155 results on '"Dania Mohty"'
Search Results
2. Established and candidate transthyretin amyloidosis variants identified in the Saudi population by data mining
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Mohamed Abouelhoda, Dania Mohty, Islam Alayary, Brian F. Meyer, Stefan T. Arold, Bahaa M. Fadel, and Dorota Monies
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Transthyretin ,Amyloidosis ,Familial ,Saudi population ,Epidemiology ,Medicine ,Genetics ,QH426-470 - Abstract
Abstract Background Familial transthyretin (TTR) amyloidosis (ATTR) is an autosomal dominant disease with significant phenotypic heterogeneity. Its prevalence in Saudi Arabia has not previously been investigated. An existing exome variant database of Saudi individuals, sequenced to globally investigate rare diseases in the population, was mined for TTR variants and filtered for missense mutations resulting in single amino acid changes. A total of 13,906 Saudi exomes from unrelated individuals were analyzed blindly. Results Three TTR variants known to be associated with ATTR amyloidosis were identified. Additionally, three novel TTR mutations were identified. Structural analysis of the three novel variants suggests that at least two could be amyloidogenic. The most common variant associated with amyloidosis was p.Val142Ile (allele frequency 0.001). Further investigation of these variants and their translation to clinical practice may help to diagnose, monitor, and manage patients with ATTR amyloidosis. Conclusion Multiple TTR variants potentially associated with systemic ATTR amyloidosis were identified in the Saudi population. Early diagnosis and intervention, facilitated by familial genetic testing of patients with ATTR amyloidosis, may benefit in the management of this disease. Early diagnosis could be enhanced through inclusion of ATTR variants in existing population-based screening programs.
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- 2021
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- View/download PDF
3. Causes and consequences of cardiac fibrosis in patients referred for surgical aortic valve replacement
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Arnault Galat, Aziz Guellich, Diane Bodez, Larissa Lipskaia, Stéphane Moutereau, Eric Bergoend, Sophie Hüe, Julien Ternacle, Dania Mohty, Jean‐Luc Monin, Geneviève Derumeaux, Costin Radu, and Thibaud Damy
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Aortic stenosis ,Cardiac fibrosis ,Inflammation ,IL‐6 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims Cardiac fibrosis is associated with left ventricular (LV) remodelling and contractile dysfunction in aortic stenosis (AS). The fibrotic process in this condition is still unclear. The aim of this study was to determine the role of both local and systemic inflammation as underlying mechanisms of LV fibrosis and contractile dysfunction. The diagnostic values of 2D‐strain echocardiography and serum biomarkers in the evaluation of cardiac fibrosis in this condition were assessed through correlation analyses. Methods and results Patients with AS referred for surgical valve replacement were prospectively and consecutively included. They all had a comprehensive echocardiography including 2D strain. Blood samples were collected to measure cytokines and inflammatory biomarkers using Luminex bead‐based assays. A per‐surgical myocardial biopsy of the basal antero‐septal segment (S1) was performed. Serial sections of each biopsy were stained with Sirius red. Digital image analysis was used to quantify fibrosis. Immunostainings using specific antibodies against macrophage, glycoprotein (gp) 130, and interleukin 6 (IL‐6) were also performed. Patients were divided into tertiles reflecting the severity of fibrosis: mild, moderate, and severe load (TF1 to TF3). The mean age of the 58 included patients was 73 ± 11 years. Twenty‐four (43%) were in New York Heart Association III–IV. Mean aortic valve area was 0.8 ± 0.2 cm2. Mean aortic stenosis peak velocity and mean gradient were respectively 4.5 ± 0.8 m/s and 54 ± 15 mmHg. The mean LV ejection fraction was 54 ± 12%, and the global LV longitudinal strain was −15 ± 4%. The mean S1 strain, corresponding to the biopsied region, was −10 ± 6% and was strongly correlated to fibrosis load (R = 0.83, P
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- 2019
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4. Insights into the Classification of Cardiomyopathies: Past, Present, and Future Directions
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Vera Maria Cury Salemi, Dania Mohty, Sonia Lages Lustosa de Altavila, Marcelo Dantas Tavares de Melo, Roberto Kalil Filho, and Edimar Alcides Bocchi
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Medicine (General) ,R5-920 - Published
- 2021
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5. Echocardiographic Patterns of Left Ventricular Diastolic Function in Cardiac Amyloidosis: An Updated Evaluation
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Silvia Oghina, Wulfran Bougouin, Mounira Kharoubi, Louis Bonnefous, Arnault Galat, Soulef Guendouz, Mélanie Bezard, Fabien Le Bras, Jean-François Deux, Emmanuel Itti, Anissa Moktefi, Pascale Fanen, Emmanuel Teiger, Dania Mohty, Thibaud Damy, and Diane Bodez
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cardiac amyloidosis ,heart failure ,diastolic function ,echocardiography ,guidelines ,Medicine - Abstract
Aims: Multimodal imaging has allowed cardiac amyloidosis (CA) to be increasingly recognised as a treatable cause of heart failure with preserved ejection fraction, but its prognosis remains poor due to late diagnosis. To assess the left ventricular diastolic function (LVDF) patterns in a large contemporary CA cohort according to the current recommendations and to identify their determinants. Methods and Results: We conducted a monocentric, observational study on a cohort of CA patients from a tertiary CA referral centre. Diastolic function was analysed using standard echocardiography and clinical, laboratory and survival parameters were collected. Four hundred and sixty-four patients with one of the three main type of CA were included: 41% had grade III diastolic dysfunction (restrictive mitral pattern), 25% had grade II diastolic dysfunction, and 25% had grade I diastolic dysfunction; 9% were unclassified. No difference was found between the main CA types. After multivariate analyses, grades II and III were independently associated with dyspnoea, elevated NT-proBNP, cardiac infiltration and systolic dysfunction (global longitudinal strain). Grade I patients had a better prognosis. Conclusions: All LVDF patterns can be observed in CA. One quarter of CA patients have grade I LVDF, reflecting the emergence of earlier stage-related phenotypes with a better prognosis.
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- 2021
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6. Efficacy of bortezomib, cyclophosphamide and dexamethasone in treatment-naïve patients with high-risk cardiac AL amyloidosis (Mayo Clinic stage III)
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Arnaud Jaccard, Raymond L. Comenzo, Parameswaran Hari, Philip N. Hawkins, Murielle Roussel, Pierre Morel, Margaret Macro, Jean-Luc Pellegrin, Estibaliz Lazaro, Dania Mohty, Patrick Mercie, Olivier Decaux, Julian Gillmore, David Lavergne, Frank Bridoux, Ashutosh D. Wechalekar, and Christopher P. Venner
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Bortezomib is an active agent in AL amyloidosis and responses to this drug in combination with cyclophosphamide and dexamethasone are both rapid and deep. Here we present an international, multicenter series of 60 patients with Mayo Clinic stage III cardiac amyloidosis to assess the impact of this regimen in improving outcomes in this poor-risk group. The median follow-up for the entire cohort is 11.8 months. The overall response rate was 68%. In a landmark analysis, examining patients who survived more than 3 months, the overall response rate was 86%. A cardiac response was seen in 32% of patients. The estimated 1-year survival rate for the whole cohort was 57% and 24 patients (40%) died while on therapy. Although unable to save the poorest risk patients, the combination of bortezomib, cyclophosphamide and dexamethasone can achieve a high number of hematologic and cardiac responses, likely improving overall survival and justifying a prospective trial.
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- 2014
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7. Ultrasound Imaging of the Superior Vena Cava: A State-of-the-Art Review
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Bahaa M. Fadel, Bahaa Kazzi, and Dania Mohty
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Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine - Published
- 2023
8. Cardiac amyloidosis: A survey of current awareness, diagnostic modalities, treatment practices, and clinical challenges among cardiologists in selected Middle Eastern countries
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Dania Mohty, Samer Nasr, Hany Ragy, Hasan A. Farhan, Bahaa Fadel, Islam Alayary, and Marcelle Ghoubar
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
9. Constrictive pericarditis following heart transplantation: Reality or fiction?
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Brigitte E. Kazzi, Haifa Mahjoub, Bahaa M. Fadel, Elias J Salem, Najmeddine Echahidi, and Dania Mohty
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Heart transplantation ,Constrictive pericarditis ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Diastolic heart failure ,medicine.disease ,Pericardial effusion ,Mediastinitis ,Cardiac surgery ,medicine.anatomical_structure ,Internal medicine ,Heart failure ,cardiovascular system ,medicine ,Cardiology ,Pericardium ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business - Abstract
Constrictive pericarditis (CP) is a curable cause of diastolic heart failure with prior cardiac surgery being a recognizable etiology. We report a patient who developed CP one year following heart transplantation. Several clinical and imaging related factors may lead to diagnostic delays in similar patients, including the mistaken belief that transplanted hearts are devoid of pericardium and thus do not develop constriction. Post-transplantation pericardial effusion, mediastinitis, and cardiac rejection predispose to future CP. Caretakers should consider this entity in allograft recipients who develop heart failure symptoms of unclear etiology.
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- 2021
10. Does Secondary Antibiotic Prophylaxis Improve Clinical Outcomes in Adult Rheumatic Heart Disease Patients Post-Valve Replacement?
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Abdulrazaq S Al-Jazairi, Ahlam M Althobaiti, Josef Marek, Edward B Devol, Zohair Al Halees, Dania Mohty, and Bahaa M Fadel
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Pediatrics, Perinatology and Child Health ,Surgery ,General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Background Secondary prevention of recurrent rheumatic fever in individuals with rheumatic heart disease (RHD) requires continuous antibiotic prophylaxis. However, the impact of antibiotic prophylaxis on the outcome of patients with severe RHD who underwent heart valve replacement is unknown. The objective of the study was to assess the relationship between the use of antibiotics as secondary prophylaxis in RHD patients who underwent valve replacement and clinical outcomes including mortality, reoperation, and valve-related hospitalization. Methods We retrospectively compared outcomes of adult patients who underwent heart valve replacement for RHD at our institution from 1990 through 2014 and who received secondary antibiotic prophylaxis (prophylaxis group) with those who did not receive prophylaxis (nonprophylaxis group) using propensity score matching analysis. Results A total of 1094 patients (56% females, median age 40 years, range 31-53 years) were included with a median follow-up of 9.6 years (range 2.9-12.6 years). Antibiotic prophylaxis was prescribed in 201 patients (18%). Propensity score matching analysis demonstrated no significant difference in overall survival (95% [92%-98%] vs 97% [95%-99%], respectively; P = .7), valve-related hospitalization-independent survival (72% [range 65%-78%] vs 81% [range 76%-88%]; P = .25), and redo valve surgery-independent survival [76% [range 70%-83%] vs 75% [range 72%-79%]; P = .41) at 10-year follow-up in the nonantibiotic prophylaxis versus the antibiotic prophylaxis group. Conclusion Secondary antibiotic prophylaxis among adult RHD patients following valve replacement is not associated with improved clinical outcomes.
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- 2022
11. Treatment of amyloid light chain cardiac amyloidosis: systematic review and future directions
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Dunya, Alsomali, Dania, Mohty, Martha, Grogan, Angela, Dispenzieri, Mahmoud, Aljurf, Shaji, Kumar, Morie A, Gertz, Amr, Hanbali, and Shahrukh K, Hashmi
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Bortezomib ,Treatment Outcome ,Hematopoietic Stem Cell Transplantation ,Humans ,Immunoglobulin Light-chain Amyloidosis ,Melphalan ,Transplantation, Autologous - Abstract
Several treatment strategies for amyloid light chain cardiac amyloidosis (AL-CA) have been described in the literature; however, there is no consensus about the optimal approach to AL-CA.We conducted this systematic review to summarize current evidence from published studies about the safety and efficacy of various treatment regimens for patients with AL-CA, mainly focusing on autologous stem cell transplant (ASCT) and heart transplant.An electronic literature search of PubMed, Web of Science, Scopus, EBSCO, and CINAHL Plus was conducted through December 2019 using the relevant keywords and prespecified MeSH terminology. Records were screened, and eligible studies were selected and narratively discussed. Data on the hematologic and cardiac responses as well as the safety of the treatment regimens were extracted and synthesized narratively in the context of the systematic review.Thirty published articles were included in this systematic review. The most commonly used first-line treatment in the included studies was bortezomib-based therapy followed by high-dose melphalan and ASCT, with recent evidence of improved outcome with the addition of daratumumab. Heart transplant was found to extend survival for selected patients who were not eligible for ASCT; however, it was found to affect the patients' tolerance of further chemotherapy in some studies. Published data on longterm outcomes with immunomodulatory agents were scarce.Current evidence suggests several possible regimens for the treatment of AL-CA. Effective treatment approaches for AL-CA include induction therapy with bortezomib-based or immunotherapy-based combinations in moderate/severe forms of cardiac involvement, followed by high-dose melphalan and ASCT in eligible patients, and heart transplant for selected severe cases. Therefore, we highlight the necessity of conducting well-designed, randomized controlled trials to provide evidence about the efficacy of these drugs with respect to ASCT.
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- 2022
12. Established and candidate transthyretin amyloidosis variants identified in the Saudi population by data mining
- Author
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Stefan T. Arold, Bahaa M. Fadel, Dorota Monies, Dania Mohty, Islam Alayary, Brian F. Meyer, and Mohamed Abouelhoda
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Adult ,Male ,Adolescent ,Epidemiology ,Population ,Mutation, Missense ,Saudi Arabia ,QH426-470 ,Saudi population ,Transthyretin ,Young Adult ,Familial ,Gene Frequency ,Drug Discovery ,medicine ,Genetics ,Data Mining ,Humans ,Prealbumin ,Genetic Predisposition to Disease ,Genetic Testing ,Child ,education ,Molecular Biology ,Allele frequency ,Exome ,Exome sequencing ,Aged ,Amyloid Neuropathies, Familial ,education.field_of_study ,biology ,Genetic heterogeneity ,business.industry ,Amyloidosis ,Genetic Variation ,Autosomal dominant trait ,Middle Aged ,medicine.disease ,biology.protein ,Molecular Medicine ,Medicine ,Female ,Primary Research ,business - Abstract
Abstract Background Familial transthyretin (TTR) amyloidosis (ATTR) is an autosomal dominant disease with significant phenotypic heterogeneity. Its prevalence in Saudi Arabia has not previously been investigated. An existing exome variant database of Saudi individuals, sequenced to globally investigate rare diseases in the population, was mined for TTR variants and filtered for missense mutations resulting in single amino acid changes. A total of 13,906 Saudi exomes from unrelated individuals were analyzed blindly. Results Three TTR variants known to be associated with ATTR amyloidosis were identified. Additionally, three novel TTR mutations were identified. Structural analysis of the three novel variants suggests that at least two could be amyloidogenic. The most common variant associated with amyloidosis was p.Val142Ile (allele frequency 0.001). Further investigation of these variants and their translation to clinical practice may help to diagnose, monitor, and manage patients with ATTR amyloidosis. Conclusion Multiple TTR variants potentially associated with systemic ATTR amyloidosis were identified in the Saudi population. Early diagnosis and intervention, facilitated by familial genetic testing of patients with ATTR amyloidosis, may benefit in the management of this disease. Early diagnosis could be enhanced through inclusion of ATTR variants in existing population-based screening programs.
