed, Systole, Pregnancy Complications, Cardiovascular, Hemodynamics, Clinical Investigations, Stroke Volume, Ventricular Function, Left, Ventricular Dysfunction, Left, Dyspnea, Diastole, Pregnancy, Risk Factors, Case-Control Studies, Humans, Female, Prospective Studies, Israel
Abstract

BACKGROUND: Shortness of breath (SOB) is common among healthy women with normal pregnancies. However, when no overt cardiac or extra cardiac etiology is found, a subtle cardiac source must be excluded. HYPOTHESIS: Pregnancy may induce or unmask myocardial dysfunction that may cause SOB. METHODS: Healthy pregnant women with significant SOB were recruited for this study. We performed a comprehensive echocardiographic assessment including tissue Doppler imaging (TDI) and 2‐ dimensional strain imaging (2DS). The echocardiographic data obtained were compared with that of a control group of pregnant women without SOB. RESULTS: Thirty pregnant women with SOB were enrolled in the study (age, 31.8 ± 4.9 years, and gestation, 38.2 ± 2.8 weeks) for whom no overt etiology for SOB was detected. Patients with SOB compared with controls had thicker hearts (septum: 10.1 ± 1.1 vs 8.9 ± 0.9 mm; P

Published
2015

177. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12 440 patients of the ESC Heart Failure Long-Term Registry

