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1. ISE/ISHNE Expert Consensus Statement on ECG Diagnosis of Left Ventricular Hypertrophy: The Change of the Paradigm. The joint paper of the International Society of Electrocardiology and the International Society for Holter Monitoring and Noninvasive Electrocardiology

Author

Bacharova, Ljuba, Chevalier, Philippe, Gorenek, Bulent, Jons, Christian, Li, Yi-Gang, Locati, Emanuela T., Maanja, Maren, Pérez-Riera, Andrés Ricardo, Platonov, Pyotr G., Ribeiro, Antonio Luiz P., Schocken, Douglas, Soliman, Elsayed Z., Svehlikova, Jana, Tereshchenko, Larisa G., Ugander, Martin, Varma, Niraj, Zaklyazminskaya, Elena, and Ikeda, Takanori

Published
2023
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6. Hypertrophic cardiomyopathy detection with artificial intelligence electrocardiography in international cohorts: an external validation study

Author

Siontis, Konstantinos C, primary, Wieczorek, Mikolaj A, additional, Maanja, Maren, additional, Hodge, David O, additional, Kim, Hyung-Kwan, additional, Lee, Hyun-Jung, additional, Lee, Heesun, additional, Lim, Jaehyun, additional, Park, Chan Soon, additional, Ariga, Rina, additional, Raman, Betty, additional, Mahmod, Masliza, additional, Watkins, Hugh, additional, Neubauer, Stefan, additional, Windecker, Stephan, additional, Siontis, George C M, additional, Gersh, Bernard J, additional, Ackerman, Michael J, additional, Attia, Zachi I, additional, Friedman, Paul A, additional, and Noseworthy, Peter A, additional

Published
2024
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10. ISE/ISHNE expert consensus statement on the ECG diagnosis of left ventricular hypertrophy: The change of the paradigm

Author

Bacharova, Ljuba, primary, Chevalier, Philippe, additional, Gorenek, Bulent, additional, Jons, Christian, additional, Li, Yi‐Gang, additional, Locati, Emanuela T., additional, Maanja, Maren, additional, Pérez‐Riera, Andrés Ricardo, additional, Platonov, Pyotr G., additional, Ribeiro, Antonio Luiz Pinho, additional, Schocken, Douglas, additional, Soliman, Elsayed Z., additional, Svehlikova, Jana, additional, Tereshchenko, Larisa G., additional, Ugander, Martin, additional, Varma, Niraj, additional, Elena, Zaklyazminskaya, additional, and Ikeda, Takanori, additional

Published
2023
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12. ISE/ISHNE expert consensus statement on the ECG diagnosis of left ventricular hypertrophy: The change of the paradigm.

Author

Bacharova, Ljuba, Chevalier, Philippe, Gorenek, Bulent, Jons, Christian, Li, Yi‐Gang, Locati, Emanuela T., Maanja, Maren, Pérez‐Riera, Andrés Ricardo, Platonov, Pyotr G., Ribeiro, Antonio Luiz Pinho, Schocken, Douglas, Soliman, Elsayed Z., Svehlikova, Jana, Tereshchenko, Larisa G., Ugander, Martin, Varma, Niraj, Elena, Zaklyazminskaya, and Ikeda, Takanori

Abstract

The ECG diagnosis of LVH is predominantly based on the QRS voltage criteria. The classical paradigm postulates that the increased left ventricular mass generates a stronger electrical field, increasing the leftward and posterior QRS forces, reflected in the augmented QRS amplitude. However, the low sensitivity of voltage criteria has been repeatedly documented. We discuss possible reasons for this shortcoming and proposal of a new paradigm. The theoretical background for voltage measured at the body surface is defined by the solid angle theorem, which relates the measured voltage to spatial and non‐spatial determinants. The spatial determinants are represented by the extent of the activation front and the distance of the recording electrodes. The non‐spatial determinants comprise electrical characteristics of the myocardium, which are comparatively neglected in the interpretation of the QRS patterns. Various clinical conditions are associated with LVH. These conditions produce considerable diversity of electrical properties alterations thereby modifying the resultant QRS patterns. The spectrum of QRS patterns observed in LVH patients is quite broad, including also left axis deviation, left anterior fascicular block, incomplete and complete left bundle branch blocks, Q waves, and fragmented QRS. Importantly, the QRS complex can be within normal limits. The new paradigm stresses the electrophysiological background in interpreting QRS changes, i.e., the effect of the non‐spatial determinants. This postulates that the role of ECG is not to estimate LV size in LVH, but to understand and decode the underlying electrical processes, which are crucial in relation to cardiovascular risk assessment. [ABSTRACT FROM AUTHOR]

