1,364 results on '"M. Metra"'
Search Results
2. Congenital heart disease in the ESC EORP Registry of Pregnancy and Cardiac disease (ROPAC)
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Karishma P. Ramlakhan, Mark R. Johnson, Malgorzata Lelonek, Aly Saad, Zaur Gasimov, Natalia V. Sharashkina, Patrick Thornton, Margaret Arstall, Roger Hall, Jolien W. Roos-Hesselink, Jolien Roos-Hesselink, Joerg Stein, William Anthony Parsonage, Werner Budts, Julie De Backer, Jasmin Grewal, Ariane Marelli, Harald Kaemmerer, Guillaume Jondeau, Mark Johnson, Aldo P. Maggioni, Luigi Tavazzi, Ulf Thilen, Uri Elkayam, Catherine Otto, Karen Sliwa, A. Aquieri, A. Saad, H. Ruda Vega, J. Hojman, J.M. Caparros, M. Vazquez Blanco, M. Arstall, C.M. Chung, G. Mahadavan, E. Aldridge, M. Wittwer, Y.Y. Chow, W.A. Parsonage, K. Lust, N. Collins, G. Warner, R. Hatton, A. Gordon, E. Nyman, J. Stein, E. Donhauser, H. Gabriel, A. Bahshaliyev, F. Guliyev, I. Hasanova, T. Jahangirov, Z. Gasimov, A. Salim, C.M. Ahmed, F. Begum, M.H. Hoque, M. Mahmood, M.N. Islam, P.P. Haque, S.K. Banerjee, T. Parveen, M. Morissens, J. De Backer, L. Demulier, M. de Hosson, W. Budts, M. Beckx, M. Kozic, M. Lovric, T. Kovacevic-Preradovic, N. Chilingirova, P. Kratunkov, N. Wahab, S. McLean, E. Gordon, L. Walter, A. Marelli, A.R. Montesclaros, G. Monsalve, C. Rodriguez, F. Balthazar, V. Quintero, W. Palacio, L.A. Mejía Cadavid, E. Munoz Ortiz, F. Fortich Hoyos, E. Arevalo Guerrero, J. Gandara Ricardo, J. Velasquez Penagos, Z. Vavera, Prague, J. Popelova, N. Vejlstrup, L. Grønbeck, M. Johansen, A. Ersboll, Y. Elrakshy, K. Eltamawy, M. Gamal Abd-El Aziz, A. El Nagar, H. Ebaid, H. Abo Elenin, M. Saed, S. Farag, W. Makled, K. Sorour, Z. Ashour, G. El-Sayed, M. Abdel Meguid Mahdy, N. Taha, A. Dardeer, M. Shabaan, M. Ali, P. Moceri, G. Duthoit, M. Gouton, J. Nizard, L. Baris, S. Cohen, M. Ladouceur, D. Khimoud, B. Iung, F. Berger, A. Olsson, U. Gembruch, W.M. Merz, E. Reinert, S. Clade, Y. Kliesch, C. Wald, C. Sinning, R. Kozlik-Feldmann, S. Blankenberg, E. Zengin-Sahm, G. Mueller, M. Hillebrand, P. Hauck, Y. von Kodolitsch, N. Zarniko, Muenster H. Baumgartner, R. Schmidt, A. Hellige, O. Tutarel, H. Kaemmerer, B. Kuschel, N. Nagdyman, R. Motz, D. Maisuradze, A. Frogoudaki, E. Iliodromitis, M. Anastasiou-Nana, Marousi, D. Triantafyllis, G. Bekiaris, H. Karvounis, G. Giannakoulas, D. Ntiloudi, S.A. Mouratoglou, A. Temesvari, H. Balint, D. Kohalmi, B. Merkely, C. Liptai, A. Nemes, T. Forster, A. Kalapos, K. Berek, K. Havasi, N. Ambrus, A. Shelke, R. Kawade, S. Patil, E. Martanto, T.M. Aprami, A. Purnomowati, C.J. Cool, M. Hasan, R. Akbar, S. Hidayat, T.I. Dewi, W. Permadi, D.A. Soedarsono, M.M. Ansari-Ramandi, N. Samiei, A. Tabib, F. Kashfi, S. Ansari-Ramandi, S. Rezaei, H. Ali Farhan, A. Al-Hussein, G. Al-Saedi, G. Mahmood, I.F. Yaseen, L. Al-Yousuf, M. AlBayati, S. Mahmood, S. Raheem, T. AlHaidari, Z. Dakhil, P. Thornton, J. Donnelly, M. Bowen, A. Blatt, G. Elbaz-Greener, A. Shotan, S. Yalonetsky, S. Goland, M. Biener, G. Egidy Assenza, M. Bonvicini, A. Donti, A. Bulgarelli, D. Prandstraller, C. Romeo, R. Crepaz, E. Sciatti, M. Metra, R. Orabona, L. Ait Ali, P. Festa, V. Fesslova, C. Bonanomi, M. Calcagnino, F. Lombardi, A.M. Colli, M.W. Ossola, C. Gobbi, E. Gherbesi, L. Tondi, M. Schiavone, M. Squillace, M.G. Carmina, A. Maina, C. Macchi, E. Gollo, F.M. Comoglio, N. Montali, P. Re, R. Bordese, T. Todros, V. Donvito, W. Grosso Marra, G. Sinagra, B. D'Agata Mottolese, M. Bobbo, V. Gesuete, S. Rakar, F. Ramani, K. Niwa, D. Mekebekova, A. Mussagaliyeva, T. Lee, E. Mirrakhimov, S. Abilova, E. Bektasheva, K. Neronova, O. Lunegova, R. Žaliūnas, R. Jonkaitienė, J. Petrauskaitė, A. Laucevicius, D. Jancauskaite, L. Lauciuviene, L. Gumbiene, L. Lankutiene, S. Glaveckaite, M. Laukyte, S. Solovjova, V. Rudiene, K.H. Chee, C.C.-W. Yim, H.L. Ang, R. Kuppusamy, T. Watson, M. Caruana, M.-E. Estensen, M.G.A. Mahmood Kayani, R. Munir, A. Tomaszuk-Kazberuk, B. Sobkowicz, J. Przepiesc, A. Lesniak-Sobelga, L. Tomkiewicz-Pajak, M. Komar, M. Olszowska, P. Podolec, S. Wisniowska-Smialek, M. Lelonek, U. Faflik, A. Cichocka-Radwan, K. Plaskota, O. Trojnarska, N. Guerra, L. de Sousa, C. Cruz, V. Ribeiro, S. Jovanova, V. Petrescu, R. Jurcut, C. Ginghina, I. Mircea Coman, M. Musteata, O. Osipova, T. Golivets, I. Khamnagadaev, O. Golovchenko, A. Nagibina, I. Ropatko, I.R. Gaisin, L. Valeryevna Shilina, N. Sharashkina, E. Shlyakhto, O. Irtyuga, O. Moiseeva, E. Karelkina, I. Zazerskaya, A. Kozlenok, I. Sukhova, L. Jovovic, K. Prokšelj, M. Koželj, A.O. Askar, A.A. Abdilaahi, M.H. Mohamed, A.M. Dirir, K. Sliwa, P. Manga, A. Pijuan-Domenech, L. Galian-Gay, P. Tornos, M.T. Subirana, M. T, Subirana, J.M. Oliver, B. Garcia-Aranda Dominguez, I. Hernandez Gonzalez, J.F. Delgado Jimenez, P. Escribano Subias, N. Murga, A. Elbushi, A. Suliman, K. Jazzar, M. Murtada, N. Ahamed, M. Dellborg, E. Furenas, M. Jinesjo, K. Skoglund, P. Eriksson, T. Gilljam, U. Thilen, D. Tobler, K. Wustmann, F. Schwitz, M. Schwerzmann, T. Rutz, J. Bouchardy, M. Greutmann, B.M. Santos Lopes, L. Meier, M. Arrigo, K. de Boer, T. Konings, E. Wajon, L.J. Wagenaar, P. Polak, E.P.G. Pieper, J. Roos-Hesselink, I. van Hagen, H. Duvekot, J.M.J. Cornette, C. De Groot, C. van Oppen, L. Sarac, O. Batukan Esen, S. Catirli Enar, C. Mondo, P. Ingabire, B. Nalwanga, T. Semu, B.T. Salih, W.A.R. Almahmeed, S. Wani, F.S. Mohamed Farook, Al Ain, F. Gerges, A.M. Komaranchath, F. Al bakshi, A. Al Mulla, A.H. Yusufali, E.I. Al Hatou, N. Bazargani, F. Hussain, L. Hudsmith, P. Thompson, S. Thorne, S. Bowater, A. Money-Kyrle, P. Clifford, P. Ramrakha, S. Firoozan, J. Chaplin, N. Bowers, D. Adamson, F. Schroeder, R. Wendler, S. Hammond, P. Nihoyannopoulos, Norwich Norfolk, R. Hall, L. Freeman, G. Veldtman, J. Kerr, L. Tellett, N. Scott, A.B. Bhatt, D. DeFaria Yeh, M.A. Youniss, M. Wood, A.A. Sarma, S. Tsiaras, A. Stefanescu, J.M. Duran, L. Stone, D.S. Majdalany, J. Chapa, K. Chintala, P. Gupta, J. Botti, J. Ting, W.R. Davidson, G. Wells, D. Sparks, V. Paruchuri, K. Marzo, D. Patel, W. Wagner, S.N. Ahanya, L. Colicchia, T. Jentink, K. Han, M. Loichinger, M. Parker, C. Longtin, A. Yetman, K. Erickson, J. Cramer, S. Tsai, B. Fletcher, S. Warta, C. Cohen, C. Lindblade, R. Puntel, K. Nagaran, N. Croft, M. Gurvitz, C. Otto, C. Talluto, D. Murphy, and M.G. Perlroth
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Congenital heart disease ,Pregnancy ,Maternal health ,Observational registry ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2021
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3. Raised homocystein plasma concentration in patients with Heart Failure: clinical significance
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E. Vizzardi, S. Nodari, C. Fiorina, M. Metra, and L. Dei Cas
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Medicine - Abstract
Elevated plasma levels of homocysteine is associated with increased risk of thrombotic and atherosclerotic vascular disease. Several studies have demonstrated that hyperhomocysteinemia is an indipendent risk factor for vascular disease and is associated to heart failure. However there are no data regarding the association between homocysteine and various objective as well as subjective measures of heart failure. We hypothesized that plasma homocysteine is associated with clinical and echocardiographic signs of heart failure. On this ground we have analysed levels of homocysteine in patients with heart failure and possible correlation between these levels and clinical-functional pattern (NYHA class and ejection fraction). Methods: Plasma homocysteine levels were determined in 123 patients with dilated cardiomyopathy (59 males, 64 females, mean age 67±10 years, mean EF 31±11% and mean NYHA 2.4±0.9, 47 idiopatic and 76 postischemic cardiomyopathy) and 85 healthy control subjects (homogeneus group for sex and age). Patients with chronic renal failure, vitamin B12 and folate deficiency or factors affecting homocysteine plasma levels were escluded from this study. Homocysteine levels were determined in coded plasma samples by immunoenzimatic methods. Results: Patients with heart failure had a higher homocysteine level (mcg/L) than control subjects (21.72±10.28 vs 12.9±6.86, p
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- 2016
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4. Combined pre- and post-capillary pulmonary hypertension in left heart disease
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M. Riccardi, M. Pagnesi, E. Sciatti, C. M. Lombardi, R. M. Inciardi, M. Metra, and E. Vizzardi
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Pulmonary artery wedge pressure ,Combined pre- and post-capillary pulmonary hypertension ,Echocardiography ,Heart failure ,Phosphodiesterase 5 inhibitors ,Right heart catheterization ,Cardiology and Cardiovascular Medicine - Abstract
Patients with heart failure (HF) often have pulmonary hypertension (PH), which is mainly post-capillary; however, some of them also develop a pre-capillary component. The exact mechanisms leading to combined pre- and post-capillary PH are not yet clear, but the phenomenon seems to start from a passive transmission of increased pressure from the left heart to the lungs, and then continues with the remodeling of both the alveolar and vascular components through different pathways. More importantly, it is not yet clear which patients are predisposed to develop the disease. These patients have some characteristics similar to those with idiopathic pulmonary arterial hypertension (e.g., young age and frequent incidence in female gender), but they share cardiovascular risk factors with patients with HF (e.g., obesity and diabetes), with both reduced and preserved ejection fraction. Thanks to echocardiography parameters and newly introduced scores, more tools are available to distinguish between idiopathic pulmonary arterial hypertension and combined PH and to guide patients' management. It may be hypothesized to treat patients in whom the pre-capillary component is predominant with specific therapies such as those for idiopathic pulmonary arterial hypertension; however, no adequately powered trials of PH-specific treatment are available in combined PH. Early evidence of clinical benefit has been proven in some trials on phosphodiesterase type 5 inhibitors, while data on prostacyclin analogues, endothelin-1 receptor antagonists, and soluble guanylate cyclase stimulators are still controversial.
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- 2022
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5. Echocardiographic and invasive evaluation of left atrial pressure in patients undergoing catheter ablation for atrial fibrillation
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A Cersosimo, G Arabia, R M Inciardi, M Cerini, A Bonelli, G Dell'era, A Degiovanni, E Spinoni, M Bosco, F Salghetti, C M Lombardi, R Patti, M Metra, and A Curnis
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Funding Acknowledgements Type of funding sources: None. AIMS Estimation of left ventricle (LV) filling pressure is one of the most important parameters to provide information in clinical practice. However, the challenging in investigating this parameter through invasive methods makes it difficult to be used. The study aims to investigate the association between cardiac structure and function derived by transthoracic echocardiography (TTE) and left atrial (LA) invasive pressure (LAP). Methods The study was a multi-center prospective study enrolling 73 patients (mean age 65 ± 8, 27% female) undergoing primary catheter ablation for AF. Patients were evaluated and enrolled from June 2021 to April 2022. Complete TTE assessing measures of LV, LA and right ventricle (RV) structure and function including speckle tracking echocardiography, was performed at baseline. Echocardiographic data have been assessed the same day of the invasive measurement of the LAP during AF ablative procedure. Linear regression analysis has been performed to assess the relationship between measures of cardiac structure and function and LAP. Logistic regression analysis assessed the parameters associated with elevated LAP (≥ 15mmHg). Results Baseline clinical characteristics of the study population did not differ according to elevated LAP vs. non-elevated LAP. Patients with elevated LAP showed instead abnormal measures of LV global longitudinal strain, measures of LA structure and function, except for LA maximal volume, and RV structure and function. After multivariable adjustment, including demographic factors and comorbidities, E/e`(p = 0,024), LA minimal volume (p = 0,009), LA emptying fraction (LAEF) (p = 0,012), LA Reservoir (p = 0,039), TAPSE (p= 0,010) and RV free wall strain (p= 0,028), but not LA maximal volume (p=0,11), were significantly associated with LAP. Similarly, these measures, but nor LA maximal volume, were significant determinants of elevated LAP. Overall, LA minimal volume and LAEF showed the best diagnostic accuracy to predict elevated LAP (AUC 0.72 and 0.73, respectively). Conclusions Novel measures of LA structure and function, but not standard assessment by LA maximal volume, were significantly associated with LAP in patients affected by AF. These measures, along with measures of LV and RV function may be used in the diagnostic assessment of filling pressure in ambulatory settings.
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- 2023
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6. Functional and prognostic impact of hypertensive response to exercise across the heart failure spectrum
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N De Biase, L Del Punta, A Balletti, S Armenia, S Buralli, A Mengozzi, S Taddei, M Metra, M Pagnesi, B A Borlaug, B Williams, S Masi, and N R Pugliese
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Epidemiology ,Cardiology and Cardiovascular Medicine - Abstract
Funding Acknowledgements Type of funding sources: None. Background Conflicting data exist regarding the prognostic significance of hypertensive response to exercise (HRE), commonly defined according to absolute peak systolic blood pressure (SBP) values. Limited evidence is available regarding the impact of workload-indexed HRE in patients at different stages of the heart failure (HF) spectrum as defined by the American College of Cardiology/American Heart Association HF staging system. Purpose We evaluated the SBP/Workload slope during exercise across the HF spectrum and investigated the haemodynamic, functional and prognostic correlates of HRE. Methods We prospectively enrolled 58 healthy controls, 201 subjects at risk of developing HF (HF Stages A-B), and 369 patients with a definite diagnosis of HF (Stage C); among the latter, 143 had preserved (HFpEF) and 226 reduced (HFrEF) left ventricular ejection fraction. All patients underwent a combined cardiopulmonary-exercise stress echocardiography test. For each patient, we recorded the first (i.e., within the first minute of exercise) and last (i.e., at peak effort) BP measurement during the ramp protocol. The SBP/Workload slope (Figure 1) was calculated as the ratio of the difference in SBP over the corresponding increment in watts (W): (SBPpeak – SBPfirst)/(Wpeak – Wfirst). In each subgroup, we divided patients according to SBP/Workload slope tertiles; HRE was defined as the highest sex-specific SBP/Workload slope tertile in each HF stage. The primary outcome was a composite of all-cause mortality and hospitalization for cardiovascular reasons. Results Median SBP/Workload slope was 0.53 mmHg/W, interquartile range 0.36-0.72 mmHg/W; the slope was 39% steeper in women than in men (p Conclusion HRE, as evaluated by the SBP/Workload slope, is associated with distinct pathophysiological features and impaired functional capacity across the HF spectrum, especially in Stages A-B and in patients with HFpEF. Patients with HRE in these subgroups may be at increased risk of adverse cardiovascular outcomes.
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- 2023
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7. Disconnect between the effects of serelaxin on renal function and outcome in acute heart failure
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I. E. Beldhuis, J. M. ter Maaten, S. M. Figarska, K. Damman, P. S. Pang, B. Greenberg, B. A. Davison, G. Cotter, T. Severin, C. Gimpelewicz, G. M. Felker, G. Filippatos, J. R. Teerlink, M. Metra, and A. A. Voors
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General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Background We aimed to study whether improvement in renal function by serelaxin in patients who were hospitalized for acute heart failure (HF) might explain any potential effect on clinical outcomes. Methods We included 6318 patients from the RELAXin in AHF-2 (RELAX-AHF2) study. Improvement in renal function was defined as a decrease in serum creatinine of ≥ 0.3 mg/dL and ≥ 25%, or increase in estimated glomerular filtration rate of ≥ 25% between baseline and day 2. Worsening renal function (WRF) was defined as the reverse. We performed causal mediation analyses regarding 180-day all-cause mortality (ACM), cardiovascular death (CVD), and hospitalization for HF/renal failure. Results Improvement in renal function was more frequently observed with serelaxin when compared with placebo [OR 1.88 (95% CI 1.64–2.15, p p Conclusions Despite the significant improvement in renal function by serelaxin in patients with acute HF, the potential beneficial treatment effect was not mediated by improvement in renal function. These data suggest that improvement in renal function might not be a suitable surrogate marker for potential treatment efficacy in future studies with novel relaxin agents in acute HF. Graphical abstract Central illustration. Conceptual model explaining mediation analysis; treatment efficacy of heart failure therapies mediated by renal function.
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- 2023
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8. P408 PREVALENCE CHARACTERISTICS AND OUTCOMES OF COVID 19 ASSOCIATED ACUTE MYOCARDITIS
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M Palazzini, E Ammirati, L Lupi, C Giannattasio, F Soriano, P Pedrotti, D Briguglia, M Mapelli, J Campodonico, P Agostoni, S Leonardi, A Turco, S Guida, G Peretto, S Sala, P Camici, F Marzo, A Grosu, M Senni, F Turrini, M Bramerio, M Marini, M Matassini, S Rizzo, C Basso, M De Gaspari, N Hendren, M Schmidt, T Bochaton, N Piriou, A Ubarri, C Van De Heyning, A Ariza Sole, A Cannatà, J Salamanca, J Lehtonen, F Huang, E Adler, and M Metra
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Cardiology and Cardiovascular Medicine - Abstract
Background Acute myocarditis (AM) is thought to be a rare cardiovascular complication of COVID–19, although minimal data are available beyond case reports. We aim to report the prevalence, baseline characteristics, in–hospital management, and outcomes for patients with COVID–19–associated AM on the basis of a retrospective cohort from 23 hospitals in the United States and Europe. Methods A total of 112 patients with suspected AM from 56963 hospitalized patients with COVID–19 were evaluated between February 1, 2020, and April 30, 2021. Inclusion criteria were hospitalization for COVID–19 and a diagnosis of AM on the basis of endomyocardial biopsy or increased troponin level plus typical signs of AM on cardiac magnetic resonance imaging. We identified 97 patients with possible AM, and among them, 54 patients with definite/probable AM supported by endomyocardial biopsy in 17 (31.5%) patients or magnetic resonance imaging in 50 (92.6%). We analyzed patient characteristics, treatments, and outcomes among all COVID–19–associated AM. Results AM prevalence among hospitalized patients with COVID–19 was 2.4 per 1000 hospitalizations considering definite/probable and 4.1 per 1000 considering also possible AM. The median age of definite/probable cases was 38 years, and 38.9% were female. On admission, chest pain and dyspnea were the most frequent symptoms (55.5% and 53.7%, respectively). Thirty–one cases (57.4%) occurred in the absence of COVID–19–associated pneumonia. Twenty– one (38.9%) had a fulminant presentation requiring inotropic support or temporary mechanical circulatory support. The composite of in–hospital mortality or temporary mechanical circulatory support occurred in 20.4%. At 120 days, estimated mortality was 6.6%, 15.1% in patients with associated pneumonia versus 0% in patients without pneumonia (P=0.044). During hospitalization, left ventricular ejection fraction, assessed by echocardiography, improved from a median of 40% on admission to 55% at discharge (n=47; P Conclusions AM occurrence is estimated between 2.4 and 4.1 out of 1000 patients hospitalized for COVID–19. The majority of AM occurs in the absence of pneumonia and is often complicated by hemodynamic instability. AM is a rare complication in patients hospitalized for COVID–19, with an outcome that differs on the basis of the presence of concomitant pneumonia.
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- 2023
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9. C84 OUTCOME AND MORPHO–FUNCTIONAL CHANGES ON CARDIAC MAGNETIC RESONANCE IN PATIENT WITH ACUTE MYOCARDITIS FOLLOWING MRNA COVID 19 VACCINATION
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M Palazzini, E Ammirati, L Lupi, A Garascia, P Gentile, P Pedrotti, C Giannattasio, M Ciabatti, V Rossi, F Ruschitzka, A Uribarri, C Vecchio, D Nassiacos, A Cereda, G Tumminiello, N Piriou, M Stucchi, G Peretto, M Galasso, S Sala, P Camici, F Huang, U Ianni, A Procopio, G Saponara, P Cimaglia, D Tomasoni, F Moroni, A Turco, G Di Tano, E Bollano, C Moro, A Abbate, R Dalla Bona, I Porto, S Carugo, J Campodonico, G Pontone, A Grosu, M Adamo, J Salamanca, K Ozieransky, L Sardo Infirri, A Cannatà, E Adler, G Sinagra, L Potena, A Foà, M Metra, and M Pieroni
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Cardiology and Cardiovascular Medicine - Abstract
Background MessengerRNA (mRNA) COVID–19 vaccination has been associated with a higher–than–expected occurrence of acute myocarditis. Scarce information is available on mid–term prognosis and changes in cardiac function, volumes, and tissue characterization on cardiac magnetic resonance (CMR). Methods Retrospective, multicenter study including patients with a definite diagnosis of acute myocarditis within 30 days from mRNA COVID–19 vaccination. The diagnosis is based on endomyocardial biopsy (EMB) or autopsy or by the coexistence of positive biomarkers (troponin >99th upper reference limit or elevated creatine kinase myocardial band [CK–MB]) and cardiac MRI findings consistent with AM according to the 2018 updated Lake Louise Criteria. Results 77 patients (median age 25 years [IQR 20–35], 15% female) were included and followed–up for 147 days [IQR 74–215]. Follow–up CMR was available in n=49 patients and showed no changes in biventricular ejection fraction (EF) as compared to CMR at diagnosis (left ventricular EF: 59%[55–65]vs. 60%[57–64], p=0.507, right ventricular EF: 56%[52–62]vs. 57%[52–61], p=0.563, respectively). Late gadolinium enhancement was present in all patients at diagnosis and persisted in only n=39 (79.6%) at follow–up (p=0.001), generally sparing the anterior wall and the septum. N=10 (20.4%) had a persistent edema based on T2–weighted short tau inversion recovery (STIR) sequences, with predominant involvement of inferior or inferior–lateral walls. The proportion of patients with increased T1 and T2 mapping signals significantly decreased at follow–up (n=13 (68%) vs. n=4 (13%),p Conclusions At mid–term follow–up, patients who experienced an acute myocarditis after a mRNA COVID–19 vaccine had preserved biventricular EF. The rate and localization of residual scar or edema on CMR is in line with classic viral myocarditis with a good prognosis. This new piece of information should further reassure patients who experience acute myocarditis after mRNA COVID–19 vaccination.
