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8. The role of cancer-associated fibroblasts and their extracellular vesicles in prostate cancer progression

Author

Johannes Linxweiler, Turkan Hajili, Christina Körbel, K. Junker, A. Zaccagnino, Michael Stöckle, D. Himbert, Philip Zeuschner, Matthias Saar, and Michael D. Menger

Subjects
Prostate cancer, business.industry, Urology, Cancer research, medicine, Cancer-Associated Fibroblasts, medicine.disease, business, lcsh:Diseases of the genitourinary system. Urology, lcsh:RC870-923, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Extracellular vesicles, lcsh:RC254-282
Published
2020

17. Les procédures interventionnelles de prise en charge de la fuite tricuspide

Author

D. Himbert, Marie-Pierre Dilly, Marina Urena, Eric Brochet, Patrick Nataf, Claire Bouleti, A. Vahanian, Phalla Ou, J.-M. Juliard, and Bernard Iung

Subjects
03 medical and health sciences, 0302 clinical medicine, business.industry, Medicine, 030212 general & internal medicine, 030204 cardiovascular system & hematology, Cardiology and Cardiovascular Medicine, business
Published
2017
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18. P210Long- term outcome of primary mitral valve prolapse: results from a population of 250 patients referred to a tertiary cardiovascular center.P211Rheumatic Heart Disease in Uganda - Results from more than 600 echocardiograms in a no-profit hospitalP212Higher ventricular ectopy burden in asymptomatic severe Barlows mitral valve disease compared to similar patients with mitral valve prolapseP213Surgical mitral valve repair for severe secondary mitral regurgitation: prognostic implications of left ventricular forward flowP214Multicentre trial results of a transfemoral annuloplasty system for mitral valve reconstruction -P215Comparative assessment of paravalvular leaks with 3D-transesophageal echocardiography and cardiac computed tomographyP216Failing surgical aortic bioprosthetic valves: redo aortic valve surgery versus percutaneous valve-in-valve replacementP217Mitral annular calcification and infective endocarditisP218Infective endocarditis - a changing diseaseP219Staphilococcus aureus bacteremia: application of the ESC proposed diagnostic echocardiographic algorithm in clinical practiceP220ESC proposed diagnostic echocardiographic algorithm in elective patients with clinical suspicion of infective endocarditis and negative blood cultures: diagnostic yield and prognostic implicationsP221Three-dimensional transesophageal echocardiography versus multidetector computed tomography for aortic annulus sizing in TAVI: a worthy alternativeP222Early and mid-term improvement in left ventricular function after transcatheter aortic valve replacement as assessed by myocardial strain imagingP223Dynamic of aortic root as predictor of paravalvular regurgitation after transcatheter aortic valve implantationP224Short term effect of heart rate reduction by Ivabradine on left ventricular function and remodeling in systolic heart failure patientsP225Global longitudinal strain and regional longitudinal strain in patients with hypertrophic cardiomyopathy: are they associated with the presence of myocardial fibrosis?P226Investigation of mitral leaflet elongation in patients with non-obstructive versus latent-obstructive hypertrophic cardiomyopathyP227Hypertrophic cardiomyopathy: to what degree have the new ESC guidelines been implemented in routine clinical practice? A retrospective audit assessing current practice in a large general UK hospitalP228New genotype-phenotype associations in hypertrophic cardiomyopathy patients studied with cardiac magnetic resonance with feature-trackingP229How many are too many - frequent premature ventricular contractions and left ventricular functionP230Two-dimensional global longitudinal strain and strain rate for evaluation of inflammatory cardiomyopathy as proven by endomyocardial biopsyP231The echocardiographic features of young asymptomatic screening population with left ventricular hypertrabeculationP232Use of amlodipine to decrease myocardial iron in thalassemia major (AMIT trial): comparison of T2* CMR and echocardiography for assessment of cardiac volumes and functionP233Echocardiographic comparison of Fabry cardiomyopathy and light-chain amyloid heart diseaseP234Early detection of left atrial enlargement using 3D echocardiography in patients undergoing breast cancer treatment

Author

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

Subjects
education.field_of_study, Mitral regurgitation, medicine.medical_specialty, Ejection fraction, business.industry, Population, valvular heart disease, Atrial fibrillation, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, Sudden death, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Cardiology, Mitral valve prolapse, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, medicine.symptom, Cardiology and Cardiovascular Medicine, business, education
Abstract

Background Outcome of Mitral Valve Prolapse (MVP) was controversial for long time. Many studies reported great differences in the incidence of cardiovascular events due, above all, to heterogeneous and small studied populations. Most of theme were also published to late '80 of the last century till early '00. Purpose To make a contemporary survey on the incidence of cardiovascular events in a selected population of patients affected by primary MVP referred to a tertiary cardiovascular center for the medical and surgical care of valvular heart disease. Methods We reviewed our MVP database; patients with at least 2 cardiologic evaluations inclusive of echocardiographic examination and at least 6 months follow up were enrolled. A total of 250 patients (126 F) were selected. Their mean age was 52.1 years (ranging from 13 to 88 yo). The average follow-up time was 100 months (8,33 yrs). Results At the first medical and echocardiographic examination 8 patients (3,2%) had no mitral regurgitation (MR), 104 (41.6%) have a trace/mild MR, 93 (37,2%) a moderate MR and 46 (18,4%) a severe MR. They were widely asymptomatic (NYHA I 205-82%, NYHA II 44-17.60%, NYHA III 1- 0.40%). Most of theme presented a bileaflet (140-55.8%) or a posterior MVP (94 - 37.6%); an isolated anterior MVP was rare (16 - 6,4%). Flail leaflet was present in 8 (3,2%) and 25 (10%) had a chordal rupture. Respectively 165 (65,6%) and 115 (46,1%) patients had thick and redundant leaflets. Mean antero-posterior mitral annulus diameter was 37 mm. During the follow up 7 patients died of non-cardiac cause and 5 (2%) of suspected cardiac cause (2 because of acute coronary syndrome and 3 died suddenly). MR progresses in 43 (17,2%) patients and finally we observed 81 (32,4%) moderate/severe and severe MR. 12 new chordal rupture occurred during the follow up in most cases concerning mitral chordae linked to posterior mitral leaflet (10 cases-83,3%). The worsening of MR provoked an evolution of the clinical condition of 48 patients (19.2%) which developed Dyspnea On Excertion (DOE) with 42 new NYHA II and 6 new NYHA III. At the end of the follow up the amount of patients symptomatic for DOE was 93 (37.2% vs 18% at the initial evaluation). A total of 45 patients (18%) underwent mitral valve surgery. 40 needed in-hospital treatment in most cases due to the development of atrial fibrillation (19 -7.6%) or heart failure ( 8- 3,2%). Endocarditis occurred in 4 patients (1.6%) and cerebrovascular accidents/cardioembolic event in 6 (2.4%). The overall cardiovascular event rate was 4,33/100 patients-year, significantly higher than reported in community based studies. Conclusions The prognosis of a MVP population referred to a tertiary cardiovascular center is not benign. The most frequent complications are progression of MR and MV surgery. Sudden death is also more frequent than in general population. More studies are needed to identify what patients with MVP are at risk for it.

Published
2016
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19. Club 35 Poster session 2: Thursday 4 December 2014, 08:30-18:00 * Location: Poster area

Author

M. Santos, J. Rivero, S. Mccullough, A. Opotowsky, A. Waxman, D. Systrom, A. Shah, C. Santoro, R. Esposito, V. Schiano Lomoriello, R. Raia, D. De Palma, R. Ippolito, P. Ierano, G. Arpino, G. De Simone, M. Galderisi, M. Cameli, M. Lisi, C. Di Tommaso, M. Solari, M. Focardi, M. Maccherini, M. Henein, S. Mondillo, I. Simova, T. Katova, B. Pauncheva, A. Vrettos, D. Dawson, C. Grigoratos, C. Papapolychroniou, P. Nihoyannopoulos, D. Voilliot, O. Huttin, T. Vaugrenard, C. Venner, N. Sadoul, E. Aliot, Y. Juilliere, C. Selton-Suty, I. Hamdi, H. Mahfoudhi, N. Ben Mansour, R. Dahmani, D. Lahidheb, W. Fehri, H. Haouala, H. Erken Pamukcu, D. Gerede, M. Sorgun, C. Akbostanci, S. Turhan, u. Erol, J. Magne, R. Dulgheru, S. Kou, C. Henri, L. Caballero, C. De Sousa, M. Sprynger, L. Pierard, P. Lancellotti, M. L. Panelo, A. Rodriguez-Fernandez, S. Escriba-Bori, W. Krol, M. Konopka, K. Burkhard, I. Jedrzejewska, A. Pokrywka, A. Klusiewicz, J. Chwalbinska, M. Dluzniewski, W. Braksator, A. Elmissiri, M. Eid, I. Sayed, H. Awadalla, V. Schiano-Lomoriello, F. Lo Iudice, P. Ibrahimi, F. Jashari, E. Johansson, C. Gronlund, G. Bajraktari, P. Wester, R. Potluri, A. Aziz, J. Hooper, S. Mummadi, H. Uppal, O. Asghar, S. Chandran, E. A. Surkova, O. V. Tereshina, U. V. Shchukin, A. O. Rubanenko, E. A. Medvedeva, L. Krapf, V. Nguyen, C. Cimadevilla, D. Himbert, E. Brochet, B. Iung, A. Vahanian, D. Messika-Zeitoun, C. M. Van De Heyning, P. Bruyere, L. Davin, C. De Maeyer, B. Paelinck, C. Vrints, P. Bertrand, Y. Groenendaels, V. Vertessen, W. Mullens, M. Pettinari, H. Gutermann, R. Dion, D. Verhaert, P. Vandervoort, S. Guven, T. Sen, O. Tufekcioglu, E. Gucuk, B. Uygur, E. Kahraman, Z. Valuckiene, R. Jurkevicius, R. Pranevicius, J. Marcinkeviciene, D. Zaliaduonyte-Peksiene, N. Stoskute, and R. Zaliunas