Published
2024
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15. INVESTIGATING CAUSE OF DEATH IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY

Author

Farahani, Nasibeh Zanjirani, primary, Luceno, Lisvet, additional, Aguirre, Mateo Alzate, additional, Pumarejo, Andredi, additional, Maanja, Maren, additional, Enayati, Moein, additional, Siontis, Konstantinos, additional, Bos, Martijn, additional, Geske, Jeffrey Benjamin, additional, Ackerman, Michael John, additional, and Arruda-Olson, Adelaide Maria, additional

Published
2023
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16. Heart age gap estimated by explainable advanced electrocardiography is associated with cardiovascular risk factors and survival

Author

Lindow, Thomas, Maanja, Maren, Schelbert, Erik B., Horta Ribeiro, Antônio, Ribeiro, Antonio Luiz P., Schlegel, Todd T., Ugander, Martin, Lindow, Thomas, Maanja, Maren, Schelbert, Erik B., Horta Ribeiro, Antônio, Ribeiro, Antonio Luiz P., Schlegel, Todd T., and Ugander, Martin

Abstract

AimsDeep neural network artificial intelligence (DNN-AI)-based Heart Age estimations have been presented and used to show that the difference between an electrocardiogram (ECG)-estimated Heart Age and chronological age is associated with prognosis. An accurate ECG Heart Age, without DNNs, has been developed using explainable advanced ECG (A-ECG) methods. We aimed to evaluate the prognostic value of the explainable A-ECG Heart Age and compare its performance to a DNN-AI Heart Age.Methods and resultsBoth A-ECG and DNN-AI Heart Age were applied to patients who had undergone clinical cardiovascular magnetic resonance imaging. The association between A-ECG or DNN-AI Heart Age Gap and cardiovascular risk factors was evaluated using logistic regression. The association between Heart Age Gaps and death or heart failure (HF) hospitalization was evaluated using Cox regression adjusted for clinical covariates/comorbidities. Among patients [n = 731, 103 (14.1%) deaths, 52 (7.1%) HF hospitalizations, median (interquartile range) follow-up 5.7 (4.7-6.7) years], A-ECG Heart Age Gap was associated with risk factors and outcomes [unadjusted hazard ratio (HR) (95% confidence interval) (5 year increments): 1.23 (1.13-1.34) and adjusted HR 1.11 (1.01-1.22)]. DNN-AI Heart Age Gap was associated with risk factors and outcomes after adjustments [HR (5 year increments): 1.11 (1.01-1.21)], but not in unadjusted analyses [HR 1.00 (0.93-1.08)], making it less easily applicable in clinical practice.ConclusionA-ECG Heart Age Gap is associated with cardiovascular risk factors and HF hospitalization or death. Explainable A-ECG Heart Age Gap has the potential for improving clinical adoption and prognostic performance compared with existing DNN-AI-type methods. Graphical Abstract

Published
2023
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18. Diffuse myocardial fibrosis associates with incident ventricular arrhythmia in implantable cardioverter defibrillator recipients

Author

Olausson, Eric, primary, Wertz, Jonathon, additional, Fridman, Yaron, additional, Bering, Patrick, additional, Maanja, Maren, additional, Niklasson, Louise, additional, Wong, Timothy C, additional, Fukui, Miho, additional, Cavalcante, João L., additional, Cater, George, additional, Kellman, Peter, additional, Bukhari, Syed, additional, Miller, Christopher A., additional, Saba, Samir, additional, Ugander, Martin, additional, and Schelbert, Erik B., additional

Published
2023
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23. Advanced electrocardiography in myocardial electrical remodeling : insights from cardiovascular magnetic resonance imaging

