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1. Flow mapping of Intraventricular velocity behaviour along the early diastolic filling streamline in patients with atrial fibrillation: implication for HFpEF

Author

J L Moya Mur, C Fernandez Golfin, D Rodriguez Munoz, B Jug, B. Berlot, and J L Zamorano

Subjects
medicine.medical_specialty, Flow mapping, business.industry, Diastole, Atrial fibrillation, medicine.disease, Internal medicine, medicine, Cardiology, Early diastolic, In patient, Systole, Cardiology and Cardiovascular Medicine, Heart failure with preserved ejection fraction, business
Abstract

Aims Intraventricular velocity distribution reflects left ventricular (LV) diastolic function and can be measured non-invasively by flow mapping technologies. We sought to compare intraventricular velocity gradient during early diastole – obtained by vector flow mapping (VFM) technology – in consecutive patients with normal ejection fraction (EF >55%) and atrial fibrillation (AF) with and without clinical evidence of heart failure (HFpEF), and controls in sinus rhythm. We hypothesised that the VFM-derived Intraventricular Velocity Gradient over e' ratio (GrIV/e') would discriminate between the groups beyond conventional echocardiographic markers of elevated LV filling pressure. Methods and results Two-dimensional streamline fields were obtained using VFM technology in 120 subjects, i) 60 in sinus rhythm with normal systolic and diastolic function, ii) 29 out-patients with AF and no signs or symptoms of heart failure, and iii) 31 patients in AF hospitalized with signs of HFpEF. We compared the intraventricular gradient along the early diastolic streamline between groups, and correlated it with conventional echocardiographic parameters. GrIV/e' was the lowest in control group, followed by AF without HFpEF and the highest in AF HFpEF groups (GrIV/e' = 0.5±0.2, vs 0.9±0.4 vs. 2.0±1.2, p Conclusion The novel VFM parameter – reflecting early-diastole intraventricular dynamics – may discriminate between patients with AF with and without HFpEF beyond conventional echocardiography. While further studies are need to validate its clinical impact, GrIV/e' has the potential to become a novel parameter for diastolic function assessment in this population. VFM vs. Conventional echo parameter Funding Acknowledgement Type of funding source: None

Published
2020
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2. 1645 Unexpected aortic bioprosthetic valve thrombosis

Author

R Hinojar Baydes, J J Jimenez Nacher, J L Moya Mur, J.L. Zamorano Gómez, D Kristo, A Carvelli, M Pascual Izco, Alberto G. Ayala, A. González, C Fernandez Golfin, J Ramos Jimenez, A. García, and J D Vega Sanchez

Subjects
Bioprosthetic valve, medicine.medical_specialty, business.industry, Internal medicine, cardiovascular system, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, General Medicine, Cardiology and Cardiovascular Medicine, medicine.disease, business, Thrombosis
Abstract

Introduction Prosthetic valve thrombosis (PVT) is a rare but feared complication of cardiac valve replacement which usually represents a difficult diagnostic challenge. Although PVT is not frequent in bioprosthetic valves, the advent of transcatheter heart valves and the advances in computed tomography, allowing the detection of subclinical thrombosis, have yielded growing interest in that field, specially taking into account that there is no consensus on optimal antithrombotic approach in these patients. Clinical Case A 74-year-old male with prior cardiac antecedents of aortic valve replacement (April 2010) with a bovine pericardial bioprosthesis (Mitroflow 25, Sorin group Inc.), ischemic dilated cardiomyopathy with moderately depressed left ventricle ejection fraction (33%) and carrier of VDD pacemaker due to third degree atrioventricular block was admitted to advanced heart failure unit. During routine follow-up echocardiograms, prosthetic valve presented no signs of dysfunction except slightly increased gradients (image C): max 38 mmHg (normal 95%) and dyspnea NYHA class III the patient was referred for upgrade to cardiac resynchronization therapy (CRT). Computed tomography to asses epicardial venous anatomy prior to CRT implant was performed. In addition to venous distribution, it was described a repletion defect in aortic bioprosthetic valve suggestive of leaflet thrombosis (image A). To complete the study the patient underwent a transesophageal echocardiography (TOE) revealing a swallow’s nest shaped hypoechoic occupation of non-coronary and left aortic leaflets (image B), and 3D effective orifice area of 0,9 cm2. Oral anticoagulation was started in association to previously taken acetylsalicylic acid (ASA). Control TOE was performed 3 months after diagnosis showing almost complete resolution of thrombi. During the follow-up a CRT-D was implanted, with significant response in systolic performance, reaching a LVEF of 45%. Interestingly, despite the increase in anterograde aortic flow, progressive decrease of aortic gradients (max 24 mmHg, med 15 mmHg) until normalization was found (image D). Clinical benefit was also patent, being the patient in NYHA class I at the moment. Discusion Valve thrombosis could be difficult to diagnose in the presence of left ventricle dysfunction as gradients shall remain low despite an important compromise in valve motion. We present a case of incidental diagnosis of non-obstructive leaflet thrombosis that was managed conservatively with oral anticoagulation and ASA. The descent in transaortic gradients, moreover taking into account the response to CRT increasing LVEF, indicates that gradients slightly increased or in the upper limit of normality should raise suspicion in valve dysfunction in the presence of decreased LVEF. Abstract 1645 Figure.

Published
2020
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3. P288 Prognostic role of hemoglobin levels in patients with severe tricuspid regurgitation

Author

E Casas Rojo, M Pascual Izco, Covadonga Fernández-Golfín, M Abellas Sequeiros, J L Moya Mur, J.L. Zamorano Gómez, Rocio Hinojar, M Plaza Martin, J M Monteagudo Ruiz, V Barrios Alonso, G.L. Alonso Salinas, A Garcia Martin, J J Jimenez Nacher, A Gonzalez Gomez, and S Ruiz Leria

Subjects
medicine.medical_specialty, business.industry, Internal medicine, Regurgitation (digestion), medicine, Cardiology, Radiology, Nuclear Medicine and imaging, In patient, General Medicine, Hemoglobin levels, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract

Background Patients with severe tricuspid regurgitation (TR) frequently develop heart failure (HF) and their surgical therapeutic options are limited because of very high or prohibitive risk. According to the 2016 ESC guidelines for HF, anaemia and iron deficiency are associated with worse prognosis and intravenous iron therapy should be considered in symptomatic patients with HF reduced ejection fraction (HFrEF) in order to alleviate symptoms, improve exercise capacity and quality of life. The effect of treating iron deficiency in HF preserved ejection fraction (HFpEF) is unknown. The purpose of this study was to analyze the correlation between levels of hemoglobin (Hb) and the prognosis in patients with severe TR and preserve EF. Methods Consecutive patients with significant TR (moderate to severe or severe by echocardiography) evaluated in the Heart Valve Clinic between 2015-2018 were included. End-point included cardiovascular mortality, tricuspid valve surgery or heart failure. Results A total of 70 patients were included (mean age was 74± 8 years, 71% females). According to aetiology, 94% were functional TR (60% due to left valve disease, 27% due to tricuspid annulus dilatation, 13% others). Mean left ventricular ejection fraction was 56,5% ±6,7%. During a median follow up of 18 months [IQR: 4-28], 35% of the patients reached the combined end-point (n = 16 developed right HF, n = 17 underwent tricuspid valve surgery, and n = 3 died). Patients with events showed lower Hb values (p = 0.04). The level of anaemia was a prognostic factor of the combined endpoint (per gr/dl, HR 0.77 [0-61-0.98], p = 0.036). Conclusion Hemoglobin is predictive of poor outcomes in patients with significant TR. According to these preliminary results, iron deficiency could be a therapeutic target in this subgroup of patients with limited therapeutic options.

Published
2020
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4. P726 Cardiac amyloidosis: unmasking the simulator

Author

J.D. Sánchez Vega, G.L. Alonso Salinas, A. García, M Pascual Izco, J L Zamorano, A. González, Covadonga Fernández-Golfín, J L Moya Mur, J Ramos Jimenez, R Hinojar Baydes, A Carvelli, and J J Jimenez Nacher

Subjects
medicine.medical_specialty, Cardiac amyloidosis, business.industry, Internal medicine, Cardiology, Medicine, Radiology, Nuclear Medicine and imaging, General Medicine, Cardiology and Cardiovascular Medicine, business
Abstract

Introduction A non-invasive diagnosis of cardiac amyloidosis is a challenge, especially in cases of atypical phenotypic presentation. Differential diagnosis includes hypertrophic cardiomyopathy (HCM), hypertensive cardiomyopathy, and other infiltrative disorders. Multimodality imaging is essential to make a final diagnosis. Case We present the case of a 65 years old woman, with a personal history of resistant arterial hypertension and mild hypertensive cardiomyopathy. She was diagnosed 6 years earlier with multiple myeloma, treated with chemotherapy and allogeneic hematopoietic stem cell transplant, presenting with several relapses and in a stable situation at the moment of our first consult. The patient was referred for heart failure in context of acquired community pneumonia one month earlier. Transthoracic echocardiography showed severe asymmetric left ventricle (LV) hypertrophy (Image A), systolic anterior motion of the mitral valve and diastolic dysfunction suggestive of HCM, not present in the previous examination. Strain imaging of the LV showed a typical amyloid infiltration pattern, with lower longitudinal strain values in the base compared to the apical segments (Image D). Further characterization of the myocardial tissue established the diagnosis along with performing a cardiac magnetic nuclear imaging (MRI). It showed the presence of inferior septum severe LV hypertrophy along with extensive patchy late gadolinium enhancement (LGE) of the lateral wall involving the endocardium (Image C), with normal LV contractility. There was no pleural effusion, but a small pericardial effusion was seen (Image B). With the suspicion of infiltrative heart disease, probably amyloid with an atypical LGE pattern, an oral mucosal biopsy was performed confirming amyloid diagnosis (Images E1,E2). Heart failure treatment was continued, but clinical evolution was poor with the deceasement of the patient 3 years after diagnosis. Discussion This case represents an example of the variety of imaging patterns we can see in cardiac amyloidosis. Despite the classical pattern of cardiac amyloidosis, with concentric LV hypertrophy, up to 8% of cases may present with asymmetrical LV hypertrophy, mimicking HCM. LGE extension and pattern can shows this variability as well: global transmural or subendocardial LGE is the most common, but focal patterns (up to 6% of cases) are described. The complexity of the diagnosis in these cases require a clinical and multimodality image approach. Abstract P726 Figure. Images of the case

Published
2020
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5. Clinical presentation, aetiology and outcomes of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study