Subjects
medicine.medical_specialty, business.industry, Thursday, Medicine, Radiology, Nuclear Medicine and imaging, Medical physics, General Medicine, Club, Radiology, Session (computer science), Cardiology and Cardiovascular Medicine, business
Published
2014
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22. Club 35 Poster Session Wednesday 11 December: 11/12/2013, 09:30-16:00 * Location: Poster area

Author

M. Montoro Lopez, I. Pons De Antonio, C. Itziar Soto, R. Florez Gomez, A. Alonso Ladreda, J. Rios Blanco, E. Refoyo Salicio, M. Moreno Yanguela, J. Lopez Sendon, G. Guzman Martinez, C. M. Van De Heyning, J. Magne, L. Pierard, P. Bruyere, L. Davin, C. De Maeyer, B. Paelinck, C. Vrints, P. Lancellotti, B. Michalski, M. Krzeminska-Pakula, P. Lipiec, E. Szymczyk, L. Chrzanowski, J. Kasprzak, R. N. Leao, A. F. Florencio, A. R. Oliveira, B. Bento, S. Lopes, J. Calaca, R. Palma Reis, M. Krestjyaninov, R. Gimaev, V. Razin, D. Arangalage, A. Chiampan, C. Cimadevilla, A. Touati, D. Himbert, E. Brochet, B. Iung, P. Nataf, A. Vahanian, D. Messika-Zeitoun, T. Guvenc, D. Karacimen, H. Erer, E. Ilhan, N. Sayar, G. Karakus, M. Eren, X. Iriart, N. Tafer, F. Roubertie, P. Mauriat, J. Thambo, J. Wang, F. Fang, G. W. Yip, J. Sanderson, W. Feng, C. Yu, Y. Lam, A. Assabiny, A. Apor, A. Nagy, H. Vago, A. Toth, B. Merkely, A. Kovacs, B. Castaldi, V. Vida, A. Guariento, M. Padalino, A. Cerutti, N. Maschietto, R. Biffanti, E. Reffo, G. Stellin, O. Milanesi, K. Baronaite-Dudoniene, L. Urbaite, V. Smalinskas, R. Veisaite, T. Vasylius, J. Vaskelyte, A. Puodziukynas, J. Wieczorek, A. Rybicka-Musialik, A. Berger-Kucza, A. Hoffmann, A. Wnuk-Wojnar, K. Mizia-Stec, F. Melao, V. Ribeiro, S. Amorim, C. Araujo, J. Torres, J. Cardoso, P. Pinho, M. Maciel, P. Storsten, M. Eriksen, E. Boe, M. Estensen, G. Erikssen, O. Smiseth, H. Skulstad, M. Miglioranza, L. Gargani, R. Sant`Anna, M. Rover, V. Martins, A. Mantovanni, R. Kalil, T. Leiria, X. Luo, P. Lee, Z. Zhang, J. S. Kwong, A. Borowiec, R. Dabrowski, J. Wozniak, S. Jasek, T. Chwyczko, I. Kowalik, J. Janas, E. Musiej-Nowakowska, H. Szwed, M. Palinsky, J. Petrovicova, M. Pirscova, Z. Baricevic, D. Lovric, M. Cikes, B. Skoric, J. Ljubas Macek, V. Reskovic Luksic, J. Separovic Hanzevacki, D. Milicic, A. Elmissiri, G. El Shahid, S. Abdal-Wahhab, M. G. Vural, M. Yilmaz, S. Cetin, R. Akdemir, T. K. Yoldas, E. Yeter, A. Karamanou, E. Hamodraka, I. Lekakis, I. Paraskevaidis, D. Kremastinos, E. K. Appiah-Dwomoh, V. Wang, C. Otto, F. Mayar, K. Bonaventura, H. Sunman, U. Canpolat, M. Kuyumcu, H. Yorgun, L. Sahiner, and N. Ozer

Subjects
medicine.medical_specialty, business.industry, Family medicine, medicine, Radiology, Nuclear Medicine and imaging, General Medicine, Club, Session (computer science), Cardiology and Cardiovascular Medicine, business
Published
2013
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23. Poster session Friday 13 December - PM: 13/12/2013, 14:00-18:00 * Location: Poster area