Author

Maggioni, Aldo P, Anker, Stefan D., Dahlström, Ulf, Filippatos, Gerasimos, Ponikowski, Piotr, Zannad, Faiez, Amir, Offer, Chioncel, Ovidiu, Leiro, Marisa Crespo, Drozdz, Jaroslaw, Erglis, Andrejs, Fazlibegovic, Emir, Fonseca, Candida, Fruhwald, Friedrich, Gatzov, Plamen, Goncalvesova, Eva, Hassanein, Mahmoud, Hradec, Jaromir, Kavoliuniene, Ausra, Lainscak, Mitja, Logeart, Damien, Merkely, Bela, Metra, Marco, Persson, Hans, Seferovic, Petar, Temizhan, Ahmet, Tousoulis, Dimitris, Tavazzi, Luigi, Andarala, M., Fiorucci, E., Folkesson, E., Glemot, M., Gracia, G., Konte, M., Laroche, C., Mcneill, P. a., Missiamenou, V., Taylor, C., Fruhwald, F., Eberl, Alexander, Heller, S., Dolze, T., Platzer, V., Ablasser, K., Auer, J., Poelzl, G., Moertl, D., Podczeck Schweighofer, A., Reiter, S., Pravdic, D., Fazlibegovic, E., Muslibegovic, A., Vitlianova, K., Katova, T., Kotirkov, K., Petrov, I., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Tisheva, S., Sirakova, V., Krejci, J., Spinar, J., Mikolaskova, M., Krupicka, J., Malek, F., Hegarova, M., Pudil, R., Monhart, Z., Lazarova, M., Reda, A., Khairy, T., Farag, N., Saleh, A., Said, K., Abdel Hamid, M., Halawa, S., Ibrahim, B., Hanna, R., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Aboleineen, W., Gouda, M., Youssef, A., Elbahry, A., Abdel, A., Ebeid, H., Nasr, G., Sobhy, H., Ashmawy, M., Lefol, C., Isnard, R., Hagege, A., Thevenin, S., Jondeau, G., Logeart, D., Codjia, R., Galinier, M., Bauer, F., Delahaye, F., Lamblin, N., Fertin, M., De Groote, P., Coisne, D., Le Marcis, V., Lequeux, B., J. F., Ly, Lotton, P., Donal, E., Le Moal, V., Basquin, A., Reynaud, A., Ridard, C., Thebault, C., Behar, N., Mascle, S., Schiele, F., Seronde, M. F., Morel, M., Meneveau, N., Luporsi, P., Bernard, Y., Pillot, M., Briand, F., Damy, T., Eicher, J. C., Avgeropoulou, C., Panagiotis, T., Tousoulis, D., Kotrogiannis, I., Stefanadis, C., Chrysohoou, C., Tsitsinakis, G., Dimitroula, T., Karavidas, A., Matzaraki, V., Terrovitis, J., Kapelios, C., Sfakianaki, T., Filippatos, G., Parissis, J. T., Ntai, K., Papadopoulou, A., Tziourganou, H., Douras, A., Ntertsas, K., Karotsaki, T., Nikoloulis, N., Tsaknakis, T., Patrianakos, A., Nyktari, E., Vardas, P., Soos, P., Nyolczas, N., Csaba Nagy, A., Halmosi, R., Nemeth, F., Amon, G., Dinnyes, J., Vazan Fuhrmann, A., Shotan, A., Alony, I., Elber, J., Olaru, A., Valenti, C., Reggianini, L., Modena, M. G., Copelli, S., Leuzzi, Concetta, Dei Cas, L., Carubelli, V., Lombardi, Cecilia, Bulgari, M., Tanghetti, E., Quinzani, F., Metra, M., Rovetta, R., Brasolin, B., Fedele, F., Sergi, Daniela, Romeo, F., Scarfò, I., Vellini, M., Fabris, E., Cinquetti, Martino, Stolfo, Davide, Sinagra, Gianfranco, Merlo, Marco, Fucili, A., Ferrari, R., Vassanelli, C., Torelli, F., Marchese, G., Zanolla, L., Cicoira, M., Anselmi, Manuel, Piccinino, C., Sartori, C., Di Ruocco, M. V., Marino, P. N., Giordano, A., Brognoli, S., Zanelli, E., Cosmi, F., Cadeddu, C., Bandino, S., Mercuro, G., Deidda, M., Salvemini, G., Correale, M., Di Biase, M., Musio, S., Passero, T., Italiano, Graziella, Agostoni, P., Salvioni, E., Schiavina, G., Squeri, CARLO ATTILIO, Bosi, S., Barbieri, A., Lemme, E., Penco, M., Marcon, S., Romano, S., Di Mauro, M., Frisinghelli, A., Veniani, M., Pieri, Pietro, Novo, S., Proclemer, Alessandro, Fresco, C., Miani, Daniela, Artico, Jessica, Gaita, F., Bergerone, S., Pirelli, SALVATORE DONATO, Di Tano, G., Cattaneo, Silvana, Gualco, A., Opasich, C., Priori, S. G., Iori, Elisa, Leci, E., Melandri, F., Voronina, N., Erglis, A., Kalnins, A., Kavoliuniene, A., Rumbinaite, E., Kazakauskaite, E., Petraskiene, I., Karaliute, R., Smalinskas, V., Tamakauskas, V., Petraskiene, D., Brazyte Ramanauskiene, R., Vysniauskas, V., Nowicka, A., Grabia, J., Dankowski, R., Szyszka, A., Szymanowska, K., Straburzynska Migaj, E., Kaluzna Oleksy, M., Grajek, S., Kasztelowicz, P., Orzel, T., Bednarczyk, G., Ruszkowski, P., Klimkiewicz, J., Majzner, A., Matusiak, A., Bylicka, E., Kwiatkowska, E., Kwiatkowska, K., Ochnio, M., Krzyzewska, T., Tarnowska, A., Komuda, K., Sobieszczanska Malek, M., Leszek, P., Rywik, T., Wisniewska, J., Kozar Kaminska, K., Piotrowska, M., Zielinski, T., Mamcarz, A., Welnicki, M., Folga, A., Kaplon Cieslicka, A., Opolski, G., Marchel, M., Balsam, P., Michalek, A., Pawlak, A., Byczkowska, K., Mozenska, O., Gil, K., Gil, R. J., Skrobowski, A., Uzieblo Zyczkowska, B., Piotrowicz, K., Krzesinski, P., Stanczyk, A., Ciurzynski, M., Bienias, P., Pruszczyk, P., Juszczyk, Z., Switala, P., Stankala, S., Polonski, L., Rozentryt, P., Gabryel, J., Lazorko Piega, M., Kardaszewicz, P., Poprawa, I., Komorowska, E., Lauko Rachocka, A., Abdulkarim, A. F., Dudzik Plocica, A., Zolbach, A., Sajnaga, D., Komorowska, K., Baczynska, K., Samcik, M., Wolniewicz, L., Wozakowska Kaplon, B., Sosnowska Pasiarska, B., Bartkowiak, R., Fiega, A., Serwicka, A., Szymczyk, A., Fitas, G., Zysko, D., Poliwczak, A., Broncel, M., Bala, A., Kasprzak, J. D., Jankowski, L., Rudzinska, M., Zycinski, P., Retwinski, A., Pietka, I., Drozdz, J., Wojtczak Soska, K., Jankowska, E., Ponikowski, P., Cichy, A., Kostka, A., Kaminski, L., Weglarz, J., Bodys, A., Flis, P., Kleinrok, A., Prokop Lewicka, G., Mosakowska, K., Rynkiewicz, A., Bellwon, J., Dabrowska Kugacka, A., Lewicka, E., Raczak, G., Skorek, E., Szabowski, S., Krysiak, W., Pietrzak, J., Gilewski, W., Sinkiewicz, W., Furman, A., Zalewski, J., Nessler, J., Bury, K., Grzegorzko, A., Zabojszcz, M., Mirek Bryniarska, E., Klys, J., Przybylska, K., Szulik, M., Kalarus, Z., Kuczaj, A., Nowalany Kozielska, E., Krzeminski, A., Ventosa, A., Tavares Aguiar, C., Moura, B., Cardoso, J. S., De Jesus, I., Chin, J., Faria, R., Pereira, S., Lima, Giuseppe, Oliveira Guimarães, T., Francisco, A. R., Brito, D., Placido, R., Martins, S., Fonseca, C., Marques, F., Araujo, I., Proenca, M., Cardiga, R., Andrade, A., Castro, Alessandra, Pereira, A., Queirós, C., Silva, P., Santos, R., Lourenço, C., Moreno, N., Almeida, F., Quelhas, I., Baptista, A., Ferreira, A., Magalhaes, P., Ferreira, Clara, Moreira, I., Durao, D., Severino, D., Ferreira Da Silva, G., Marta, L., Peres, Martina, Stanescu, C., Dan, A., Dan, G. A., Daha, I., Popescu, R., Vinereanu, D., Sinescu, C. J., Macarie, C., Radoi, M., Nechita, E., Christodorescu, R., Datcu, M., Craiu, E., Otasevic, P., Ristic, A. D., Simeunovic, D., Seferovic, P., Pencic, B., Andric, A., Stojcevski, B., Lebedinski, E., Suzic Lazic, J., Celic, V., Krotin, M., Radovanovic, Slavena, Iric Cupic, V., Milanov, S., Davidovic, G., Jovic, Masa, Radin, A., Mihajlovic, B., Stojiljkovic, J., Cankovic, M., Cemerlic Adic, N., Dodic, Sara, Kecojevic, S., Stojsic, S., Petrovic, D., Deljanin Ilic, M., Ilić, Saša, Stoickov, V., Antic, S., Stanojevic, D., Pavlovic, M., Atanaskovic, V., Mitic, Vanja, Kovar, F., Goncalvesova, E., Murin, J., Pernicky, M., Klabnik, A., Kmec, J., Rajtman, D., Kovac, D., Horvat, Sara, Krunic, B., Bombek, M., Krajnc, I., Losic, R., Glavic, T., Komel, Janja, Cernic Suligoj, N., Ravnikar, T., Letonja, M., Cencic, Vanja, Savnik Iskra, M., Strasek, M., Leskovar, B., Drnovsek, B., Klen, J., Marolt, A., Kladnik, M., Slemenik Pusnik, C., Pusnik Vrckovnik, M., Jug, Barbara, Fras, Z., Bartolic, Andrej, Melihen Bartolic, C., Valentincic, M., Winkler, R., Blanco Canosa, P., Grille Cancela, Z., Crespo Leiro, M., Paniagua Martin, M. J., Marzoa Rivas, R., Barge Caballero, E., Torres Calvo, F., Bravo Marques, R., Epelde Gonzalo, F., Recio Platero, A., De La Fuente Galan, L., Lopez Diaz, J., Goncalvez Ramirez, L. Renier, Cubero Gallego, H., Sliwiski Herrera, J. F., Bierge Valero, D., Salmeron, F. M., Gallego Page, J. C., Jose Fernandez, M., Sahuquillo, A., Garcia De La Villa, B., Castro Conde, A., Iniesta Manjavacas, A. M., Salvador Montanes, O., Gonzalez Gallarza, R. Dalmau, Ofelia Rosillo, S., Araujo, A., Briceno, A., Alonso Pulpon, L., Cobo, M., Soria, T., Gomez Bueno, M., Garcia Pavia, P., Gonzalez Segovia, A., Sayago, I., Segovia Cubero, J., Delgado Jiménez, J. F., Angel Gomez Sanchez, M., Escribano Subias, P., Barrios Garrido Lestache, E., Ruiz Cano, M. J., Vicente Hernandez, M., Puga Martinez, M., Lopez Moreno, E., Serrano Martinez, J. L., Fernandez Alvarez, M., Rivera Lopez, R., Lopez Fernandez, S., Alcade Martinez, V., Sanmartin, M., Pellicer Cabo, A., Garcia Escriva, D., Ridocci Soriano, F., Perez Silvestre, J., Facila Rubio, L., Garcia Gonzalez, P., Sanchez Lazaro, I. J., Almenar Bonet, L., Garcia Pinilla, J. M., Andres, Ulrike Julia, Bayes Genis, A., Roig, E., Mirabet, S., Mendez, A., Garcia Cosio, L., Garay, A., Muntane, G., Gonzalez Costello, J., Leon, V., Diaz Molina, B., Famara Hernandez, I., Lara Padron, A., Laynez Cerdena, I., Mateo, I., Quiles, J., Bertomeu, V., Elamrani, A., Angel Rodrigez Ortega, J., Martinez Abellan, R., Valero, R., Fernandez Vivancos, C., Sanz Julve, M., Perez Martinez, M. T., Pascual Figal, D. A., Martinez Martinez Espejo, M. D., Rosario Gracia Rodenas, M., Pastor Perez, F., Melin, M., Hägglund, E., Stenberg, A., Lindahl, I. M., Asserlund, B., Olsson, L., Dahlström, U., Afzelius, M., Karlström, P., Tengvall, L., Wiklund, P. A., Olsson, B., Temizhan, A., Kalayci, S., Bozkurt, M., Taraktas, M., Cavusoglu, Y., Gunes, H., Birhan Yilmaz, M., Demir, B., Gencer, E., Maggioni, Aldo P, Anker, Stefan D., Dahlström, Ulf, Filippatos, Gerasimo, Ponikowski, Piotr, Zannad, Faiez, Amir, Offer, Chioncel, Ovidiu, Leiro, Marisa Crespo, Drozdz, Jaroslaw, Erglis, Andrej, Fazlibegovic, Emir, Fonseca, Candida, Fruhwald, Friedrich, Gatzov, Plamen, Goncalvesova, Eva, Hassanein, Mahmoud, Hradec, Jaromir, Kavoliuniene, Ausra, Lainscak, Mitja, Logeart, Damien, Merkely, Bela, Metra, Marco, Persson, Han, Seferovic, Petar, Temizhan, Ahmet, Tousoulis, Dimitri, Tavazzi, Luigi, Andarala, M., Fiorucci, E., Folkesson, E., Glemot, M., Gracia, G., Konte, M., Laroche, C., Mcneill, P. a., Missiamenou, V., Taylor, C., Fruhwald, F., Eberl, Alexander, Heller, S., Dolze, T., Platzer, V., Ablasser, K., Auer, J., Poelzl, G., Moertl, D., Podczeck Schweighofer, A., Reiter, S., Pravdic, D., Fazlibegovic, E., Muslibegovic, A., Vitlianova, K., Katova, T., Kotirkov, K., Petrov, I., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Tisheva, S., Sirakova, V., Krejci, J., Spinar, J., Mikolaskova, M., Krupicka, J., Malek, F., Hegarova, M., Pudil, R., Monhart, Z., Lazarova, M., Reda, A., Khairy, T., Farag, N., Saleh, A., Said, K., Abdel Hamid, M., Halawa, S., Ibrahim, B., Hanna, R., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Aboleineen, W., Gouda, M., Youssef, A., Elbahry, A., Abdel, A., Ebeid, H., Nasr, G., Sobhy, H., Ashmawy, M., Lefol, C., Isnard, R., Hagege, A., Thevenin, S., Jondeau, G., Logeart, D., Codjia, R., Galinier, M., Bauer, F., Delahaye, F., Lamblin, N., Fertin, M., De Groote, P., Coisne, D., Le Marcis, V., Lequeux, B., Ly, J. F., Lotton, P., Donal, E., Le Moal, V., Basquin, A., Reynaud, A., Ridard, C., Thebault, C., Behar, N., Mascle, S., Schiele, F., Seronde, M. F., Morel, M., Meneveau, N., Luporsi, P., Bernard, Y., Pillot, M., Briand, F., Damy, T., Eicher, J. C., Avgeropoulou, C., Panagiotis, T., Tousoulis, D., Kotrogiannis, I., Stefanadis, C., Chrysohoou, C., Tsitsinakis, G., Dimitroula, T., Karavidas, A., Matzaraki, V., Terrovitis, J., Kapelios, C., Sfakianaki, T., Filippatos, G., Parissis, J. T., Ntai, K., Papadopoulou, A., Tziourganou, H., Douras, A., Ntertsas, K., Karotsaki, T., Nikoloulis, N., Tsaknakis, T., Patrianakos, A., Nyktari, E., Vardas, P., Soos, P., Nyolczas, N., Csaba Nagy, A., Halmosi, R., Nemeth, F., Amon, G., Dinnyes, J., Vazan Fuhrmann, A., Shotan, A., Alony, I., Elber, J., Olaru, A., Valenti, C., Reggianini, L., Modena, M. G., Copelli, S., Leuzzi, Concetta, Dei Cas, L., Carubelli, V., Lombardi, Cecilia, Bulgari, M., Tanghetti, E., Quinzani, F., Metra, M., Rovetta, R., Brasolin, B., Fedele, F., Sergi, Daniela, Romeo, F., Scarfò, I., Vellini, M., Fabris, E., Cinquetti, Martino, Stolfo, Davide, Sinagra, Gianfranco, Merlo, Marco, Fucili, A., Ferrari, R., Vassanelli, C., Torelli, F., Marchese, G., Zanolla, L., Cicoira, M., Anselmi, Manuel, Piccinino, C., Sartori, C., Di Ruocco, M. V., Marino, P. N., Giordano, A., Brognoli, S., Zanelli, E., Cosmi, F., Cadeddu, C., Bandino, S., Mercuro, G., Deidda, M., Salvemini, G., Correale, M., Di Biase, M., Musio, S., Passero, T., Italiano, Graziella, Agostoni, P., Salvioni, E., Schiavina, G., Squeri, CARLO ATTILIO, Bosi, S., Barbieri, A., Lemme, E., Penco, M., Marcon, S., Romano, S., Di Mauro, M., Frisinghelli, A., Veniani, M., Pieri, Pietro, Novo, S., Proclemer, Alessandro, Fresco, C., Miani, Daniela, Artico, Jessica, Gaita, F., Bergerone, S., Pirelli, SALVATORE DONATO, Di Tano, G., Cattaneo, Silvana, Gualco, A., Opasich, C., Priori, S. G., Iori, Elisa, Leci, E., Melandri, F., Voronina, N., Erglis, A., Kalnins, A., Kavoliuniene, A., Rumbinaite, E., Kazakauskaite, E., Petraskiene, I., Karaliute, R., Smalinskas, V., Tamakauskas, V., Petraskiene, D., Brazyte Ramanauskiene, R., Vysniauskas, V., Nowicka, A., Grabia, J., Dankowski, R., Szyszka, A., Szymanowska, K., Straburzynska Migaj, E., Kaluzna Oleksy, M., Grajek, S., Kasztelowicz, P., Orzel, T., Bednarczyk, G., Ruszkowski, P., Klimkiewicz, J., Majzner, A., Matusiak, A., Bylicka, E., Kwiatkowska, E., Kwiatkowska, K., Ochnio, M., Krzyzewska, T., Tarnowska, A., Komuda, K., Sobieszczanska Malek, M., Leszek, P., Rywik, T., Wisniewska, J., Kozar Kaminska, K., Piotrowska, M., Zielinski, T., Mamcarz, A., Welnicki, M., Folga, A., Kaplon Cieslicka, A., Opolski, G., Marchel, M., Balsam, P., Michalek, A., Pawlak, A., Byczkowska, K., Mozenska, O., Gil, K., Gil, R. J., Skrobowski, A., Uzieblo Zyczkowska, B., Piotrowicz, K., Krzesinski, P., Stanczyk, A., Ciurzynski, M., Bienias, P., Pruszczyk, P., Juszczyk, Z., Switala, P., Stankala, S., Polonski, L., Rozentryt, P., Gabryel, J., Lazorko Piega, M., Kardaszewicz, P., Poprawa, I., Komorowska, E., Lauko Rachocka, A., Abdulkarim, A. F., Dudzik Plocica, A., Zolbach, A., Sajnaga, D., Komorowska, K., Baczynska, K., Samcik, M., Wolniewicz, L., Wozakowska Kaplon, B., Sosnowska Pasiarska, B., Bartkowiak, R., Fiega, A., Serwicka, A., Szymczyk, A., Fitas, G., Zysko, D., Poliwczak, A., Broncel, M., Bala, A., Kasprzak, J. D., Jankowski, L., Rudzinska, M., Zycinski, P., Retwinski, A., Pietka, I., Drozdz, J., Wojtczak Soska, K., Jankowska, E., Ponikowski, P., Cichy, A., Kostka, A., Kaminski, L., Weglarz, J., Bodys, A., Flis, P., Kleinrok, A., Prokop Lewicka, G., Mosakowska, K., Rynkiewicz, A., Bellwon, J., Dabrowska Kugacka, A., Lewicka, E., Raczak, G., Skorek, E., Szabowski, S., Krysiak, W., Pietrzak, J., Gilewski, W., Sinkiewicz, W., Furman, A., Zalewski, J., Nessler, J., Bury, K., Grzegorzko, A., Zabojszcz, M., Mirek Bryniarska, E., Klys, J., Przybylska, K., Szulik, M., Kalarus, Z., Kuczaj, A., Nowalany Kozielska, E., Krzeminski, A., Ventosa, A., Tavares Aguiar, C., Moura, B., Cardoso, J. S., De Jesus, I., Chin, J., Faria, R., Pereira, S., Lima, Giuseppe, Oliveira Guimarães, T., Francisco, A. R., Brito, D., Placido, R., Martins, S., Fonseca, C., Marques, F., Araujo, I., Proenca, M., Cardiga, R., Andrade, A., Castro, Alessandra, Pereira, A., Queirós, C., Silva, P., Santos, R., Lourenço, C., Moreno, N., Almeida, F., Quelhas, I., Baptista, A., Ferreira, A., Magalhaes, P., Ferreira, Clara, Moreira, I., Durao, D., Severino, D., Ferreira Da Silva, G., Marta, L., Peres, Martina, Stanescu, C., Dan, A., Dan, G. A., Daha, I., Popescu, R., Vinereanu, D., Sinescu, C. J., Macarie, C., Radoi, M., Nechita, E., Christodorescu, R., Datcu, M., Craiu, E., Otasevic, P., Ristic, A. D., Simeunovic, D., Seferovic, P., Pencic, B., Andric, A., Stojcevski, B., Lebedinski, E., Suzic Lazic, J., Celic, V., Krotin, M., Radovanovic, Slavena, Iric Cupic, V., Milanov, S., Davidovic, G., Jovic, Masa, Radin, A., Mihajlovic, B., Stojiljkovic, J., Cankovic, M., Cemerlic Adic, N., Dodic, Sara, Kecojevic, S., Stojsic, S., Petrovic, D., Deljanin Ilic, M., Ilić, Saša, Stoickov, V., Antic, S., Stanojevic, D., Pavlovic, M., Atanaskovic, V., Mitic, Vanja, Kovar, F., Goncalvesova, E., Murin, J., Pernicky, M., Klabnik, A., Kmec, J., Rajtman, D., Kovac, D., Horvat, Sara, Krunic, B., Bombek, M., Krajnc, I., Losic, R., Glavic, T., Komel, Janja, Cernic Suligoj, N., Ravnikar, T., Letonja, M., Cencic, Vanja, Savnik Iskra, M., Strasek, M., Leskovar, B., Drnovsek, B., Klen, J., Marolt, A., Kladnik, M., Slemenik Pusnik, C., Pusnik Vrckovnik, M., Jug, Barbara, Fras, Z., Bartolic, Andrej, Melihen Bartolic, C., Valentincic, M., Winkler, R., Blanco Canosa, P., Grille Cancela, Z., Crespo Leiro, M., Paniagua Martin, M. J., Marzoa Rivas, R., Barge Caballero, E., Torres Calvo, F., Bravo Marques, R., Epelde Gonzalo, F., Recio Platero, A., De La Fuente Galan, L., Lopez Diaz, J., Goncalvez Ramirez, L. Renier, Cubero Gallego, H., Sliwiski Herrera, J. F., Bierge Valero, D., Salmeron, F. M., Gallego Page, J. C., Jose Fernandez, M., Sahuquillo, A., Garcia De La Villa, B., Castro Conde, A., Iniesta Manjavacas, A. M., Salvador Montanes, O., Gonzalez Gallarza, R. Dalmau, Ofelia Rosillo, S., Araujo, A., Briceno, A., Alonso Pulpon, L., Cobo, M., Soria, T., Gomez Bueno, M., Garcia Pavia, P., Gonzalez Segovia, A., Sayago, I., Segovia Cubero, J., Delgado Jiménez, J. F., Angel Gomez Sanchez, M., Escribano Subias, P., Barrios Garrido Lestache, E., Ruiz Cano, M. J., Vicente Hernandez, M., Puga Martinez, M., Lopez Moreno, E., Serrano Martinez, J. L., Fernandez Alvarez, M., Rivera Lopez, R., Lopez Fernandez, S., Alcade Martinez, V., Sanmartin, M., Pellicer Cabo, A., Garcia Escriva, D., Ridocci Soriano, F., Perez Silvestre, J., Facila Rubio, L., Garcia Gonzalez, P., Sanchez Lazaro, I. J., Almenar Bonet, L., Garcia Pinilla, J. M., Andres, Ulrike Julia, Bayes Genis, A., Roig, E., Mirabet, S., Mendez, A., Garcia Cosio, L., Garay, A., Muntane, G., Gonzalez Costello, J., Leon, V., Diaz Molina, B., Famara Hernandez, I., Lara Padron, A., Laynez Cerdena, I., Mateo, I., Quiles, J., Bertomeu, V., Elamrani, A., Angel Rodrigez Ortega, J., Martinez Abellan, R., Valero, R., Fernandez Vivancos, C., Sanz Julve, M., Perez Martinez, M. T., Pascual Figal, D. A., Martinez Martinez Espejo, M. D., Rosario Gracia Rodenas, M., Pastor Perez, F., Melin, M., Hägglund, E., Stenberg, A., Lindahl, I. M., Asserlund, B., Olsson, L., Dahlström, U., Afzelius, M., Karlström, P., Tengvall, L., Wiklund, P. A., Olsson, B., Temizhan, A., Kalayci, S., Bozkurt, M., Taraktas, M., Cavusoglu, Y., Gunes, H., Birhan Yilmaz, M., Demir, B., and Gencer, E.