Author

Habib G., Erba P. A., Iung B., Donal E., Cosyns B., Laroche C., Popescu B. A., Prendergast B., Tornos P., Sadeghpour A., Oliver L., Vaskelyte J. -J., Sow R., Axler O., Maggioni A. P., Lancellotti P, C P Gale, B Beleslin, A Budaj, O Chioncel, N Dagres, N Danchin, J Emberson, D Erlinge, M Glikson, A Gray, M Kayikcioglu, A P Maggioni, V K Nagy, A Nedoshivin, A-S Petronio, J Roos-Hesselink, L Wallentin, U Zeymer, G Habib, P Lancellotti, B Cosyns, E Donal, P Erba, B Iung, B A Popescu, B Prendergast, P Tornos, M Andarala, C Berle, A Brunel-Lebecq, E Fiorucci, C Laroche, V Missiamenou, C Taylor, N N Ali Tatar-Chentir, M Al-Mallah, M Astrom Aneq, G Athanassopoulos, L P Badano, S Benyoussef, E Calderon Aranda, N M Cardim, K-L Chan, I Cruz, T Edvardsen, G Goliasch, A Hagendorff, K Hristova, O Kamp, D-H Kang, W Kong, S Matskeplishvili, M Meshaal, M Mirocevic, A N Neskovic, M Pazdernik, E Plonska-Gosciniak, M Raissouni, R Ronderos, L E Sade, A Sadeghpour, A Sambola, S Sengupta, J Separovic-Hanzevacki, M Takeuchi, E Tucay, A C Tude Rodrigues, A Varga, J Vaskelyte, K Yamagata, K Yiangou, H Zaky, I Granada, M Mahia, S Ressi, F Nacinovich, A Iribarren, P Fernandez Oses, G Avegliano, E Filipini, R Obregon, M Bangher, J Dho, L Cartasegna, M L Plastino, V Novas, C Shigel, G Reyes, M De Santos, N Gastaldello, M Granillo Fernandez, M Potito, G Streitenberger, P Velazco, J H Casabé, C Cortes, E Guevara, F Salmo, M Seijo, F Weidinger, M Heger, R Brooks, C Stöllberger, C-Y Ho, L Perschy, L Puskas, C Binder, R Rosenhek, M Schneider, M-P Winter, E Hoffer, M Melissopoulou, E Lecoq, D Legrand, S Jacquet, M Massoz, L Pierard, S Marchetta, R Dulgheru, C D Emal, C Oury, S Droogmans, D Kerkhove, D Plein, L Soens, C Weytjens, A Motoc, B Roosens, I Lemoine, I Rodrigus, B Paelinck, B Amsel, P Unger, D Konopnicki, C Beauloye, A Pasquet, J L Vanoverschelde, S Pierard, D Vancraeynest, F Sinnaeve, J L Andrade, K Staszko, R Dos Santos Monteiro, M H Miglioranza, D L Shuha, M Alcantara, V Cravo, L Fazzio, A Felix, M Iso, C Musa, A P Siciliano, F Villaca Filho, A Rodrigues, F Vilela, J Braga, R Silva, D Rodrigues, L Silva, S Morhy, C Fischer, M Vieira, T Afonso, J Abreu, S N Falcao, V A Moises, A Gouvea, F J Mancuso, A C Souza, C Y Silva, G João, C S Abboud, R Bellio de Mattos Barretto, A Ramos, R Arnoni, J E Assef, D J Della Togna, D Le Bihan, L Miglioli, A P Romero Oliveira, R Tadeu Magro Kroll, D Cortez, C L Gelape, M D C Peirira Nunes, T C De Abreu Ferrari, K Hay, V Le, M Page, F Poulin, C Sauve, K Serri, C Mercure, J Beaudoin, P Pibarot, I A Sebag, L G Rudski, G Ricafort, B Barsic, V Krajinovic, M Vargovic, D Lovric, V Reskovic-Luksic, J Vincelj, S Jaksic Jurinjak, V Yiannikourides, M Ioannides, C Pofaides, V Masoura, J Pudich, A Linhart, M Siranec, J Marek, K Blechova, M Kamenik, R Pelouch, Z Coufal, M Mikulica, M Griva, E Jancova, M Mikulcova, M Taborsky, J Precek, M Jecmenova, J Latal, J Widimsky, T Butta, S Machacek, R Vancata, J Spinar, M Holicka, F Pow Chon Long, N Anzules, A Bajana Carpio, G Largacha, E Penaherrera, D Moreira, E Mahfouz, E Elsafty, A Soliman, Y Zayed, J Aboulenein, M Abdel-Hay, A Almaghraby, M Abdelnaby, M Ahmed, B Hammad, Y Saleh, H Zahran, O Elgebaly, A Saad, M Ali, A Zeid, R El Sharkawy, A Al Kholy, R Doss, D Osama, H Rizk, A Elmogy, M Mishriky, P Assayag, S El Hatimi, S Hubert, J-P Casalta, F Gouriet, F Arregle, S Cammilleri, L Tessonnier, A Riberi, E Botelho-Nevers, A Gagneux-Brunon, R Pierrard, C Tulane, S Campisi, J-F Fuzellier, M Detoc, T Mehalla, D Boutoille, A S Lecompte, M Lefebvre, S Pattier, O Al Habash, N Asseray-Madani, C Biron, J Brochard, J Caillon, C Cueff, T Le Tourneau, R Lecomte, M M Magali Michel, J Orain, S Delarue, M Le Bras, J-F Faucher, V Aboyans, A Beeharry, H Durox, M Lacoste, J Magne, D Mohty, A David, V Pradel, V Sierra, A Neykova, B Bettayeb, S Elkentaoui, B Tzvetkov, G Landry, C Strady, K Ainine, S Baumard, C Brasselet, C Tassigny, V Valente-Pires, M Lefranc, B Hoen, B Lefevre, E Curlier, C Callier, N Fourcade, Y Jobic, S Ansard, R Le Berre, F Le Ven, M-C Pouliquen, G Prat, P Le Roux, F Bouchart, A Savoure, C Alarcon, C Chapuzet, I Gueit, C Tribouilloy, Y Bohbot, F Peugnet, M Gun, X Duval, X Lescure, E Ilic-Habensus, N Sadoul, C Selton-Suty, F Alla, F Goehringer, O Huttin, E Chevalier, R Garcia, V Le Marcis, P Tattevin, E Flecher, M Revest, C Chirouze, K Bouiller, L Hustache-Mathieu, T Klopfenstein, J Moreau, D Fournier, A-S Brunel, P Lim, L Oliver, J Ternacle, A Moussafeur, P Chavanet, L Piroth, A Salmon-Rousseau, M Buisson, S Mahy, C Martins, S Gohier, O Axler, F Baumann, S Lebras, C Piper, D Guckel, J Börgermann, D Horstkotte, E Winkelmann, B Brockmeier, D Grey, G Nickenig, R Schueler, C Öztürk, E Stöhr, C Hamm, T Walther, R Brandt, A-C Frühauf, C T Hartung, C Hellner, C Wild, M Becker, S Hamada, W Kaestner, K Stangl, F Knebel, G Baldenhofer, A Brecht, H Dreger, C Isner, F Pfafflin, M Stegemann, R Zahn, B Fraiture, C Kilkowski, A-K Karcher, S Klinger, H Tolksdorf, D Tousoulis, C Aggeli, S Sideris, E Venieri, G Sarri, D Tsiapras, I Armenis, A Koutsiari, G Floros, C Grassos, S Dragasis, L Rallidis, C Varlamos, L Michalis, K Naka, A Bechlioulis, A Kotsia, L Lakkas, K Pappas, C Papadopoulos, S Kiokas, A Lioni, S Misailidou, J Barbetseas, M Bonou, C Kapelios, I Tomprou, K Zerva, A Manolis, E Hamodraka, D Athanasiou, G Haralambidis, H Samaras, L Poulimenos, A Nagy, A Bartykowszki, E Gara, K Mungulmare, R Kasliwal, M Bansal, S Ranjan, A Bhan, M Kyavar, M Maleki, F Noohi Bezanjani, A Alizadehasl, S Boudagh, A Ghavidel, P Moradnejad, H R Pasha, B Ghadrdoost, D Gilon, J Strahilevitz, M Wanounou, S Israel, C d'Agostino, P Colonna, L De Michele, F Fumarola, M Stante, N Marchionni, V Scheggi, B Alterini, S Del Pace, P Stefano, C Sparano, N Ruozi, R Tenaglia, D Muraru, U Limbruno, A Cresti, P Baratta, M Solari, C Giannattasio, A Moreo, B De Chiara, B Lopez Montero, F Musca, C A Orcese, F Panzeri, F Spano, C F Russo, O Alfieri, M De Bonis, S Chiappetta, B Del Forno, M Ripa, P Scarpellini, C Tassan Din, B Castiglioni, R Pasciuta, S Carletti, D Ferrara, M Guffanti, G Iaci, E Lapenna, T Nisi, C Oltolini, E Busnardo, U Pajoro, E Agricola, R Meneghin, D Schiavi, F Piscione, R Citro, R M Benvenga, L Greco, L Soriente, I Radano, C Prota, M Bellino, D Di Vece, F Santini, A Salsano, G M Olivieri, F Turrini, R Messora, S Tondi, A Olaru, V Agnoletto, L Grassi, C Leonardi, S Sansoni, S Del Ponte, G M Actis Dato, A De Martino, N Ohte, S Kikuchi, K Wakami, K Aonuma, Y Seo, T Ishizu, T Machino-Ohtsuka, M Yamamoto, N Iida, H Nakajima, Y Nakagawa, C Izumi, M Amano, M Miyake, K Takahashi, I Shiojima, Y Miyasaka, H Maeba, Y Suwa, N Taniguchi, S Tsujimoto, T Kitai, M Ota, S Yuda, S Sasaki, N Hagiwara, K Yamazaki, K Ashihara, K Arai, C Saitou, S Saitou, G Suzuki, Y Shibata, N Watanabe, S Nishino, K Ashikaga, N Kuriyama, K Mahara, T Okubo, H Fujimaki, H Shitan, H Yamamoto, K Abe, M Terada, S Takanashi, M Sata, H Yamada, K Kusunose, Y Saijo, H Seno, O Yuichiro, T Onishi, F Sera, S Nakatani, H Mizuno, K Sengoku, S W Park, K Eun Kyoung, L Ga Yeon, J-W Hwang, C Jin-Oh, S-J Park, L Sang-Chol, C Sung-A, S Y Jang, R Heo, S Lee, J-M Song, E Jung, J Plisiene, A Dambrauskaite, G Gruodyte, R Jonkaitiene, V Mizariene, J Atkocaityte, R Zvirblyte, R Sow, A Codreanu, T Staub, C Michaux, E C L De la Vega, L Jacobs-Orazi, C Mallia Azzopardi, R G Xuereb, T Piscopo, J Farrugia, M Fenech, E Pllaha, C Vella, D Borg, R Casha, L Grib, E Raevschi, A Grejdieru, D Kravcenco, E Prisacari, E Samohvalov, S Samohvalov, N Sceglova, E Panfile, L Cardaniuc, V Corcea, A Feodorovici, V Gaina, L Girbu, P Jimbei, G Balan, I Cardaniuc, I Benesco, V Marian, N Sumarga, B Bozovic, N Bulatovic, P Lakovic, L Music, R Budde, A Wahadat, T Gamela, T Meijers, J P Van Melle, V M Deursen, H J Crijns, S C Bekkers, E C Cheriex, M Gilbers, B L Kietselaer, C Knackstedt, R Lorusso, S Schalla, S A Streukens, S Chamuleau, M-J Cramer, A Teske, T Van der Spoel, A Wind, J Lokhorst, O Liesbek, H Van Heusden, W Tanis, I Van der Bilt, J Vriend, H De Lange-van Bruggen, E Karijodikoro, R Riezebos, E van Dongen, J Schoep, V Stolk, J T Offstad, J O Beitnes, T Helle-Valle, H Skulstad, R Skardal, N Qamar, S Furnaz, B Ahmed, M H Butt, M F Khanzada, T Saghir, A Wahid, T Hryniewiecki, P Szymanski, K Marzec, M Misztal-Ogonowska, W Kosmala, M Przewlocka-Kosmala, A Rojek, K Woznicka, J Zachwyc, A Lisowska, M Kaminska, J D Kasprzak, E Kowalczyk, D F Strzecka, P Wejner-Mik, M Trabulo, P Freitas, S Ranchordas, G Rodrigues, P Pinto, C Queiros, J Azevedo, L Marques, D Seabra, L Branco, M Cruz, A Galrinho, R Moreira, P Rio, A T Timoteo, M Selas, V Carmelo, B Duque Neves, H Pereira, A Guerra, A Marques, I Pintassilgo, M C Tomescu, N-M Trofenciuc, M Andor, A Bordejevic, H S Branea, F Caruntu, L A Velcean, A Mavrea, M F Onel, T Parvanescu, D Pop, A L Pop-Moldovan, M I Puticiu, L Cirin, I M Citu, C A Cotoraci, D Darabantiu, R Farcas, I Marincu, A Ionac, D Cozma, C Mornos, F Goanta, I Popescu, R Beyer, R Mada, R Rancea, R Tomoaia, H Rosianu, C Stanescu, Z Kobalava, J Karaulova, E Kotova, A Milto, A Pisaryuk, N Povalyaev, M Sorokina, J Alrahimi, A Elshiekh, A Jamiel, A Ahmed, N Attia, B Putnikovic, A Dimic, B Ivanovic, S Matic, D Trifunovic, J Petrovic, D Kosevic, I Stojanovic, I Petrovic, P Dabic, P Milojevic, I Srdanovic, S Susak, L Velicki, A Vulin, M Kovacevic, A Redzek, M Stefanovic, T C Yeo, W Kf Kong, K K Poh, I Vilacosta, C Ferrera, C Olmos, M Abd El-Nasser, F Calvo Iglesias, E Blanco-Gonzalez, M Bravo Amaro, E Lopez-Rodriguez, J Lugo Adan, A N Germinas, P Pazos-Lopez, M Pereira Loureiro, M T Perez, S Raposeiras-Roubin, S Rasheed Yas, M-M Suarez-Varela, F Vasallo Vidal, D Garcia-Dorado, N Fernandez-Hidalgo, T Gonzalez-Alujas, J Lozano, O Maisterra, N Pizzi, R Rios, A Bayes-Genis, L Pedro Botet, N Vallejo, C Llibre, L Mateu, R Nunez, D Quesada, E Berastegui, D Bosch Portell, J Aboal Vinas, X Albert Bertran, R Brugada Tarradellas, P Loma-Osorio Ricon, C Tiron de Llano, M A Arnau, A Bel, M Blanes, A Osa, M Anguita, F Carrasco, J C Castillo, J L Zamorano, J L Moya Mur, M Alvaro, C Fernandez-Golfin, J M Monteagudo, E Navas Elorza, M C Farinas Alvarez, J Aguero Balbin, J Zarauza, J F Gutierrez-Diez, C