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- 2023
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10. Deep learning to detect significant coronary artery disease from plain chest radiographs
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G D'Ancona, M Massussi, M Savardi, A Signoroni, L Di Bacco, D Farina, M Metra, R Maroldi, C Muneretto, H Ince, F Marinoni, G Chizzola, S Curello, and S Benussi
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Cardiology and Cardiovascular Medicine - Abstract
Background Coronary artery disease (CAD) is the single leading cause of mortality, premature death, and morbidity worldwide. Artificial intelligence (AI) could help identify markers present within first-line diagnostic imaging routinely performed in patients referred for suspected angina, such as chest radiographs. Purpose To train, test, and validate a deep learning (DL) algorithm for detecting the presence of significant CAD based on chest radiographs. Methods Data of patients undergoing chest radiography and coronary angiography were retrospectively analysed. A deep convolutional neural network (DCNN) was designed to detect significant CAD from the patient posteroanterior/anteroposterior chest radiograph. The DCNN was trained for binary classification of severe CAD absence/presence (at least one diseased coronary vessel with ≥70% stenosis). Coronary angiography reports were used as the ground truth. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of the DCNN were calculated. Multivariate analysis was performed to identify independent correlation among the presence of significant CAD (dependent variable), DCNN prediction, and CAD risk factors. Results Information of 7728 patients referred for suspected angina was reviewed. Severe CAD was present in 4482 patients (58%; 1% left main, 28% one vessel, 16% two vessels, and 12% 3 vessels). Patients were randomly divided for training (70%; n=5454) and fine-tuning/testing (10%; n=773) of the algorithm. Internal validation was performed with the remaining patients (20%; n=1501). At binary logistic regression, the DCNN prediction was the strongest independent determinant of severe CAD (p Conclusion The chest radiograph is ubiquitous and carries a plethora of information concerning the patient's health status, including direct and indirect signs of CAD. Our DL algorithm can predict, with high sensitivity, the presence of severe CAD in patients referred for suspected angina. It could be used to pre-test significant CAD probability in outpatient clinics, emergency room settings, and CAD screening in more extensive settings. Further studies are required to externally validate the algorithm and develop a clinically applicable tool. Funding Acknowledgement Type of funding sources: None.
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- 2022
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11. Staging heart failure patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge repair
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L Stolz, N Karam, R S Von Bardeleben, R Pfister, A Petronio, C Butter, B Melica, F Praz, S Massberg, D Kalbacher, P Lurz, M Adamo, M Metra, J J Bax, and J Hausleiter
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Cardiology and Cardiovascular Medicine - Abstract
Background Heart failure with reduced ejection fraction (HFrEF) and secondary mitral regurgitation (SMR) are closely related. Progression of HFrEF-SMR is associated with characteristic pathophysiological changes. Recently, staging of HFrEF-SMR patients showed prognostic value in a SMR cohort on medical therapy. Whether these stages are prognostic for SMR patients undergoing transcatheter edge-to-edge mitral valve repair (M-TEER) in addition to drug therapy is unknown. Purpose The present study aimed at classifying HFrEF-SMR patients undergoing M-TEER into progressive disease stages based on cardiac and extracardiac involvement. We sought to evaluate the impact of the disease stages on survival outcome and symptomatic improvement after M-TEER Methods Based on echocardiographic transthoracic evaluation, patients were assigned into one of the following subsequent HFrEF-SMR stages representing disease progression (Figure 1): left ventricular (LV) dysfunction alone (Stage 1, LV end diastolic volume ≥159 ml and/or LV ejection fraction 34 ml/m2); right ventricular (RV) pressure/volume overload (Stage 3, tricuspid regurgitation ≥3+ and/or systolic pulmonary artery pressure >65 mmHg); biventricular failure (Stage 4, RV to pulmonary artery coupling Results Among a total of 849 included patients who underwent M-TEER for symptomatic MR from 2008 until 2019, 9.5% (n=81) presented with LV dysfunction alone, 46% (n=393) with LA involvement, 15% (n=129) with pressure/volume overload and 29% (n=246) with biventricular failure. At baseline and follow-up, successive HFrEF-SMR stages were associated with more severe heart failure symptoms as expressed by NYHA functional class. An increase in HFrEF-SMR stage was associated with increased two-year all-cause mortality rates after M-TEER (Hazard ratio 1.39, confidence interval 1.23–1.58, p Conclusions Classifying HFrEF-SMR patients undergoing M-TEER into subsequent disease stages provides prognostic value regarding heart failure symptoms and survival. Funding Acknowledgement Type of funding sources: None.
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- 2022
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12. Sex‐ and age‐related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long‐Term Registry
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Lainscak, M., Milinkovic, I., Polovina, M., Crespo-Leiro, M. G., Lund, L. H., Anker, S. D., Laroche, C., Ferrari, R., Coats, A. J. S., Mcdonagh, T., Filippatos, G., Maggioni, A. P., Piepoli, M. F., Rosano, G. M. C., Ruschitzka, F., Simic, D., Asanin, M., Eicher, J. -C., Yilmaz, M. B., Seferovic, P. M., Gale, C. P., Chair, G. B., Branko Beleslin, R. S., Andrzej Budaj, P. L., Ovidiu Chioncel, R. O., Nikolaos Dagres, D. E., Nicolas Danchin, F. R., David Erlinge, S. E., Jonathan Emberson, G. B., Michael Glikson, I. L., Alastair Gray, G. B., Meral Kayikcioglu, T. R., Aldo Maggioni, I. T., Klaudia Vivien Nagy, H. U., Aleksandr Nedoshivin, R. U., Anna-Sonia Petronio, I. T., Jolien Roos-Hesselink, N. L., Lars Wallentin, S. E., Uwe Zeymer, D. E., Crespo-Leiro, M., Anker, S., Mebazaa, A., Coats, A., A. Goda A. L., M. Diez A. R., A. Fernandez A. R., F. Fruhwald A. T., Fazlibegovic, E., P. Gatzov B. G., A. Kurlianskaya B. Y., R. Hullin C. H., T. Christodoulides C. Y., J. Hradec C. Z., O. Wendelboe Nielsen D. K., R. Nedjar D. Z., T. Uuetoa E. E., M. Hassanein E. G., J. F. Delgado Jimenez E. S., P. Harjola F. I., V, D. Logeart F. R., V. Chumburidze G. E., D. Tousoulis G. R., D. Milicic H. R., B. Merkely H. U., O'Donoghue IE, E., O. Amir I. L., A. Shotan I. L., D. Shafie I. R., M. Metra I. T., A. Matsumori J. P., E. Mirrakhimov K. G., A. Kavoliuniene L. T., A. Erglis L. V., Vataman, E., M. Otljanska M. K., E. Srbinovska Kostovska M. K., D. Cassar DeMarco M. T., J. Drozdz P. L., Fonseca, C., O. Chioncel R. O., M. Dekleva R. S., E. Shkolnik R. U., U. Dahlstrom S. E., M. Lainscak S. I., E. Goncalvesova S. K., A. Temizhan T. R., V. Estrago U. Y., G. Bajraktari X. K., Auer, J., Ablasser, K., Fruhwald, F., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Logeart, D., Le Marcis, V., J. -F., Ly, Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Tousoulis, D., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Merkely, B., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Alony, I., Shotan, A., Fuhrmann, A. V., Amir, O., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Metra, M., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Dessalvi, C. C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Erglis, A., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Kavoliuniene, A., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Drozdz, J., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Aguiar, C. T., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Guimaraes, T. O., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Correia, A. S., Peres, M., Marta, L., da Silva, G. F., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Cordeiro, A. F., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Lazic, J. S., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Ilic, M. D., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Goncalvesova, E., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Vrckovnik, M. P., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Page, J. C. G., Martinez, F. M. S., Andres, J., Genis, A. B., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Cerdena, I. L., Baldomero, I. F. H., Padron, A. L., Rosillo, S. O., Gonzalez-Gallarza, R. D., Montanes, O. S., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Cubero, J. S., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Hernandez, M. V., Cano, M. J. R., Sanchez, M. A. G., Jimenez, J. F. D., Garrido-Lestache, E. B., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Dahlstrom, U., Afzelius, M., Karlstrom, P., Tengvall, L., Wiklund, P. -A., Olsson, B., Kalayci, S., Temizhan, A., Cavusoglu, Y., Gencer, E., Gunes, H., Lainscak, M., Milinkovic, I., Polovina, M., Crespo-Leiro, M. G., Lund, L. H., Anker, S. D., Laroche, C., Ferrari, R., Coats, A. J. S., Mcdonagh, T., Filippatos, G., Maggioni, A. P., Piepoli, M. F., Rosano, G. M. C., Ruschitzka, F., Simic, D., Asanin, M., Eicher, J. -C., Yilmaz, M. B., Seferovic, P. M., Gale, C. P., Chair, G. B., Branko Beleslin, R. S., Andrzej Budaj, P. L., Ovidiu Chioncel, R. O., Nikolaos Dagres, D. E., Nicolas Danchin, F. R., David Erlinge, S. E., Jonathan Emberson, G. B., Michael Glikson, I. L., Alastair Gray, G. B., Meral Kayikcioglu, T. R., Aldo Maggioni, I. T., Klaudia Vivien Nagy, H. U., Aleksandr Nedoshivin, R. U., Anna-Sonia Petronio, I. T., Jolien Roos-Hesselink, N. L., Lars Wallentin, S. E., Uwe Zeymer, D. E., Crespo-Leiro, M., Anker, S., Mebazaa, A., Coats, A., A. Goda A., L., M. Diez A., R., A. Fernandez A., R., F. Fruhwald A., T., Fazlibegovic, E., P. Gatzov B., G., A. Kurlianskaya B., Y., R. Hullin C., H., T. Christodoulides C., Y., J. Hradec C., Z., O. Wendelboe Nielsen D., K., R. Nedjar D., Z., T. Uuetoa E., E., M. Hassanein E., G., J. F. Delgado Jimenez E., S., V-, P. Harjola F. I., D. Logeart F., R., V. Chumburidze G., E., D. Tousoulis G., R., D. Milicic H., R., B. Merkely H., U., O'Donoghue IE, E., O. Amir I., L., A. Shotan I., L., D. Shafie I., R., M. Metra I., T., A. Matsumori J., P., E. Mirrakhimov K., G., A. Kavoliuniene L., T., A. Erglis L., V., Vataman, E., M. Otljanska M., K., E. Srbinovska Kostovska M., K., D. Cassar DeMarco M., T., J. Drozdz P., L., Fonseca, C., O. Chioncel R., O., M. Dekleva R., S., E. Shkolnik R., U., U. Dahlstrom S., E., M. Lainscak S., I., E. Goncalvesova S., K., A. Temizhan T., R., V. Estrago U., Y., G. Bajraktari X., K., Auer, J., Ablasser, K., Fruhwald, F., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Logeart, D., Le Marcis, V., Ly, J. -F., Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Tousoulis, D., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Merkely, B., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Alony, I., Shotan, A., Fuhrmann, A. V., Amir, O., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Metra, M., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Dessalvi, C. C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Erglis, A., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Kavoliuniene, A., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Drozdz, J., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Aguiar, C. T., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Guimaraes, T. O., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Correia, A. S., Peres, M., Marta, L., da Silva, G. F., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Cordeiro, A. F., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Lazic, J. S., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Ilic, M. D., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Goncalvesova, E., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Vrckovnik, M. P., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Page, J. C. G., Martinez, F. M. S., Andres, J., Genis, A. B., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Cerdena, I. L., Baldomero, I. F. H., Padron, A. L., Rosillo, S. O., Gonzalez-Gallarza, R. D., Montanes, O. S., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Cubero, J. S., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Hernandez, M. V., Cano, M. J. R., Sanchez, M. A. G., Jimenez, J. F. D., Garrido-Lestache, E. B., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Dahlstrom, U., Afzelius, M., Karlstrom, P., Tengvall, L., Wiklund, P. -A., Olsson, B., Kalayci, S., Temizhan, A., Cavusoglu, Y., Gencer, E., Gunes, H., University of Zurich, and Seferović, Petar M
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Male ,Registry ,medicine.medical_specialty ,Adverse outcomes ,610 Medicine & health ,Angiotensin-Converting Enzyme Inhibitors ,030204 cardiovascular system & hematology ,Independent predictor ,2705 Cardiology and Cardiovascular Medicine ,Ventricular Function, Left ,03 medical and health sciences ,Age ,0302 clinical medicine ,Internal medicine ,Age related ,Hospitalization ,Mortality ,Sex ,medicine ,Humans ,Registries ,Medical prescription ,Aged ,Heart Failure ,Ejection fraction ,business.industry ,Stroke Volume ,medicine.disease ,Ageing ,Heart failure ,10209 Clinic for Cardiology ,Female ,Angiotensin Receptor Blockers ,Cardiology and Cardiovascular Medicine ,business - Abstract
[Abstract] Aims. This study aimed to assess age‐ and sex‐related differences in management and 1‐year risk for all‐cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results. Of 16 354 patients included in the European Society of Cardiology Heart Failure Long‐Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline‐directed medical therapy (GDMT) were high (angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers, beta‐blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1‐year follow‐up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all‐cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all‐cause hospitalization (21.9% vs. 27.3%; P < 0.001) and there were no differences in causes of death. All‐cause mortality and all‐cause hospitalization increased with greater age in both sexes. Sex was not an independent predictor of 1‐year all‐cause mortality (restricted to patients with LVEF ≤45%). Mortality risk was significantly lower in patients of younger age, compared to patients aged >75 years. Conclusions. There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all‐cause mortality in patients with LVEF ≤45%.
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- 2019
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13. P206 DO WE NEED LOWER CUT–OFFS OF LEFT VENTRICULAR WALL THICKNESS TO SUSPECT CARDIAC TRANSTHYRETIN AMYLOIDOSIS IN WOMEN?
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A Aimo, D Tomasoni, A Porcari, M Adamo, G Bonfioli, C Lombardi, M Nardi, G Varrà, R Saro, M Rossi, M Merlo, V Castiglione, G Vergaro, C Passino, M Metra, G Sinagra, and M Emdin
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Cardiology and Cardiovascular Medicine - Abstract
Background Echocardiographic reference values for interventricular septal (IVS) thickness (upper reference limit [URL] 11.2 mm in women vs. 12.4 mm in men), and posterior wall (PW) thickness (URL 11.5 mm vs. 12.3 mm, respectively) exist. According to a European Society of Cardiology position statement, cardiac amyloidosis (CA) should be suspected when left ventricular (LV) wall thickness is ≥12 mm and at least one red flag is present. Given the normal difference between men and women, a same cut–off might cause a diagnostic delay in women. Methods Consecutive patients diagnosed with amyloid transthyretin (ATTR)–CA at 3 centers were evaluated. Results The cohort included 302 patients (Pisa, n=215; Brescia, n=58; Trieste, n=29). Women (n=49, 16%) were older than men (median age 83 years [interquartile range 80–85] vs. 80 years [76–84], p=0.009), but their survival free from all–cause death (p=0.380) or heart failure (HF) hospitalization (p=0.381) did not differ significantly. N–terminal pro–B–type natriuretic peptide values (p=0.897), the proportion of patients with variant ATTR (p=0.369), the prevalence of hypertension (p=0.659), diabetes (p=0.629), or New York Heart Association class III–IV (p=0.613) were not different. LV ejection fraction was 53% (43–60%) in women vs. 50% (43–65%) in men (p=0.066), and tricuspid annular plane systolic excursion was 16 mm (13–20) in women vs. 16 mm (14–19) in men (p=0.674). Even relative wall thickness (RWT) did not differ significantly (0.61 [0.49–0.98] in women vs. 0.69 [0.57–0.87] in men; p=0.448). Conversely, women had lower IVS (15 mm [14–18] vs. 17 mm [15–20]) and PW thickness (13 mm [12–16] vs. 15 mm [13–17]). These differences disappeared when IVS and PW thicknesses were indexed for height (as m), height2,7, or body surface area: IVS, p=0.150, 0.212, 0.325, respectively; PW, p=0.309, 0.107, 0.743, respectively. Conclusions At the time of diagnosis, women with ATTR–CA are older, but their biventricular function, the pattern of LV remodeling, and final outcome did not differ significantly from men, suggesting a similar disease stage. Even indexed IVS or PW thicknesses are similar, while non–indexed measures may point to a less advanced disease and then be misleading. Indexed measures or sex–specific cut–offs (e.g., 11 mm in women vs. 12 mm in men) to suspect CA might be considered.
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- 2023
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14. Pregnancy Outcomes in Women After Arterial Switch Operation for Transposition of the Great Arteries: Results From ROPAC (Registry of Pregnancy and Cardiac Disease) of the European Society of Cardiology EURObservational Research Programme
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Oktay Tutarel, Karishma P. Ramlakhan, Lucia Baris, Maria T. Subirana, Judith Bouchardy, Attila Nemes, Niels G. Vejlstrup, Olga A. Osipova, Mark R. Johnson, Roger Hall, Jolien W. Roos‐Hesselink, Christopher Peter Gale, Branko Beleslin, Andrzej Budaj, Ovidiu Chioncel, Nikolaos Dagres, Nicolas Danchin, David Erlinge, Jonathan Emberson, Michael Glikson, Alastair Gray, Meral Kayikcioglu, Aldo Maggioni, Klaudia Vivien Nagy, Aleksandr Nedoshivin, Anna‐Sonia Petronio, Jolien Roos‐Hesselink, Lars Wallentin, Uwe Zeymer, Joerg Stein, William Anthony Parsonage, Werner Budts, Julie De Backer, Jasmin Grewal, Ariane Marelli, Harald Kaemmerer, Guillaume Jondeau, Mark Johnson, Aldo P. Maggioni, Luigi Tavazzi, Ulf Thilen, Uri Elkayam, Catherine Otto, Karen Sliwa, A. Aquieri, A. Saad, H. Ruda Vega, J. Hojman, J. M. Caparros, M. Vazquez Blanco, M. Arstall, C. M. Chung, G. Mahadavan, E. Aldridge, M. Wittwer, Y. Y. Chow, W. A. Parsonage, K. Lust, N. Collins, G. Warner, R. Hatton, A. Gordon, E. Nyman, J. Stein, E. Donhauser, H. Gabriel, A. Bahshaliyev, F. Guliyev, I. Hasanova, T. Jahangirov, Z. Gasimov, A. Salim, C. M. Ahmed, F. Begum, M. H. Hoque, M. Mahmood, M. N. Islam, P. P. Haque, S. K. Banerjee, T. Parveen, M. Morissens, J. De Backer, L. Demulier, M. de Hosson, W. Budts, M. Beckx, M. Kozic, M. Lovric, T. Kovacevic‐Preradovic, N. Chilingirova, P. Kratunkov, N. Wahab, S. McLean, E. Gordon, L. Walter, A. Marelli, A. R. Montesclaros, G. Monsalve, C. Rodriguez, F. Balthazar, V. Quintero, W. Palacio, L. A. Mejía Cadavid, E. Munoz Ortiz, F. Fortich Hoyos, E. Arevalo Guerrero, J. Gandara Ricardo, J. Velasquez Penagos, Z. Vavera, J. Popelova, N. Vejlstrup, L. Grønbeck, M. Johansen, A. Ersboll, Y. Elrakshy, K. Eltamawy, M. Gamal Abd‐El Aziz, A. El Nagar, H. Ebaid, H. Abo Elenin, M. Saed, S. Farag, W. Makled, K. Sorour, Z. Ashour, G. El‐Sayed, M. Abdel Meguid Mahdy, N. Taha, A. Dardeer, M. Shabaan, M. Ali, P. Moceri, G. Duthoit, M. Gouton, J. Nizard, L. Baris, S. Cohen, M. Ladouceur, D. Khimoud, B. Iung, F. Berger, A. Olsson, U. Gembruch, W. M. Merz, E. Reinert, S. Clade, Y. Kliesch, C. Wald, C. Sinning, R. Kozlik‐Feldmann, S. Blankenberg, E. Zengin‐Sahm, G. Mueller, M. Hillebrand, P. Hauck, Y. von Kodolitsch, N. Zarniko, H. Baumgartner, R. Schmidt, A. Hellige, O. Tutarel, H. Kaemmerer, B. Kuschel, N. Nagdyman, R. Motz, D. Maisuradze, A. Frogoudaki, E. Iliodromitis, M. Anastasiou‐Nana, D. Triantafyllis, G. Bekiaris, H. Karvounis, G. Giannakoulas, D. Ntiloudi, S. A. Mouratoglou, A. Temesvari, H. Balint, D. Kohalmi, B. Merkely, C. Liptai, A. Nemes, T. Forster, A. Kalapos, K. Berek, K. Havasi, N. Ambrus, A. Shelke, R. Kawade, S. Patil, E. Martanto, T. M. Aprami, A. Purnomowati, C. J. Cool, M. Hasan, R. Akbar, S. Hidayat, T. I. Dewi, W. Permadi, D. A. Soedarsono, M. M. Ansari‐Ramandi, N. Samiei, A. Tabib, F. Kashfi, S. Ansari‐Ramandi, S. Rezaei, H. Ali Farhan, A. Al‐Hussein, G. Al‐Saedi, G. Mahmood, I. F. Yaseen, L. Al‐Yousuf, M. AlBayati, S. Mahmood, S. Raheem, T. AlHaidari, Z. Dakhil, P. Thornton, J. Donnelly, M. Bowen, A. Blatt, G. Elbaz‐Greener, A. Shotan, S. Yalonetsky, S. Goland, M. Biener, G. Egidy Assenza, M. Bonvicini, A. Donti, A. Bulgarelli, D. Prandstraller, C. Romeo, R. Crepaz, E. Sciatti, M. Metra, R. Orabona, L. Ait Ali, P. Festa, V. Fesslova, C. Bonanomi, M. Calcagnino, F. Lombardi, null Colli, M. W. Ossola, C. Gobbi, E. Gherbesi, L. Tondi, M. Schiavone, M. Squillace, M. G. Carmina, A. Maina, C. Macchi, E. Gollo, F. M. Comoglio, N. Montali, P. Re, R. Bordese, T. Todros, V. Donvito, W. Grosso Marra, G. Sinagra, B. D'Agata Mottolese, M. Bobbo, V. Gesuete, S. Rakar, F. Ramani, K. Niwa, D. Mekebekova, A. Mussagaliyeva, T. Lee, E. Mirrakhimov, S. Abilova, E. Bektasheva, K. Neronova, O. Lunegova, R. Žaliūnas, R. Jonkaitienė, J. Petrauskaitė, A. Laucevicius, D. Jancauskaite, L. Lauciuviene, L. Gumbiene, L. Lankutiene, S. Glaveckaite, M. Laukyte, S. Solovjova, V Rudiene, K. H. Chee, C. C.‐W. Yim, H. L. Ang, R. Kuppusamy, T. Watson, M. Caruana, M.