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3. Brain volumetric deficits in MAPT mutation carriers: a multisite study

Author

Chu, S.A. (Stephanie A.), Flagan, T.M. (Taru M.), Staffaroni, A.M. (Adam M.), Jiskoot, L.C. (Lize), Deng, J. (Jersey), Spina, S. (Salvatore), Zhang, L. (Liwen), Sturm, V.E. (Virginia E.), Yokoyama, J.S. (Jennifer S.), Seeley, W.W. (William W.), Papma, J.M. (Janne), Geschwind, H., Rosen, H.J. (Howard J.), Boeve, B.F. (Bradley F.), Boxer, A.L. (Adam), Heuer, H.W. (Hilary W.), Forsberg, L.K. (Leah K.), Brushaber, D.E. (Danielle E.), Grossman, M. (Murray), Coppola, G. (Giovanni), Dickerson, F. (Faith), Bordelon, Y.M. (Yvette M.), Faber, K. (Kelley), Feldman, H.H. (Howard), Fields, J.A. (Julie A.), Fong, J.C. (Jamie C.), Foroud, T. (Tatiana), Gavrilova, R.H. (Ralitza H.), Ghoshal, N. (Nupur), Graff-Radford, N.R. (Neill), Hsiung, G.Y.R. (Ging-Yuek), Huey, E.D. (Edward), Irwin, D.J. (David J.), Kantarci, K. (Kejal), Kaufer, D.I. (Daniel I.), Karydas, A.M. (Anna M.), Knopman, D.S. (David), Kornak, J. (John), Kramer, J.H. (Joel), Kukull, W.A., Lapid, M.I. (Maria I.), Litvan, I., Mackenzie, I.R.A. (Ian), Mendez, M.F. (Mario), Miller, B.L. (Bruce Lars), Onyike, C.U. (Chiadi), Pantelyat, A.Y. (Alexander Y.), Rademakers, S. (Suzanne), Marisa Ramos, E. (Eliana), Roberson, E.D. (Erik D.), Carmela Tartaglia, M. (Maria), Tatton, N.A. (Nadine A.), Toga, A.W. (Arthur), Vetor, A. (Ashley), Weintraub, S. (Sandra), Wong, B. (Bonnie), Wszolek, Z.K. (Zbigniew), Swieten, J.C. (John) van, Lee, S.E. (Suzee E.), Chu, S.A. (Stephanie A.), Flagan, T.M. (Taru M.), Staffaroni, A.M. (Adam M.), Jiskoot, L.C. (Lize), Deng, J. (Jersey), Spina, S. (Salvatore), Zhang, L. (Liwen), Sturm, V.E. (Virginia E.), Yokoyama, J.S. (Jennifer S.), Seeley, W.W. (William W.), Papma, J.M. (Janne), Geschwind, H., Rosen, H.J. (Howard J.), Boeve, B.F. (Bradley F.), Boxer, A.L. (Adam), Heuer, H.W. (Hilary W.), Forsberg, L.K. (Leah K.), Brushaber, D.E. (Danielle E.), Grossman, M. (Murray), Coppola, G. (Giovanni), Dickerson, F. (Faith), Bordelon, Y.M. (Yvette M.), Faber, K. (Kelley), Feldman, H.H. (Howard), Fields, J.A. (Julie A.), Fong, J.C. (Jamie C.), Foroud, T. (Tatiana), Gavrilova, R.H. (Ralitza H.), Ghoshal, N. (Nupur), Graff-Radford, N.R. (Neill), Hsiung, G.Y.R. (Ging-Yuek), Huey, E.D. (Edward), Irwin, D.J. (David J.), Kantarci, K. (Kejal), Kaufer, D.I. (Daniel I.), Karydas, A.M. (Anna M.), Knopman, D.S. (David), Kornak, J. (John), Kramer, J.H. (Joel), Kukull, W.A., Lapid, M.I. (Maria I.), Litvan, I., Mackenzie, I.R.A. (Ian), Mendez, M.F. (Mario), Miller, B.L. (Bruce Lars), Onyike, C.U. (Chiadi), Pantelyat, A.Y. (Alexander Y.), Rademakers, S. (Suzanne), Marisa Ramos, E. (Eliana), Roberson, E.D. (Erik D.), Carmela Tartaglia, M. (Maria), Tatton, N.A. (Nadine A.), Toga, A.W. (Arthur), Vetor, A. (Ashley), Weintraub, S. (Sandra), Wong, B. (Bonnie), Wszolek, Z.K. (Zbigniew), Swieten, J.C. (John) van, and Lee, S.E. (Suzee E.)

Abstract

Objective: MAPT mutations typically cause behavioral variant frontotemporal dementia with or without parkinsonism. Previous studies have shown that symptomatic MAPT mutation carriers have frontotemporal atrophy, yet studies have shown mixed results as to whether presymptomatic carriers have low gray matter volumes. To elucidate whether presymptomatic carriers have lower structural brain volumes within regions atrophied during the symptomatic phase, we studied a large cohort of MAPT mutation carriers using a voxelwise approach. Methods: We studied 22 symptomatic carriers (age 54.7 ± 9.1, 13 female) and 43 presymptomatic carriers (age 39.2 ± 10.4, 21 female). Symptomatic carriers’ clinical syndromes included: behavioral variant frontotemporal dementia (18), an amnestic dementia syndrome (2), Parkinson’s disease (1), and mild cognitive impairment (1). We performed voxel-based morphometry on T1 images and assessed brain volumetrics by clinical subgroup, age, and mutation subtype. Results: Symptomatic carriers showed gray matter atrophy in bilateral frontotemporal cortex, insula, and striatum, and white matter atrophy in bilateral corpus callosum and uncinate fasciculus. Approximately 20% of presymptomatic carriers had low gray matter volumes in bilateral hippocampus, amygdala, and lateral temporal cortex. Within these regions, low gray matter volumes

Published
2020
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5. Genetically elevated high-density lipoprotein cholesterol through the cholesteryl ester transfer protein gene does not associate with risk of Alzheimer's disease