Arminanzas, F Arnaiz de Las Revillas, A Arnaiz Garcia, M Cobo Belaustegui, M Fernandez Sampedro, M Gutierrez Cuadra, L Garcia Cuello, C Gonzalez Rico, R Rodriguez-Alvarez, J Goikoetxea, M Montejo, J M Miro, M Almela, J Ambrosioni, A Moreno, E Quintana, E Sandoval, A Tellez, J M Tolosana, B Vidal, C Falces, D Fuster, C Garcia-de-la-Maria, M Hernandez-Meneses, J Llopis, F Marco, I Ruiz-Zamora, A Bardaji Ruiz, E Sanz Girgas, G Garcia-Pardo, M Guillen Marzo, A Rodriguez Oviedo, A Villares Jimenez, L Abid, R Hammami, S Kammoun, M S Mourali, F Mghaieth Zghal, M Ben Hlima, S Boudiche, S Ouali, L Zakhama, S Antit, I Slama, O Gulel, M Sahin, E Karacaglar, S Kucukoglu, O Cetinarslan, U Y Sinan, U Canpolat, B Mutlu, H Atas, R Dervishova, C Ileri, J Alhashmi, J Tahir, P Zarger, F Baslib, S Woldman, L Menezes, C Primus, R Uppal, I Bvekerwa, B Chandrasekaran, A Kopanska, J Chambers, J Hancock, J Klein, R Rajani, M P Ursi, S Cannata, R Dworakowski, A Fife, J Breeze, M Browne-Morgan, M Gunning, S Streather, F M Asch, M Zemedkun, B Alyavi, J Uzokov, G., Habib, P. A., Erba, B., Iung, E., Donal, B., Cosyn, C., Laroche, B. A., Popescu, B., Prendergast, P., Torno, A., Sadeghpour, L., Oliver, J. -J., Vaskelyte, R., Sow, O., Axler, A. P., Maggioni, P, Lancellotti, P Gale, C, Beleslin, B, Budaj, A, Chioncel, O, Dagres, N, Danchin, N, Emberson, J, Erlinge, D, Glikson, M, Gray, A, Kayikcioglu, M, P Maggioni, A, K Nagy, V, Nedoshivin, A, Petronio, A-S, Roos-Hesselink, J, Wallentin, L, Zeymer, U, Habib, G, Lancellotti, P, Cosyns, B, Donal, E, Erba, P, Iung, B, A Popescu, B, Prendergast, B, Tornos, P, Andarala, M, Berle, C, Brunel-Lebecq, A, Fiorucci, E, Laroche, C, Missiamenou, V, Taylor, C, N Ali Tatar-Chentir, N, Al-Mallah, M, Astrom Aneq, M, Athanassopoulos, G, P Badano, L, Benyoussef, S, Calderon Aranda, E, M Cardim, N, Chan, K-L, Cruz, I, Edvardsen, T, Goliasch, G, Hagendorff, A, Hristova, K, Kamp, O, Kang, D-H, Kong, W, Matskeplishvili, S, Meshaal, M, Mirocevic, M, N Neskovic, A, Pazdernik, M, Plonska-Gosciniak, E, Raissouni, M, Ronderos, R, E Sade, L, Sadeghpour, A, Sambola, A, Sengupta, S, Separovic-Hanzevacki, J, Takeuchi, M, Tucay, E, C Tude Rodrigues, A, Varga, A, Vaskelyte, J, Yamagata, K, Yiangou, K, Zaky, H, Granada, I, Mahia, M, Ressi, S, Nacinovich, F, Iribarren, A, Fernandez Oses, P, Avegliano, G, Filipini, E, Obregon, R, Bangher, M, Dho, J, Cartasegna, L, L Plastino, M, Novas, V, Shigel, C, Reyes, G, De Santos, M, Gastaldello, N, Granillo Fernandez, M, Potito, M, Streitenberger, G, Velazco, P, H Casabé, J, Cortes, C, Guevara, E, Salmo, F, Seijo, M, Weidinger, F, Heger, M, Brooks, R, Stöllberger, C, Ho, C-Y, Perschy, L, Puskas, L, Binder, C, Rosenhek, R, Schneider, M, Winter, M-P, Hoffer, E, Melissopoulou, M, Lecoq, E, Legrand, D, Jacquet, S, Massoz, M, Pierard, L, Marchetta, S, Dulgheru, R, D Emal, C, Oury, C, Droogmans, S, Kerkhove, D, Plein, D, Soens, L, Weytjens, C, Motoc, A, Roosens, B, Lemoine, I, Rodrigus, I, Paelinck, B, Amsel, B, Unger, P, Konopnicki, D, Beauloye, C, Pasquet, A, L Vanoverschelde, J, Pierard, S, Vancraeynest, D, Sinnaeve, F, L Andrade, J, Staszko, K, Dos Santos Monteiro, R, H Miglioranza, M, L Shuha, D, Alcantara, M, Cravo, V, Fazzio, L, Felix, A, Iso, M, Musa, C, P Siciliano, A, Villaca Filho, F, Rodrigues, A, Vilela, F, Braga, J, Silva, R, Rodrigues, D, Silva, L, Morhy, S, Fischer, C, Vieira, M, Afonso, T, Abreu, J, N Falcao, S, A Moises, V, Gouvea, A, J Mancuso, F, C Souza, A, Y Silva, C, João, G, S Abboud, C, Bellio de Mattos Barretto, R, Ramos, A, Arnoni, R, E Assef, J, J Della Togna, D, Le Bihan, D, Miglioli, L, P Romero Oliveira, A, Tadeu Magro Kroll, R, Cortez, D, L Gelape, C, C Peirira Nunes, M D, C De Abreu Ferrari, T, Hay, K, Le, V, Page, M, Poulin, F, Sauve, C, Serri, K, Mercure, C, Beaudoin, J, Pibarot, P, A Sebag, I, G Rudski, L, Ricafort, G, Barsic, B, Krajinovic, V, Vargovic, M, Lovric, D, Reskovic-Luksic, V, Vincelj, J, Jaksic Jurinjak, S, Yiannikourides, V, Ioannides, M, Pofaides, C, Masoura, V, Pudich, J, Linhart, A, Siranec, M, Marek, J, Blechova, K, Kamenik, M, Pelouch, R, Coufal, Z, Mikulica, M, Griva, M, Jancova, E, Mikulcova, M, Taborsky, M, Precek, J, Jecmenova, M, Latal, J, Widimsky, J, Butta, T, Machacek, S, Vancata, R, Spinar, J, Holicka, M, Pow Chon Long, F, Anzules, N, Bajana Carpio, A, Largacha, G, Penaherrera, E, Moreira, D, Mahfouz, E, Elsafty, E, Soliman, A, Zayed, Y, Aboulenein, J, Abdel-Hay, M, Almaghraby, A, Abdelnaby, M, Ahmed, M, Hammad, B, Saleh, Y, Zahran, H, Elgebaly, O, Saad, A, Ali, M, Zeid, A, El Sharkawy, R, Al Kholy, A, Doss, R, Osama, D, Rizk, H, Elmogy, A, Mishriky, M, Assayag, P, El Hatimi, S, Hubert, S, Casalta, J-P, Gouriet, F, Arregle, F, Cammilleri, S, Tessonnier, L, Riberi, A, Botelho-Nevers, E, Gagneux-Brunon, A, Pierrard, R, Tulane, C, Campisi, S, Fuzellier, J-F, Detoc, M, Mehalla, T, Boutoille, D, S Lecompte, A, Lefebvre, M, Pattier, S, Al Habash, O, Asseray-Madani, N, Biron, C, Brochard, J, Caillon, J, Cueff, C, Le Tourneau, T, Lecomte, R, M Magali Michel, M, Orain, J, Delarue, S, Le Bras, M, Faucher, J-F, Aboyans, V, Beeharry, A, Durox, H, Lacoste, M, Magne, J, Mohty, D, David, A, Pradel, V, Sierra, V, Neykova, A, Bettayeb, B, Elkentaoui, S, Tzvetkov, B, Landry, G, Strady, C, Ainine, K, Baumard, S, Brasselet, C, Tassigny, C, Valente-Pires, V, Lefranc, M, Hoen, B, Lefevre, B, Curlier, E, Callier, C, Fourcade, N, Jobic, Y, Ansard, S, Le Berre, R, Le Ven, F, Pouliquen, M-C, Prat, G, Le Roux, P, Bouchart, F, Savoure, A, Alarcon, C, Chapuzet, C, Gueit, I, Tribouilloy, C, Bohbot, Y, Peugnet, F, Gun, M, Duval, X, Lescure, X, Ilic-Habensus, E, Sadoul, N, Selton-Suty, C, Alla, F, Goehringer, F, Huttin, O, Chevalier, E, Garcia, R, Le Marcis, V, Tattevin, P, Flecher, E, Revest, M, Chirouze, C, Bouiller, K, Hustache-Mathieu, L, Klopfenstein, T, Moreau, J, Fournier, D, Brunel, A-S, Lim, P, Oliver, L, Ternacle, J, Moussafeur, A, Chavanet, P, Piroth, L, Salmon-Rousseau, A, Buisson, M, Mahy, S, Martins, C, Gohier, S, Axler, O, Baumann, F, Lebras, S, Piper, C, Guckel, D, Börgermann, J, Horstkotte, D, Winkelmann, E, Brockmeier, B, Grey, D, Nickenig, G, Schueler, R, Öztürk, C, Stöhr, E, Hamm, C, Walther, T, Brandt, R, Frühauf, A-C, T Hartung, C, Hellner, C, Wild, C, Becker, M, Hamada, S, Kaestner, W, Stangl, K, Knebel, F, Baldenhofer, G, Brecht, A, Dreger, H, Isner, C, Pfafflin, F, Stegemann, M, Zahn, R, Fraiture, B, Kilkowski, C, Karcher, A-K, Klinger, S, Tolksdorf, H, Tousoulis, D, Aggeli, C, Sideris, S, Venieri, E, Sarri, G, Tsiapras, D, Armenis, I, Koutsiari, A, Floros, G, Grassos, C, Dragasis, S, Rallidis, L, Varlamos, C, Michalis, L, Naka, K, Bechlioulis, A, Kotsia, A, Lakkas, L, Pappas, K, Papadopoulos, C, Kiokas, S, Lioni, A, Misailidou, S, Barbetseas, J, Bonou, M, Kapelios, C, Tomprou, I, Zerva, K, Manolis, A, Hamodraka, E, Athanasiou, D, Haralambidis, G, Samaras, H, Poulimenos, L, Nagy, A, Bartykowszki, A, Gara, E, Mungulmare, K, Kasliwal, R, Bansal, M, Ranjan, S, Bhan, A, Kyavar, M, Maleki, M, Noohi Bezanjani, F, Alizadehasl, A, Boudagh, S, Ghavidel, A, Moradnejad, P, R Pasha, H, Ghadrdoost, B, Gilon, D, Strahilevitz, J, Wanounou, M, Israel, S, D'Agostino, C, Colonna, P, De Michele, L, Fumarola, F, Stante, M, Marchionni, N, Scheggi, V, Alterini, B, Del Pace, S, Stefano, P, Sparano, C, Ruozi, N, Tenaglia, R, Muraru, D, Limbruno, U, Cresti, A, Baratta, P, Solari, M, Giannattasio, C, Moreo, A, De Chiara, B, Lopez Montero, B, Musca, F, A Orcese, C, Panzeri, F, Spano, F, F Russo, C, Alfieri, O, DE BONIS, Michele, Chiappetta, S, Del Forno, B, Ripa, M, Scarpellini, P, Tassan Din, C, Castiglioni, B, Pasciuta, R, Carletti, S, Ferrara, D, Guffanti, M, Iaci, G, Lapenna, E, Nisi, T, Oltolini, C, Busnardo, E, Pajoro, U, Agricola, E, Meneghin, R, Schiavi, D, Piscione, F, Citro, R, M Benvenga, R, Greco, L, Soriente, L, Radano, I, Prota, C, Bellino, M, Di Vece, D, Santini, F, Salsano, A, M Olivieri, G, Turrini, F, Messora, R, Tondi, S, Olaru, A, Agnoletto, V, Grassi, L, Leonardi, C, Sansoni, S, Del Ponte, S, M Actis Dato, G, De Martino, A, Ohte, N, Kikuchi, S, Wakami, K, Aonuma, K, Seo, Y, Ishizu, T, Machino-Ohtsuka, T, Yamamoto, M, Iida, N, Nakajima, H, Nakagawa, Y, Izumi, C, Amano, M, Miyake, M, Takahashi, K, Shiojima, I, Miyasaka, Y, Maeba, H, Suwa, Y, Taniguchi, N, Tsujimoto, S, Kitai, T, Ota, M, Yuda, S, Sasaki, S, Hagiwara, N, Yamazaki, K, Ashihara, K, Arai, K, Saitou, C, Saitou, S, Suzuki, G, Shibata, Y, Watanabe, N, Nishino, S, Ashikaga, K, Kuriyama, N, Mahara, K, Okubo, T, Fujimaki, H, Shitan, H, Yamamoto, H, Abe, K, Terada, M, Takanashi, S, Sata, M, Yamada, H, Kusunose, K, Saijo, Y, Seno, H, Yuichiro, O, Onishi, T, Sera, F, Nakatani, S, Mizuno, H, Sengoku, K, W Park, S, Eun Kyoung, K, Ga Yeon, L, Hwang, J-W, Jin-Oh, C, Park, S-J, Sang-Chol, L, Sung-A, C, Y Jang, S, Heo, R, Lee, S, Song, J-M, Jung, E, Plisiene, J, Dambrauskaite, A, Gruodyte, G, Jonkaitiene, R, Mizariene, V, Atkocaityte, J, Zvirblyte, R, Sow, R, Codreanu, A, Staub, T, Michaux, C, L De la Vega, E C, Jacobs-Orazi, L, Mallia Azzopardi, C, G Xuereb, R, Piscopo, T, Farrugia, J, Fenech, M, Pllaha, E, Vella, C, Borg, D, Casha, R, Grib, L, Raevschi, E, Grejdieru, A, Kravcenco, D, Prisacari, E, Samohvalov, E, Samohvalov, S, Sceglova, N, Panfile, E, Cardaniuc, L, Corcea, V, Feodorovici, A, Gaina, V, Girbu, L, Jimbei, P, Balan, G, Cardaniuc, I, Benesco, I, Marian, V, Sumarga, N, Bozovic, B, Bulatovic, N, Lakovic, P, Music, L, Budde, R, Wahadat, A, Gamela, T, Meijers, T, P Van Melle, J, M Deursen, V, J Crijns, H, C Bekkers, S, C Cheriex, E, Gilbers, M, L Kietselaer, B, Knackstedt, C, Lorusso, R, Schalla, S, A Streukens, S, Chamuleau, S, Cramer, M-J, Teske, A, Van der Spoel, T, Wind, A, Lokhorst, J, Liesbek, O, Van Heusden, H, Tanis, W, Van der Bilt, I, Vriend, J, De Lange-van Bruggen, H, Karijodikoro, E, Riezebos, R, van Dongen, E, Schoep, J, Stolk, V, T Offstad, J, O Beitnes, J, Helle-Valle, T, Skulstad, H, Skardal, R, Qamar, N, Furnaz, S, Ahmed, B, H Butt, M, F Khanzada, M, Saghir, T, Wahid, A, Hryniewiecki, T, Szymanski, P, Marzec, K, Misztal-Ogonowska, M, Kosmala, W, Przewlocka-Kosmala, M, Rojek, A, Woznicka, K, Zachwyc, J, Lisowska, A, Kaminska, M, D Kasprzak, J, Kowalczyk, E, F