- Published
- 2021
13. Describing mode of death in three major cardiac amyloidosis subtypes to improve management and survival
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Mounira Kharoubi, Diane Bodez, Mélanie Bézard, Amira Zaroui, Arnault Galat, Soulef Guendouz, Thierry Gendre, Luc Hittinger, David Attias, Dania Mohty, Eric Bergoend, Emmanuel Itti, Fabien Lebras, David Hamon, Elsa Poullot, Valérie Molinier-Frenkel, Nicolas Lellouche, Jean-François Deux, Benoit Funalot, Pascale Fannen, Silvia Oghina, Raphael Arrouasse, Philippe Lecorvoisier, Sarah Souvannanorath, Aurelien Amiot, Emmanuel Teiger, Wulfran Bougouin, and Thibaud Damy
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Heart Failure ,Amyloid Neuropathies, Familial ,Death, Sudden ,Internal Medicine ,Humans ,Amyloidosis ,Cardiomyopathies ,Retrospective Studies - Abstract
The three main cardiac amyloidosis (CA) types have different progression and prognosis. Little is known about the mode of death (MOD) which is commonly attributed to cardiovascular causes in CA. Improving MOD’s knowledge could allow to adapt patient care. This retrospective study describes the MOD that occurred during long-term follow-up in CA patients in light-chain (AL), transthyretin hereditary (ATTRv) or wild-type (ATTRwt). Patients referred to and cared for, at the French referral centre for CA, Henri Mondor Hospital, Créteil between 2010 and 2016 were included. Clinical information surrounding patient deaths were investigated and centrally evaluated by two blinded clinical committees which classified MOD as cardiovascular, non-cardiovascular or unknown and sub-classified it depending on its subtype. From the 566 patients included, 187 had AL, 206 ATTRv and 173 ATTRwt. During the 864 patient-year follow-up, 160 (28%) deaths occurred, with median survival time of 17.3 months (interquartile range 5.1–35.4). The most frequent MOD was cardiovascular (64%) of which worsening heart failure occurred most frequently and for which, 69% were of AL subtype, 79% ATTRv and 76% ATTRwt. Sudden death also occurred more frequently in AL subtype accounting for 29% of AL deaths. Non-cardiovascular MOD occurred in 26% of patients overall. Among these, infection was the most common non-cardiovascular MOD in any type of CA (80%). Mortality is high during natural course of CA and differs between subtypes. The main MOD were worsening heart failure, sudden death and infection, opening room to optimise management.
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- 2022
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14. Aortic Stenosis and Cardiac Amyloidosis
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Dania Mohty, Marie-Annick Clavel, Philippe Pibarot, Romain Gallet, Francois Tournoux, Annabelle Nguyen, Julien Magne, Emmanuel Teiger, Nancy Côté, Thibaud Damy, Julien Ternacle, Laura Krapf, and Arnault Galat
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Tafamidis ,medicine.medical_specialty ,biology ,medicine.diagnostic_test ,business.industry ,030204 cardiovascular system & hematology ,Doppler echocardiography ,medicine.disease ,Pharmacological treatment ,03 medical and health sciences ,Stenosis ,Transthyretin ,chemistry.chemical_compound ,0302 clinical medicine ,Cardiac amyloidosis ,chemistry ,Heart failure ,Internal medicine ,medicine ,biology.protein ,Cardiology ,In patient ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Highlights •CA may be present in ≤15% of patients with AS. •Clinical and imaging “red flags” for CA should be systematically searched in patients with AS. •Transcatheter rather than surgical AVR may be preferred in patients with CA. •Recently developed pharmacological treatment for transthyretin CA should be instituted as soon as diagnosis is confirmed.
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- 2019
15. Contemporary Management of Severe Symptomatic Aortic Stenosis
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Marc Eugène, Piotr Duchnowski, Bernard Prendergast, Olaf Wendler, Cécile Laroche, Jean-Luc Monin, Yannick Jobic, Bogdan A. Popescu, Jeroen J. Bax, Alec Vahanian, Bernard Iung, Jeroen Bax, Michele De Bonis, Victoria Delgado, Michael Haude, Gerhard Hindricks, Aldo P. Maggioni, Luc Pierard, Susanna Price, Raphael Rosenhek, Frank Ruschitzka, Stephan Windecker, Souad Mekhaldi, Katell Lemaitre, Sébastien Authier, Magdy Abdelhamid, Astrid Apor, Gani Bajraktari, Branko Beleslin, Alexander Bogachev-Prokophiev, Daniela Cassar Demarco, Agnes Pasquet, Sait Mesut Dogan, Andrejs Erglis, Arturo Evangelista, Artan Goda, Nikolaj Ihlemann, Huseyin Ince, Andreas Katsaros, Katerina Linhartova, Julia Mascherbauer, Erkin Mirrakhimov, Vaida Mizariene, Shelley Rahman-Haley, Regina Ribeiras, Fuad Samadov, Antti Saraste, Iveta Simkova, Elizabeta Srbinovska Kostovska, Lidia Tomkiewicz-Pajak, Christophe Tribouilloy, Eliverta Zera, Mimoza Metalla, Ervina Shirka, Elona Dado, Loreta Bica, Jorida Aleksi, Gerti Knuti, Lidra Gjyli, Rudina Pjeci, Eritinka Shuperka, Erviola Lleshi, Joana Rustemaj, Marsjon Qordja, Mirald Gina, Senada Husi, Daniel Basic, Regina Steringer-Mascherbauer, Charlotte Huber, Christian Ebner, Elisabeth Sigmund, Andrea Ploechl, Thomas Sturmberger, Veronica Eder, Tanja Koppler, Maria Heger, Andreas Kammerlander, Franz Duca, Christina Binder, Matthias Koschutnik, Leonard Perschy, Lisa Puskas, Chen-Yu Ho, Farid Aliyev, Vugar Guluzada, Galib Imanov, Firdovsi Ibrahimov, Abbasali Abbasaliyev, Tahir Ahmedov, Fargana Muslumova, Jamil Babayev, Yasmin Rustamova, Tofig Jahangirov, Rauf Samadov, Muxtar Museyibov, Elnur Isayev, Oktay Musayev, Shahin Xalilov, Saleh Huseynov, Madina Yuzbashova, Vuqar Zamanov, Vusal Mammadov, Gery Van Camp, Martin Penicka, Hedwig Batjoens, Philippe Debonnaire, Daniel Dendooven, Sebastien Knecht, Mattias Duytschaever, Yves Vandekerckhove, Luc Missault, Luc Muyldermans, René Tavernier, Tineke De Grande, Patrick Coussement, Joyce DeTroyer, Katrien Derycker, Kelly De Jaegher, Antoine Bondue, Christophe Beauloye, Céline Goffinet, Daniela Corina Mirica, Frédéric Vanden Eynden, Philippe Van de Borne, Béatrice Van Frachen, David Vancraeynest, Jean Louis Vanoverschelde, Sophie Pierard, Mihaela Malanca, Florence Sinnaeve, Séverine Tahon, Marie De Clippel, Frederic Gayet, Jacques Loiseau, Nico Van de Veire, Veronique Moerman, Anne-Marie Willems, Bernard Cosyns, Steven Droogmans, Andreea Motoc, Dirk Kerkhove, Daniele Plein, Bram Roosens, Caroline Weytjens, Patrizio Lancellotti, Elena Raluca Dulgheru, Ilona Parenicova, Helena Bedanova, Frantisek Tousek, Stepanka Sindelarova, Julia Canadyova, Milos Taborsky, Jiri Ostransky, null Ivona simkova, Marek Vicha, Libor Jelinek, Irena Opavska, Miroslav Homza, Miriam Kvrayola, Radim Brat, Dan Mrozek, Eva Lichnerova, Iveta Docekalova, Marta Zarybnicka, Marketa Peskova, Patrik Roucka, Vlasta Stastna, Dagmar Jungwirtova Vondrackova, Alfred Hornig, Matus Niznansky, Marian Branny, Alexandra Vodzinska, Miloslav Dorda, Libor Snkouril, Krystyna Kluz, Jana Kypusova, Radka Nezvalova, Niels Thue Olsen, Hosam Hasan Ali, Salma Taha, Mohamed Hassan, Ahmed Afifi, Hamza Kabil, Amr Mady, Hany Ebaid, Yasser Ahmed, Mohammad Nour, Islam Talaat, CairoMaiy El Sayed, Ahmad Elsayed Mostafa, CairoYasser Sadek, CairoSherif Eltobgi, Sameh Bakhoum, Ramy Doss, Mahmoud Sheashea, Abd Allah Elasry, Ahmed Fouad, Mahmoud Baraka, Sameh Samir, Alaa Roshdy, Yasmin AbdelRazek, Mostafa M. Abd Rabou, Ahmed Abobakr, Moemen Moaaz, Mohamed Mokhtar, Mohamed Ashry, Khaled Elkhashab, Haytham Soliman Ghareeb, Mostafa Kamal, Gomaa AbdelRazek, GizaNabil Farag, Giza:Ahmed Elbarbary, Evette Wahib, Ghada Kazamel, Diaa Kamal, Mahmoud Tantawy, Adel Alansary, Mohammed Yahia, Raouf Mahmoud, Tamer El Banna, Mohamed Atef, Gamela Nasr, Salah Ahmed, Ehab E. El Hefny, Islam Saifelyazal, Mostafa Abd El Ghany, Abd El Rahman El Hadary, Ahmed Khairy, Jyri Lommi, Mika Laine, Minna Kylmala, Katja Kankanen, Anu Turpeinen, Juha Hartikainen, Lari Kujanen, Juhani Airaksinen, Tuija Vasankari, Catherine Szymanski, Yohann Bohbot, Mesut Gun, Justine Rousseaux, Loic Biere, Victor Mateus, Martin Audonnet, Jérémy Rautureau, Charles Cornet, Emmanuel Sorbets, BourgesKarine Mear, Adi Issa, Florent Le Ven, Marie-Claire Pouliquen, Martine Gilard, Alice Ohanessian, Ali Farhat, Alina Vlase, Fkhar Said, Caroline Lasgi, Carlos Sanchez, Romain Breil, Marc Peignon, Jean-Philippe Elkaim, Virginie Jan-Blin, Sylvain Ropars BertrandM'Ban, Hélène Bardet, Samuel Sawadogo, Aurélie Muschoot, Dieudonné Tchatchoua, Simon Elhadad, Aline Maubert, Tahar Lazizi, Kais Ourghi, Philippe Bonnet, Clarisse Menager-Gangloff, Sofiene Gafsi, Djidjiga Mansouri, Victor Aboyans, Julien Magne, Elie Martins, Sarah Karm, Dania Mohty, Guillaume Briday, Amandine David, Sylvestre Marechaux, Caroline Le Goffic, Camille Binda, Aymeric Menet, Francois Delelis, Anne Ringlé, Anne-Laure Castel, Ludovic Appert, Domitille Tristram, Camille Trouillet, Yasmine Nacer, Lucas Ngoy, MarseilleGilbert Habib, Franck Thuny, Julie Haentjens, Jennifer Cautela, Cécile Lavoute, Floriane Robin, Pauline Armangau, Ugo Vergeylen, Khalil Sanhadji, Nessim Hamed Abdallah, Hassan Kerzazi, Mariana Perianu, François Plurien, Chaker Oueslati, Mathieu Debauchez, Zannis Konstantinos, Alain Berrebi, Alain Dibie, Emmanuel Lansac, Aurélie Veugeois, Christelle Diakov, Christophe Caussin, Daniel Czitrom, Suzanna Salvi, Nicolas Amabile, Patrice Dervanian, Stéphanie Lejeune, Imane Bagdadi, Yemmi Mokrane, Gilles Rouault, Jerome Abalea, Marion Leledy, Patrice Horen, Erwan Donal, Christian Bosseau, Elise Paven, Elena Galli, Edouard Collette, Jean-Marie Urien, Valentin Bridonneau, Renaud Gervais, Fabrice Bauer, Houzefa Chopra, Arthur Charbonnier, David Attias, Nesrine Dahouathi, Moukda Khounlaboud, Magalie Daudin, Christophe Thebault, Cécile Hamon, Philippe Couffon, Catherine Bellot, Maelle Vomscheid, Anne Bernard, Fanny Dion, Djedjiga Naudin, Mohammed Mouzouri, Mathilde Rudelin, Alain Berenfeld, Thibault Vanzwaelmen, Tarik Alloui, Marija Gjerakaroska Radovikj, Slavica Jordanova, Werner Scholtz, Eva Liberda-Knoke, Melanie Wiemer, Andreas Mugge, Georg Nickenig, Jan-Malte Sinning, Alexander Sedaghat, Matthias Heintzen, Jan Ballof, Daniel Frenk, Rainer Hambrecht, Harm Wienbergen, Annemarie Seidel, Rico Osteresch, Kirsten Kramer, Janna Ziemann, Ramona Schulze, Wolfgang Fehske, Clarissa Eifler, Bahram Wafaisade, Andreas Kuhn, Sören Fischer, Lutz Lichtenberg, Mareike Brunold, Judith Simons, Doris Balling, Thomas Buck, Bjoern Plicht, Wolfgang Schols, Henning Ebelt, Marwan Chamieh, Jelena Anacker, Tienush Rassaf, Alexander Janosi, Alexander Lind, Julia Lortz, Peter Lüdike, Philipp Kahlert, Harald Rittger, Gabriele Eichinger, Britta Kuhls, Stephan B. Felix, Kristin Lehnert, Ann-Louise Pedersen, Marcus Dorr, Klaus Empen, Sabine Kaczmarek, Mathias Busch, Mohammed Baly, Fikret Er, Erkan Duman, Linda Gabriel, Christof Weinbrenner, Johann Bauersachs, Julian Wider, Tibor Kempf, Michael Bohm, Paul-Christian Schulze, C. Tudor Poerner, Sven Möbius-Winkler, Karsten Lenk, Kerstin Heitkamp, Marcus Franz, Sabine Krauspe, Burghard Schumacher, Volker Windmuller, Sarah Kurwitz, Holger Thiele, Thomas Kurz, Roza Meyer-Saraei, Ibrahim Akin, Christian Fastner, Dirk Lossnitzer, Ursula Hoffmann, Martin Borggrefe, Stefan Baumann, Brigitte Kircher, Claudia Foellinger, Heike Dietz, Bernhard Schieffer, Feraydoon Niroomand, Harald Mudra, Lars Maier, Daniele Camboni, Christoph Birner, Kurt Debl, Michael Paulus, Benedikt Seither, Nour Eddine El Mokhtari, Alper Oner, Evren Caglayan, Mohammed Sherif, Seyrani Yucel, Florian Custodis, Robert Schwinger, Marc Vorpahl, Melchior Seyfarth, Ina Nover, Till Koehler, Sarah Christiani, David Calvo Sanchez, Barbel Schanze, Holger Sigusch, Athir Salman, Jane Hancock, John Chambers, Camelia Demetrescue, Claire Prendergast, Miles Dalby, Robert Smith, Paula Rogers, Cheryl Riley, Dimitris Tousoulis, Ioannis Kanakakis, Konstantinos Spargias, Konstantinos Lampropoulos, Tolis Panagiotis, Athanasios Koutsoukis, Lampros Michalis, Ioannis Goudevenos, Vasileios Bellos, Michail Papafaklis, Lampros Lakkas, George Hahalis, Athanasios Makris, Haralampos Karvounis, Vasileios Kamperidis, Vlasis Ninios, Vasileios Sachpekidis, Pavlos Rouskas, Leonidas Poulimenos, Georgios Charalampidis, Eftihia Hamodraka, Athanasios Manolis, Robert