Author

A. Rojek, M. Bekbossynova, J. Onaindia, R. Ferrer Lopez, B. Javani, A. Sharif-Rasslan, N. Al, R. Davies, U. Ikeda, R. Ferreira, A. Cincin, M. Plewka, F. Weidemann, B. Fadel, O. Akgul, Z. Frikha, M. Haghjoo, J. Jensen, G. Agoston, M. Sunbul, R. Strasser, M. Pepi, Y. Fuku, M. Minamisawa, J. Holm, O. Dzikowska Diduch, Y. Pya, J. Macancela Quinones, P. Gaudron, G. Ertl, S. Thivolet, C. Koukoulis, H. Yun, S. Iancovici, D. Capodanno, M. Barthelet, A. Medeiros-Domingo, T. Le Tourneau, A. P. Lee, G. Derumeaux, I. Rodriguez, B. Naegeli, S. Rahmatullah, A. Bayes, H. Schaff, A. M. Caggegi, C. Zito, M. D'alto, R. Favilli, J. Baan, M. Aydin, J. Bonaque Gonzalez, A. Akhundova, I. Cruz, R. Karpov, H. Okura, D. Dequanter, M. T. Grillo, A. Ingvarsson, S. Prasad, A. Dahiya, U. Rosenschein, G. Sinagra, J. Kochanowski, M. Niemann, Y. Saijo, B. Bouma, K. Sveric, Y. Topilsky, M. Ministeri, J. Piek, C. Marinescu, M. Bilik, I. Ikuta, M. Al-Admawi, C. Araujo, D. Trifunovic, S. Onciul, G. Pavlidis, F. Ruiz Lopez, M. Oyumlu, C. Kenny, F. Kayan, C. Ginghina, R. Piatkowski, I. Lekuona Goya, A. Almeida, G. Portugal, H. Motoki, M. Cinteza, B. Seifert, S. Lee, M. Banovic, T. Sakakura, A. Pappalardo, B. Stuart, Y. Chuyasova, T. Yamanaka, N. Roche, C. Wunderlich, X. Arana, L. Ernande, V. Ribeiro, Y. Tanabe, L. Vazdar, Y. Tayyareci, E. Malev, M. Eren, J. Gil, S. Lunghetti, D. Krieger, S. Mangiafico, M. Izumo, D. Cacela, A. Kovacs, A E Van Den Bosch, E. Reffo, P. G. Jorgensen, O. Dubourg, J. Abreu, S. Wang, E. Cervesato, K. Theodoropoulos, N. Ozaydogdu, L. Jung, Y. Kijima, E. Ostenfeld, C. Corsi, M. Florescu, M. Chenilleau, K. Yokota, A. Faeh-Gunz, R. Winter, J. Dreyfus, D. Kang, S. K. Saha, S. Surdulli, L. Abikeyeva, M. Marchel, P. Meregalli, M. Yamat, X. Arana Achaga, C. Shahla, V. Palicka, M. Tanaka, A. Galrinho, K. Endo, M. Saravi, J. Bogaert, H. Oeygarden, S. Okabe, J. Reiken, G. Ionescu, C. Selton-Suty, A. Nunes-Diogo, E. S. Davidsen, E. Kinova, A. Bandeira, Y. Seo, S. Hojberg, G. Siblini, M. Pellegrino, M. Ostojic, J. J. Onaindia Gandarias, M. Pereira, F. Antonini-Canterin, F. Akturk, T. Nakajima, M. Al Fayyadh, S. Herrmann, G. Stellin, M. E. Menting, B. Sasko, J. Song, T. Kurokawa, F. Dipasqua, T. Maruo, M. Geleijnse, H. Triantafyllidi, M. Komeda, R. Praus, V. Nesvetov, M. Fineschi, A. Auricchio, M. Dorobantu, A. Degirmencioglu, E. Laraudogoitia Zaldumbide, S. Velasco Del Castillo, Z. Marcetic, U. Waje-Andreassen, F. Fang, K. Farsalinos, L. Vasina, D. Muraru, M. Faludi, P. Rio, S. Peppes, T. Karaahmet, G. Suermeci, P. Maccarthy, S. Kotsovilis, Y. Akashi, G. Di Salvo, Z. Issa, J. Gibbs, A. Poletti, E. Bonnefoy-Cudraz, A. Madej-Pilarczyk, E. Gerdts, K. Solymossy, P. Kogoj, T. Tomita, M. Lisi, K. Suzuki, S. Sifakis, E.A. Surkova, T. Fritz-Hansen, V. Tritakis, E. Romeo, T. Akesson-Lindow, B. Lasota, A. Florian, M. Maciel, K. Gieszczyk-Strozik, M. Imazio, S. Ozyilmaz, K. Kadota, V. Peric, E. Zencirci, B. Tzvetkov, U. Aguirre Larracoechea, D. Caldeira, Y. Motoyoshi, M. Russo, R. Suri, H. Pintaric, O. Celik, D. Himbert, L. Branco, B. Sun, S. Dzhetybayeva, A. Esen Zencirci, M. Ciurzynski, R. Nunyez, B. Iung, K. Takenaka, A. S. Omran, K. Ozden, J. Argacha, S. Pradel, A. M. Pistritto, M. Pfyffer, C. Dedobbeleer, J. Vojacek, P. Costa, E. Albuquerque, A. Tamadoni, B. Sarubbi, M. Carlsson, R. Mogelvang, G. Oria, K. Kimura, E. Kim, F. Kousathana, A. Mateescu, A. Varga, J. Clerc, M. Noni, S. Kyrzopoulos, S. Andossova, S. Almeida, E. Shkolnik, J. Koyama, M. Daimon, S. Saeed, B. Popescu, M. Tigen, R. Wennemann, C. Venner, M. Guazzi, R. Magalhaes, H. Hayashi, M. Salagianni, A. Kiotsekoglou, A. Baggiano, C. Chao, T. Nakao, H. Becher, R. Zeppellini, J. Marrugat, G. Erente, P. Lancellotti, R. Rimbas, D. M'barek, M. Cameli, Y. Katahira, S. Carerj, C. Grasso, P. Moulin, D. Lavergne, B. Merkely, D. Mahoney, C. Tamburino, W. Kosmala, G. Romagna, T. Potpara, T. Ha, R. Biffanti, C. Dundar, E. Gunyeli, L. Weinert, R. Dworakowski, A. Ferreira, T. Biering-Sorensen, H. Engblom, M. Erturk, G. Varlan, M. Ikeda, L. Thorell, S Von Bardeleben, S. Palomar, K. Boerlage-Van Dijk, T. Ishizu, S. Stoerk, I. Germanakis, H. Yamamoto, Q. Shang, A. Borizanova, C. Fiorentini, R. Candinas, U. Inci, F. Macedo, O. Huttin, R. Pudil, I. D. Gabric, C. Silveira, I. Sari, V. Lambadiari, L. Laczmanski, E. Timofeev, A. Izgi, D. Bravo Bustos, K. Wierzbowska-Drabik, P. Masci, H. Pusuroglu, F. Navarro Garcia, P. Adhikari, K. Mizia-Stec, S. Celik, A. Medressova, S. Pala, R. Retkoceri, O. Tautu, S. Tzikas, S. Ohtsuki, T. Akbulut, S. Goliszek, K. Mitsudo, P. Palczewski, A. Spyrou, K. Filipiak, I. Tzoulaki, A. Erdem, M. Krupa, K. Yoshida, M. Polovina, J. Vanoverschelde, H. Pereira, K. Obase, O. V. Tereshina, J. Liebeton, L. Petrescu, W. Gin-Sing, T. A. Warsame, B. Lichodziejewska, M. Takeuchi, J. Cuypers, Y. Jung, E. Martins, S. Mondillo, D. Liu, D. Planinc, I. Subirana, S. Shahrzad, U. Richter, M. Prull, C.H. Attenhofer Jost, E. Alfonzetti, A. Kosztin, V. Carvalho, M. van Bracht, K. Shahgaldi, M. Altman, A. Cacicedo, R. Dulgheru, M. Arslan, L. Dell'angela, M. De Biasio, J. Roos-Hesselink, A. Sawant, B. Ghadrdoust, H. Tabuchi, I. Rangel, M. Aguado Martin, L. Pedro-Botet, K. Koch, G. Zugazabeitia Irazabal, I. Hausmanowa-Petrusewicz, A. Werther-Evaldsson, A. Korshunova, Q. Zhang, A. Anton Ladislao, C. Bergerot, F. Karlsen, T. Akagi, M. Jasinski, I. Komuro, A. Apor, L. Fourcade, P. Argiento, E. Zemtsovsky, A. Correra, J. Chudek, S. Choi, G. Barletta, A. Varela, A. Manouras, H. Oe, A. D'andrea, S. Ramezani, M. Akil, A. Azevedo, S. Imme, A. Ionac, E. Saracoglu, K. Nakagawa, O. Vinter, S. Reeva, G. Van Camp, T. Forster, T. Butz, I. Ikonomidis, A. Costa, M. Ruiz Lopez, D. Vinereanu, G. Opolski, K. Akay, A. Vrublevsky, J. Silva Marques, L. Sousa, F. D'ascenzi, N. Oprescu, F. Veronesi, A. Mysiak, R. Dan, M. Nobre Menezes, D. Kim, V. Vida, Y. Kim, V. Di Bello, D. Sharif, A. I. Nagy, A. Sikora-Puz, H. Moladoust, C. Florescu, M. Kostrubiec, L. Pierard, E. Ural, A. Goncalves, K. Grudzka, A. Charalampopoulos, A. Luycx-Bore, M. Wilkins, S. Mushtaq, D. Messika-Zeitoun, N. Olsen, C. Mornos, M. Tesic, R. Symons, S. Bekbossynov, H. Erer, M. Kokorina, I. Joao, C. Cotrim, D. Voilliot, M. Yamawaki, N. Roszczyk, J. Inamo, C. Sousa, A. Porto, I. Lekakis, A. G. Caelian, D. Rigopoulos, T. Komori, G. Pontone, S. Scandura, F. Melao, N. Toh, A. Neikova, V. Aboyans, S. La Carrubba, D. Zamfir, S. Dymarkowski, J. Magne, G. Szeplaki, S. Velasco, J. Mcghie, M. Losito, L. Shkolnik, M. Petrovic, I. Papadakis, D. Brito, I. Schilling, O. Bech-Hanssen, M. Enriquez-Sarano, C. Lafaras, O. Enescu, B. Bijnens, R. Lang, C. Lestuzzi, C. Kirma, N. Vallejo, F. Elmkies, M. Vasatova, N. Uslu, M. Yuksel, M. Anastasiou-Nana, G. Gatti, O. Milanesi, V. Donghi, A. Kozuka, C. Henri, K. Tsimopoulou, G. Karakus, A. Cerutti, J. Macancela Quinonez, E. Laraudogoitia, P. Unger, A. Roijer, K. Kurnicka, M. Carasi, D. Djikic, M. Dragovic, H. Aksu, S. Srivatsa, A. Khan, N. Maschietto, D. Cozma, V. Andreakos, C. Meurling, O. Wendler, C. Doulaptsis, E. Aliot, T. Damy, Z. Ojaghihaghighi, L. Mateu, S. Knop, M. Vis, M. Mizia, A. Khalil, E. Abate, M. Gomez Recio, J. Ko, M. Seo, D. Tsiapras, E. Tekbas, C. Celeng, K. Aonuma, M. Przewlocka-Kosmala, S. Laaraibi, T. Sahin, D. Mohty, P. Jorgensen, A. Fiarresga, C. Scharf, E. Conte, V. Pergola, C. Jons, M. Padalino, R. Krecki, M. Malicse, F. Parthenakis, N. Bolivar Herrera, G. Foldes, O. Vriz, J. Kasprzak, S. Janssens, H. Bejiqi, H. Nakajima, R. Naeije, E. Papadavid, A. Subinas, R. Calabro, M. Trbusic, W. Tomkowski, M. Ooshima, A N Vachev, A. Fotaki, E. Brochet, F. Scholz, A. Boshchenko, P. Massoure, S. Munoz Troyano, J. Zumalde, M. Tsakalou, E. Bertella, M. Carminati, A. Kalkan, Y. Miyashita, I. Comanescu, A. M. Esen, K. Nakamura, A. Sanchez Espino, G. Berkenboom, H. Trappe, B. Castaldi, M. Cielecka-Prynda, Y. Otsuji, R. Bejiqi, E. Caiani, A. Moreo, P. Vaida, J. Castillo, S. Stankovic, C. Davos, H. Murata, T. Komiya, K. Berta, A. Aussoleil, A. Yildiz, B. Piamonti, K. Sato, J. Silva-Cardoso, I. Popescu, R. Pap, A. Serafin, K. Addetia, F. Olsen, J. Cautela, C. Yu, R. El Mahmoud, C. Cardoso, N. Echahidi, V. Pyankov, T. Yamada, R. Hoffmann, H. Johno, L. Lopes, R. Li, R. Onut, J. Lekakis, G. Nicolosi, N. Watanabe, Y. Basaran, A. Matos, A. Chmiel, N. Host, M. Sabria, N. Gronkova, P. Hulek, H. Cakmak, E. Wiegerinck, A. Goudev, A. Romero Pereiro, A. Pellegrini, L. Badano, P. Cameli, N. Abdullah, M. Deja, A. Ekmekci, A. Vahanian, A. Retkoceri, V. Mor-Avi, H. Ito, N. Bindraban, T. Rigo, R. Vanderpool, N. Mansencal, M. K. Tigen, J. Bech, H. Thibault, A. Pshepiy, A. Decker-Bellaton, L. Saghy, Z. Al Bulbul, G. Generati, I. Nedeljkovic, Y. Kuatbayev, G. A. Derumeaux, M. Varoudi, Y. Juilliere, K. Uno, P. Virot, B.M. van Dalen, M. Witsenburg, E. Yamashita, K. Okada, E. Gomez, P. Pinto-Teixeira, T. Yambe, N. Preumont, K. Hu, R. Jalalian, A. Formenti, M. Monaghan, P. Pruszczyk, L. Massa, D. Andreini, A. Fromm, E. Stoupel, D. Ural, R. Pilliere, L. Llobera, W. Kim, M. Sobczak, F. Bandera, S. Oliveira, P. Mills, H. Zemir, E. Oner, S. Sparla, C. Cosgrove, S. Kou, A. Annoni, B. Vujisic-Tesic, M. Hojati, L. Carr, P. Meimoun, A. Jaccard, E. Varotto, N. Bulj, T. Kawata, M. Bulut, G. Dimitriadis, B. Ramondo, V. Voudris, H. Christensen, H. Eguchi, J. Grapsa, P. R. Silva Fazendas Adame, C. Cimadevilla, L. Christensen, M. Cikes, A. Izawa, G. Merchan Ortega, A. Makrigiannakis, M. Forkmann, G. Radegran, P. Dias, A. Faiz, C. Stefopoulos, Y. Vasyuk, A. Akyol, L. Howard, A. Correia, J. Younger, and C. Greis