Strzecka, D, Wejner-Mik, P, Trabulo, M, Freitas, P, Ranchordas, S, Rodrigues, G, Pinto, P, Queiros, C, Azevedo, J, Marques, L, Seabra, D, Branco, L, Cruz, M, Galrinho, A, Moreira, R, Rio, P, T Timoteo, A, Selas, M, Carmelo, V, Duque Neves, B, Pereira, H, Guerra, A, Marques, A, Pintassilgo, I, C Tomescu, M, Trofenciuc, N-M, Andor, M, Bordejevic, A, S Branea, H, Caruntu, F, A Velcean, L, Mavrea, A, F Onel, M, Parvanescu, T, Pop, D, L Pop-Moldovan, A, I Puticiu, M, Cirin, L, M Citu, I, A Cotoraci, C, Darabantiu, D, Farcas, R, Marincu, I, Ionac, A, Cozma, D, Mornos, C, Goanta, F, Popescu, I, Beyer, R, Mada, R, Rancea, R, Tomoaia, R, Rosianu, H, Stanescu, C, Kobalava, Z, Karaulova, J, Kotova, E, Milto, A, Pisaryuk, A, Povalyaev, N, Sorokina, M, Alrahimi, J, Elshiekh, A, Jamiel, A, Ahmed, A, Attia, N, Putnikovic, B, Dimic, A, Ivanovic, B, Matic, S, Trifunovic, D, Petrovic, J, Kosevic, D, Stojanovic, I, Petrovic, I, Dabic, P, Milojevic, P, Srdanovic, I, Susak, S, Velicki, L, Vulin, A, Kovacevic, M, Redzek, A, Stefanovic, M, C Yeo, T, Kf Kong, W, K Poh, K, Vilacosta, I, Ferrera, C, Olmos, C, Abd El-Nasser, M, Calvo Iglesias, F, Blanco-Gonzalez, E, Bravo Amaro, M, Lopez-Rodriguez, E, Lugo Adan, J, N Germinas, A, Pazos-Lopez, P, Pereira Loureiro, M, T Perez, M, Raposeiras-Roubin, S, Rasheed Yas, S, Suarez-Varela, M-M, Vasallo Vidal, F, Garcia-Dorado, D, Fernandez-Hidalgo, N, Gonzalez-Alujas, T, Lozano, J, Maisterra, O, Pizzi, N, Rios, R, Bayes-Genis, A, Pedro Botet, L, Vallejo, N, Llibre, C, Mateu, L, Nunez, R, Quesada, D, Berastegui, E, Bosch Portell, D, Aboal Vinas, J, Albert Bertran, X, Brugada Tarradellas, R, Loma-Osorio Ricon, P, Tiron de Llano, C, A Arnau, M, Bel, A, Blanes, M, Osa, A, Anguita, M, Carrasco, F, C Castillo, J, L Zamorano, J, L Moya Mur, J, Alvaro, M, Fernandez-Golfin, C, M Monteagudo, J, Navas Elorza, E, C Farinas Alvarez, M, Aguero Balbin, J, Zarauza, J, F Gutierrez-Diez, J, Arminanzas, C, Arnaiz de Las Revillas, F, Arnaiz Garcia, A, Cobo Belaustegui, M, Fernandez Sampedro, M, Gutierrez Cuadra, M, Garcia Cuello, L, Gonzalez Rico, C, Rodriguez-Alvarez, R, Goikoetxea, J, Montejo, M, M Miro, J, Almela, M, Ambrosioni, J, Moreno, A, Quintana, E, Sandoval, E, Tellez, A, M Tolosana, J, Vidal, B, Falces, C, Fuster, D, Garcia-de-la-Maria, C, Hernandez-Meneses, M, Llopis, J, Marco, F, Ruiz-Zamora, I, Bardaji Ruiz, A, Sanz Girgas, E, Garcia-Pardo, G, Guillen Marzo, M, Rodriguez Oviedo, A, Villares Jimenez, A, Abid, L, Hammami, R, Kammoun, S, S Mourali, M, Mghaieth Zghal, F, Ben Hlima, M, Boudiche, S, Ouali, S, Zakhama, L, Antit, S, Slama, I, Gulel, O, Sahin, M, Karacaglar, E, Kucukoglu, S, Cetinarslan, O, Y Sinan, U, Canpolat, U, Mutlu, B, Atas, H, Dervishova, R, Ileri, C, Alhashmi, J, Tahir, J, Zarger, P, Baslib, F, Woldman, S, Menezes, L, Primus, C, Uppal, R, Bvekerwa, I, Chandrasekaran, B, Kopanska, A, Chambers, J, Hancock, J, Klein, J, Rajani, R, P Ursi, M, Cannata, S, Dworakowski, R, Fife, A, Breeze, J, Browne-Morgan, M, Gunning, M, Streather, S, M Asch, F, Zemedkun, M, Alyavi, B, Uzokov, J, Hôpital de la Timone [CHU - APHM] (TIMONE), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), University Medical Center Groningen [Groningen] (UMCG), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Université de Médecine Carol Davila, Guy's and St Thomas' Hospital [London], CHU Henri Mondor, Centre Hospitalier Universitaire de Liège (CHU-Liège), AstraZeneca, Bayer, Edwards Lifesciences, Servier, Abbott Vascular Int., Amgen Cardiovascular, Pfizer Alliance, Daiichi Sankyo Europe GmbH, Alliance Daiichi Sankyo Europe GmbH, Gedeon Richter Plc., Menarini Int. Op., Vifor, Boehringer Ingelheim, Boston Scientific Corporation, Bristol-Myers Squibb, Eli Lilly and Company, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, UCL - (SLuc) Service de pathologies cardiovasculaires intensives, UCL - (SLuc) Service de soins intensifs, Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Oxford University Hospitals NHS Trust, University of Oxford [Oxford], Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Bordeaux (UB), Research Center [Associazione Nazionale Medici Cardiologi Ospedalieri] (ANMCO Research Center), Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Service de cardiologie [Liège], CHU de Liège-Domaine Universitaire du Sart Tilman, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Exeter, Instituto Nacional de Tecnología Agropecuaria, Pergamino, Argentina, Laboratory of In Vivo Cellular and Molecular Imaging, Vrije Universiteit Brussel (VUB), Centre National de la Recherche Scientifique (CNRS), Division of Engineering and Applied Science, California Institute of Technology, California Institute of Technology (CALTECH), Departamento de Biologia de la Reproduccion, Universidad Autónoma Metropolitana Iztapalapa (UAMI), Universidade Federal de Itajubá, Departamento de Física [Coimbra] (DFC), Universidade de Coimbra [Coimbra], Section of Internal Medicine and Endocrine and Metabolic Sciences, Università degli Studi di Perugia (UNIPG), LIP-Coimbra & Department of Physics of the University of Coimbra, Service Hospitalier Frédéric Joliot (SHFJ), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Quebec Heart Institute/Laval Hospital, Université Laval [Québec] (ULaval)-Quebec Heart Institute, Institut Lavoisier de Versailles (ILV), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU AMU), CHU Saint-Etienne, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Service des maladies infectieuses et tropicales [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service de bactériologie et hygiène hospitalière [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Institut du thorax, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Maladies infectieuses et tropicales [CHU Limoges], CHU Limoges, Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre Hospitalier Universitaire de Reims (CHU Reims), Anesthésie et réanimation en chirurgie cardiaque [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Normandie Université (NU), Service des maladies infectieuses et tropicales [Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Cardiology [Ospedali del Tigullio], Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Service des maladies infectieuses et réanimation médicale, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Laboratoire Chrono-environnement - CNRS - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), service de maladies infectieuses CHU J Minjoz Besancon, Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Département d'infectiologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Virologie et pathogenèse virale (VPV), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Institució Catalana de Recerca i Estudis Avançats (ICREA), Institute for Advanced Studies in Basic Sciences, affiliation inconnue, Dipartamento di Fisica 'E.R. Caianiello', Università degli Studi di Salerno (UNISA), The University of Tokyo, Northern Research Station, Forestry Commission, University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Instituto de Plasmas e Fusão Nuclear [Lisboa] (IPFN), Instituto Superior Técnico, Universidade Técnica de Lisboa (IST), Instituto de Investigaciones Marinas (CSIC), Faculté des Sciences Pharmaceutiques, EA 4529, Laboratoire de Biochimie, Université Paris-Sud - Paris 11 (UP11), Istituto di Virologia Vegetale, Università degli studi di Torino (UNITO), Universidad Nacional Autónoma de México (UNAM), Service de Chirurgie Cardiovasculaire, University Hospital of Cruces, Geneva University Hospital (HUG), Institut Jean Le Rond d'Alembert (DALEMBERT), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Preventive Medicine Unit, University Hospital Joan XXIII, IISPV, Rovira and Virgili University, Popescu, B, Maggioni, A, Gale, C, Nagy, V, Petronio, A, Ali Tatar-Chentir, N, Badano, L, Cardim, N, Chan, K, Kang, D, Neskovic, A, Sade, L, Tude Rodrigues, A, Plastino, M, Casabe, J, Stollberger, C, Ho, C, Winter, M, Emal, C, Vanoverschelde, J, Andrade, J, Miglioranza, M, Shuha, D, Siciliano, A, Falcao, S, Moises, V, Mancuso, F, Souza, A, Silva, C, Joao, G, Abboud, C, Assef, J, Della Togna, D, Romero Oliveira, A, Gelape, C, Peirira Nunes, M, De Abreu Ferrari, T, Sebag, I, Rudski, L, Casalta, J, Fuzellier, J, Lecompte, A, Magali Michel, M, Faucher, J, Pouliquen, M, Brunel, A, Borgermann, J, Ozturk, C, Stohr, E, Fruhauf, A, Hartung, C, Karcher, A, Pasha, H, Orcese, C, Russo, C, De Bonis, M, Benvenga, R, Olivieri, G, Actis Dato, G, Park, S, Hwang, J, Jang, S, Song, J, De la Vega, E, Xuereb, R, Van Melle, J, Deursen, V, Crijns, H, Bekkers, S, Cheriex, E, Kietselaer, B, Streukens, S, Cramer, M, Offstad, J, Beitnes, J, Butt, M, Khanzada, M, Kasprzak, J, Strzecka, D, Timoteo, A, Tomescu, M, Trofenciuc, N, Branea, H, Velcean, L, Onel, M, Pop-Moldovan, A, Puticiu, M, Citu, I, Cotoraci, C, Yeo, T, Poh, K, Germinas, A, Perez, M, Suarez-Varela, M, Arnau, M, Castillo, J, Zamorano, J, Moya Mur, J, Monteagudo, J, Farinas Alvarez, M, Gutierrez-Diez, J, Miro, J, Tolosana, J, Mourali, M, Yasar, U, Ursi, M, Asch, F, Clinical sciences, Cardio-vascular diseases, Cardiology, Medical Imaging, Cardiovascular Centre (CVC), Service de médecine nucléaire [Marseille], Imagerie MOléculaire pour applications THéranostiques personnalisées (IMOTHEP), Institut FRESNEL (FRESNEL), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Saclay-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC), MGSOG Scientific staff, MUMC+: MA Cardiologie (9), Cardiologie, RS: Carim - H01 Clinical atrial fibrillation, RS: CARIM - R2.01 - Clinical atrial fibrillation, RS: CARIM - R3.11 - Imaging, Promovendi CD, Fysiologie, MUMC+: MA Med Staf Artsass CTC (9), RS: CARIM - R1.06 - Genetic Epidemiology and Genomics of cardiovascular diseases, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H02 Cardiomyopathy, RS: CARIM - R2.02 - Cardiomyopathy, CTC, MUMC+: MA Med Staf Spec CTC (9), RS: Carim - V04 Surgical intervention, RS: CARIM - R2.12 - Surgical intervention, RS: FdR IC Aansprakelijkheid, Graduate School, ACS - Heart failure & arrhythmias, Radiotherapy, CCA - Imaging and biomarkers, CCA - Cancer Treatment and Quality of Life, and ACS - Atherosclerosis & ischemic syndromes