Gabor Kiss, Tunde Borsanyi, Zoltan Jarai, Andras Zsary, Elektra Bartha, Annamaria Kosztin, Alexandra Doronina, Attila Kovacs, Barabas Janos Imre, Chun Chao, Kalman Benke, Istvan Karoczkai, Kati Keltai, Zsolt Förchécz, Zoltán Pozsonyi, Zsigmond Jenei, Adam Patthy, Laszlo Sallai, Zsuzsanna Majoros, Tamás Pál, Jusztina Bencze, Ildiko Sagi, Andrea Molnar, Anita Kurczina, Gabor Kolodzey, Istvan Edes, Valeria Szatmari, Zsuzsanna Zajacz, Attila Cziraki, Adam Nemeth, Reka Faludi, Laszlone Vegh, Eva Jebelovszki, Geza Karoly Lupkovics, Zsofia Kovacs, Andras Horvath, Gezim Berisha, Pranvera Ibrahimi, Luan Percuku, Rano Arapova, Elmira Laahunova, Kseniia Neronova, Zarema Zhakypova, Gulira Naizabekova, Gulnazik Muratova, Iveta Sime, Nikolajs Sorokins, Ginta Kamzola, Irina Cgojeva-Sproge, Gita Rancane, Ramune Valentinaviciene, Laima Rudiene, Rasa Raugaliene, Aiste Bardzilauske, Regina Jonkaitiene, Jurate Petrauskaite, Monika Bieseviciene, Raimonda Verseckaite, Ruta Zvirblyte, Danute Kalibatiene, Greta Radauskaite, Gabija Janaviciute-Matuzeviciene, Dovile Jancauskaite, Deimile Balkute, Juste Maneikyte, Ingrida Mileryte, Monika Vaisvilaite, Lina Gedvilaite, Mykolas Biliukas, Vaiva Karpaviciene, Robert George Xuereb, Elton Pllaha, Roxana Djaberi, Klaudiusz Komor, Agnieszka Gorgon-Komor, Beata Loranc, Jaroslaw Myszor, Katarzyna Mizia-Stec, Adrianna Berger-Kucza, Magdalena Mizia, Mateusz Polak, Piotr Bogacki, Piotr Podolec, Monika Komar, Ewa Sedziwy, Dorota Sliwiak, Bartosz Sobien, Beata Rog, Marta Hlawaty, Urszula Gancarczyk, Natasza Libiszewska, Danuta Sorysz, Andrzej Gackowski, Malgorzata Cieply, Agnieszka Misiuda, Franciszek Racibor, Anna Nytko, Kazimierz Widenka, Maciej Kolowca, Janusz Bak, Andrzej Curzytek, Mateusz Regulski, Malgorzata Kamela, Mateusz Wisniowski, Tomasz Hryniewiecki, Piotr Szymanski, Monika Rozewicz, Maciej Grabowski, Andrzej Budaj, Beata Zaborska, Ewa Pilichowska-Paskiet, Malgorzata Sikora-Frac, Tomasz Slomski, Isabel Joao, Ines Cruz, Hélder Pereira, Rita Cale, Ana Marques, Ana Rita Pereira, Carlos Morais, Antonio Freitas, David Roque, Nuno Antunes, Antonio Costeira Pereira, Catarina Vieira, Nuno Salome, Juliana Martins, Isabel Campos, Goncalo Cardoso, Claudia Silva, Afonso Oliveira, Mariana Goncalves, Rui Martins, Nuno Quintal, Bruno Mendes, Joseline Silva, Joao Ferreira, James Milner, Patricia Alves, Vera Marinho, Paula Gago, Jose Amado, Joao Bispo, Dina Bento, Inocencia Machado, Margarida Oliveira, Lucy Calvo, Pedro von Hate, Bebiana Faria, Ana Galrinho, Luisa Branco, Antonio Goncalves, Tiago Mendonca, Mafalda Selas, Filipe Macedo, Carla Sousa, Sofia Cabral, Filomena Oliveira, Maria Trepa, Marta Fontes-Oliveira, Alzira Nunes, Paulo Araújo, Vasco Gama Ribeiro, Joao Almeida, Alberto Rodrigues, Pedro Braga, Sonia Dias, Sofia Carvalho, Catarina Ferreira, Alberto Ferreira, Pedro Mateus, Miguel Moz, Silvia Leao, Renato Margato, Ilidio Moreira, Jose Guimanaes, Joana Ribeiro, Fernando Goncalves, Jose Cabral, Ines Almeida, Luisa Goncalves, Mariana Tarusi, Calin Pop, Claudia Matei, Diana Tint, Sanziana Barbulescu, Sorin Micu, Ioana Pop, Costica Baba, Doina Dimulescu, Maria Dorobantu, Carmen Ginghina, Roxana Onut, Andreea Popescu, Brandusa Zamfirescu, Raluca Aflorii, Mihaela Popescu, Liviu Ghilencea, Andreeea Rachieru, Monica Stoian, Nicoleta Oprescu, Silvia Iancovici, Iona Petre, Anca Doina Mateescu, Andreea Calin, Simona Botezatu, Roxana Enache, Monica Rosca, Daniela Ciuperca, Evelyn Babalac, Ruxandra Beyer, Laura Cadis, Raluca Rancea, Raluca Tomoaia, Adela Rosianu, Emese Kovacs, Constantin Militaru, Alina Craciun, Oana Mirea, Mihaela Florescu, Lucica Grigorica, Daniela Dragusin, Luiza Nechita, Mihai Marinescu, Teodor Chiscaneanu, Lucia Botezatu, Costela Corciova, Antoniu Octavian Petris, Catalina Arsenescu-Georgescu, Delia Salaru, Dan Mihai Alexandrescu, Carmjen Plesoianu, Ana Tanasa, Ovidiu Mitu, Irina Iuliana Costache, Ionut Tudorancea, Catalin Usurelu, Gabriela Eminovici, Ioan Manitiu, Oana Stoia, Adriana Mitre, Dan-Octavian Nistor, Anca Maier, Silvia Lupu, Mihaela Opris, Adina Ionac, Irina Popescu, Simina Crisan, Cristian Mornos, Flavia Goanta, Liana Gruescu, Oana Voinescu, Madalina Petcu, Ramona Cozlac, Elena Damrina, Liliya Khilova, Irina Ryazantseva, Dmitry Kozmin, Maria Kiseleva, Marina Goncharova, Kamila Kitalaeva, Victoria Demetskay, Artem Verevetinov, Mikhail Fomenko, Elena Skripkina, Viktor Tsoi, Georgii Antipov, Yuri Schneider, Denis Yazikov, Marina Makarova, Aleksei Cherkes, Natalya Ermakova, Aleksandr Medvedev, Anastasia Sarosek, Mikhail Isayan, Tatyana Voronova, Oleg Kulumbegov, Alina Tuchina, Sergei Stefanov, Margarita Klimova, Konstantin Smolyaninov, Zhargalma Dandarova, Victoriya Magamet, Natalia Spiropulos, Sergey Boldyrev, Kirill Barbukhatty, Dmitrii Buyankov, Vladimir Yurin, Yuriy Gross, Maksim Boronin, Mariya Mikhaleva, Mariya Shablovskaya, Alex Zotov, Daniil Borisov, Vasily Tereshchenko, Ekaterina Zubova, A. Kuzmin, Ivan Tarasenko, Alishir Gamzaev, Natalya Borovkova, Tatyana Koroleva, Svetlana Botova, Ilya Pochinka, Vera Dunaeva, Victoria Teplitskaya, Elena I. Semenova, Olga V. Korabel'Nikova, Denis S. Simonov, Elena Denisenko, Natalia Harina, Natalia Yarohno, Svetlana Alekseeva, Julia Abydenkova, Lyubov Shabalkina, Olga Mayorova, Valeriy Tsechanovich, Igor Medvedev, Michail Lepilin, PenzaEvgenii Nemchenko, Vadim Karnahin, Vasilya Safina, Yaroslav Slastin, Venera Gilfanova, Roman Gorbunov, Ramis Jakubov, Aigul Fazylova, Mansur Poteev, Laysan Vazetdinova, Indira Tarasova, Rishat Irgaliyev, Olga Moiseeva, Mikhail Gordeev, Olga Irtyuga, Raisa Moiseeva, Nina Ostanina, Dmitry Zverev, Patimat Murtazalieva, Dmitry Kuznetsov, Mariya Skurativa, Larisa Polyaeva, Kirill Mihaiilov, Biljana Obrenovic-Kircanski, Svetozar Putnik, Dragan Simic, Milan Petrovic, Natasa Markovic Nikolic, Ljiljana Jovovic, Dimitra Kalimanovska Ostric, Milan Brajovic, Milica Dekleva Manojlovic, Vladimir Novakovic, Danijela Zamaklar-Trifunovic, Bojana Orbovic, Olga Petrovic, Marija Boricic-Kostic, Kristina Andjelkovic, Marko Milanov, Maja Despotovic-Nikolic, Sreten Budisavljevic, Sanja Veljkovic, Nataša Cvetinovic, Daniijela Lepojevic, Aleksandra Todorovic, Aleksandra Nikolic, Branislava Borzanovic, Ljiljana Trkulja, Slobodan Tomic, Milan Vukovic, Jelica Milosavljevic, Mirjana Milanovic, Vladan Stakic, Aleksandra Cvetkovic, Suzana Milutinovic, Olivera Bozic, Miodrag Miladinovic, Zoran Nikolic, Dinka Despotovic, Dimitrije Jovanovic, Anastazija Stojsic-Milosavljevic, Aleksandra Ilic, Mirjana Sladojevic, Stamenko Susak, Srdjan Maletin, Salvo Pavlovic, Vladimir Kuzmanovic, Nikola Ivanovic, Jovana Dejanovic, Dusan Ruzicic, Dragana Drajic, Danijel Cvetanovic, Marija Mirkovic, Jon Omoran, Roman Margoczy, Katarina Sedminova, Adriana Reptova, Eva Baranova, Tatiana Valkovicova, Gabriel Valocik, Marian Kurecko, Marianna Vachalcova, Alzbeta Kollarova, Martin Studencan, Daniel Alusik, Marek Kozlej, Jana Macakova, Sergio Moral, Merce Cladellas, Daniele Luiso, Alicia Calvo, Jordi Palet, Juli Carballo, Gisela Teixido Tura, Giuliana Maldonado, Laura Gutierrez, Teresa Gonzalez-Alujas, Rodriguez Palomares Jose Fernando, Nicolas Villalva, Ma Jose Molina-Mora, Ramon Rubio Paton, Juan Jose Martinez Diaz, Pablo Ramos Ruiz, Alfonso Valle, Ana Rodriguez, Edgardo Alania, Emilio Galcera, Julia Seller, Gonzalo de la Morena Valenzuela, Daniel Saura Espin, Dolores Espinosa Garcia, Maria Jose Oliva Sandoval, Josefa Gonzalez, Miguel Garcia Navarro, Maria Teresa Perez-Martinez, Jose Ramon Ortega Trujillo, Irene Menduina Gallego, Daniel San Roman, Eliu David Perez Nogales, Olga Medina, Rodolfo Antonio Montiel Quintero, Pablo Felipe Bujanda Morun, Marta Lopez Perez, Jimmy Plasencia Huaripata, Juan Jose Morales Gonzalez, Veronica Quevedo Nelson, Jose Luis Zamorano, Ariana Gonzalez Gomez, Alfonso Fraile, Maria Teresa Alberca, Joaquin Alonso Martin, Covadonga Fernandez-Golfin, Javier Ramos, Sergio Hernandez Jimenez, Cristina Mitroi, Pedro L. Sanchez Fernandez, Elena Diaz-Pelaez, Beatriz Garde, Luis Caballero, Fermin Martinez Garcia, Francisco Cambronero, Noelia Castro, Antonio Castro, Alejandro De La Rosa, Pastora Gallego, Irene Mendez, David Villagomez Villegas, Manuel Gonzalez Correa, Roman Calvo, Francisco Florian, Rafael Paya, Esther Esteban, Francisco Buendia, Andrés Cubillos, Carmen Fernandez, Juan Pablo Cárdenas, José Leandro Pérez-Boscá, Joan Vano, Joaquina Belchi, Cristina Iglesia-Carreno, Francisco Calvo Iglesias, Aida Escudero-Gonzalez, Sergio Zapateria-Lucea, Juan Sterling Duarte, Lara Perez-Davila, Rafael Cobas-Paz, Rosario Besada-Montenegro, Maribel Fontao-Romeo, Elena Lopez-Rodriguez, Emilio Paredes-Galan, Berenice Caneiro-Queija, Alba Guitian Gonzalez, Abdi Bozkurt, Serafettin Demir, Durmus Unlu, Caglar Emre Cagliyan, Muslum Firat Ikikardes, Mustafa Tangalay, Osman Kuloglu, Necla Ozer, Ugur Canpolat, Melek Didem Kemaloglu, Abdullah Orhan Demirtas, Didar Elif Akgün, Eyup Avci, Gokay Taylan, Mustafa Adem Yilmaztepe, Fatih Mehmet Ucar, Servet Altay, Muhammet Gurdogan, Naile Eris Gudul, Mujdat Aktas, Mutlu Buyuklu, Husnu Degirmenci, Mehmet Salih Turan, Kadir Ugur Mert, Gurbet Ozge Mert, Muhammet Dural, Sukru Arslan, Nurten Sayar, Batur Kanar, Beste Ozben Sadic, Ahmet Anil Sahin, Ahmet Buyuk, Onur Kilicarslan, Cem Bostan, Tarik Yildirim, Seda Elcim Yildirim, Kahraman Cosansu, Perihan Varim, Ersin Ilguz, Recep Demirbag, Asuman Yesilay, Abdullah Cirit, Eyyup Tusun, Emre Erkus, Muhammet Rasit Sayin, Zeynep Kazaz, Selim Kul, Turgut Karabag, Belma Kalayci, Clinical sciences, Cardio-vascular diseases, and Cardiology
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Male ,medicine.medical_specialty ,Multivariate analysis ,Clinical Decision-Making ,Risk Assessment ,Severity of Illness Index ,decision making ,surgery ,Risk Factors ,Internal medicine ,Intervention (counseling) ,medicine ,Clinical endpoint ,Humans ,03.02. Klinikai orvostan ,guidelines ,Symptomatic aortic stenosis ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,valvular heart disease ,Disease Management ,aortic stenosis ,Aortic Valve Stenosis ,Odds ratio ,medicine.disease ,Europe ,Stenosis ,Treatment Outcome ,Echocardiography ,Aortic Valve ,Charlson comorbidity index ,transcatheter aortic valve replacement ,Female ,Morbidity ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,surgical aortic valve replacement - Abstract
BACKGROUND There were gaps between guidelines and practice when surgery was the only treatment for aortic stenosis (AS). OBJECTIVES This study analyzed the decision to intervene in patients with severe AS in the EORP VHD (EURObservational Research Programme Valvular Heart Disease) II survey. METHODS Among 2,152 patients with severe AS, 1,271 patients with high-gradient AS who were symptomatic fulfilled a Class I recommendation for intervention according to the 2012 European Society of Cardiology guidelines; the primary end point was the decision for intervention. RESULTS A decision not to intervene was taken in 262 patients (20.6%). In multivariate analysis, the decision not to intervene was associated with older age (odds ratio [OR]: 1.34 per 10-year increase; 95% CI: 1.11 to 1.61; P = 0.002), New York Heart Association functional classes I and II versus III (OR: 1.63; 95% CI: 1.16 to 2.30; P = 0.005), higher age adjusted Charlson comorbidity index (OR: 1.09 per 1-point increase; 95% CI: 1.01 to 1.17; P = 0.03), and a lower transaortic mean gradient (OR: 0.81 per 10-mm Hg decrease; 95% CI: 0.71 to 0.92; P < 0.001). During the study period, 346 patients (40.2%, median age 84 years, median EuroSCORE II [European System for Cardiac Operative Risk Evaluation II] 3.1%) underwent transcatheter intervention and 515 (59.8%, median age 69 years, median EuroSCORE II 1.5%) underwent surgery. A decision not to intervene versus intervention was associated with lower 6-month survival (87.4%; 95% CI: 82.0 to 91.3 vs 94.6%; 95% CI: 92.8 to 95.9; P < 0.001). CONCLUSIONS A decision not to intervene was taken in 1 in 5 patients with severe symptomatic AS despite a Class I recommendation for intervention and the decision was particularly associated with older age and combined comorbidities. Transcatheter intervention was extensively used in octogenarians. (J Am Coll Cardiol 2021;78:2131-2143) (c) 2021 by the American College of Cardiology Foundation.