‐E. Estensen, M. G. A. Mahmood Kayani, R. Munir, A. Tomaszuk‐Kazberuk, B. Sobkowicz, J. Przepiesc, A. Lesniak‐Sobelga, L. Tomkiewicz‐Pajak, M. Komar, M. Olszowska, P. Podolec, S. Wisniowska‐Smialek, M. Lelonek, U. Faflik, A. Cichocka‐Radwan, K. Plaskota, O. Trojnarska, N. Guerra, L. de Sousa, C. Cruz, V. Ribeiro, S. Jovanova, V. Petrescu, R. Jurcut, C. Ginghina, I. Mircea Coman, M. Musteata, O. Osipova, T. Golivets, I. Khamnagadaev, O. Golovchenko, A. Nagibina, I. Ropatko, I. R. Gaisin, L. Valeryevna Shilina, N. Sharashkina, E. Shlyakhto, O. Irtyuga, O. Moiseeva, E. Karelkina, I. Zazerskaya, A. Kozlenok, I. Sukhova, L. Jovovic, K. Prokšelj, M. Koželj, A. O. Askar, A. A. Abdilaahi, M. H. Mohamed, A. M. Dirir, K. Sliwa, P. Manga, A. Pijuan‐Domenech, L. Galian‐Gay, P. Tornos, M. T. Subirana, N. Murga, J. M. Oliver, B. Garcia‐Aranda Dominguez, I. Hernandez Gonzalez, J. F. Delgado Jimenez, P. Escribano Subias, A. Elbushi, A. Suliman, K. Jazzar, M. Murtada, N. Ahamed, M. Dellborg, E. Furenas, M. Jinesjo, K. Skoglund, P. Eriksson, T. Gilljam, U. Thilen, D. Tobler, K. Wustmann, F. Schwitz, M. Schwerzmann, T. Rutz, J. Bouchardy, M. Greutmann, B. M. Santos Lopes, L. Meier, M. Arrigo, K. de Boer, T. Konings, E. Wajon, L. J. Wagenaar, P. Polak, E. P. G. Pieper, J. Roos‐Hesselink, I. van Hagen, H. Duvekot, J. M. J. Cornette, C. De Groot, C. van Oppen, L. Sarac, O. Batukan Esen, S. Catirli Enar, C. Mondo, P. Ingabire, B. Nalwanga, T. Semu, B. T. Salih, W. A. R. Almahmeed, S. Wani, F. S. Mohamed Farook, Al Ain, F. Gerges, A. M. Komaranchath, F. Al bakshi, A. Al Mulla, A. H. Yusufali, E. I. Al Hatou, N. Bazargani, F. Hussain, L. Hudsmith, P. Thompson, S. Thorne, S. Bowater, A. Money‐Kyrle, P. Clifford, P. Ramrakha, S. Firoozan, J. Chaplin, N. Bowers, D. Adamson, F. Schroeder, R. Wendler, S. Hammond, P. Nihoyannopoulos, R. Hall, L. Freeman, G. Veldtman, J. Kerr, L. Tellett, N. Scott, A. B. Bhatt, D. DeFaria Yeh, M. A. Youniss, M. Wood, A. A. Sarma, S. Tsiaras, A. Stefanescu, J. M. Duran, L. Stone, D. S. Majdalany, J. Chapa, K. Chintala, P. Gupta, J. Botti, J. Ting, W. R. Davidson, G. Wells, D. Sparks, V. Paruchuri, K. Marzo, D. Patel, W. Wagner, S. N. Ahanya, L. Colicchia, T. Jentink, K. Han, M. Loichinger, M. Parker, C. Longtin, A. Yetman, K. Erickson, J. Cramer, S. Tsai, B. Fletcher, S. Warta, C. Cohen, C. Lindblade, R. Puntel, K. Nagaran, N. Croft, M. Gurvitz, C. Otto, C. Talluto, D. Murphy, M. G. Perlroth, ROPAC (Registry of Pregnancy and Cardiac Disease) Investigators Group, Gale, C.P., Beleslin, B., Budaj, A., Chioncel, O., Dagres, N., Danchin, N., Erlinge, D., Emberson, J., Glikson, M., Gray, A., Kayikcioglu, M., Maggioni, A., Nagy, K.V., Nedoshivin, A., Petronio, A.S., Roos-Hesselink, J., Wallentin, L., Zeymer, U., Hall, R., Stein, J., Parsonage, W.A., Budts, W., De Backer, J., Grewal, J., Marelli, A., Kaemmerer, H., Jondeau, G., Johnson, M., Maggioni, A.P., Tavazzi, L., Thilen, U., Elkayam, U., Otto, C., Sliwa, K., Aquieri, A., Saad, A., Ruda Vega, H., Hojman, J., Caparros, J.M., Vazquez Blanco, M., Arstall, M., Chung, C.M., Mahadavan, G., Aldridge, E., Wittwer, M., Chow, Y.Y., Lust, K., Collins, N., Warner, G., Hatton, R., Gordon, A., Nyman, E., Donhauser, E., Gabriel, H., Bahshaliyev, A., Guliyev, F., Hasanova, I., Jahangirov, T., Gasimov, Z., Salim, A., Ahmed, C.M., Begum, F., Hoque, M.H., Mahmood, M., Islam, M.N., Haque, P.P., Banerjee, S.K., Parveen, T., Morissens, M., Demulier, L., de Hosson, M., Beckx, M., Kozic, M., Lovric, M., Kovacevic-Preradovic, T., Chilingirova, N., Kratunkov, P., Wahab, N., McLean, S., Gordon, E., Walter, L., Montesclaros, A.R., Monsalve, G., Rodriguez, C., Balthazar, F., Quintero, V., Palacio, W., Mejía Cadavid, L.A., Munoz Ortiz, E., Fortich Hoyos, F., Arevalo Guerrero, E., Gandara Ricardo, J., Velasquez Penagos, J., Vavera, Z., Popelova, J., Vejlstrup, N., Grønbeck, L., Johansen, M., Ersboll, A., Elrakshy, Y., Eltamawy, K., Gamal Abd-El Aziz, M., El Nagar, A., Ebaid, H., Abo Elenin, H., Saed, M., Farag, S., Makled, W., Sorour, K., Ashour, Z., El-Sayed, G., Abdel Meguid Mahdy, M., Taha, N., Dardeer, A., Shabaan, M., Ali, M., Moceri, P., Duthoit, G., Gouton, M., Nizard, J., Baris, L., Cohen, S., Ladouceur, M., Khimoud, D., Iung, B., Berger, F., Olsson, A., Gembruch, U., Merz, W.M., Reinert, E., Clade, S., Kliesch, Y., Wald, C., Sinning, C., Kozlik-Feldmann, R., Blankenberg, S., Zengin-Sahm, E., Mueller, G., Hillebrand, M., Hauck, P., von Kodolitsch, Y., Zarniko, N., Baumgartner, H., Schmidt, R., Hellige, A., Tutarel, O., Kuschel, B., Nagdyman, N., Motz, R., Maisuradze, D., Frogoudaki, A., Iliodromitis, E., Anastasiou-Nana, M., Triantafyllis, D., Bekiaris, G., Karvounis, H., Giannakoulas, G., Ntiloudi, D., Mouratoglou, S.A., Temesvari, A., Balint, H., Kohalmi, D., Merkely, B., Liptai, C., Nemes, A., Forster, T., Kalapos, A., Berek, K., Havasi, K., Ambrus, N., Shelke, A., Kawade, R., Patil, S., Martanto, E., Aprami, T.M., Purnomowati, A., Cool, C.J., Hasan, M., Akbar, R., Hidayat, S., Dewi, T.I., Permadi, W., Soedarsono, D.A., Ansari-Ramandi, M.M., Samiei, N., Tabib, A., Kashfi, F., Ansari-Ramandi, S., Rezaei, S., Ali Farhan, H., Al-Hussein, A., Al-Saedi, G., Mahmood, G., Yaseen, I.F., Al-Yousuf, L., AlBayati, M., Mahmood, S., Raheem, S., AlHaidari, T., Dakhil, Z., Thornton, P., Donnelly, J., Bowen, M., Blatt, A., Elbaz-Greener, G., Shotan, A., Yalonetsky, S., Goland, S., Biener, M., Egidy Assenza, G., Bonvicini, M., Donti, A., Bulgarelli, A., Prandstraller, D., Romeo, C., Crepaz, R., Sciatti, E., Metra, M., Orabona, R., Ait Ali, L., Festa, P., Fesslova, V., Bonanomi, C., Calcagnino, M., Lombardi, F., Colli, C., Ossola, M.W., Gobbi, C., Gherbesi, E., Tondi, L., Schiavone, M., Squillace, M., Carmina, M.G., Maina, A., Macchi, C., Gollo, E., Comoglio, F.M., Montali, N., Re, P., Bordese, R., Todros, T., Donvito, V., Grosso Marra, W., Sinagra, G., D'Agata Mottolese, B., Bobbo, M., Gesuete, V., Rakar, S., Ramani, F., Niwa, K., Mekebekova, D., Mussagaliyeva, A., Lee, T., Mirrakhimov, E., Abilova, S., Bektasheva, E., Neronova, K., Lunegova, O., Žaliūnas, R., Jonkaitienė, R., Petrauskaitė, J., Laucevicius, A., Jancauskaite, D., Lauciuviene, L., Gumbiene, L., Lankutiene, L., Glaveckaite, S., Laukyte, M., Solovjova, S., Rudiene, V., Chee, K.H., Yim, C.C., Ang, H.L., Kuppusamy, R., Watson, T., Caruana, M., Estensen, M.E., Mahmood Kayani, MGA, Munir, R., Tomaszuk-Kazberuk, A., Sobkowicz, B., Przepiesc, J., Lesniak-Sobelga, A., Tomkiewicz-Pajak, L., Komar, M., Olszowska, M., Podolec, P., Wisniowska-Smialek, S., Lelonek, M., Faflik, U., Cichocka-Radwan, A., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Cruz, C., Ribeiro, V., Jovanova, S., Petrescu, V., Jurcut, R., Ginghina, C., Mircea Coman, I., Musteata, M., Osipova, O., Golivets, T., Khamnagadaev, I., Golovchenko, O., Nagibina, A., Ropatko, I., Gaisin, I.R., Valeryevna Shilina, L., Sharashkina, N., Shlyakhto, E., Irtyuga, O., Moiseeva, O., Karelkina, E., Zazerskaya, I., Kozlenok, A., Sukhova, I., Jovovic, L., Prokšelj, K., Koželj, M., Askar, A.O., Abdilaahi, A.A., Mohamed, M.H., Dirir, A.M., Manga, P., Pijuan-Domenech, A., Galian-Gay, L., Tornos, P., Subirana, M.T., Murga, N., Oliver, J.M., Garcia-Aranda Dominguez, B., Hernandez Gonzalez, I., Delgado Jimenez, J.F., Escribano Subias, P., Elbushi, A., Suliman, A., Jazzar, K., Murtada, M., Ahamed, N., Dellborg, M., Furenas, E., Jinesjo, M., Skoglund, K., Eriksson, P., Gilljam, T., Tobler, D., Wustmann, K., Schwitz, F., Schwerzmann, M., Rutz, T., Bouchardy, J., Greutmann, M., Santos Lopes, B.M., Meier, L., Arrigo, M., de Boer, K., Konings, T., Wajon, E., Wagenaar, L.J., Polak, P., Pieper, EPG, van Hagen, I., Duvekot, H., Cornette, JMJ, De Groot, C., van Oppen, C., Sarac, L., Batukan Esen, O., Catirli Enar, S., Mondo, C., Ingabire, P., Nalwanga, B., Semu, T., Salih, B.T., Almahmeed, WAR, Wani, S., Mohamed Farook, F.S., Ain, A., Gerges, F., Komaranchath, A.M., Al Bakshi, F., Al Mulla, A., Yusufali, A.H., Al Hatou, E.I., Bazargani, N., Hussain, F., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Money-Kyrle, A., Clifford, P., Ramrakha, P., Firoozan, S., Chaplin, J., Bowers, N., Adamson, D., Schroeder, F., Wendler, R., Hammond, S., Nihoyannopoulos, P., Freeman, L., Veldtman, G., Kerr, J., Tellett, L., Scott, N., Bhatt, A.B., DeFaria Yeh, D., Youniss, M.A., Wood, M., Sarma, A.A., Tsiaras, S., Stefanescu, A., Duran, J.M., Stone, L., Majdalany, D.S., Chapa, J., Chintala, K., Gupta, P., Botti, J., Ting, J., Davidson, W.R., Wells, G., Sparks, D., Paruchuri, V., Marzo, K., Patel, D., Wagner, W., Ahanya, S.N., Colicchia, L., Jentink, T., Han, K., Loichinger, M., Parker, M., Longtin, C., Yetman, A., Erickson, K., Cramer, J., Tsai, S., Fletcher, B., Warta, S., Cohen, C., Lindblade, C., Puntel, R., Nagaran, K., Croft, N., Gurvitz, M., Talluto, C., Murphy, D., Perlroth, M.G., Neurosurgery, Pediatrics, Cardiology, ACS - Heart failure & arrhythmias, Obstetrics and gynaecology, Amsterdam Reproduction & Development (AR&D), Institut Català de la Salut, [Tutarel O] Department of Congenital Heart Disease and Paediatric Cardiology German Heart Centre MunichTechnical University of Munich School of MedicineTechnical University of Munich Germany. DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance Munich Germany. [Ramlakhan KP, Baris L] Department of Cardiology Erasmus University Medical Center Rotterdam the Netherlands. [Subirana MT] Unitat de Cardiopaties congènites de l’adult, Vall d'Hebron Hospital Universitari, Barcelona Spain. Hospital Sant Pau, Barcelona Spain. [Bouchardy J] Service of Cardiology University Hospital Lausanne and University of Lausanne Switzerland. Service of Cardiology University of Geneva Switzerland. [Nemes A] 2nd Department of Medicine and Cardiology Centre Medical Faculty Albert Szent-Györgyi Clinical Center University of Szeged Hungary, Szeged, Hungary, and Vall d'Hebron Barcelona Hospital Campus
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Male ,Transposition of Great Vessels ,pregnancy outcomes ,enfermedades cardiovasculares::anomalías cardiovasculares::cardiopatías congénitas::transposición de los grandes vasos [ENFERMEDADES] ,Disease ,030204 cardiovascular system & hematology ,Sistema cardiovascular - Malalties ,Ventricular tachycardia ,Vasos sanguinis - Cirurgia ,0302 clinical medicine ,Pregnancy ,Clinical endpoint ,Registries ,030212 general & internal medicine ,Cardiovascular Diseases::Pregnancy Complications, Cardiovascular [DISEASES] ,Original Research ,Aortic dissection ,Pregnancy Outcome ,Congenital Heart Disease ,Other subheadings::Other subheadings::/surgery [Other subheadings] ,arterial switch operation ,pregnancy and cardiac disease ,transposition of the great arteries ,Europe ,Great arteries ,Cardiology ,enfermedades cardiovasculares::complicaciones cardiovasculares del embarazo [ENFERMEDADES] ,Female ,Maternal death ,Cardiology and Cardiovascular Medicine ,Adult ,medicine.medical_specialty ,diagnóstico::pronóstico::resultado del embarazo [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Pregnancy Complications, Cardiovascular ,Embaràs - Complicacions ,Cardiovascular Diseases::Cardiovascular Abnormalities::Heart Defects, Congenital::Transposition of Great Vessels [DISEASES] ,Risk Assessment ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,Internal medicine ,medicine ,Humans ,Heart Failure ,business.industry ,Infant, Newborn ,Otros calificadores::Otros calificadores::/cirugía [Otros calificadores] ,Diagnosis::Prognosis::Pregnancy Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,medicine.disease ,Arterial Switch Operation ,Heart failure ,Tachycardia, Ventricular ,business - Abstract
Embaràs i malaltia cardíaca; Resultats de l’embaràs; Transposició de les grans artèries Embarazo y enfermedad cardíaca; Resultados del embarazo; Transposición de las grandes arterias Pregnancy and cardiac disease; Pregnancy outcomes, Transposition of the great arteries Background In the past 3 decades, the arterial switch procedure has replaced the atrial switch procedure as treatment of choice for transposition of the great arteries. Although survival is superior after the arterial switch procedure, data on pregnancy outcomes are scarce and transposition of the great arteries after arterial switch is not yet included in the modified World Health Organization classification of maternal cardiovascular risk. Methods and Results The ROPAC (Registry of Pregnancy and Cardiac disease) is an international prospective registry of pregnant women with cardiac disease, part of the European Society of Cardiology EURObservational Research Programme. Pregnancy outcomes in all women after an arterial switch procedure for transposition of the great arteries are described. The primary end point was a major adverse cardiovascular event, defined as combined end point of maternal death, supraventricular or ventricular arrhythmias requiring treatment, heart failure, aortic dissection, endocarditis, ischemic coronary events, and thromboembolic events. Altogether, 41 pregnant women (mean age, 26.7±3.9 years) were included, and there was no maternal mortality. A major adverse cardiovascular event occurred in 2 women (4.9%): heart failure in one (2.4%) and ventricular tachycardia in another (2.4%). One woman experienced fetal loss, whereas no neonatal mortality was observed. Conclusions Women after an arterial switch procedure for transposition of the great arteries tolerate pregnancy well, with a favorable maternal and fetal outcome. During counseling, most women should be reassured that the risk of pregnancy is low. Classification as modified World Health Organization risk class II seems appropriate. Funding from “Zabawas Foundation” and “De Hoop Foundation” in addition to the support from EURObservational Research Programme (EORP) is greatly acknowledged. Since the start of EORP, the following companies have supported the program: Abbott Vascular Int (2011–2021), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2021), Bayer AG (2009–2018), Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2019), Daiichi Sankyo Europe GmbH (2011–2020), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2014–2017), Edwards (2016–2019), Gedeon Richter Plc (2014–2016), Menarini Int Op (2009–2012), MSD‐Merck & Co (2011–2014), Novartis Pharma AG (2014–2020), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2009–2021), and Vifor (2019–2022).
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- 2021
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15. P286 ECHOCARDIOGRAPHIC FINDINGS IN SUBJECTS WITH AN AMYLOIDOGENIC APOLIPOPROTEIN A1 MUTATION
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A Aimo, D Tomasoni, C Lombardi, G Panichella, M De Angelis, I Fabiani, V Regazzoni, G Vergaro, M Nardi, C Passino, F Scolari, M Emdin, and M Metra
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Cardiology and Cardiovascular Medicine - Abstract
Background The APOA1 gene encodes the precursor of apolipoprotein AI (ApoAI), whose mature form is the major component of high–density lipoproteins. APOA1 mutations may cause a form of hereditary amyloidosis (AApoAI). Only very small case series of patients with AApoAI are available. Methods We examined 189 consecutive subjects with the heterozygous APOA1 Leu75Pro mutation referred for cardiac screening over a 10–year timespan at the Spedali Civili of Brescia (Italy). Results Subjects (men 54%, median age 55 years, renal disease 39%, liver disease 31%) had a median left ventricular ejection fraction (LVEF) of 60% (55–66), did not display a prominent diastolic dysfunction (E/e’ ratio 7 [6–10]) nor LV hypertrophy (LV mass index [LVMI] 92 g/m2 [74–111]). LV global longitudinal strain (GLS) (–19% [–21 to –17]), and mass to strain ratio (MSR) (10.0 [6.8–12.1]) were within normal limits. Age correlated with several echocardiographic parameters, including interventricular septal (IVS) thickness (r = 0.484), LVMI (r = 0.459), E/e’ (r = 0.501), and right ventricular free wall thickness (r = 0.459) (all p Conclusions In subjects with an amyloidogenic APOA1 mutation, transthoracic echocardiography showed only minor signs of cardiac disease. The correlations between age and echocardiographic findings suggested a progressive increase in wall thickness, a decline in systolic and diastolic function, and a greater uncoupling between LV mass and contractility over time. Subjects with both renal and liver disease displayed the most evident signs of biventricular involvement and had a worse outcome.
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- 2022
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16. C64 UNMASKING THE PREVALENCE OF AMYLOID CARDIOMYOPATHY IN THE REAL WORLD: RESULTS FROM PHASE 2 OF AC–TIVE STUDY, AN ITALIAN NATIONWIDE SURVEY
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M Merlo, L Pagura, A Porcari, M Cameli, G Vergaro, B Musumeci, E Biagini, M Canepa, L Crotti, M Imazio, C Forleo, F Cappelli, S Favale, G Di Bella, F Dore, F Girardi, D Tomasoni, R Pavasini, V Rella, G Palmiero, M Caiazza, M Albanese, A Igoren Guarrucci, G Branzi, A Caponetti, G Saturi, G La Malfa, A Merlo, A Andreis, F Bruno, F Longo, M Rossi, G Varra‘, R Saro, L Di Ienno, G De Carli, E Giacomin, V Spini, G Limongelli, C Autore, I Olivotto, L Badano, G Parati, S Perlini, M Metra, M Emdin, C Rapezzi, and G Sinagra
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Cardiology and Cardiovascular Medicine - Abstract
Background Clinicians need to identify patients with amyloid cardiomyopathy (AC) at an early stage, due to the availability of disease–modifying therapies. Some echocardiographic findings may rise the suspicion of AC, also in patients with mild or no symptoms, addressing second level diagnostic tests. Aim To investigate the prevalence of AC in consecutive patients ≥55 years undergoing clinically indicated, routine transthoracic echocardiogram in Italy and presenting echocardiographic signs suggestive of AC. Methods This is a prospective multicentric study conducted in Italy. It comprises two phases: 1) a recording phase consisting in a national survey on prevalence of possible echocardiographic red flags of AC in consecutive unselected patients ≥55 years undergoing routine echocardiogram (previously published) and 2) an AC diagnostic phase involving a diagnostic work–up for AC to investigate AC prevalence among patients with at least one echocardiographic red flag (herein presented). Patients that in Phase 1 presented an “AC suggestive” echocardiogram (i.e., at least one red flag of AC in hypertrophic, non–dilated left ventricles with preserved ejection fraction) underwent clinical evaluation, blood and urine tests and scintigraphy with bone tracer. Diagnosis of transthyretin related–AC (ATTR–AC) was made in presence of grade 2–3 Perugini uptake at scintigraphy and absence of monoclonal protein. The study was registered at ClinicalTrials.gov (#NCT04738266). Results Of the 5315 screened echocardiograms, 381 exams (7.2%) were classified as “AC suggestive” and proceeded to Phase 2. 217 patients completed Phase 2 investigations. Main reasons for the 164 non–entering patients into Phase 2 were death (n = 49) and refusal to participate (n = 66). A final diagnosis of AC was made in 62 patients with an estimated prevalence of 28,6% (95% CI: 22,5%–34,7%). ATTR–AC was diagnosed in 51 and AL–AC in 11 patients, ascertaining a prevalence of 23,5% (95% CI: 17,8%–29,2%) and 5,1% (95% CI: 2,2%–8,0%), respectively. Conclusion Among a cohort of consecutive unselected patients ≥55 years with echocardiographic findings suggestive of AC, the prevalence of AC ranged from 23% up to 35%. Although ATTR–AC was predominant, AL–AC was diagnosed in a significant number of cases. Echocardiography has a fundamental role in screening patients, raising the suspicion of disease and orienting diagnostic work–up for AC.
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- 2022
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17. Association of left ventricular ejection fraction with worsening renal function in patients with acute heart failure: insights from the <scp>RELAX‐AHF</scp> ‐2 study
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Satit Janwanishstaporn, P. Ponikowski, G.M. Felker, John R. Teerlink, Siting Feng, Peter S. Pang, B. Davison, Barry H. Greenberg, Gadi Cotter, A. A. Voors, Gerasimos Filippatos, Iziah E Sama, M. Metra, and Cardiovascular Centre (CVC)
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Left ventricular ejection fraction ,medicine.medical_specialty ,Worsening renal function ,Renal function ,Heart failure ,030204 cardiovascular system & hematology ,Heart failure hospitalization ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Serelaxin ,Internal medicine ,medicine ,cardiovascular diseases ,Creatinine ,Ejection fraction ,business.industry ,Hazard ratio ,medicine.disease ,chemistry ,Quartile ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology ,Kidney disease - Abstract
Aims: Whether risk of worsening renal function (WRF) during acute heart failure (AHF) hospitalization or the association between in-hospital WRF and post-discharge outcomes vary according to left ventricular ejection fraction (LVEF) is uncertain. We assessed incidence of WRF, factors related to its development and impact of WRF on post-discharge outcomes across the spectrum of LVEF in patients enrolled in RELAX-AHF-2.Methods and results: A total of 6112 patients who had LVEF measured on admission and renal function determined prospectively during hospitalization were included. WRF, defined as a rise in serum creatinine ≥0.3 mg/dL from baseline through day 5, occurred in 1722 patients (28.2%). Incidence increased progressively from lowest to highest LVEF quartile (P < 0.001). After baseline adjustment, WRF risk in Q4 (LVEF >50%) remained significantly greater than in Q1 (LVEF ≤29%; hazard ratio 1.2, 95% confidence interval 1–1.43; P = 0.050). Age and comorbidity burden including chronic kidney disease increased as LVEF increased. Neither admission haemodynamic abnormalities, extent of diuresis during hospitalization nor residual congestion explained the increased incidence of WRF in patients with higher LVEF. Serelaxin treatment and diuretic responsiveness were associated with reduced risk of WRF in all LVEF quartiles. WRF in patients in the upper three LVEF quartiles increased risk of post-discharge events.Conclusions: Worsening renal function incidence during AHF hospitalization increases progressively with LVEF. Greater susceptibility of patients with higher LVEF to WRF appears more related to their advanced age and worse underlying kidney function rather than haemodynamic or treatment effects. WRF is associated with increased risk of post-discharge events except in patients in the lowest LVEF quartile.