Subjects
medicine.medical_specialty, business.industry, medicine, Radiology, Nuclear Medicine and imaging, Medical physics, General Medicine, Session (computer science), Cardiology and Cardiovascular Medicine, business
Published
2013
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25. Poster Session 3: Friday 9 December 2011, 08:30-12:30 * Location: Poster Area

Author

C. Kenny, S. Adhya, R. Dworakowski, B. Brickham, P. Maccarthy, M. Monaghan, A. Guzzo, F. Innocenti, S. Vicidomini, D. Lazzeretti, S. Squarciotta, E. De Villa, C. Donnini, F. Bulletti, E. Guerrini, R. Pini, K. Bendjelid, J. Viale, S. Duperret, V. Piriou, D. Jacques, K. Shahgaldi, C. Silva, F. Pedro, L. Deister, L.-A. Brodin, A. Sahlen, A. Manouras, R. Winter, N. Berjeb, C. Cimadevilla, J. Dreyfus, C. Cueff, M. Malanca, A. Chiampan, A. Vahanian, D. Messika-Zeitoun, D. Muraru, D. Peluso, L. Dal Bianco, M. Beraldo, E. Solda', M. Tuveri, U. Cucchini, A. Al Mamary, L. Badano, S. Iliceto, I. Almuntaser, G. King, S. Norris, C. Daly, E. Ellis, R. Murphy, T. Erdei, M. Denes, A. Kardos, C. Foldesi, A. Temesvari, M. Lengyel, A. Bouzas Mosquera, F. Broullon, N. Alvarez-Garcia, J. Peteiro, G. Barge-Caballero, M. Lopez-Perez, A. Lopez-Sainz, A. Castro-Beiras, M. Luotolahti, H. Luotolahti, I. Kantola, J. Viikari, M. Andersen, M. Ersboell, J. Bro-Jeppesen, F. Gustafsson, L. Koeber, C. Hassager, J. Moller, D. Coisne, C. Diakov, F. Vallet, B. Lequeux, P. Blouin, L. Christiaens, R. Esposito, A. Santoro, V. Schiano Lomoriello, R. Raia, C. Santoro, G. De Simone, M. Galderisi, G. Abdula, W. Kosmala, H. Szczepanik-Osadnik, M. Przewlocka-Kosmala, A. Mysiak, T. O' Moore-Sullivan, T. Marwick, Y. T. Tan, F. Wenzelburger, F. Leyva, J. Sanderson, P. Pichler, B. Syeda, P. Hoefer, A. Zuckermann, T. Binder, M. Fijalkowski, A. Koprowski, R. Galaska, K. Blaut, K. Sworczak, A. Rynkiewicz, S. Lee, W. Kim, L. Jung, H. Yun, M. Song, J. Ko, E. A. Khalifa, P. Szymanski, M. Lipczynska, A. Klisieiwcz, P. Hoffman, C. Jorge, J. Silva Marques, S. Robalo Martins, C. Calisto, M. Mieiro, S. Vieira, M. Correia, J. Carvalho De Sousa, A. Almeida, A. Nunes Diogo, C. Park, K. March, T. Tillin, J. Mayet, N. Chaturvedi, A. Hughes, V. Di Bello, C. Giannini, M. Delle Donne, F. De Sanctis, P. Spontoni, C. Cucco, A. Corciu, C. Grigoratos, F. Bogazzi, A. Balbarini, O. Enescu, B. Suran, M. Florescu, M. Cinteza, D. Vinereanu, Y. Higuchi, K. Iwakura, A. Okamura, M. Date, K. Fujii, N. Cortez-Dias, D. Silva, P. Carrilho-Ferreira, A. Magalhaes, S. Ribeiro, S. Goncalves, M. Fiuza, F. Pinto, R. Placido, A. Bordalo, P. Grzywocz, K. Mizia-Stec, J. Chudek, Z. Gasior, A. M. Maceira Gonzalez, J. Cosin Sales, E. Dalli, B. Igual, J. Diago, J. Aguilar, J. Ruvira, S. Cimino, G. Pedrizzetti, G. Tonti, E. Canali, V. Petronilli, F. Boccalini, A. Mattatelli, Y. Hiramoto, C. Iacoboni, L. Agati, D. Trifunovic, M. Ostojic, B. Vujisic-Tesic, M. Petrovic, I. Nedeljkovic, M. Banovic, M. Boricic-Kostic, G. Draganic, M. Tesic, C. Gavina, R. Lopes, A. Lourenco, J. Almeida, J. Rodrigues, P. Pinho, J. Zamorano, A. Leite-Moreira, F. Rocha-Goncalves, M.-A. Clavel, R. Capoulade, J. Dumesnil, P. Mathieu, J.-P. Despres, P. Pibarot, S. Bull, A. Pitcher, D. Augustine, J. D'arcy, T. Karamitsos, A. Rai, B. Prendergast, H. Becher, S. Neubauer, S. Myerson, J. Magne, E. Donal, L. Davin, K. O'connor, C. Pirlet, M. Rosca, C. Szymanski, B. Cosyns, L. Pierard, P. Lancellotti, A. Calin, B. Popescu, C. Beladan, R. Enache, L. Lupascu, C. Sandu, C. Ginghina, V. Kamperidis, S. Hadjimiltiadis, G. Sianos, K. Anastasiadis, V. Grosomanidis, G. Efthimiadis, H. Karvounis, G. Parharidis, I. Styliadis, C. Gonzalez Canovas, C. Munoz-Esparza, J. Bonaque Gonzalez, A. Fernandez, M. Salar Alcaraz, D. Saura Espin, E. Pinar Bermudez, M. Oliva-Sandoval, G. De La Morena Valenzuela, M. Valdes Chavarri, E. Brochet, L. Lepage, D. Attias, D. Detaint, D. Himbert, B. Iung, B. Pirat, S. Little, S. Chang, L. Tiller, R. Kumar, W. Zoghbi, A. P.-W. Lee, M. Hsiung, S. Wan, R. Wong, F. Luo, F. Fang, J. Xie, M. Underwood, J. Sun, C. Yu, R. Jansen, W. Tietge, K. Sijbrandij, M. Cramer, L. De Heer, J. Kluin, S. A. J. Chamuleau, T. Oliveras Vila, E. Ferrer Sistach, L. Delgado Ramis, J. Lopez Ayerbe, N. Vallejo Camazon, F. Gual Capllonch, C. Garcia Alonso, A. Teis Soley, X. Ruyra Baliarda, A. Bayes Genis, S. Negrea, C. Alexandrescu, F. Bourlon, F. Civaia, G. Dreyfus, S. Paetzold, O. Luha, R. Hoedl, G. Stoschitzky, K. Pfeiffer, D. Zweiker, B. Pieske, R. Maier, T. Sevilla, A. Revilla, J. Lopez, I. Vilacosta, R. Arnold, I. Gomez, J. San Roman, G. Nikcevic, A. Djordjevic Dikic, S. Djordjevic, S. Raspopovic, V. Jovanovic, B. Kircanski, S. Pavlovic, G. Milasinovic, I. Ruiz-Zamora, F. Cabrera Bueno, M. Molina, J. Fernandez-Pastor, J. Pena, A. Linde, A. Barrera, J. Alzueta, C. Bremont, A. Bensaid, H. Alonso, O. Zaghden, J. Nahum, J. Dubois-Rande, P. Gueret, P. Lim, S.-P. Lee, K. Park, H.-R. Kim, J.-H. Lee, H.-S. Ahn, J.-H. Kim, H.-K. Kim, Y.-J. Kim, D.