Author

Peloso, G.M. (Gina M.), Lee, S.J. (Sven) van der, Sims, R. (Rebecca), van der Lee, S.J. (S. J.), Naj, A.C. (A. C.), Bellenguez, C. (Céline), Badarinarayan, N. (Nandini), Jakobsdottir, M. (Margret), Kunkle, B.W. (B. W.), Boland, A. (A.), Raybould, R. (R.), Bis, J.C. (Joshua), Martin, E.R. (E. R.), Grenier-Boley, B. (Benjamin), Heilmann-Heimbach, S. (S.), Chouraki, V. (V.), Kuzma, A.B. (A. B.), Sleegers, K. (K.), Vronskaya, M., Ruiz, A. (A.), Graham, R.R. (Robert), Olaso, R. (Robert), Hoffmann, P. (Per), Grove, M.L. (Megan), Vardarajan, B.N. (Badri), Hiltunen, M. (Mikko), Nöthen, M.M. (Markus), White, C.C. (Charles), Hamilton-Nelson, K.L. (K. L.), Epelbaum, J. (Jacques), Maier, W. (Wolfgang), Choi, S.H. (S. H.), Beecham, G.W., Dulary, C. (C.), Herms, S. (Stefan), Smith, A.V. (Albert), Funk, C.C. (C. C.), Derbois, (), Forstner, A.J. (Andreas), Ahmad, S. (S.), Li, H. (Huaixing), Bacq, D. (D.), Harold, D. (D.), Satizabal, C.L. (Claudia), Valladares, O. (Otto), Squassini, A. (Alessio), Thomas, R. (R.), Brody, J.A. (Jennifer A.), Qu, L. (Liming), Sanchez-Juan, P. (Pascual), Morgan, T. (Thomas), Wolters, F.J. (Frank), Zhao, Y. (Y.), Garcia, F.S. (F. S.), Denning, N. (Nicola), Fornage, M. (Myriam), Malamon, J. (J.), Naranjo, M.C.D. (M. C.D.), Majounie, E. (Elisa), Mosley, T.H. (Thomas H.), Dombroski, B. (B.), Wallon, D. (David), Lupton, M.K. (Michelle), Dupuis, J. (Josée), Whitehead, P. (P.), Fratiglioni, L. (L.), Medway, C. (Christopher), Jian, X. (X.), Mukherjee, S. (S.), Keller, L. (L.), Brown, K. (Kristelle), Lin, H. (Honghuang), Cantwell, L.B. (Laura B.), Panza, F. (F.), McGuinness, B. (B.), Moreno-Grau, S. (S.), Burgess, J.D. (J. D.), Solfrizzi, V. (Vincenzo), Proitsi, P. (P.), Adams, H.H.H. (Hieab), Allen, M. (M.), Seripa, D. (Davide), Pastor, P. (P.), Cupples, L.A. (L. A.), Price, N.D. (N. D.), Hannequin, D. (Didier), Frank-Garcia, A. (Ana), Levy, D. (D.), Chakrabarty, P. (P.), Caffarra, P. (Paolo), Giegling, I. (Ina), Beiser, A. (Alexa), Giedraitis, V. (Vilmantas), Hampel, H. (Heather), Garcia, M.E. (M.), Wang, X. (X.), Lannfelt, L. (Lars), Mecocci, P. (Patrizia), Eiriksdottir, G. (Gudny), Crane, L.M.A., Pasquier, F. (Florence), Boccardi, V. (V.), Henández, I. (I.), Barber, R.C. (R. C.), Scherer, M. (M.), Tárraga, L. (L.), Adams, P.M. (P. M.), Leber, I. (Isabelle), Chen, Y.D.I. (Yii-Der Ida), Albert, M. (Michael), Riedel-Heller, S. (Steffi), Emilsson, V. (Valur), Beekly, D. (D.), Braae, A. (A.), Schmidt, R. (R.), Blacker, D. (D.), Masullo, C., Schmidt, H. (Helena), Doody, R.S. (R. S.), Spalletta, G. (Gianfranco), Longstreth Jr, W.T., Fairchild, T.J. (T. J.), Bossù, P. (P.), Lopez, O.L. (Oscar), Frosch, M.P. (Matthew), Sacchinelli, E. (E.), Ghetti, B. (Bernardino), Yang, Q. (Qiong Fang), Huebinger, R.M. (R. M.), Jessen, F., Li, S. (S.), Kamboh, M.I. (M. I.), Morris, J. (J.), Sotolongo-Grau, O. (O.), Katz, M.J. (M. J.), Corcoran, C. (C.), Dunstan, M.L., Braddel, A. (A.), Thomas, C. (C.), Meggy, A. (A.), Marshall, R. (R.), Gerrish, A. (Amy), Chapman, J. (Jade), Aguilar, M. (M.), Taylor, S. (S.), Hill, M. (M.), Fairén, M.D. (M. D.), Hodges, A. (A.), Vellas, B. (B.), Soininen, H. (H.), Kloszewska, I. (Iwona), Daniilidou, M. (M.), Uphill, J. (James), Patel, Y. (Y.), Hughes, J.T. (J. T.), Lord, J. (J.), Turton, J.C. (James), Hartmann, A.M. (A. M.), Cecchetti, R. (R.), Fenoglio, C. (Chiara), Serpente, M. (Maria), Arcaro, M. (M.), Caltagirone, C. (C.), Orfei, M.D. (M. D.), Ciaramella, A. (A.), Pichler, I. (Irene), Mayhaus, M. (Manuel), Gu, W. (W.), Lleo, A. (Alberto), Fortea, J. (J.), Blesa, R. (Rafael), Barber, I.S. (I. S.), Brookes, K. (K.), Cupidi, C. (Chiara), Maletta, R. (Raffaele), Carrell, D. (D.), Sorbi, S. (Sandro), Moebus, S. (Susanne), Urbano, M. (M.), Pilotto, A. (Alberto), Kornhuber, J. (Johannes), Bosco, P. (Paolo), Todd, S. (S.), Craig, D. (D.), Johnston, J. (J.), Gill, M. (M.), Lawlor, B.A. (B.), Lynch, A. (Aoibhinn), Fox, N.C. (Nick), Hardy, J. (J.), Albin, R.L. (R. L.), Apostolova, L.G. (L. G.), Arnold, S.E. (Steven), Asthana, S. (S.), Atwood, C.S. (Craig), Baldwin, C. (Clinton), Barnes, L.L. (L. L.), Barral, S. (Sandra), Beach, T.G. (Thomas), Becker, J.T. (James), Bigio, E.H. (Eileen), Bird, T.D. (T. D.), Boeve, B.F. (Bradley), Bowen, J.D. (J. D.), Boxer, A.L. (Adam), Burke, J.R. (J. R.), Burns, J.M. (J. M.), Buxbaum, J.D. (J. D.), Cairns, N.J. (N. J.), Cao, C. (C.), Carlson, C. (Chris), Carlsson, C.M. (C. M.), Carney, R.M. (R. M.), Carrasquillo, M.M. (M. M.), Carroll, S.L. (Steven), Diaz, C.C. (C. C.), Chui, H.C. (H. C.), Clark, D.G. (D. G.), Cribbs, D.H. (D. H.), Crocco, E.A. (E. A.), DeCarli, C. (Charles), Dick, M. (M.), Duara, R. (R.), Evans, D.A. (D. A.), Faber, K.M. (Kelley), Fallon, K.B. (K. B.), Fardo, D.W. (D. W.), Farlow, M.R. (M. R.), Ferris, S. (S.), Foroud, T.M. (T. M.), Galasko, D.R. (D. R.), Gearing, M. (Marla), Geschwind, H., Gilbert, J.R. (John R.), Graff-Radford, N.R. (Neill), Green, R.C. (Robert), Growdon, J.H. (J. H.), Hamilton, R.L. (Ronald L.), Harrell, L.E. (L. E.), Honig, L.S. (L. S.), Huentelman, M.J. (M. J.), Hulette, C. (Christine), Hyman, B.T. (Bradley), Jarvik, G.P. (Gail), Abner, E. (E.), Jin, L.W. (L. W.), Jun, G. (G.), Karydas, A. (A.), Kaye, J.A. (Jeffrey), Kim, R. (R.), Kowall, N.W. (N. W.), Kramer, J.H. (Joel), LaFerla, F.M. (F. M.), Lah, J.J. (J. J.), Leverenz, J.B. (J. B.), Levey, A.I. (Allan), Li, G. (Guo), Lieberman, A.P. (A. P.), Lunetta, K.L. (Kathryn), Lyketsos, C.G. (C. G.), Marson, D.C. (D. C.), Martiniuk, F. (F.), Mash, D.C. (Deborah C.), Masliah, E. (Eliezer), McCormick, W.C. (W. C.), McCurry, S.M. (S. M.), McDavid, A.N. (A. N.), McKee, A.C. (A. C.), Mesulam, M. (Marsel), Miller, B.L. (Bruce Lars), Miller, C.A. (C. A.), Miller, J.W. (J. W.), Morris, H. (Huw), Myers, A.J. (Amanda J.), O'Bryant, S. (S.), Olichney, J.M. (J. M.), Pankratz, V.S. (Shane), Parisi, J.E. (Joseph), Paulson, H.L. (Henry), Perry, W. (W.), Peskind, E. (E.), Pierce, A. (A.), Poon, W.W. (W. W.), Potter, H. (H.), Quinn, J.F. (J. F.), Raj, A. (A.), Raskind, M. (M.), Reisberg, B. (B.), Reitz, C. (C.), Ringman, J.M. (J. M.), Roberson, E.D. (E. D.), Rogaeva, E. (Ekaterina), Rosen, H.J. (H. J.), Rosenberg, R.N. (Roger), Sager, M.A. (M. A.), Saykin, A.J. (Andrew), Schneider, J.A. (Julie), Schneider, L.S. (L. S.), Seeley, W.W. (W. W.), Smith, A.G. (A. G.), Sonnen, J.A. (J. A.), Spina, S. (S.), Stern, R.A. (R. A.), Swerdlow, R.H. (R. H.), Tanzi, R.E. (R. E.), Thornton-Wells, T.A. (Tricia), Trojanowski, J.Q. (J. Q.), Troncoso, J.C. (J. C.), Deerlin, V.M. (Vivianna), Van Eldik, L.J. (L. J.), Vinters, H.V. (Harry), Vonsattel, J.P. (Jean Paul), Weintraub, S. (Sandra), Welsh-Bohmer, K.A. (Kathleen), Wilhelmsen, K.C., Williamson, J. (J.), Wingo, T.S. (T. S.), Woltjer, R.L. (Randall), Wright, C.B. (Clinton B.), Yu, C.E. (C. E.), Yu, L. (L.), Garzia, F. (F.), Golamaully, F. (F.), Septier, G. (G.), Engelborghs, S. (Sebastiaan), Vandenberghe, R. (Rik), Deyn, P.P. (Peter) de, Fernadez, C.M. (C. M.), Benito, Y.A. (Y. A.), Thonberg, H. (Håkan), Forsell, C. (C.), Lilius, L. (Lena), Kinhult-Stählbom, A. (A.), Kilander, L. (L.), Brundin, R. (R.), Concari, L. (L.), Helisalmi, S. (S.), Koivisto, A.M. (A. M.), Haapasalo, A. (Annakaisa), Dermecourt, V. (V.), Fievet, N. (N.), Hanon, O. (Olivier), Dufouil, C. (Carole), Brice, A., Ritchie, K. (Karen), Dubois, B. (B.), Himali, J.J. (Jayandra), Keene, C.D. (C. D.), Tschanz, J. (J.), Fitzpatrick, A.L. (Annette), Kukull, W.A., Norton, M. (M.), Aspelund, T. (Thor), Larson, E.B. (Eric B.), Munger, R. (R.), Rotter, J.I. (Jerome I.), Lipton, R.B. (R. B.), Bullido, M.J. (Maria), Hofman, A. (A.), Montine, T.J. (T. J.), Coto, E. (Eliecer), Boerwinkle, E. (E.), Petersen, R.C. (R. C.), Alvarez, V. (V.), Rivadeneira Ramirez, F. (Fernando), Reiman, E.M. (Eric), Gallo, V. (Valentina), O'Donnell, C.J. (Christopher), Reisch, J.S. (J. S.), Bruni, A.C. (Amalia), Royall, D.R. (D. R.), Kubisch, C. (Christian), Sano, M. (M.), Galimberti, D. (Daniela), St. George-Hyslop, P. (Peter), Scarpini, E. (Elio), Tsuang, D.W. (Debby W.), Mancuso, M. (M.), Bonuccelli, U. (Ubaldo), Winslow, A.R. (A. R.), Daniele, A. (A.), Wu, C.K. (C. K.), Peters, O. (Oscar), Nacmias, B. (Benedetta), Riemenschneider, M. (M.), Heun, R. (Reinhard), Brayne, C. (Carol), Rubinsztein, D.C. (David), Bras, J. (J.), Guerreiro, R. (R.), Al-Chalabi, A. (Ammar), Shaw, C.E. (C. E.), Collinge, J. (J.), Mann, D. (D.), Tsolaki, M. (Magda), Clarimón, J. (J.), Sussams, R. (R.), Lovestone, S. (Simon), O'donovan, M.C. (Michael), Owen, M.J. (Michael), Behrens, T.W. (Timothy), Mead, S. (S.), Goate, A.M. (Alison), Uitterlinden, A.G. (A. G.), Holmes, C. (C.), Cruchaga, C. (Carlos), Ingelsson, M. (Martin), Bennett, D.A. (David), Powell, J. (J.), Golde, T.E. (T. E.), Graff, C. (C.), De Jager, P., Morgan, K. (Kevin), Ertekin-Taner, N. (N.), Combarros, O. (Onofre), Psaty, B.M. (Bruce), Passmore, P. (P.), Younkin, S.G. (S. G.), Berr, C. (Claudine), Gudnason, V. (Vilmundur), Rujescu, D. (D.), Dickson, D. (Dennis), Dartigues, J.-F., DeStefano, A.L. (Anita), Ortega-Cubero, S. (S.), Hakonarson, H. (Hakon), Campion, D. (Dominique), Boada, M. (M.), Kauwe, J.K. (J. K.), Farrer, L.A. (Lindsay), Broeckhoven, C. (Christine) van, Ikram, M.A. (Arfan), Jones, L. (L.), Haines, J.L. (Jonathan), Tzourio, C. (Christophe), Launer, L.J. (Lenore), Escott-Price, V. (V.), Mayeux, R. (R.), Deleuze, J.-F. (Jean-François), Amin, N. (Najaf), Holmans, P.A. (Peter A.), Kunkle, B. (Brian), Amouyel, P. (Philippe), Duijn, C.M. (Cornelia) van, Ramirez, A. (Alfredo), Wang, L.S. (L. S.), Lambert, J.