Subjects
Registrie, Male, ACE inhibitors, Angiotensin-Converting Enzyme Inhibitors, Nitrate, Beta-blockers, Ambulatory Care, Medicine, Registries, Diuretics, Mineralocorticoid Receptor Antagonists, Angiotensin Receptor Antagonist, Middle Aged, Defibrillators, Implantable, Clinical Practice, Europe, Hospitalization, Ambulatory, MRAs, Practice Guidelines as Topic, MRA, Cardiology, CRT, Female, Guideline Adherence, Implantable, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Cardiotonic Agents, cardiology and cardiovascular mediciney, Mineralocorticoid Antagonists, Adrenergic beta-Antagonists, Heart failure, ICD, Aged, Angiotensin Receptor Antagonists, Heart Failure, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Nitrates, Platelet Aggregation Inhibitors, Drug treatment, ACE inhibitor, Internal medicine, Diuretic, Cardiotonic Agent, In patient, Beta-blocker, Mineralocorticoid Receptor Antagonist, business.industry, Platelet Aggregation Inhibitor, beta-blockers, heart failure, adrenergic beta-antagonists, aged, ambulatory care, angiotensin receptor antagonists, angiotensin-converting enzyme inhibitors, cardiology, cardiotonic agents, defibrillators, implantable, diuretics, europe, female, guideline adherence, hospitalization, humans, hydroxymethylglutaryl-coa reductase inhibitors, male, middle aged, mineralocorticoid receptor antagonists, nitrates, platelet aggregation inhibitors, practice guidelines as topic, registries, Adrenergic beta-Antagonist, Angiotensin-Converting Enzyme Inhibitor, Guideline, medicine.disease, Observational study, Hydroxymethylglutaryl-CoA Reductase Inhibitor, business, Defibrillators
Abstract