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- 2021
16. Ultrasound Imaging of the Abdominal Aorta: A Comprehensive Review
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Victor Aboyans, Bahaa M. Fadel, Dania Mohty, Fatima Arshi, Najmeddine Echahidi, Bandar Alamro, Manal Mustafa, Brigitte E. Kazzi, Public Health Directorate, Saudi Ministry of Health, WHO Collaborating Center for Mass Gathering Medicine, Riyadh, Saudi Arabia, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Service de cardiologie [CHU Limoges], CHU Limoges, Johns Hopkins Hospital, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), and Université de Limoges (UNILIM)-Université de Limoges (UNILIM)
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medicine.medical_specialty ,Hemodynamics ,Aortic regurgitation ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,medicine.artery ,Ultrasound ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Aorta, Abdominal ,Abdominal aorta ,Ultrasonography ,business.industry ,Blood flow ,medicine.disease ,3. Good health ,Echocardiography ,Ultrasound imaging ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
International audience; Ultrasound is the imaging modality of choice for the initial evaluation of disorders that involve the abdominal aorta (AA). The diagnostic value of ultrasound resides in its ability to allow assessment of the anatomy and structure of the AA using two- dimensional, three-dimensional, and contrast-enhanced imaging. Moreover, ultrasound permits evaluation of the physiologic and hemodynamic consequences of abnormalities through Doppler interrogation of blood flow, thus enabling the identification and quantification of disorders within the AA and beyond its boundaries. The approach to ultrasound imaging of the AA varies, depending on the purpose of the study and whether it is performed in a radiology or vascular laboratory or in an echocardiography laboratory. The aim of this review is to demonstrate the usefulness of ultrasound imaging for the detection and evaluation of disorders that involve the AA, detail the abnormalities that are detected or further assessed, and outline its value for echocardiographers, sonographers, and radiologists.
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- 2021
17. Echocardiographic Patterns of Left Ventricular Diastolic Function in Cardiac Amyloidosis: An Updated Evaluation
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Diane Bodez, Anissa Moktefi, Dania Mohty, Arnault Galat, L. Bonnefous, Silvia Oghina, Mounira Kharoubi, Jean-François Deux, Mélanie Bézard, Wulfran Bougouin, Emmanuel Teiger, Emmanuel Itti, Fabien Le Bras, Soulef Guendouz, Thibaud Damy, and Pascale Fanen
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medicine.medical_specialty ,Multivariate analysis ,Longitudinal strain ,business.industry ,diastolic function ,Diastole ,cardiac amyloidosis ,heart failure ,General Medicine ,medicine.disease ,Article ,Cardiac amyloidosis ,Heart failure ,Internal medicine ,Cohort ,Cardiology ,Medicine ,echocardiography ,Diastolic function ,guidelines ,business ,Heart failure with preserved ejection fraction - Abstract
Aims: Multimodal imaging has allowed cardiac amyloidosis (CA) to be increasingly recognised as a treatable cause of heart failure with preserved ejection fraction, but its prognosis remains poor due to late diagnosis. To assess the left ventricular diastolic function (LVDF) patterns in a large contemporary CA cohort according to the current recommendations and to identify their determinants. Methods and Results: We conducted a monocentric, observational study on a cohort of CA patients from a tertiary CA referral centre. Diastolic function was analysed using standard echocardiography and clinical, laboratory and survival parameters were collected. Four hundred and sixty-four patients with one of the three main type of CA were included: 41% had grade III diastolic dysfunction (restrictive mitral pattern), 25% had grade II diastolic dysfunction, and 25% had grade I diastolic dysfunction, 9% were unclassified. No difference was found between the main CA types. After multivariate analyses, grades II and III were independently associated with dyspnoea, elevated NT-proBNP, cardiac infiltration and systolic dysfunction (global longitudinal strain). Grade I patients had a better prognosis. Conclusions: All LVDF patterns can be observed in CA. One quarter of CA patients have grade I LVDF, reflecting the emergence of earlier stage-related phenotypes with a better prognosis.
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- 2021
18. Using the appropriate formula for QT measurement can save lives
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Kausar Suleman, Susan Dent, Adher D. Al Sayed, Hussein Raef, Dahish Ajarim, Dania Mohty, Taher Al-Tweigeri, and Najmeddine Echahidi
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medicine.medical_specialty ,Population ,Breast Neoplasms ,Torsades de pointes ,QT interval ,Sudden cardiac death ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Heart Rate ,Internal medicine ,Humans ,Medicine ,cardiovascular diseases ,education ,education.field_of_study ,Framingham Risk Score ,business.industry ,Surrogate endpoint ,Hematology ,General Medicine ,medicine.disease ,Long QT Syndrome ,Oncology ,030220 oncology & carcinogenesis ,Cardiology ,Hormonal therapy ,Female ,business ,030215 immunology - Abstract
CDK 4/6 inhibitors, in combination with endocrine therapy, are the standard of care for patients with endocrine-sensitive advanced breast cancer. This class of drug, however, is associated with QT prolongation, which serves as a surrogate marker for Torsades de Pointes (TdP), a cause of life-threatening ventricular arrhythmias and sudden cardiac death. The ICH E14 guidance document uses the Bazett formula for reporting of cardio-dynamic and safety ECG data in clinical trials. While there is substantial familiarity with the Bazett (QTcB) formula (QT/(RR) 1/2), the Fridericia (QTcF) formula (QT/(RR) 1/3 ) is preferred in the cancer population as it is often more accurate at heart rate extreme. Accordingly, the Fridericia formula is currently the standard adopted by the FDA when submitting QT data for review. At the King Faisal Specialist Hospital and Research Center, a total of 82 patients with advanced breast cancer, had a baseline ECG on day 1 before the initiation of ribociclib based therapy. Of the enrolled 82 patients, 19 (23%) were initially excluded from receiving ribociclib based due to a prolonged QTc >450ms, however, when the QTc-interval was manually measured and recalculated using Fridericia and Framingham formulae using MDCalC (https//:www.mdcalc.com),17 of 19 patients successfully received their treatment without any arrhythmogenic effects. Repeat ECG on day14, and day 1 of cycle 2 demonstrated that none of these patients had QTc exceeding 480 ms. Our data highlights the complexities of evaluating the QT interval in oncology patients and the utility of the Fridericia/Framingham formulae in this population. Given these findings, we recommend the adoption of the Fridericia or Framingham formulae for measurement of QTc in all cancer patients exposed to potentially QT-prolonging cancer therapy.
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- 2021
19. Diagnostic Accuracy of Dobutamine Stress Echocardiography for Detection of Cardiac Allograft Vasculopathy in Orthotopic Heart Transplant Patients
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Mohammed, Mahmoodurrahman, Josef, Marek, Hamzah Ruxshan, Juhardeen, Talal, Al Otaibi, Vera Maria Cury, Salemi, Najmeddine, Echahidi, Jehad, Al Buraiki, Bahaa M, Fadel, and Dania, Mohty
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Heart transplantation ,Dobutamine echocardiography ,medicine.medical_specialty ,Myocardial ischemia ,Dobutamine stress echocardiography ,business.industry ,medicine.medical_treatment ,Diagnostic imaging tools ,Diagnostic accuracy ,Cardiac allograft vasculopathy ,Stress echocardiography ,Internal medicine ,medicine ,Stress Echocardiography ,Cardiology ,Transplant patient ,Original Article ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective Cardiac allograft vasculopathy is one of the leading causes of late graft failure and subsequent death in orthotopic heart transplant. Although invasive coronary angiography is the gold standard modality for detection of cardiac allograft vasculopathy, dobutamine stress echocardiography has been recently frequently used as an alternative. Our aim was to evaluate the diagnostic performance of dobutamine stress echocardiography for detection of cardiac allograft vasculopathy in transplant patients. Methods A retrospective analysis was conducted using a total of 150 dobutamine stress echocardiographic exams that were performed on 99 patients in our institution, with paired coronary angiogram and no acute rejection, within a median of 538 [interquartile range 371–816] days. Sensitivity and specificity of dobutamine echocardiography to detect allograft vasculopathy was evaluated. Allograft vasculopathy was defined as Grade 1 or higher based on ISHLT criteria. A positive dobutamine stress echo result was defined by new or worsening wall motion abnormality. Results Median age of the population at transplant was 34 [interquartile range 22–46] years; 76 (77%) patients were male. Allograft vasculopathy was present in 31 (20.6%) out of 150 coronary angiograms. Only 7 (4.6%) of that number were positive on dobutamine stress echocardiography. Sensitivity and specificity for allograft vasculopathy detection was 3% and 94%, respectively. Out of 7 false positive dobutamine stress echocardiograms, two were in patients with myocardial bridging. Two patients with mild acute rejection had both negative dobutamine stress echo. Conclusions Overall, positivity of dobutamine stress echocardiography in patients after heart transplant is low. It has high specificity, but very low sensitivity for detection of cardiac allograft vasculopathy. Dobutamine stress echocardiography should only be cautiously used as an alternative to coronary angiography.
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- 2021
20. Atrial function in the Fontan circulation: comparison with invasively assessed systemic ventricular filling pressure
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Monerah Alsaleh, Olga Vriz, Ziyad Issa, Yezan Salam, Shisamma Emmanual, AlJuhara Thaar AlMarzoog, Gruschen R. Veldtman, Tarek Alsaied, Rahul H. Rathod, Mathias Possner, Dania Mohty, Mohammed Saleh AlHabdan, and Ghassan Siblini
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Male ,medicine.medical_specialty ,Hemodynamics ,030204 cardiovascular system & hematology ,Fontan Procedure ,Fontan circulation ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,medicine.artery ,Occlusion ,medicine ,Ventricular Pressure ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,cardiovascular diseases ,030212 general & internal medicine ,Atrium (heart) ,Child ,business.industry ,medicine.anatomical_structure ,Echocardiography ,Pulmonary artery ,cardiovascular system ,Vascular resistance ,Cardiology ,Atrial Function, Left ,Cardiology and Cardiovascular Medicine ,business ,Ventricular filling - Abstract
Abnormal atrial mechanics in biventricular circulations have been associated with elevated left heart filling pressures. Similar associations in the Fontan circulation are unknown. The aim of this study was to examine the relationship between atrial mechanics and invasively assessed hemodynamic parameters late after the Fontan operation. Thirty-nine Fontan patients with echocardiographic and invasive hemodynamic studies done within 48 h were included and were compared to 40 age-matched healthy controls. Atrial and ventricular strain measurements were measured offline using 2-dimensional speckle-tracking. Mean age was 10.2 ± 6.7 years and 24 (62%) were male. Atrial strain measures were lower in Fontan patients compared to healthy controls. There was no significant association between atrial strain measurements and Fontan systemic ventricular filling pressures (SVFP) as indicated by pulmonary artery occlusion pressures, direct left atrial pressure or systemic ventricular end-diastolic pressure. Global atrial strain was not correlated with segmental atrial strain in the pulmonary venous atrium. Global atrial reservoir strain was positively correlated with pulmonary vascular resistance (r = 0.508, p = 0.045). Global atrial conduit strain was positively correlated with E/A ratio of the AV valve inflow (r = 0.555, p = 0.002). Atrial and ventricular strain measurements were not significantly correlated. In patients with a Fontan, global atrial function is significantly depressed, and is uncoupled from segmental left lateral atrial function. Global as well as segmental atrial mechanics are not significantly associated with SVFPs in Fontan patients. Instead, global atrial reservoir function appears to parallel pulmonary vascular resistance.