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- 2020
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18. Clinical determinants and prognostic implications of renin and aldosterone in patients with symptomatic heart failure
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João Pedro Ferreira, Susan Stienen, Kenneth Dickstein, Faiez Zannad, Jozine M. ter Maaten, Chim C. Lang, Gregoire Preud'homme, Leong L. Ng, Nilesh J. Samani, Zohra Lamiral, Patrick Rossignol, Masatake Kobayashi, Adriaan A. Voors, M. Metra, Stefan D. Anker, Dirk J. van Veldhuisen, Kevin Duarte, Nicolas Girerd, Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French-Clinical Research Infrastructure Network - F-CRIN [Paris] (Cardiovascular & Renal Clinical Trialists - CRCT ), University Medical Center Groningen [Groningen] (UMCG), University of Bergen (UiB), Department of Cardiology, Stavanger University Hospital, Department of Cardiovascular Sciences [Leicester], University of Leicester, Leicester NIHR Biomedical Research Unit in Cardiovascular Disease, University of Dundee, Ninewells Hospital and Medical School [Dundee], Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Berlin Institute of Health Center for Regenerative Therapies, German Centre for Cardiovascular Research (DZHK) partner site Berlin, University of Brescia, Civic Hospital of Brescia, This project was funded by a grant from the European Commission (FP7-242209-BIOSTAT-CHF, EudraCT 2010–020808–29). JPF, NG, PR and FZ are supported by a public grant overseen by the French National Research Agency (ANR) as part of the second 'Investissements d’Avenir' program FIGHT-HF (reference: ANR-15-RHU-0004) and by the French PIA project 'Lorraine Université d’Excellence', reference ANR-15-IDEX-04-LUE. And by Contrat de Plan Etat-Région and FEDER Lorraine., ANR-15-RHUS-0004,FIGHT-HF,Combattre l'insuffisance cardiaque(2015), ANR-15-IDEX-0004,LUE,Isite LUE(2015), European Project: 242209,EC:FP7:HEALTH,FP7-HEALTH-2009-single-stage,BIOSTAT-CHF(2010), European Project, Cardiovascular Centre (CVC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), BOZEC, Erwan, Combattre l'insuffisance cardiaque - - FIGHT-HF2015 - ANR-15-RHUS-0004 - RHUS - VALID, ISITE - Isite LUE - - LUE2015 - ANR-15-IDEX-0004 - IDEX - VALID, A systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure - BIOSTAT-CHF - - EC:FP7:HEALTH2010-04-01 - 2015-03-31 - 242209 - VALID, and EudraCT 2010–020808–29 - INCOMING
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medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,BASE-LINE ,Renal function ,Heart failure ,030204 cardiovascular system & hematology ,THERAPY ,DISEASE ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Mineralocorticoid receptor ,LEFT-VENTRICULAR DYSFUNCTION ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Prediction model ,Internal medicine ,Original Research Articles ,Renin–angiotensin system ,Renin ,medicine ,Humans ,030212 general & internal medicine ,Original Research Article ,Aldosterone ,Mineralocorticoid Receptor Antagonists ,PLASMA ,business.industry ,MORTALITY ,medicine.disease ,Prognosis ,Angiotensin II ,SPIRONOLACTONE ,Pathophysiology ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,3. Good health ,ANGIOTENSIN-II ,ADIPOSE-TISSUE ,chemistry ,lcsh:RC666-701 ,Spironolactone ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,SYSTEM - Abstract
Aims Activation of the renin-angiotensin-aldosterone system plays an important role in the pathophysiology of heart failure (HF) and has been associated with poor prognosis. There are limited data on the associations of renin and aldosterone levels with clinical profiles, treatment response, and study outcomes in patients with HF.Methods and results We analysed 2,039 patients with available baseline renin and aldosterone levels in BIOSTAT-CHF (a systems BIOlogy study to Tailored Treatment in Chronic Heart Failure). The primary outcome was the composite of all-cause mortality or HF hospitalization. We also investigated changes in renin and aldosterone levels after administration of mineralocorticoid receptor antagonists (MRAs) in a subset of the EPHESUS trial and in an acute HF cohort (PORTO). In BIOSTAT-CHF study, median renin and aldosterone levels were 85.3 (percentile(25-75) = 28-247) mu IU/mL and 9.4 (percentile(25-75) = 4.4-19.8) ng/dL, respectively. Prior HF admission, lower blood pressure, sodium, poorer renal function, and MRA treatment were associated with higher renin and aldosterone. Higher renin was associated with an increased rate of the primary outcome [highest vs. lowest renin tertile: adjusted-HR (95% CI) = 1.47 (1.16-1.86), P = 0.002], whereas higher aldosterone was not [highest vs. lowest aldosterone tertile: adjusted-HR (95% CI) = 1.16 (0.93-1.44), P = 0.19]. Renin and/or aldosterone did not improve the BIOSTAT-CHF prognostic models. The rise in aldosterone with the use of MRAs was observed in EPHESUS and PORTO studies.Conclusions Circulating levels of renin and aldosterone were associated with both the disease severity and use of MRAs. By reflecting both the disease and its treatments, the prognostic discrimination of these biomarkers was poor. Our data suggest that the "point" measurement of renin and aldosterone in HF is of limited clinical utility.
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- 2020
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19. Responder analysis for improvement in 6-min walk test with ferric carboxymaltose in patients with heart failure with reduced ejection fraction and iron deficiency
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Anker, S.D. Ponikowski, P. Khan, M.S. Friede, T. Jankowska, E.A. Fabien, V. Goehring, U.-M. Metra, M. Piña, I.L. Coats, A.J.S. Rosano, G. Dorigotti, F. Comin-Colet, J. Van Veldhuisen, D.J. Filippatos, G.S. Butler, J.
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Aim: Improving functional capacity is a key goal in heart failure (HF). This pooled analysis of FAIR-HF and CONFIRM-HF assessed the likelihood of improvement or deterioration in 6-min walk test (6MWT) among iron-deficient patients with chronic HF with reduced ejection fraction (HFrEF) receiving ferric carboxymaltose (FCM). Methods and results: Data for 760 patients (FCM: n = 454; placebo: n = 306) were analysed. The proportions of patients receiving FCM or placebo who had ≥20, ≥30, and ≥40 m improvements or ≥10 m deterioration in 6MWT at 12 and 24 weeks were assessed. Patients receiving FCM experienced a mean (standard deviation) 31.1 (62.3) m improvement in 6MWT versus 0.1 (77.1) m improvement for placebo at week 12 (difference in mean changes 26.8 [16.6–37.0]). At week 12, the odds [95% confidence interval] of 6MWT improvements of ≥20 m (odds ratio 2.16 [1.57–2.96]; p < 0.0001), ≥30 m (2.00 [1.44–2.78]; p < 0.0001), and ≥40 m (2.29 [1.60–3.27]; p < 0.0001) were greater with FCM versus placebo, while the odds of a deterioration ≥10 m were reduced with FCM versus placebo (0.55 [0.38–0.80]; p = 0.0019). Among patients who experienced 6MWT improvements of ≥20, ≥30, or ≥40 m with FCM at week 12, more than 80% sustained this improvement at week 24. Conclusion: Ferric carboxymaltose resulted in a significantly higher likelihood of improvement and a reduced likelihood of deterioration in 6MWT versus placebo among iron-deficient patients with HF. Of the patients experiencing clinically significant improvements at week 12, the majority sustained this improvement at week 24. These results are supportive of FCM to improve exercise capacity in HF. © 2022 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
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- 2022
20. Efficacy of intravenous ferric carboxymaltose in patients with acute heart failure and iron deficiency with and without anaemia: a subgroup analysis of AFFIRM-AHF
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Javed Butler, P van der Meer, Iain C. Macdougall, Sandra Waechter, Ewa A. Jankowska, Dimitrios Farmakis, Gerasimos Filippatos, Frank Ruschitzka, M. Metra, Bridget-Anne Kirwan, Vincent Fabien, Piotr Ponikowski, and Stefan D. Anker
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medicine.medical_specialty ,business.industry ,Internal medicine ,Heart failure ,Medicine ,In patient ,Subgroup analysis ,Iron deficiency ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease ,Gastroenterology ,FERRIC CARBOXYMALTOSE - Abstract
Background Iron deficiency is associated with increased morbidity and mortality in patients with acute heart failure (HF), even in the absence of anaemia. Purpose This prespecified subanalysis of the AFFIRM-AHF trial investigated the effects of ferric carboxymaltose (FCM) on recurrent HF hospitalisations and cardiovascular (CV) mortality in patients with and without anaemia defined as baseline haemoglobin (Hb) Methods In total, 1108 patients (558 FCM, 550 placebo) were included in the modified intention-to-treat AFFIRM-AHF analysis. The primary outcome was a composite of total HF hospitalisations and CV death, evaluated up to 52 weeks post-randomisation. Results Of the 1108 patients, 228 and 329 in the FCM group and 236 and 314 in the placebo group had Hb Conclusion Iron deficiency treatment with FCM following acute HF reduced the risk of HF hospitalisations and CV death, irrespective of Hb level at baseline. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Vifor Pharma Ltd. Figure 1
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- 2021
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21. Cardiovascular death risk in mid-range ejection fraction heart failure: insights from cardiopulmonary exercise test
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Gianfranco Sinagra, Maria Antonietta Cicoira, Susanna Sciomer, Giuseppe Limongelli, Massimo F Piepoli, Piergiuseppe Agostoni, M.A Volpe, Elisabetta Salvioni, Giovanna Gallo, Damiano Magrì, Michele Senni, Ugo Corrà, M. Metra, P. Perrone Filardi, and Gianfranco Parati
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Cardiovascular death ,medicine.medical_specialty ,Ejection fraction ,business.industry ,Internal medicine ,Cardiopulmonary exercise test ,Heart failure ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business - Abstract
Background The pivotal role of cardiopulmonary exercise testing (CPET) in the assessment of functional capacity and prognosis of patients with heart failure with reduced ejection fraction (HFrEF), either as a single CPET parameter (i.e. peak oxygen uptake, peak VO2), as a combination of CPET parameters (i.e. oxygen uptake at the anaerobic threshold (AT) and ventilatory efficiency (VE/VCO2 slope), or as a part of more comprehensive scores (i.e. Metabolic Exercise combined with Cardiac and Kidney Indexes, MECKI) is well established. Just few studies are available with respect a possible role of CPET in risk stratification of patients in HF with midrange EF (HFmrEF) subset, namely HF patients with LVEF between 40% and 49%. Purpose The aim of the present large Italian multicenter study was to characterize and to compare stable HFmrEF and HFrEF patients in terms of exercise capacity as well as of instrumental and laboratory variables. We analyzed a possible independent and incremental prognostic value of CPET parameters in identifying those HFmrEF patients at high cardiovascular death risk. Methods We retrospectively analyzed clinical and CPET data of stable HF patients with HFrEF and HFmrEF from the MECKI Score database. Five-thousand-seven-hundred-eleven patients, 4,535 with HFrEF and 1,176 with HFmrEF, were considered for the study. The end-point was cardiovascular death at 5 years. The median follow-up was 1343 days (25th–75th range, 627–2403 days). Results Cardiovascular death occurred in 552 HFrEF (12.2% event rate) and 61 HFmrEF (5.2% event rate) patients. At multivariate analysis, an independent role of variables included in the MECKI score (age, atrial fibrillation, LVEF, haemoglobin, sodium, MDRD, AT identification, VO2 at AT, peak VO2 also expressed as percentage of the maximum predicted, VE/VCO2 slope) was confirmed in HFrEF group (C-index=0.744) whereas, in the HFmrEF group, only age and peak VO2 remained outcome predictors (C-index=0.745). We identified a peak VO2 31 as the most accurate cut-off values able to identify a HFmrEF subgroup with a cardiovascular mortality rate significantly higher than the overall HFmrEF (5.2% vs 8.5%) (Figure 1). By using both cut-off values contextually, we recognized a relatively small HFmrEF population with a cardiovascular risk quite similar to the HFrEF sample (11.4% vs 12.2%) (Figure 1). Conclusions Present data support the CPET as a useful tool in the HFmrEF management. Besides the peak VO2, which resulted as a strong independent outcome predictor, also a number of other CPET variables were associated to the cardiovascular death risk. Particularly, a peak VO2 ≤55% of the maximum and a VE/VCO2 slope ≥31 identified a HFmrEF subgroup of patients with a high cardiovascular death risk, similar to the one observed in the HFrEF group. Funding Acknowledgement Type of funding sources: None. Figure 1
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- 2021
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22. Exercise oscillatory ventilation and prognosis in heart failure patients with reduced and mid‐range ejection fraction
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Michele Correale, Massimo F Piepoli, Domenico Scrutinio, Alice Bonomi, Mariantonietta Cicoira, Francesco Bandera, Luca Arcari, Rocco Lagioia, Giuseppe Pacileo, Maurizio Bussotti, M. Metra, Angela Beatrice Scardovi, Marco Guazzi, Giuseppe Limongelli, Massimo Mapelli, Federica Re, Giovanni Quinto Villani, Carlo Vignati, Susanna Sciomer, Claudio Passino, S. Paolillo, Aldo P. Maggioni, Michele Emdin, A. Di Lenarda, P. Perrone Filardi, Enrico Perna, Piergiuseppe Agostoni, Damiano Magrì, Roberto Badagliacca, Gaia Cattadori, Maria Frigerio, Roberto C. Raimondo, I. Mattavelli, Elisa Battaia, Chiara Minà, Francesco Clemenza, Michele Senni, Sara Rovai, Gianfranco Sinagra, Alessandra Magini, Gianfranco Parati, Carolina Lombardi, Elisabetta Salvioni, Ugo Corrà, Rovai, S., Corra, U., Piepoli, M., Vignati, C., Salvioni, E., Bonomi, A., Mattavelli, I., Arcari, L., Scardovi, A. B., Perrone Filardi, P., Lagioia, R., Paolillo, S., Magri, D., Limongelli, G., Metra, M., Senni, M., Scrutinio, D., Guarino, Raimondo, Emdin, M., Lombardi, C., Cattadori, G., Parati, G., Re, F., Cicoira, M., Villani, G. Q., Mina, C., Correale, M., Frigerio, M., Perna, E., Mapelli, M., Magini, A., Clemenza, F., Bussotti, M., Battaia, E., Guazzi, M., Bandera, F., Badagliacca, R., Di Lenarda, A., Pacileo, G., Maggioni, A., Passino, C., Sciomer, S., Sinagra, G., Agostoni, P., Raimondo, R., Rovai, S, Corra, U, Piepoli, M, Vignati, C, Salvioni, E, Bonomi, A, Mattavelli, I, Arcari, L, Scardovi, A, Perrone Filardi, P, Lagioia, R, Paolillo, S, Magri, D, Limongelli, G, Metra, M, Senni, M, Scrutinio, D, Raimondo, R, Emdin, M, Lombardi, C, Cattadori, G, Parati, G, Re, F, Cicoira, M, Villani, G, Mina, C, Correale, M, Frigerio, M, Perna, E, Mapelli, M, Magini, A, Clemenza, F, Bussotti, M, Battaia, E, Guazzi, M, Bandera, F, Badagliacca, R, Di Lenarda, A, Pacileo, G, Maggioni, A, Passino, C, Sciomer, S, Sinagra, G, and Agostoni, P
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Male ,medicine.medical_specialty ,Prognosi ,medicine.medical_treatment ,Left ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,Exercise oscillatory ventilation ,Cardiovascular death ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Cardiopulmonary exercise test ,Prevalence ,medicine ,Ventricular Function ,Humans ,In patient ,Registries ,Heart failure with mid-range ejection fraction ,Prognosis ,Aged ,Exercise Test ,Female ,Follow-Up Studies ,Heart Failure ,Italy ,Middle Aged ,Retrospective Studies ,Stroke Volume ,Survival Rate ,Survival analysis ,cardiopulmonary exercise test ,exercise oscillatory ventilation ,heart failure with mid-range ejection fraction ,prognosis ,Ejection fraction ,Oscillatory ventilation ,business.industry ,medicine.disease ,Ventricular assist device ,Heart failure ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims: Exercise oscillatory ventilation (EOV) is a pivotal cardiopulmonary exercise test parameter for the prognostic evaluation of patients with chronic heart failure (HF). It has been described in patients with HF with reduced ejection fraction (50%, HFpEF), but no data are available for patients with HF with mid-range ejection fraction (40–49%, HFmrEF). The aim of the study was to evaluate the prognostic role of EOV in HFmrEF patients. Methods and results: We analysed 1239 patients with HFmrEF and 4482 patients with HFrEF, enrolled in the MECKI score database, with a 2-year follow-up. The study endpoint was the composite of cardiovascular death, urgent heart transplant, and ventricular assist device implantation. We identified EOV in 968 cases (16% and 17% of cases in HFmrEF and HFrEF,. respectively). HFrEF EOV+ patients were significantly older, and their parameters suggested a more severe HF than HFrEF EOV− patients. A similar behaviour was found in HFmrEF EOV+ vs. EOV− patients. Kaplan–Meier analysis, irrespective of ejection fraction, showed that EOV is associated with a worse survival, and that patients with HFrEF and HFmrEF EOV+ had a significantly worse outcome than the EOV− of the same ejection fraction groups. EOV-associated survival differences in HFmrEF patients started after 18 months of follow-up. Conclusion: Exercise oscillatory ventilation has a similar prevalence and ominous prognostic value in both HFmrEF and HFrEF patients, indicating a group of patients in need of a more intensive follow-up and a more aggressive therapy. In HFmrEF, the survival curves between EOV+ and EOV− patients diverged only after 18 months.
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- 2019
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23. Restricted mean survival time analysis in heart failure clinical trials
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M. Metra, M. A. Psotka, Christopher M. O'Connor, C Perego, Claudia Specchia, Lee-Jen Wei, M Sbolli, Mona Fiuzat, Giulia Peveri, and Chiara Oriecuia
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medicine.medical_specialty ,Ejection fraction ,business.industry ,medicine.disease ,chemistry.chemical_compound ,chemistry ,Heart failure ,Internal medicine ,medicine ,Spironolactone ,Cardiology ,Enalapril ,Cardiology and Cardiovascular Medicine ,business ,Ivabradine ,Carvedilol ,Sacubitril, Valsartan ,medicine.drug ,Metoprolol - Abstract
Background The hazard ratio (HR) is the most common measure used to quantify treatment effects in heart failure (HF) clinical trials. However, the HR is only valid when the proportional hazards assumption is plausible, and the HR may be difficult to interpret for clinicians and laypeople. Restricted mean survival time (RMST), defined as the average time-to-event before a specific timepoint, is an intuitive summary of group-wise survival. The difference between two RMSTs measures treatment effects without model assumptions and may communicate more clinically interpretable results. Purpose To evaluate statistical and clinical properties of RMST-based statistics applied to clinical trial data for treatments of HF with reduced ejection fraction. Methods Patient time-to-event data was reconstructed from the published primary and secondary outcome Kaplan-Meier curves from landmark HF clinical trials. We estimated the RMST-differences between treatment groups as a measure of treatment effect with published data, and compared statistical testing results and effect size values to HR analysis results. Results We analyzed 7 HF clinical trials, including data from a total of 27,845 patients (Table 1). RMST should be interpreted as the average number of months that the outcome is avoided over the study period. As examples: On average, treatment with enalapril for 12 months extended each patient's life by 2.2 months compared to placebo, and treatment with spironolactone for 34 months extended each patient's life by 2.2 months compared to placebo. Conclusions RMST-difference test statistic has identical statistical conclusions as HRs but provided an intuitive estimate of each treatment effect. RMST-based data can potentially be used to better communicate treatment effects to patients, to assist in patient-preference discussions and shared decision-making Funding Acknowledgement Type of funding source: None
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- 2020
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24. Conducting clinical trials in heart failure during (and after) the COVID-19 pandemic: An Expert Consensus Position Paper from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)
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Anker, S.D. Butler, J. Khan, M.S. Abraham, W.T. Bauersachs, J. Bocchi, E. Bozkurt, B. Braunwald, E. Chopra, V.K. Cleland, J.G. Ezekowitz, J. Filippatos, G. Friede, T. Hernandez, A.F. Lam, C.S.P. Lindenfeld, J. McMurray, J.J.V. Mehra, M. Metra, M. Packer, M. Pieske, B. Pocock, S.J. Ponikowski, P. Rosano, G.M.C. Teerlink, J.R. Tsutsui, H. Van Veldhuisen, D.J. Verma, S. Voors, A.A. Wittes, J. Zannad, F. Zhang, J. Seferovic, P. Coats, A.J.S.
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The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has important implications for the safety of participants in clinical trials and the research staff caring for them and, consequently, for the trials themselves. Patients with heart failure may be at greater risk of infection with COVID-19 and the consequences might also be more serious, but they are also at risk of adverse outcomes if their clinical care is compromised. As physicians and clinical trialists, it is our responsibility to ensure safe and effective care is delivered to trial participants without affecting the integrity of the trial. The social contract with our patients demands no less. Many regulatory authorities from different world regions have issued guidance statements regarding the conduct of clinical trials during this COVID-19 crisis. However, international trials may benefit from expert guidance from a global panel of experts to supplement local advice and regulations, thereby enhancing the safety of participants and the integrity of the trial. Accordingly, the Heart Failure Association of the European Society of Cardiology on 21 and 22 March 2020 conducted web-based meetings with expert clinical trialists in Europe, North America, South America, Australia, and Asia. The main objectives of this Expert Position Paper are to highlight the challenges that this pandemic poses for the conduct of clinical trials in heart failure and to offer advice on how they might be overcome, with some practical examples. While this panel of experts are focused on heart failure clinical trials, these discussions and recommendations may apply to clinical trials in other therapeutic areas. © 2020 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020.
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- 2020
25. Heart failure etiologies and clinical factors precipitating for worsening heart failure: Findings from BIOSTAT-CHF
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Leong L. Ng, Patrick Rossignol, Masatake Kobayashi, John G.F. Cleland, João Pedro Ferreira, Kenneth Dickstein, Faiez Zannad, Chim C. Lang, Nicolas Girerd, M. Metra, Kevin Duarte, Adriaan A. Voors, Maxime Billotte, Dirk J. van Veldhuisen, Stefan D. Anker, Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French-Clinical Research Infrastructure Network - F-CRIN [Paris] (Cardiovascular & Renal Clinical Trialists - CRCT ), University Medical Center Groningen [Groningen] (UMCG), University Medical Center Göttingen (UMG), Royal Brompton Hospital, University of Dundee, Ninewells Hospital & Medical School, University of Leicester, Glenfield Hospital, NIHR Leicester Cardiovascular Biomedical Research Unit, University of Stavanger, Università degli Studi di Brescia [Brescia], Contrat de Plan Etat-Lorraine and FEDER Lorraine, IMPACT GEENAGE, ANR-15-IDEX-0004,LUE,Isite LUE(2015), ANR-15-RHUS-0004,FIGHT-HF,Combattre l'insuffisance cardiaque(2015), European Project: 242209,EC:FP7:HEALTH,FP7-HEALTH-2009-single-stage,BIOSTAT-CHF(2010), Cardiovascular Centre (CVC), CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique plurithématique Pierre Drouin (CIC-P), Charité - Universitätsmedizin Berlin / Charite - University Medicine Berlin, Institute of Health and Wellbeing, University of Glasgow-Gartnavel General Hospital, Glasgow, Biology, genetics and statistics (BIGS), Inria Nancy - Grand Est, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut Élie Cartan de Lorraine (IECL), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Center for Molecular and Vascular Biology, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), ANR-15-IDEX-04-LUE,LUE,Lorraine Université d'Excellence(2016), ANR-15-RHU-0004,FIGHT-HF ,Fighting Heart Failure, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Università degli Studi di Brescia = University of Brescia (UniBs), DE CARVALHO, Philippe, ISITE - Isite LUE - - LUE2015 - ANR-15-IDEX-0004 - IDEX - VALID, Combattre l'insuffisance cardiaque - - FIGHT-HF2015 - ANR-15-RHUS-0004 - RHUS - VALID, and A systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure - BIOSTAT-CHF - - EC:FP7:HEALTH2010-04-01 - 2015-03-31 - 242209 - VALID
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medicine.medical_specialty ,Acute coronary syndrome ,Etiology ,[SDV]Life Sciences [q-bio] ,PROGNOSTIC IMPACT ,Heart failure ,DETERMINANTS ,030204 cardiovascular system & hematology ,DIAGNOSIS ,03 medical and health sciences ,0302 clinical medicine ,Primary outcome ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Internal medicine ,Internal Medicine ,Humans ,Medicine ,030212 general & internal medicine ,ESC GUIDELINES ,OUTCOMES ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,Task force ,business.industry ,MORTALITY ,Arrhythmias, Cardiac ,Dilated cardiomyopathy ,Atrial fibrillation ,ASSOCIATION ,medicine.disease ,MITRAL REGURGITATION ,Prognosis ,R1 ,EUROPEAN-SOCIETY ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,3. Good health ,[SDV] Life Sciences [q-bio] ,Hospitalization ,Hypertension ,Cohort ,Cardiology ,Precipitating factor ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,TASK-FORCE - Abstract
International audience; BACKGROUND:Knowledge on the association between heart failure (HF) etiologies, precipitant causes and clinical outcomes may help in ascertaining patient's risk and in selecting tailored therapeutic strategies.METHODS:The prognostic value of both HF etiologies and precipitants for worsening HF were analyzed using the index cohort of BIOSTAT-CHF. The studied HF etiologies were: a) ischemic HF; b) dilated cardiomyopathy; c) hypertensive HF; d) valvular HF; and e) other/unknown. The precipitating factors for worsening HF were: a) atrial fibrillation; b) non-adherence; c) renal failure; d) acute coronary syndrome; e) hypertension; and f) Infection. The primary outcome was the composite of all-cause death or HF hospitalization.RESULTS:Among 2465 patients included in the study, 45% (N = =1102) had ischemic HF, 23% (N = =563) dilated cardiomyopathy, 15% (N = =379) other/unknown, 10% (N = =237) hypertensive and 7% (N = =184) valvular HF. Patients with ischemic HF had the worst prognosis, whereas patients with dilated cardiomyopathy had the best prognosis. From the precipitating factors for worsening HF, renal failure was the one independently associated with worse prognosis (adjusted HR (95%CI) = =1.48 (1.04-2.09), p 0.10 for all). Treatment up-titration benefited patients regardless of their underlying etiology or precipitating cause (p interaction > 0.10 for all).CONCLUSIONS:In BIOSTAT-CHF, patients with HF of an ischemic etiology, and those with worsening HF precipitated by renal failure (irrespective of the underlying HF etiology), had the highest rates of death and HF hospitalization, but still benefited equally from treatment up-titration.Crown Copyright © 2019. Published by Elsevier B.V. All rights reserved.
