28 results on '"Luchian ML"'
Search Results
2. Persistent dyspnea 1 year after COVID - 19 infection in apparently healthy subjects: a potential indicator of subclinical cardiac dysfunction
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Luchian, ML, primary, Motoc, AI, additional, Lochy, S, additional, Belsack, D, additional, Magne, J, additional, Roosens, B, additional, De Mey, J, additional, Boeckstaens, S, additional, Van Den Bussche, K, additional, Geers, J, additional, Chameleva, H, additional, Houard, L, additional, Weytjens, C, additional, Droogmans, S, additional, and Cosyns, B, additional
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- 2022
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3. Epicardial adipose tissue thickness in COVID-19 hospitalized patients: a tool for risk stratification
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Luchian, ML, primary, Motoc, AI, additional, Lochy, S, additional, Belsack, D, additional, Boeckstaens, S, additional, Geers, J, additional, Tanaka, K, additional, Scheirlynck, E, additional, De Mey, J, additional, Allard, S, additional, Magne, J, additional, Roosens, B, additional, Weytjens, C, additional, Cosyns, B, additional, and Droogmans, S, additional
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- 2022
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4. Prognostic value of coronary artery calcium score in hospitalized COVID - 19 patients
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Motoc, A, primary, Luchian, ML, additional, Lochy, S, additional, Belsack, D, additional, Magne, J, additional, Roosens, B, additional, De Mey, J, additional, Boeckstaens, S, additional, Van Den Bussche, K, additional, Geers, J, additional, Galloo, X, additional, Francois, C, additional, Weytjens, C, additional, Droogmans, S, additional, and Cosyns, B, additional
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- 2022
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5. Left atrial function by speckle tracking echocardography in HFpEF v1
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Rimbas, RC, primary, Magda, SL, additional, Mihaila-Baldea, S, additional, Luchian, ML, additional, Chitroceanu, AM, additional, Hayat, M, additional, Mihalcea, DJ, additional, Dragoi-Galrinho-Antunes-Guerra, R, additional, Stefan, M, additional, Velcea, A, additional, Andronic, A, additional, Lungeanu-Juravle, L, additional, Nicula, AI, additional, and Vinereanu, D, additional
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- 2021
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6. Multimodality imaging approach by speckle tracking echocardiography and cardiac magnetic resonance of heart failure with preserved ejection fraction, a step forward
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Rimbas, RC, primary, Mihalcea, DJ, additional, Chitroceanu, AM, additional, Visoiu, SI, additional, Mihaila-Baldea, S, additional, Magda, LS, additional, Luchian, ML, additional, Marinescu, AV, additional, Necula, AI, additional, and Vinereanu, D, additional
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- 2021
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7. A first reported aetiology of septic shock diagnosed with TEE and ultrasonic contrast agent.
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Higny J, Benoît M, Henry JP, Kalscheuer G, Delaere B, Michaux I, Jamart L, Dive F, and Luchian ML
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- Humans, Male, Shock, Septic diagnosis, Contrast Media, Echocardiography, Transesophageal methods
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- 2024
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8. Impact of Pre-Transplant Left Ventricular Diastolic Pressure on Primary Graft Dysfunction after Lung Transplantation: A Narrative Review.
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Henry JP, Carlier F, Higny J, Benoit M, Xhaët O, Blommaert D, Telbis AM, Robaye B, Gabriel L, Guedes A, Michaux I, Demeure F, and Luchian ML
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Lung transplantation (LT) constitutes the last therapeutic option for selected patients with end-stage respiratory disease. Primary graft dysfunction (PGD) is a form of severe lung injury, occurring in the first 72 h following LT and constitutes the most common cause of early death after LT. The presence of pulmonary hypertension (PH) has been reported to favor PGD development, with a negative impact on patients' outcomes while complicating medical management. Although several studies have suggested a potential association between pre-LT left ventricular diastolic dysfunction (LVDD) and PGD occurrence, the underlying mechanisms of such an association remain elusive. Importantly, the heterogeneity of the study protocols and the various inclusion criteria used to define the diastolic dysfunction in those patients prevents solid conclusions from being drawn. In this review, we aim at summarizing PGD mechanisms, risk factors, and diagnostic criteria, with a further focus on the interplay between LVDD and PGD development. Finally, we explore the predictive value of several diastolic dysfunction diagnostic parameters to predict PGD occurrence and severity.
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- 2024
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9. Emerging Trends in Left Ventricular Thrombus: A Comprehensive Review of Non-Ischemic and Ischemic Cardiopathies, Including Eosinophilic Myocarditis, Chagas Cardiomyopathy, Amyloidosis, and Innovative Anticoagulant Approaches.