-W. Sohn, M. Niemann, S. Herrmann, K. Hu, D. Liu, M. Beer, G. Ertl, C. Wanner, T. Takenaka, C. Tei, F. Weidemann, H. Madeira, M. Mendes Pedro, D. Brito, R. Ippolito, D. De Palma, S. Gati, D. Oxborough, M. Reed, A. Zaidi, S. Ghani, N. Sheikh, M. Papadakis, S. Sharma, V. Chow, A. Ng, T. Pasqualon, W. Zhao, D. Hanzek, T. Chung, T. Yeoh, L. Kritharides, L. Magda, D. Mihalcea, D. Jinga, R. Mincu, E. Ferrazzi, G. Segato, F. Folino, G. Famoso, M. Senzolo, R. Bellu, F. Corbetti, F. Tona, O. Azevedo, I. Quelhas, J. Guardado, M. Fernandes, V. Pereira, R. Medeiros, P. Sousa, W. Santos, S. Pereira, N. Marques, J. Mimoso, V. Marques, I. Jesus, L. Rustad, K. Nytroen, L. Gullestad, B. Amundsen, S. Aakhus, K. Linhartova, G. Sterbakova, J. Necas, S. Kovalova, R. Cerbak, N. Nelassov, N. Korotkijan, A. Shishkina, B. Gagieva, M. Nagaplev, O. Eroshenko, M. Morgunov, S. Parmon, S. Velthuis, M. Van Gent, M. Post, C. Westermann, J. Mager, R. Snijder, S. P. Koyalakonda, M. Anderson, M. Burgess, L. Bergenzaun, M. Chew, H. Ohlin, G. F. Gjerdalen, J. Hisdal, E. Solberg, T. Andersen, Z. Radunovic, K. Steine, T. Rutz, A. Kuehn, K. Petzuch, M. Pekala, J. Elmenhorst, S. Fratz, J. Mueller, A. Hager, J. Hess, M. Vogt, D. Van Der Linde, I. Van De Laar, M. Wessels, J. Bekkers, A. Moelker, H. Tanghe, F. Van Kooten, R. Oldenburg, A. Bertoli-Avella, J. Roos-Hesselink, A. Cresti, L. Fontani, P. Calabria, E. Capati, S. Severi, M. Lynch, S. Saraf, B. Sandler, S. Yoon, S. Kim, C. Ko, S. Ryu, Y. Byun, H. Seo, Q. Ciampi, F. Rigo, L. Pratali, S. Gherardi, B. Villari, E. Picano, R. Sicari, J. Celutkiene, D. Zakarkaite, V. Skorniakov, V. Zvironaite, V. Grabauskiene, J. Sinicyna, G. Gruodyte, K. Janonyte, A. Laucevicius, J. O'driscoll, K. Schmid, A. Marciniak, A. Saha, S. Gupta, R. Smith, R. Sharma, N. Alvarez Garcia, O. Prada, A. Rodriguez Vilela, G. Barge Caballero, M. Lopez Perez, A. Lopez Sainz, A. Castro Beiras, J. Kochanowski, P. Scislo, R. Piatkowski, M. Grabowski, M. Marchel, M. Roik, D. Kosior, G. Opolski, C. M. Van De Heyning, H. Mahjoub, H. Clausen, C. Basaggianis, J. Newton, A. Del Pasqua, A. Carotti, D. Di Carlo, E. Cetrano, A. Toscano, R. Iacobelli, C. Esposito, M. Chinali, G. Pongiglione, G. Rinelli, M. Larsson, A. Bjallmark, K. Caidahl, L. Brodin, H. Gao, M. Lugiez, C. Guivier, R. Rieu, J. D'hooge, G. Hang, C. Guerin, M. Menard, J.-U. Voigt, J. Dungu, G. Campos, R. Jaffarulla, S. Gomes-Pereira, N. Sutaria, C. Baker, P. Nihoyannopoulos, M. Bellamy, D. Harries, N. Walker, P. Pearson, J. Reiken, J. Batteson, R. Kamdar, F. Murgatroyd, A. D'andrea, L. Riegler, R. Scarafile, E. Pezzullo, G. Salerno, E. Bossone, G. Limongelli, M. Russo, G. Pacileo, R. Calabro', Y. Kang, J. Cui, H. Chen, C. Pan, X. Shu, A. Kiotsekoglou, S. Saha, R. Toole, S. Govind, A. Gopal, F. Crispi, B. Bijnens, E. Sepulveda-Swatson, J. Rojas-Benavente, J. Dominguez, M. Illa, E. Eixarch, M. Sitges, E. Gratacos, C. Prinz, R. Faludi, A. Walker, M. Amzulescu, T. Uejima, A. Fraser, J. Voigt, M. Esmaeilzadeh, M. Maleki, A. Amin, F. Vakilian, F. Noohi, Z. Ojaghi Haghighi, P. Nakhostin Davari, H. Bakhshandeh Abkenar, R. Rimbas, R. Dulgheru, A. Margulescu, M. D' Asaro, C. Mizzon, F. Parisi, B.-C. Jung, B.-Y. Lee, H.-J. Kang, M. Kim, Y. Kim, D. Cho, S. Park, S. Hong, D. Lim, W. Shim, H. Bellsham-Revell, S. Tibby, A. J. Bell, O. I. Miller, G. Greil, J. M. Simpson, R. A. Providencia, J. Trigo, A. Botelho, P. Gomes, L. Seca, S. Barra, A. Faustino, G. Costa, N. Quintal, A. Leitao-Marques, E. Nestaas, A. Stoylen, D. Fugelseth, C. Mornos, A. Ionac, L. Petrescu, D. Cozma, D. Dragulescu, A. Mornos, S. Pescariu, A. Fontana, M. Abbate, M. Cazzaniga, C. Giannattasio, G. Trocino, K. Laser, L. Faber, M. Fischer, H. Koerperich, D. Kececioglu, M. F. Elnoamany, A. Dawood, M. Elhabashy, Y. Khalil, N. Piriou, K. Warin-Fresse, M. Caza, G. Fau, D. Crochet, N. Xhabija, I. Allajbeu, E. Petrela, M. Heba, M. Barreiro Perez, M. Martin Fernandez, A. Renilla Gonzalez, J. Florez Munoz, O. Fernandez Cimadevilla, I. Alvarez Pichel, E. Velasco Alonso, D. Leon Duran, E. Benito Martin, S. Secades Gonzalez, L. Gargani, P. Pang, E. Davis, A. Schumacher, A. Silva Ferreira, N. Bettencourt, P. Matos, L. Oliveira, J. Cosin-Sales, M. Lopez Lereu, J. Monmeneu, J. Estornell, M. Tsverava, D. Tsverava, A. Varela, M. Salagianni, I. Galani, E. Andreakos, C. Davos, I. Ikonomidis, J. Lekakis, V. Tritakis, N. Kadoglou, J. Papadakis, P. Trivilou, S. Tzortzis, C. Koukoulis, I. Paraskevaidis, M. Anastasiou-Nana, G. Kim, H. Youn, P. Ibrahimi, G. Bajraktari, F. Jashari, A. Ahmeti, A. Poniku, E. Haliti, M. Henein, B. Pezo Nikolic, H. Jurin, D. Lovric, Z. Baricevic, I. Ivanac Vranesic, M. Lovric Bencic, A. Ernst, and J. Separovic Hanzevacki

Subjects
Novel technique, business.industry, Medicine, Radiology, Nuclear Medicine and imaging, Computer vision, Nanotechnology, General Medicine, Contrast (music), Artificial intelligence, Cardiology and Cardiovascular Medicine, business
Published
2011
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27. Percutaneous aortic valve interventions in heart failure patients

Author

M, Urena, D, Himbert, J, Rodés-Cabau, and A, Vahanian

Subjects
Balloon Valvuloplasty, Heart Failure, Risk, Transcatheter Aortic Valve Replacement, Ventricular Dysfunction, Left, Humans, Aortic Valve Stenosis, Aged
Abstract

The onset of symptoms of heart failure is a landmark in the natural history of aortic stenosis, and is associated with a dramatic reduction in survival. Aortic valve replacement markedly increases life-expectancy in such patients. However, the presence of heart failure and/or left ventricular dysfunction are strong predictors of poor acute and late mortality after cardiac surgery and the most frequent conditions leading to deny surgical aortic valve replacement in elderly patients. The last decade has witnessed the development of transcatheter aortic valve implantation (TAVI) and, consequently, the resurgence of percutaneous balloon aortic valvuloplasty (PBAV) and, both, are currently routine therapy for high-risk patients. These minimally invasive procedures are appealing therapeutic options for the subset of patients with heart failure and or/left ventricular systolic dysfunction. The available evidence on the results of PBAV and TAVI therapies in this setting is discussed and a management strategy is proposed.