AimsTo evaluate how recommendations of European guidelines regarding pharmacological and non-pharmacological treatments for heart failure (HF) are adopted in clinical practice.Methods and resultsThe ESC-HF Long-Term Registry is a prospective, observational study conducted in 211 Cardiology Centres of 21 European and Mediterranean countries, members of the European Society of Cardiology (ESC). From May 2011 to April 2013, a total of 12 440 patients were enrolled, 40.5% with acute HF and 59.5% with chronic HF. Intravenous treatments for acute HF were heterogeneously administered, irrespective of guideline recommendations. In chronic HF, with reduced EF, renin-angiotensin system (RAS) blockers, beta-blockers, and mineralocorticoid antagonists (MRAs) were used in 92.2, 92.7, and 67.0% of patients, respectively. When reasons for non-adherence were considered, the real rate of undertreatment accounted for 3.2, 2.3, and 5.4% of the cases, respectively. About 30% of patients received the target dosage of these drugs, but a documented reason for not achieving the target dosage was reported in almost two-thirds of them. The more relevant reasons for non-implantation of a device, when clinically indicated, were related to doctor uncertainties on the indication, patient refusal, or logistical/cost issues.ConclusionThis pan-European registry shows that, while in patients with acute HF, a large heterogeneity of treatments exists, drug treatment of chronic HF can be considered largely adherent to recommendations of current guidelines, when the reasons for non-adherence are taken into account. Observations regarding the real possibility to adhere fully to current guidelines in daily clinical practice should be seriously considered when clinical practice guidelines have to be written. © 2013 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2013. For permissions please email: journals.permissions@oup.com

Published
2013

178. Thrombolysis-facilitated primary percutaneous coronary intervention as a therapeutic approach to stent thrombosis

Author

Lubov Vasilenko, Aya Asif, Avraham Shotan, Mark Kazatsker, Yaniv Levi, Aaron Frimerman, Simcha R. Meisel, Michael Shochat, and David S. Blondheim

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Myocardial Infarction, Coronary Disease, Coronary Angiography, Therapeutic approach, Electrocardiography, Percutaneous Coronary Intervention, Internal medicine, Coronary Circulation, medicine, Humans, cardiovascular diseases, Aged, medicine.diagnostic_test, business.industry, Percutaneous coronary intervention, Thrombosis, General Medicine, Thrombolysis, Middle Aged, Coronary arteries, surgical procedures, operative, medicine.anatomical_structure, Treatment Outcome, Conventional PCI, Angiography, Cardiology, Female, Stents, Cardiology and Cardiovascular Medicine, business, TIMI, Artery
Abstract

Stent thrombosis is a clinically significant event occurring days to weeks or, infrequently, months or years after percutaneous coronary intervention (PCI). Current therapeutic approach is immediate PCI aimed to recanalize the occluded artery in order to restore flow and diminish irreversible myocardial damage.We evaluated the coronary patency, TIMI flow and TIMI myocardial perfusion grade (TMPG) in 6 patients presenting with STEMI due to stent thrombosis treated by thrombolysis followed by immediate PCI. These were compared with control patients treated conventionally by primary PCI.Immediate or early coronary angiography in the treatment group showed good coronary flow in 5 of 6 implicated arteries, whereas immediate angiography in the control group demonstrated 8 completely occluded coronary arteries of 9 with stent thrombosis. The pre-intervention TIMI flow in the control study group was 0.2±0.5 (median-0), and TMPG was 0.1±0.3 (median-0) compared with 2.1±1.1 (median-2.3, p0.001) and 1.8±1.0 (median-2, p0.001) in the treatment group, respectively. This striking difference in the rate of coronary patency, pre-procedural TIMI flow and TMPG, however, did not translate into better cardiac function in the treatment group.These findings suggest that thrombolysis-facilitated PCI may confer benefit and need not be considered contraindicated when treating stent thrombosis. This therapeutic approach should be evaluated as a viable therapeutic approach to stent thrombosis.

Published
2015

179. Aortic dimensions by multi-detector computed tomography vs. echocardiography

Author

Michael Shochat, Aya Asif, Yair Glick, Avraham Shotan, Simcha R. Meisel, Abdel-Rauf Zeina, David S. Blondheim, Lubov Vassilenko, and Alicia Nachtigal

Subjects
Aortic arch, Male, medicine.medical_specialty, Computed tomography, 030204 cardiovascular system & hematology, Aortography, 03 medical and health sciences, 0302 clinical medicine, medicine.artery, Ascending aorta, Multidetector Computed Tomography, medicine, Humans, Body Weights and Measures, Cardiac skeleton, Aorta, Aged, medicine.diagnostic_test, business.industry, Multi detector computed tomography, Echo (computing), Reproducibility of Results, Aortic Valve Stenosis, Middle Aged, 030228 respiratory system, Echocardiography, Aortic Valve, cardiovascular system, Female, Aortic diameter, Radiology, Cardiology and Cardiovascular Medicine, business
Abstract

Objective Clinical follow-up of aortic dimensions is performed interchangeably by multi-detector computed tomography (MDCT) and by cardiac echocardiography (ECHO). This study assesses the relationship between measurements of the aortic diameter by MDCT and ECHO at various predetermined locations using several methods. Methods The aortic diameter was measured at 6 locations between the aortic annulus and the aortic arch in 49 patients who underwent both MDCT and ECHO. Measurements were performed by three methods: internal-to-internal edge (INT), external-to-internal edge (MIX), and external-to-external edge (EXT). Measurements by MDCT and ECHO were made by an experienced radiologist and cardiologist, respectively, both blinded to results and images from the other modality. Results The average aortic diameter at all locations was significantly different between the MDCT and ECHO by all three methods (INT: 30.0 ± 5.8 mm vs. 27.8 ± 5.9 mm; MIX: 31.5 ± 5.8 mm vs. 30.8 ± 5.8 mm; EXT: 32.9 ± 6.6 mm vs. 33.8 ± 6.5 mm, p

Published
2015

180. Internal thoracic impedance monitoring: a novel method for the preclinical detection of acute heart failure

Author

Aaron Frimerman, Simcha R. Meisel, Avraham Shotan, Gideon Charach, Shmuel Meyler, Paul Rabinovich, Mark Kazatzker, Morris Mosseri, and Michael Shochat

Subjects
Adult, Male, medicine.medical_specialty, Acute coronary syndrome, Baseline level, Cardiography, Impedance, Thoracic impedance, Internal medicine, Edema, Humans, Medicine, Stage (cooking), Aged, Aged, 80 and over, Heart Failure, Lung, business.industry, General Medicine, Middle Aged, medicine.disease, Surgery, Logistic Models, medicine.anatomical_structure, Heart failure, Acute Disease, Cardiology, Feasibility Studies, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Preclinical stage, business, Algorithms
Abstract

Acute heart failure (AHF) evolves through two phases. In the first phase, there is interstitial congestion with no clinical sign of edema (preclinical phase); the second, during which lung alveoli begin to fill with fluid, manifests as clinically overt alveolar edema. Treatment of AHF at its preclinical phase can alleviate its clinical impact. Presently, there is no technique that detects the interstitial phase of AHF. We used a device based on a new method of lung bioimpedance measurement. The device measures internal thoracic impedance (ITI), which nearly equals inherent lung bioimpedance. This method can detect small changes in lung fluid that occur during the interstitial stage of AHF.The objective of this study was to assess the feasibility and efficacy of the said new method in detecting preclinical AHF.Internal thoracic impedance and pertinent clinical parameters were monitored for 72 h in 403 patients hospitalized for an acute coronary syndrome without evidence of AHF at study entry.Seventy patients developed AHF during monitoring. Internal thoracic impedance decreased in these patients by 16.4% (95% CI=-12.2% to -20.6%; P.0001) from the baseline level at 44+/-15.1 min prior to the onset of lung rales. The other 333 patients had no clinical sign of AHF, and their ITI declined only by 4.5% (95% CI=2.5% to -11.5%; P=.3) compared with the baseline level.The new method for ITI measurement is sufficiently sensitive in detecting AHF at its preclinical stage. An ITI decrease of more than 12% heralds the appearance of clinically overt AHF and, thus, allows earlier therapy.

Published
2006
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181. Relation of Left Atrial Size to Function as Determined by Transesophageal Echocardiography

Author

Simcha R. Meisel, Michael Shochat, Aaron Frimerman, Avraham Shotan, David S. Blondheim, and Aya Osipov

Subjects
Male, medicine.medical_specialty, Chi-Square Distribution, business.industry, Left atrium, Reproducibility of Results, Fractional shortening, Middle Aged, medicine.disease, medicine.anatomical_structure, Left atrial, Internal medicine, Circulatory system, medicine, Cardiology, Humans, Atrial Function, Left, Female, Heart Atria, Cardiology and Cardiovascular Medicine, business, Heart atrium, Stroke, Echocardiography, Transesophageal
Abstract

One hundred thirty-nine patients who underwent transesophageal echocardiographic studies were grouped by their maximal left atrial (LA) volumes, and their stroke volumes, emptying fractions, and fractional shortening were calculated. In large atria, an inverse relation was found between further increases in LA volume and LA function, determined by emptying fractions and fractional shortening.