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Colle B, Demeure F, Higny J, Benoit M, Henry JP, Michaux I, Robaye B, Xhaët O, Gabriel L, Guedes A, Blommaert D, Dulieu N, Berners Y, Wery F, Droogmans S, Cosyns B, and Luchian ML
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This comprehensive review explores the intricate aspects of left ventricular thrombus (LVT), a potential complication in both ischemic and non-ischemic cardiomyopathies. It provides a thorough understanding of left ventricular thrombus, revealing its uncommon incidence in the general population (7 cases per 10,000 patients), predominantly linked to ischemic heart diseases (ICMs) at an 80% prevalence rate. Diagnostic tools, notably transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR), demonstrate varying sensitivity but remain indispensable in specific clinical contexts related to LVT as non-invasive diagnostic modalities. A detailed comparison between ICM patients and those with non-ischemic cardiomyopathy (NICM) who have left ventricular thrombus reveals subtle distinctions with significant clinical implications. This analysis underscores the importance of these imaging techniques in distinguishing between the two conditions. Additionally, we explored the occurrence of LVT in specific non-ischemic cardiomyopathies, including Takotsubo syndrome, hypertrophic cardiomyopathy, eosinophilic myocarditis, Chagas disease, cardiac amyloidosis, and several other conditions. The article further delves into anticoagulation strategies, thoroughly examining their impact on LVT regression and patient outcomes. Pharmacological interventions, with a focus on direct oral anticoagulants, emerge as promising alternatives; however, there is insufficient information on their efficiency and safety, especially in NICM population. In conclusion, this review highlights the complex nature of LVT, incorporating a range of etiopathogenic factors, diagnostic complexities, and evolving therapeutic approaches. It emphasizes the pressing need for ongoing research in this field.
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- 2024
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10. Unmasking Pandemic Echoes: An In-Depth Review of Long COVID's Unabated Cardiovascular Consequences beyond 2020.
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Luchian ML, Higny J, Benoit M, Robaye B, Berners Y, Henry JP, Colle B, Xhaët O, Blommaert D, Droogmans S, Motoc AI, Cosyns B, Gabriel L, Guedes A, and Demeure F
- Abstract
At the beginning of 2020, coronavirus disease 2019 (COVID-19) emerged as a new pandemic, leading to a worldwide health crisis and overwhelming healthcare systems due to high numbers of hospital admissions, insufficient resources, and a lack of standardized therapeutic protocols. Multiple genetic variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been detected since its first public declaration in 2020, some of them being considered variants of concern (VOCs) corresponding to several pandemic waves. Nevertheless, a growing number of COVID-19 patients are continuously discharged from hospitals, remaining symptomatic even months after their first episode of COVID-19 infection. Long COVID-19 or 'post-acute COVID-19 syndrome' emerged as the new pandemic, being characterized by a high variability of clinical manifestations ranging from cardiorespiratory and neurological symptoms such as chest pain, exertional dyspnoea or cognitive disturbance to psychological disturbances, e.g., depression, anxiety or sleep disturbance with a crucial impact on patients' quality of life. Moreover, Long COVID is viewed as a new cardiovascular risk factor capable of modifying the trajectory of current and future cardiovascular diseases, altering the patients' prognosis. Therefore, in this review we address the current definitions of Long COVID and its pathophysiology, with a focus on cardiovascular manifestations. Furthermore, we aim to review the mechanisms of acute and chronic cardiac injury and the variety of cardiovascular sequelae observed in recovered COVID-19 patients, in addition to the potential role of Long COVID clinics in the medical management of this new condition. We will further address the role of future research for a better understanding of the actual impact of Long COVID and future therapeutic directions.
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- 2023
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11. Left ventricle hypertrophy - What else is there?
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Luchian ML and Motoc AI
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- Humans, Heart Ventricles diagnostic imaging, Hypertrophy, Left Ventricular diagnosis, Hypertrophy, Left Ventricular etiology
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- 2023
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12. Multimodality Imaging and Biomarker Approach to Characterize the Pathophysiology of Heart Failure in Left Ventricular Non-Compaction with Preserved Ejection Fraction.