Published
2015

28. [Percutaneous approaches to mitral valve disease]

Author

A-A, Fassa, D, Himbert, E, Brochet, C, Bouleti, and A, Vahanian

Subjects
Heart Valve Prosthesis Implantation, Mitral Valve Annuloplasty, Heart Valve Prosthesis, Heart Valve Diseases, Humans, Minimally Invasive Surgical Procedures, Mitral Valve, Mitral Valve Insufficiency, Cardiac Surgical Procedures, Prosthesis Design
Abstract

Percutaneous approaches to mitral valve disease consist in modifications of existing surgical techniques, aiming to replicate the favourable outcomes of surgery, with less procedure-related risk, due to their less invasive nature. While some of these techniques are clearly indicated for the management of certain valve diseases, other appear as possible alternatives to surgery among patients deemed at high-risk or considered inoperable, or are still under clinical investigation. Major development of these percutaneous approaches is expected within the future, thus hopefully allowing treatment of a larger proportion of patients with mitral valve disease.

Published
2015

29. Aortic stenosis: prognosis and management: Aortic stenosis

Author

R. Zilberszac, H. Gabriel, G. Maurer, R. Rosenhek, R. Dulgheru, J. Magne, R. Capoulade, L. Pierard, P. Pibarot, P. Lancellotti, C. Zito, M. Todaro, M. Cusma-Piccione, G. Falanga, G. Di Bella, E. Acri, A. Pardeo, V. Virga, C. Barbaro, S. Carerj, M. Lisi, M. Henein, M. Cameli, P. Ballo, R. Reccia, E. Bennati, M. Chiavarelli, M. Maccherini, S. Mondillo, J. Dahl, L. Videbaek, M. Poulsen, T. Rudbaek, P. Pellikka, L. Rasmussen, J. Moller, A. Touati, D. Messika-Zeitoun, D. Himbert, M. Sordi, A. Chiampan, E. Brochet, B. Iung, A. Vahanian, J. Serfaty, M. Muratori, G. Tamborini, P. Gripari, L. Fusini, P. Barbier, L. Salvi, A. Bartorelli, F. Maffessanti, F. Alamanni, M. Pepi, N. Rajamannan, C. Da Silva, A. Manouras, R. Winter, M. Back, A. Ruck, M. Settergren, A. Sahlen, and K. Shahgaldi

Subjects
medicine.medical_specialty, Stenosis, business.industry, Internal medicine, Cardiology, Medicine, Radiology, Nuclear Medicine and imaging, General Medicine, Cardiology and Cardiovascular Medicine, business, medicine.disease
Published
2012
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30. L'angor instable du sujet âgé

Author

D Himbert

Subjects
medicine.medical_specialty, Percutaneous, business.industry, Unstable angina, medicine.medical_treatment, Revascularization, medicine.disease, Culprit, Angioplasty, Internal medicine, Eptifibatide, medicine, Cardiology, Derivation, Cardiology and Cardiovascular Medicine, business, TIMI, medicine.drug
Abstract

Unstable angina and acute coronary syndromes without persistent ST-segment elevation are frequent and their prognosis is poor in the elderly. Indeed, age is the most powerful predictor of in-hospital mortality in this setting. The clinical benefit of interventional strategies, as demonstrated by FRISC II and TACTICS TIMI 18 studies, seems to be most important in this age subset. PURSUIT trial demonstrates that the efficacy of eptifibatide, a IIb/IIIa platelet receptor inhibitor, increases in elderly patients who simultaneously undergo revascularization interventions. Individual application of such treatment strategies may be difficult. Potential triggering factors of unstable angina and comorbidities have to be taken into account, and the overall management should be highly individualized in elderly patients. The aim remains to achieve appropriate myocardial revascularization, as often as possible by focusing coronary angioplasty on the culprit vessel. Coronary surgery generally should be reserved for coronary lesions which are not suitable for percutaneous revascularization. Clinical improvement is maximal in patients with severe initial presentation.

Published
2001
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32. Bioprothèses aortiques implantées par cathéter : apport du scanner

Author

D. Détaint, J P Laissy, E. Brochet, D Messika-Zeitoun, D. Himbert, A Vahanian, N Pasi, and Jean-Michel Serfaty

Abstract

En 2002, Cribier et al. (1) ont implante la premiere valve aortique par voie transcutanee (TAVI pour transcatheter aortic valve implantation) pour le traitement d’une stenose valvulaire aortique serree (retrecissement aortique calcifie ou RAC). Cette procedure a ete realisee avec succes chez un patient presentant de nombreuses comorbidites, en choc cardiogenique, et chez qui une chirurgie conventionnelle du RAC avait ete refusee par plusieurs equipes de chirurgiens. Depuis, la technique a connu un developpement rapide, avec aujourd’hui plus de 5 000 TAVI implantees dans le monde chez des patients consideres a tres haut risque chirurgical, principalement octogenaires. Dans le cadre du bilan realise avant TAVI, un scanner thoraco-abdomino-pelvien est realise. L’objectif de ce travail est de rappeler rapidement les etapes essentielles de la procedure TAVI, les complications potentielles et de passer en revue les informations que peut apporter le scanner dans le but d’eviter ces complications.

Published
2013
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33. [Percutaneous exclusion of the left atrial appendage: perspectives]

Author

P, Aubry, J-M, Juliard, E, Brochet, D, Himbert, and A, Vahanian

Subjects
Incidence, Anticoagulants, Prostheses and Implants, Prosthesis Design, Risk Assessment, Stroke, Treatment Outcome, Risk Factors, Atrial Fibrillation, Practice Guidelines as Topic, Prevalence, Humans, Atrial Appendage, France, Warfarin, Angioplasty, Balloon, Coronary, Follow-Up Studies, Randomized Controlled Trials as Topic
Abstract

With its high prevalence and well-known thromboembolic risk, atrial fibrillation (AF) is a crucial component of the 2010-2014 actions plan, ongoing in France to reduce the annual incidence of stroke. The stroke risk is stratified well with the CHA(2)DS(2)-VASc score. With the current guidelines, most patients with AF should be on oral anticoagulant regimen, a treatment recognized as effective but whose bleeding risks limit its use. In clinical practice, warfarin is often not prescribed in patients with high risk of stroke. Thus, the exploration of new ways in preventing thromboembolic events in patients with AF is needed. Beside new more convenient anticoagulant agents, the exclusion of the left atrial appendage recognized as main source of thrombi, may be an alternative in patients with both high risk of thrombotic and haemorrhagic events. Surgical experience showed that the results depend on the quality of the exclusion. For over the past 10 years, several percutaneous exclusion systems of the left atrial appendage have been developed. A randomized study (PROTECT AF) demonstrated the non-inferiority of the percutaneous exclusion in comparison with the warfarin. However, the place of this interventional therapy remains to be clarified, particularly the definition of the target population. This often multidisciplinary approach will have to be accompanied by a reduction of periprocedural complications, increase in rate of complete occlusion, and enough long clinical follow-up to assess the efficiency of this strategy.

Published
2012

34. Méthodes d'évaluation du dysfonctionnement ventriculaire gauche

Author

M. Dahan, R Gourgon, Cohen-Solal A, and D Himbert

Subjects
Gastroenterology, Internal Medicine
Abstract

Resume L'efficacite preventive d'un traitement precoce d'une dysfonction ventriculaire gauche (VG) paraissant maintenant admise, il importe de la reconnaitre avant que les criteres cliniques et radiologiques traditionnels de l'insuffisance cardiaque soient reunis. Analytiquement, il peut s'agir d'un trouble 1) global et/ou segmentaire, 2) affectant la pompe et/ou le muscle cardiaque, 3) alterant leur aptitude a se vider (fonction systolique d'ejection) et/ou a se remplir (relaxation et diastole). La prise en compte de la masse (seule son augmentation definit l'hypertrophie) et de la geometrie VG est necessaire pour, a partir des relations pression-volume (fonction « pompe ), acceder aux fonctions « muscle . L'echocardiographie doppler est actuellement le moyen le plus utilise pour le diagnostic et la surveillance des dysfonctions VG car dans la tres grande majorite des cas, elle permet une bonne quantification de la masse, de la geometrie, des dimensions VG et des fonctions systoliques globale et segmentaire. De meme en l'absence d'atteinte valvulaire aortique, la mesure du debit cardiaque est convenable. En revanche, l'evaluation de la fonction de remplissage VG est beaucoup plus incertaine. Ce n'est pas meconnaitre l'apport considerable des ultrasons que de rappeler leurs limites dont les principales sont une faisabilite inconstante et une reproductibilite insuffisante en dehors de mains expertes. L'utilisation des isotopes prend le relais des methodes ultrasonores lorsque celles-ci ne sont pas techniquement satisfaisantes. Les mesures hemodynamiques, sous reserve de capteurs a haute fidelite, restent la reference dans le doute ou a l'occasion d'un examen coronarographique ou biopsique. Dans le cas les plus proches de la normalite, des epreuves dynamiques (effort, tests pharmacologiques, etc) et la surveillance de l'evolution sont necessaires pour affirmer la nature pathologique des resultats recucillis. Le diagnostic de dysfonction VG etant etabli, les resultats de l'enquete etiologique interviennent dans les choix therapeutiques. La gravite hemodynamique, l'etiologie, la VO2 atteinte lors de l'epreuve d'effort, l'existence ou non d'arythmies ventriculaires « malignesconstituent les meilleurs elements d'un pronostic qui reste grave et non parfaitement previsible.