Published
2005
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182. Fluid overload contributing to heart failure

Author

David S. Blondheim, Michael Shochat, Marc Kazatsker, Samir Dacca, Simcha R. Meisel, and Avraham Shotan

Subjects
Nesiritide, Heart transplantation, Transplantation, medicine.medical_specialty, Cardiac output, Aldosterone, Heart disease, business.industry, medicine.medical_treatment, medicine.disease, Hypertonic saline, chemistry.chemical_compound, Endocrinology, chemistry, Nephrology, Heart failure, Internal medicine, Extracellular fluid, medicine, Cardiology, business, medicine.drug
Abstract

Background In advanced heart failure, the compensatory responses to reduced cardiac output, in spite of fluid retention, lead to maladaptive consequences. Methods We performed a Medline survey for fluid overload and heart failure as well as reviewing textbook chapters. Results The increased sympathetic nervous system, renin-angiotensin-aldosterone system, and antidiuretic hormone stimulation and release lead to a vicious cycle--augmenting pre-load, contractility and after-load, as well as increased fluid overload. The elevated work load on an already failed cardio-circulatory system results in further deterioration. Plasma volume is usually increased in untreated patients with increased extracellular fluid. However, it may range from reduced to increased in treated patients. Currently, diuretics remain the initial first line of therapy. In refractory cases, restoring plasma volume and osmolality, by adding albumin or hypertonic saline solutions, neurohormonal antagonists such as vasopressin receptors antagonists, aldosterone antagonists, or administration of nesiritide, may help in overcoming fluid overload. Conclusion Exact measurement of plasma volume in various forms of heart failure and adjusting the treatment accordingly, establishing favourable and detrimental effects of various therapies, and introducing additional and new therapeutic options require further investigation.

Published
2005
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183. Pregnancy-Associated Cardiomyopathy

Author

Mohammed W. Akhter, Avraham Shotan, Afshan B. Hameed, Uri Elkayam, Fahed Bitar, Salman Khan, and Harpreet Singh

Subjects
Adult, Gestational hypertension, medicine.medical_specialty, Adolescent, Peripartum cardiomyopathy, Pregnancy Complications, Cardiovascular, Tocolysis, Cardiomyopathy, Gestational Age, Pregnancy, Physiology (medical), Internal medicine, medicine, Humans, Twin Pregnancy, Ejection fraction, business.industry, Postpartum Period, Gestational age, Stroke Volume, medicine.disease, Hypertension, Cardiology, Female, Pregnancy, Multiple, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business, Postpartum period
Abstract

Background— Cardiomyopathy associated with pregnancy was first described more than half a century ago. However, because of its rare occurrence and geographical differences, the clinical profile of this condition has remained incompletely defined. Methods and Results— Data obtained from 123 women with a history of cardiomyopathy diagnosed during pregnancy or the postpartum period were reviewed. One hundred women met traditional criteria of peripartum cardiomyopathy; 23 were diagnosed with pregnancy-associated cardiomyopathy earlier than the last gestational month. Peripartum cardiomyopathy patients had a mean age of 31±6 years and were mostly white (67%). Common associated conditions were gestational hypertension (43%), tocolytic therapy (19%), and twin pregnancy (13%). Left ventricular ejection fraction at the time of diagnosis was 29±11% and improved to 46±14% ( P ≤0.0001) at follow-up. Normalization of left ventricular ejection fraction occurred in 54% and was more likely in patients with left ventricular ejection fraction >30% at diagnosis. Maternal mortality was 9%. A comparison between the peripartum cardiomyopathy and early pregnancy-associated cardiomyopathy groups revealed no differences in age, race, associated conditions, left ventricular ejection fraction at diagnosis, its rate and time of recovery, and maternal outcome. Conclusions— This study helps to define the clinical profile of patients with pregnancy-associated cardiomyopathy diagnosed in the United States. Clinical presentation and outcome of patients with pregnancy-associated cardiomyopathy diagnosed early in pregnancy are similar to those of patients with traditional peripartum cardiomyopathy. These 2 conditions may represent a continuum of a spectrum of the same disease.

Published
2005
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184. Ventricular tachyarrhythmia during pregnancy in women with heart disease: Data from the ROPAC, a registry from the European Society of Cardiology

Author

Ertekin, E. (Ebru), Hagen, I.M. (Iris) van, Salam, A.M. (Amar M.), Ruys, T.P.E. (Titia), Johnson, M.R. (Mark), Popelová, J. (Jana), Parsonage, W.A. (William A.), Ashour, Z. (Zeinab), Shotan, A. (Avraham), Oliver, J.M. (José M.), Veldtman, G.R. (Gruschen R.), Hall, R. (Ruth), Roos-Hesselink, J.W. (Jolien), Ertekin, E. (Ebru), Hagen, I.M. (Iris) van, Salam, A.M. (Amar M.), Ruys, T.P.E. (Titia), Johnson, M.R. (Mark), Popelová, J. (Jana), Parsonage, W.A. (William A.), Ashour, Z. (Zeinab), Shotan, A. (Avraham), Oliver, J.M. (José M.), Veldtman, G.R. (Gruschen R.), Hall, R. (Ruth), and Roos-Hesselink, J.W. (Jolien)

Abstract

Objectives To describe the incidence, onset, predictors and outcome of ventricular tachyarrhythmia (VTA) in pregnant women with heart disease. Background VTA during pregnancy will cause maternal morbidity and even mortality and will have impact on fetal outcome. Insufficient data exist on the incidence and outcome of VTA in pregnancy. Methods and results From January 2007 up to October 2013, 99 hospitals in 39 countries enrolled 2966 pregnancies in women with structural heart disease. Forty-two women (1.4%) developed clinically relevant VTA during pregnancy, which occurred mainly in the third trimester (48%). NYHA class > 1 before pregnancy was an independent predictor for VTA. Heart failure during pregnancy was more common in women with VTA than in women without VTA (24% vs. 12%, p = 0.03) and maternal mortality was respectively 2.4% and 0.3% (p = 0.15). More women with VTA delivered by Cesarean section than women without VTA (68% vs. 47%, p = 0.01). Neonatal death, preterm birth (< 37 weeks), low birthweight (< 2500 g) and Apgar score < 7 occurred more often in women with VTA (4.8% vs. 0.3%, p = 0.01; 36% vs. 16%, p = 0.001; 33% vs. 15%, p = 0.001 and 25% vs. 7.3%, p = 0.001, respectively). Conclusions VTA occurred in 1.4% of pregnant women with cardiovascular disease, mainly in the third trimester, and was associated with heart failure during pregnancy. NYHA class before pregnancy was predictive. VTA during pregnancy had clear impact on fetal outcome.

Published
2016
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185. Pulmonary hypertension and pregnancy outcomes: Data from the Registry of Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiology

Author

Sliwa, Karen, van Hagen, Iris M., Budts, Werner, Swan, Lorna, Sinagra, Gianfranco, Caruana, Maryanne, Blanco, Manuel Vazquez, Wagenaar, Lodewijk J., Johnson, Mark R., Webb, Gary, Hall, Roger, Roos-Hesselink, Jolien W., Ferrari, Roberto, Maggioni, Aldo P., Marelli, Ariane, Kaemmerer, Harald, Popelova, Jana, Tavazzi, Luigi, Parsonage, William Anthony, Stein, Joerg, Elkayam, Uri, Thilen, Ulf, Ruys, Titia, Vardas, Panos, Komajda, Michel, Pinto, Fausto, Alonso, Angeles, Wood, David, Maniadakis, Nikolaos, Ferreira, Thierry, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Andarala, Maryna, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti Ann, Pommier, Caroline, Lafay, Myriam, Aquieri, A., Vega, H. Ruda, Lust, K., Fagermo, N., Gabriel, H., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. Vilas, Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., El Sayed Makled, W. A., Taha, N., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. Gamal, Saad, Aly, Aboleineen, W., Ashour, Z., Sorour, K., Mahdy, M. A.Meguid, Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Baumgartner, H., Orwat, S., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. Vazan, Shotan, A., Goland, S., Festa, P., Ali, L. Ait, Puggia, I., Mottolese, B. D.Agata, Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Karamermer, Y., Cornette, J. M.J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P.G., van Oppen, C., Polak, P., Wajon, E., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Lelonek, M., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. Mircea, Gaisin, I. Ravilevich, Shilina, L. Valeryevna, Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subías, P., Ruiz-Cano, M. J., Delgado-Jiménez, J., Furenas, E., Dellborg, M., Thilén, U., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Esen, O. Batukan, Enar, S. Catirli, Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Almahmeed, W., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., Davidson, W. R., Sliwa, Karen, van Hagen, Iris M., Budts, Werner, Swan, Lorna, Sinagra, Gianfranco, Caruana, Maryanne, Blanco, Manuel Vazquez, Wagenaar, Lodewijk J., Johnson, Mark R., Webb, Gary, Hall, Roger, Roos-Hesselink, Jolien W., Ferrari, Roberto, Maggioni, Aldo P., Marelli, Ariane, Kaemmerer, Harald, Popelova, Jana, Tavazzi, Luigi, Parsonage, William Anthony, Stein, Joerg, Elkayam, Uri, Thilen, Ulf, Ruys, Titia, Vardas, Panos, Komajda, Michel, Pinto, Fausto, Alonso, Angeles, Wood, David, Maniadakis, Nikolaos, Ferreira, Thierry, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Andarala, Maryna, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti Ann, Pommier, Caroline, Lafay, Myriam, Aquieri, A., Vega, H. Ruda, Lust, K., Fagermo, N., Gabriel, H., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. Vilas, Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., El Sayed Makled, W. A., Taha, N., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. Gamal, Saad, Aly, Aboleineen, W., Ashour, Z., Sorour, K., Mahdy, M. A.Meguid, Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Baumgartner, H., Orwat, S., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. Vazan, Shotan, A., Goland, S., Festa, P., Ali, L. Ait, Puggia, I., Mottolese, B. D.Agata, Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Karamermer, Y., Cornette, J. M.J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P.G., van Oppen, C., Polak, P., Wajon, E., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Lelonek, M., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. Mircea, Gaisin, I. Ravilevich, Shilina, L. Valeryevna, Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subías, P., Ruiz-Cano, M. J., Delgado-Jiménez, J., Furenas, E., Dellborg, M., Thilén, U., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Esen, O. Batukan, Enar, S. Catirli, Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Almahmeed, W., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., and Davidson, W. R.