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Visoiu IS, Rimbas RC, Nicula AI, Mihaila-Baldea S, Magda SL, Mihalcea DJ, Hayat M, Luchian ML, Chitroceanu AM, and Vinereanu D
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Left ventricular non-compaction (LVNC) with preserved ejection fraction (EF) is still a controverted entity. We aimed to characterize structural and functional changes in LVNC with heart failure with preserved EF (HFpEF)., Methods: We enrolled 21 patients with LVNC and HFpEF and 21 HFpEF controls. For all patients, we performed CMR, speckle tracking echocardiography (STE), and biomarker assessment for HFpEF (NT-proBNP), for myocardial fibrosis (Galectin-3), and for endothelial dysfunction [ADAMTS13, von Willebrand factor, and their ratio]. By CMR, we assessed native T1 and extracellular volume (ECV) for each LV level (basal, mid, and apical). By STE, we assessed longitudinal strain (LS), globally and at each LV level, base-to-apex gradient, LS layer by layer, from epicardium to endocardium, and transmural deformation gradient., Results: In the LVNC group, mean NC/C ratio was 2.9 ± 0.4 and the percentage of NC myocardium mass was 24.4 ± 8.7%. LVNC patients, by comparison with controls, had higher apical native T1 (1061 ± 72 vs. 1008 ± 40 ms), diffusely increased ECV (27.2 ± 2.9 vs. 24.4 ± 2.5%), with higher values at the apical level (29.6 ± 3.8 vs. 25.2 ± 2.8%) (all p < 0.01); they had a lower LS only at the apical level (-21.4 ± 4.4 vs. -24.3 ± 3.2%), with decreased base-to-apex gradient (3.8 ± 4.7 vs. 6.9 ± 3.4%) and transmural deformation gradient (3.9 ± 0.8 vs. 4.8 ± 1.0%). LVNC patients had higher NT-proBNP [237 (156-489) vs. 156 (139-257) pg/mL] and Galectin-3 [7.3 (6.0-11.5) vs. 5.6 (4.8-8.3) ng/mL], and lower ADAMTS13 (767.3 ± 335.5 vs. 962.3 ± 253.7 ng/mL) and ADAMTS13/vWF ratio (all p < 0.05)., Conclusion: LVNC patients with HFpEF have diffuse fibrosis, which is more extensive at the apical level, explaining the decrease in apical deformation and overexpression of Galectin-3. Lower transmural and base-to-apex deformation gradients underpin the sequence of myocardial maturation failure. Endothelial dysfunction, expressed by the lower ADAMTS13 and ADAMTS13/vWF ratio, may play an important role in the mechanism of HFpEF in patients with LVNC.
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- 2023
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13. Resuscitative TEE after open heart surgery: When POCUS fails to FOCUS.
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Higny J, Berners Y, and Luchian ML
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Echocardiography is key in evaluating the cause of collapse in the post-cardiac surgery patient. Transesophageal echocardiography provides a greater capability for the diagnosis of pericardial effusion in patients who arrest after cardiac surgery., Competing Interests: The authors have no conflicts of interest to declare., (© 2023 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)
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- 2023
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14. Prognostic value of left ventricular global constructive work in patients with cardiac amyloidosis.
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Geers J, Luchian ML, Motoc A, De Winter J, Roosens B, Bjerke M, Van Eeckhaut A, Wittens MMJ, Demeester S, Forsyth R, de Ravel T, Bissay V, Schots R, Verbrugge FH, Weytjens C, Weets I, Cosyns B, and Droogmans S
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- Humans, Prognosis, Retrospective Studies, Stroke Volume, Predictive Value of Tests, Ventricular Function, Left, Heart Failure, Amyloidosis, Ventricular Dysfunction, Left
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Purpose: The aim of the present study was to evaluate the role of ejection fraction (EF), left ventricular (LV) global longitudinal strain (LVGLS) and global constructive work (GCW) as prognostic variables in patients with cardiac amyloidosis (CA)., Methods: CA patients were retrospectively identified between 2015 and 2021 at a tertiary care hospital. Comprehensive clinical, biochemical, and imaging evaluation including two-dimensional (2D) echocardiography with myocardial work (MW) analysis was performed. A clinical combined endpoint was defined as all-cause mortality and heart failure readmission., Results: 70 patients were followed for 16 (7-37) months and 37 (52.9%) reached the combined endpoint. Patient with versus without clinical events had a significantly lower LVEF (40.71% vs. 48.01%, p = 0.039), LVGLS (-9.26 vs. -11.32, p = 0.034) and GCW (1034.47mmHg% vs. 1424.86mmHg%, p = 0.011). Multivariable analysis showed that LVEF ( odds ratio (OR): 0.904; 95% confidence interval (CI): 0.839-0.973, p = 0.007), LVGLS ( OR: 0.620; 95% CI: 0.415-0.926, p = 0.020) and GCW ( OR: 0.995; 95% CI: 0.990-0.999, p = 0.016) were significant predictors of outcome, but the model including GCW had the best discriminative ability to predict the combined endpoint (C-index = 0.888). A GCW less than 1443mmHg% was able to predict the clinical endpoint with a sensitivity of 94% and a specificity of 64% (Area under the curve (AUC): 0.771 (95% CI: 0.581-0.961; p = 0.005))., Conclusion: In CA patients, GCW may be of additional prognostic value to LVEF and GLS in predicting heart failure hospitalization and all-cause mortality., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
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- 2023
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15. The relationship between left atrial and left ventricular remodeling: A dangerous liaison.