-C. (J.), Seshadri, S. (Sudha), Williams, J. (J.), Schellenberg, G.D. (Gerard), Destefano, A.L. (Anita L.), Seshardi, S. (Sudha), Peloso, G.M. (Gina M.), Lee, S.J. (Sven) van der, Sims, R. (Rebecca), van der Lee, S.J. (S. J.), Naj, A.C. (A. C.), Bellenguez, C. (Céline), Badarinarayan, N. (Nandini), Jakobsdottir, M. (Margret), Kunkle, B.W. (B. W.), Boland, A. (A.), Raybould, R. (R.), Bis, J.C. (Joshua), Martin, E.R. (E. R.), Grenier-Boley, B. (Benjamin), Heilmann-Heimbach, S. (S.), Chouraki, V. (V.), Kuzma, A.B. (A. B.), Sleegers, K. (K.), Vronskaya, M., Ruiz, A. (A.), Graham, R.R. (Robert), Olaso, R. (Robert), Hoffmann, P. (Per), Grove, M.L. (Megan), Vardarajan, B.N. (Badri), Hiltunen, M. (Mikko), Nöthen, M.M. (Markus), White, C.C. (Charles), Hamilton-Nelson, K.L. (K. L.), Epelbaum, J. (Jacques), Maier, W. (Wolfgang), Choi, S.H. (S. H.), Beecham, G.W., Dulary, C. (C.), Herms, S. (Stefan), Smith, A.V. (Albert), Funk, C.C. (C. C.), Derbois, (), Forstner, A.J. (Andreas), Ahmad, S. (S.), Li, H. (Huaixing), Bacq, D. (D.), Harold, D. (D.), Satizabal, C.L. (Claudia), Valladares, O. (Otto), Squassini, A. (Alessio), Thomas, R. (R.), Brody, J.A. (Jennifer A.), Qu, L. (Liming), Sanchez-Juan, P. (Pascual), Morgan, T. (Thomas), Wolters, F.J. (Frank), Zhao, Y. (Y.), Garcia, F.S. (F. S.), Denning, N. (Nicola), Fornage, M. (Myriam), Malamon, J. (J.), Naranjo, M.C.D. (M. C.D.), Majounie, E. (Elisa), Mosley, T.H. (Thomas H.), Dombroski, B. (B.), Wallon, D. (David), Lupton, M.K. (Michelle), Dupuis, J. (Josée), Whitehead, P. (P.), Fratiglioni, L. (L.), Medway, C. (Christopher), Jian, X. (X.), Mukherjee, S. (S.), Keller, L. (L.), Brown, K. (Kristelle), Lin, H. (Honghuang), Cantwell, L.B. (Laura B.), Panza, F. (F.), McGuinness, B. (B.), Moreno-Grau, S. (S.), Burgess, J.D. (J. D.), Solfrizzi, V. (Vincenzo), Proitsi, P. (P.), Adams, H.H.H. (Hieab), Allen, M. (M.), Seripa, D. (Davide), Pastor, P. (P.), Cupples, L.A. (L. A.), Price, N.D. (N. D.), Hannequin, D. (Didier), Frank-Garcia, A. (Ana), Levy, D. (D.), Chakrabarty, P. (P.), Caffarra, P. (Paolo), Giegling, I. (Ina), Beiser, A. (Alexa), Giedraitis, V. (Vilmantas), Hampel, H. (Heather), Garcia, M.E. (M.), Wang, X. (X.), Lannfelt, L. (Lars), Mecocci, P. (Patrizia), Eiriksdottir, G. (Gudny), Crane, L.M.A., Pasquier, F. (Florence), Boccardi, V. (V.), Henández, I. (I.), Barber, R.C. (R. C.), Scherer, M. (M.), Tárraga, L. (L.), Adams, P.M. (P. M.), Leber, I. (Isabelle), Chen, Y.D.I. (Yii-Der Ida), Albert, M. (Michael), Riedel-Heller, S. (Steffi), Emilsson, V. (Valur), Beekly, D. (D.), Braae, A. (A.), Schmidt, R. (R.), Blacker, D. (D.), Masullo, C., Schmidt, H. (Helena), Doody, R.S. (R. S.), Spalletta, G. (Gianfranco), Longstreth Jr, W.T., Fairchild, T.J. (T. J.), Bossù, P. (P.), Lopez, O.L. (Oscar), Frosch, M.P. (Matthew), Sacchinelli, E. (E.), Ghetti, B. (Bernardino), Yang, Q. (Qiong Fang), Huebinger, R.M. (R. M.), Jessen, F., Li, S. (S.), Kamboh, M.I. (M. I.), Morris, J. (J.), Sotolongo-Grau, O. (O.), Katz, M.J. (M. J.), Corcoran, C. (C.), Dunstan, M.L., Braddel, A. (A.), Thomas, C. (C.), Meggy, A. (A.), Marshall, R. (R.), Gerrish, A. (Amy), Chapman, J. (Jade), Aguilar, M. (M.), Taylor, S. (S.), Hill, M. (M.), Fairén, M.D. (M. D.), Hodges, A. (A.), Vellas, B. (B.), Soininen, H. (H.), Kloszewska, I. (Iwona), Daniilidou, M. (M.), Uphill, J. (James), Patel, Y. (Y.), Hughes, J.T. (J. T.), Lord, J. (J.), Turton, J.C. (James), Hartmann, A.M. (A. M.), Cecchetti, R. (R.), Fenoglio, C. (Chiara), Serpente, M. (Maria), Arcaro, M. (M.), Caltagirone, C. (C.), Orfei, M.D. (M. D.), Ciaramella, A. (A.), Pichler, I. (Irene), Mayhaus, M. (Manuel), Gu, W. (W.), Lleo, A. (Alberto), Fortea, J. (J.), Blesa, R. (Rafael), Barber, I.S. (I. S.), Brookes, K. (K.), Cupidi, C. (Chiara), Maletta, R. (Raffaele), Carrell, D. (D.), Sorbi, S. (Sandro), Moebus, S. (Susanne), Urbano, M. (M.), Pilotto, A. (Alberto), Kornhuber, J. (Johannes), Bosco, P. (Paolo), Todd, S. (S.), Craig, D. (D.), Johnston, J. (J.), Gill, M. (M.), Lawlor, B.A. (B.), Lynch, A. (Aoibhinn), Fox, N.C. (Nick), Hardy, J. (J.), Albin, R.L. (R. L.), Apostolova, L.G. (L. G.), Arnold, S.E. (Steven), Asthana, S. (S.), Atwood, C.S. (Craig), Baldwin, C. (Clinton), Barnes, L.L. (L. L.), Barral, S. (Sandra), Beach, T.G. (Thomas), Becker, J.T. (James), Bigio, E.H. (Eileen), Bird, T.D. (T. D.), Boeve, B.F. (Bradley), Bowen, J.D. (J. D.), Boxer, A.L. (Adam), Burke, J.R. (J. R.), Burns, J.M. (J. M.), Buxbaum, J.D. (J. D.), Cairns, N.J. (N. J.), Cao, C. (C.), Carlson, C. (Chris), Carlsson, C.M. (C. M.), Carney, R.M. (R. M.), Carrasquillo, M.M. (M. M.), Carroll, S.L. (Steven), Diaz, C.C. (C. C.), Chui, H.C. (H. C.), Clark, D.G. (D. G.), Cribbs, D.H. (D. H.), Crocco, E.A. (E. A.), DeCarli, C. (Charles), Dick, M. (M.), Duara, R. (R.), Evans, D.A. (D. A.), Faber, K.M. (Kelley), Fallon, K.B. (K. B.), Fardo, D.W. (D. W.), Farlow, M.R. (M. R.), Ferris, S. (S.), Foroud, T.M. (T. M.), Galasko, D.R. (D. R.), Gearing, M. (Marla), Geschwind, H., Gilbert, J.R. (John R.), Graff-Radford, N.R. (Neill), Green, R.C. (Robert), Growdon, J.H. (J. H.), Hamilton, R.L. (Ronald L.), Harrell, L.E. (L. E.), Honig, L.S. (L. S.), Huentelman, M.J. (M. J.), Hulette, C. (Christine), Hyman, B.T. (Bradley), Jarvik, G.P. (Gail), Abner, E. (E.), Jin, L.W. (L. W.), Jun, G. (G.), Karydas, A. (A.), Kaye, J.A. (Jeffrey), Kim, R. (R.), Kowall, N.W. (N. W.), Kramer, J.H. (Joel), LaFerla, F.M. (F. M.), Lah, J.J. (J. J.), Leverenz, J.B. (J. B.), Levey, A.I. (Allan), Li, G. (Guo), Lieberman, A.P. (A. P.), Lunetta, K.L. (Kathryn), Lyketsos, C.G. (C. G.), Marson, D.C. (D. C.), Martiniuk, F. (F.), Mash, D.C. (Deborah C.), Masliah, E. (Eliezer), McCormick, W.C. (W. C.), McCurry, S.M. (S. M.), McDavid, A.N. (A. N.), McKee, A.C. (A. C.), Mesulam, M. (Marsel), Miller, B.L. (Bruce Lars), Miller, C.A. (C. A.), Miller, J.W. (J. W.), Morris, H. (Huw), Myers, A.J. (Amanda J.), O'Bryant, S. (S.), Olichney, J.M. (J. M.), Pankratz, V.S. (Shane), Parisi, J.E. (Joseph), Paulson, H.L. (Henry), Perry, W. (W.), Peskind, E. (E.), Pierce, A. (A.), Poon, W.W. (W. W.), Potter, H. (H.), Quinn, J.F. (J. F.), Raj, A. (A.), Raskind, M. (M.), Reisberg, B. (B.), Reitz, C. (C.), Ringman, J.M. (J. M.), Roberson, E.D. (E. D.), Rogaeva, E. (Ekaterina), Rosen, H.J. (H. J.), Rosenberg, R.N. (Roger), Sager, M.A. (M. A.), Saykin, A.J. (Andrew), Schneider, J.A. (Julie), Schneider, L.S. (L. S.), Seeley, W.W. (W. W.), Smith, A.G. (A. G.), Sonnen, J.A. (J. A.), Spina, S. (S.), Stern, R.A. (R. A.), Swerdlow, R.H. (R. H.), Tanzi, R.E. (R. E.), Thornton-Wells, T.A. (Tricia), Trojanowski, J.Q. (J. Q.), Troncoso, J.C. (J. C.), Deerlin, V.M. (Vivianna), Van Eldik, L.J. (L. J.), Vinters, H.V. (Harry), Vonsattel, J.P. (Jean Paul), Weintraub, S. (Sandra), Welsh-Bohmer, K.A. (Kathleen), Wilhelmsen, K.C., Williamson, J. (J.), Wingo, T.S. (T. S.), Woltjer, R.L. (Randall), Wright, C.B. (Clinton B.), Yu, C.E. (C. E.), Yu, L. (L.), Garzia, F. (F.), Golamaully, F. (F.), Septier, G. (G.), Engelborghs, S. (Sebastiaan), Vandenberghe, R. (Rik), Deyn, P.P. (Peter) de, Fernadez, C.M. (C. M.), Benito, Y.A. (Y. A.), Thonberg, H. (Håkan), Forsell, C. (C.), Lilius, L. (Lena), Kinhult-Stählbom, A. (A.), Kilander, L. (L.), Brundin, R. (R.), Concari, L. (L.), Helisalmi, S. (S.), Koivisto, A.M. (A. M.), Haapasalo, A. (Annakaisa), Dermecourt, V. (V.), Fievet, N. (N.), Hanon, O. (Olivier), Dufouil, C. (Carole), Brice, A., Ritchie, K. (Karen), Dubois, B. (B.), Himali, J.J. (Jayandra), Keene, C.D. (C. D.), Tschanz, J. (J.), Fitzpatrick, A.L. (Annette), Kukull, W.A., Norton, M. (M.), Aspelund, T. (Thor), Larson, E.B. (Eric B.), Munger, R. (R.), Rotter, J.I. (Jerome I.), Lipton, R.B. (R. B.), Bullido, M.J. (Maria), Hofman, A. (A.), Montine, T.J. (T. J.), Coto, E. (Eliecer), Boerwinkle, E. (E.), Petersen, R.C. (R. C.), Alvarez, V. (V.), Rivadeneira Ramirez, F. (Fernando), Reiman, E.M. (Eric), Gallo, V. (Valentina), O'Donnell, C.J. (Christopher), Reisch, J.S. (J. S.), Bruni, A.C. (Amalia), Royall, D.R. (D. R.), Kubisch, C. (Christian), Sano, M. (M.), Galimberti, D. (Daniela), St. George-Hyslop, P. (Peter), Scarpini, E. (Elio), Tsuang, D.W. (Debby W.), Mancuso, M. (M.), Bonuccelli, U. (Ubaldo), Winslow, A.R. (A. R.), Daniele, A. (A.), Wu, C.K. (C. K.), Peters, O. (Oscar), Nacmias, B. (Benedetta), Riemenschneider, M. (M.), Heun, R. (Reinhard), Brayne, C. (Carol), Rubinsztein, D.C. (David), Bras, J. (J.), Guerreiro, R. (R.), Al-Chalabi, A. (Ammar), Shaw, C.E. (C. E.), Collinge, J. (J.), Mann, D. (D.), Tsolaki, M. (Magda), Clarimón, J. (J.), Sussams, R. (R.), Lovestone, S. (Simon), O'donovan, M.C. (Michael), Owen, M.J. (Michael), Behrens, T.W. (Timothy), Mead, S. (S.), Goate, A.M. (Alison), Uitterlinden, A.G. (A. G.), Holmes, C. (C.), Cruchaga, C. (Carlos), Ingelsson, M. (Martin), Bennett, D.A. (David), Powell, J. (J.), Golde, T.E. (T. E.), Graff, C. (C.), De Jager, P., Morgan, K. (Kevin), Ertekin-Taner, N. (N.), Combarros, O. (Onofre), Psaty, B.M. (Bruce), Passmore, P. (P.), Younkin, S.G. (S. G.), Berr, C. (Claudine), Gudnason, V. (Vilmundur), Rujescu, D. (D.), Dickson, D. (Dennis), Dartigues, J.-F., DeStefano, A.L. (Anita), Ortega-Cubero, S. (S.), Hakonarson, H. (Hakon), Campion, D. (Dominique), Boada, M. (M.), Kauwe, J.K. (J. K.), Farrer, L.A. (Lindsay), Broeckhoven, C. (Christine) van, Ikram, M.A. (Arfan), Jones, L. (L.), Haines, J.L. (Jonathan), Tzourio, C. (Christophe), Launer, L.J. (Lenore), Escott-Price, V. (V.), Mayeux, R. (R.), Deleuze, J.-F. (Jean-François), Amin, N. (Najaf), Holmans, P.A. (Peter A.), Kunkle, B. (Brian), Amouyel, P. (Philippe), Duijn, C.M. (Cornelia) van, Ramirez, A. (Alfredo), Wang, L.S. (L. S.), Lambert, J.-C. (J.), Seshadri, S. (Sudha), Williams, J. (J.), Schellenberg, G.D. (Gerard), Destefano, A.L. (Anita L.), and Seshardi, S. (Sudha)