Abstract

Aims: To describe the outcomes of pregnancy in women with pulmonary hypertension. Methods and results: In 2007 the European Registry on Pregnancy and Heart Disease was initiated by the European Society of Cardiology. Consecutive patients with all forms of cardiovascular disease, presenting with pregnancy, were enrolled with the aim of investigating the pregnancy outcomes. This subgroup of the cohort included 151 women with pulmonary hypertension (PH) either diagnosed by right heart catheterization or diagnosed as possible PH by echocardiographic signs, with 26% having pulmonary arterial hypertension (PAH), in three subgroups: idiopathic (iPAH), associated with congenital heart disease (CHD-PAH), or associated with other disease (oPAH), and 74% having PH caused by left heart disease (LHD-PH, n = 112). Maternal mean age was 29.2 ± 5.6 years and 37% were nulliparous. Right ventricular systolic pressure was <50 mmHg in 59.6% of patients, 50–70 mmHg in 28.5% and >70 mmHg in 11.9%. In more than 75% of patients, the diagnosis of PH had been made before pregnancy. Maternal death up to 1 week after delivery occurred in five patients (3.3%), with another two out of 78 patients who presented for follow-up (2.6%), dying within 6 months after delivery. The highest mortality was found in iPAH (3/7, 43%). During pregnancy, heart failure occurred in 27%. Caesarean section was performed in 63.4% (23.9% as emergency). Therapeutic abortion was performed in 4.0%. Complications included miscarriage (5.6%), fetal mortality (2%), premature delivery (21.7%), low birth weight (19.0%), and neonatal mortality (0.7%). Conclusion: Mortality in this group of patients with various forms of PH was lower than previously reported as specialized care during pregnancy and delivery was available. However, maternal and fetal mortality remains prohibitively high in women with iPAH, although this conclusion is restricted by limited numbers. Early advice on c

Published
2016

186. Risk of pregnancy in moderate and severe aortic stenosis: From the multinational ROPAC registry

Author

Orwat, Stefan, Diller, Gerhard Paul, van Hagen, Iris M., Schmidt, Renate, Tobler, Daniel, Greutmann, Matthias, Jonkaitiene, Regina, Elnagar, Amro, Johnson, Mark R., Hall, Roger, Roos-Hesselink, Jolien W., Baumgartner, Helmut, Ferrari, Roberto, Maggioni, Aldo P., Marelli, Ariane, Webb, Gary, Kaemmerer, Harald, Popelova, Jana, Sliwa, Karen, Tavazzi, Luigi, Parsonage, William Anthony, Stein, Joerg, Elkayam, Uri, Thilen, Ulf, Budts, Werner, Ruys, Titia, Vardas, Panos, Komajda, Michel, Pinto, Fausto, Alonso, Angeles, Wood, David, Maniadakis, Nikolaos, Ferreira, Thierry, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Andarala, Maryna, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti Ann, Pommier, Caroline, Lafay, Myriam, Aquieri, A., Vega, H. Ruda, Blanco, M. Vázquez, Lust, K., Fagermo, N., Gabriel, H., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. Vilas, Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., El Sayed Makled, W. A., Taha, N., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. Gamal, Saad, A., Aboleineen, W., Ashour, Z., Sorour, K., Mahdy, M. A.Meguid, Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. Vazan, Shotan, A., Goland, S., Festa, P., Ali, L. Ait, Sinagra, G., Puggia, I., Mottolese, B. D.Agata, Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Caruana, M., Karamermer, Y., Cornette, J. M.J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P.G., van Oppen, C., Polak, P., Wajon, E., Wagenaar, L., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Lelonek, M., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. Mircea, Gaisin, I. Ravilevich, Shilina, L. Valeryevna, Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subías, P., Ruiz-Cano, M. J., Delgado-Jiménez, J., Furenas, E., Dellborg, M., Thilén, U., Schwerzmann, M., Bouchardy, J., Rutz, T., Sarac, L., Esen, O. Batukan, Enar, S. Catirli, Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Almahmeed, W., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., Davidson, W. R., Orwat, Stefan, Diller, Gerhard Paul, van Hagen, Iris M., Schmidt, Renate, Tobler, Daniel, Greutmann, Matthias, Jonkaitiene, Regina, Elnagar, Amro, Johnson, Mark R., Hall, Roger, Roos-Hesselink, Jolien W., Baumgartner, Helmut, Ferrari, Roberto, Maggioni, Aldo P., Marelli, Ariane, Webb, Gary, Kaemmerer, Harald, Popelova, Jana, Sliwa, Karen, Tavazzi, Luigi, Parsonage, William Anthony, Stein, Joerg, Elkayam, Uri, Thilen, Ulf, Budts, Werner, Ruys, Titia, Vardas, Panos, Komajda, Michel, Pinto, Fausto, Alonso, Angeles, Wood, David, Maniadakis, Nikolaos, Ferreira, Thierry, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Andarala, Maryna, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti Ann, Pommier, Caroline, Lafay, Myriam, Aquieri, A., Vega, H. Ruda, Blanco, M. Vázquez, Lust, K., Fagermo, N., Gabriel, H., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. Vilas, Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., El Sayed Makled, W. A., Taha, N., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. Gamal, Saad, A., Aboleineen, W., Ashour, Z., Sorour, K., Mahdy, M. A.Meguid, Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. Vazan, Shotan, A., Goland, S., Festa, P., Ali, L. Ait, Sinagra, G., Puggia, I., Mottolese, B. D.Agata, Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Caruana, M., Karamermer, Y., Cornette, J. M.J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P.G., van Oppen, C., Polak, P., Wajon, E., Wagenaar, L., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Lelonek, M., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. Mircea, Gaisin, I. Ravilevich, Shilina, L. Valeryevna, Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subías, P., Ruiz-Cano, M. J., Delgado-Jiménez, J., Furenas, E., Dellborg, M., Thilén, U., Schwerzmann, M., Bouchardy, J., Rutz, T., Sarac, L., Esen, O. Batukan, Enar, S. Catirli, Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Almahmeed, W., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., and Davidson, W. R.

Abstract

Background Controversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). Objectives The authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. Methods The Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient ≥64 mm Hg) were analyzed. Results Of 2,966 pregnancies in ROPAC, the authors identified 96 women who had at least moderate AS (34 with severe AS). No deaths were observed during pregnancy and in the first week after delivery. However, 20.8% of women were hospitalized for cardiac reasons during pregnancy. This was significantly more common in severe AS compared with moderate AS (35.3% vs. 12.9%; p = 0.02), and reached the highest rate (42.1%) in severe, symptomatic AS. Pregnancy was complicated by heart failure in 6.7% of asymptomatic and 26.3% of symptomatic patients, but could be managed medically, except for 1 patient who was symptomatic before pregnancy and underwent balloon valvotomy. Children of patients with severe AS had a significantly higher percentage of low birth weight (35.0% vs. 6.0%; p = 0.006). Conclusions Mortality in pregnant women with AS, including those with severe AS, appears to be close to zero in the current era. Symptomatic and severe AS does, however, carry a substantial risk of heart failure and is associated with high rates of hospitalization for cardiac reasons, although heart failure can nearly always be managed medically. The results highlight the importance of appropriate pre-conceptional patient evaluation and counseling.

Published
2016

187. Utilization of low-profile intra-aortic balloon catheters inserted by the sheathless technique in acute cardiac patients: Clinical efficacy with a very low complication rate

Author

Benny Peled, Alexander Kogan, Avraham Shotan, Samir Abu Sheikha, Aya Osipov, Aharon Frimerman, Michael Shochat, M.Sc Simcha Meisel M.D., Gideon Sahar, R N Nizar Anabussi, and R N Bracha Suari

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Balloon catheter, General Medicine, medicine.disease, Thrombosis, Surgery, Catheter, Pseudoaneurysm, medicine, Myocardial infarction, Embolization, Cardiology and Cardiovascular Medicine, Complication, business, Intra-aortic balloon pump
Abstract

Background: Initial intra-aortic balloon pump (IABP) catheters were of large caliber and their utilization resulted in a high incidence of complications, including limb ischemia, bleeding and thrombosis, peripheral neurologic sequelae, and infection. Despite eventual decrease in the size of IABP catheters, the complication rate has remained high. Hypothesis: The study was undertaken to determine whether use of recently available low-profile IABP catheters would result in a lower incidence of vascular and bleeding complications. Methods: We prospectively evaluated the incidence of complications when consecutively using the low-profile (8F) IABP catheter inserted mostly sheathlessly in 161 acute cardiac patients between January 1, 2000 and April, 2003. Results: Complications encountered included mild transient limb ischemia in two patients (1.2%), minor bleeding episodes in four patients (2.4%), one major puncture site bleeding (0.6%), and a pseudoaneurysm treated percutaneously in two patients (1.2%). Two patients (1.2%) suffered limb ischemia due to embolization or local thrombosis requiring vascular intervention. These complications were milder and their incidence remarkably lower than those reported previously when IABP catheters larger than 8F were used. Conclusion: Utilization of low-profile IABP 8F catheters in a sheathless technique entails an exceedingly low complication rate despite an acute presentation, intense anticoagulant and antiaggregant therapy, frequent comorbidity, advanced age, severe coronary disease, and reduced cardiac function in a large proportion of treated patients.