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Motoc A, Luchian ML, and Cosyns B
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- Atrial Function, Left, Heart Atria diagnostic imaging, Humans, Ventricular Function, Left, Atrial Remodeling, Ventricular Remodeling
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- 2022
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16. Comparison between the novel diamond temp and the classical 8-mm tip ablation catheters in the setting of typical atrial flutter.
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Ramak R, Lipartiti F, Mojica J, Monaco C, Bisignani A, Eltsov I, Sorgente A, Capulzini L, Paparella G, Deruyter B, Iacopino S, Motoc AI, Luchian ML, Osorio TG, Overeinder I, Bala G, Almorad A, Ströker E, Sieira J, Jordaens L, Brugada P, de Asmundis C, and Chierchia GB
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- Catheters, Diamond, Humans, Temperature, Treatment Outcome, Tricuspid Valve surgery, Atrial Flutter surgery, Catheter Ablation methods
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Purpose: Radiofrequency (RF) catheter ablation is widely accepted as a first-line therapy for cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL). The novel DiamondTemp (DT) catheter with temperature feedback during RF ablation has been released recently on the market. The purpose of this study was to evaluate the impact of DiamondTemp (DT) technology on ablation efficiency during AFL., Methods: In this single-center study, 30 consecutive patients with typical AFL indicated to ablation of CTI were included. The first 15 patients underwent CTI ablation using 8-mm tip catheter, and the following 15 patients underwent temperature-controlled RF ablation using DT catheter. The endpoints were number and mean total duration of RF applications, mean temperature reached in the setting of CTI, procedural times, and fluoroscopy times., Results: There were no significant differences between the two groups concerning baseline characteristics. Mean duration of the each application (71.5 s ± 30.6 vs 12.4 s ± 13.2, p value < 0.001), mean total duration of RF applications (517,73 s ± 377,96 vs 112,8 s ± 43,58; p value < 0.001), procedural times (51.6 min ± 24.2 vs 38.6 ± 8.2; p = 0.03), and fluoroscopy times (16.2 min ± 10.2 vs 8 min ± 4.24; p = 0.005) were longer in the 8-mm ablation catheter group. Mean temperature measurements (51.9 °C ± 3.59 vs 56.7 °C ± 3.34, p value < 0.003) were as well lower in the 8-mm ablation catheter group., Conclusions: Catheter ablation of CTI-dependent AFL by means of DT resulted in a significant reduction of total and single application RF delivery time, procedure, and fluoroscopy times., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2022
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17. Subclinical Myocardial Dysfunction in Patients with Persistent Dyspnea One Year after COVID-19-Why Should Screening for Cardiovascular Diseases Be Performed? Reply to Vankrunkelsven, P. Tendentious Paper-Titles and Wrong Conclusions Lead to Fear in the Population and Medical Overconsumption. Comment on "Luchian et al. Subclinical Myocardial Dysfunction in Patients with Persistent Dyspnea One Year after COVID-19. Diagnostics 2022, 12 , 57".
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Luchian ML, Motoc A, Lochy S, Magne J, Belsack D, De Mey J, Roosens B, Van den Bussche K, Boeckstaens S, Chameleva H, Geers J, Houard L, De Potter T, Allard S, Weytjens C, Droogmans S, and Cosyns B
- Abstract
We have read with interest the comment by Vankrunkelsven P. [...].
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- 2022
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18. New insights into the potential utility of the left atrial function analysis in heart failure with preserved ejection fraction diagnosis.