Abstract

Introduction: There is conflicting evidence whether high-density lipoprotein cholesterol (HDL-C) is a risk factor for Alzheimer's disease (AD) and dementia. Genetic variation in the cholesteryl ester transfer protein (CETP) locus is associated with altered HDL-C. We aimed to assess AD risk by genetically predicted HDL-C. Methods: Ten single nucleotide polymorphisms within the CETP locus predicting HDL-C were applied to the International Genomics of Alzheimer's Project (IGAP) exome chip stage 1 results in up 16,097 late onset AD cases and 18,077 cognitively normal elderly controls. We performed instrumental variables analysis using inverse variance weighting, weighted median, and MR-Egger. Results: Based on 10 single nucleotide polymorphisms distinctly predicting HDL-C in the CETP locus, we found that HDL-C was not associated with risk of AD (P >.7). Discussion: Our study does not support the role of HDL-C on risk of AD through HDL-C altered b

Published
2018
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6. Poly(GP), neurofilament and grey matter deficits in C9orf72 expansion carriers

Author

Meeter, L.H.H. (Lieke), Gendron, T.F. (Tania F.), Sias, A.C. (Ana C.), Jiskoot, L.C. (Lize), Russo, S.P. (Silvia P.), Donker Kaat, L. (Laura), Papma, J.M. (Janne), Panman, J.L. (Jessica), Ende, E.L. (Emma) van der, Dopper, E.G.P. (Elise), Franzen, S. (Sanne), Graff, C. (Caroline), Boxer, A.L. (Adam), Rosen, H.J. (Howard J.), Sánchez-Valle, R. (Raquel), Galimberti, D. (Daniela), Pijnenburg, Y.A.L. (Yolande), Benussi, L. (Luisa), Ghidoni, R. (Roberta), Borroni, B. (Barbara), Laforce, R. (Robert), del Campo, M. (Marta), Teunissen, C.E. (Charlotte), Thornton, A.S. (Andrew), Rojas, J.C. (Julio C.), Coppola, D. (Domenico), Geschwind, H., Rademakers, S. (Suzanne), Karydas, A.M. (Anna M.), Öijerstedt, L. (Linn), Scarpini, E. (Elio), Binetti, G. (Giuliano), Padovani, A. (Alessandro), Cash, D.M. (David M.), Dick, K.M. (Katrina M.), Bocchetta, M. (Martina), Miller, B.L. (Bruce Lars), Rohrer, J.D. (Jonathan), Petrucelli, L. (Leonard), Swieten, J.C. (John) van, Lee, S.E. (Suzee E.), Meeter, L.H.H. (Lieke), Gendron, T.F. (Tania F.), Sias, A.C. (Ana C.), Jiskoot, L.C. (Lize), Russo, S.P. (Silvia P.), Donker Kaat, L. (Laura), Papma, J.M. (Janne), Panman, J.L. (Jessica), Ende, E.L. (Emma) van der, Dopper, E.G.P. (Elise), Franzen, S. (Sanne), Graff, C. (Caroline), Boxer, A.L. (Adam), Rosen, H.J. (Howard J.), Sánchez-Valle, R. (Raquel), Galimberti, D. (Daniela), Pijnenburg, Y.A.L. (Yolande), Benussi, L. (Luisa), Ghidoni, R. (Roberta), Borroni, B. (Barbara), Laforce, R. (Robert), del Campo, M. (Marta), Teunissen, C.E. (Charlotte), Thornton, A.S. (Andrew), Rojas, J.C. (Julio C.), Coppola, D. (Domenico), Geschwind, H., Rademakers, S. (Suzanne), Karydas, A.M. (Anna M.), Öijerstedt, L. (Linn), Scarpini, E. (Elio), Binetti, G. (Giuliano), Padovani, A. (Alessandro), Cash, D.M. (David M.), Dick, K.M. (Katrina M.), Bocchetta, M. (Martina), Miller, B.L. (Bruce Lars), Rohrer, J.D. (Jonathan), Petrucelli, L. (Leonard), Swieten, J.C. (John) van, and Lee, S.E. (Suzee E.)