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- 2020
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26. Heart Failure Association of the European Society of Cardiology update on sodium–glucose co-transporter 2 inhibitors in heart failure
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Seferović, P.M. Fragasso, G. Petrie, M. Mullens, W. Ferrari, R. Thum, T. Bauersachs, J. Anker, S.D. Ray, R. Çavuşoğlu, Y. Polovina, M. Metra, M. Ambrosio, G. Prasad, K. Seferović, J. Jhund, P.S. Dattilo, G. Čelutkiene, J. Piepoli, M. Moura, B. Chioncel, O. Ben Gal, T. Heymans, S. Jaarsma, T. Hill, L. Lopatin, Y. Lyon, A.R. Ponikowski, P. Lainščak, M. Jankowska, E. Mueller, C. Cosentino, F. Lund, L.H. Filippatos, G.S. Ruschitzka, F. Coats, A.J.S. Rosano, G.M.C.
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The Heart Failure Association (HFA) of the European Society of Cardiology (ESC) has recently issued a position paper on the role of sodium–glucose co-transporter 2 (SGLT2) inhibitors in heart failure (HF). The present document provides an update of the position paper, based of new clinical trial evidence. Accordingly, the following recommendations are given:. • Canagliflozin, dapagliflozin empagliflozin, or ertugliflozin are recommended for the prevention of HF hospitalization in patients with type 2 diabetes mellitus and established cardiovascular disease or at high cardiovascular risk. • Dapagliflozin or empagliflozin are recommended to reduce the combined risk of HF hospitalization and cardiovascular death in symptomatic patients with HF and reduced ejection fraction already receiving guideline-directed medical therapy regardless of the presence of type 2 diabetes mellitus. © 2020 European Society of Cardiology
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- 2020
27. Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry
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Lainšcak, M. Milinkovic, I. Polovina, M. Crespo-Leiro, M.G. Lund, L.H. Anker, S.D. Laroche, C. Ferrari, R. Coats, A.J.S. McDonagh, T. Filippatos, G. Maggioni, A.P. Piepoli, M.F. Rosano, G.M.C. Ruschitzka, F. Simic, D. Ašanin, M. Eicher, J.-C. Yilmaz, M.B. Seferovic, P.M. Gale, C.P. Chair, G.B. Branko Beleslin, R.S. Andrzej Budaj, P.L. Chioncel, R.O. Nikolaos Dagres, D.E. Nicolas Danchin, F.R. David Erlinge, S.E. Jonathan Emberson, G.B. Michael Glikson, I.L. Alastair Gray, G.B. Meral Kayikcioglu, T.R. Aldo Maggioni, I.T. Klaudia Vivien Nagy, H.U. Aleksandr Nedoshivin, R.U. Anna-Sonia Petronio, I.T. Jolien Roos-Hesselink, N.L. Lars Wallentin, S.E. Uwe Zeymer, D.E. Mebazaa, A. Coats, A. A. Goda, A.L. M. Diez, A.R. A. Fernandez, A.R. F. Fruhwald, A.T. Fazlibegovic, E. P. Gatzov, B.G. A. Kurlianskaya, B.Y. R. Hullin, C.H. T. Christodoulides, C.Y. J. Hradec, C.Z. O. Wendelboe Nielsen, D.K. R. Nedjar, D.Z. T. Uuetoa, E.E. M. Hassanein, E.G. J. F. Delgado Jimenez, E.S. V-P. Harjola, F.I. D. Logeart, F.R. V. Chumburidze, G.E. D. Tousoulis, G.R. D. Milicic, H.R. B. Merkely, H.U. O'Donoghue IE, E. O. Amir, I.L. A. Shotan, I.L. D. Shafie, I.R. M. Metra, I.T. A. Matsumori, J.P. E. Mirrakhimov, K.G. A. Kavoliuniene, L.T. A. Erglis, L.V. Vataman, E. M. Otljanska, M.K. E. Srbinovska Kostovska, M.K. D. Cassar DeMarco, M.T. J. Drozdz, P.L. Fonseca, C. M. Dekleva, R.S. E. Shkolnik, R.U. U. Dahlstrom, S.E. M. Lainscak, S.I. E. Goncalvesova, S.K. A. Temizhan, T.R. V. Estrago, U.Y. G. Bajraktari, X.K. Auer, J. Ablasser, K. Fruhwald, F. Dolze, T. Brandner, K. Gstrein, S. Poelzl, G. Moertl, D. Reiter, S. Podczeck-Schweighofer, A. Muslibegovic, A. Vasilj, M. Cesko, M. Zelenika, D. Palic, B. Pravdic, D. Cuk, D. Vitlianova, K. Katova, T. Velikov, T. Kurteva, T. Gatzov, P. Kamenova, D. Antova, M. Sirakova, V. Krejci, J. Mikolaskova, M. Spinar, J. Krupicka, J. Malek, F. Hegarova, M. Lazarova, M. Monhart, Z. Hassanein, M. Sobhy, M. El Messiry, F. El Shazly, A.H. Elrakshy, Y. Youssef, A. Moneim, A.A. Noamany, M. Reda, A. Dayem, T.K.A. Farag, N. Halawa, S.I. Hamid, M.A. Said, K. Saleh, A. Ebeid, H. Hanna, R. Aziz, R. Louis, O. Enen, M.A. Ibrahim, B.S. Nasr, G. Elbahry, A. Sobhy, H. Ashmawy, M. Gouda, M. Aboleineen, W. Bernard, Y. Luporsi, P. Meneveau, N. Pillot, M. Morel, M. Seronde, M.-F. Schiele, F. Briand, F. Delahaye, F. Damy, T. de Groote, P. Fertin, M. Lamblin, N. Isnard, R. Lefol, C. Thevenin, S. Hagege, A. Jondeau, G. Logeart, D. Le Marcis, V. Ly, J.-F. Coisne, D. Lequeux, B. Le Moal, V. Mascle, S. Lotton, P. Behar, N. Donal, E. Thebault, C. Ridard, C. Reynaud, A. Basquin, A. Bauer, F. Codjia, R. Galinier, M. Tourikis, P. Stavroula, M. Tousoulis, D. Stefanadis, C. Chrysohoou, C. Kotrogiannis, I. Matzaraki, V. Dimitroula, T. Karavidas, A. Tsitsinakis, G. Kapelios, C. Nanas, J. Kampouri, H. Nana, E. Kaldara, E. Eugenidou, A. Vardas, P. Saloustros, I. Patrianakos, A. Tsaknakis, T. Evangelou, S. Nikoloulis, N. Tziourganou, H. Tsaroucha, A. Papadopoulou, A. Douras, A. Polgar, L. Merkely, B. Kosztin, A. Nyolczas, N. Nagy, A.C. Halmosi, R. Elber, J. Alony, I. Shotan, A. Fuhrmann, A.V. Amir, O. Romano, S. Marcon, S. Penco, M. Di Mauro, M. Lemme, E. Carubelli, V. Rovetta, R. Metra, M. Bulgari, M. Quinzani, F. Lombardi, C. Bosi, S. Schiavina, G. Squeri, A. Barbieri, A. Di Tano, G. Pirelli, S. Fucili, A. Passero, T. Musio, S. Di Biase, M. Correale, M. Salvemini, G. Brognoli, S. Zanelli, E. Giordano, A. Agostoni, P. Italiano, G. Salvioni, E. Copelli, S. Modena, M.G. Reggianini, L. Valenti, C. Olaru, A. Bandino, S. Deidda, M. Mercuro, G. Dessalvi, C.C. Marino, P.N. Di Ruocco, M.V. Sartori, C. Piccinino, C. Parrinello, G. Licata, G. Torres, D. Giambanco, S. Busalacchi, S. Arrotti, S. Novo, S. Inciardi, R.M. Pieri, P. Chirco, P.R. Galifi, M.A. Teresi, G. Buccheri, D. Minacapelli, A. Veniani, M. Frisinghelli, A. Priori, S.G. Cattaneo, S. Opasich, C. Gualco, A. Pagliaro, M. Mancone, M. Fedele, F. Cinque, A. Vellini, M. Scarfo, I. Romeo, F. Ferraiuolo, F. Sergi, D. Anselmi, M. Melandri, F. Leci, E. Iori, E. Bovolo, V. Pidello, S. Frea, S. Bergerone, S. Botta, M. Canavosio, F.G. Gaita, F. Merlo, M. Cinquetti, M. Sinagra, G. Ramani, F. Fabris, E. Stolfo, D. Artico, J. Miani, D. Fresco, C. Daneluzzi, C. Proclemer, A. Cicoira, M. Zanolla, L. Marchese, G. Torelli, F. Vassanelli, C. Voronina, N. Erglis, A. Tamakauskas, V. Smalinskas, V. Karaliute, R. Petraskiene, I. Kazakauskaite, E. Rumbinaite, E. Kavoliuniene, A. Vysniauskas, V. Brazyte-Ramanauskiene, R. Petraskiene, D. Stankala, S. Switala, P. Juszczyk, Z. Sinkiewicz, W. Gilewski, W. Pietrzak, J. Orzel, T. Kasztelowicz, P. Kardaszewicz, P. Lazorko-Piega, M. Gabryel, J. Mosakowska, K. Bellwon, J. Rynkiewicz, A. Raczak, G. Lewicka, E. Dabrowska-Kugacka, A. Bartkowiak, R. Sosnowska-Pasiarska, B. Wozakowska-Kaplon, B. Krzeminski, A. Zabojszcz, M. Mirek-Bryniarska, E. Grzegorzko, A. Bury, K. Nessler, J. Zalewski, J. Furman, A. Broncel, M. Poliwczak, A. Bala, A. Zycinski, P. Rudzinska, M. Jankowski, L. Kasprzak, J.D. Michalak, L. Soska, K.W. Drozdz, J. Huziuk, I. Retwinski, A. Flis, P. Weglarz, J. Bodys, A. Grajek, S. Kaluzna-Oleksy, M. Straburzynska-Migaj, E. Dankowski, R. Szymanowska, K. Grabia, J. Szyszka, A. Nowicka, A. Samcik, M. Wolniewicz, L. Baczynska, K. Komorowska, K. Poprawa, I. Komorowska, E. Sajnaga, D. Zolbach, A. Dudzik-Plocica, A. Abdulkarim, A.-F. Lauko-Rachocka, A. Kaminski, L. Kostka, A. Cichy, A. Ruszkowski, P. Splawski, M. Fitas, G. Szymczyk, A. Serwicka, A. Fiega, A. Zysko, D. Krysiak, W. Szabowski, S. Skorek, E. Pruszczyk, P. Bienias, P. Ciurzynski, M. Welnicki, M. Mamcarz, A. Folga, A. Zielinski, T. Rywik, T. Leszek, P. Sobieszczanska-Malek, M. Piotrowska, M. Kozar-Kaminska, K. Komuda, K. Wisniewska, J. Tarnowska, A. Balsam, P. Marchel, M. Opolski, G. Kaplon-Cieslicka, A. Gil, R.J. Mozenska, O. Byczkowska, K. Gil, K. Pawlak, A. Michalek, A. Krzesinski, P. Piotrowicz, K. Uzieblo-Zyczkowska, B. Stanczyk, A. Skrobowski, A. Ponikowski, P. Jankowska, E. Rozentryt, P. Polonski, L. Gadula-Gacek, E. Nowalany-Kozielska, E. Kuczaj, A. Kalarus, Z. Szulik, M. Przybylska, K. Klys, J. Prokop-Lewicka, G. Kleinrok, A. Aguiar, C.T. Ventosa, A. Pereira, S. Faria, R. Chin, J. De Jesus, I. Santos, R. Silva, P. Moreno, N. Queirós, C. Lourenço, C. Pereira, A. Castro, A. Andrade, A. Guimaraes, T.O. Martins, S. Placido, R. Lima, G. Brito, D. Francisco, A.R. Cardiga, R. Proenca, M. Araujo, I. Marques, F. Moura, B. Leite, S. Campelo, M. Silva-Cardoso, J. Rodrigues, J. Rangel, I. Martins, E. Correia, A.S. Peres, M. Marta, L. da Silva, G.F. Severino, D. Durao, D. Leao, S. Magalhaes, P. Moreira, I. Cordeiro, A.F. Ferreira, C. Araujo, C. Ferreira, A. Baptista, A. Radoi, M. Bicescu, G. Vinereanu, D. Sinescu, C.-J. Macarie, C. Popescu, R. Daha, I. Dan, G.-A. Stanescu, C. Dan, A. Craiu, E. Nechita, E. Aursulesei, V. Christodorescu, R. Otasevic, P. Simeunovic, D. Ristic, A.D. Celic, V. Pavlovic-Kleut, M. Lazic, J.S. Stojcevski, B. Pencic, B. Stevanovic, A. Andric, A. Iric-Cupic, V. Jovic, M. Davidovic, G. Milanov, S. Mitic, V. Atanaskovic, V. Antic, S. Pavlovic, M. Stanojevic, D. Stoickov, V. Ilic, S. Ilic, M.D. Petrovic, D. Stojsic, S. Kecojevic, S. Dodic, S. Adic, N.C. Cankovic, M. Stojiljkovic, J. Mihajlovic, B. Radin, A. Radovanovic, S. Krotin, M. Klabnik, A. Goncalvesova, E. Pernicky, M. Murin, J. Kovar, F. Kmec, J. Semjanova, H. Strasek, M. Iskra, M.S. Ravnikar, T. Suligoj, N.C. Komel, J. Fras, Z. Jug, B. Glavic, T. Losic, R. Bombek, M. Krajnc, I. Krunic, B. Horvat, S. Kovac, D. Rajtman, D. Cencic, V. Letonja, M. Winkler, R. Valentincic, M. Melihen-Bartolic, C. Bartolic, A. Vrckovnik, M.P. Kladnik, M. Pusnik, C.S. Marolt, A. Klen, J. Drnovsek, B. Leskovar, B. Anguita, M.J.F. Page, J.C.G. Martinez, F.M.S. Andres, J. Bayes-Genis, A. Mirabet, S. Mendez, A. Garcia-Cosio, L. Roig, E. Leon, V. Gonzalez-Costello, J. Muntane, G. Garay, A. Alcade-Martinez, V. Fernandez, S.L. Rivera-Lopez, R. Puga-Martinez, M. Fernandez-Alvarez, M. Serrano-Martinez, J.L. Grille-Cancela, Z. Marzoa-Rivas, R. Blanco-Canosa, P. Paniagua-Martin, M.J. Barge-Caballero, E. Cerdena, I.L. Baldomero, I.F.H. Padron, A.L. Rosillo, S.O. Gonzalez-Gallarza, R.D. Montanes, O.S. Manjavacas, A.M.I. Conde, A.C. Araujo, A. Soria, T. Garcia-Pavia, P. Gomez-Bueno, M. Cobo-Marcos, M. Alonso-Pulpon, L. Cubero, J.S. Sayago, I. Gonzalez-Segovia, A. Briceno, A. Subias, P.E. Hernandez, M.V. Cano, M.J.R. Sanchez, M.A.G. Jimenez, J.F.D. Garrido-Lestache, E.B. Pinilla, J.M.G. de la Villa, B.G. Sahuquillo, A. Marques, R.B. Calvo, F.T. Perez-Martinez, M.T. Gracia-Rodenas, M.R. Garrido-Bravo, I.P. Pastor-Perez, F. Pascual-Figal, D.A. Molina, B.D. Orus, J. Gonzalo, F.E. Bertomeu, V. Valero, R. Martinez-Abellan, R. Quiles, J. Rodrigez-Ortega, J.A. Mateo, I. ElAmrani, A. Fernandez-Vivancos, C. Valero, D.B. Almenar-Bonet, L. Sanchez-Lazaro, I.J. Marques-Sule, E. Facila-Rubio, L. Perez-Silvestre, J. Garcia-Gonzalez, P. Ridocci-Soriano, F. Garcia-Escriva, D. Pellicer-Cabo, A. de la Fuente Galan, L. Diaz, J.L. Platero, A.R. Arias, J.C. Blasco-Peiro, T. Julve, M.S. Sanchez-Insa, E. Aured-Guallar, C. Portoles-Ocampo, A. Melin, M. Hägglund, E. Stenberg, A. Lindahl, I.-M. Asserlund, B. Olsson, L. Dahlström, U. Afzelius, M. Karlström, P. Tengvall, L. Wiklund, P.-A. Olsson, B. Kalayci, S. Temizhan, A. Cavusoglu, Y. Gencer, E. Gunes, H. the European Society of Cardiology Heart Failure Long-Term Registry Investigators Group
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Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P 75 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF ≤45%. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology
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- 2020
28. Sodium–glucose co-transporter 2 inhibitors in heart failure: beyond glycaemic control. A position paper of the Heart Failure Association of the European Society of Cardiology
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Seferović, P.M. Fragasso, G. Petrie, M. Mullens, W. Ferrari, R. Thum, T. Bauersachs, J. Anker, S.D. Ray, R. Çavuşoğlu, Y. Polovina, M. Metra, M. Ambrosio, G. Prasad, K. Seferović, J. Jhund, P.S. Dattilo, G. Čelutkiene, J. Piepoli, M. Moura, B. Chioncel, O. Ben Gal, T. Heymans, S. de Boer, R.A. Jaarsma, T. Hill, L. Lopatin, Y. Lyon, A.R. Ponikowski, P. Lainščak, M. Jankowska, E. Mueller, C. Cosentino, F. Lund, L. Filippatos, G.S. Ruschitzka, F. Coats, A.J.S. Rosano, G.M.C.
- Abstract
Heart failure (HF) is common and associated with a poor prognosis, despite advances in treatment. Over the last decade cardiovascular outcome trials with sodium–glucose co-transporter 2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus have demonstrated beneficial effects for three SGLT2 inhibitors (empagliflozin, canagliflozin and dapagliflozin) in reducing hospitalisations for HF. More recently, dapagliflozin reduced the risk of worsening HF or death from cardiovascular causes in patients with chronic HF with reduced left ventricular ejection fraction, with or without type 2 diabetes mellitus. A number of additional trials in HF patients with reduced and/or preserved left ventricular ejection fraction are ongoing and/or about to be reported. The present position paper summarises recent clinical trial evidence and discusses the role of SGLT2 inhibitors in the treatment of HF, pending the results of ongoing trials in different populations of patients with HF. © 2020 European Society of Cardiology
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- 2020
29. Tumour biomarkers: association with heart failure outcomes
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R. A. De Boer, M. Metra, C. Shi, Martin M Dokter, H. H. Van Der Wal, J. Post, F. Zannad, Adriaan A. Voors, Chim C. Lang, F. van den Berg, John G.F. Cleland, P. L. van Haelst, Jourik A. Gietema, L. Huizinga, D. J. Van Veldhuisen, Kenneth Dickstein, Pietro Ameri, Nilesh J. Samani, Marco Canepa, Leong L. Ng, M. Vriesema, Herman H W Silljé, Stefan D. Anker, BOZEC, Erwan, ERC CoG 818715, SECRETE‐HF - INCOMING, A systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure - BIOSTAT-CHF - - EC:FP7:HEALTH2010-04-01 - 2015-03-31 - 242209 - VALID, University Medical Center Groningen [Groningen] (UMCG), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Imperial College London - National Heart and Lung Institute, Robertson Centre for Biostatistics, University of Glasgow, University of Leicester, Stavanger University Hospital, Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French-Clinical Research Infrastructure Network - F-CRIN [Paris] (Cardiovascular & Renal Clinical Trialists - CRCT ), Ninewells Hospital and Medical School [Dundee], F. Hoffmann-La Roche [Basel], University of Brescia, Ospedale Policlinico San Martino [Genoa], Università degli studi di Genova = University of Genoa (UniGe), This study was funded by grant from theEuropean Research Council (ERC CoG 818715, SECRETE‐HF) and the European Commission (FP7‐242209‐BIOSTAT‐CHF).Canxia Shi is supported with a scholarship from the China Scholarship Council [CSC number: 201806170057]. Dr. de Boer is furthermore supported by the Dutch Heart Foundation [CVON DOSIS, grant 2014‐40, CVON SHE‐PREDICTS‐HF, grant 2017‐21, CVON RED‐CVD, grant 2017‐11, and CVON PREDICT2, grant 2018‐30], and the Innovational Research Incentives Scheme program of the Netherlands Organization for Scientific Research [NWO VIDI, grant 917·13·350], and by a grant from the Leducq Foundation [Cure PhosphoLambaN‐induced Cardiomyopathy (Cure‐PLaN)]. We would like to thank Roche Diagnostics for providing reagents to measure the tumour biomarkers (Dr. K van Lynden, Roche Diagnostics BV, the Netherlands)., European Project, European Project: 242209,EC:FP7:HEALTH,FP7-HEALTH-2009-single-stage,BIOSTAT-CHF(2010), Cardiovascular Centre (CVC), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Imperial College London, Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), and University of Genoa (UNIGE)
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Male ,0301 basic medicine ,PROGNOSIS ,neoplasms ,heart failure ,030204 cardiovascular system & hematology ,Gastroenterology ,0302 clinical medicine ,Carcinoembryonic antigen ,MARKERS ,Natriuretic Peptide, Brain ,RISK ,biology ,Hazard ratio ,Atrial fibrillation ,SERUM-LEVELS ,3. Good health ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Hospitalization ,Quartile ,Cohort ,Female ,Original Article ,alpha-Fetoproteins ,biomarkers ,natriuretic peptides ,tumour ,EXPRESSION ,medicine.medical_specialty ,medicine.drug_class ,CARCINOEMBRYONIC ANTIGEN ,03 medical and health sciences ,PANCREATIC ADENOCARCINOMA ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Antigens, Neoplasm ,Internal medicine ,Biomarkers, Tumor ,Internal Medicine ,medicine ,Humans ,Antigens, Tumor-Associated, Carbohydrate ,CANCER PATIENTS ,Beta blocker ,Aged ,Keratin-19 ,Receiver operating characteristic ,business.industry ,Membrane Proteins ,CLINICAL UTILITY ,Original Articles ,medicine.disease ,Peptide Fragments ,030104 developmental biology ,CA-125 Antigen ,Heart failure ,ATRIAL-FIBRILLATION ,biology.protein ,business ,Follow-Up Studies - Abstract
International audience; Background: There is increasing recognition that heart failure (HF) and cancer are conditions with a number of shared characteristics.Objectives: To explore the association between tumour biomarkers and HF outcomes.Methods: In 2,079 patients of BIOSTAT-CHF cohort, we measured six established tumour biomarkers: CA125, CA15-3, CA19-9, CEA, CYFRA 21-1 and AFP.Results: During a median follow-up of 21 months, 555 (27%) patients reached the primary end-point of all-cause mortality. CA125, CYFRA 21-1, CEA and CA19-9 levels were positively correlated with NT-proBNP quartiles (all P < 0.001, P for trend < 0.001) and were, respectively, associated with a hazard ratio of 1.17 (95% CI 1.12-1.23; P < 0.0001), 1.45 (95% CI 1.30-1.61; P < 0.0001), 1.19 (95% CI 1.09-1.30; P = 0.006) and 1.10 (95% CI 1.05-1.16; P < 0.001) for all-cause mortality after correction for BIOSTAT risk model (age, BUN, NT-proBNP, haemoglobin and beta blocker). All tumour biomarkers (except AFP) had significant associations with secondary end-points (composite of all-cause mortality and HF hospitalization, HF hospitalization, cardiovascular (CV) mortality and non-CV mortality). ROC curves showed the AUC of CYFRA 21-1 (0.64) had a noninferior AUC compared with NT-proBNP (0.68) for all-cause mortality (P = 0.08). A combination of CYFRA 21-1 and NT-proBNP (AUC = 0.71) improved the predictive value of the model for all-cause mortality (P = 0.0002 compared with NT-proBNP).Conclusions: Several established tumour biomarkers showed independent associations with indices of severity of HF and independent prognostic value for HF outcomes. This demonstrates that pathophysiological pathways sensed by these tumour biomarkers are also dysregulated in HF.s.