Published
2004
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188. ESC Guidelines on the management of cardiovascular diseases during pregnancy

Author

European Society of Gynecology, Association for European Paediatric Cardiology, German Society for Gender Medicine, Authors/Task Force Members, Regitz Zagrosek V., Blomstrom Lundqvist C., Cifkova R., Ferreira R., Foidart J. M., Gibbs J. S., Gohlke Baerwolf C., Gorenek B., Iung B., Kirby M., Maas A. H., Morais J., Nihoyannopoulos P., Pieper P. G., Presbitero P., Roos Hesselink J. W., Schaufelberger M., Seeland U., Torracca L, ESC Committee for Practice Guidelines, Bax J., Auricchio A., Baumgartner H., Ceconi C., Dean V., Deaton C., Fagard R., Funck Brentano C., Hasdai D., Hoes A., Knuuti J., Kolh P., McDonagh T., Moulin C., Poldermans D., Popescu B. A., Reiner Z., Sechtem U., Sirnes P. A., Torbicki A., Vahanian A., Windecker S., Document Reviewers, Aguiar C., Al Attar N., Garcia A. A., Antoniou A., Coman I., Elkayam U., Gomez Sanchez M. A., Gotcheva N., Hilfiker Kleiner D., Kiss R. G., Kitsiou A., Konings K. T., Lip G. Y., Manolis A., Mebaaza A., Mintale I., Morice M. C., Mulder B. J., Pasquet A., Price S., Priori S. G., Salvador M. J., Shotan A., Silversides C. K., Skouby S. O., Stein J. I., Tornos P., Vejlstrup N., Walker F., Warnes C., BORGHI, CLAUDIO, European Society of Gynecology, Association for European Paediatric Cardiology, German Society for Gender Medicine, Authors/Task Force Members, Regitz-Zagrosek V., Blomstrom Lundqvist C., Borghi C., Cifkova R., Ferreira R., Foidart J.M., Gibbs J.S., Gohlke-Baerwolf C., Gorenek B., Iung B., Kirby M., Maas A.H., Morais J., Nihoyannopoulos P., Pieper P.G., Presbitero P., Roos-Hesselink J.W., Schaufelberger M., Seeland U., Torracca L, ESC Committee for Practice Guidelines, Bax J., Auricchio A., Baumgartner H., Ceconi C., Dean V., Deaton C., Fagard R., Funck-Brentano C., Hasdai D., Hoes A., Knuuti J., Kolh P., McDonagh T., Moulin C., Poldermans D., Popescu B.A., Reiner Z., Sechtem U., Sirnes P.A., Torbicki A., Vahanian A., Windecker S., and Document Reviewers, Baumgartner H., Deaton C., Aguiar C., Al-Attar N., Garcia A.A., Antoniou A., Coman I., Elkayam U., Gomez-Sanchez M.A., Gotcheva N., Hilfiker-Kleiner D., Kiss R.G., Kitsiou A., Konings K.T., Lip G.Y., Manolis A., Mebaaza A., Mintale I., Morice M.C., Mulder B.J., Pasquet A., Price S., Priori S.G., Salvador M.J., Shotan A., Silversides C.K., Skouby S.O., Stein J.I., Tornos P., Vejlstrup N., Walker F., Warnes C.

Subjects
Counseling, Prenatal Diagnosi, Pregnancy Complications, Cardiovascular, Heart failure, Abortion, Induced, Prenatal Care, Venous Thromboembolism, Guideline, Cardiovascular disease, Aortic Disease, Valvular heart disease, Management, Congential heart disease, Heart Disease, Cardiovascular Agent, Pregnancy, Hypertension, Pregnancy Complications, Infectiou, Female, Cardiology and Cardiovascular Medicine, Arrhythmia, Risk assessment, Human
Abstract

not available

Published
2011

189. Corrigendum to ‘Ventricular tachyarrhythmia during pregnancy in women with heart disease: Data from the ROPAC, a registry from the European Society of Cardiology’ [Int. J. Cardiol. 220 (2016) 131–136]

Author

Gruschen R. Veldtman, Mark R. Johnson, Avraham Shotan, Iris M. van Hagen, Zeinab Ashour, William A. Parsonage, Roger Hall, Jana Popelová, Ebru Ertekin, Amar M Salam, José M. Oliver, Jolien W. Roos-Hesselink, and Titia P.E. Ruys

Subjects
Pathology, medicine.medical_specialty, Pregnancy, Heart disease, Ventricular Tachyarrhythmias, business.industry, Family medicine, medicine, Cardiology and Cardiovascular Medicine, medicine.disease, business, Bristol-Myers
Abstract

The authors regret that some dates of sponsor's involvement in the program were incorrectly reported in the initial published paper, therefore please consider the below corrected information: Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011–2014), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2017), Bayer (2009–2018), Boehringer Ingelheim (2009–2016), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2016), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2011–2017), Gedeon Richter Plc. (2014–2017), Menarini Int. Op. (2009–2012), MSD-Merck & Co. (2011–2014), Novartis Pharma AG (2014–2017), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2009–2018). The authors would like to apologise for any inconvenience caused.

Published
2017
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191. Maternal and Fetal Outcomes of Subsequent Pregnancies in Women with Peripartum Cardiomyopathy

Author

Uri Elkayam, Ilyas S. Karaalp, Mohammed W. Akhter, Afshan B. Hameed, Avraham Shotan, Omar R Wani, Padmini P. Tummala, Kalpana Rao, and Israel Gviazda

Subjects
Adult, medicine.medical_specialty, Heart disease, Peripartum cardiomyopathy, Pregnancy Complications, Cardiovascular, Cardiomyopathy, Ventricular Dysfunction, Left, Pregnancy, Recurrence, medicine, Humans, Abortion, Therapeutic, Retrospective Studies, Ejection fraction, Obstetrics, business.industry, Data Collection, Pregnancy Outcome, Stroke Volume, Retrospective cohort study, Puerperal Disorders, General Medicine, medicine.disease, Surgery, Heart failure, Cohort, Female, Cardiomyopathies, business, Follow-Up Studies
Abstract

Peripartum cardiomyopathy is a rare and sometimes fatal form of heart failure. Little is known about the outcomes of subsequent pregnancies in women who have had the disorder.Through a survey of members of the American College of Cardiology, we identified 44 women who had had peripartum cardiomyopathy and had a total of 60 subsequent pregnancies. We then reviewed the medical records of these women and interviewed the women or their physicians.Among the first subsequent pregnancies in the 44 women, 28 occurred in women in whom left ventricular function had returned to normal (group 1) and 16 occurred in women with persistent left ventricular dysfunction (group 2). The pregnancies were associated with a reduction in the mean (+/-SD) left ventricular ejection fraction both in the total cohort (from 49+/-12 percent to 42+/-13 percent, P0.001) and in each group separately (from 56+/-7 percent to 49+/-10 percent in group 1, P=0.002; and from 36+/-9 percent to 32+/-11 percent in group 2, P=0.08). During these pregnancies, a decrease of more than 20 percent in the left ventricular ejection fraction occurred in 21 percent of the women in group 1 and 25 percent of those in group 2, and symptoms of heart failure occurred in 21 percent of the women in group 1 and 44 percent of those in group 2. The mortality rate was 0 percent in group 1 and 19 percent in group 2 (P=0.06). In addition, the frequency of premature delivery was higher in group 2 (37 percent vs. 11 percent), as was that of therapeutic abortions (25 percent vs. 4 percent).Subsequent pregnancy in women with a history of peripartum cardiomyopathy is associated with a significant decrease in left ventricular function and can result in clinical deterioration and even death.

Published
2001
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192. Sex Differences in Management and Outcome After Acute Myocardial Infarction in the 1990s

Author

Solomon Behar, Jonathan Leor, Shlomo Stern, Lori Mandelzweig, V. Boyko, Avraham Shotan, Benjamin Mazouz, Shmuel Gottlieb, Miriam Cohen, and David Harpaz

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Thrombolysis, Odds ratio, Revascularization, medicine.disease, Comorbidity, Physiology (medical), Emergency medicine, Medicine, Observational study, Myocardial infarction, Myocardial infarction diagnosis, Cardiology and Cardiovascular Medicine, business, Intensive care medicine, Prospective cohort study
Abstract

Background —Previous studies have suggested that women with acute myocardial infarction (AMI) are less aggressively managed than are men. The aim of this study was to assess sex differences in medical and invasive coronary procedures (angiography, PTCA, and CABG) in AMI patients admitted to cardiac care units (CCUs) in Israel in the mid 1990s and their association with early and 1-year prognosis. Methods and Results —We studied 2867 consecutive AMI patients (2125 men, 74%) hospitalized in all 25 CCUs in Israel from 3 prospective nationwide surveys conducted in 1992, 1994, and 1996. Women were, on average, older than men (69 versus 61 years, P Conclusions —This prospective nationwide observational community-based study of consecutive AMI patients hospitalized in the CCUs in the mid 1990s indicates that women fare significantly worse than do men at 30 days but not thereafter at 1-year. The difference in 30-day outcome was not influenced by the use of different therapeutic modalities, including thrombolysis and invasive coronary procedures, but was rather due to the older age and greater comorbidity of women; these findings seem also to explain the less frequent use of invasive procedures in women.