Abstract

Objective: To evaluate poly(GP), a dipeptide repeat protein, and neurofilament light chain (NfL) as biomarkers in presymptomatic C9orf72 repeat expansion carriers and patients with C9orf72-associated frontotemporal dementia. Additionally, to investigate the relationship of poly(GP) with indicators of neurodegeneration as measured by NfL and grey matter volume. Methods: We measured poly(GP) and NfL levels in cerebrospinal fluid (CSF) from 25 presymptomatic C9orf72 expansion carriers, 64 symptomatic expansion carriers with dementia, and 12 noncarriers. We explored associations with grey matter volumes using region of interest and voxel-wise analyses. Results: Poly(GP) was present in C9orf72 expansion carriers and absent in noncarriers (specificity 100%, sensitivity 97%). Presymptomatic carriers had lower poly(GP) levels than symptomatic carriers. NfL levels were higher in symptomatic carriers than in presymptomatic carriers and healthy noncarriers. NfL was highest in patients with concomitant motor neuron disease, and correlated with disease severity and survival. Associations between poly(GP) levels and small grey matter regions emerged but did not survive multiple comparison correction, while higher NfL levels were associated with atrophy in frontotemporoparietal cortices and the thalamus. Interpretation: This study of C9orf72 expansion carriers reveals that: (1) poly(GP) levels discriminate presymptomatic and symptomatic expansion carriers from noncarriers, but are not associated with indicators of neurodegeneration; and (2) NfL levels are associated with grey matter atrophy, disease severity, and shorter survival. Together, poly(GP) and NfL show promise as complementary biomarkers for clinical trials for C9orf72-associated frontotemporal dementia, with poly(GP) as a potential marker for target engagement and NfL as a marker of disease activity and progression.

Published
2018
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10. Percutaneous mid infra-red laser coronary angioplasty

Author

Seung-Jea Tahk, Georges Boussignac, Geschwind H, Jean-Luc Dubois-Randé, and Robin Zelinsky

Subjects
medicine.medical_specialty, Percutaneous, business.industry, medicine.medical_treatment, Perforation (oil well), Lumen (anatomy), Dermatology, Balloon, Laser, medicine.disease, law.invention, Surgery, Stenosis, Catheter, law, Angioplasty, medicine, business
Abstract

Thirty patients with stenosis or total occlusion of the coronary artery were treated with mid infra-red pulsed laser angioplasty. The device consisted of a holmium-YAG laser operating at 2.1μm, 500 mJ pulse−1, 3.5 Hz, 250μs pulse−1. The laser was coupled into a multifibre catheter consisting of 37 optical fibres of 150μm each concentrically arranged around a central lumen for the passage of a guidewire. This ‘over-the-wire’ system allowed for safe and effective recanalization without perforation, death, arrythmia, distal embolus. Chest sensation but not pain occurred during laser emission. There was spasm in six patients which could be relieved by nitrates. In previously failed balloon angioplasty laser angioplasty allowed for successful repeat dilatation with low inflation pressure. Technical improvement should be made in reducing the dead space left in between the fibres at the distal catheter tip, in distal tip flexibility and in increasing the channel diameter for more laser ‘stand-alone’ therapy.

Published
1991

11. Laser angioplasty in peripheral arterial disease

Author

Robin Zelinsky, Georges Boussignac, Geschwind H, Jean-Luc Dubois-Randé, and Seung-Jea Tahk

Subjects
medicine.medical_specialty, Dye laser, business.industry, medicine.medical_treatment, Dermatology, Laser, Balloon, Peripheral, law.invention, medicine.anatomical_structure, law, Angioplasty, Occlusion, medicine, Continuous wave, Surgery, Radiology, business, Artery
Abstract

Laser angioplasty was performed in 66 patients with total occlusion of the ilio-femoral artery. The system used consisted of a pulsed dye laser operating at 480 nm, 50 mJ pulse−1, 2μs pulse−1 and 5 Hz. The treatment laser was coupled into a 200μm optical fibre wrapped around a coil for improved flexibility and radiopacity. The treatment laser was connected with a diagnostic laser consisting of a continuous wave helium-cadmium laser operating at 325 nm, 50 ms and 3 mW for tissue detection using fluorescence spectroscopy. The primary success rate was 82%, the complication rate was 15% without any clinical sequelae and the 18 month follow-up patency rate was 64%. Due to the narrow pilot channel created by laser angioplasty, in each case a complementary balloon angioplasty was required to restore the arterial lumen. The success rate did not depend upon the length of occlusion but was rather related to the extent of calcification. Laser angioplasty guided by spectroscopy is effective and safe in patients with totally occluded peripheral arteries in whom mechanical devices failed to cross the obstruction.

Published
1991

12. Percutaneous coronary mid-infra-red laser angioplasty

Author

Geschwind H, Jean-L. Dubois-Rande, Georges Boussignac, Robin Zelinsky, and Jean F. Morelle

Subjects
Adult, Male, medicine.medical_specialty, Percutaneous, medicine.medical_treatment, Coronary Disease, Pilot Projects, Coronary Angiography, Balloon, Angioplasty, Laser, law.invention, law, Angioplasty, medicine.artery, Occlusion, Humans, Medicine, Angioplasty, Balloon, Coronary, Aged, business.industry, Lasers, Middle Aged, Laser, medicine.disease, Surgery, Stenosis, Catheter, Right coronary artery, Cineangiography, Female, Cardiology and Cardiovascular Medicine, business
Abstract

A pilot study was performed to determine the safety and efficacy of coronary pulsed mid-infra-red laser angioplasty. The laser was coupled with a novel 2.0 mm multifiber catheter consisting of 37 optical fibers of 150 microns each arranged concentrically around a 0.018-inch central lumen and a soft leading tapered distal tip to maintain coaxial alignment and position plaque in front of fibers. The laser was operated at 500 millijoules/pulse, 3.5 Hz, and 250 microseconds/pulse. Twenty-three patients with stenosis or occlusion of the left anterior descending or right coronary artery were selected for laser treatment. In three patients the catheter could not be positioned against the obstruction. In the 20 remaining patients laser angioplasty increased the diameter of the lumen from 0.3 +/- 0.3 mm to 1.4 +/- 0.3 mm and reduced the stenosis from 91 +/- 8% to 57 +/- 10%. In three patients "stand-alone" laser treatment was sufficient. In 17 patients balloon dilatation further reduced the stenosis to 20 +/- 18%. In two patients who had previously undergone unsuccessful balloon angioplasty with high inflation pressure, laser angioplasty allowed subsequent successful dilatation with low inflation pressure. There were no deaths, perforations, dissections, or arrhythmias. One patient had abrupt reclosure 24 hours after the procedure. Spasm occurred in four patients, and six patients had chest sensations during laser emission. Thus mid-infra-red pulsed coronary laser angioplasty is safe and effective for recanalization of stenosed and totally occluded arteries. The efficacy may be sufficient for "stand-alone" laser treatment. The technique may improve the efficacy of balloon angioplasty in cases of unsuccessful primary dilatation.

Published
1991

13. Results and follow-up after percutaneous pulsed laser-assisted balloon angioplasty guided by spectroscopy

Author

Geschwind H, Zelinsky R, Eduardo Aptecar, Boussignac G, Poirot G, Takanobu Tomaru, and Jean-Luc Dubois-Randé

Subjects
Male, medicine.medical_specialty, Time Factors, Percutaneous, medicine.medical_treatment, Arterial Occlusive Diseases, Balloon, Angioplasty, Laser, Iliac Artery, law.invention, Recurrence, law, Physiology (medical), Angioplasty, medicine, Humans, Vascular Patency, Dye laser, medicine.diagnostic_test, business.industry, Middle Aged, Laser, Femoral Artery, Catheter, medicine.anatomical_structure, Evaluation Studies as Topic, Angiography, Female, Radiology, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, Artery
Abstract

BACKGROUND Few data are available on the long-term outcome of patients who undergo laser-assisted balloon angioplasty for recanalization of occluded peripheral arteries. Because the cost of laser angioplasty is high, the value of the method should be carefully analyzed before it can be considered a routine method for recanalization. The purpose of this study was to evaluate the early and late results of laser-assisted balloon angioplasty in patients who could not be recanalized by conventional techniques. METHODS AND RESULTS Laser angioplasty was performed in 66 patients with total occlusion of the iliofemoral artery in whom mechanical techniques failed to recanalize the obstructed vessel. The system consisted of a pulsed dye laser operated at 480 nm, 2 microseconds/pulse, 5 Hz, 50 mJ/pulse coupled into a 0.021-in. laser catheter. The treatment laser was connected with a diagnostic laser to induce tissue fluorescence for spectroscopic analysis via the same fiber. The treatment laser was emitted only when atheromatous tissue was recognized. After a pilot hole was created by laser emission, dilatation was performed to enlarge the channel. The mean length of occlusion was 8.8 +/- 6.1 cm. The primary success rate was 82%. It did not depend on the length of occlusion but was greater in non-calcified than in calcified lesions (88% versus 71%, p less than 0.03). Complications included seven early reocclusions that could be recanalized and eight perforations without clinical sequelae. At a mean 18-month follow-up, 64% of the laser-treated arteries remained patent. The rate of patency was related neither to the length of the occlusion nor to calcifications but was lower in patients who had early reocclusion (p less than 0.02). CONCLUSIONS Pulsed dye laser-assisted balloon angioplasty is effective for recanalization of totally occluded arteries that cannot be treated by conventional means. The efficacy is limited by calcifications. The long-term patency rate is acceptable given the severity of the lesions.