Author

Maanja, Maren and Maanja, Maren

Abstract

The electrocardiogram (ECG) is a common diagnostic tool in cardiology thanks to its high accessibility and low cost. However, in several cardiovascular diagnoses, including left ventricular hypertrophy (LVH), current conventional ECG measures and criteria have a poor diagnostic performance. LVH is associated with hypertension and diabetes, but is often missed by the standard 12-lead ECG. LVH is typically diagnosed by non-invasive imaging methods. Cardiovascular magnetic resonance (CMR) is the gold standard for diagnosing LVH. Advanced-ECG (A-ECG) is a term used to describe a combination of advanced ECG analysis methods, and has been shown to be of diagnostic and prognostic utility. The aims of this thesis were to investigate the ability of A-ECG to diagnose LVH, using CMR as reference, as well as investigating the prognostic ability of A-ECG measures with regards to morbidity and mortality. We found that increased extracellular volume fraction by CMR reduces voltage measures of conventional ECG criteria for LVH, including the Sokolow-Lyon index and Cornell indices. This may explain the limited sensitivity of the ECG in detecting LVH. We further investigated different patterns of LVH based on the relation between increased mass and wall thickness, and found that the different patterns differ on their electrocardiographic manifestation by A- ECG. Furthermore, A-ECG had a higher diagnostic performance compared to conventional ECG LVH criteria. The ECG detects electrical changes, while LVH represents a structural change. Therefore, the electrical changes associated with LVH may be better referred to as left ventricular electrical remodeling (LVER). LVER, defined as the A-ECG measure spatial QRS-T angle exceeding the upper limit of normal, was found to have a higher accuracy in diagnosing LVH compared to conventional ECG LVH criteria. We also found that patients with LVER have a worse prognosis compared to patients without LVER. Lastly, we optimized a score based on ECG

Published
2020

24. Extracellular Volume and Global Longitudinal Strain Both Associate With Outcomes But Correlate Minimally

Author

Fröjdh, Fredrika, primary, Fridman, Yaron, additional, Bering, Patrick, additional, Sayeed, Aatif, additional, Maanja, Maren, additional, Niklasson, Louise, additional, Olausson, Eric, additional, Pi, Hongyang, additional, Azeem, Ali, additional, Wong, Timothy C., additional, Kellman, Peter, additional, Feingold, Brian, additional, Christopher, Adam, additional, Fukui, Miho, additional, Cavalcante, João L., additional, Miller, Christopher A., additional, Butler, Javed, additional, Ugander, Martin, additional, and Schelbert, Erik B., additional

Published
2020
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27. Extracellular Volume Associates With Outcomes More Strongly Than Native or Post-Contrast Myocardial T1

Author

Treibel, Thomas A., primary, Fridman, Yaron, additional, Bering, Patrick, additional, Sayeed, Aatif, additional, Maanja, Maren, additional, Frojdh, Fredrika, additional, Niklasson, Louise, additional, Olausson, Eric, additional, Wong, Timothy C., additional, Kellman, Peter, additional, Miller, Christopher A., additional, Moon, James C., additional, Ugander, Martin, additional, and Schelbert, Erik B., additional

Published
2020
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28. DISTINCT MYOCARDIAL DISEASE PATTERNS DETECTED ON FREE-BREATHING MOTION-CORRECTED LATE GADOLINIUM ENHANCEMENT ASSOCIATE WITH BASELINE DISEASE SEVERITY AND INCIDENT OUTCOMES IN A LARGE CLINICAL POPULATION

Author

Pi, Hongyang, primary, Fröjdh, Fredrika, additional, Olausson, Eric, additional, Sayeed, Aatif, additional, Maanja, Maren, additional, Niklasson, Louise, additional, Wong, Timothy C., additional, Ugander, Martin, additional, Xue, Hui, additional, Kellman, Peter, additional, and Schelbert, Erik, additional

Published
2019
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29. DIFFUSE MYOCARDIAL FIBROSIS MEASURED BY EXTRACELLULAR VOLUME ASSOCIATES WITH INCIDENT VENTRICULAR ARRHYTHMIA IN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR RECIPIENTS MORE THAN FOCAL FIBROSIS

Author

Olausson, Eric, primary, Fröjdh, Fredrika, additional, Maanja, Maren, additional, Niklasson, Louise, additional, Fridman, Yaron, additional, Bering, Patrick, additional, Wertz, Jonathan, additional, Wong, Timothy, additional, Kellman, Peter, additional, Miller, Chris, additional, Saba, Samir, additional, Ugander, Martin, additional, and Schelbert, Erik, additional

Published
2018
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30. Temporal Relation Between Myocardial Fibrosis and Heart Failure With Preserved Ejection Fraction