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- 2020
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CS. Park, L. Capotosto, IP. Monte, E. Sciatti, L. Faber, PJ. Mccall, M. Kaznica-Wiatr, A. Porpaczy, R. Pavasini, D. Forsha, AA. Tantawy, G. Romano, M. Strachinaru, ML. Geleijnse, JG. Bosch, N. De Jong, AFW Van Der Steen, BM. Van Dalen, HJ. Vos, S. Magro, C. Mina', G. Novo, S. Dell'oglio, C. Falletta, G. Di Gesaro, F. Clemenza, D. Bellavia, N. Habeeb, NHK El Sherif, AE. Abdelhamid, L. Li, N. Joseph, S. Kutty, MK. Freidberg, C. Cirillo, I. Mordi, J. Grapsa, N. Tzemos, A. Nogradi, M. Strenner, T. Minier, L. Czirjak, A. Komocsi, R. Faludi, M. Nowacka, G. Kopec, M. Waligora, M. Olszowska, P. Podolec, P. Sonecki, J. Kinsella, BG. Shelley, S. Scholtz, Z. Dimitriadis, A. Graw, N. Bogunovic, W. Scholtz, J. Boergermann, J. Gummert, D. Horstkotte, E. Vizzardi, I. Bonadei, F. Platto, M. Metra, VE. Bottari, S. Gentile, C. Romano, MS. Rodolico, V. Losi, C. Tamburino, R. Ashurov, G. Truscelli, G. Placanica, S. Lai, A. Vitarelli, MH. Jeong, HS. Ahn, JS. Cho, and HJ. Youn
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Aortic valve ,medicine.medical_specialty ,Shear waves ,Phonocardiogram ,business.industry ,Wave propagation ,General Medicine ,01 natural sciences ,medicine.anatomical_structure ,Ventricle ,Internal medicine ,Heart sounds ,Mitral valve ,0103 physical sciences ,medicine ,Cardiology ,Front velocity ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,010301 acoustics - Abstract
__Background:__ The closure of the valves generates shear waves in the heart walls. The propagation velocity of shear waves relates to stiffness. This could potentially be used to estimate the stiffness of the myocardium, with huge potential implications in pathologies characterized by a deterioration of the diastolic properties of the left ventricle. In an earlier phantom study we already validated shear wave tracking with a clinical ultrasound system in cardiac mode. __Purpose:__ In this study we aimed to measure the shear waves velocity in normal individuals. __Methods:__ 12 healthy volunteers, mean age=37±10, 33% females, were investigated using a clinical scanner (Philips iE33), equipped with a S5-1 probe, using a clinical tissue Doppler (TDI) application. ECG and phonocardiogram (PCG) were synchronously recorded. We achieved a TDI frame rate of >500Hz by carefully tuning normal system settings. Data were processed offline in Philips Qlab 8 to extract tissue velocity along a virtual M-mode line in the basal third of the interventricular septum, in parasternal long axis view. This tissue velocity showed a propagating wave pattern after closure of the valves. The slope of the wave front velocity in a space-time panel was measured to obtain the shear wave propagation velocity. The velocity of the shear waves induced by the closure of the mitral valve (1st heart sound) and aortic valve (2nd heart sound) was averaged over 4 heartbeats for every subject. __Results:__ Shear waves were visible after each closure of the heart valves, synchronous to the heart sounds. The figure shows one heart cycle of a subject, with the mean velocity along a virtual M-mode line in the upper panel, synchronous to the ECG signal (green line) and phonocardiogram (yellow line) in the lower panel. The slope of the shear waves is marked with dotted lines and the onset of the heart sounds with white lines. In our healthy volunteer group the mean velocity of the shear wave induced by mitral valve closure was 4.8±0.7m/s, standard error of 0.14 m/s. The mean velocity after aortic valve closure was 3.4±0.5m/s, standard error of 0.09 m/s. We consistently found that for any subject the velocity after mitral valve closure was higher than after aortic valve closure. __Conclusion:__ The velocity of the shear waves generated by the closure of the heart valves can be measured in normal individuals using a clinical TDI application. The shear wave induced after mitral valve closure was consistently faster than after aortic valve closure. Abstract P1138.
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- 2016
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31. P594Contrast transthoracic echocardiography as a gatekeeper for patent foramen ovale closureP595Mitral annular displacement in apical four-chamber view by speckle-tracking echocardiography as a simple index for left ventricular longitudinal systolic functionP596Impact of chronic glycemic control on left ventricular myocardial function in young patients with type 1 diabetes mellitusP597Association of left atrial function echocardiographic parametres with fibrosis assesed invasively in patients with sinus rhythm and atrial fibrillation undergoing ablation for atrial fibrillationP598Mitral annular calcification decreases diastolic tissue Doppler velocity(E') in regions affected with calcificationsP5992D longitudinal LV speckle tracking strain pattern in breast cancer survivors: sports activity vs exercise as prescription modelP600Catheter related atrial fibrillation is associated with left atrial deformation in patients with paroxsymal supraventricular tachycardia: a study of two-dimensional speckle tracking echocardiographyP601Early radiotherapy-induced ecg changes and their comparison with echocardiography in breast cancer patientsP602Renal function is a major determinant of decreased sub-epicardial longitudinal strain in hypertensionP603Evaluation of left atrial function in patients with non valvular atrial fibrillation post cardioversion: speckle tracking echocardiographyP604Myocardial dysfunction in ANCA vasculitis measured by two-dimensional speckle tracking echocardiographyP605CRT, arterial stiffness and ventricular-arterial coupling in HFrEFP606Mitral annular morphology and function in cardiac amyloidosis as assessed by three-dimensional speckle tracking echocardiographyP607Coronary plaque characterization in Egyptian metabolic syndrome patients using 64-MDCT
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EHAB Selim, A. Nemes, E. Sciatti, A. Bajrangee, W. Khalil, W-H Li, KT. Keski-Pukkila, M. Akcakoyun, L. Stefani, L. Chebrolu, E. Pilichowska, C. Ruisanchez Villar, T. Hozumi, M. Muratori, G. Italiano, E. Innocenti, L. Fusini, M. Mapelli, G. Tamborini, S. Ghulam Ali, P. Gripari, A. Maltagliati, F. Celeste, M. Pepi, H. Emori, K. Takemoto, K. Terada, M. Orii, K. Ohkochi, T. Kameyama, Y. Ozaki, A. Kuroi, T. Tanimoto, Y. Matsuo, Y. Ino, T. Kubo, A. Tanaka, T. Akasaka, FJ. Gonzalez Vilchez, M. Piedra Leon, M. Marigomez Estrada, C. Pesquera Gonzalez, J. Ruano Calvo, J. Zarauza Navarro, R. Martin Duran, JA. Amado Senaris, J. Baran, P. Kulakowski, B. Zaborska, R. Schutt, D. Maragiannis, M. Abudiab, A. Sunkara, P. Alvarez, S. Nagueh, WA. Zoghbi, GP. Pedrizzetti, BT. Tosi, SP. Pedri, GG. Galanti, H. Eren, A. Avci, S. Demir, M. Evlice, A. Guner, M. Tabakci, C. Toprak, M. Inanir, R. Kargin, S. Tuohinen, T. Skytta, H. Huhtala, V. Virtanen, P-L Kellokumpu-Lehtinen, P. Raatikainen, K. Nikus, Y. Liu, W-C Tsai, S. Mahabir, G. King, S. Cuddy, C. Feigherty, AO. Maree, N. Conlon, RT. Murphy, E. Vizzardi, I. Bonadei, F. Platto, M. Metra, D. Foldeak, P. Domsik, A. Kalapos, Z. Borbenyi, R. Sepp, T. Forster, SALAH El Tahan, M. Loutfi, and EMAN El Sharkawy
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medicine.medical_specialty ,Intracardiac echocardiography ,Percutaneous ,business.industry ,030208 emergency & critical care medicine ,General Medicine ,Gold standard (test) ,030204 cardiovascular system & hematology ,medicine.disease ,body regions ,Shunting ,Decompression sickness ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Pfo closure ,Internal medicine ,Cardiology ,medicine ,Patent foramen ovale ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Foramen ovale (heart) - Abstract
Background. The presence of patent foramen ovale (PFO) has been linked to many illness, including cryptogenic stroke, transient ischemic attack, migraine, platypnea-orthodeoxia syndrome and decompression sickness in scuba divers. Transesophageal echocardiography is the gold standard technique for the visualization of atrial septal anatomy, but it is a secondary level exam, not always available, with additional associated costs and not completely free from procedural risks. Standard transthoracic echocardiography (TTE) has a too low sensitivity for PFO screening. Purpose. The aim of the study was to assess the role of TTE associated with agitated saline contrast injection (contrast-TTE) as a gatekeeper for the identification of PFO in a large cohort of patients undergoing selection for percutaneous closure. Methods. A total of 200 patients undergoing a diagnostic work-up for the identification of PFO was imaged by contrast-TTE at rest and after provocative maneuvers (PM: Valsalva in all cases). Contrast TTE was graded from 0 to 4 on the bases of bubbles counting (0: no bubbles; 1: 30 bubbles; 4: complete LV opacification). PFO closure was performed after a consensual clinical decision by the cardiologist and the neurologist taking into account comprehensive imaging, clinical evaluation and thrombophilia screening. PFO closure was always monitored by intracardiac echocardiography. Results. At baseline contrast TTE was positive (≥2) in 34 patients (17%) while contrast TTE with PM was positive in 94 cases (47%). 27 out of 200 patients (14%) had an interatrial septal aneurysms. PFO closure was performed in 34 cases (17%). All of these had severe right-to-left shunting (≥3) at contrast TTE and 9 cases had also an interatrial septal aneurysms. The procedure was aborted in only 1 patient due to a complex defect anatomy. Conclusion. Contrast TTE with PM may be not only considered an accurate tool for the detection of PFO but may be also inserted in the diagnostic work- up as a primary gatekeeper for percutaneous closure. Severe shunting at contrast TTE influences final decision making in a large cohort of cases undergoing screening for PFO closure.
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- 2016
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32. P544The importance of contractile reserve when assessing asymptomatic patients with aortic stenosisP545Determinants of secondary mitral regurgitation in patients with aortic stenosis and preserved ejection fractionP546Exercise physiology in patients with mitral annular calcificationP547Evaluation of left atrial strain in patients with rheumatic mitral stenosisP548Impact of mitral regurgitation on impaired alveolar-capillary membrane diffusion in heart failure with reduced ejection fractionP549Edge-to-edge-repair in patients with dilated cardiomyopathy and secondary mitral regurgitation: acute effect on annular geometryP550Changes in the management of functional mitral regurgitation in the last 8 years in a tertiary referral hospitalP551Percutaneous closure of periprosthetic paravalvular leaks under echocardiographic guidance: establishing an alternative to reoperation?P552Clinical profile and predictors of mortality in infective endocarditis with neurologic complicationsP553TAVI, arterial stiffness and ventricular-arterial couplingP554Low contrast media CT angiography prior to transcatheter aortic valve implantation procedureP555Hemodynamic and prognostic impact of permanent pacemaker implantation following transcatheter aortic valve implantationP556Impact of transfemoral aortic valve implantation or surgical aortic valve replacement on right ventricular function in the early postprocedural phaseP557Effects of atrial fibrillation in patients undergoing mitral valve repair with the mitraclip system:one-year outcomes from the GRASP registryP558Who will not benefit from cardioversionP559Is there residual mechanical dysynchrony after initial IEGM optimization in cardiac resynchronization patients?P560Left ventricular reverse remodeling in dilated cardiomyopathy- maintained subclinical myocardial systolic and diastolic dysfunctionP561Improvement of left ventricular ejection fraction is correlated with serum markers of extracellular matrix fibrosis in dilated cardiomyopathyP5622D-radial strain as a novel tool to identify pre-clinical hypertrophic cardiomyopathy mutation carriersP563Long term vigorous exercise is well tolerated in hypertrophic cardiomyopathyP564Left atrial volume and not diameter is the main determinant of atrial fibrillation in patients with hypertrophic cardiomyopathyP565Assessment of papillary muscle mass, apical displacement and mitral valve function in children and young adults with hypertrophic cardiomyopathy using three dimensional echocardiographyP566Combining tissue Doppler-derived Tei index and two-dimensional speckle tracking imaging derived longitudinal strain to predict outcome of patients with light-chain cardiac amyloidosisP567Left and right ventricular dysfunction in patients submitted to chemotherapy with anthracyclines - predictive value of myocardial deformation imagingP568Echocardiography outcome monitoring of hypertensive patients with diastolic dysfunction under doxorubicin therapy
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AL. Pop-Moldovan, AC. Gomes, D. Liu, N. Joseph, M. Rosca, LA. Dejgaard, G. Santambrogio, S. Wisniowska-Smialek, S M R Amorim, J. Ljubas Macek, M. Leitman, AM. Caggegi, A. Mas-Stachurska, M. Drakopoulou, A. Annoni, E. Sciatti, M. Braga, AI. Azevedo, M. Ruiz Ortiz, L. Faber, D. Fina, FA. Castro, G. Pressman, JM. Bantu-Bimbi, JJ. Van Zalen, S. Badiani, L. Hart, A. Marshall, N. Patel, G. Lloyd, L. Jahjah, D. Schulze, T. Tran, T. Pepersack, JL. Vandenbossche, P. Unger, Y. Topilsky, E. Donal, O. Azevedo, M. Lourenco, M. Fernandes, I. Oliveira, A. Lourenco, G. Santos, V. Labate, A. Gasperetti, PL. Laforgia, F. Bandera, E. Alfonzetti, M. Guazzi, W. Scholtz, A. Graw, N. Bogunovic, Z. Dimitriadis, S. Scholtz, J. Boergermann, J. Gummert, D. Horstkotte, D. Mesa, M. Delgado, G. Gutierrez Ballesteros, C. Aristizabal Duque, J. Fernandez Cabeza, E. Duran, C. Ferreiro, J. Sanchez Fernandez, J. Suarez De Lezo, P. Braga, A. Rodrigues, L. Santos, B. Melica, J. Ribeiro, F. Sampaio, R. Fontes-Carvalho, A. Dias, V. Gama Ribeiro, H. Nascimento, L. Flores, V. Ribeiro, F. Melao, C. Sousa, F. Macedo, P. Dias, MJ. Maciel, E. Vizzardi, I. Bonadei, F. Platto, M. Metra, A. Formenti, ME. Mancini, G. Pontone, D. Andreini, L. Fusini, M. Muratori, S. Mushtaq, M. Guglielmo, M. Pepi, K. Toutouzas, K. Stathogiannis, A. Michelongona, G. Latsios, A. Synetos, G. Trantalis, S. Sideris, G. Lazaros, D. Tousoulis, M. Cladellas, M. Ble, B. Vaquerizo, N. Farre, L. Molina, M. Gomez, R. Millan, J. Marti, S. Scandura, P. Capranzano, S. Mangiafico, G. Ronsivalle, M. Chiaranda', S. Giaquinta, A. Popolo Rubbio, S. Farruggio, S. Buccheri, S. Imme', G. Castania, ME. Di Salvo, D. Capodanno, C. Tamburino, V. Tyomkin, E. Peleg, T. Fuchs, Z. Gabara, Z. Vered, V. Reskovic Luksic, M. Pasalic, B. Pezo Nikolic, M. Brestovac, J. Separovic Hanzevacki, J. Rodrigues, M. Campelo, B. Moura, E. Martins, J. Silva-Cardoso, P. Rubis, L. Khachatryan, A. Karabinowska, P. Faltyn, E. Dziewiecka, B. Biernacka-Fijalkowska, A. Lesniak-Sobelga, M. Kostkiewicz, P. Podolec, A. Peritore, P. Vallerio, F. Spano', L. Occhi, R. Facchetti, E. Manfredini, F. Turazza, A. Moreo, C. Giannattasio, TF. Haland, OH. Lie, M. Ribe, IS. Leren, T. Edvardsen, KH. Haugaa, L. Mandes, A. Calin, CC. Beladan, R. Enache, A. Mateescu, C. Baicus, C. Ginghina, BA. Popescu, L. Li, M. Craft, L. Mill, C. Erickson, S. Kutty, K. Hu, S. Herrmann, M. Cikes, G. Ertl, F. Weidemann, S. Stoerk, P. Nordbeck, LR. Lopes, M. Correia, AG. Ferreira, H. Mansinho, H. Pereira, M. Trofenciuc, DA. Darabantiu, M. Puschita, and RM. Christodorescu
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Aortic valve ,medicine.medical_specialty ,Ejection fraction ,business.industry ,Diastole ,General Medicine ,medicine.disease ,Asymptomatic ,Stenosis ,medicine.anatomical_structure ,Internal medicine ,Aortic valve stenosis ,medicine ,Cardiology ,Stress Echocardiography ,Radiology, Nuclear Medicine and imaging ,Systole ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Asymptomatic patients may exhibit symptoms during objective exercise testing, but whether symptoms are due to the obstructively of the valve (typified by the mean gradient) or underlying ventricular function remains unknown. While the mean gradient is an easy parameter to measure no consensus about the measurement of contractile reserve exists. Longitudinal abnormalities may occur in the presence of a normal ejection fraction and the augmentation of these parameters is poorly described. To obtain an objective regarding patients exercise ability is best determined using cardiopulmonary exercise testing. We therefore examined echocardiographic predictors of exercise ability during cardiopulmonary exercise testing.24 asymptomatic patients with moderate to severe or severe aortic stenosis and preserved ejection fraction underwent stress echocardiography with simultaneous cardiopulmonary exercise testing. The primary assessment of exercise ability was the VO2peak and OUES. Echocardiography was measured at rest and during maximal exercise (defined as RER > 1)OUES and VO2peak showed a poor relationship with conventional parameters of severity including peak and mean gradients, AVA and dimensionless index, resting systolic function (by EF and TDI). During exercise systolic augmentation had a good relationship with exercise ability but the exercise mean gradient and exercise LVEF did not.Longitudinal systolic function and particularly systolic augmentation is the strongest predictor of exercise ability when compared to conventional measures of severity.VO2peakOUESS' exerciseRho=0.69 (p=0.001)R= 0.71 (p=0.001)S' restRho=0.52 (p=0.01)R= 0.44 (p=ns)Rest AV max VRho= 0.09 (p=ns)R= -0.08 (p=ns)Rest AV mean PGRho= 0.34 (p=ns)R=-0.10 (p=ns)Exercise AV max VRho=0.43 (p=0.05)R=0.23 (p=ns)Exercise AVmean PGRho= 0.51 (p=0.001)R=0.26 (p=ns)Rest AVARho=0.40 (p=ns)Rho=0.46 (p=0.04)Dimensionless indexRho=0.15 (p=ns)R=0.13 (p=ns)LVEF restRho=-0.18 (p=ns)R=-0.32 (p=ns)LVEF exerciseRho=0.18 (p=ns)R=0.17 (p=ns)S' - systolic velocity; V - velocity; AV - aortic valve; AVA- aortic valve area; LVEF - left ventricular ejection fraction.
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- 2016
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33. 4329Mega-studies in heart failure, effect dilution in examination of new therapies
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Barry H. Greenberg, M. Metra, Beth A. Davison, Naoki Sato, Aldo P. Maggioni, Gary G. Koch, O Cotter, Olav W. Nielsen, A Mebazza, John R. Teerlink, Gadi Cotter, Ovidiu Chioncel, Peter S. Pang, Stefanie Senger, and A. A. Voors
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medicine.medical_specialty ,Dilution technique ,Surrogate endpoint ,business.industry ,medicine.disease ,Dilution ,Serelaxin ,Heart failure ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,Dilute (action) ,business ,Heart failure with preserved ejection fraction - Abstract
Aims All phase 3 studies in patients with acute heart failure (AHF) and HF with preserved ejection fraction (HFpEF) have failed in the last decades. We explore the likelihood that the negative results are due to chance and/or to study size and dilution of statistical power. Methods and results First, using simulations, we examined the probability that a positive finding in phase 2 would result in studying truly effective drugs in phase 3. We simulated phase 2 studies under six scenarios where the range of true relative risk (RR) for an outcome of interest varied from 0.5 (major benefit) to 1.15 (some harm). The proportion of simulated studies where the RR Figure 1. Power at two-sided 0.05 significance level to detect an effect size of hazard ratio of 0.65 (left) or 0.8 (right) with a placebo event rate of 10% (top) and 20% (bottom) at N=100 at various treatment effect dilutions with increasing sample size. Conclusion These data suggest that it is unlikely that the very high rate of negative AHF phase III trials can be explained by chance alone. Potentially, our tendency to increase sample size does not necessarily increase statistical power, due to more heterogenous populations leading to reduced event rates and treatment effects.
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- 2019
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34. P3367Echocardiographic assessment of right ventricle function in patients with severe tricuspid regurgitation and correlates with outcomes
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L P B Badano, R R Raddino, M M Metra, Mara Gavazzoni, Enrico Vizzardi, Assunta Castiello, and M D Muraru
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medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Ventricle ,Internal medicine ,medicine ,Cardiology ,In patient ,Regurgitation (circulation) ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background/Introduction Speckle tracking echocardiography has been recently proposed as an accurate and sensitive measure of right ventricle (RV) function that could integrate other more conventional parameters. This tool can be important in the clinical context of severe tricuspid regurgitation (TR), since TAPSE is not fully representative of global RV function and can overestimate this in presence of severe TR. Purpose Evaluate the prognostic relevance of different parameters of RV structure and function derived from 2D and speckle tracking echocardiographic analysis of clinically stable patients with severe TR referred for routine follow up in the context of many etiologies of left side heart disease (secondary TR). Methods The present is a retrospective analysis of prospectively acquired echocardiographic studies including patients with severe secondary TR in the context of left side heart disease. Fractional area change (FAC), tricuspid annular plane systolic excursion (TAPSE), RV global longitudinal strain (RVLS) and RV free-wall longitudinal strain (RVFWLS) as well as LV function were measured. As suggested in previous studies, we also aimed to explored the use in this population of: i)RVLS/pulmonary systolic arterial pressure (PASP); ii) RVFWLS (average lateral 3 segments strain)/IVSLS (average medial 3 segment strain) as index of RV-LV dependency. The composite end-point of this study included death for any cause and heart failure hospitalization. Results 61 patients (mean age 58±20 years, 65% men), were included. After a mean follow up period of 3,6±2 years 57% of patients reached the combined end-point. At Cox regression univariate analysis a significant correlation with outcomes was found for RVend-diastolic diameter (HR 0,42, p: 0.018), right atrial area (HR: 3, p: 0.02), RVFWLS/IVSLS (HR: 0.5, p: 0.020), RVLS/PASP (HR 0.186, p: 0.039). In multivariable Cox-regression model we found that LVEF, RV dimension and RVFWLS/IVSLS were independently related to outcome; this last one parameter showed the best correlation with outcomes. Conclusions In asymptomatic and clinically stable patients with severe secondary TR longitudinal function of RV free wall is not related to outcomes but RV-arterial coupling and the ratio between deformation of free wall and septal wall of RV are good predictors of clinical deterioration at follow up. The last one conceptually represents the interaction between RV and LV in secondary TR and allows a real “correction” of those effects of severity of TR on the base to apex gradient of lateral wall longitudinal deformation (TR increases movement of basal segments).