Published
1991

14. The immediate and long-term effect of optimal balloon angioplasty on the absolute coronary blood flow velocity reserve. A subanalysis of the DEBATE study. Doppler Endpoints Balloon Angioplasty Trial Europe

Author

Piek, J. J., Boersma, E., Voskuil, M., di Mario, C., Schroeder, E., Vrints, C., Probst, P., de Bruyne, B., Hanet, C., Fleck, E., Haude, M., Verna, E., Voudris, V., Geschwind, H., Emanuelsson, H., Mühlberger, V., Peels, H. O., Serruys, P. W., and Other departments

Abstract

There are limited data regarding the immediate and long-term effect of balloon angioplasty on the coronary flow reserve evaluated in a multicentre setting. A total of 86 patients with one-vessel disease and normal left ventricular function were analysed before and after optimal balloon angioplasty (diameter stenosis 2.5 (46% vs 23% and 36% vs 16%, respectively; P 2.5. This patient group consists of patients prone to develop restenosis, while other patients are characterized by a persistently low coronary flow reserve, probably secondary to disturbed autoregulation and/or diffuse mild coronary atherosclerosis. Coronary flow reserve alterations in patients without restenosis were related to changes in hyperaemic blood flow velocity, suggesting that this phenomenon relates to epicardial remodelling

Published
2001

15. Angiographical and Doppler flow-derived parameters for assessment of coronary lesion severity and its relation to the result of exercise electrocardiography

Author

Piek, JJ, Boersma, E, di Mario, C, Schroeder, E, Vrints, C, Probst, P, de Bruyne, B, Hanet, C, Fleck, E, Haude, M, Verna, E, Voudris, [No Value], Geschwind, H, Emanuelsson, H, Muhlberger, [No Value], Serruys, PW, and Faculteit Medische Wetenschappen/UMCG

Subjects
coronary stenosis, BALLOON ANGIOPLASTY, MYOCARDIAL BLOOD-FLOW, ARTERY STENOSES, HUMANS, PRESSURE, VELOCITY RESERVE, GUIDE-WIRE, VALIDATION, DISEASE, exercise electrocardiography, intracoronary Doppler, DISTAL, angiography
Abstract

Aims Evaluation of angiographical and intracoronary Doppler-derived parameters of coronary stenosis severity. Methods and Results A total of 225 patients with one-vessel disease were studied before PTCA and at 6 months follow-up. Exercise electrocardiography was performed to document presence (n=157) or absence (n=138) of an ST segment shift (greater than or equal to 0.1 mV). Intracoronary blood flow velocity analysis was performed to determine the proximal/distal flow velocity ratio, the distal diastolic/systolic flow velocity ratio and coronary flow velocity reserve. Receiver operator characteristic curves were calculated to assess the predictive value of these variables compared with the exercise test. The distal coronary flow velocity reserve demonstrated the best linear correlation for both percentage diameter stenosis and minimum lumen diameter (r=0.67 and r=0.66; P Conclusions The distal coronary flow velocity reserve is the best intracoronary Doppler parameter for evaluation of coronary narrowings. Angiographical estimates of coronary lesion severity and distal coronary flow velocity reserve are good and independent predictors for the assessment of functional severity of coronary stenosis, emphasizing the complementary role of these parameters for clinical decision making. (C) 2000 The European Society of Cardiology.

Published
2000

16. Prognostic value of intracoronary flow velocity and diameter stenosis in assessing the short- and long-term outcomes of coronary balloon angioplasty - The DEBATE study (Doppler Endpoints Balloon Angioplasty Trial Europe)

Author

Serruys, PW, diMario, C, Piek, J, Schroeder, E, Vrints, C, Probst, P, deBruyne, B, Hanet, C, Fleck, E, Haude, M, Verna, E, Voudris, [No Value], Geschwind, H, Emanuelsson, H, Muhlberger, [No Value], Danzi, G, Ford, AJ, Boersma, E, and Faculteit Medische Wetenschappen/UMCG

Subjects
RESERVE, ARTERY DISEASE, stenosis, angioplasty, balloon, prognosis, RESTENOSIS, PRESSURE, STENT IMPLANTATION, GUIDE, VALIDATION
Abstract

Background The aim of this prospective, multicenter study was the identification of Doppler flow velocity measurements predictive of clinical outcome of patients undergoing single-vessel balloon angioplasty with no previous Q-wave myocardial infarction. Methods and Results In 297 patients, a Doppler guidewire was used to measure basal and maximal hyperemic flow velocities proximal and distal to the stenosis before and after angioplasty. In 225 patients with an angiographically successful percutaneous transluminal coronary angioplasty (PTCA), post-procedural distal coronary flow reserve (CFR) and percent diameter stenosis (DS%) were correlated with symptoms and/or ischemia at 1 and 6 months, with the need for target lesion revascularization, and with angiographic restenosis (defined as DS greater than or equal to 50% at follow-up). Logistic regression and receiver operator characteristic curve analyses were applied to determine the prognostic cutoff value of CFR and DS separately and in combination. Optimal cutoff criteria for predictors of these clinical events were DS, 35%; CFR, 2.5. A distal CFR after angioplasty >2.5 with a residual DS less than or equal to 35% identified lesions with a low incidence of recurrence of symptoms at 1 month (10% versus 19%, P=.149) and at 6 months (23% versus 47%, P=.005), a low need for reintervention (16% versus 34%, P=.024), and a low restenosis rate (16% versus 41%, P=.002) compared with patients who did nor meet these criteria. Conclusions Measurements of distal CFR after PTCA, in combination with DS%, have a predictive value, albeit modest for the short-and long-term outcomes after PTCA, and thus may be used to identify patients who will or will not benefit from additional therapy such as stent implantation.

Published
1997

17. Improvement of subendocardial myocardial perfusion after percutaneous transluminal coronary angioplasty. A myocardial contrast echocardiography study with correlation between myocardial contrast reserve and Doppler coronary reserve

Author

Geschwind H, Patrick Dupouy, Luc Hittinger, Jean-Luc Dubois-Randé, Gabriel Pelle, Philippe Brun, Anne-Marie Duval-Moulin, Alain Castaigne, and Hervé Perchet

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Coronary Disease, Anterior Descending Coronary Artery, Physiology (medical), Internal medicine, Angioplasty, Coronary Circulation, Papaverine, medicine, Humans, Angioplasty, Balloon, Coronary, Diatrizoate Meglumine, Meglumine, Vascular disease, business.industry, Reproducibility of Results, Blood flow, Middle Aged, medicine.disease, Echocardiography, Doppler, Stenosis, Parasternal line, Echocardiography, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Perfusion, medicine.drug
Abstract

Background After angioplasty coronary reserve improves but does not normalize in most patients. The purpose of this study was to examine before and after angioplasty coronary reserve and transmural myocardial blood flow distribution using myocardial contrast echocardiography. Methods and Results Twelve patients with left anterior descending coronary artery stenosis were investigated before and immediately after angioplasty. A Doppler catheter was placed in the proximal segment. Myocardial contrast echocardiography was performed by imaging the septum in M mode in a parasternal view using a 3.0-mL bolus of sonicated amidotrizoate sodium meglumine through the guiding catheter. The gray level before injection was subtracted from the gray level after injection to maximize contrast time-intensity curves. The area under the curve was used as an indicator of myocardial blood flow, and subendocardial/subepicardial ratios were measured. After baseline measurements were obtained, Doppler and echographic data were recorded after a bolus infusion of papaverine into the left main coronary artery. The same protocol was performed in patients after angioplasty and in five control subjects with normal coronary arteries. Before angioplasty, echocardiographic and Doppler coronary reserve were 2.57±0.48 and 2.54±0.57, respectively. Both increased after angioplasty to 3.65±0.57 and 3.36±0.70, respectively ( P r =.81; P =.0001). Before angioplasty, subendocardial/subepicardial septal ratios decreased from 0.80±0.48 to 0.60±0.27 after papaverine ( P Conclusions These results show that myocardial contrast echocardiography yields flow reserve values that correlate with values obtained using intracoronary Doppler. This technique may be considered as an accurate tool to assess coronary reserve in humans.

Published
1995

18. Transcatheter arterial chemoembolization of liver tumors: Effects of embolization protocol on injectable volume of chemotherapy and subsequent arterial patency

Author

Geschwind, H., Ramsey, D.E. (Douglas), Cleffken, B.I. (Berry), Wal, B.C.H. (Bart C.) van der, Kobeiter, H. (Hicham), Juluru, K. (Krishna), Hartnell, G.G. (George), Choti, M.A., Geschwind, H., Ramsey, D.E. (Douglas), Cleffken, B.I. (Berry), Wal, B.C.H. (Bart C.) van der, Kobeiter, H. (Hicham), Juluru, K. (Krishna), Hartnell, G.G. (George), and Choti, M.A.

Published
2003
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19. Excimer and holmium yttrium aluminum garnet laser coronary angioplasty

Author

Geschwind H, Jean Luc Dubois-Rande, Fumitaka Nakamura, and Jan Kvasnicka

Subjects
Adult, Male, medicine.medical_specialty, Infrared Rays, Ultraviolet Rays, medicine.medical_treatment, chemistry.chemical_element, Coronary Disease, Excimer, Angioplasty, Laser, law.invention, Postoperative Complications, Restenosis, law, Recurrence, Angioplasty, medicine, Humans, Treatment Failure, Aged, Excimer laser, business.industry, Yttrium, Middle Aged, medicine.disease, Laser, Coronary Vessels, Coronary arteries, medicine.anatomical_structure, Treatment Outcome, chemistry, Evaluation Studies as Topic, Female, Radiology, Cardiology and Cardiovascular Medicine, Holmium, business, Follow-Up Studies
Abstract

Recently access to the coronary arteries became available to laser angioplasty because of a new technique utilizes a pulsed laser source and multifiber, "over-the-wire" guided catheters. The aim of this study was to evaluate the early and long-term results and the side effects of coronary angioplasty with an excimer or a Ho-YAG laser. Forty consecutive patients were treated with the Ho-YAG laser (group I) and 46 consecutive patients were treated with the excimer laser (group II). The primary laser angioplasty success rate was 55% and 72% (NS) for groups I and II, respectively. This success rate was highest in saphenous vein grafts. It was similar in calcified and noncalcified lesions and in total occlusions and stenoses. It tended to be lower in long lesions than in short ones (40% vs 60%; p0.05 and 44% vs 78%; NS for groups I and II, respectively). Laser stand-alone therapy was performed in 5% of patients in group I compared with 22% in group II (p0.05). Failures were due to the inability of the laser catheter tip to reach the lesion, to cross the obstruction, or to obtain a significant reduction in stenosis. They were more frequent in patients in group I than in those in group II (45% vs 28%). There were no deaths, no myocardial infarctions, and no need for emergency coronary artery bypass grafting because most patients had total occlusions or a well-protected coronary artery. Complications included acute closure in 8% of patients in group I and in 17% of patients in group II and spasm in 10% and 13% of patients in groups I and II, respectively. Dissection occurred more frequently in patients in group II than in those in group I (28% vs 7%; p0.04). The angiographic patency rate at 6-month follow-up was 33% and 29% for patients groups I and II, respectively. Multifiber, wire-guided catheters provide easy access to the coronary arteries. Excimer laser angioplasty is effective but induces a high rate of dissections. Technical improvements are required to ablate more tissue to possibly reduce the restenosis rate. Further studies are needed to elucidate the mechanism of side effects and to reduce the restenosis rate.