Author

Schelbert, Erik B., primary, Fridman, Yaron, additional, Wong, Timothy C., additional, Abu Daya, Hussein, additional, Piehler, Kayla M., additional, Kadakkal, Ajay, additional, Miller, Christopher A., additional, Ugander, Martin, additional, Maanja, Maren, additional, Kellman, Peter, additional, Shah, Dipan J., additional, Abebe, Kaleab Z., additional, Simon, Marc A., additional, Quarta, Giovanni, additional, Senni, Michele, additional, Butler, Javed, additional, Diez, Javier, additional, Redfield, Margaret M., additional, and Gheorghiade, Mihai, additional

Published
2017
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32. ORAL AB AGORA1362Cardiac Involvement in Patients With Different Rheumatic Disorders1366Gender differences in the development of cardiac complications: a multicentric prospective study in a large cohort of thalassemia major patients1646Comparison of T1-mapping, T2-weighted and contrast-enhanced cine imaging at 3.0T CMR for diagnostic oedema assessment in ST-segment elevation myocardial infarction1375Evaluation of Tissue Changes in Remote Noninfarcted Myocardium after Acute Myocardial Infarction using T1-mapping1377Right ventricular long axis strain – The prognostic value of a novel parameter in non-ischemic dilated cardiomyopathy using standard cardiac magnetic resonance imaging1389The role of the right ventricular insertion point in heart failure patients with preserved ejection fraction: Insights from a cardiovascular magnetic resonance study1398Myocardial fibrosis associates with B-type natriuretic peptide levels and outcomes more than wall stress1478Prognostic Value of Pulmonary Blood Volume by Contrast-Enhanced Magnetic Resonance Imaging in Heart Failure Outpatients – The PROVE-HF Study1370Magnetic Resonance Adenosine Perfusion Imaging as Gatekeeper of Invasive Coronary1509Influence of non-invasive hemodynamic CMR parameters on maximal exercise capacity in surgically untreated patients with Ebstein's anomaly1356Proximal aortic stiffening in Turner patients is more pronounced in the presence of a bicuspid valve. A segmental functional MRI study1503Flow pattern and vascular distensibility of the pulmonary arteries in patients after repair of tetralogy of Fallot. Insights from 4D flow CMR1516Myocardial deformation characteristics of the systemic right ventricle after atrial switch operation for transposition of the great arteries1633Three-dimensional vortex formation in patients with a Fontan circulation: evaluation with 4D flow CMR1483Mitral valve prolapse: arrhythmogenic substrates by cardiac magnetic imaging1596Increased local wall shear stress after coarctation repair is associated with descending aorta pulse wave velocity: evaluation with CMR and 4D flow1636Three-dimensional wall shear stress assessed by 4Dflow CMR in bicuspid aortic valve disease1464Cardiac Amyloidosis and Aortic Stenosis – The Convergence of Two Aging Processes1630Blood T1 variability explained in healthy volunteers: an analysis on MOLLI, ShMOLLI and SASHA1408Myocardial deformation on CMR predicts adverse outcomes in carcinoid heart disease - a new marker of risk1492Myocardial Perfusion Reserve and Global Longitudinal Strain in Early Rheumatoid Arthritis1500Exercise CMR to differentiate athlete's heart from patients with early dilated cardiomyopathy1559Real-Time, x-mri guidance to optimise left ventricular lead placement for delivery of cardiac resynchronisation therapy1560The role of Cardiac magnetic resonance imaging in patients undergoing ablation for ventricular tachycardia- Defining the substrate and visualizing the outcome1590Impact of cardiovascular magnetic resonance on clinical management and decision-making of out of hospital cardiac arrest survivors with inconclusive coronary angiogram1561Detection of coronary stenosis at rest using Oxygenation-Sensitive Magnetic Resonance Imaging