Published
2000
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193. Abciximab in Carotid Stenting for Postsurgical Carotid Restenosis: Intermediate Results

Author

David Varon, Alexander Gerniak, Benyamina Morag, Avraham Shotan, Uri Seligsohn, Uri Rimon, Raphael Adar, and Jacob Schneiderman

Subjects
Adult, Male, medicine.medical_specialty, Percutaneous, Platelet Aggregation, Abciximab, medicine.medical_treatment, Pilot Projects, Platelet Glycoprotein GPIIb-IIIa Complex, 030204 cardiovascular system & hematology, Revascularization, 030218 nuclear medicine & medical imaging, Immunoglobulin Fab Fragments, 03 medical and health sciences, 0302 clinical medicine, Restenosis, Recurrence, Internal medicine, Angioplasty, medicine.artery, medicine, Humans, Carotid Stenosis, Radiology, Nuclear Medicine and imaging, Aged, Endarterectomy, Carotid, Platelet Count, business.industry, Antibodies, Monoclonal, Middle Aged, medicine.disease, Radiography, Stenosis, Intracranial Embolism, Cardiology, Female, Stents, Surgery, Carotid stenting, Internal carotid artery, Cardiology and Cardiovascular Medicine, business, Angioplasty, Balloon, Carotid Artery, Internal, Platelet Aggregation Inhibitors, medicine.drug
Abstract

Purpose: To report intermediate results of a pilot study in which the glycoprotein IIb/IIIa receptor antagonist abciximab was given to patients during percutaneous carotid stenting for recurrent internal carotid artery (ICA) stenosis. The objective was to prevent procedure-related cerebral embolic events and decrease the incidence of recurrent stenosis. Methods: Sixteen patients (9 women; mean age 66.5 years, range 39–78) with severe ICA recurrent stenosis (>80%) underwent balloon angioplasty and stenting. Before the procedure, abciximab was administered intravenously as a bolus (0.25 mg/kg) followed by a 12-hour continuous infusion (10 µg/min). Results: Fifteen patients received stents (14 Wallstent and 1 Strecker); 1 vessel was dilated with only 50% improvement in luminal diameter. Two stented arteries had residual stenosis (Conclusions: The administration of abciximab in conjunction with percutaneous revascularization procedures for postsurgical carotid artery stenosis may reduce cerebral ischemic episodes. It may also attenuate restenosis in the treated artery.

Published
2000
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194. TE-TM coupled mode dynamics in a semiconductor laser subject to feedback with variably rotated polarization

Author

Zav Shotan, Noam Gross, Tal Galfsky, and Lev Khaykovich

Subjects
Physics, business.industry, Polarization (waves), Laser, Atomic and Molecular Physics, and Optics, Electronic, Optical and Magnetic Materials, law.invention, Optics, Semiconductor, law, Relative phase, Electrical and Electronic Engineering, Physical and Theoretical Chemistry, business, Lasing threshold
Abstract

We report on the experimental observation of dynamical collapses which address selectively the TM-mode of a laser subject to optical feedback with variably rotated polarization. Simultaneously, the TE-mode which remains the dominant lasing mode exhibits power bursts. We analyze the relative phase shift between the feedback fields into the TE- and TM-mode and find that the dynamical collapses, observed in a specific range of polarization rotation angles, can be attributed to large phase shift feedback conditions applied on the TM-mode.

Published
2009
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195. Prevalence and prognostic significance of unrecognized systemic hypertension in patients with diabetes mellitus and healed myocardial infarction and/or stable angina pectoris

Author

Michael Motro, Valentina Boyko, Uri Goldbourt, Solomon Behar, Alexander Tenenbaum, Joseph Shemesh, Enrique Z. Fisman, Henrietta Reicher-Reiss, Ilan Auerbach, and Avraham Shotan

Subjects
Male, medicine.medical_specialty, Myocardial Infarction, Infarction, Angina Pectoris, Diabetes Complications, Diabetes mellitus, Internal medicine, Diabetes Mellitus, Prevalence, Humans, Medicine, Myocardial infarction, Aged, Proportional Hazards Models, business.industry, Proportional hazards model, Hazard ratio, Middle Aged, Prognosis, medicine.disease, Confidence interval, Cerebrovascular Disorders, Hypertension, Multivariate Analysis, Cardiology, Myocardial infarction complications, Female, Ischemic chest pain, Cardiology and Cardiovascular Medicine, business
Abstract

Few data are available regarding the prevalence and prognostic significance of the triple coexistence of undiagnosed systemic hypertension, diabetes mellitus, and coronary heart disease. This study aimed to evaluate the prevalence and prognostic significance of unrecognized hypertension in cardiac diabetic patients previously defined as "normotensives" over a 5-year follow-up period. The study sample comprised 11,515 patients aged 45 to 74 years with a previous myocardial infarction and/or anginal syndrome who were screened but not included in the Bezafibrate Infarction Prevention study. Among them, 9,033 were nondiabetics and 2,482, diabetics. The diabetics were divided into 3 groups: (1) 1,272 normotensives, (2) 152 patients without history of hypertension but with elevated blood pressure ("unrecognized hypertensives"), and (3) 1,058 hypertensives with established diagnosis. The prevalence of both diagnosed and unrecognized hypertension in diabetics pooled together increased from 49% to 69% when World Health Organization and new Joint National Committee-VI criteria were compared. Crude all-cause mortality was lower in nondiabetics than in diabetics (11.2% vs 22.0%; p

Published
1999
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196. Double-Blind, Placebo-Controlled Study to Evaluate the Effect of Organic Nitrates in Patients With Chronic Heart Failure Treated With Angiotensin-Converting Enzyme Inhibition

Author

Avraham Shotan, Syed Bokhari, Omar R Wani, Janet V. Johnson, Menahem Canetti, Alejandro Solodky, Uri Elkayam, and Ilyas S. Karaalp

Subjects
Male, medicine.medical_specialty, Cardiac output, Time Factors, Heart disease, Vasodilator Agents, Cardiac Output, Low, Placebo-controlled study, Angiotensin-Converting Enzyme Inhibitors, Blood Pressure, Placebo, law.invention, Nitroglycerin, Double-Blind Method, Randomized controlled trial, Heart Rate, law, Physiology (medical), Internal medicine, medicine, Humans, Single-Blind Method, Exercise, Cross-Over Studies, biology, business.industry, Angiotensin-converting enzyme, Middle Aged, medicine.disease, Crossover study, Surgery, Echocardiography, Heart failure, Chronic Disease, Quality of Life, biology.protein, Cardiology, Drug Therapy, Combination, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background —Organic nitrates are widely used in the treatment of chronic heart failure (CHF). No information, however, is available regarding their effect in patients already treated with ACE inhibitors. Methods and Results —In a randomized, double-blind, crossover design, we studied the effects of high-dose (50 to 100 mg) transdermal nitroglycerin (NTG) and placebo given daily for 12 hours in 29 patients with CHF (NYHA functional classes II to III). Exercise time (4 hours after patch application) showed a progressive improvement during NTG administration, with an increase of 38±35 seconds (9±7%) at the end of the first month ( P =NS), 76±28 seconds (16±6%) at the end of the second month ( P =0.01), and 117±34 seconds (27±6%) at the end of the third month ( P =0.003). No significant change was seen during placebo administration (12±20, 5±26, and 19±28 seconds, all P =NS). Exercise time 8 hours after NTG application measured at 3 months was also significantly longer, with a difference of 87±28 seconds ( P =0.006), but not with placebo (23±36 seconds, P =0.53). Assessment of quality of life and need for additional diuretics or hospitalizations for CHF failed to demonstrate a significant difference between the 2 treatment periods. In contrast, NTG decreased left ventricular end-diastolic (−2.1±0.1%, P P P Conclusion —High-dose nitrate therapy significantly improves exercise tolerance and left ventricular size and systolic function in patients with chronic, mild to moderate CHF already treated with ACE inhibitors. These findings support the role of organic nitrates as an adjunctive therapy to ACE inhibitors in patients with chronic CHF.

Published
1999
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197. Hypertension in Diet Versus Pharmacologically Treated Diabetics

Author

Solomon Behar, Enrique Z. Fisman, Alexander Tenenbaum, Joseph Shemesh, Michael Motro, Avraham Shotan, Valentina Boyko, Uri Goldbourt, Eran Graff, and Henrietta Reicher-Reiss

Subjects
Male, medicine.medical_specialty, Time Factors, Diet therapy, Myocardial Ischemia, Infarction, Diabetic angiopathy, Gastroenterology, Internal medicine, Diabetes mellitus, Prevalence, Internal Medicine, medicine, Humans, Prospective Studies, Myocardial infarction, Prospective cohort study, Aged, business.industry, Hazard ratio, Middle Aged, medicine.disease, Endocrinology, Diabetes Mellitus, Type 2, Hypertension, Female, Ischemic chest pain, business, Diabetic Angiopathies, Follow-Up Studies
Abstract

Abstract —The natural history of non–insulin-dependent diabetes mellitus (NIDDM) differs markedly between patients with diet treated and pharmacologically treated disease. However, the interrelationship between hypertension and these common diabetes types has not been specifically addressed in previous studies. This study was designed to evaluate the prognostic significance and prevalence of hypertension in coronary patients with diet versus pharmacologically treated NIDDM over a 5-year follow-up period. The study sample comprised 11 515 patients aged 45 to 74 years with a previous myocardial infarction and/or anginal syndrome who had been screened but were not included in the Bezafibrate Infarction Prevention study. Among them, 9033 were nondiabetics and 2482, diabetics (987 diet treated and 1495 pharmacologically treated). The prevalence of hypertension among nondiabetics, diet-treated diabetics, and pharmacologically treated diabetics was 31%, 42%, and 43%, respectively. Crude all-cause mortality (CM) was lower in the nondiabetic patients (11.2% versus 22.0%; P

Published
1999
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199. Two-dimensional strain echocardiography for diagnosing chest pain in the emergency room: a multicentre prospective study by the Israeli echo research group

Author

Shiran, Avinoam, primary, Blondheim, David S., additional, Shimoni, Sara, additional, Jabarren, Mohamed, additional, Rosenmann, David, additional, Sagie, Alex, additional, Leibowitz, David, additional, Leitman, Marina, additional, Feinberg, Micha, additional, Beeri, Ronen, additional, Adawi, Salim, additional, Shotan, Avraham, additional, Goland, Sorel, additional, Bloch, Lev, additional, Kobal, Sergio L., additional, and Liel-Cohen, Noah, additional

Published
2016
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