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- 2021
21. Data Mining for the Identification of Known and Candidate Transthyretin Amyloidosis Variants in the Saudi Population
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Dorota Monies, Islam Alayary, Dania Mohty, Mohamed Abouelhoda, Bahaa M. Fadel, Brian F. Meyer, and Stefan T. Arold
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Transthyretin ,education.field_of_study ,biology ,Amyloidosis ,Population ,biology.protein ,medicine ,Identification (biology) ,Computational biology ,education ,medicine.disease - Abstract
BackgroundFamilial transthyretin (TTR) amyloidosis (ATTR) is an autosomal dominant disease with significant phenotypic heterogeneity. Its prevalence in Saudi Arabia has not previously been investigated. An existing exome variant database of Saudi individuals, sequenced to globally investigate rare diseases in the population, was mined for TTR variants and filtered for missense mutations resulting in single amino acid changes. A total of 13,906 Saudi exomes from unrelated individuals were analyzed blindly. ResultsThree TTR variants known to be associated with ATTR amyloidosis were identified. Additionally, three novel TTR mutations were identified. Structural analysis of the three novel variants suggests that at least two could be amyloidogenic. The most common variant associated with amyloidosis was p.Val142Ile (allele frequency 0.001). Further investigation of these variants and their translation to clinical practice may help to diagnose, monitor and manage patients with ATTR amyloidosis.ConclusionMultiple TTR variants potentially associated with systemic ATTR amyloidosis were identified in the Saudi population. Early diagnosis and intervention, facilitated by familial genetic testing of patients with ATTR amyloidosis, may benefit in the management of this disease. Early diagnosis could be enhanced through inclusion of ATTR variants in existing population-based screening programs.
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- 2021
22. Causes and consequences of cardiac fibrosis in patients referred for surgical aortic valve replacement
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Aziz Guellich, Julien Ternacle, Eric Bergoend, Larissa Lipskaia, Diane Bodez, Arnault Galat, Costin Radu, Geneviève Derumeaux, Thibaud Damy, Jean-Luc Monin, Sophie Hüe, Stéphane Moutereau, and Dania Mohty
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Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_specialty ,Cardiac fibrosis ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Aortic valve replacement ,Valve replacement ,Fibrosis ,Original Research Articles ,Internal medicine ,Biopsy ,medicine ,Humans ,Prospective Studies ,Original Research Article ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,Heart Valve Prosthesis Implantation ,Inflammation ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Myocardium ,Aortic stenosis ,Aortic Valve Stenosis ,IL‐6 ,Middle Aged ,medicine.disease ,Stenosis ,lcsh:RC666-701 ,Heart failure ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Cardiac fibrosis is associated with left ventricular (LV) remodelling and contractile dysfunction in aortic stenosis (AS). The fibrotic process in this condition is still unclear. The aim of this study was to determine the role of both local and systemic inflammation as underlying mechanisms of LV fibrosis and contractile dysfunction. The diagnostic values of 2D‐strain echocardiography and serum biomarkers in the evaluation of cardiac fibrosis in this condition were assessed through correlation analyses. Methods and results Patients with AS referred for surgical valve replacement were prospectively and consecutively included. They all had a comprehensive echocardiography including 2D strain. Blood samples were collected to measure cytokines and inflammatory biomarkers using Luminex bead‐based assays. A per‐surgical myocardial biopsy of the basal antero‐septal segment (S1) was performed. Serial sections of each biopsy were stained with Sirius red. Digital image analysis was used to quantify fibrosis. Immunostainings using specific antibodies against macrophage, glycoprotein (gp) 130, and interleukin 6 (IL‐6) were also performed. Patients were divided into tertiles reflecting the severity of fibrosis: mild, moderate, and severe load (TF1 to TF3). The mean age of the 58 included patients was 73 ± 11 years. Twenty‐four (43%) were in New York Heart Association III–IV. Mean aortic valve area was 0.8 ± 0.2 cm2. Mean aortic stenosis peak velocity and mean gradient were respectively 4.5 ± 0.8 m/s and 54 ± 15 mmHg. The mean LV ejection fraction was 54 ± 12%, and the global LV longitudinal strain was −15 ± 4%. The mean S1 strain, corresponding to the biopsied region, was −10 ± 6% and was strongly correlated to fibrosis load (R = 0.83, P
- Published
- 2019
23. Distribution and Prognostic Significance of Left Ventricular Global Longitudinal Strain in Asymptomatic Significant Aortic Stenosis
- Author
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Milind Y. Desai, Helle Gervig Carstensen, Kimi Sato, Patrizio Lancellotti, Jordi S. Dahl, Masaaki Takeuchi, Concetta Zito, Anne-Claire Casalta, Erwan Donal, Thomas H. Marwick, Dania Mohty, Luc Pierard, Gilbert Habib, Bogdan A. Popescu, Bernard Cosyns, Leighton G Kearney, and Julien Magne
- Subjects
medicine.medical_specialty ,Ejection fraction ,business.industry ,Mortality rate ,Hazard ratio ,030204 cardiovascular system & hematology ,16. Peace & justice ,medicine.disease ,Asymptomatic ,Confidence interval ,030218 nuclear medicine & medical imaging ,3. Good health ,03 medical and health sciences ,Stenosis ,0302 clinical medicine ,Meta-analysis ,Aortic valve stenosis ,Internal medicine ,medicine ,Cardiology ,Radiology, Nuclear Medicine and imaging ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES In this individual participant data meta-analysis on left ventricular global longitudinal strain (LVGLS), our objective was to 1) describe its distribution; 2) identify the most predictive cutoff values; and 3) assess its impact on mortality in asymptomatic patients with significant aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF). BACKGROUND The evidence supporting the prognostic role of LVGLS in asymptomatic patients with AS has been obtained from several relatively small studies. METHODS A literature search was performed for studies published between 2005 and 2017 without language restriction according to the following criteria "aortic stenosis" AND "longitudinal strain." The corresponding authors of selected studies were contacted and invited to share their data that we computerized in a specific database. The primary endpoint was all-cause mortality. RESULTS Among the 10 studies included, 1,067 asymptomatic patients with significant AS and LVEF >50% were analyzed. The median of LVGLS was 16.2% (from 5.6% to 30.1%). There were 91 deaths reported during follow-up with median of 1.8 (0.9 to 2.8) years, resulting in a pooled crude mortality rate of 8.5%. The LVGLS performed well in the prediction of death (area under the curve 0.68). The best cutoff value identified was LVGLS of 14.7% (sensitivity, 60%; specificity, 70%). Using random effects model, the risk of death for patients with LVGLS 2.5 (hazard ratio 2.62; 95% confidence interval 1.66 to 4.13; p = 60% (p = 0.001). CONCLUSIONS This individual participant data meta-analysis demonstrates that in asymptomatic patients with significant AS and normal LVEF, impaired LVGLS is associated with reduced survival. These data emphasize the potential usefulness of LVGLS for risk stratification and management of these patients. (C) 2019 the American College of Cardiology Foundation. Published by Elsevier. All rights reserved.
- Published
- 2019
24. Multiparametric Approach for the Assessment of Mechanical Prosthetic Tricuspid Leaflet Function
- Author
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Marie-Annick Clavel, Brigitte E. Kazzi, Bahaa M. Fadel, Dania Mohty, Khadija Alassas, Philippe Pibarot, and Mohamad Fekredeen Ayas
- Subjects
medicine.medical_specialty ,Heart Valve Diseases ,Flow propagation ,Internal medicine ,medicine ,Ventricular outflow tract ,Fluoroscopy ,Humans ,Radiology, Nuclear Medicine and imaging ,Tricuspid valve ,medicine.diagnostic_test ,Effective orifice area ,business.industry ,Area under the curve ,medicine.disease ,Thrombosis ,Echocardiography, Doppler ,medicine.anatomical_structure ,Echocardiography ,Heart Valve Prosthesis ,cardiovascular system ,Cardiology ,Early diastolic ,Mitral Valve ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background There is a lack of comprehensive echocardiographic data to allow discrimination of normal versus abnormal mechanical prosthetic tricuspid valve (MPTV) leaflet function. The identification of such parameters is essential to optimize diagnostic and therapeutic measures. Methods The authors investigated bileaflet MPTV function by comparing transthoracic echocardiographic data from 21 episodes of leaflet dysfunction due to valve thrombosis in 12 patients with data from 56 individuals with normal MPTV function. All episodes of dysfunction were confirmed by transesophageal echocardiography and/or cine fluoroscopy. Transthoracic echocardiography–derived two-dimensional, color, and spectral Doppler variables, including MPTV peak early diastolic velocity (E velocity), mean gradient, pressure half-time, time-velocity integral (TVI) of the MPTV, ratio of TVIMPTV to TVI of the left ventricular outflow tract (LVOT) and TVI of the right ventricular outflow tract (RVOT), and continuity-derived effective orifice area, were measured in both groups. Results Most episodes of MPTV dysfunction resulted from simultaneous involvement of both leaflets (57%), with leaflet(s) often immobilized in the open or semiopen position (71%). Transthoracic and transesophageal echocardiography performed similarly in detecting abnormal leaflet motion (90% vs 88%, P = .68), whereas transesophageal echocardiography was better in identifying MPTV thrombosis (31% vs 14%, respectively, P = .01). Color Doppler demonstrated flow propagation abnormalities in 67% of episodes of leaflet dysfunction but not in the control group (P 1.6 m/sec, mean gradient > 5 mm Hg, PHT > 157 msec, TVIMPTV > 42 cm, TVIMPTV/TVILVOT > 2.3, TVIMPTV/TVIRVOT > 3.0, and continuity-derived effective orifice area ≤ 1.1 cm2, with most variables showing high and similar accuracy (area under the curve ≥ 95%). Conclusions This study represents the first comprehensive echocardiographic assessment of MPTV leaflet dysfunction that provides parameters and criteria to distinguish normal versus abnormal prosthetic valve function.
- Published
- 2021
25. The role of transcatheter approaches for the treatment of pulmonary homograft dysfunction
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Dania Mohty, Bahaa M. Fadel, Khadija Alassas, and Zohair Al-Halees
- Subjects
medicine.medical_specialty ,Text mining ,Editorial ,business.industry ,medicine ,Surgery ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business - Published
- 2020
26. Spectral Doppler Interrogation of the Pulmonary Veins for the Diagnosis of Cardiac Disorders: A Comprehensive Review
- Author
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Domenico Galzerano, Najmeddine M Echahidi, Philippe Pibarot, Haïfa Mahjoub, Mohammad Al-Admawi, Mohammad Alhumaid, Bahaa M. Fadel, Dania Mohty, Brigitte E. Kazzi, and Bandar Alamro
- Subjects
medicine.medical_specialty ,Hemodynamics ,030204 cardiovascular system & hematology ,Doppler echocardiography ,030218 nuclear medicine & medical imaging ,Pulmonary vein ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Interrogation ,Cardiac disorders ,Mitral regurgitation ,medicine.diagnostic_test ,business.industry ,Mitral Valve Insufficiency ,Ultrasonography, Doppler ,Blood flow ,Echocardiography, Doppler ,Pulmonary Veins ,symbols ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Doppler effect ,Blood Flow Velocity - Abstract
Data obtained from echocardiographic studies are used on a daily basis to guide clinical decision-making regarding patient management and the need for additional diagnostic investigations. Interrogation of blood flow in the pulmonary veins by spectral, most often pulsed-wave, Doppler is an important component of any comprehensive echocardiographic study. Whereas it is most often used to help assess left-sided filling pressure and quantify the severity of mitral regurgitation, the pulmonary vein Doppler profile provides added diagnostic insights into several disorders that affect heart function and allows assessment of their hemodynamic consequences on the heart. The aim of this review is to summarize current knowledge in the field of PV Doppler interrogation, highlight the physiological and pathological parameters that influence it, and delineate the manifestations of various cardiovascular disorders on the flow profile.
- Published
- 2020
27. Transcatheter versus surgical valve replacement for a failed pulmonary homograft in the Ross population
- Author
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Marie-Annick Clavel, Mansour Aljoufan, Talal Hijji, Bahaa M. Fadel, Dania Mohty, Khadija Alassas, Zohair Al-Halees, Aysha Husain, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de cardiologie [CHU Limoges], CHU Limoges, Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), and Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Male ,Cardiac Catheterization ,Time Factors ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Valve replacement ,Risk Factors ,Pulmonary Valve Replacement ,Medicine ,030212 general & internal medicine ,Heart Valve Prosthesis Implantation ,education.field_of_study ,Ross procedure ,Hazard ratio ,Allografts ,Prosthesis Failure ,3. Good health ,Treatment Outcome ,medicine.anatomical_structure ,Heart Valve Prosthesis ,Infective endocarditis ,outcome ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Adult ,Reoperation ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Adolescent ,Population ,Prosthesis Design ,Young Adult ,03 medical and health sciences ,Internal medicine ,Humans ,education ,Retrospective Studies ,Bioprosthesis ,reintervention ,Pulmonary Valve ,business.industry ,Hemodynamics ,Recovery of Function ,medicine.disease ,Pulmonary Valve Insufficiency ,transcatheter pulmonary replacement ,Echocardiography, Doppler, Color ,Pulmonary valve ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Surgery ,business ,Mace - Abstract
International audience; BACKGROUND:Patients who undergo the Ross procedure are at increased risk of pulmonary valve (PV) homograft dysfunction. For those who require reintervention on the homograft, transcatheter PV replacement (tPVR) provides a less invasive therapeutic option than surgical PVR (sPVR). We examined the outcomes following tPVR versus sPVR in a cohort of patients who underwent the Ross procedure.METHODS:We performed a retrospective analysis of Ross patients age ≥14 years who underwent tPVR (n = 47) or sPVR (n = 41) at our institution. The patients' clinical and echocardiographic data were reviewed.RESULTS:Baseline parameters, including demographic data and left ventricular and right ventricular (RV) systolic function, were similar in the 2 groups. The mean follow-up was 56 ± 24 months for the tPVR group and 89 ± 46 months for the sPVR group (P < .001). No procedure-related mortality was noted in either group. At 6-year follow-up, there was no significant between-group difference in event-free survival (tPVR, 79% ± 7% vs sPVR, 91% ± 4%; P = .15) or PV reintervention (tPVR, 26% ± 9% vs sPVR, 8% ± 5%; P = .31). PV-associated infective endocarditis (IE) was significantly more common with tPVR (tPVR, 13% vs sPVR, 0%; P = .04), with an annualized rate of 2.98% per patient-year. In addition, there was a trend toward more valve dysfunction following sPVR (sPVR, 67% ± 8% vs tPVR, 35% ± 8%; P = .08).CONCLUSIONS:In Ross patients who require reintervention on the PV homograft, both tPVR and sPVR provide low procedural mortality and comparable midterm outcome with no significant difference in mortality or PV reintervention. However, IE is more common following tPVR. A larger randomized study is needed to determine the role of each procedure in patient management.