Author

Greulich, S., primary, Meloni, A., primary, Nazir, Sheraz A., primary, Stefan Biesbroek, P., primary, Arenja, Nisha, primary, Kammerlander, Andreas A., primary, Sayeed, Aatif, primary, Ricci, F., primary, Bernhardt, Peter, primary, Meierhofer, Christian, primary, Devos, Daniel G.H., primary, Ruecker, Beate, primary, Burkhardt, B.E.U., primary, Kamphuis, Vivian P., primary, De Lazzari, Manuel, primary, Nederend, I., primary, Dux-Santoy, Lydia, primary, Cavalcante, João L., primary, Rosmini, Stefania, primary, Liu, B., primary, Fent, G.J., primary, Claessen, G., primary, Behar, Jonathan, primary, Oebel, S., primary, Baritussio, A., primary, Ranjit Arnold, J., primary, Kitterer, D., additional, Latus, J., additional, Henes, J., additional, Kurmann, R., additional, Gloekler, S., additional, Wahl, A., additional, Buss, S., additional, Katus, H., additional, Bobbo, M., additional, Lombardi, M., additional, Braun, N., additional, Alscher, M.D., additional, Sechtem, U., additional, Mahrholdt, H., additional, Neri, M.G., additional, Preziosi, P., additional, Grassedonio, E., additional, Schicchi, N., additional, Keilberg, P., additional, Pulini, S., additional, Facchini, E., additional, Positano, V., additional, Pepe, A., additional, Shetye, Abhishek, additional, Khan, Jamal N., additional, Singh, Anvesha, additional, Kanagala, Prathap, additional, Swarbrick, Daniel, additional, Gulsin, Gaurav, additional, Graham-Brown, Matthew, additional, Squire, Iain, additional, Gershlick, Anthony, additional, McCann, Gerry P., additional, Amier, Raquel P., additional, Teunissen, Paul F.A., additional, Robbers, Lourens F.H.J., additional, Beek, Aernout M., additional, van Rossum, Albert C., additional, Hofman, Mark B.M., additional, van Royen, Niels, additional, Nijveldt, Robin, additional, Riffel, Johannes H, additional, Djiokou, Charly Noel, additional, Andre, Florian, additional, Fritz, Thomas, additional, Halder, Manuel, additional, Thomas, Zelniker, additional, Korosoglou, Grigorios, additional, Katus, Hugo A, additional, Buss, Sebastian J, additional, Schwaiger, Marianne L., additional, Duca, Franz, additional, Aschauer, Stefan, additional, Marzluf, Beatrice A., additional, Zotter-Tufaro, Caroline, additional, Dalos, Daniel, additional, Pfaffenberger, Stefan, additional, Bonderman, Diana, additional, Mascherbauer, Julia, additional, Fridman, Yaron, additional, Hackman, Brianne, additional, Kadakkal, Ajay, additional, Maanja, Maren, additional, Daya, Hussein Abu, additional, Wong, Timothy C., additional, Schelbert, Erik B., additional, Barison, A., additional, Todiere, G., additional, Gaeta, R., additional, Galllina, S., additional, Emdin, M., additional, De Caterina, R., additional, Aquaro, G.D., additional, Buckert, Dominik, additional, Dyckmanns, Nils, additional, Rottbauer, Wolfgang, additional, Kühn, Andreas, additional, Shehu, Nerejda, additional, Müller, Jan, additional, Stern, Heiko, additional, Ewert, Peter, additional, Fratz, Sohrab, additional, Vogt, Manfred, additional, De Groote, Katya, additional, Babin, Danilo, additional, Demulier, Laurent, additional, Taeymans, Yves, additional, Westenberg, Jos J., additional, Van Bortel, Luc, additional, Segers, Patrick, additional, Achten, Eric, additional, De Schepper, Jean, additional, Rietzschel, Ernst, additional, Geiger, Julia, additional, Makki, Malek, additional, Burkhardt, Barbara, additional, Kellenberger, Christian