Published
1993

20. The immediate and long-term effect of optimal balloon angioplasty on the absolute coronary blood flow velocity reserve - A subanalysis of the DEBATE study

Author

UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Piek, JJ, Hanet, Claude, Boersma, E., Voskuil, M, di Mario, C, Schroeder, Erwin, Vrints, C, Probst, P., de Bruyne, B, Fleck, E., Haude, M, Verna, E, Voudris, V, Geschwind, H, Emanuelsson, H, Muhlberger, V, Peels, HO, Serruys, PW., UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Piek, JJ, Hanet, Claude, Boersma, E., Voskuil, M, di Mario, C, Schroeder, Erwin, Vrints, C, Probst, P., de Bruyne, B, Fleck, E., Haude, M, Verna, E, Voudris, V, Geschwind, H, Emanuelsson, H, Muhlberger, V, Peels, HO, and Serruys, PW.

Abstract

Background There are limited data regarding the immediate and long-term effect of balloon angioplasty on the coronary flow reserve evaluated in a multicentre setting. Methods and Results A total of 86 patients with one-vessel disease and normal left ventricular function were analysed before and after optimal balloon angioplasty (diameter stenosis <35%) and at 6-month follow-up. Coronary flow reserve was assessed with a Doppler guide wire. A low coronary flow reserve (2.5) after PTCA, due to an increased baseline blood flow velocity, was encountered in 42 of the 86 patients (49%). Recurrence of angina and target lesion revascularization were more frequent in these patients than in patients with a coronary flow reserve >2.5 (46% vs 23% and 36% vs 16%, respectively; P<0.05) due to a trend towards restenosis (29% vs 16%; P=0.15) or a low coronary flow reserve at follow-up due to persistent elevated baseline blood flow velocity. Patients without restenosis showed a decrease or increase of coronary flow reserve during follow-up, determined by alterations of hyperaemic blood flow velocity. Conclusions Patients with an impaired coronary flow reserve directly after optimal balloon angioplasty showed a higher target lesion revascularization rate compared to patients with a coronary flow reserve >2.5. This patient group consists of patients prone to develop restenosis, while other patients are characterized by a persistently low coronary flow reserve, probably secondary to disturbed autoregulation and/or diffuse mild coronary atherosclerosis. Coronary flow reserve alterations in patients without restenosis were related to changes in hyperaemic blood flow velocity, suggesting that this phenomenon relates to epicardial remodelling.

Published
2001

21. Beta-adrenergic contractile reserve as a predictor of clinical outcome in patients with idiopathic dilated cardiomyopathy

Author

Serge Adnot, Françoise Roudot, Lut Hittinger, Alain Castaigne, Duval Am, Geschwind H, Benvenuti C, Pascal Merlet, D. Loisance, André Syrota, and Jean-Luc Dubois-Randé

Subjects
Adult, Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Heart disease, Epinephrine, medicine.medical_treatment, Cardiac index, Ventricular Function, Left, Norepinephrine, Predictive Value of Tests, Internal medicine, Dobutamine, Idiopathic dilated cardiomyopathy, Receptors, Adrenergic, beta, medicine, Humans, Prospective Studies, Heart transplantation, Ejection fraction, business.industry, Hypertrophic cardiomyopathy, Stroke Volume, Middle Aged, medicine.disease, Prognosis, Myocardial Contraction, Heart failure, Multivariate Analysis, Cardiology, Regression Analysis, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug, Follow-Up Studies
Abstract

To examine the ability of β-adrenergic contractile reserve assessment to predict the outcome of patients with heart failure, a prospective study was undertaken in 35 patients with idiopathic dilated cardiomyopathy and radionuclide ejection fraction below 40%. During right- and left-sided catheterization, right atrial and left ventricular (LV) pressures, peak positive LV dpdt, cardiac index, and plasma norepinephrine and epinephrine concentrations were measured at baseline. After a left main intracoronary infusion of dobutamine (25 to 200 μg · min−1), β-adrenergic contractile responsiveness was assessed as the net increase in peak positive LV dpdt (Δ LV dpdt). After the initial examination, patients were treated with diuretics, digitalis, and angiotensin converting enzyme inhibitors and then followed-up. After a mean follow-up period of 13 ± 7 months, two groups of patients were distinguished: those who responded to medical therapy (group A, n = 26) and those with clinical deterioration (group B, n = 9) leading to death (n = 4) or heart transplantation (n = 5). Initial peak positive LV dpdt, LV end-diastolic pressure, cardiac index, and LV ejection fraction were better in group A than in group B (p < 0.001). Initial plasma norepinephrine and epinephrine concentrations were significantly higher and Δ LV dpdt was lower in group B than in group A (p < 0.001). Multivariate stepwise logistic regression analysis showed that Δ LV dpdt (p < 0.0001) and LV ejection fraction (p = 0.0001) were independently related to prognosis. At threshold values of either 250 mm Hg · sec−1 for Δ LV dpdt or 20% for LV ejection fraction, their prognostic predictive values were 69% and 53%, respectively. When the same threshold values were used, a combination of these two parameters led to a positive predictive value of 100%. In conclusion, patients who do not respond to medical therapy were those with the lowest β-adrenergic contractile reserve. Regarding clinical outcome, low- and high-risk populations may be discriminated by combining LV ejection fraction and β-adrenergic contractile reserve assessment.

Published
1992

23. Angiographical and Doppler flow-derived parameters for assessment of coronary lesion severity and its relation to the result of exercise electrocardiography

Author

UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Piek, JJ, Hanet, Claude, Boersma, E., di Mario, C, Schroeder, Erwin, Vrints, C, Probst, P., de Bruyne, B, Fleck, E., Haude, M, Verna, E, Voudris, V, Geschwind, H, Emanuelsson, H, Muhlberger, V, Peels, HO, Serruys, PW., UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Piek, JJ, Hanet, Claude, Boersma, E., di Mario, C, Schroeder, Erwin, Vrints, C, Probst, P., de Bruyne, B, Fleck, E., Haude, M, Verna, E, Voudris, V, Geschwind, H, Emanuelsson, H, Muhlberger, V, Peels, HO, and Serruys, PW.

Abstract

Aims Evaluation of angiographical and intracoronary Doppler-derived parameters of coronary stenosis severity. Methods and Results A total of 225 patients with one-vessel disease were studied before PTCA and at 6 months follow-up. Exercise electrocardiography was performed to document presence (n=157) or absence (n=138) of an ST segment shift (greater than or equal to 0.1 mV). Intracoronary blood flow velocity analysis was performed to determine the proximal/distal flow velocity ratio, the distal diastolic/systolic flow velocity ratio and coronary flow velocity reserve. Receiver operator characteristic curves were calculated to assess the predictive value of these variables compared with the exercise test. The distal coronary flow velocity reserve demonstrated the best linear correlation for both percentage diameter stenosis and minimum lumen diameter (r=0.67 and r=0.66; P<0.01), compared to the diastolic/systolic flow velocity ratio (r=0.19 and r=0.14; P<0.01) and the proximal/distal flow velocity ratio (r=0.03 and r=0.07; not significant). The areas under the curve were 0.84 +/- 0.02; 0.82 +/- 0.03 and 0.83 +/- 0.03 for diameter stenosis, minimum lumen diameter and coronary flow velocity reserve, respectively. Logistic regression analysis revealed that the percentage diameter stenosis or minimum lumen diameter and coronary flow velocity reserve were independent predictors for the result of stress testing. Conclusions The distal coronary flow velocity reserve is the best intracoronary Doppler parameter for evaluation of coronary narrowings. Angiographical estimates of coronary lesion severity and distal coronary flow velocity reserve are good and independent predictors for the assessment of functional severity of coronary stenosis, emphasizing the complementary role of these parameters for clinical decision making. (C) 2000 The European Society of Cardiology.

Published
2000

24. Hemopump for supported angioplasty

Author

Geschwind H, J. Okude, Ph. Deleuze, Norihiko Shiiya, Wan F, Jean-Luc Dubois-Randé, D. Loisance, and O. Rosenval

Subjects
Pump head, medicine.medical_specialty, Myocardial ischaemia, business.industry, medicine.medical_treatment, Sudden cardiac arrest, Mechanical assistance, Blood pump, medicine.anatomical_structure, Ventricle, Angioplasty, Internal medicine, medicine, Cardiology, medicine.symptom, business, Hemopump
Abstract

A new approach in the management of extremely sick patients with unstable myocardial ischaemia selected for coronary angioplasty has been recently proposed (2). It is based on mechanical assistance of the left ventricle, obtained by intra-ventricular implantation of the Hemopump. The prophylactic implantation of this new type of intra-ventricular pump, prior to the coronary angioplasty itself, should reduce the risk and the consequences of sudden cardiac arrest during the procedure. The present report of the first nine cases performed at Henri-Mondor’s Hospital clearly shows the benefit and limitations of the technique.