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- 2018
28. Les amyloses cardiaques : les reconnaître et les prendre en charge
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Jean-François Deux, V. Plante-Bordeneuve, Aziz Guellich, Fabien Le Bras, Soulef Guendouz, Nicole Benhaiem, Dania Mohty, Pascale Fanen, Valérie Molinier-Frenkel, Thibaud Damy, Benoît Funalot, Nicolas Lellouche, Jean-Luc Dubois-Randé, Arnault Galat, Jean Rosso, and Diane Bodez
- Subjects
Chemotherapy ,medicine.medical_specialty ,Ejection fraction ,medicine.diagnostic_test ,biology ,business.industry ,Amyloidosis ,medicine.medical_treatment ,Hypertrophic cardiomyopathy ,nutritional and metabolic diseases ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,03 medical and health sciences ,Transthyretin ,0302 clinical medicine ,Cardiac amyloidosis ,Bone scintigraphy ,Internal medicine ,Cardiology ,biology.protein ,Medicine ,030212 general & internal medicine ,business - Abstract
Cardiac amyloidosis must be suspected in all cases of hypertrophic cardiomyopathy with preserved left ventricular ejection fraction to allow specific management. Final diagnosis needs pathological evidence, but bone scintigraphy may be an alternative for TTR amyloidosis. Invasive samplings are limited by new tools. Amyloidosis typing is required to start specific therapies if possible. Main specific treatments that are available are chemotherapy for AL; transthyretin stabilizer or gene therapy, studied for TTR-related cardiac amyloidosis.
- Published
- 2016
29. Manifestations of Cardiovascular Disorders on Doppler Interrogation of the Hepatic Veins
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Bahaa M. Fadel, Bandar Alamro, Domenico Galzerano, Dania Mohty, Khadija Alassas, Olga Vriz, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [CHU Limoges], and CHU Limoges
- Subjects
medicine.medical_specialty ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,Respiration ,hepatic veins ,Humans ,Medicine ,echocardiography ,Radiology, Nuclear Medicine and imaging ,ComputingMilieux_MISCELLANEOUS ,business.industry ,Doppler ,Reproducibility of Results ,right heart disorders ,Echocardiography, Doppler ,Liver circulation ,Cardiovascular Diseases ,Predictive value of tests ,Hepatic veins ,cardiovascular system ,symbols ,Cardiology ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Cardiology and Cardiovascular Medicine ,business ,Doppler effect ,Blood Flow Velocity ,Liver Circulation ,circulatory and respiratory physiology - Abstract
Spectral (pulsed-wave) Doppler interrogation of flow in the hepatic veins (HVs) is a part of any comprehensive echocardiographic examination. Analysis of the direction, velocity, and duration of the Doppler waveforms and their phasic response to respiration allows distinguishing normal from abnormal
- Published
- 2019
30. Echocardiography is useful to predict postoperative atrial fibrillation in patients undergoing isolated coronary bypass surgery: A prospective study
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Dania Mohty, Alessandro Piccardo, Florence Rollé, Julien Magne, Victor Aboyans, Baptiste Salerno, Alexandre Le Guyader, Claire Serena, Najmeddine Echahidi, Clinical sciences, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [CHU Limoges], CHU Limoges, and Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges]
- Subjects
Male ,medicine.medical_specialty ,macromolecular substances ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Risk Assessment ,Preoperative care ,Electrocardiography ,03 medical and health sciences ,Coronary artery bypass surgery ,Postoperative Complications ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,coronary artery bypass graft ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,echocardiography ,In patient ,Prospective Studies ,030212 general & internal medicine ,Major complication ,cardiovascular diseases ,Coronary Artery Bypass ,Prospective cohort study ,Aged ,business.industry ,Incidence ,Atrial fibrillation ,General Medicine ,Middle Aged ,medicine.disease ,Echocardiography, Doppler ,3. Good health ,medicine.anatomical_structure ,Bypass surgery ,Cardiology ,cardiovascular system ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,France ,Cardiology and Cardiovascular Medicine ,business ,left atrial volume ,Artery - Abstract
Objective: Postoperative atrial fibrillation is a major complication following coronary artery bypass graft. We hypothesized that, beyond clinical and electrocardiogram (ECG) data, transthoracic echocardiography could improve the prediction of postoperative atrial fibrillation. Methods: We prospectively studied 169 patients in sinus rhythm who underwent isolated coronary artery bypass graft in our institution. Clinical, biological, ECG and transthoracic echocardiography data were collected within 24 h before surgery. The patients were continuously monitored during the first five days, and then had daily 12-lead ECG afterwards until discharge. Postoperative atrial fibrillation was defined by any episode >10 min. Results: Postoperative atrial fibrillation was found in 65 patients (38%). Compared with those without, patients with postoperative atrial fibrillation were significantly older ( p=0.008), had more frequently a history of hypertension ( p=0.009), history of atrial fibrillation ( p2) of the model, from 34 to 57. Conclusion: A history of atrial fibrillation and indexed left atrial maximal volume are the best predictors of the occurrence of postoperative atrial fibrillation following coronary artery bypass graft. The identification of high risk population of postoperative atrial fibrillation using these two factors could lead to the development of targeted strategies to limit this frequent complication in these patients.
- Published
- 2019
31. Left ventricular assessment in patients with systemic light chain amyloidosis: a 3-dimensional speckle tracking transthoracic echocardiographic study
- Author
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Vera Maria Cury Salemi, Julien Magne, Bahaa M. Fadel, Arnaud Jaccard, Victor Aboyans, Dania Mohty, Thibaud Damy, Sarah Pradel, Cyrille Boulogne, Service de cardiologie [CHU Limoges], CHU Limoges, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité fonctionnelle insuffisance cardiaque, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est (UPE), Clinical sciences, CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service d'Hématologie clinique et thérapie cellulaire [CHU Limoges], and Grelier, Elisabeth
- Subjects
Male ,medicine.medical_specialty ,Databases, Factual ,Systole ,Echocardiography, Three-Dimensional ,3-Dimensional echocardiography ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Ventricular Function, Left ,03 medical and health sciences ,Ventricular Dysfunction, Left ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,medicine ,AL amyloidosis ,Circumferential strain ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Immunoglobulin Light-chain Amyloidosis ,Prospective Studies ,Stage (cooking) ,Cardiac imaging ,Speckle tracking imaging ,Aged ,Ejection fraction ,business.industry ,Amyloidosis ,Left ventricular function ,Reproducibility of Results ,Stroke Volume ,Middle Aged ,medicine.disease ,3. Good health ,Early Diagnosis ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,030220 oncology & carcinogenesis ,Case-Control Studies ,Cardiology ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Light chain amyloidosis ,Cardiology and Cardiovascular Medicine ,business ,Cardiomyopathies - Abstract
Cardiac involvement in systemic light chain (AL) amyloidosis carries a poor prognosis mainly through involvement of the left ventricular (LV) myocardium. Despite its limitations, two-dimensional transthoracic echocardiography (2D-TTE) remains the main tool used for the assessment of LV systolic function in AL patients. We hypothesize that 3D-TTE coupled with speckle tracking imaging allows earlier detection of LV systolic dysfunction than 2D-TTE in AL amyloidosis. We prospectively studied 71 subjects including 58 patients with confirmed AL amyloidosis (mean age 66 +/- 10years, 60% male) and 21 healthy control (mean age 64 +/- 7years, 48% male) from 2011 to 2014at the University Hospital of Limoges. The AL patients were divided into three groups according to Mayo Clinic (MC) staging and all subjects underwent 2D-TTE and 3D-TTE at the same setting. Using 2D-TTE, there was no significant difference in LV ejection fraction (EF) between the groups [LVEF=63 +/- 7% (control), 59 +/- 6% (MC stage I), 60 +/- 8% (MC stage II) and 57 +/- 14% (MC stage III) (p=0.24)]. In contrast, 3D-TTE demonstrated significantly worse LV systolic function in stage II and III patients using 3D-LVEF [MC II and III 45 +/- 8% and 39 +/- 12% vs. control 53 +/- 8% (p
- Published
- 2019
32. Mid- and long-term prognosis of off- vs. on-pump coronary artery bypass graft in patients with multisite artery disease
- Author
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Alexandre Le Guyader, Philippe Lacroix, Victor Aboyans, Elisabeth Cornu, Alessandro Piccardo, Louis Le Bivic, Dania Mohty, Julien Magne, Hélène Wojtyna, J D Blossier, Service de cardiologie [CHU Limoges], CHU Limoges, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), and Clinical sciences
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Bypass grafting ,Coronary Artery Bypass, Off-Pump ,Disease ,030204 cardiovascular system & hematology ,Risk Assessment ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,In patient ,cardiovascular diseases ,Coronary Artery Bypass ,Aged ,Retrospective Studies ,Cardiopulmonary Bypass ,business.industry ,General Medicine ,Middle Aged ,Atherosclerosis ,medicine.disease ,Progression-Free Survival ,3. Good health ,Cardiac surgery ,Treatment Outcome ,surgical procedures, operative ,medicine.anatomical_structure ,030228 respiratory system ,Propensity score matching ,Cohort ,Cardiology ,Female ,Surgery ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Cardiology and Cardiovascular Medicine ,business ,coronary artery disease ,Artery - Abstract
BACKGROUND: Among patients with coronary artery disease (CAD), around 25% have multisite artery disease (MSAD). Patients with CAD and MSAD are at higher risk of peri-operative and long-term cardiovascular events. Whether off-pump coronary bypass grafting (CABG) can improve their prognosis is unknown. We aimed to assess the benefits of off- vs. on-pump cardiac surgery in patients undergoing CABG, according to coexistence of extra-cardiac artery disease. METHODS: Between April 1998 and September 2008, 1221 patients undergoing CABG without any other intervention were enrolled. Overall death and major cardiovascular events were recorded at 1-month and during long-term follow-up. A propensity score (PS), derived from all relevant variables (P
- Published
- 2018
33. Comparison of echocardiographic parameters in Fabry cardiomyopathy and light-chain cardiac amyloidosis
- Author
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Julien Magne, Bahaa M. Fadel, Josef Marek, Tomas Palecek, Arnaud Jaccard, Dania Mohty, David Lavergne, Aleš Linhart, Cyrille Boulogne, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hématologie clinique et thérapie cellulaire [CHU Limoges], Charles University [Prague] (CU), Service de cardiologie [CHU Limoges], and Clinical sciences
- Subjects
Male ,medicine.medical_specialty ,Heart Diseases ,systolic function ,restrictive cardiomyopathy ,Heart Ventricles ,Diastole ,Cardiomyopathy ,030204 cardiovascular system & hematology ,Sensitivity and Specificity ,Ventricular Dysfunction, Left ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,echocardiography ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Fabry disease ,Ejection fraction ,Ventricular Remodeling ,business.industry ,diastolic function ,Restrictive cardiomyopathy ,Reproducibility of Results ,Amyloidosis ,Middle Aged ,medicine.disease ,Cardiac amyloidosis ,Radiology Nuclear Medicine and imaging ,Heart failure ,Cardiology ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine ,Amyloid cardiomyopathy ,business - Abstract
BACKGROUND: Fabry cardiomyopathy (FC) and light-chain amyloid cardiomyopathy (AL) present with concentric left ventricular (LV) hypertrophy/remodeling and diastolic rather than systolic dysfunction. Direct comparisons are difficult due to rarity and confounded by variability of LV thickness. AIMS: To compare LV diastolic and systolic properties between patients with FC and AL in a cohort matched for interventricular septal thickness (IVS). METHODS: A two-center echocardiographic analysis was performed, comprising 118 patients with IVS ≥12 mm (FC and AL 59 patients each) matched by IVS. RESULTS: Fabry cardiomyopathy patients had larger LV end-diastolic diameter (47.7 [44.0-50.9] vs 45.0 [41.5-49.0] mm, P = 0.002), better LV ejection fraction (EF 68.7 [63.4-74.0] vs 63.0 [54.0-70.0]%, P = 0.001) and midwall fractional shortening (midFS 14.8 [13.0-16.1] vs 12.1 [8.9-15.0]%, P = 0.006). LV EF
- Published
- 2018
34. Intramyocardial haemorrhage: a rare sequela of acute myopericarditis
- Author
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Dania Mohty, Pei Gee Chew, Aleem Khand, Kate Batouskaya, Jakub Lagan, and Sahar Mohmed
- Subjects
medicine.medical_specialty ,genetic structures ,medicine.diagnostic_test ,business.industry ,Cardiomyopathy ,Sequela ,medicine.disease ,Sudden cardiac death ,medicine.anatomical_structure ,Cardiac magnetic resonance imaging ,Internal medicine ,cardiovascular system ,medicine ,Cardiology ,Pericardium ,Myocardial infarction ,business ,Ventricular remodeling ,Myopericarditis - Abstract
INTRODUCTION Acute myopericarditis is an inflammatory disease of myocardium and pericardium. The disease has variable presentation ranging from mildly symptomatic cases to severe disease manifested by cardiomyopathy with associated risk of sudden cardiac death. However, the association with intramyocardial hemorrhage (IMH) has not been previously described. CASE REPORT We describe an IMH detected by cardiac magnetic resonance imaging, in a patient with classical ‘de novo’ myopericarditis. To the best of the authors’ knowledge, this has not been previously described in patients without associated haematological or connective tissue disorders. CONCLUSION The adverse prognostic signal of IMH in acute myocardial infarction may also be reflected by IMH in acute myopericarditis and lead to adverse ventricular remodeling. The pathophysiology of IMH in myopericarditis is unknown and warrants further exploration.