J., additional, Buechel, Emanuela R. Valsangiacomo, additional, Kellenberger, C.J., additional, Geiger, J., additional, Ruecker, B., additional, Buechel, E.R. Valsangiacomo, additional, Elbaz, Mohammed S.M., additional, Kroft, Lucia J.M., additional, van der Geest, Rob J., additional, de Roos, Albert, additional, Blom, Nico A., additional, Westenberg, Jos J.M., additional, Roest, Arno A.W., additional, Cipriani, Alberto, additional, Susana, Angela, additional, Rizzo, Stefania, additional, Giorgi, Benedetta, additional, Carmelo, Lacognata, additional, Bertaglia, Emanuele, additional, Bauce, Barbara, additional, Corrado, Domenico, additional, Thiene, Gaetano, additional, Marra, Martina Perazzolo, additional, Basso, Cristina, additional, Iliceto, Sabino, additional, Roest, A.A.W., additional, van den Boogaard, P.J., additional, ten Harkel, A.D.J., additional, de Geus, J.C.N., additional, Kroft, L.J.M., additional, de Roos, A., additional, Westenberg, J.J.M., additional, Kale, Raquel, additional, Teixido-Tura, Gisela, additional, Maldonado, Giuliana, additional, Huguet, Marina, additional, Garcia-Dorado, David, additional, Evangelista, Artur, additional, Rodriguez-Palomares, Jose, additional, Rijal, Shasank, additional, Schindler, John T., additional, Gleason, Thomas G., additional, Lee, Joon S., additional, Bulluck, Heerajnarain, additional, Treibel, Thomas A, additional, Bhuva, Anish, additional, Abdel-Gadir, Amna, additional, Culotta, Veronica, additional, Merghani, Ahmed, additional, Maestrini, Viviana, additional, Herrey, Anna S, additional, Kellman, Peter, additional, Manisty, Charlotte, additional, Moon, James C, additional, Hayer, M.K., additional, Baig, S., additional, Shah, T., additional, Rooney, S.J., additional, Edwards, N.C., additional, Steeds, R.P., additional, Garg, P., additional, Swoboda, P., additional, Dobson, L.E., additional, Musa, T.A., additional, Foley, J.F., additional, Haaf, P., additional, Greenwood, J.P., additional, Plein, S., additional, Schnell, F., additional, Bogaert, J., additional, Dymarkowski, S., additional, Pattyn, N., additional, Claus, P., additional, Van Cleemput, J., additional, Gerche, A. La, additional, Heidbuchel, H., additional, Toth, Daniel, additional, Reiml, Sabrina, additional, Panayiotou, Maria, additional, Claridge, Simon, additional, Jackson, Tom, additional, Sohal, Manav, additional, Webb, Jessica, additional, O'Neill, Mark, additional, Brost, Alexander, additional, Mountney, Peter, additional, Razavi, Reza, additional, Rhode, Kawal, additional, Rinaldi, Christopher Aldo, additional, Arya, A., additional, Hilbert, S., additional, Bollmann, A., additional, Hindricks, G., additional, Jahnke, C., additional, Paetsch, I., additional, Dinov, B., additional, Perazzolo Marra, M., additional, Ghosh Dastidar, A., additional, Rodrigues, J., additional, Zorzi, A., additional, Susana, A., additional, Scatteia, A., additional, De Garate, E., additional, Mattesi, G., additional, Strange, J., additional, Corrado, D., additional, Bucciarelli-Ducci, C., additional, Jerosch-Herold, Michael, additional, Karamitsos, Theodoros D., additional, Francis, Jane M., additional, Bhamra-Ariza, Paul, additional, Sarwar, Rizwan, additional, Choudhury, Robin, additional, Selvanayagam, Joseph B., additional, and Neubauer, Stefan, additional