Published
1991

25. Holmium YAG laser coronary angioplasty with multifiber catheters

Author

Fumitaka Nakamura, Takanobu Tomaru, Geschwind H, and Jan Kvasnicka

Subjects
medicine.medical_specialty, Infrared Rays, medicine.medical_treatment, Coronary Disease, Balloon, Angioplasty, Laser, law.invention, Coronary artery bypass surgery, Postoperative Complications, law, Angioplasty, medicine, Humans, Radiology, Nuclear Medicine and imaging, Myocardial infarction, business.industry, Far-infrared laser, Equipment Design, medicine.disease, Laser, Coronary arteries, Catheter, medicine.anatomical_structure, Evaluation Studies as Topic, Radiology, Cardiology and Cardiovascular Medicine, business
Abstract

Excimer lasers are being extensively used for coronary angioplasty along with multifiber over-the-wire catheters. To determine whether another wavelength could be an alternative, the laser-tissue interaction and the clinical usefulness of an infrared laser were studied. The laser consisted of a Holmium YAG pulsed laser coupled into a multifiber catheter. Experimental data from our laboratory showed that this solid stale laser had the ability to cut calcified tissue, to be preferentially absorbed by atheroma, and to ablate tissue even when the catheter tip was positioned at a distance from the target. These results were obtained with only minimal thermal effects. After assessment of the efficacy and safety of this technique, laser angioplasty was performed in 53 consecutive patients with totally occluded (40%) or stenosed (mean percent 94) coronary arteries with a mean length of 6 mm. The primary laser and the procedure success rate were 64% and 94%, respectively. Failures were due to inability to advance the catheter against the lesion or to cross the obstruction. Stand-alone laser therapy could be achieved in only 18% of patients. In previous dilatation failures, laser irradiation allowed for subsequent balloon angioplasty to be successfully performed at a lower inflation pressure than that used in the failed dilatation. Complications included abrupt (during the procedure) and early (within 24 hours) vessel closure in 19% of cases, dissection without hemodynamic consequence in 28% and spasm. Reoccluded arteries could all be recanalized with dilatation. There was no death, myocardial infarction, and no urgent coronary artery bypass surgery (CABG). Thus, infrared laser angioplasty is effective in difficult lesions for dilatation. The results are obtained with a reliable, easy to use and to maintain laser source.

Published
1990

26. Prophylactic intraventricular pumping in high-risk coronary angioplasty

Author

Jean-Luc Dubois-Randé, Ph. Deleuze, Geschwind H, J. Okude, Daniel Loisance, and O. Rosenval

Subjects
Male, Coronary artery surgery, medicine.medical_specialty, Myocardial ischaemia, medicine.medical_treatment, Cardiac index, Coronary Disease, Electrocardiography, Risk Factors, Internal medicine, Angioplasty, medicine, Humans, Pulmonary Wedge Pressure, Cardiac Output, Pulmonary wedge pressure, Aged, Medical treatment, business.industry, General Medicine, Equipment Design, Middle Aged, Surgery, Heart Arrest, medicine.anatomical_structure, Ventricle, Evaluation Studies as Topic, Cardiology, Female, Heart-Assist Devices, business, Angioplasty, Balloon, Hemopump
Abstract

The 'Hemopump', an axial flow pump, when inserted in the left ventricle brings about mechanical unloading of the ventricle, thus reducing the risk of cardiac arrest during coronary angioplasty. In this study eight very ill patients with unstable myocardial ischaemia and various contraindications for coronary artery surgery were selected for coronary angioplasty with insertion of the hemopump. Anatomical difficulties prevented insertion in three patients, but coronary angioplasty was carried out successfully with the pump in place in the other five. When the pump was working the cardiac index rose by an average of 23% (8-50%) and the pulmonary capillary wedge pressure fell by 17% (0-22%). Though electrocardiographic monitoring showed temporary rhythm instability during angioplasty in four of the five patients, there was no clinical deterioration. Four of the five patients are symptom-free on medical treatment and the other is well after surgical revascularisation.

Published
1990

32. Myocardial contractility after myocardial infarction and detection of myocardial viability by Thallium-201 SPECT

Author

J. Garot, Alain Castaigne, Geschwind H, J-L. Dubois-Randé, J. L. Monin, Michel Meignan, Pascal Gueret, P. Dupouy, Marielle Scherrer-Crosbie, and Jean Rosso

Subjects
medicine.medical_specialty, business.industry, chemistry.chemical_element, medicine.disease, Contractility, chemistry, Internal medicine, medicine, Cardiology, Thallium, Radiology, Nuclear Medicine and imaging, Myocardial infarction, Cardiology and Cardiovascular Medicine, business
Published
1995

33. Influence of infarct territory on the detection of myocardial viability by Thallium-201 SPECT

Author

Jean Rosso, Alain Castaigne, J. Garot, Pascal Gueret, J-L. Dubois-Randé, P. Dupouy, J. L. Monin, Marielle Scherrer-Crosbie, Michel Meignan, and Geschwind H

Subjects
medicine.medical_specialty, chemistry, business.industry, Internal medicine, Cardiology, medicine, Thallium, chemistry.chemical_element, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business
Published
1995

35. Conditions for effective Nd-YAG laser angioplasty.

Author

Geschwind, H J, Boussignac, G, Teisseire, B, Benhaiem, N, Bittoun, R, and Laurent, D

Abstract

To establish the optimal conditions for recanalisation of obstructed arteries without damage to vessel walls, a Nd-YAG laser coupled to a 0.2 mm diameter optic fibre was used on obstructed human cadaver coronary and peripheral arteries and on popliteal arteries in amputated limbs. Vaporization of atheromatous plaques was consistently obtained with an energy of 360-600 J and a diluted blood perfusate (3 g/100 ml haemoglobin) at a rate of 20 ml/min. The arterial wall was protected from thermal injury by inserting the optic fibre into an inflated balloon catheter and by cooling the system with the perfusate. Since recanalisation of occluded arteries was consistently obtained without damage to the arterial wall or debris and thin and flexible optic fibres were easy to guide in the arteries, percutaneous transluminal Nd-YAG laser angioplasty was used in obstructed femoral and popliteal arteries in three patients. The first European trials in man showed the method to be feasible, effective, and harmless, although further studies are required to improve penetration of the obstruction and increase the diameter of tunnel. [ABSTRACT FROM PUBLISHER]

Published
1984
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44. Effects of Contrast Material on Blood Volume

Author

Geschwind H, Huet Y, E. Wirquin, and Loiret J

Subjects
Ventricular function, business.industry, media_common.quotation_subject, Hemodynamics, Blood volume, Plasma volume, Contrast medium, Anesthesia, cardiovascular system, Contrast (vision), Medicine, cardiovascular diseases, business, media_common
Abstract

Since angiocardiographic methods are extensively used to assess ventricular function and repeated injections of contrast medium are required in valvular, coronary, and congenital heart diseases, it is important to evaluate the hemodynamic changes that result from the introduction of a large quantity of contrast material into the vascular system.

Published
1982

45. Right atrial septal aneurysm: an unusual cause of recurrent pulmonary embolism

Author

Huet Y, Geschwind H, Didier Payen, de Cremoux H, Menu P, and Lemaire F

Subjects
Male, medicine.medical_specialty, Pulmonary Artery, Critical Care and Intensive Care Medicine, Right atrial, Aneurysm, Recurrence, Internal medicine, medicine, Humans, cardiovascular diseases, Recurrent pulmonary embolism, Heart Aneurysm, Atrial septal aneurysm, medicine.diagnostic_test, business.industry, Heart, Phlebography, Middle Aged, medicine.disease, Venous thrombosis, Angiography, cardiovascular system, Cardiology, business, Pulmonary Embolism
Abstract

Angiography was used to diagnose atrial septal aneurysm in a 46-yr-old man suffering from recurrent pulmonary emboli, who had normal venograms of his lower extremities. This case demonstrates the usefulness of searching for sources of emboli other than deep venous thrombosis, but illustrates the limits of two-dimensional echocardiography in diagnosing atrial septal aneurysm.

Published
1985

46. [Right ventricular function in mitral-aortic valvulopathies]

Author

Huet Y, Geschwind H, Fischler M, VEyssière F, Langella B, Jean-Paul Richalet, Loiret J, and Lorino H

Subjects
Adult, Male, Adolescent, Cardiac Volume, Heart Ventricles, Aortic Valve Insufficiency, Hemodynamics, Mitral Valve Insufficiency, Aortic Valve Stenosis, Middle Aged, Humans, Mitral Valve Stenosis, Female, Cardiac Output, Aged
Published
1982

48. Acute response of the arterial wall to pulsed laser irradiation

Author

Fumitaka Nakamura, Hassan Bousbaa, Françoise Lange, Micheline Levame, Jan Kvasnicka, and Geschwind H

Subjects
Male, Materials science, medicine.medical_treatment, Perforation (oil well), chemistry.chemical_element, Dermatology, Excimer, Angioplasty, Laser, Iliac Artery, law.invention, law, medicine, Animals, Irradiation, Excimer laser, Pulse (signal processing), business.industry, Lasers, Anatomy, Laser, Radiography, medicine.anatomical_structure, chemistry, Surgery, Rabbits, Nuclear medicine, business, Holmium, Artery
Abstract

This study was designed to examine the acute response of normal arterial wall to pulsed laser irradiation. Irradiation with an Excimer or a Holmium YAG laser was performed in 15 normal iliac sites of 8 male New Zealand white rabbits. The excimer laser was operated at 308 nm, 25 Hz, 50 mj/mm2/pulse, and 135 nsec/pulse and the Ho:YAG laser was operated at 2.1 μm, 3.5 Hz, 400 mj/ pulse, 250 μsec/pulse. The excimer and Ho:YAG laser were coupled into a multifiber wire-guided catheter of 1.4 and 1.5 mm diameter, respectively. The mean luminal diameter increased similarly from 2.01 ± 0.29 to 2.46 ± 0.27 mm (P < 0.0005) and from 2.09 ± 0.53 to 2.45 ± 0.30 mm (P < 0.005) after excimer and Ho:YAG laser irradiation, respectively. Perforation occurred in 3 of 15 Ho:YAG irradiated sites and 0 of 15 excimer laser irradiated sites. The sites irradiated with excimer or Ho:YAG laser had similar histologic features, consisting of shedding of the endothelium, disorganization of internal elastic lamina, localized necrosis of vascular smooth muscle cells, and fissures in the medial layer. However, the sites irradiated with excimer laser had lower grading scores than those irradiated with the Ho:YAG laser (P

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