- Published
- 2021
35. Identification of prognostic markers in transthyretin and AL cardiac amyloidosis*
- Author
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Aziz Guellich, Valérie Frenkel, Diane Bodez, Jean-François Deux, Luc Hittinger, Jehan Dupuis, Thibaud Damy, Charlotte Rigaud, Arnaud Jaccard, Violaine Planté-Bordeneuve, David Lavergne, Arnault Galat, and Dania Mohty
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Male ,Cardiac function curve ,endocrine system ,medicine.medical_specialty ,Cardiac Output, Low ,030204 cardiovascular system & hematology ,Pericardial Effusion ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Natriuretic Peptide, Brain ,Internal Medicine ,medicine ,Humans ,Prealbumin ,In patient ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,Ejection fraction ,biology ,business.industry ,Amyloidosis ,nutritional and metabolic diseases ,Stroke Volume ,Middle Aged ,Prognosis ,medicine.disease ,Brain natriuretic peptide ,Survival Analysis ,Peptide Fragments ,Transthyretin ,Cardiac amyloidosis ,Heart failure ,biology.protein ,Cardiology ,Female ,Immunoglobulin Light Chains ,Cardiomyopathies ,business ,Biomarkers ,Follow-Up Studies - Abstract
Background: The prognosis of amyloidosis is known to depend heavily on cardiac function and may be improved by identifying patients at highest risk for adverse cardiac events.Aims: Identify predictors of mortality in patients with cardiac light-chain amyloidosis (AL), hereditary transthyretin amyloidosis (m-TTR), or wild-type transthyretin amyloidosis (WT-TTR) to prompt physician to refer these patients to dedicated centers.Methods and results: Observational study. About 266 patients referred for suspected cardiac amyloidosis (CA) in two French university centers were included. About 198 patients had CA (AL = 118, m-TTR = 57, and WT-TTR = 23). Their median (25th–75th percentile) age, NT-proBNP left ventricular ejection fraction were, respectively, 68 years (59–76), 2339 pg mL−1 (424–5974), and 60% (48–66). About 31% were in NYHA class III–IV. Interventricular septal thickness was greater in the m-TTR and WT-TTR groups than in the AL group (p
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- 2016
36. Aortic stenosis and transthyretin cardiac amyloidosis: the chicken or the egg?
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David Messika Zeitoun, Marina Dijos, Aziz Guellich, Thibaud Damy, Jean-Luc Dubois-Randé, David Attias, Olivier Milleron, Emmanuel Teiger, Jean-Luc Monin, Michel Slama, Dania Mohty, Arnault Galat, Etienne Audureau, Jean Rosso, Diane Bodez, CHU Henri Mondor, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Réanimation Médicale [CHU Henri Mondor - APHP] (DHU A-TVB), CHU Henri Mondor-Université Paris-Est Créteil, Faculté de Médecine [Créteil] (UPEC-Médecine), AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Bordeaux [Bordeaux], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Centre cardiologique du Nord (CCN), Hôpital Dupuytren [CHU Limoges], Hôpital Henri Mondor, Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique (CEpiA), Département de physiologie (CHU Henri Mondor), and DESSAIVRE, Louise
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Male ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Cardiac amyloidosis ,030204 cardiovascular system & hematology ,Transthyretin ,03 medical and health sciences ,0302 clinical medicine ,Valve replacement ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Humans ,Prealbumin ,030212 general & internal medicine ,Interventricular septum ,Aged ,Amyloid Neuropathies, Familial ,Ejection fraction ,business.industry ,Aortic stenosis ,Stroke Volume ,Atrial fibrillation ,Aortic Valve Stenosis ,Stroke volume ,medicine.disease ,Peptide Fragments ,[SDV] Life Sciences [q-bio] ,Stenosis ,Treatment Outcome ,medicine.anatomical_structure ,Aortic valve stenosis ,Cardiology ,Female ,Low-flow low-gradient ,Cardiology and Cardiovascular Medicine ,business - Abstract
International audience; Background Aortic stenosis (AS) and transthyretin cardiac amyloidosis (TTR-CA) are both frequent in elderly. The combination of these two diseases has never been investigated. Aims To describe patients with concomitant AS and TTR-CA. Methods Six cardiologic French centres identified retrospectively cases of patients with severe or moderate AS associated with TTR-CA hospitalized during the last 6 years. Results Sixteen patients were included. Mean +/- SD age was 79 +/- 6 years, 81% were men. Sixty per cent were NYHA III-IV, 31% had carpal tunnel syndrome, and 56% had atrial fibrillation. Median (Q1; Q4) NT-proBNP was 4382 ( 2425; 4730) pg/mL and 91% had elevated cardiac troponin level. Eighty-eight per cent had severe AS (n = 14/16), of whom 86% (n = 12) had low-gradient AS. Mean +/- SD interventricular septum thickness was 18 +/- 4 mm. Mean left ventricular ejection fraction and global LS were 50 +/- 13% and -7 +/- 4%, respectively. Diagnosis of TTR-CAwas histologically proven in 38%, and was based on strong cardiac uptake of the tracer at biphosphonate scintigraphy in the rest. Eighty-one per cent had wild-type TTR-CA (n = 13), one had mutated Val122l and 19% did not had genetic test (n = 3). Valve replacement was surgical in 63% and via transcatheter in 13%. Median follow-up in survivors was 33 (16; 65) months. Mortality was of 44% (n = 7) during the whole follow-up period. Conclusions Combination of AS and TTR-CA may occur in elderly patients particularly those with a low-flow low-gradient AS pattern and carries bad prognosis. Diagnosis of TTR-CA in AS is relevant to discuss specific treatment and management.
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- 2016
37. Causes and Consequences of Longitudinal LV Dysfunction Assessed by 2D Strain Echocardiography in Cardiac Amyloidosis
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Aziz Guellich, Diane Bodez, Jean-François Deux, Costin Radu, Thibaud Damy, Soulef Guendouz, Violaine Planté-Bordeneuve, Julien Ternacle, Stéphane Rappeneau, Luc Hittinger, Nicole Benhaiem, Dania Mohty, Jean-Paul Couetil, Pascal Lim, Jean-Luc Dubois-Randé, and Etienne Audureau
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Male ,medicine.medical_specialty ,Pathology ,Time Factors ,medicine.drug_class ,Biopsy ,030204 cardiovascular system & hematology ,Multimodal Imaging ,Ventricular Function, Left ,Ventricular Dysfunction, Left ,03 medical and health sciences ,Basal (phylogenetics) ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Natriuretic peptide ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,cardiovascular diseases ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,Ejection fraction ,biology ,business.industry ,Myocardium ,Amyloidosis ,Middle Aged ,Prognosis ,medicine.disease ,Magnetic Resonance Imaging ,Biomechanical Phenomena ,Transthyretin ,Cardiac amyloidosis ,Radiology Nuclear Medicine and imaging ,Heart failure ,Cardiology ,biology.protein ,Female ,Stress, Mechanical ,Cardiomyopathies ,business ,Cardiology and Cardiovascular Medicine ,Mace - Abstract
Objectives The aim of this study was to compare left ventricular longitudinal strain (LS) evaluated by 2-dimensional echocardiography with cardiac magnetic resonance (CMR) in cardiac amyloidosis (CA), establish correlations between histological and imaging findings, and assess the prognostic usefulness of LS measurement and CMR. Background CA is a condition with a poor prognosis due chiefly to 3 forms of amyloidosis: light-chain amyloidosis (AL), hereditary transthyretin (M-TTR), and wild-type transthyretin (WT-TTR). Two-dimensional echocardiography measurement of LS has been reported to detect early left ventricular systolic dysfunction. The pathophysiological underpinnings, regional distribution, and prognostic significance of LS in CA are unclear. Methods All patients underwent echocardiography, and 53 underwent CMR. The native hearts of the 3 patients who received heart transplants were subjected to histological examination. For each of the 17 left ventricular segments in the American Heart Association model, we evaluated LS, late gadolinium enhancement (LGE) by CMR, and cardiac amyloid deposition. Univariate and multivariate analyses were performed at 6 months to identify variables associated with major adverse cardiac events (MACE). Results We studied 79 patients with CA; 26 had AL, 36 M-TTR, and 17 WT-TTR. Mean LS was −10 ± 4%. Both LS and amyloid deposits showed a basal-to-apical gradient. The mean LS and number of segments with LGE were similar across the 3 CA types. LS correlated with LGE and amyloid burden (r = 0.72). LGE was seen in the 6 basal segments in all WT-TTR patients. During the median follow-up of 11 months (range 4 to 17 months), 36 (46%) patients experienced MACE. Independent predictors of MACE were apical LS (cutoff, −14.5%), N-terminal pro–B-type natriuretic peptide (cutoff, 4,000 ng/l), and New York Heart Association functional class III to IV heart failure. Conclusions Basal-to-apical LS abnormalities are similar across CA types and reflect the amyloid burden. Apical LS independently predicts MACE.
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- 2016
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38. Outcome and Impact of Aortic Valve Replacement in Patients With Preserved LVEF and Low-Gradient Aortic Stenosis
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Victor Dayan, Julien Magne, Philippe Pibarot, Gustavo M Vignolo, Marie-Annick Clavel, Dania Mohty, Cardio-vascular diseases, Clinical sciences, Service de Neurologie [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Quebec Heart and Lung Institute, Université Laval [Québec] (ULaval), Service de cardiologie [CHU Limoges], Quebec Heart Institute/Laval Hospital, and Université Laval [Québec] (ULaval)-Quebec Heart Institute
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medicine.medical_specialty ,low gradient aortic stenosis ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Aortic valve replacement ,Internal medicine ,medicine ,In patient ,aortic valve replacement ,030212 general & internal medicine ,paradoxical flow aortic stenosis ,Ejection fraction ,business.industry ,Hazard ratio ,Stroke volume ,Odds ratio ,medicine.disease ,Confidence interval ,3. Good health ,Stenosis ,Cardiology ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Cardiology and Cardiovascular Medicine - Abstract
International audience; BACKGROUND:Low mean transvalvular gradient (
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- 2015
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39. Spectral Doppler of the Hepatic Veins in Rate, Rhythm, and Conduction Disorders
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Najmeddine Echahidi, Bahaa M. Fadel, Ziad Dahdouh, Khadija Alassas, Aysha Husain, Dania Mohty, Giovanni Di Salvo, Fadel, Bahaa M, Mohty, Dania, Husain, Aysha, Alassas, Khadija, Echahidi, Najmeddine, Dahdouh, Ziad, and DI SALVO, Giovanni
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Tachycardia ,medicine.medical_specialty ,Sinus bradycardia ,Hemodynamics ,030204 cardiovascular system & hematology ,Doppler echocardiography ,arrhythmia ,Intracardiac injection ,03 medical and health sciences ,0302 clinical medicine ,Cardiac Conduction System Disease ,Heart Rate ,Internal medicine ,atrioventricular block ,Heart rate ,hepatic veins ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Brugada Syndrome ,medicine.diagnostic_test ,business.industry ,Doppler ,Blood flow ,medicine.disease ,Echocardiography, Doppler ,Echocardiography ,hepatic vein ,arrhythmias ,Blood Flow Velocity ,Hepatic Veins ,cardiovascular system ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Atrioventricular block - Abstract
Doppler interrogation of blood flow in the hepatic veins (HVs) provides valuable information regarding a wide spectrum of pathological processes that affect the right heart. Systematic analysis of the direction, velocity, and phasicity of the HV waveforms allows one to distinguish normal from abnormal patterns and provides important diagnostic information. Abnormalities in heart rate, rhythm, and intracardiac conduction are commonly encountered during echocardiographic studies. Sinus bradycardia and tachycardia, bradyarrhythmias and tachyarrhythmias as well as atrioventricular conduction disturbances influence the flow pattern in the HVs and may pose a challenge to the correct interpretation of the HV Doppler. Alterations in HV flow that are induced by the electrical abnormalities may mimic right heart pathology. Awareness of these alterations allows one to avoid misinterpretation of the HV signal, helps diagnose the underlying rhythm or conduction abnormality, and permits assessment of the impact on right heart hemodynamics.
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- 2015
40. Aortic stenosis and amyloid heart disease: ‘the 2A dangerous liaisons’
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Philippe Pibarot, Thibaud Damy, and Dania Mohty
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medicine.medical_specialty ,business.industry ,MEDLINE ,medicine.disease ,Amyloid heart disease ,Stenosis ,Text mining ,Cardiac amyloidosis ,Internal medicine ,Aortic valve stenosis ,Cardiology ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2020
41. P1813Incidence and prevalence of light chain amyloidosis: a population-based study
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S Guthrie, A Jaccard, Aboyans, D Bordessoule, D Lavergne, Julien Magne, S Duhamel, and Dania Mohty
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Population based study ,medicine.medical_specialty ,business.industry ,Amyloidosis ,medicine ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Immunoglobulin light chain ,Dermatology - Published
- 2018
42. Distribution and Prognostic Significance of Left Ventricular Global Longitudinal Strain in Asymptomatic Significant Aortic Stenosis: An Individual Participant Data Meta-Analysis
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Julien, Magne, Bernard, Cosyns, Bogdan A, Popescu, Helle G, Carstensen, Jordi, Dahl, Milind Y, Desai, Leighton, Kearney, Patrizio, Lancellotti, Thomas H, Marwick, Kimi, Sato, Masaaki, Takeuchi, Concetta, Zito, Anne-Claire, Casalta, Dania, Mohty, Luc, Piérard, Gilbert, Habib, and Erwan, Donal
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Aged, 80 and over ,Male ,Heart Ventricles ,Stroke Volume ,Aortic Valve Stenosis ,Middle Aged ,Prognosis ,Myocardial Contraction ,Risk Assessment ,Ventricular Function, Left ,Echocardiography ,Predictive Value of Tests ,Risk Factors ,Asymptomatic Diseases ,Humans ,Female ,Stress, Mechanical ,Aged - Abstract
In this individual participant data meta-analysis on left ventricular global longitudinal strain (LVGLS), our objective was to: 1) describe its distribution; 2) identify the most predictive cutoff values; and 3) assess its impact on mortality in asymptomatic patients with significant aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF).The evidence supporting the prognostic role of LVGLS in asymptomatic patients with AS has been obtained from several relatively small studies.A literature search was performed for studies published between 2005 and 2017 without language restriction according to the following criteria: "aortic stenosis" AND "longitudinal strain." The corresponding authors of selected studies were contacted and invited to share their data that we computerized in a specific database. The primary endpoint was all-cause mortality.Among the 10 studies included, 1,067 asymptomatic patients with significant AS and LVEF50% were analyzed. The median of LVGLS was 16.2% (from 5.6% to 30.1%). There were 91 deaths reported during follow-up with median of 1.8 (0.9 to 2.8) years, resulting in a pooled crude mortality rate of 8.5%. The LVGLS performed well in the prediction of death (area under the curve: 0.68). The best cutoff value identified was LVGLS of 14.7% (sensitivity, 60%; specificity, 70%). Using random effects model, the risk of death for patients with LVGLS 14.7% is multiplied by2.5 (hazard ratio: 2.62; 95% confidence interval: 1.66 to 4.13; p 0.0001), without significant heterogeneity between studies (IThis individual participant data meta-analysis demonstrates that in asymptomatic patients with significant AS and normal LVEF, impaired LVGLS is associated with reduced survival. These data emphasize the potential usefulness of LVGLS for risk stratification and management of these patients.