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Rimbas RC, Visoiu IS, Magda SL, Mihaila-Baldea S, Luchian ML, Chitroceanu AM, Hayat M, Mihalcea DJ, Dragoi-Galrinho-Antunes-Guerra R, Stefan M, Velcea A, Andronic AA, Lungeanu-Juravle L, Nicula AI, and Vinereanu D
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- Echocardiography methods, Heart Atria diagnostic imaging, Humans, Risk Factors, Stroke Volume, Ventricular Function, Left, Atrial Function, Left, Heart Failure diagnostic imaging
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Aims: None of the conventional echocardiographic parameters alone predict increased NTproBNP level and symptoms, making diagnosis of heart failure with preserved ejection fraction (HFpEF) very difficult in some cases, in resting condition. We evaluated LA functions by 2D speckle tracking echocardiography (STE) on top of conventional parameters in HFpEF and preHF patients with diastolic dysfunction (DD), in order to establish the added value of the LA deformation parameters in the diagnosis of HFpEF., Methods: We prospectively enrolled 125 patients, 88 with HFpEF (68±9 yrs), and 37 asymptomatic with similar risk factors with DD (preHF) (61±8 yrs). We evaluated them by NTproBNP, conventional DD parameters, and STE. Global longitudinal strain (GS) was added. LA reservoir (R), conduit (C), and pump function (CT) were assessed both by volumetric and STE. 2 reservoir strain (S) derived indices were also measured, stiffness (SI) and distensibility index (DI)., Results: LA R and CT functions were significantly reduced in HFpEF compared to preHF group (all p<0.001), whereas conduit was similarly in both groups. SI was increased, whereas DI was reduced in HFpEF group (p<0.001). By adding LA strain analysis, from all echocardiographic parameters, SR_CT<-1.66/s and DI<0.57 (AUC = 0.76, p<0.001) demonstrated the highest accuracy to identify HFpEF diagnosis. However, by multivariate logistic regression, the model that best identifies HFpEF included only SR_CT, GS and sPAP (R2 = 0.506, p<0.001). Moreover, SR_CT, DI, and sPAP registered significant correlation with NTproBNP level., Conclusions: By adding LA functional analysis, we might improve the HFpEF diagnosis accuracy, compared to present guidelines. LA pump function is the only one able to differentiates preHF from HFpEF patients at rest. A value of SR_CT < -1.66/s outperformed conventional parameters from the scoring system, reservoir strain, and LA overload indices in HFpEF diagnosis. We suggest that LA function by STE could be incorporated in the current protocol for HFpEF diagnosis at rest as a major functional criterion, in order to improve diagnostic algorithm, and also in the follow-up of patients with risk factors and DD, as a prognostic marker. Future studies are needed to validate our findings., Competing Interests: The authors have declared that no competing interests exist.
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- 2022
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19. Additional value of left atrium remodeling assessed by three-dimensional echocardiography for the prediction of atrial fibrillation recurrence after cryoballoon ablation.
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Motoc A, Scheirlynck E, Roosens B, Luchian ML, Chameleva H, Gevers M, Galloo X, von Kemp B, de Asmundis C, Magne J, Droogmans S, and Cosyns B
- Abstract
Cryoballoon ablation (CBA) is a safe and efficient therapeutic option for atrial fibrillation (AF). However, AF recurrence occurs in 25% of the patients, leading to repeated ablations and complications. Previous reports have shown that left atrium (LA) assessed by M-Mode and two-dimensional echocardiography (2DE) predicts AF recurrence. Nevertheless, these methods imply geometrical assumptions of the LA remodeling, which is a three-dimensional process. We hypothesized that LA remodeling by three-dimensional echocardiography (3DE) has an additional value for AF recurrence prediction post-CBA. 172 consecutive patients (62.2 ± 12.2 years, 61% male) were prospectively recruited. Echocardiography was performed before CBA. Blanking period was defined as the first three months post-ablation. The primary endpoint was AF recurrence after the blanking period. 50 (29%) patients had AF recurrence. 3DE LA maximum volume index (LAVI) had the highest incremental predictive value for AF recurrence (HR 5.50, 95% CI 1.34 -22.45, p < 0.001). In patients with non-dilated LA diameter index and LAVI by 2DE, LAVI by 3DE was able to discriminate AF recurrence with a sensitivity of 90% and a specificity of 66%, for an optimal cut-off value of 30.4 ml/m
2 . LA remodeling by 3DE predicted AF recurrence, even in patients with non-dilated LA by M-Mode and 2DE, suggesting that 3DE might reflect better and earlier the asymmetric and variable nature of LA remodeling and it should be considered for systematic use to evaluate AF recurrence risk post-CBA., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)- Published
- 2022
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20. Subclinical Myocardial Dysfunction in Patients with Persistent Dyspnea One Year after COVID-19.
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Luchian ML, Motoc A, Lochy S, Magne J, Belsack D, De Mey J, Roosens B, Van den Bussche K, Boeckstaens S, Chameleva H, Geers J, Houard L, De Potter T, Allard S, Weytjens C, Droogmans S, and Cosyns B
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Long coronavirus disease 2019 (COVID-19) was described in patients recovering from COVID-19, with dyspnea being a frequent symptom. Data regarding the potential mechanisms of long COVID remain scarce. We investigated the presence of subclinical cardiac dysfunction, assessed by transthoracic echocardiography (TTE), in recovered COVID-19 patients with or without dyspnea, after exclusion of previous cardiopulmonary diseases. A total of 310 consecutive COVID-19 patients were prospectively included. Of those, 66 patients (mean age 51.3 ± 11.1 years, almost 60% males) without known cardiopulmonary diseases underwent one-year follow-up consisting of clinical evaluation, spirometry, chest computed tomography, and TTE. From there, 23 (34.8%) patients reported dyspnea. Left ventricle (LV) ejection fraction was not significantly different between patients with or without dyspnea (55.7 ± 4.6 versus (vs.) 57.6 ± 4.5, p = 0.131). Patients with dyspnea presented lower LV global longitudinal strain, global constructive work (GCW), and global work index (GWI) compared to asymptomatic patients (-19.9 ± 2.1 vs. -21.3 ± 2.3 p = 0.039; 2183.7 ± 487.9 vs. 2483.1 ± 422.4, p = 0.024; 1960.0 ± 396.2 vs. 2221.1 ± 407.9, p = 0.030). GCW and GWI were inversely and independently associated with dyspnea ( p = 0.035, OR 0.998, 95% CI 0.997-1.000; p = 0.040, OR 0.998, 95% CI 0.997-1.000). Persistent dyspnea one-year after COVID-19 was present in more than a third of the recovered patients. GCW and GWI were the only echocardiographic parameters independently associated with symptoms, suggesting a decrease in myocardial performance and subclinical cardiac dysfunction.