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- 2019
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35. Supplemental material for Relationship between endothelial dysfunction, videocapillaroscopy and circulating CD3+CD31+CXCR4+ lymphocytes in systemic lupus erythematosus without cardiovascular risk factors
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I. Cavazzana, S. Piantoni, E. Sciatti, M. Fredi, M. Taraborelli, I. Bonadei, P. Airò, M. Metra, A. Tincani, F. Franceschini, and E. Vizzardi
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immune system diseases ,111702 Aged Health Care ,FOS: Health sciences ,skin and connective tissue diseases - Abstract
Supplemental Material for Relationship between endothelial dysfunction, videocapillaroscopy and circulating CD3+CD31+CXCR4+ lymphocytes in systemic lupus erythematosus without cardiovascular risk factors by I. Cavazzana, S. Piantoni, E. Sciatti, M. Fredi, M. Taraborelli, I. Bonadei, P. Airò, M. Metra, A. Tincani, F. Franceschini and E. Vizzardi in Lupus
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- 2019
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36. Novel endotypes in heart failure: effects on guideline-directed medical therapy
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P. Ponikowski, Leong L. Ng, A. H. Zwinderman, Hans L. Hillege, Biniyam G. Demissei, F. Zannad, Gerasimos Filippatos, John G.F. Cleland, Adriaan A. Voors, P. van der Harst, Wouter Ouwerkerk, D. J. Van Veldhuisen, Nilesh J. Samani, Kenneth Dickstein, Jasper Tromp, M. Metra, P van der Meer, Chim C. Lang, Stefan D. Anker, Cardiovascular Centre (CVC), Life Course Epidemiology (LCE), Groningen Kidney Center (GKC), Restoring Organ Function by Means of Regenerative Medicine (REGENERATE), Epidemiology and Data Science, Dermatology, Graduate School, and APH - Methodology
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Male ,medicine.medical_specialty ,Endotype ,Adrenergic beta-Antagonists ,Angiotensin-Converting Enzyme Inhibitors ,Heart failure ,Medication ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Cluster Analysis ,Humans ,HETEROGENEITY ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,Ejection fraction ,business.industry ,Hazard ratio ,Stroke Volume ,Guideline ,Middle Aged ,medicine.disease ,Peptide Fragments ,Confidence interval ,Hospitalization ,Phenotypes ,Phenotype ,Treatment Outcome ,Practice Guidelines as Topic ,Cohort ,SURVIVAL ,Biomarker (medicine) ,Female ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
Aims:\ud \ud We sought to determine subtypes of patients with heart failure (HF) with a distinct clinical profile and treatment response, using a wide range of biomarkers from various pathophysiological domains.\ud Methods and results:\ud \ud We performed unsupervised cluster analysis using 92 established cardiovascular biomarkers to identify mutually exclusive subgroups (endotypes) of 1802 patients with HF and reduced ejection fraction (HFrEF) from the BIOSTAT-CHF project. We validated our findings in an independent cohort of 813 patients. Based on their biomarker profile, six endotypes were identified. Patients with endotype 1 were youngest, less symptomatic, had the lowest N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and lowest risk for all-cause mortality or hospitalization for HF. Patients with endotype 4 had more severe symptoms and signs of HF, higher NT-proBNP levels and were at highest risk for all-cause mortality or hospitalization for HF [hazard ratio (HR) 1.4; 95% confidence interval (CI) 1.1–1.8]. Patients with endotypes 2, 3, and 5 were better uptitrated to target doses of beta-blockers (P
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- 2018
37. Compensatory activation in fronto-parietal cortices among HIV-infected persons during a monetary decision-making task
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Christina S. Meade, Scott A. Huettel, Daniella M. Cordero, Andréa L. Hobkirk, Brandon M. Metra, and Nan-kuei Chen
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0301 basic medicine ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,Parietal lobe ,Case-control study ,Brain mapping ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Neurology ,Frontal lobe ,medicine ,Radiology, Nuclear Medicine and imaging ,Neurology (clinical) ,Temporal discounting ,Anatomy ,Young adult ,Psychology ,Functional magnetic resonance imaging ,Neurocognitive ,Neuroscience ,030217 neurology & neurosurgery - Abstract
HIV infection can cause direct and indirect damage to the brain and is consistently associated with neurocognitive disorders, including impairments in decision-making capacities. The tendency to devalue rewards that are delayed (temporal discounting) is relevant to a range of health risk behaviors. Making choices about delayed rewards engages the executive control network of the brain, which has been found to be affected by HIV. In this case-control study of 18 HIV-positive and 17 HIV-negative adults, we examined the effects of HIV on brain activation during a temporal discounting task. Functional MRI (fMRI) data were collected while participants made choices between smaller, sooner rewards and larger, delayed rewards. Choices were individualized based on participants' unique discount functions, so each participant experienced hard (similarly valued), easy (disparately valued), and control choices. fMRI data were analyzed using a mixed-effects model to identify group-related differences associated with choice difficulty. While there was no difference between groups in behavioral performance, the HIV-positive group demonstrated significantly larger increases in activation within left parietal regions and bilateral prefrontal regions during easy trials and within the right prefrontal cortex and anterior cingulate during hard trials. Increasing activation within the prefrontal regions was associated with lower nadir CD4 cell count and risk-taking propensity. These results support the hypothesis that HIV infection can alter brain functioning in regions that support decision making, providing further evidence for HIV-associated compensatory activation within fronto-parietal cortices. A history of immunosuppression may contribute to these brain changes. Hum Brain Mapp 37:2455-2467, 2016. © 2016 Wiley Periodicals, Inc.
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- 2016
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38. VP42.13: Maternal hemodynamics, arterial stiffness and elastic aortic properties in uncomplicated twin pregnancies: a longitudinal study
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E. Sciatti, R. Orabona, E. Vizzardi, I. Bonadei, A. Dell'aquila, M. Metra, E. Sartori, T. Frusca, A. Pinna, R. Bellocco, and F. Prefumo
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Reproductive Medicine ,Radiological and Ultrasound Technology ,Obstetrics and Gynecology ,Radiology, Nuclear Medicine and imaging ,General Medicine - Published
- 2020
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39. P4233Safe multidisciplinary management of new therapies: the RITMO project (Real Time Continuous Web Monitoring)
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Gianmarco Arabia, Laura Lupi, I Papa, F Glisenti, M Piazzani, V Guerini, M. Metra, Savina Nodari, and F. Fioretti
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Engineering management ,Multidisciplinary approach ,business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2018
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40. Determinants and clinical outcome of uptitration of ACE-inhibitors and beta-blockers in patients with heart failure
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Chim C. Lang, Hans L. Hillege, Leong L. Ng, N J Samani, Stefan D. Anker, J. M. ter Maaten, A. H. Zwinderman, A. A. Voors, Kenneth Dickstein, D. J. Van Veldhuisen, Piotr Ponikowski, F Zannad, Wouter Ouwerkerk, P. van der Harst, M. Metra, John G.F. Cleland, G Filippatos, Cardiovascular Centre (CVC), Life Course Epidemiology (LCE), Groningen Kidney Center (GKC), Graduate School, Epidemiology and Data Science, Dermatology, and APH - Methodology
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Male ,Angiotensin-Converting Enzyme Inhibitors ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,ACE-inhibitor ,ARB ,Beta-blocker ,Heart failure ,Uptitration ,Cardiology and Cardiovascular Medicine ,0302 clinical medicine ,030212 general & internal medicine ,Prospective Studies ,METOPROLOL CR/XL ,Carvedilol ,ELDERLY-PATIENTS ,Ejection fraction ,Mortality rate ,PRIMARY-CARE ,3. Good health ,Europe ,Hospitalization ,Treatment Outcome ,Cardiology ,Female ,TRIAL ,medicine.symptom ,INTERVENTION ,medicine.drug ,medicine.medical_specialty ,medicine.drug_class ,Adrenergic beta-Antagonists ,Drug Administration Schedule ,03 medical and health sciences ,LEFT-VENTRICULAR DYSFUNCTION ,Median follow-up ,Internal medicine ,medicine ,Humans ,Beta blocker ,Aged ,CARVEDILOL ,Dose-Response Relationship, Drug ,business.industry ,MORTALITY ,Organ dysfunction ,medicine.disease ,CONVERTING ENZYME-INHIBITORS ,CAUSAL INFERENCE ,ACE inhibitor ,business - Abstract
Introduction Despite clear guidelines recommendations, most patients with heart failure and reduced ejection–fraction (HFrEF) do not attain guideline-recommended target doses. We aimed to investigate characteristics and for treatment-indication-bias corrected clinical outcome of patients with HFrEF that did not reach recommended treatment doses of ACE-inhibitors/Angiotensin receptor blockers (ARBs) and/or beta-blockers. Methods and results BIOSTAT-CHF was specifically designed to study uptitration of ACE-inhibitors/ARBs and/or beta-blockers in 2516 heart failure patients from 69 centres in 11 European countries who were selected if they were suboptimally treated while initiation or uptitration was anticipated and encouraged. Patients who died during the uptitration period (n = 151) and patients with a LVEF > 40% (n = 242) were excluded. Median follow up was 21 months. We studied 2100 HFrEF patients (76% male; mean age 68 ±12), of which 22% achieved the recommended treatment dose for ACE-inhibitor/ARB and 12% of beta-blocker. There were marked differences between European countries. Reaching Conclusion Patients with HFrEF who were treated with less than 50% of recommended dose of ACE-inhibitors/ARBs and beta-blockers seemed to have a greater risk of death and/or heart failure hospitalization compared with patients reaching ≥100%.
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- 2017
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41. The Relationship between LVEF and Cardiovascular Outcomes Following Hospitalization for Heart failure: Insights from the RELAX-AHF-2 Trial
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M. Metra, Barry H. Greenberg, Satit Janwanishstaporn, Adriaan A. Voors, Gerasimos Filippatos, G. Cotter, J.R. Teerlink, Siting Feng, Claudio Gimpelewicz, M. Felker, Piotr Ponikowski, I.E. Sama, B.A. Davidson, P.S. Pang, and T. Severin
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medicine.medical_specialty ,Ejection fraction ,business.industry ,Composite outcomes ,medicine.disease ,humanities ,Continuous variable ,Quartile ,Heart failure ,Internal medicine ,cardiovascular system ,Cardiology ,Etiology ,Medicine ,In patient ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business ,therapeutics ,Cardiovascular outcomes ,circulatory and respiratory physiology - Abstract
Background Although left ventricular ejection fraction (LVEF) is routinely used to categorize heart failure (HF) patients, whether this variable predicts outcomes across the full spectrum of patients with acute heart failure (AHF) is uncertain. We assessed the relationship between LVEF and cardiovascular outcomes in a large cohort of patients hospitalized with AHF. Methods 6128 AHF patients from the RELAX-AHF-2 trial who had LVEF measured during AHF hospitalization were separated into quartiles: Q1, LVEF 7-29%; Q2, LVEF >29-38%; Q3, LVEF >38-50% and Q4, LVEF >50-87% in order to determine the relationship between LVEF and a composite of cardiovascular (CV) mortality and rehospitalization for HF or renal failure (RF) through 180 days, the individual components of this composite and all-cause mortality. Results Patients in the lowest LVEF quartile had the highest risk for the composite of CV mortality and HF or RF hospitalization. When LVEF was assessed as a continuous variable, risk for the composite outcome, its components and all-cause mortality became progressively lower as EF increased (HR 0.95, 95% CI 0.93-0.98 per 5% LVEF increase for composite endpoint, P Conclusions In patients hospitalized with AHF, cardiovascular events occurred more frequently at 180 days in patients in the lowest LVEF quartile, especially in patients with an ischemic etiology and pre-existing HF.
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- 2019
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42. Raised homocystein plasma concentration in patients with Heart Failure: clinical significance
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L. Dei Cas, Enrico Vizzardi, M. Metra, Savina Nodari, and Claudia Fiorina
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Hyperhomocysteinemia ,Homocysteine ,Cardiomyopathy ,lcsh:Medicine ,chemistry.chemical_compound ,Internal medicine ,medicine ,Humans ,Risk factor ,Aged ,Heart Failure ,Creatinine ,Ejection fraction ,lcsh:R ,Dilated cardiomyopathy ,Middle Aged ,medicine.disease ,chemistry ,Heart failure ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine - Abstract
Elevated plasma levels of homocysteine is associated with increased risk of thrombotic and atherosclerotic vascular disease. Several studies have demonstrated that hyperhomocysteinemia is an indipendent risk factor for vascular disease and is associated to heart failure. However there are no data regarding the association between homocysteine and various objective as well as subjective measures of heart failure. We hypothesized that plasma homocysteine is associated with clinical and echocardiographic signs of heart failure. On this ground we have analysed levels of homocysteine in patients with heart failure and possible correlation between these levels and clinical-functional pattern (NYHA class and ejection fraction). Methods: Plasma homocysteine levels were determined in 123 patients with dilated cardiomyopathy (59 males, 64 females, mean age 67±10 years, mean EF 31±11% and mean NYHA 2.4±0.9, 47 idiopatic and 76 postischemic cardiomyopathy) and 85 healthy control subjects (homogeneus group for sex and age). Patients with chronic renal failure, vitamin B12 and folate deficiency or factors affecting homocysteine plasma levels were escluded from this study. Homocysteine levels were determined in coded plasma samples by immunoenzimatic methods. Results: Patients with heart failure had a higher homocysteine level (mcg/L) than control subjects (21.72±10.28 vs 12.9±6.86, p
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- 2016
43. Abstracts
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O. Barthelemy, J. Silvain, D. Brieger, A. Bellemain-Appaix, G. Cayla, F. Beygui, R. Lancar, J. P. Collet, A. Mercadier, G. Montalescot, K. S. Cha, Y. H. Nam, J. H. Kim, S. Y. Park, T. H. Park, M. H. Kim, Y. D. Kim, H. C. Lee, M. S. Ahn, T. J. Hong, R. Blanco, F. Blanco, J. Szarfer, A. Garcia Escudero, G. Gigena, J. Gagliardi, A. Rodriguez, R. Sarmiento, S. Affatatto, M. Riccitelli, A. Petris, M. D. Datcu, C. Pop, M. Radoi, C. Arsenescu-Georgescu, I. Petrescu, L. Petrescu, L. Serban, E. Nechita, G. Tatu-Chitoiu, M. Dorobantu, I. Benedek, E. Craiu, C. Sinescu, D. D. Ionescu, C. Ginghina, B. Minescu, A. Izzo, P. Mantovani, L. Tomasi, L. Dall'oglio, S. Bonatti, R. Rosiello, M. Romano, F. Agostini, R. Zanini, Z. Y. Zhao, Y. J. Wu, J. J. Li, Y. J. Yany, H. Y. Qian, Y. D. Tang, A. T. Timoteo, A. Toste, A. Lousinha, R. Ramos, J. A. Oliveira, M. L. Ferreira, R. C. Ferreira, C. Cabades, J. L. Diez Gil, P. Aguar, D. Sanmiguel, A. Lopez-March, R. Marmol, L. Guerra, V. Girbes, J. Ferrando, A. Rincon De Arellano, L. Patricio, M. Blondal, T. Ainla, T. Marandi, J. Eha, M. M. Oliveira, M. N. Silva, P. S. Cunha, J. Feliciano, S. Silva, J. Kanovsky, P. Kala, J. Parenica, M. Poloczek, K. Prymusova, L. Kubkova, J. Spinar, D. Olinic, C. Homorodean, M. Ober, M. Olinic, C. Andrioaia, A. Condac, M. Masmoudi, B. Berdaoui, S. Labidi, C. Tapia Ballesteros, C. Hernandez Luis, M. G. Sandin, J. M. Vegas, R. Andion, N. Martinez, I. A. Gonzalez, M. Alvarado, I. J. Amat, J. A. San Roman, M. J. Garcia Gonzalez, E. Arroyo Ucar, C. Hernandez Garcia, M. Dorta Martin, F. Marrero Rodriguez, R. Dragu, M. Kapeliovich, H. Hammerman, D. Silva, N. Cortez-Dias, C. Jorge, J. Silva Marques, P. Carilho Ferreira, S. Robalo Martins, M. Almeida Ribeiro, C. Calisto, M. Fiuza, M. G. Lopes, P. Milicevic, M. Panic, I. Stankovic, D. Milicevic, T. Kalezic, S. Kafedzic, I. Ilic, M. Cerovic, B. Putnikovic, A. Neskovic, D. Rott, D. Leibowitz, Z. Monhart, J. Reissigova, H. Grunfeldova, P. Jansky, B. Valente, I. Villanueva Benito, I. Solla, E. Paredes, O. Diaz Castro, F. Calvo, J. A. Baz, A. Iniguez, A. Aleksova, R. Gerloni, R. Belfiore, C. Carriere, G. Barbati, E. Fabris, F. Possa, D. Nait, M. Milo, G. Sinagra, N. Marques, J. Mimoso, V. Gomes, R. M. Agra Bermejo, E. A. A. Emad Abu Assi, S. R. R. Sergio Raposeiras Roubin, P. C. G. Pilar Cabanas Grandio, C. P. G. Carlos Pena Gil, J. M. G. A. Jose Maria Garcia Acuna, J. R. G. J. Jose Ramon Gonzalez Juanatey, M. J. Daly, P. Scott, C. G. Owens, A. Tomlin, B. Smith, A. A. J. Adgey, L. R. Alvarez-Contreras, U. Juarez, A. Altamirano, A. Arias, A. Alvarez-San Gabriel, H. Gonzalez-Pacheco, C. Martinez-Sanchez, M. Rahnavardi, M. Keshtkar-Jahromi, H. Vakili, S. Gholamin, S. M. Razavi, T. Gilis-Januszewski, K.- P. Mellwig, M. Wiemer, J. Gilis-Januszewski, A. Peterschroeder, J. Koerfer, D. Horstkotte, M. Vrsalovic, B. Getaldic, N. Vrkic, H. Pintaric, S. Khan, B. Wasan, L. Moretti, P. Grossi, S. Silenzi, M. Testa, L. Candelori, L. N. Clementi, M. 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Leitao Marques, R. Margato, P. Sousa, H. Ribeiro, L. Rocha, A. Correia, J. I. Moreira, H. C. Carvalho, M. Afifi, N. Abed, A. Suarez-Barrientos, D. Vivas, F. Castro-Ferreira, E. Franco, J. C. Garcia-Rubira, V. Fuster, C. Macaya, B. Ibanez Cabeza, S. Salinger, D. Milic, T. Stanojlovic, T. Kostic, M. A. Khan, F. Vrapi, K. Naeem, J. Davar, K. Hristova, G. Pencheva, R. Radeva, S. Milanov, A. Fareed, M. Oraby, G. M. Nasr, F. Maklady, P. Dupouy, J. T. Sorensen, C. J. Terkelsen, J. F. Lassen, S. Trautner, E. F. Christensen, T. T. Nielsen, H. E. Botker, H. R. Andersen, K. A. Thygesen, L. Checco, T. Usmiani, P. L. Sbarra, M. Boffini, R. Saviolo, C. Grasso, F. Conrotto, M. Marchetti, M. Rinaldi, S. Marra, F. Moscoso Costa, J. Ferreira, L. Raposo, C. Aguiar, M. Trabulo, J. A. Silva, V. Marques, A. Swiatkowski, J. Kowalczyk, R. Lenarczyk, P. Chodor, G. Honisz, T. Was, M. Swierad, B. Sredniawa, L. Polonski, Z. Kalarus, A. S. Postadzhiyan, H. Velinov, V. Velchev, D. Hazarbasanov, M. Apostolova, B. Finkov, M. Petrovic, A. Jovelic, T. Canji, I. Srdanovic, T. Popov, M. Golubovic, K. Pavlovic, N. Cemerlic-Adjic, J. Bro-Jeppesen, J. Kjaergaard, M. C. Wanscher, S. L. Nielsen, L. S. Rasmussen, C. Hassager, M. Khan, E. Crolla, H. Morley, L. Akeroyd, Y. Beaini, C. Morley, R. H. Bekeredjian, U. Krumsdorf, W. Rottbauer, H. A. Katus, S. Pleger, A. Botelho, N. Quintal, P. Faria, S. Gomes, J. C. Roussel, T. Senage, C. Perigaud, O. Habash, M. Michel, M. Treilhaud, P. Despins, J. N. Trochu, O. Baron, D. Duveau, A. N. Kitsiou, K. Giannakopoulos, G. Papadimitriou, S. Karas, Z. Babic, V. Nikolic Heitzler, D. Milicic, M. Bergovec, M. Raguz, J. Mirat, M. Strozzi, Z. Plazonic, L. Giunio, R. Steiner, M. Freynhofer, I. Brozovic, V. Bruno, L. Leherbauer, M. Djurkovic, M. Willheim, W. Huebl, S. Hahne, I. Kozanli, K. Kalla, A. Geppert, G. Unger, A. F. Simoes Marques Assuncao Caetano, C. Faustino, A. Ariza Sole, J. C. Sanchez Salado, V. Lorente Tordera, V. Martinez Garcia, J. Salazar Mendiguchia Y Garcia, J. A. Gomez Hospital, J. Maristany Daunert, F. J. Berdejo Gago, E. Esplugas Oliveras, A. Brzozowska-Czarnek, A. Urbanik, N. Kakouros, S. Kakouros, J. Lekakis, J. Rizos, D. Kokkinos, J. Venevtseva, A. Melnikov, M. Valiahmetov, T. Gomova, I. Perelomova, J. J. Ferrer Hita, F. Bosa-Ojeda, A. Sanchez-Grande-Flecha, G. Yanes-Bowden, M. J. Vargas-Torres, A. Rodriguez-Gonzalez, C. Rubio-Iglesias-Garcia, A. Dominguez-Rodriguez, C. Enjuanes-Grau, F. Marrero-Rodriguez, A. I. Suceveanu, A. Suceveanu, L. Mazilu, L. Alexandrescu, E. Dumitru, V. Miu, V. Jitari, F. L. Voinea, K. P. Balachandran, R. Schofield, R. Sankaranarayanan, K. Helm, C. Crowe, R. Singh, J. Mcdonald, M. J. Chuen, M. Kobusiak-Prokopowicz, M. Preglowska, A. Mysiak, T. Doi, T. Sakoda, T. Akagami, T. Naka, T. Tsujino, T. Masuyama, M. Ohyanagi, N. Kume, H. Mitsuoka, K. Hayashida, M. Tanaka, L. M. Biasucci, R. Della Bona, G. Biasillo, M. Leo, M. Zaninotto, M. Plebani, F. Crea, R. Dellabona, B. Gok, A. Unalir, B. Timuralp, N. Nikulina, S. S. Yakushin, G. I. Furmenko, S. A. Akinina, R. Ingrid, L. Bronze, S. Djambazov, A. Zhivkov, I. Maznev, M. Ingeliev, R. Slavov, N. Cvetkova, V. Patarinski, L. Groch, J. Horak, N. Dimitrov, H. G. Hayrapetyan, P. Cabanas-Grandio, C. Pena-Gil, N. A. Mc Keag, C. J. Mc Cann, C. Cardwell, I. S. Young, N. Mikhalchikova, N. Burova, M. Zaccaria, P. Palmisano, V. Palumbo, M. M. Ciccone, S. Favale, K. C. Chen, W. H. Yin, J. H. Liu, S. Goncalves, J. F. Santos, P. Amador, L. N. Soares, K. Zahidova, F. Guliyev, N. Zahidov, P. Carrilho-Ferreira, J. S. Marques, J. Carvalho