Subjects
Male, SURGERY, Embolism, Infective endocarditi, Infective endocarditis, Registry, Valve disease, 030204 cardiovascular system & hematology, 0302 clinical medicine, Africa, Northern, Positron Emission Tomography Computed Tomography, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Registries, Prospective cohort study, Abscess, Aged, 80 and over, medicine.diagnostic_test, Middle Aged, Staphylococcal Infections, 3. Good health, Cardiac surgery, Community-Acquired Infections, Europe, Treatment Outcome, Positron emission tomography, Echocardiography, Heart Valve Prosthesis, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, ECHOCARDIOGRAPHY, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Asia, Prosthesis-Related Infections, DIAGNOSIS, 03 medical and health sciences, Fluorodeoxyglucose F18, Internal medicine, Streptococcal Infections, medicine, MANAGEMENT, Journal Article, Humans, Aged, business.industry, EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY, Endocarditis, Bacterial, South America, medicine.disease, Heart failure, Etiology, Radiopharmaceuticals, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Enterococcus
Abstract

Aims The EURO-ENDO registry aimed to study the management and outcomes of patients with infective endocarditis (IE). Methods and results Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. Conclusion Infective endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.

Published
2019
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6. Club 35 Poster session 3: Friday 5 December 2014, 08:30-18:00 * Location: Poster area

Author

J.-H. Lee, O. Milanesi, B. Brekke, G. Giovanni Antonelli, S. Mulvagh, A. Guimaraes, N. Barrett, K. Ozawa, A. Revishvili, C. Lazaro Rivera, Sergio Mondillo, C. Carlo Gaetano Sassi, T. Chumarnaya, D. Vinereanu, K. Sveric, A. Alexandrescu, M. Y. Kolesnyk, J. Ovsianas, M. Masuda, M. Ozkan, B. Castaldi, R. Mccully, D. Dosen, O. Solovyova, V. Kochmasheva, O. Tautu, M. Yesin, C. Ball, M. Astarcioglu, N. Funabashi, C. Missant, C. Fernandez-Golfin, A. Assabiny, G. Cavalli, A. Stoylen, E. Reffo, S. Mihaila, F. Nomura, P. Haemers, A. Nagy, M. Kalcik, L. C. Lervik Nilsen, B. Cakal, Z. Valuckiene, J. Zamorano Gomez, N. Ioannou, G. Carr-White, J L Moya Mur, A. Carbonell Sanroman, E. Piasentini, C. Meadows, V. Kutyifa, E. Casas Rojo, S. Gunduz, F. Mantovani, G. Sutherland, K. Victor, M. Dorobantu, A. Ionescu, V. Mizariene, N. Maschietto, G. Stellin, S. Onciul, V. Reskovic Luksic, P. Aruta, T. Kamata, C. Langrish, F. Federico Alvino, R. Biffanti, S. Fernandez Santos, L. Tong, A. Argiolas, J. D'almeida, G. Cho, B. Ebner, D. Muraru, S. Mikhailov, B. Lakatos, A Garcia Martin, B. Merkely, J. D'hooge, C. Scott, V. Markhasin, M. Fujita, S. Cersit, O. Ostern, S. Iliceto, C. Toprak, D. Peluso, C. Santoro, A. Kovacs, T. Kanda, V. Zysek, A. Cerutti, A. Ladeia, M. M. Gurzun, S. Okamoto, H. Takaoka, D Rodriguez Munoz, L. Badano, K. Nanto, D. Lux, M. Takahara, A. Santoro, R. Strasser, A. Caldas, S. Karakoyun, O. Iida, T. Katova, I. Simova, S. Cekovic, L. Ucci, M. Rady, T. Ishihara, Y. Kobayashi, M. Gursoy, R. Onut, R. Huang, I. Lalov, S. Abdelmoneim Mohamed, V. Vida, I. Petre, T. Shiraki, D. Zamfir, A. Apor, R. Jurkevicius, S. Ulbrich, M. Padalino, A. Ortega, G. Glover, M. Galderisi, M. Valverde Gomez, Y. Alueva, M. Uematsu, and J. Separovic Hanzevacki