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- 2021
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21. Incremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation.
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Motoc A, Luchian ML, Scheirlynck E, Roosens B, Chameleva H, Gevers M, Galloo X, von Kemp B, Ramak R, Sieira J, de Asmundis C, Chierchia GB, Magne J, Weytjens C, Droogmans S, and Cosyns B
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- Aged, Cryosurgery methods, Diagnostic Tests, Routine methods, Echocardiography methods, Female, Heart Atria physiopathology, Humans, Hypertrophy physiopathology, Male, Middle Aged, Atrial Fibrillation prevention & control, Atrial Function, Left physiology, Cryosurgery adverse effects
- Abstract
Objective: Atrial fibrillation (AF) recurrence occurs in approximately 25% of the patients undergoing cryoballoon ablation (CBA), leading to repeated ablations and complications. Left atrial (LA) dilation has been proposed as a predictor of AF recurrence. However, LA strain is a surrogate marker of LA mechanical dysfunction, which might appear before the enlargement of the LA. The purpose of this study was to evaluate the additional predictive value of LA function assessed using strain echocardiography for AF recurrence after CBA., Methods: 172 consecutive patients (62.2 ± 12.2 years, 61% male) were prospectively analyzed. Echocardiography was performed before CBA. Blanking period was defined as the first three months post-ablation. The primary endpoint was AF recurrence after the blanking period., Results: 50 (29%) patients had AF recurrence. In the overall study population, peak atrial longitudinal strain (PALS) ≤ 17% had the highest incremental predictive value for AF recurrence (HR = 9.45, 95%CI: 3.17-28.13, p < 0.001). In patients with non-dilated LA, PALS≤17% remained an independent predictor of AF recurrence (HR = 5.39, 95%CI: 1.66-17.52, p = 0.005)., Conclusions: This study showed that LA function assessed by PALS provided an additional predictive value for AF recurrence after CBA, over LA enlargement. In patients with non-dilated LA, PALS also predicted AF recurrence. These findings emphasize the added value of LA strain, suggesting that it should be implemented in the systematic evaluation of AF patients before CBA., Competing Interests: The authors have declared that no competing interests exist.
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- 2021
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22. Prognostic Value of Coronary Artery Calcium Score in Hospitalized COVID-19 Patients.
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Luchian ML, Lochy S, Motoc A, Belsack D, Magne J, Roosens B, de Mey J, Tanaka K, Scheirlynck E, Boeckstaens S, Van den Bussche K, De Potter T, von Kemp B, Galloo X, François C, Weytjens C, Droogmans S, and Cosyns B
- Abstract
Background: The association of known cardiovascular risk factors with poor prognosis of coronavirus disease 2019 (COVID-19) has been recently emphasized. Coronary artery calcium (CAC) score is considered a risk modifier in the primary prevention of cardiovascular disease. We hypothesized that the absence of CAC might have an additional predictive value for an improved cardiovascular outcome of hospitalized COVID-19 patients. Materials and methods: We prospectively included 310 consecutive hospitalized patients with COVID-19. Thirty patients with history of coronary artery disease were excluded. Chest computed tomography (CT) was performed in all patients. Demographics, medical history, clinical characteristics, laboratory findings, imaging data, in-hospital treatment, and outcomes were retrospectively analyzed. A composite endpoint of major adverse cardiovascular events (MACE) was defined. Results: Two hundred eighty patients (63.2 ± 16.7 years old, 57.5% male) were included in the analysis. 46.7% patients had a CAC score of 0. MACE rate was 21.8% (61 patients). The absence of CAC was inversely associated with MACE (OR 0.209, 95% CI 0.052-0.833, p = 0.027), with a negative predictive value of 84.5%. Conclusion: The absence of CAC had a high negative predictive value for MACE in patients hospitalized with COVID-19, even in the presence of cardiac risk factors. A semi-qualitative assessment of CAC is a simple, reproducible, and non-invasive measure that may be useful to identify COVID-19 patients at a low risk for developing cardiovascular complications., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Luchian, Lochy, Motoc, Belsack, Magne, Roosens, de Mey, Tanaka, Scheirlynck, Boeckstaens, Van den Bussche, De Potter, von Kemp, Galloo, François, Weytjens, Droogmans and Cosyns.)