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- 2018
43. Ankle–Brachial Index: An Ubiquitous Marker of Cognitive Impairment—The EPIDEMCA Study
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Jean-François Dartigues, Benoît Marin, Bébène Ndamba-Bandzouzi, Pascal M'Belesso, Dania Mohty, Victor Aboyans, Epidemca investigators, Maëlenn Guerchet, Ileana Desormais, Philippe Lacroix, Pierre-Marie Preux, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [CHU Limoges], Institute of Psychiatry, Psychology & Neuroscience, King's College London, King‘s College London, Centre Hospitalier et Universitaire de Brazzaville (CHUB), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM), Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Male ,Rural Population ,medicine.medical_specialty ,Urban Population ,030204 cardiovascular system & hematology ,Neuropsychological Tests ,03 medical and health sciences ,0302 clinical medicine ,Sex Factors ,Elderly ,Internal medicine ,Epidemiology ,medicine ,Dementia ,Humans ,Africa, Central ,Ankle Brachial Index ,Cognitive Dysfunction ,Cognitive impairment ,Aged ,business.industry ,Age Factors ,Central africa ,Cognition ,Odds ratio ,medicine.disease ,Atherosclerosis ,Confidence interval ,3. Good health ,medicine.anatomical_structure ,Logistic Models ,Ankle-brachial index ,Africa ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Ankle ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Epidemiological research on the implication of atherosclerosis in the development of cognitive impairment is lacking in low- and middle-income countries, where two-thirds of the individuals affected by dementia live. Individuals aged ≥65 years living in urban and rural areas of 2 countries in Central Africa were invited. Demographic, clinical, and biological data were collected, and the ankle–brachial index (ABI) was measured. Cognitive impairment was defined according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Among 1662 participants (age 72.9 years, 59.3% females), the prevalence of cognitive impairment was 13.6%, which is higher in individuals with ABI ≤ 0.90 and ABI ≥ 1.40 than those with 0.90 < ABI < 1.40 (20.1% and 17% vs 12%, P = .0024). Cognitive impairment was significantly associated with the factors such as age (odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.07-1.12, P < .0001), female gender (OR: 2.36, 95% CI: 1.59-3.49, P < .0001), smoking (OR: 1.54, 95% CI: 1.06-2.23, P = .0026), and low ABI (≤0.90; OR: 1.52, 95% CI: 1.03-2.25, P = .0359). The ABI, a ubiquitous marker of atherosclerosis, provides independent and incremental information on susceptibility to present with cognitive disorders.
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- 2018
44. Which echocardiographic parameters improve the risk prediction for peri-operative outcomes in patients undergoing coronary bypass surgery: a prospective study
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Julien Magne, Claire Serena, Victor Aboyans, Jean-Philippe Marsaud, Dania Mohty, J D Blossier, Baptiste Salerno, Alessandro Piccardo, Elisabeth Cornu, Alexandre Le Guyader, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service d'Anesthésie-Réanimation [CHU Limoges], and Service de cardiologie [CHU Limoges]
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Male ,medicine.medical_specialty ,Bypass grafting ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Coronary artery bypass graft ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Prospective Studies ,Coronary Artery Bypass ,Prospective cohort study ,Perioperative Period ,Aged ,business.industry ,Operative mortality ,tricuspid annular plane systolic excursion ,General Medicine ,Perioperative ,Prognosis ,Surgery ,Survival Rate ,medicine.anatomical_structure ,Bypass surgery ,Echocardiography ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Female ,France ,Cardiology and Cardiovascular Medicine ,business ,left atrial volume ,Artery ,operative risk assessment - Abstract
Objective: To assess the performance of transthoracic echocardiographic parameters to predict operative mortality and morbidity in patients undergoing coronary artery bypass grafting, and to assess its incremental prognostic value as compared to the Society of Thoracic Surgeons (STS) score. Materials and methods: We prospectively collected the clinical and biological data required to calculate the STS score in patients hospitalised for coronary artery bypass grafting. Preoperative transthoracic echocardiography was performed for each patient. The primary endpoint was 30-day mortality or major morbidity (i.e. stroke, renal failure, prolonged ventilation, deep sternal wound infection, reoperation) as defined by the STS. The secondary endpoint was prolonged hospitalisation for over 14 days. Results: A total of 172 patients was included (mean age 66.1±10.2 years, 12.2% were women). The primary endpoint occurred in 33 patients (19.2%), and 28 patients (16.3%) had a prolonged hospital stay. Independent predictive factors for the primary endpoint were an increased left atrial volume (>31 mL/m²; odds ratio (OR) 3.55, 95% confidence interval (CI) 1.38–9.12; P=0.004) and a decreased tricuspid annular plane systolic excursion ( Conclusion: In patients undergoing coronary artery bypass grafting, preoperative assessment of left atrial size and tricuspid annular plane systolic excursion should be performed systematically, as it provides additional prognostic information to the STS score.
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- 2018
45. Left atrial function in patients with light chain amyloidosis: A transthoracic 3D speckle tracking imaging study
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Chahrazed Elhamel, Arnaud Jaccard, Julien Magne, Victor Aboyans, Cyrille Boulogne, Dounia Rouabhia, Vincent Petitalot, Dania Mohty, Bahaa M. Fadel, Thibaud Damy, David Lavergne, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de cardiologie [CHU Limoges], CHU Limoges, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], Service d'Hématologie clinique et thérapie cellulaire [CHU Limoges], Unité fonctionnelle insuffisance cardiaque, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est (UPE), Contrôle de la Réponse Immune B et des Lymphoproliférations (CRIBL), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Grelier, Elisabeth, and Clinical sciences
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Cardiac function curve ,Male ,medicine.medical_specialty ,Echocardiography, Three-Dimensional ,030204 cardiovascular system & hematology ,Immunoglobulin light chain ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,Left atrial ,Internal medicine ,medicine ,Humans ,In patient ,Immunoglobulin Light-chain Amyloidosis ,Heart Atria ,Stage (cooking) ,Left atrial function ,Speckle tracking imaging ,Aged ,Outcome ,business.industry ,Amyloidosis ,Middle Aged ,medicine.disease ,Prognosis ,Peak atrial global longitudinal strain ,Echocardiography ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,3D left atrial volumes ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Cardiology ,Atrial Function, Left ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Light chain amyloidosis ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Systemic light chain amyloidosis (AL) is characterized by the extracellular deposition of amyloid fibrils. Transthoracic echocardiography is the modality of choice to assess cardiac function in patients with AL. Whereas left ventricular (LV) function has been well studied in this patient population, data regarding the value of left atrial (LA) function in AL patients are lacking. In this study, we aim to examine the impact of LA volumes and function on survival in AL patients as assessed by real-time 3D echocardiography. Methods: A total of 77 patients (67 ± 10 years, 60% men) with confirmed AL and 39 healthy controls were included. All standard 2D echocardiographic and 3D-LA parameters were obtained. Results: Fourteen patients (18%) were in Mayo Clinic (MC) stage I, 30 (39%) in stage II, and 33 (43%) in stage III at initial evaluation. There was no significant difference among the MC stages groups in terms of age, gender, or cardiovascular risk factors. As compared to patients in MC II and MC I, those in MC III had significantly larger indexed 3D-LA volumes (MCIII: 46 ± 15 mL/m 2, MC II: 38 ± 12 mL/m 2, and MC I: 23 ± 9 mL/m 2, p < 0.0001), lower 3D-LA total emptying fraction (3D-tLAEF) (21 ± 13% vs. 31 ± 15% vs. 43 ± 7%, respectively, p < 0.0001), and worse 3D peak atrial longitudinal strain (3D-PALS) (11 ± 9% vs. 18 ± 13% vs. 20 ± 7%, respectively, p = 0.007). Two-year survival was significantly lower in patients with 3D-tLAEF < + 34% (p = 0.003) and in those with 3D-PALS < + 14% (p = 0.034). Both parameters provided incremental prognostic value over maximal LA volume in multivariate analysis. Conclusion: Functional LA parameters are progressively altered in AL patients according to the MC stage. A decrease in 3D-PALS is associated with worse outcome, independently of LA volume.
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- 2018
46. Author's reply
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Dania Mohty, Vincent Petitalot, Julien Magne, Bahaa M. Fadel, Cyrille Boulogne, Dounia Rouabhia, Chahrazed El Hamel, David Lavergne, Thibaud Damy, Victor Aboyans, Arnaud Jaccard, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [CHU Limoges], CHU Limoges, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], Service d'Hématologie clinique et thérapie cellulaire [CHU Limoges], Unité fonctionnelle insuffisance cardiaque, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est (UPE), Contrôle de la Réponse Immune B et des Lymphoproliférations (CRIBL), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), and Université de Limoges (UNILIM)-Université de Limoges (UNILIM)
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03 medical and health sciences ,0302 clinical medicine ,Imaging, Three-Dimensional ,Humans ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Atrial Function, Left ,030212 general & internal medicine ,Amyloidosis ,030204 cardiovascular system & hematology ,Cardiology and Cardiovascular Medicine ,ComputingMilieux_MISCELLANEOUS - Abstract
International audience
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- 2018
47. Relation Between Renin-Angiotensin System Blockers and Survival Following Isolated Aortic Valve Replacement for Aortic Stenosis
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Jean-Philippe Marsaud, Emmanuelle Begot, Julien Magne, Barthélémy Guinot, Victor Aboyans, Alexandre Le Guyader, Dania Mohty, Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service d'Anesthésie-Réanimation [CHU Limoges], Service de cardiologie [CHU Limoges], Clinical sciences, and Grelier, Elisabeth
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Male ,medicine.medical_specialty ,Treatment outcome ,Angiotensin-Converting Enzyme Inhibitors ,Comorbidity ,030204 cardiovascular system & hematology ,Angiotensin Receptor Antagonists ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,Aortic valve replacement ,Risk Factors ,Internal medicine ,Renin–angiotensin system ,medicine ,Humans ,030212 general & internal medicine ,Survival rate ,Aged ,Retrospective Studies ,Heart Valve Prosthesis Implantation ,2. Zero hunger ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Aortic Valve Stenosis ,Middle Aged ,medicine.disease ,3. Good health ,Survival Rate ,Stenosis ,Treatment Outcome ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Aortic Valve ,Heart Valve Prosthesis ,Cardiology ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Cardiology and Cardiovascular Medicine - Abstract
International audience; Renin-angiotensin system blockers (RASb) improve cardiac remodeling, but their clinical utility after surgical aortic valve replacement (SAVR) for aortic stenosis (AS) is unclear. We aimed to assess the impact of RASb on short- and long-term survival following isolated SAVR for severe AS. From January 2005 to January 2014, 508 consecutive patients had isolated SAVR for severe AS. Patients with RASb (n = 286; 53%) were more often female (p = 0.039), hypertensive (p
- Published
- 2018
48. Stress Echocardiography in Aortic Valve Disease
- Author
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Dania Mohty, Erwan Donal, Julien Magne, Luc Pierard, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Liège
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Aortic valve disease ,medicine.medical_specialty ,Ejection fraction ,business.industry ,Dobutamine stress echocardiography ,030204 cardiovascular system & hematology ,medicine.disease ,Asymptomatic ,3. Good health ,03 medical and health sciences ,Stenosis ,0302 clinical medicine ,Internal medicine ,cardiovascular system ,medicine ,Stress Echocardiography ,Cardiology ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,In patient ,030212 general & internal medicine ,Exercise stress echocardiography ,medicine.symptom ,business - Abstract
International audience; In aortic valve disease, the role of stress echocardiography is well supported by the literature. Exercise stress echocardiography is a tool of choice in asymptomatic patients with aortic stenosis (AS). However, it remains strictly contra-indicated in patients with symptoms. During exercise, the changes in trans-aortic velocity and gradient, in systolic pulmonary arterial pressure and in left ventricular ejection fraction, are of clinical and prognostic interest. The dobutamine stress echocardiography in patients with AS and low flow-low gradient (i.e. with impaired left ventricular ejection fraction) is useful to differentiate true severe and pseudo severe AS, to assess flow reserve, and ultimately to guide decision making and stratify the risk of patients.
- Published
- 2017
49. Prognostic impact of global left ventricular hemodynamic afterload in severe aortic stenosis with preserved ejection fraction
- Author
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Mathieu Deltreuil, Najmeddine Echahidi, Dania Mohty, Julien Magne, Patrice Virot, Cyrille Boulogne, Claude Cassat, Victor Aboyans, Philippe Lacroix, Marc Laskar, Service de cardiologie [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Equipe de Recherche Médicale Appliquée (ERMA), Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], Cardio-vascular diseases, and Clinical sciences
- Subjects
Male ,Cardiac Catheterization ,medicine.medical_specialty ,Survival ,Heart Ventricles ,medicine.medical_treatment ,Hemodynamics ,Severity of Illness Index ,Ventricular Function, Left ,Catheterization ,Afterload ,Risk Factors ,Internal medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,Cardiac catheterization ,Ejection fraction ,business.industry ,Aortic stenosis ,Hazard ratio ,Impedance ,Aortic Valve Stenosis ,Stroke volume ,Prognosis ,medicine.disease ,3. Good health ,Stenosis ,Blood pressure ,Echocardiography ,Cardiology ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Introduction: Global left ventricular (LV) afterload as assessed by valvulo-arterial impedance (Zva), may be an independent predictor of mortality in patients with severe aortic stenosis (AS) and preserved LV ejection fraction (LVEF). However, its quantification using echocardiography may be subject to error measurement. We aimed to determine the prevalence and impact on long-term survival of high Zva, purposely measured by cardiac catheterization. Methods and results: 676 patients with preserved LVEF and severe AS without other valvular heart diseases underwent cardiac catheterization. Zva was derived from catheterization and calculated as follows: mean aortic gradient + systolic blood pressure/ indexed LV stroke volume. Zva was considered high when > 5mmHg/mL/m(2) based on previous studies. Overall, high Zva was found in 42% of all AS patients. Four-year survival and 8-year survival were significantly reduced in patients with high Zva (74 +/- 3% and 57 +/- 4%) as compared to those with low Zva (85 +/- 2% and 74 +/- 3%; p = 0.002). After adjustment for all other risk factors, Zva was independently associated with reduced long-term survival (hazard ratio [HR] = 1.47 95% CI: 1.04-2.09; p = 0.029). Of interest, high Zva remained associated with reduced survival as compared to low Zva, in patients with normal LV stroke volume, but was no longer significant in low flow patients (p = 0.98). Conclusion: High Zva, estimated invasively in our study, is frequent in patients with severe AS, and appears as a robust and independent predictor of survival. Zva should be used as an additional parameter for risk stratification of severe AS, more particularly in patients with normal flow. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
- Published
- 2015
50. Aortic prosthesis-patient mismatch in patients with paradoxical low flow severe aortic stenosis: A dreadful combination
- Author
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Cyrille Boulogne and Dania Mohty
- Subjects
medicine.medical_specialty ,LVEF ,Bas débit paradoxal ,Treatment outcome ,Aortic prosthesis-patient mismatch ,Prosthesis Design ,Severity of Illness Index ,Ventricular Function, Left ,Paradoxical low flow ,Aortic prosthesis ,Postoperative Complications ,Risk Factors ,Internal medicine ,Sténose aortique ,Fraction d’éjection préservée ,Severity of illness ,medicine ,Humans ,In patient ,Heart Valve Prosthesis Implantation ,Ejection fraction ,Ventricular function ,business.industry ,Aortic stenosis ,Stroke Volume ,General Medicine ,Stroke volume ,Aortic Valve Stenosis ,medicine.disease ,Surgery ,Stenosis ,Treatment Outcome ,Aortic Valve ,Heart Valve Prosthesis ,Cardiology ,business ,Cardiology and Cardiovascular Medicine ,Mismatch patient-prothèse - Published
- 2015
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