De Sousa, H. Uthoff, C. Thalhammer, M. Potocki, T. Reichlin, M. Noveanu, M. Aschwanden, D. Staub, N. Arenja, T. Socrates, C. Mueller, Y. Zhao, X. Wu, Q. Xue, L. Gao, H. Lin, S. Wang, K. Watanabe, A. Kawamura, T. Seko, A. Omura, S. Sakabe, A. Kasai, A. V. Starodubova, G. Storozhakov, O. Kisliak, F. Hautieva, M. Tursheva, N. Fedotova, R. C. Di Maio, J. Mclaughlin, J. D. Allen, J. M. C. Anderson, H. Khaled Nagi, O. Tayeh, W. Farok, A. Mousa, P. Neuzil, J. Skoda, J. Petru, L. Sediva, S. Kralovec, F. Holy, K. Holdova, P. Jehlicka, P. Plasil, V. Y. Reddy, S. Alabakovska, D. Labudovic, S. Jovanova, K. Tosheska, M. Alabakovski, K. Jeevaratnam, S. P. Tee, Y. Zhang, L. Guzadhur, I. S. Gurung, R. Duehmke, A. A. Grace, M. Lei, C. L. Huang, Y. Ishibashi, M. Yamauchi, Y. Akashi, H. Musha, F. Miyake, T. Hnatek, L. Kamenik, P. Sedlon, J. Luxova, B. Steuerova, J. Skvaril, M. Cernohous, M. Zavoral, N. Ratkovic, N. R. Nemanja Djenic, A. J. Aleksandra Jovelic, S. O. Slobodan Obradovic, B. G. Branko Gligic, E. Kletsiou, M. Giannakopoulou, E. Bozas, E. K. Iliodromitis, E. D. E. Papathanassoglou, M. Anton, G. Anton, M. Muraru, S. Salinger Martinovic, M. Radosavljevic, D. Stanojevic, M. Zivkovic, T. Pessoa, N. Aspromonte, C. Ronco, M. Tubaro, M. Santini, F. Colivicchi, A. Aiello, D. Cruz, A. Anzoletti Boscolo, G. Vianello, R. Valle, A. Parspour, S. Watkins, D. Datta, A. G. Nikishin, M. M. Pirnazarov, T. A. Nurbaev, Z. Motovska, M. Fischerova, P. Osmancik, M. Maly, P. Widimsky, E. Pavli, A. Dibra, J. Mehilli, L. Dibra, A. Schoemig, A. Kastrati, P. Carmo, M. Almeida, R. Teles, P. Goncalves, J. Brito, F. D'ascenzo, A. Gonella, G. Longo, A. Pullara, C. Moretti, F. Sciuto, P. Omede', G. Biondi Zoccai, G. P. Trevi, I. Sheiban, H. M. Cafe, D. Pereira, D. Freitas, D. Ortiz Berbel, J. M. Rabasa Baraibar, A. M. Leone, A. De Caterina, A. Aurelio, A. Sciahbasi, E. Lioy, C. Trani, F. Burzotta, I. Porto, A. G. Rebuzzi, K. Trusinskis, D. Juhnevica, K. Strenge, D. Sondore, I. Kumsars, S. Jegere, I. Narbute, A. Grave, I. Zakke, A. Erglis, C. Ferrari, A. L. Bartorelli, M. Saeed, D. Cozma, S. Pescariu, S. I. Dragulescu, H. S. Kamal, A. Abdelfattah, A. M. Abdelbary, H. Elassar, A. Naggar, M. Khaled, A. M. Fareed, J. M. Pernes, J. C. Gaux, M. W. Prull, B. Sasko, H. Wirdemann, A. Bittlinsky, T. Butz, H. J. Trappe, M. Perazzolo Marra, L. Cacciavillani, A. Marzari, M. De Lazzari, R. Turri, P. China, F. Corbetti, S. Iliceto, L. L. Stazhadze, E. A. Spiridonova, N. A. Bulanova, A. A. Ermolaev, L. Savic, I. Mrdovic, G. Krljanac, J. Perunicic, M. Asanin, R. Lasica, M. Matic, Z. Vasiljevic, M. Ostojic, M. Tichy, C. Andrys, A. Conti, C. Poggioni, G. Viviani, F. Bulletti, V. Boni, M. Luzzi, S. Vicidomini, M. Donati, B. Del Taglia, R. Pini, O. Sousa, R. Fontes-Carvalho, D. Caeiro, N. Dias Ferreira, G. Silva, E. Pereira, J. Ribeiro, A. Albuquerque, V. Gama Ribeiro, M. Murai, Y. Takeda, T. Shinmyo, J. Tanigawa, H. Hazui, T. Nakakohji, Y. Ohishi, M. Hoshiga, T. Ishihara, T. Hanafusa, J. Belohlavek, V. Rohn, J. Kunstyr, M. Lips, M. Semrad, F. Mlejnsky, J. Tosovsky, A. Linhart, J. Lindner, Z. Sablik, A. Samborska-Sablik, J. Drozdz, W. Gaszynski, M. M. Izquierdo-Gomez, R. Juarez-Prera, G. Blanco-Palacios, R. Lakhdar, M. Drissa, B. Jedaida, H. Drissa, F. Sampaio, H.- T. Hsin, J.- H. Huang, K.- M. Chiu, Z.- S. Chen, P.- C. Lin, L.- Y. Chen, S.- H. Chu, I. Efthimiadis, P. Skendros, A. Sarantopoulos, P. Boura, A. M. Van Der Laan, P. A. Van Der Vleuten, M. Klees, J. G. P. Tijssen, B. E. Backus, A. J. Six, J. H. Kelder, A. Mosterd, E. G. Mast, T. P. Mast, R. Braam, R. Tio, R. Veldkamp, P. A. Doevendans, N. Paarup Dridi, L. Holmvang, T. Engstroem, S. Rekik, J. Brunet, F. X. Hager, G. Bayet, L. Meille, J. M. Quatre, J. Sainsous, P.- H. Chu, C.- H. Tang, N. Pogosova, I. E. Koltunov, I. D. Sapunova, V. A. Vigodin, R. Uhliar, A. Schmidt, B. Brockmeyer, A. Suzuki, Y. Eki, H. Higuchi, A. Yukawa, R. Yamauchi, Y. Sato, Y. Endo, J. Salazar Mendigucha Garcia, S. Homs Vila, A. Cequier Fillat, R. Andion Ogando, M. Sandin Fuentes, J. M. Vegas Valle, I. A. Gonzalez Garcia, I. A. Duro Aguado, A. J. Palomino Doza, I. Gomez Salvador, J. A. San Roman Calvar, T. M. Mamarasulov, L. Todorovic, Z. C. H. Cherneva, S. D. Denchev, K. Heltai, A. Boytsov, N. N. Nikulina, D. Zanna, V. Marangelli, C. Caiati, R. Picon Heras, M. J. Loureiro, I. Urazovskaya, D. Vinogradova, E. Vasilieva, A. Shpektor, E. Conti, M. B. Musumeci, F. M. Lauri, E. Dito, M. De Giusti, A. Lallo, D. Fusco, M. Davoli, M. Volpe, C. Autore, H. Gamra, Z. Dridi, M. Hassine, F. Addad, I. Gherissi, A. Reda, M. Mahjoub, S. Bouraoui, M. Abdennadher, F. Betbout, P. M. F. P. Mota, J. D. Silva, R. Jankovic Tomasevic, V. Djordjevic, D. Djordjevic Radojkovic, A. Scafa Udriste, A. Fruntelata, E. Gainoiu, S. Bogdan, D. Zamfir, C. Teodorescu, M. Guran, D. Constantinescu, A. Konopka, M. Banaszewski, I. Wojtkowska, J. Stepinska, J. V. Vidergold, I. V. Osipova, T. V. Tavrovskaya, J. V. Galkina, A. V. Timofeev, R. I. Vorobyov, E. N. Vorobyova, L. Matos, A. C. C. Carvalho, W. Oliveira, F. Cintra, D. Poyares, M. Andersen, R. Martins, S. Tufik, P. Ostadal, J. Brada, S. Horakova, M. Mlcek, V. Hrachovina, O. Kittnar, I. V. Gorudko, I. V. Buko, S. N. Cherenkevich, L. Z. Polonetsky, V. Y. Plotkin, M. A. Timoshina, S. V. Azanchevskaya, N. N. Chromov-Borisov, A. Vorlat, L. Snoep, M. J. Claeys, C. J. Vrints, A. Palazzuoli, M. Caputo, I. Quatrini, A. Calabro, G. Antonelli, M. S. Campagna, B. Franci, R. Nuti, A. Maisel, M. Negrini, T. Minora, P. Marino, R. Seregni, E. Tavlueva, O. Barbarash, L. Barbarash, T. Janota, J. Kudlicka, K. Malik, D. Wichterle, J. Hradec, R. Body, S. D. Carley, G. Mcdowell, M. Nuttall, C. Wibberley, M. France, J. K. Cruickshank, K. Mackway-Jones, M. Leon, C. Cozma, F. Mitu, D. R. Almeida, C. B. Dias, I. Burazor, M. Burazor, M. Krstic, M. Lazovic, M. Vukmanovic, J. Djordjevic, Z. Radovanovic, D. Ilic, P. Bosnjakovic, A. C. Ferreira, P. S. Mateus, P. Fontes, T. Teixeira, G. Conte, A. Menozzi, E. Solinas, M. G. Bolognesi, I. Tadonio, F. Mantovani, A. Cattabiani, L. Vignali, D. Ardissino, O. Tautu, A. Alexandrescu, R. Niculescu, R. Jankovic, N. Bozinovic, C. Santos, F. Costa, G. Cardoso, I. Correia, K. Fountoulaki, S. Kastellanos, E. Voltirakis, A. Kokotos, C. Michalakeas, K. Kontsas, K. Hasioti, E. T. Iliodromitis, M. G. Sandin Fuentes, E. Zatarain Nicolas, N. Martinez Uruena, M. Alvarado Montes De Oca, V. Dytrych, T. Kovarnik, O. Smid, A. Kral, A. G. Aroutunov, S. Intwala, I. Jegere, H. S. H. Shaalan, Z. Pagava, R. Agladze, R. Shakarishvili, N. Sharashidze, L. Gujejiani, G. Saatashvili, T. Z. Katova, V. Kostova, Y. Simova, S. Vukotic, S. Rafajlovski, R. Romanovic, N. Antonijevic, B. Gligic, M. Hutyra, T. Skala, D. Horak, D. Vindis, M. Taborsky, A. Contine, M. Del Pinto, F. Angeli, P. Verdecchia, F. Borgognoni, E. Grikstaite, P. Pantano, G. Ambrosio, C. Cavallini, C. Bonanad, J. Sanchis, V. Bodi, J. Nunez, X. Bosch, M. Heras, M. Pellicer, A. Llacer, L. Adao, M. Oliveira, H. Goncalves, J. Primo, V. Gama, C. Lombardi, M. Metra, S. Bugatti, E. Pasotti, F. Quinzani, M. Adamo, C. Villa, R. Rovetta, A. Manerba, M. Mariani, A. Dushpanova, M. Baroni, E. Cerone, A. Nardelli, J. Gianetti, S. Berti, F. Feliciano, R. Soares, S. Santos, A. Kruger, D. Vondrakova, J. Herget, C. Navarro, N. A. Cromie, J. A. A. Adgey, D. Caeiro Pereira, P. Braga, R. Fontes Carvalho, A. Rodrigues, M. Goncalves, L. Simoes, and K. V. Borisov
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Cardiology and Cardiovascular Medicine - Published
- 2010
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44. Valves in the Heart of the Big Apple V: Evaluation and Management of Valvular Heart Diseases 2007.Third Annual Scientific Session: Heart Valve Society of America, New York City, N.Y., April 12–14, 2007
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Kurt Boman, Harun Evrengul, E. Vizzardi, Jacob Goldstein, M. Metra, Daniel P. Shmorhun, Yu Shu Li, Chia-Ti Tsai, Pei-Leun Kang, Ke Ping Yang, Kai Mortensen, Gerhard Blazek, Claudia Stöllberger, Christopher Gans, Rodolfo Ventura, Debabrata Mukherjee, J. Kogias, Holger Diedrichs, Sena Tokay, Sungha Park, Seyhan Tanriverdi, James Blasetto, Adam Torbicki, David Köhler, Ken-ichi Sugimoto, Joško Osredkar, C. Fiorina, Akira Suda, Pablo Ancillo, Ahmet Oktay, Se-Jung Yoon, D. Tanne, Gertrud Wüstefeld, Refik Erdim, Matthias Pfisterer, Teiichi Yamane, Anthony Roselli, Daniel Petrovič, Chi Young Shim, Erol Saygili, Xue-Bing Li, H. Asuman Kaftan, Muhammet Ali Aydin, Uwe Nixdorff, Barbara Lewis, Susan Harris, Zaza Iakobishvili, Dariusz A. Kosior, Ulrich Keller, Renata Verhovec, Basil S. Lewis, Lutz Klinghammer, V. Boyko, V. Caldir, Ronen Jaffe, Basheer Karkabi, Daniel Seidensticker, Robert H. G. Schwinger, Shih Kai Lin, Tsutomu Yoshikawa, S. Behar, John Kao, Midori Yamakawa, Andreas Schuchert, Yung-Zu Tseng, Mona Olofsson, Ronen Rubinshtein, Miodrag Filipovic, Kimiaki Komukai, U. Guray, Yuichiro Maekawa, Gabriele Pfitzer, Ling-Ping Lai, Zenon S. Kyriakides, Hiroyuki Hazeyama, Ralph Stephan von Bardeleben, Manfred D. Seeberger, Konrad Frank, Josef Finsterer, Kamran Aghasadeghi, S. Kormaz, Chanmi Park, Hartwig Wolburg, Hemender S. Vats, Elinor Miller, M. Haim, Yohei Ohno, Param P. Sharma, Takashi Kohno, U. Goldbourt, Hiromichi Hara, Hyun Young Park, Joji Urata, Taro Date, Ming-Ren Chen, S. Nodari, Shye-Jao Wu, Nurullah Tuzun, Shiro Iwanaga, A. Serdar Fak, Donald G. Vidt, S. Cay, Chun-Peng Liu, Doron Zahger, Holger K. Eltzschig, Mojca Globočnik Petrovič, Ing-Sh Chiu, Namsik Chung, Yasar Enli, Juey-Jen Hwang, S. Sideris, David J. Moliterno, Jonathan Rosen, Toshihisa Anzai, H. Sasmaz, Esra Saygili, Yuan-Sheng Liu, Halil Tanriverdi, K. Tsatiris, David Hasdai, Toshihide Shinozaki, M.B. Yilmaz, Mei-Hwan Wu, R. Zimlichman, Borut Peterlin, Gautam Nayak, M. Bonios, Fu-Tien Chiang, Moshe Y. Flugelman, L. Dei Cas, Knut Gjesdal, Maria Winkler-Dworak, Susanne Mohr-Kahaly, Carsten Zobel, Amir Aslani, Grzegorz Opolski, Tobias Eckle, Guang Yuan Mar, Omur Kuru, Y. Guray, Dan Edebro, Fernando Arós, Pedro Morillas, David A. Halon, Rita Dictiar, Tao Yu Lee, Deniz Seleci, Takashi Sakamoto, Raban Jeger, Stephanie Zug, Jochen Müller-Ehmsen, Ping Zhang, Hai-Cheng Zhang, Bermseok Oh, Hidehiro Kaneko, Zhi-Hong Zhao, Shmuel Gottlieb, Chuen-Wang Chiou, Thomas Meinertz, Z. Matas, Hung-Chi Lue, Jiunn-Lee Lin, Dan Atar, Yangsoo Jang, José Luis Priego Bermejo, Gökmen Gemici, Karin Klingel, Alex I. Malinin, George Arealis, Hakan Tezcan, Savvas Nikolidakis, Young Guk Ko, Daisuke Utsunomiya, Donghoon Choi, Birgit Bölck, Satoshi Ogawa, Kotaro Naito, Arne Warth, Solomon Behar, Pedro Pabón, John J. Hayes, Yuan Xu, M. Benderly, Humberto Vidaillet, Ming Hua Luo, Hui-Chong Li, Avital Porter, Yasushi Asakura, C. Melexopoulou, Stephan Willems, Jou-Kou Wang, Yasuo Sugano, Taiji Nishiharu, Marion Faigle, P. Exarchos, Seibu Mochizuki, Haim Hammerman, Yasuyuki Yamashita, Robert J. Goldberg, Shih Hung Hsiao, Hung Tae Kim, Nevzat Karabulut, Carmen Fernández, Hanoch Hod, Michael Koutouzis, Vicente Bertomeu, Obaida R. Rana, Hannes Reuter, Kazuo Awai, James Shepherd, Ikuo Taniguchi, Victor L. Serebruany, Chuen-Den Tseng, and Ji-Hong Guo
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medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Internal medicine ,General surgery ,Cardiology ,Medicine ,Pharmacology (medical) ,Heart valve ,Session (computer science) ,Cardiology and Cardiovascular Medicine ,business - Published
- 2007
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45. Endothelial dysfunction and vascular stiffness in women with previous pregnancy complicated by early or late pre-eclampsia
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R, Orabona, E, Sciatti, E, Vizzardi, I, Bonadei, A, Valcamonico, M, Metra, and T, Frusca
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Adult ,Microcirculation ,Gestational Age ,Pulse Wave Analysis ,Uterine Artery ,Vascular Stiffness ,Pre-Eclampsia ,Cardiovascular Diseases ,Pregnancy ,Risk Factors ,Humans ,Female ,Prospective Studies ,Retrospective Studies - Abstract
Pre-eclampsia (PE) is associated with an increased cardiovascular risk later in life. The persistence of endothelial dysfunction after delivery may represent the link between PE and cardiovascular disease. We aimed to evaluate endothelial function and arterial stiffness after delivery of pregnancy complicated by early-onset (EO) or late-onset (LO) PE and their correlation with gestational age and mean uterine artery pulsatility index at PE diagnosis and birth-weight percentile.The study included 30 women with previous EO-PE, 30 with previous LO-PE and 30 controls with no previous PE. Participants were examined at between 6 months and 4 years after delivery. All included women were free from cardiovascular risk factors and drugs. Data on demographic and clinical characteristics during pregnancy were collected retrospectively from obstetrical charts. Endothelial function and arterial stiffness were assessed by peripheral arterial tonometry and pulse-wave analysis.All vascular parameters were significantly different, indicating circulatory impairment, in women with previous EO-PE. Women with previous LO-PE had higher vascular rigidity than did controls and all had normal values of reactive hyperemia index, although they were significantly lower when compared with those of controls. On multivariate analysis, gestational age and mean uterine artery pulsatility index at the time of PE diagnosis, and birth-weight percentile were all statistically related to the vascular indices studied, after correcting for confounding parameters.Women with previous pregnancy complicated by PE, in particular those with early-onset disease, showed persistent microcirculatory dysfunction, as suggested by a significant reduction in reactive hyperemia index value, and increased arterial stiffness. Copyright © 2016 ISUOG. Published by John WileySons Ltd.
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- 2015
46. Compensatory activation in fronto-parietal cortices among HIV-infected persons during a monetary decision-making task
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Christina S, Meade, Daniella M, Cordero, Andrea L, Hobkirk, Brandon M, Metra, Nan-Kuei, Chen, and Scott A, Huettel
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Adult ,Brain Mapping ,Adolescent ,Decision Making ,HIV Infections ,Middle Aged ,Neuropsychological Tests ,Magnetic Resonance Imaging ,Article ,CD4 Lymphocyte Count ,Frontal Lobe ,Young Adult ,Risk-Taking ,Case-Control Studies ,Parietal Lobe ,Humans - Abstract
HIV infection can cause direct and indirect damage to the brain and is consistently associated with neurocognitive disorders, including impairments in decision-making capacities. The tendency to devalue rewards that are delayed (temporal discounting) is relevant to a range of health risk behaviors. Making choices about delayed rewards engages the executive control network of the brain, which has been found to be affected by HIV. In this case-control study of 18 HIV-positive and 17 HIV-negative adults, we examined the effects of HIV on brain activation during a temporal discounting task. Functional MRI (fMRI) data were collected while participants made choices between smaller, sooner rewards and larger, delayed rewards. Choices were individualized based on participants' unique discount functions, so each participant experienced hard (similarly valued), easy (disparately valued), and control choices. fMRI data were analyzed using a mixed-effects model to identify group-related differences associated with choice difficulty. While there was no difference between groups in behavioral performance, the HIV-positive group demonstrated significantly larger increases in activation within left parietal regions and bilateral prefrontal regions during easy trials and within the right prefrontal cortex and anterior cingulate during hard trials. Increasing activation within the prefrontal regions was associated with lower nadir CD4 cell count and risk-taking propensity. These results support the hypothesis that HIV infection can alter brain functioning in regions that support decision making, providing further evidence for HIV-associated compensatory activation within fronto-parietal cortices. A history of immunosuppression may contribute to these brain changes. Hum Brain Mapp 37:2455-2467, 2016. © 2016 Wiley Periodicals, Inc.
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- 2015
47. Reply to: Aortic stiffness in hypertrophic cardiomyopathy
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E, Vizzardi, E, Sciatti, I, Bonadei, S, Gelsomino, R, Lorusso, and M, Metra
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Male ,Vascular Stiffness ,Echocardiography ,Humans ,Female ,Cardiomyopathy, Hypertrophic ,Aorta ,Echocardiography, Doppler - Published
- 2015
48. Elastic aortic properties in hypertrophic cardiomyopathy: a single center echocardiographic evaluation
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E, Vizzardi, E, Sciatti, I, Bonadei, S, Gelsomino, R, Lorusso, and M, Metra
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Adult ,Male ,Vascular Stiffness ,Echocardiography ,Case-Control Studies ,Humans ,Female ,Cardiomyopathy, Hypertrophic ,Aorta ,Echocardiography, Doppler - Abstract
Previous studies revealed that hypertrophic cardiomyopathy (HCM) patients have impaired aortic elastic properties with contrasting data about aortic dimensions. We aimed to extend our knowledge about this topic, considering tissue Doppler imaging (TDI) and tissue strain.25 HCM patients and 25 healthy volunteers matched for age and sex were enrolled. They underwent transthoracic echocardiography to measure aortic dimensions at four levels (Valsalva sinuses, sinotubular junction, tubular tract, aortic arch), elastic properties (i.e., distensibility, stiffness, M-mode strain, tissue strain), and TDI aortic wall velocities (S', E', A' waves).Aortic dimensions differed between the two groups only at sinotubular junction (18 ± 6 vs. 15 ± 3 mm/m2; p = 0.039) and aortic arch levels (19 ± 5 vs. 11 ± 8 mm/m2; p0.001). Aortic stiffness was significantly higher among patients (16.4 ± 23.2 vs. 5.9 ± 3.4; p = 0.034), and TDI waves greater (S': 5.2 ± 1.9 vs. 8.0 ± 2.7 cm/s, p0.001; E': -5.3 ± 2.4 vs. -7.2 ± 2.7 cm/s, p = 0.012; A': -5.3 ± 1.6 vs. -8.6 ± 4.5 cm/s, p = 0.002). M-mode and tissue strains, and aortic distensibility did not reach statistical significance, although showing a tendency to altered values in the HCM group.Patients affected by HCM show a larger aorta and altered aortic elastic properties compared with healthy volunteers. These findings could help to investigate treatment response and prognosis of these alterations.
- Published
- 2014
49. A case of isolated left ventricle diverticulum
- Author
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A, D'Aloia, R, Rovetta, E, Vizzardi, I, Bonadei, E, Sciatti, and M, Metra
- Subjects
Letter ,cardiac diverticulum ,cardiac computer tomography ,echocardiography - Published
- 2014
50. Elastic properties of ascending aorta in women with previous pregnancy complicated by early- or late-onset pre-eclampsia
- Author
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R, Orabona, E, Sciatti, E, Vizzardi, I, Bonadei, A, Valcamonico, M, Metra, and T, Frusca
- Subjects
Blood Pressure ,Gestational Age ,Ultrasonography, Doppler ,Pulse Wave Analysis ,Echocardiography, Doppler ,Uterine Artery ,Vascular Stiffness ,Pre-Eclampsia ,Predictive Value of Tests ,Pregnancy ,Elasticity Imaging Techniques ,Humans ,Female ,Aorta ,Retrospective Studies - Abstract
To evaluate the elastic properties of the ascending aorta in women with a previous pregnancy complicated by early-onset (EO) or late-onset (LO) pre-eclampsia (PE) and the correlation with gestational age (GA), systolic/diastolic blood pressure (SBP/DBP) and mean uterine artery pulsatility index (UtA-PI) at diagnosis of the disease as well as with birth weight of the neonate.Thirty women who had a previous pregnancy complicated by EO-PE, 30 with a previous pregnancy complicated by LO-PE and 30 normal controls were selected retrospectively from our electronic database and then recalled for assessment from 6 months to 4 years after delivery. Data regarding GA, SBP/DBP and mean UtA-PI at the diagnosis of PE were obtained from medical records. At our assessment, aortic M-mode and tissue Doppler imaging (TDI) parameters were measured. Aortic diameters were assessed at end-diastole at four levels: Valsalva sinuses, sinotubular junction, tubular tract and aortic arch. Aortic compliance, distensibility, stiffness index (SI), Peterson's elastic modulus (EM), pulse-wave velocity and M-mode strain were calculated using standard formulae. Aortic expansion velocity, early and late diastolic retraction velocities and peak systolic tissue strain (TDI-ϵ) were determined.Aortic diameters at the four levels were significantly greater in both EO-PE and LO-PE groups than in controls. Aortic compliance and distensibility and TDI-ϵ were lower in EO-PE than in LO-PE (P = 0.001, P = 0.002 and P = 0.011, respectively) and controls (P = 0.037, P = 0.044 and P = 0.013, respectively). SI and EM were higher in EO-PE than in LO-PE (P = 0.001 and P 0.001, respectively) and than in controls (P = 0.035 and P = 0.036, respectively). Multivariate analysis showed GA, DBP and UtA-PI at diagnosis of PE to be independent predictors of aortic elastic properties.Elastic properties of the ascending aorta were altered in women with a previous pregnancy complicated by EO-PE, but not in those with LO-PE. Copyright © 2015 ISUOG. Published by John WileySons Ltd.
- Published
- 2014
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