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- 2021
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23. Feasibility, Reproducibility and Validation of Right Ventricular Volume and Function Assessment Using Three-Dimensional Echocardiography.
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De Potter T, Weytjens C, Motoc A, Luchian ML, Scheirlynck E, Roosens B, Tanaka K, Houard L, Droogmans S, and Cosyns B
- Abstract
Three-dimensional echocardiography (3DE) is advised for right ventricular (RV) assessment. Data regarding the optimal acquisition settings and optimization are still scarce. We aimed to evaluate the feasibility, reproducibility and validation of 3DE for RV volume and function assessment, using cardiac magnetic resonance (CMR) as gold standard. Thirty healthy volunteers and 36 consecutive patients were prospectively included. CMR was performed in the latter. Standard apical four-chamber view (A4CV), focused A4CV and modified A4CV were used for 3DE RV acquisition. Feasibility (and the effect of changes in settings) was evaluated. Intra and interobserver analyses were performed by three observers (expert vs. novice). RV parameters by echocardiography were compared to CMR. Feasibility of acquisition was 16.7% for A4CV, 80.0% for focused A4CV and 16.7% for modified A4CV. Changes in settings had no significant influence on feasibility and further analysis. Intraobserver variability was good in both expert and novice, interobserver variability was good between experienced observers. Compared to CMR, 3DE volumes were significantly lower with fair to moderate correlation (EDV: 91.1 ± 24.4 mL vs. 144.3 ± 43.0 mL ( p < 0.001), r = 0.653 and ESV: 48.1 ± 16.4 mL vs. 60.4 ± 21.2 mL ( p < 0.001), r = 0.530, by multi-beat 3DE and CMR respectively). These findings suggest that standardization is needed in order to implement this technique in clinical practice, thus further studies are required.
- Published
- 2021
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24. Troponin T in COVID-19 hospitalized patients: Kinetics matter.
- Author
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Luchian ML, Motoc AI, Lochy S, Magne J, Roosens B, Belsack D, Van den Bussche K, von Kemp B, Galloo X, François C, Scheirlynck E, Boeckstaens S, De Potter T, Seyler L, van Laethem J, Hennebicq S, Weytjens C, Droogmans S, and Cosyns B
- Subjects
- Aged, Aged, 80 and over, Biomarkers blood, Female, Humans, Kinetics, Male, Middle Aged, Proportional Hazards Models, COVID-19 diagnosis, Troponin T blood
- Abstract
Background: Coronavirus disease 2019 (COVID-19) emerged as a worldwide health crisis, overwhelming healthcare systems. Elevated cardiac troponin T (cTn T) at admission was associated with increased in-hospital mortality. However, data addressing the role of cTn T in major adverse cardiovascular events (MACE) in COVID-19 are scarce. Therefore, we assessed the role of baseline cTn T and cTn T kinetics for MACE and in-hospital mortality prediction in COVID-19., Methods: Three hundred and ten patients were included prospectively. One hundred and eight patients were excluded due to incomplete records. Patients were divided into three groups according to cTn T kinetics: ascending, descending, and constant. The cTn T slope was defined as the ratio of the cTn T change over time. The primary and secondary endpoints were MACE and in-hospital mortality., Results: Two hundred and two patients were included in the analysis (mean age 64.4 ± 16.7 years, 119 [58.9%] males). Mean duration of hospitalization was 14.0 ± 12.3 days. Sixty (29.7%) patients had MACE, and 40 (19.8%) patients died. Baseline cTn T predicted both endpoints (p = 0.047, hazard ratio [HR] 1.805, 95% confidence interval [CI] 1.009-3.231; p = 0.009, HR 2.322, 95% CI 1.234-4.369). Increased cTn T slope predicted mortality (p = 0.041, HR 1.006, 95% CI 1.000-1.011). Constant cTn T was associated with lower MACE and mortality (p = 0.000, HR 3.080, 95% CI 1.914-4.954, p = 0.000, HR 2.851, 95% CI 1.828-4.447)., Conclusions: The present study emphasizes the additional role of cTn T testing in COVID-19 patients for risk stratification and improved diagnostic pathway and management.
- Published
- 2021
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25. Feasibility and Reproducibility of Left Atrium Measurements Using Different Three-Dimensional Echocardiographic Modalities.