Subjects
Medical education, business.industry, Medicine, Radiology, Nuclear Medicine and imaging, General Medicine, Session (computer science), Club, Cardiology and Cardiovascular Medicine, business
Published
2014
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7. Poster session: Aortic stenosis

Author

R. Piccolo, J. Clarke, C. A. Brambila, B. Igual Munoz, K. Hristova, M. S. Carvalho, M. Tesic, O. Azevedo, J. A. Del Prado, A. Mcculloch, O. Kaitozis, B. Popovic, S. Stankovic, H. Chamsi-Pasha, R. Abdelfatah, V. Parisi, K. Pushparajah, E. Zemtsovsky, B. Kilickiran Avci, A. Manouras, K. Takenaka, F. Parthenakis, P. Vardas, A. Goudev, M. Orii, A. Kutarski, R. De Rosa, M. Castillo Orive, A. Sahlen, H. Ahn, S. Nedjati-Gilani, G. J. King, H. Bellsham-Revell, D. Lahidheb, M. Anastasiou-Nana, F. Pereira Machado, S. Yurdakul, N. Olsen, S. Pica, A. Ebihara, T. Nakajima, P. Molina Aguilar, R. Hornsten, M. Elnoamany, M. Cramer, G. Tamborini, G. Pagano, H. Kim, S. Soderberg, A. M. Gonzalez, N. Zlatareva, E. Marangio, F. Yang, G. Cho, I. Paunovic, C. Jons, T. Tanimoto, H. Triantafyllidi, D. Gopalan, O. Ozcan, M. Norman, G. Grazioli, F. Castillo, E. Kort, R. Bruno, J. Kostic, M. Daimon, D. Kang, C. Badiu, C. Magnino, C. Bucca, I. Joao, F. Buendia Sanchez, A. Tomaszewski, M. Alasnig, J. Kisslo, T. Kawata, S. Fernandez Casares, A. Livingston, J. Silva Cardoso, S. Korkmaz, J. Rodriguez Garcia, M. Tomaszewski, Y. Motoyoshi, A. Kaneva, E. Kinova, J. Lekakis, N. Bruun, M. Elneklawy, K. Uno, K. Nour, J. M. Ferrer, T. Wada, T. Katova, E. Ermis, F. Gaita, S. Rafla, F. Macedo, S. Woo, S. Perry, M. Lonnebakken, K. Thapa, M. Banovic, C. Selton-Suty, V. Pereira, A. Lourenco, G. Dreyfus, W. Serra, M. Hedstrom, A. Hagendorff, H. Nishino, T. Filali, M. Muratori, F. De Stefano, J. Marin, B. Jedaida, I. Rangel, J. Haertel, S. Tzortzis, A. Kalogerakis, G. Galasso, P. Hoffman, L. Chen, Y. Juilliere, V. Kostova, J. Navarro Manchon, C. J. Lopez-Guarch, J L Moya Mur, J. D. J. Baguda, C. Moretti, C. Manisty, N. Hajlaoui, H. Mahfoudhi, E. Martins, F. Bourlon, Y. Choi, C. Papadopoulos, A. Santos, I. V. Vassiliadis, A. Pereira, D. Domingo Valero, P. Iacotucci, C. Fernandez-Golfin, P. Li, I. Xanthopoulou, G. Pontone, R. Tan, D. D. Valero, D. Cramariuc, D. Lovric, F. Maffessanti, V. Pehar Pejcinovic, Y. Xu, M. Gurzun, L. Mitrofanova, P. Sousa, M. Miglioranza, A. Goncalves, I. Nedeljkovic, S. Stanic, C Di Mario, Y. Shiono, Y. Bian, E. Tossavainen, N. Risum, L. Sargento, K. Hirata, K. Said, H. Park, A. M. Argudo, T. Kubo, S. Barker, A. Chetta, R. Palma Reis, E. Malev, C. Yao, I. Papadakis, R. Medeiros, J. Tong, M. Previtali, T. Yamaguchi, S.-H. Shin, M. Sitges, C. Calinescu, J. Rueda Soriano, K. Steine, R. Ichikawa, K. Farouk, S. Pedri, J. Ripsweden, S. Carillo, G. Gelbrich, P. Rees, F. Costantino, S. Hutchings, A. Bel Minguez, A. Gaspar, M. Petrovic, M. Li Kam Wa, E. Mavronasiou, R. Winter, I. Quelhas, J. Johnson, A. Gopal, H. Jurin, R. Rordorf, M. Al-Mallah, A. Kydd, M. Ezat, A. M. Duncan, A. Kyriacou, Y. Kim, D. Mihalcea, J. Lessa, L. Mont, T. Fritz Hansen, J. Separovic Hanzevacki, D. Mesa, R. Mincu, G. Pavlidis, A.D.J. Ten Harkel, L. Gabrielli, F. Civaia, B. Vujisic-Tesic, M. Lourenco, C. Cefalu, C. Alexandrescu, L. Stefani, D. Gerede, M. Bartesaghi, C. Calin, F. Alamanni, A. Giesecke, P. Fazendas, C. Sousa, C. Ginghina, J. Magne, S. Lemoine, M. Gonzalez, C. Gohlke-Baerwolf, K. H. Hirata, S. Fawzi, H. Kisacik, B. Popescu, L. Visconti, W. Brzozowski, M. Driessen, V. Schiano Lomoriello, S. Yamada, I. Machado, F. Silveira, A. Nordin, E. Velazquez, J. Simpson, D. Vasilev, R. Rimbas, R. Murphy, C. Szymanski, T. Imanishi, M. Martirosyan, E. Najjar, J. Chambers, I. Jovanovic, A. Nagorni, E. Gunyeli, M. Omelchenko, P. De Araujo Goncalves, E. Avenatti, R. Marinov, A. Rieck, C. Tribouilloy, I. Sitges, P. Navas Tejedor, N. Lousada, W. Fehri, B. Pezo Nikolic, T. Leiner, C. Lazaro Rivera, H. Pereira, M. Loeffler, R. Hural, D. Caldeira, D. Francis, M. Di Natale, P. Salgado Filho, F. Gao, C. Alm, G. Tarsia, A. Aleixo, D. Vinereanu, C. Cotrim, M. Lotfi, B. Mc Loughlin, H. Morita, S. K. Saha, A. Djordjevic-Dikic, D. Voilliot, R. Camporotondo, J. Shin, P. Pavlov, M. A. Cattabiani, G. Sekita, A. Djordjevic Dikic, K. Ishibashi, C. Pare, J. Kwan, S. Miyazaki, V. Di Tante, E. Svenungsson, V. Giga, Y. Ino, M. Rover, J. Niewiadomska, M. Florescu, I. Skjoerten, C. Wilson, P. Davlouros, M. Hazekamp, N. Moat, A. Correia, C. Tekedis, I. Ikonomidis, B. Dilekci, L. Magda, T. Le, D. Sohn, S. Hamdy, M. Cinteza, R. Enache, A. Milan, R. Dahmani, A. Lopez Granados, J. Zamorano Gomez, E. Zorio Grima, S. Ghulam Ali, B. Demirkan, A. Shehata, M. Vono, M. Chiarlo, Miguel Mota Carmo, D. Trifunovic, B. Bijnens, Y. Yatomi, J J Jimenez Nacher, B. Rogge, R. Nagai, D. Dutka, X. Shen, I. Mordi, M. Henein, F. Celeste, G. Nadais, H. El Atroush, T. Yamano, D. Andreini, B. Beleslin, H. Suzuki, L. Yan, S. Ghio, C. C. De Sousa, S. Stoebe, S. Petrovic-Nagorni, D. Leosco, T. Komori, S. El-Tobgi, S. Mihaila, A. Madureira, T. Leiria, G. Kim, H. Haouala, B. Stuart, G. Touati, K. Oleszczak, M. Ostojic, J. Song, D. Presutti, A. Fournier, H. Daida, M. Perez Guillen, I. Kuipers, H. Hwang, B. Belesiln, K. Park, Y. Guray, D. Pfeiffer, C. Reverberi, A. Lech, A. Valentini, A. Cogo, F. Piscione, S. Negrea, S. Mezghani, V. Pilosoff, P. Sogaard, N. Blom, N. Tzemos, A. Mantovani, K. Okada, A. Turco, M. Peltier, B. Lopez Melgar, U. Guray, Q. Chen, S. Chamuleau, T. Stanton, F. Baeza, S. M. Rafla, J. Roquette, I. Almuntaser, E. Picano, D. Rusinaru, R. Kalil, R. Martin Asenjo, A. Kiotsekoglou, A. Chilingaryan, B. Candemir, P. Sonecki, A. Moulias, M. Rosca, H. Marques, A. Patrianakos, S. Sahin, J. Estornell Erill, O. Enescu, J. Spratt, P. Barbier, M. Maciel, I. Ivanac Vranesic, P. Lindqvist, T. Snow, J. Silva-Cardoso, N. Koutsogiannis, D. Ardissino, L. Zhong, K. Adamyan, L. Mccormick, A. Calin, P. Innelli, S. Yokoyama, C. Erol, P. Pabari, A. Tarr, M. Galderisi, S. Govind, B. Suran, I. Simova, E. Guyeli, T. Pinho, L. Bjornadal, B. Diaz Anton, J. Hilde, R. Sicari, C. Beladan, M. Ege, A. Zacharaki, L. Ghiadoni, A. A. La Huerta, S. Zdravkovic-Ciric, O. Huttin, K. Jensen-Urstad, F. Veglio, M. Elsedi, M. Nakabachi, P. Zinzius, D. Kim, H. Dores, A. Kakkavas, H. Badran, V. Sanchez Sanchez, E. Duo, J. Carrasco, A. Almeida, M. Virdee, M. Llemit, A. Anwar, L. Pratali, J. Monmeneu Menadas, S. Nevin, L. Fusini, F. Lombera Romero, E. Despotopoulos, E. Nyktari, G. Galanti, K. Kim, A. Van Der Hulst, H. Khachab, M. Dikic, I. Cruz, M. Melsom, J. Brugada, V. Mitic, M. Landolina, S. Turhan, V. Hansteen, D Rodriguez Munoz, J. S. De Lezo, N. Gori, Z. Baricevic, S.-P. Lee, M. Arnau Vives, S. Lee, P. Gripari, S. Humerfelt, F. Huang, T. Mikami, G. Soltan, T. Akasaka, S. Kaga, G. Penney, L. Toncelli, K. Boman, B. Basnyat, E. Kowalik, A. Bartolini, S. Georgiev, K. Shahgaldi, M. Pepi, M. Ruiz Ortiz, R. Sant'anna, H. Tsutsui, P. A. Fernandez, G. Tempesti, S. Aytekin, H. Iwano, Y. Nosir, C. Raineri, J. Rasmunsson, S. Lasarov, P. Lopez Lereu, V. Persic, F. Khan, J. Hisdal, M. Gommidh, A. Alhagoly, E. Gerdts, M. Milicia, G. Rengo, K. Kimura, F. Hakansson, M. Morenate, P. Mitev, M. Yacoub, M. Satendra, B. Kusmierczyk-Droszcz, E. Romo, R. Jankovic-Tomasevic, A. Roest, J. Stepanovic, J. Schwartz, Z. Ashour, L. Klitsie, J. Giner Blasco, M. Delgado, P. Omede, S. Mayordomo Gomez, I. Paraskevaidis, J. L. Zamorano, N. Goodfield, E. Dores, S. Davies, N. Patrascu, D. Alexopoulos, L. Donate Bertolin, D. Stanojevic, E. Psathakis, M. Dobric, P. Trivilou, H. Sasmaz, A. Marinkovic, O. Mirea, G. Sieswerda, M. Maruyama, A. M. Maceira Gonzalez, T. I. Imanishi, A. Santoro, G. Festa, R. Coma Samartin, and V. Atanaskovic