Published
1993
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37. [Echocardiography in the catheterization unit]

Author

E, Brochet, D, Detaint, L, Lepage, D, Messika Zeitoun, J-M, Juliard, P, Aubry, D, Himbert, B, Cormier, and A, Vahanian

Subjects
Cardiac Catheterization, Echocardiography, Humans, Cardiac Surgical Procedures, Ultrasonography, Interventional
Abstract

Non-coronary interventional cardiology has for about ten years been undergoing significant development, with the arrival of new percutaneous procedures in various domains. Some of them have already been well validated, notably percutaneous mitral comissurotomy, percutaneous closure of inter-atrial (IA) communications and patent foramen ovale, trans-septal catheterisation, and alcohol septal ablation of hypertrophic obstructive cardiomyopathy. Other interventional techniques are still in the validation phase, such as the techniques for percutaneous occlusion of the left atrium, percutaneous implantation of valvular prostheses, or the new approaches to percutaneous treatment of mitral valvulopathy. The rapid development of these techniques has benefited widely from the use of echocardiography in the catheter suite, providing a very precise clarification of the anatomy and continuous guidance during procedures. This echocardiographic guidance provides optimal results for the interventional procedure and reduces the incidence of complications.

Published
2008

38. [A pitfall of transseptal catheterisation for percutaneous mitral commissurotomy: interruption of the inferior vena cava with azygos continuation]

Author

D, Attias, D, Himbert, A, Redheuil, E, Brochet, E, Mousseaux, J, Blanc, B, Lung, and A, Vahanian

Subjects
Adult, Cardiac Catheterization, Azygos Vein, Humans, Mitral Valve Stenosis, Female, Radiography, Thoracic, Magnetic Resonance Imaging
Abstract

Transseptal catheterisation is a widely used technique in interventional cardiology. The authors report the case of a 37 year old woman admitted for percutaneous mitral commissurotomy of a symptomatic rheumatic mitral stenosis in whom transseptal catheterisation was impossible because of a rare congenital anomaly: interruption of the inferior vena cava with azygos vein continuation.

Published
2007

39. [Intracardiac echography]

Author

E, Brochet, P, Aubry, J M, Juliard, D, Himbert, and A, Vahanian

Subjects
Echocardiography, Humans, Arrhythmias, Cardiac, Heart Septal Defects, Atrial, Monitoring, Physiologic
Abstract

The role of echocardiography during non-coronary interventions is of increasing importance. They include percutaneous closure of atrial septal defects (ASD) or patent foramen ovale (PFO), percutaneous balloon mitral valvuloplasty (PMV), septal alcoholization, or interventional procedures managing arrhythmia. In all cases, echographic monitoring enables to guide the procedures, optimize and assess their results and avoid complications. This role could even increase with the development of other interventional techniques such as left auricle appendage exclusion or the percutaneous treatment of valvular diseases. This article reviews this new approach and its value in interventional cardiology.

Published
2007

40. [Myocardial infarction and disseminated lupus erythematosus]

Author

A, Cachier, F, Aubart, A, Scheublé, J M, Juliard, A, Vahanian, and D, Himbert

Subjects
Adult, Male, Myocardial Infarction, Humans, Lupus Erythematosus, Systemic, Female, Middle Aged
Abstract

Myocardial infarction is an underestimated complication of disseminated lupus erythematosus (DLE). Its features, treatment and prognosis are poorly understood. From June 1988 to December 2002, out of 1572 consecutive patients admitted during the first hours of acute myocardial infarction with ST elevation, 7 (5 women, aged 38 +/- 7 years) had DLE. The commonest risk factor was smoking (N = 4). There was a higher incidence of anterior infarction (N = 5). The infarct occurred 7 +/- 5 years after diagnosis of DLE. There were other complications of DLE in all cases. Three patients had antiphospholipid syndromes. The culprit artery was usually the left anterior descending (N = 5). The lesions included stenosing atheroma (N = 5) and extensive thrombosis (N = 5). The coronary disease was usually limited to a single vessel (N = 5). Revascularisation procedures include pre-hospital thrombolysis (N = 3) followed by immediate angioplasty (N = 2) or primary angioplasty (N = 4). TIMI grade 3 flow was obtained in all cases, 278 +/- 162 min after the onset of symptoms. The clinical course was characterised by acute reocclusion in 3 patients, recurrent in 2 patients with an antiphospholipid syndrome, and death in 1 case. Acute myocardial infarction occurs in already complicated cases of DLE, in young patients, associating atherosclerosis and extensive thrombosis. The risk of early reocclusion after reperfusion is high, especially in cases with the antiphospholipid syndrome.

Published
2004

41. [Unstable angina in the elderly]

Author

D, Himbert

Subjects
Age Factors, Humans, Coronary Disease, Angina, Unstable, Syndrome, Prognosis, Aged
Abstract

Unstable angina and acute coronary syndromes without persistent ST-segment elevation are frequent and their prognosis is poor in the elderly. Indeed, age is the most powerful predictor of in-hospital mortality in this setting. The clinical benefit of interventional strategies, as demonstrated by FRISC II and TACTICS TIMI 18 studies, seems to be most important in this age subset. PURSUIT trial demonstrates that the efficacy of eptifibatide, a IIb/IIIa platelet receptor inhibitor, increases in elderly patients who simultaneously undergo revascularization interventions. Individual application of such treatment strategies may be difficult. Potential triggering factors of unstable angina and comorbidities have to be taken into account, and the overall management should be highly individualized in elderly patients. The aim remains to achieve appropriate myocardial revascularization, as often as possible by focusing coronary angioplasty on the culprit vessel. Coronary surgery generally should be reserved for coronary lesions which are not suitable for percutaneous revascularization. Clinical improvement is maximal in patients with severe initial presentation.

Published
2003

42. ST-segment elevation in precordial leads: anterior or right ventricular myocardial infarction?

Author

D, Logeart, D, Himbert, and A, Cohen-Solal

Subjects
Adult, Diagnosis, Differential, Male, Electrocardiography, Heart Conduction System, Ventricular Dysfunction, Right, Myocardial Infarction, Humans
Abstract

Isolated acute right ventricular (RV) infarction is rare, and ECG diagnosis may be difficult. We report two cases of acute myocardial infarction with ST-segment elevation in anterior precordial leads caused by such an RV involvement. Potential mechanisms for the relationship are given.

Published
2001

43. ['Early repolarization'. The diagnostic pitfall of an atypical form of ST elevation]

Author

L, Gauci, F, Medkour, and D, Himbert

Subjects
Male, Electrocardiography, Humans, Thrombolytic Therapy, Middle Aged, Angina Pectoris
Abstract

The authors report the case of a coloured man who was treated with intravenous thrombolysis for chest pain and "atypical" ST elevation related to early repolarisation. The interest of this case is to underline the electrocardiographic criteria of early repolarisation and to propose, in appropriate conditions of management, emergency coronary angiography in patients with an uncertain diagnosis of infarct-like chest pain associated with suspicious electrocardiographic changes.

Published
1999

44. [Acute myocardial infarction. Experiences of the referral network of the Beaujon and Bichat hospitals (with the collaboration of the Emergency Medical and Resuscitation Service of Beaujon)]

Author

D, Logeart, A, Gace, D, Himbert, A, Ricard-Hibon, A, Cohen-Solal, and R, Gourgon

Subjects
Male, Emergency Medical Services, Paris, Patient Selection, Age Factors, Myocardial Infarction, Myocardial Reperfusion, Middle Aged, Coronary Angiography, Interinstitutional Relations, Patient Admission, Cause of Death, Humans, Female, Thrombolytic Therapy, Cardiology Service, Hospital, Angioplasty, Balloon, Coronary, Emergency Service, Hospital, Referral and Consultation, Aged
Abstract

Hospital management of acute myocardial infarction raises many problems in terms of medical care and organization, especially concerning the use or not of emergency corongraphy and angiography. We assessed the pertinence and consequences of a referral network operating between two cardiology units at the Beaujon and Bichat hospitals in Paris. All interventional procedures were performed at the Bichat unit. Prehospital emergency care units were integrated into the exprience and informed of indications for first line coronarography.All cases of myocardial infarction admitted within 6 hours to the two units between 1993 to 1996 were analyzed and compared.Indications for referral from Beaujon to Bichat for emergency coronarography and possible angioplasy declined from 21% in 1993 to 10% in 1996. This decline was particularly noteworthy for first intention indications suggesting improved prehospital selection since the number of cases of acute myocardial infarction admitted to Beaujon remained unchanged. Certain patient characteristics differed between the two units: age (68.4 +/- 12.9 years at Beaujon versus 60.5 +/- 13.6 years at Bichat in 1996, p0.01) and reperfusion attempts (73% versus 90% in 1996 respectively, p0.01). The rate of fatal and non-fatal events were not different: 40 and 40% at Beaujon and 38 and 28% at Bichat in 1993 and 1996 respectively.These findings demonstrate that a management network can operate effectively between two hospital cardiology units and emergency care structures, allowing better patient selection for emergency coronography and possible angioplasty.