- Author
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Motoc A, Roosens B, Scheirlynck E, Tanaka K, Luchian ML, Magne J, Mandoli GE, Hinojar R, Cameli M, Zamorano JL, Droogmans S, and Cosyns B
- Abstract
Left atrium (LA) volume is a biomarker of cardiovascular outcomes. Three-dimensional echocardiography (3DE) provides an accurate LA evaluation, but data regarding the optimal 3DE method is scarce. We assessed the feasibility and reproducibility of LA measurements using different 3DE methods. One hundred and ninety-four patients were prospectively analyzed. Conventional 3DE and two semi-automatic 3DE algorithms (Tomtec™ and Dynamic Heart Model (DHM)) were used in 110 patients. Intra- and interobserver reproducibility and intervendor comparison were performed in additional patients' subsets. Forty patients underwent cardiac magnetic resonance (CMR). Feasibility was 100% for Tomtec, 98.2% for DHM, and 72.8% for conventional 3DE. Tomtec volumes were higher than 3DE and DHM ( p < 0.001). Reproducibility was better for DHM (intraobserver LA maximum volume (LAmax) ICC 0.99 (95% CI 1.0-0.99), LA minimum volume (LAmin) 0.98 (95% CI 0.95-0.99), LApreA 0.96 (95% CI 0.91-0.98); interobserver LAmax ICC 0.98 (95% CI 0.96-0.99), LAmin 0.99 (95% CI 0.99-1.00), and LApreA 0.97 (95% CI 0.94-0.99)). Intervendor comparison showed differences between left ventricle (LV) software adapted for LA ( p < 0.001). Tomtec underestimated the least LA volumes compared to CMR. These findings emphasize that dedicated software should be used for LA assessment, for consistent clinical longitudinal follow-up and research.
- Published
- 2020
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26. Coronary Calcium Score in COVID-19 Hospitalized Patients.
- Author
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Cosyns B, Motoc A, Luchian ML, Lochy S, and Belsack D
- Subjects
- Humans, Risk Factors, SARS-CoV-2, COVID-19, Calcium
- Published
- 2020
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27. The role of cardiovascular imaging for myocardial injury in hospitalized COVID-19 patients.
- Author
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Cosyns B, Lochy S, Luchian ML, Gimelli A, Pontone G, Allard SD, de Mey J, Rosseel P, Dweck M, Petersen SE, and Edvardsen T
- Subjects
- Biomarkers, COVID-19, Cardiac Imaging Techniques statistics & numerical data, Cardiovascular Diseases diagnostic imaging, Cardiovascular Diseases epidemiology, Comorbidity, Coronavirus Infections prevention & control, Disease Management, Echocardiography, Doppler methods, Echocardiography, Doppler statistics & numerical data, Electrocardiography methods, Electrocardiography statistics & numerical data, Female, Humans, Magnetic Resonance Imaging, Cine methods, Male, Pandemics prevention & control, Pneumonia, Viral prevention & control, Practice Guidelines as Topic, Prognosis, Risk Assessment, Role, Cardiac Imaging Techniques methods, Coronavirus Infections epidemiology, Myocardial Infarction diagnostic imaging, Myocardial Infarction epidemiology, Pandemics statistics & numerical data, Pneumonia, Viral epidemiology, Troponin I blood
- Abstract
Recent EACVI recommendations described the importance of limiting cardiovascular imaging during the COVID-19 pandemic in order to reduce virus transmission, protect healthcare professionals from contamination, and reduce consumption of personal protective equipment. However, an elevated troponin remains a frequent request for cardiac imaging in COVID-19 patients, partly because it signifies cardiac injury due to a variety of causes and partly because it is known to convey a worse prognosis. The present paper aims to provide guidance to clinicians regarding the appropriateness of cardiac imaging in the context of troponin elevation and myocardial injury, how best to decipher the mechanism of myocardial injury, and how to guide patient management., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
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28. Extensive Cardiac Involvement in a Young Woman With Polymyositis: The Devil Behind the Curtain Unmasked by a Multimodality Imaging Approach.
- Author
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Luchian ML, Stoicescu CI, Nicula AI, Vinereanu D, and Rimbas RC
- Subjects
- Adult, Biopsy, Cardiovascular Agents therapeutic use, Diagnostic Errors, Echocardiography, Doppler, Color, Female, Heart Diseases drug therapy, Heart Diseases etiology, Heart Diseases immunology, Humans, Immunosuppressive Agents therapeutic use, Magnetic Resonance Imaging, Myositis diagnosis, Myositis drug therapy, Myositis immunology, Predictive Value of Tests, Tomography, Optical Coherence, Acute Coronary Syndrome diagnostic imaging, Heart Diseases diagnostic imaging, Multimodal Imaging, Myositis complications
- Published
- 2019
- Full Text
- View/download PDF
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