Subjects
medicine.medical_specialty, Stenosis, business.industry, Internal medicine, Cardiology, medicine, Radiology, Nuclear Medicine and imaging, General Medicine, Session (computer science), Cardiology and Cardiovascular Medicine, business, medicine.disease
Published
2012
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8. Valoración pronóstica de los pacientes con disfunción sistólica: estudio funcional y ecocardiográfico

Author

Enrique Asín, J. L. Moya Mur, Manuel Alonso Recarte, Javier Balaguer, Gabriela Guzmán, J. Alberto, José Luis Moya, Mar Alameda, García Lledó, and Celia Vaticón

Subjects
Heart transplantation, medicine.medical_specialty, business.industry, Walking test, Mortality rate, medicine.medical_treatment, Regression analysis, Surgery, New York Heart Association Classification, Left atrial, Statistical significance, Internal medicine, medicine, Cardiology, Functional status, Cardiology and Cardiovascular Medicine, business
Abstract

Introduction and objectives. Multiple clinical and echocardiographic parameters have been shown to have prognostic value in cases of left ventricular dysfunction. The purpose of this paper was to evaluate the relative predictive power of such parameters. Methods. Ninety-one patients with systolic dysfunction were prospectively studied. Functional status was evaluated using the New York Heart Association classification and the 6-minute walking test. Other clinical and biochemical parameters were assessed, and an anatomic and functional echocardiographic study was performed. Results. Mean follow-up was 16.5 months (SD: 6.95). Eighteen patients died and two underwent heart transplantation (cardiac death 22%). Multiple regression analysis showed that the only independent predictor of death was functional status. Functional classes I and II showed a 16-month mortality rate of 10%, class III 40% and class IV 83%. The mortality rate was 67% for patients who walked 500 meters. When echocardiographic results were analyzed separately, the only independent predictors of outcome were left atrial diameter and the E wave deceleration time. Deceleration times 5 cm were associated with a mortality rate of 46%. The correlation between E wave deceleration time and the walking test was r = 0.55, p < 0.0001. Conclusions. Functional status is the main predictor of outcome in patients with systolic dysfunction, whether assessed subjectively or estimated objectively by a walking test. Among echo-Doppler parameters, the deceleration time of the E wave and left atrial diameter gave similar prognostic information, although with less statistical significance. They can confirm or substitute the prognosis obtained by the functional classification.

Published
2002
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9. [Yield of transthoracic echocardiography with high frequency transducer in the study of the anterior descending coronary artery]

Author

J L, Moya Mur, G, Guzmán, P, Catalán, A, Megías, S, Ruiz, V, Barrios, J, Ortega, C, de Pablo, C, Harriague, A, García Lledó, and E, Asín Cardiel

Subjects
Male, Myocardial Infarction, Humans, Female, Middle Aged, Coronary Vessels, Echocardiography, Transesophageal, Aged
Abstract

This study was performed to evaluate the feasibility and utility of a transthoracic high frequency transducer to detect and measure the left anterior descending coronary artery flow in patients with lesions in this artery or anterior myocardial infarction.We studied 11 subjects with lesions greater than 75% and another 10 with anterior myocardial infarction. We compared the results with a control group of 18 subjects. An ATL HDI 5000 ultrasound unit with a 5-8 MHz transducer was used to identify the left anterior descending in the anterior interventricular sulcus from an apical four chamber window. We considered that left anterior descending was detected when a diastolic predominant flow pattern was obtained with pulse Doppler.Left anterior descending was detected in 37/39 of cases (94.4%). Patients with coronary lesions showed a decrease in the limit of significance in the diastolic/systolic peak velocity ratios: 2.5 (SD 0.7) vs 1.8 (SD 0.3) with a p = 0.024. Patients with anterior myocardial infarction obtained lower diastolic/systolic peak velocity ratios than controls: 2.5 (SD 0.7) vs 1.4 (SD 0.3) with a p = 0.001.Left anterior descending coronary artery flow can be assessed by transthoracic high frequency echocardiography in greater than 90% of the cases. Patients with coronary lesions and those with anterior myocardial infarction have a decreased diastolic/systolic peak velocity ratio.

Published
2001

10. [Hepatopulmonary syndrome]

Author

R, Aller de la Fuente, V, Moreira Vicente, J L, Moya Mur, D, Boixeda de Miquel, and D A, de Luis Román

Subjects
Adult, Diagnosis, Differential, Liver Cirrhosis, Male, Vasodilation, Pulmonary Circulation, Vasoconstriction, Hypertension, Portal, Humans, Female, Hepatopulmonary Syndrome, Liver Circulation
Published
1999

11. [A simplified method of continuous-wave Doppler noninvasive assessment of ventricular relaxation in mitral insufficiency]

Author

J A, García Lledó, J L, Moya Mur, J, Balaguer Recena, E, Novo García, C, Correa Gorospe, P, Jorge, R, Barea Navarro, and L, Boquete

Subjects
Observer Variation, Diastole, Swine, Data Interpretation, Statistical, Ventricular Pressure, Animals, Mitral Valve Insufficiency, Reproducibility of Results, Ventricular Function, Echocardiography, Doppler
Abstract

The minimum value of dP/dT is a parameter of diastolic function that can be estimated noninvasively by analyzing the profile of velocity of the mitral regurgitant jet, recorded by continuous-wave Doppler. This estimation requires a complex analysis of the curves that impedes its practical use. Our objective was to validate a simplified method to estimate noninvasively the value of dP/dTmin when mitral regurgitation exists. We calculated the pendient of the profile of velocity of the curve of mitral regurgitation during its deceleration, between 3 and 1.5 m/s, an interval that defines a difference in pressure using the formula delta p = (4v2(1) - 4v2(2)). We divided this interval by the time needed by the jet to decelerate from 3 to 1.5 m/s, obtaining the rate of pressure decay, in mmHg/s.We provoked mitral regurgitation in five pigs and registered dP/dT and the curve velocity of mitral regurgitation simultaneously, by micromanometer-tipped catheter and continuous-wave Doppler, respectively. The rate of pressure decay was calculated on the mitral regurgitation curve.We obtained 29 simultaneous registers. The coefficient for the correlationship between dP/dT and the rate of pressure decay was with an r value of 0.62 (p0.0001). The rate of pressure decay underestimated systematically the value of dP/dT. Intra and interobserver variability of TDP was 9 and 11%, respectively.This study validates a simplified method to estimate dP/dT noninvasively, with acceptable correlation with invasive measurements and adequate reproducibility.

Published
1998

12. [Study of active myocardial damage in children with suspected myocarditis using antimyosin monoclonal antibodies (AMMoAb-111In)]

Author

M E, Rioja Martín, J L, Moya Mur, M, Casanova, J M, Castro Beiras, E, Asín Cardiel, L, Díez Jiménez, and A, Crespo Díez

Subjects
Male, Myocarditis, Time Factors, Child, Preschool, Indium Radioisotopes, Organometallic Compounds, Antibodies, Monoclonal, Humans, Infant, Female, Child, Radionuclide Imaging, Retrospective Studies
Abstract

The study with monoclonal antimyosin antibody-111In has proved to be useful in the detection of the myocardial damage present in different processes. There is active myocardial damage and specific antimyosin uptake in myocarditis, as both experimental and clinical trials have shown. In experimental models the evolution of myocardial damage has been studied, where a parallelism between the histological changes of the myocardial damage and the evolution on the antimyosin uptake has been found. In clinical myocarditis it is difficult to do an histological follow up of the inflammatory process, and therefore the evolution of myocardial damage present in myocarditis is unknown. The antimyosin antibody images allow a non-invasive study of this evolution.a) to study with monoclonal antimyosin antibody-111In, the myocardial damage present regarding the disease evolution in children with suspected clinical diagnosis of myocarditis; b) to evaluate the evolution of the active myocardial damage reflected on the changes on the monoclonal antimyosin antibody-111In uptake.A study with monoclonal antimyosin antibody-111In was carried out on 43 children, 16 males and 27 females with a median age of 39 months (SD 48 m; range: 2-167) with suspected diagnosis of acute myocarditis defined as the presence of congestive cardiac failure or severe ventricular arrhythmia with less than 12 months of evolution. The image evaluation was done visually and through the heart to lung ratio. Twenty of these patients were also followed up with antimyosin antibody scan for a period of 19 +/- 9 months, and 3.8 +/- 1.7 studies were performed on them in this time.The prevalence of positive myocardial uptake was 83.72%. There is a negative correlation (r = -0.352; p0.02) between the evolution time of the process and the heart to lung ratio: patients studied before two months, have a higher heart to lung ratio and greater prevalence of positive studies than those studied later (heart to lung ratio 2.09 vs 1.74; p = 0.013; 90% vs 69.2%). Of the patients followed up with antimyosin antibody scans, 6 showed a clinical relapse which increased their heart to lung ratio. The other 14 showed an progressive decrease of the heart to lung ratio reaching normality in 14 +/- 6 months.a) the uptake intensity of monoclonal antimyosin antibody-111In, as a reflection of the myocardial damage, depends on the disease evolution time, as in the first two months is when the major damage happens; b) the uptake intensity slowly decreases, tending to normality around the 14th month, although this evolution may be altered by the appearance of relapses.