Published
1998

45. Hospital outcome after bailout coronary stenting in patients with acute myocardial infarction

Author

D, Himbert, J M, Juliard, H, Benamer, L J, Feldman, P, Aubry, and P G, Steg

Subjects
Adult, Male, Myocardial Infarction, Shock, Cardiogenic, Middle Aged, Coronary Angiography, Combined Modality Therapy, Survival Rate, Treatment Outcome, Retreatment, Humans, Female, Stents, Thrombolytic Therapy, Treatment Failure, Angioplasty, Balloon, Coronary, Aged
Abstract

We evaluated the outcome of bailout coronary stenting in acute myocardial infarction. Fifty patients (35 men, mean age 60 plusmn; 12) with acute myocardial infarction consecutively underwent bailout stenting after primary and rescue coronary angioplasty (n=41 and 9, respectively). Cardiogenic shock was present in six patients, and 17 others had contraindications to thrombolysis. Stent implantation was successful in 49/50 patients. The antithrombotic regimen combined heparin, aspirin, and ticlopidine. One patient had symptomatic stent closure. Predischarge angiography in 41/44 survivors showed widely patent stents in 40/41 patients. Six patients (4 of whom had been admitted with cardiogenic shock) died in the hospital. During acute myocardial infarction, bailout stenting can achieve high TIMI grade 3 coronary patency (here, 92%), and low acute stent closure rates (here, 2%). However, in-hospital mortality remained high, at nearly 10%, mainly due to the severe risk profile in this patient subset.

Published
1998

46. [Prognostic significance of early raised cardiac troponine I in unstable angina. Contribution to the identification of a high-risk sub-group]

Author

J P, Bertinchant, T, Laperche, A, Polge, F, Raczka, P, Beyne, B, Ledermann, D, Himbert, I, Pernel, J, Nigond, and A, Cohen-Solal

Subjects
Aged, 80 and over, Male, Troponin I, Middle Aged, Coronary Angiography, Prognosis, Predictive Value of Tests, Risk Factors, Data Interpretation, Statistical, Humans, Female, Angina, Unstable, Biomarkers, Aged, Follow-Up Studies
Abstract

The authors compared the clinical and angiographic characteristics of 44 patients with unstable angina according to cardiac Troponine I concentrations (TnIc) during early blood sampling and then tried to determine a threshold value to predic the occurrence of cardiac events during the hospital period and after 12 months. Tnlc, creatinine-kinase (CK), CK-MB activity and CK-MB mass were sampled over 48 hours. Forty-five per cent of patients had TnIcor = 0.1 microgram/L; CK-MB activity and CK-MB mass were detected in 16 and 32% of patients. Age, gender, classification and recurrence of angina, previous cardiac history, risk factors, coronary angiographic appearances were comparable in patients with and without raised TnIc. No major cardiac events occurred during the hospital period in either group. The number of angioplasties and coronary bypass procedures was also comparable. At one year, the incidence of myocardial infarction (N = 4) and death (N = 5) was significantly different in patients with raised Tnlc (33% versus 0% in patients without increased TnIc). However, betablocker therapy was less prescribed in the group with the poorest outcomes and left ventricular dysfunction was also significantly more common in this group. Early elevation of Tnlc could contribute to the identification of a high risk subgroup of patients with unstable angina.

Published
1998

48. Efficacy of streptokinase, but not tissue-type plasminogen activator, in achieving 90-minute patency after thrombolysis for acute myocardial infarction decreases with time to treatment. PERM Study Group. Prospective Evaluation of Reperfusion Markers

Author

P G, Steg, T, Laperche, J L, Golmard, J M, Juliard, H, Benamer, D, Himbert, and P, Aubry

Subjects
Male, Time Factors, Myocardial Infarction, Myocardial Reperfusion, Middle Aged, Coronary Angiography, Plasminogen Activators, Logistic Models, Fibrinolytic Agents, Tissue Plasminogen Activator, Multivariate Analysis, Humans, Female, Streptokinase, Thrombolytic Therapy, Vascular Patency, Retrospective Studies
Abstract

We sought to examine the relation between time to treatment and 90-min patency rates in patients receiving intravenous streptokinase (SK) or accelerated tissue-type plasminogen activator (t-PA).Early patency of the infarct-related artery is a major determinant of survival after thrombolysis for acute myocardial infarction. Some data suggest that time to treatment may influence the efficacy of nonfibrin-specific thrombolytic agents in restoring early patency of the infarct-related vessel.We performed a retrospective analysis of a cohort of 481 patients receiving thrombolytic therapy for acute myocardial infarction6 h after pain onset, all of whom underwent 90-min coronary angiography. Patency of the infarct-related artery was graded by two observers who had no knowledge of the treatment received or the time between pain and therapy.There was no difference in baseline clinical or angiographic characteristics according to the timing or nature of treatment. Thrombolysis in Myocardial Infarction (TIMI) flow grade 2 or 3 patency rate after SK correlated negatively with the time between onset of pain and thrombolysis (r = 0.8, p = 0.05), whereas the 90-min patency rate after t-PA appeared stable as a function of time to treatment. When patients were categorized as having received treatment3 oror = 3 h after pain onset, the patency rate was similar with t-PA, but significantly higher when SK was administered early rather than late, regardless of whether TIMI flow grades 2 and 3 were pooled (86.9% vs. 59.4%, p = 0.0001) or TIMI flow grade 3 alone was considered to indicate patency (81.7% vs. 53.6%, p = 0.0001). Multivariate logistic regression analysis showed a negative effect of time to treatment on the patency probability for SK (p = 0.0001) but not for t-PA.The efficacy of streptokinase but not t-PA in restoring early coronary patency after intravenous thrombolysis is markedly lower when patients are treated later after onset of pain.

Published
1998

49. Revascularization of patients with unstable coronary artery disease: the case for early intervention

Author

P G, Steg, D, Himbert, and P, Seknadji

Subjects
Time Factors, Treatment Outcome, Disease Progression, Myocardial Revascularization, Humans, Coronary Disease, Thrombolytic Therapy, Angioplasty, Balloon, Coronary, Coronary Artery Bypass, Coronary Angiography
Abstract

In unstable angina, there are data to suggest a substantial risk of recurrent ischemia, infarction, and death when early angiography and/or revascularization have been deferred. Conversely, it has been suggested that early angiography and revascularization are more dangerous than deferred procedures. Critical review of the literature, however, suggests that there is no specific risk inherent in early intervention, but rather that patients who cannot wait are at higher risk anyway. The most valuable data on the comparison of an "early invasive" and a "conservative" strategy in unstable angina come from the Thrombolysis in Myocardial Ischemia (TIMI) IIIB study. The results show no major difference in outcome between groups (despite a high intervention rate in the conservative group), but a shorter hospital stay, lower drug use, and fewer rehospitalizations in the group treated according to the early invasive strategy. These results have been interpreted as favoring early intervention, due to the potential for a shorter hospital stay (a major determinant of cost in many countries) because of the possibility of achieving complete diagnosis and treatment within several days of admission, with good results. In addition, since the inception of the TIMI IIIB study, there have been major improvements in the field of angioplasty, such as the increased use of stents and the availability of safe and effective glycoprotein (GP) IIb-IIIa inhibitors. Thus, the pathophysiology, the excellent results of early intervention, and the recent improvements in angioplasty and its medical and pharmacologic environment, provide a strong rationale for early intervention.

Published
1997

50. [Diagnostic value of myocardial thallium stress scintigraphy in the detection of coronary artery disease in patients undergoing chronic hemodialysis]

Author

M, Dahan, B, Legallicier, D, Himbert, M, Faraggi, N, Aubry, P, Siohan, B, Viron, R, Gourgon, and F, Mignon

Subjects
Adult, Male, Tomography, Emission-Computed, Single-Photon, Vasodilator Agents, Coronary Disease, Dipyridamole, Middle Aged, Coronary Angiography, Sensitivity and Specificity, Thallium Radioisotopes, Predictive Value of Tests, Renal Dialysis, Hypertension, Exercise Test, Humans, Kidney Failure, Chronic, Female, Prospective Studies, Aged
Abstract

Atherosclerotic heart disease is the leading cause of death in patients with end stage renal disease, but its non invasive detection remains difficult because of a low efficacy of exercise testing. The aim of the study was to evaluate diagnostic accuracy of thallium myocardial imaging after dipyridamole combined with exercise. Forty two chronic dialysis patients (34 men, 8 women) aged 55 +/- 11 years (range: 36 to 75) without symptom of angina nor myocardial infarction were studied. In each patient, an echocardiography, a myocardial scintigraphy with dipyridamole combined with symptom-limited exercise, and coronarography were performed. A coronary heart disease was diagnosed by coronarography in 10 patients (4.5 and 1 respectively with 1, 2 and 3 vessels diseased). Echocardiography detected a left ventricular hypertrophy (LVH) in 26 patients and a regional asynergia in 14 patients. A positive scintigraphy was present in 11 patients. Three false-positive and 2 false-negative on scintigraphy were noted. Sensibility, specificity, positive predictive value and negative predictive value were respectively evaluated at 80, 73, 73 and 93%. All the five patients with either false-positive or false-negative scintigraphy exhibited a LVH. CONCLUSION. In chronic dialysis patients, coronary heart disease may be detected by thallium myocardial imaging after dipyridamole combined with exercise.

Published
1995

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