Published
1998

13. Cardiac involvement in acromegaly: specific myocardiopathy or consequence of systemic hypertension?

Author

R, López-Velasco, H F, Escobar-Morreale, B, Vega, E, Villa, J M, Sancho, J L, Moya-Mur, and R, García-Robles

Subjects
Adult, Male, Systole, Heart, Middle Aged, Cross-Sectional Studies, Diastole, Echocardiography, Acromegaly, Hypertension, Humans, Female, Cardiomyopathies, Follow-Up Studies
Abstract

To evaluate the relative contributions of past or present GH hypersecretion and of hypertension to the cardiac abnormalities present in acromegaly, we have studied the serum GH and insulin-like growth factor I concentrations, systolic and diastolic blood pressures, and morphological and functional cardiac indexes as measured by echocardiography-Doppler, in 39 patients with active or cured acromegaly, 16 hypertensive controls, and 17 normotensive controls. Hypertension was present in 42.8% of patients with active acromegaly and in 28.0% of patients in which acromegaly was cured. Hypertension was independently related to an increase in indexes of cardiac morphology (left ventricular mass, left ventricular posterior wall thickness, interventricular septum thickness, relative wall thickness with respect to the diastolic diameter of the left ventricle, and left atrial end-systolic diameter), systolic function (stroke volume, fractional shortening, and end-systolic stress), and diastolic function (isovolumic relaxation time and maximal late diastolic flow velocity) and to a reduction in the early to late maximal diastolic flow velocity ratio. Acromegaly was related to an increase in left ventricular mass, stroke volume, cardiac output, and isovolumic relaxation time, which were independent from the presence of hypertension. End-systolic stress was reduced by acromegaly. In the five patients in which active acromegaly was successfully treated, left ventricular mass and left ventricular posterior wall thickness were reduced 1 yr later. In conclusion, the asymptomatic morphological and functional cardiac abnormalities present in acromegalic patients are independently related to acromegaly and hypertension, pointing to the existence to a specific acromegalic myocardiopathy that might be aggravated by the coexistence of hypertension.

Published
1997

14. [Penetrating trauma by foreign body in the left heart ventricle]

Author

J A, García-Lledó, J L, Moya Mur, J, Balaguer Recena, E, Novo García, J M, Sancho Piedras, R, Sáiz Beneit, C, Rubio Cantarero, A, Epeldegui Torre, and E, Oliva de Anquín

Subjects
Adult, Male, Radiography, Heart Injuries, Heart Ventricles, Humans, Wounds, Penetrating, Foreign Bodies, Echocardiography, Transesophageal
Abstract

We present the case of a patient who suffered a cardiac penetrating trauma due to a 6-cm long steel splinter. He was self-admitted to the emergency room and was asymptomatic. Cardiac trauma was diagnosed by the presence of a foreign body in his chest X-ray. Transthoracic and transesophageal echocardiography showed pericardial effusion and a dense foreign body that crossed the left ventricle from upside down and forward to back. The patient underwent cardiac surgery under extracorporal circulation. A shooting wound was seen on the left ventricular free wall. Transesophageal echocardiography was performed during surgery in order to define the position of the foreign body and to discard lesions due to multidirectional injury. Lesions were repaired and the patient was discharged with no complications. This case report illustrates the possibility of survival after cardiac penetrating trauma, and the role of echocardiography in the diagnosis and surgical repair of this type of trauma.

Published
1997

15. [Doppler echocardiography in hypertrophic myocardiopathy]

Author

E, Asín Cardiel and J L, Moya Mur

Subjects
Diastole, Humans, Mitral Valve, Hypertrophy, Left Ventricular, Cardiomyopathy, Hypertrophic, Aorta, Echocardiography, Doppler
Abstract

Hypertrophic cardiomiopathy is a peculiar process with different anatomical and functional abnormalities which are present in different degrees in each case. Echocardiography and Doppler techniques have contributed definitively to the knowledge of this process and these procedures are choices for establishing the diagnosis of hypertrophic cardiomyopathy and to evaluate the clinical and morphological diversity of this process consisting of a spectrum of abnormalities with a variable presence in each case. Disproportionate septal hypertrophy is the most frecuent finding but the hypertrophy can involve other segments and different patterns can be present; concentric hypertrophy, apical, involving right ventricle, inverted asymetric, etc. Anterior mitral valve motion can be produced by the interrelation between anatomic factors of the valve, geometry of the outflow tract and physical forces produced by flow changes. Doppler echocardiography allows us to evaluate subaortic obstruction, to define its site, to demonstrate and measure the degree of mitral regurgitation and to carry out intraoperative studies. In hypertrophy cardiomyopathy the pattern of delayed relaxation is the most frequent but patients with severe obstruction and mitral regurgitation can pseudonormalize this pattern and even show restrictive patterns.

Published
1996

16. [Doppler echocardiography in the evaluation of valvular regurgitations]

Author

E, Asín Cardiel and J L, Moya Mur

Subjects
Diagnosis, Differential, Aortic Valve Insufficiency, Heart Valve Diseases, Models, Cardiovascular, Humans, Mitral Valve Insufficiency, Echocardiography, Doppler, Echocardiography, Transesophageal, Tricuspid Valve Insufficiency, Echocardiography, Doppler, Color
Published
1994

17. [Hypertrophic obstructive myocardiopathy complicated by severe mitral insufficiency secondary to rupture of the chordae tendineae]

Author

J L, Moya Mur, C, Barjau, A, García Lledó, E, Asín Cardiel, C, de Pablo Zarzosa, A, Ortiz de Salazar, I, García Andrade, and E, Oliva

Subjects
Male, Heart Valve Prosthesis, Chronic Disease, Heart Rupture, Chordae Tendineae, Humans, Mitral Valve, Mitral Valve Insufficiency, Cardiomyopathy, Hypertrophic, Middle Aged, Combined Modality Therapy
Abstract

A case of suddenly increasing dyspnea in a patient with hypertrophic obstructive cardiomyopathy is reported. Transesophageal echocardiography showed severe mitral regurgitation secondary to ruptured chordae tendineae. Mitral valve replacement was done, correcting both mitral regurgitation and subaortic gradient. Utility of transesophageal echocardiography in diagnosis and therapeutic options are discussed.

Published
1993

18. [Rupture of the intraventricular septum and free wall of the left ventricle secondary to non-penetrating thoracic injury. Doppler echocardiography diagnosis]

Author

M, Jiménez Mena, J L, Moya Mur, J, Martínez Martínez, E, Asin Cardiel, V, Barrios Alonso, A, Hernández Madrid, and A, Epeldegui

Subjects
Adult, Male, Heart Injuries, Heart Ventricles, Heart Septum, Humans, Wounds, Nonpenetrating, Echocardiography, Doppler
Abstract

The heart is often injured in the setting of blunt chest trauma with a broad spectrum of cardiac lesions. We present a twenty-nine years old man with interventricular septal and rupture and left ventricular free wall rupture following chest trauma. Doppler echocardiography was essential in the diagnostic and therapeutic procedure. We concluded that Doppler-echocardiography must be performed in all patients with suspicion of cardiac affectation after blunt chest trauma.

Published
1991

19. [Doppler echocardiography in physiologic valvular insufficiencies]

Author

E, Asín Cardiel, M, Jiménez Mena, J L, Moya Mur, and J C, Flores

Subjects
Aortic Valve Insufficiency, Heart Valve Diseases, Humans, Mitral Valve Insufficiency, Heart Valves, Echocardiography, Doppler, Pulmonary Valve Insufficiency, Tricuspid Valve Insufficiency
Published
1991

20. [Prognostic significance of silent ischemia in the exercise test in patients with coronary disease]

Author

E, Marín Huerta, J L, Moya Mur, C, de Pablo, I, Rayo, A, Muela, R, Martín de Dios, and C, Moro

Subjects
Adult, Male, Cross-Sectional Studies, Exercise Test, Humans, Coronary Disease, Female, Middle Aged, Prognosis, Aged, Angina Pectoris, Follow-Up Studies
Abstract

To evaluate the prognostic significance of silent ischemia during exercise testing, 152 consecutive patients (143 males, 9 females) with a mean SD of 55 +/- 7 years (age range 32-73) who underwent exercise testing and coronary arteriography within 3 months were studied. All patients had the following characteristics: 1) a positive electrocardiographic exercise test response; 2) significant coronary artery disease on the arteriography; 3) uninterrupted clinical follow-up for a minimum of 6 months. The 152 patients were divided in 2 groups: group I: 56 patients (37%) with ischemic ST-segment depression during exercise testing without angina (silent ischemia); group II: 96 patients (63%) with ischemic ST-segment depression and angina (symptomatic ischemia). Patients in group I and group II showed similar time to ST-segment depression (3.6 +/- 1.5 min vs 3.2 +/- 1.4 min; p = NS), maximal ST-segment depression and peak heart rate-systolic pressure product (21,151 +/- 7,124 vs 20,456 +/- 6,024; p = NS). Exercise duration was longer in group I than in group II (5.6 +/- 2.1 min vs 4.8 +/- 1.5 min; p less than 0.001). The extent of coronary artery disease defined by the number of significant narrowed coronary vessels, left ventricular end diastolic pressure and ejection fraction were similar in the 2 groups. Sixty six patients who underwent coronary bypass surgery were not included in the analysis. The remaining 86 patients (40 in group I and 46 in group II) were medically treated. The mean follow-up period was 43,5 +/- 25 months (range 6-101).2+ myocardial ischemia during exercise testing.

Published
1990

21. Severe pulmonary arterial hypertension due to toxic oil syndrome: a new cause of plexogenic arteriopathy

Author

M J, Mestre de Juan, F J, Martinez Tello, C, Gomez Pajuelo, C, Saenz de la Calzada, J L, Moya Mur, J C, Tascon Perez, F, Lombera Romero, and M A, Gomez Sanchez

Subjects
Fatty Acids, Monounsaturated, Respiratory Distress Syndrome, Pulmonary Veins, Hypertension, Pulmonary, Fibromuscular Dysplasia, Humans, Plant Oils, Rapeseed Oil, Syndrome, Pulmonary Artery, Muscle, Smooth, Vascular
Abstract

Ten patients with severe pulmonary hypertension due to Toxic Oil Syndrome (TOS) (3 men, 7 women; mean age 27.9 +/- 11.23 yrs.) are presented. The pulmonary vessels were examined with a micromorphometric technique. All patients had intimal fibrosis of the arteries and veins. Seven also had a thrombus in different stages. All arteries were shown to have medial hypertrophy. Plexiform lexions were found in eight cases. It is concluded that TOS can produce severe pulmonary hypertension histologically undistinguishable from the primary form. TOS can be added to the list of diseases causing plexogenic arteriopathy.

Published
1990

22. [Psoriatic arthritis associated with severe aortic insufficiency and complete auriculoventricular blockage]

Author

M, Sánchez Sánchez, J L, Moya Mur, E, Brito Brito, A, Morales Piga, and M D, Morales Durán

Subjects
Male, Heart Block, Aortic Valve Insufficiency, Arthritis, Psoriatic, Humans, Middle Aged
Abstract

We report on a case of long lasting psoriatic arthritis HLA B27 positive, complicated by the presence of severe aortic regurgitation and complete atrioventricular block, which required valve replacement and a permanent pacemaker. Valvular tissue histopathological analysis showed changes similar to those found in other seronegative spondyloarthritis.

Published
1989

23. [Traumatic rupture of the aorta presenting as aortic coarctation syndrome]

Author

J L, Moya Mur, V, Barrios Alonso, J, Fraj Lazaro, M, Sánchez Sánchez, C, de Pablo Zarzosa, and I, Rayo Llerena

Subjects
Adult, Male, Aortic Rupture, Humans, Aorta, Abdominal, Syndrome, Aortic Coarctation
Abstract

Aortic rupture is a frequent cause of death in chest trauma. The coincidence with other associated severe lesions and the absence of clear cardiographic signs may induce to an important delay in the diagnosis. We report a case in which the late apparition of arterial hypertension expressed as an acute aortic coarctation syndrome pointed out the diagnosis. We review the pathogenic mechanisms of arterial hypertension in traumatic aortic rupture and the utility of different diagnostic procedures.

Published
1989

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