Published
2016
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33. BEST ORAL ABSTRACTS1575Extracellular volume associates with outcomes more strongly than native or post-contrast myocardial T11507Cardiac Magnetic Resonance measured Extracellular Volume Independently Predicts Adverse Outcome in Heart Failure with Preserved Ejection Fraction1457Cardiac MRI Under Percussive Ventilation: A New Promising Technique1644Histological Validation of Cardiac Magnetic Resonance for the Evaluation of Myocardial Fibrosis after Heart Transplantation in Children1493First Pass Perfusion Reserve Index in Paediatric Patients with Arterial Switch for Transposition of Great Arteries1652Myocardial Fibrosis is Prevalent in Obstructive Sleep Apnea and Associated with Hospitalization for Heart Failure or Death

Author

Treibel, Thomas A., primary, Duca, Franz, primary, Schwitter, Juerg, primary, Ide, Seiko, primary, Sandrini, C., primary, Fridman, Yaron, primary, Fridman, Yaron, additional, Hackman, Brianne, additional, Kadakkal, Ajay, additional, Sayeed, Aatif, additional, Maanja, Maren, additional, Daya, Hussein Abu, additional, Moon, James C., additional, Wong, Timothy C., additional, Schelbert, Erik B., additional, Kammerlander, Andreas A., additional, Zotter-Tufaro, Caroline, additional, Aschauer, Stefan, additional, Bonderman, Diana, additional, Mascherbauer, Julia, additional, Beigelman-Aubry, Catherine, additional, Peguret, Nicolas, additional, Stuber, Matthias, additional, Delacoste, Jean, additional, Belmondo, Bastien, additional, Lovis, Alban, additional, Simons, Julien, additional, Long, Olivier, additional, Grant, Kathleen, additional, Berchier, Gregoire, additional, Rohner, Chantal, additional, Bonanno, Gabriele, additional, Coppo, Simone, additional, Ozsahin, Esat-Mahmut, additional, Qanadli, Salah, additional, Meuli, Reto, additional, Bourhis, Jean, additional, Riesenkampff, Eugenie, additional, Chiasson, David, additional, Dipchand, Anne I., additional, Kantor, Paul F., additional, Chaturvedi, Rajiv R., additional, Yoo, Shi-Joon, additional, Grosse-Wortmann, Lars, additional, Aquaro, GD, additional, De Marchi, D, additional, Ait Ali, L, additional, Khraiche, D, additional, Boddaert, N, additional, Bonnet, D, additional, Raimondi, F, additional, and Hackman, Brianne E., additional

Published
2016
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34. Abstracts

Author

Treibel, Thomas A., Fridman, Yaron, Hackman, Brianne, Kadakkal, Ajay, Sayeed, Aatif, Maanja, Maren, Daya, Hussein Abu, Moon, James C., Wong, Timothy C., Schelbert, Erik B., Duca, Franz, Kammerlander, Andreas A., Zotter-Tufaro, Caroline, Aschauer, Stefan, Bonderman, Diana, Mascherbauer, Julia, Schwitter, Juerg, Beigelman-Aubry, Catherine, Peguret, Nicolas, Stuber, Matthias, Delacoste, Jean, Belmondo, Bastien, Lovis, Alban, Simons, Julien, Long, Olivier, Grant, Kathleen, Berchier, Gregoire, Rohner, Chantal, Bonanno, Gabriele, Coppo, Simone, Ozsahin, Esat-Mahmut, Qanadli, Salah, Meuli, Reto, Bourhis, Jean, Ide, Seiko, Riesenkampff, Eugenie, Chiasson, David, Dipchand, Anne I., Kantor, Paul F., Chaturvedi, Rajiv R., Yoo, Shi-Joon, Grosse-Wortmann, Lars, Sandrini, C., Aquaro, GD, De Marchi, D, Ait Ali, L, Khraiche, D, Boddaert, N, Bonnet, D, Raimondi, F, Fridman, Yaron, Hackman, Brianne E., Kadakkal, Ajay, Daya, Hussein Abu, Wong, Timothy C., Schelbert, Erik B., Angela, Susana, Alberto, Cipriani, Manuel, De Lazzari, Federico, Marin, Francesca, Prevedello, Bendetta, Giorgi, Giorgio, De Conti, Giuseppe, Tarantini, Luisa, Cacciavillani, Emanuele, Bertaglia, Domenico, Corrado, Sabino, Iliceto, Martina, Perazzolo Marra, Camaioni, Claudia, Morlon, Lucas, Vergé, Marie-Philippe, Jais, Pierre, Roudaut, Raymond, Laurent, Francois, Lafitte, Stéphane, Cochet, Hubert, Réant, Patricia, Bohnen, S., Radunski, U. K., Lund, G. K., Senel, M., Avanesov, M., Tahir, E., Stehning, C., Adam, G., Blankenberg, S., Muellerleile, K., Khanji, Mohammed Y., Balawon, Armida, Boubertakh, Redha, Petersen, Steffen E, Hilbert, Sebastian, Spampinato, Ricardo, Oebel, Sabrina, Hindricks, Gerhard, Bollmann, Andreas, Jahnke, Cosima, Paetsch, Ingo, Goetschalckx, K., Bogaert, J., Desmet, W., Toth, A., Merkely, B., Janssens, S., Claus, P., Calvieri, C., Preda, M. B., Perfetti, A., Valaperta, R., Secchi, F., Fedele, F., Martelli, F., Lombardi, M., Reinstadler, Sebastian J., Eitel, Charlotte, Fuernau, Georg, de Waha, Suzanne, Desch, Steffen, Mende, Meinhard, Metzler, Bernhard, Schuler, Gerhard, Thiele, Holger, Eitel, Ingo, Maestrini, Viviana, Mun, Hong Cheang, Kotwinski, Paul, Rosmini, Stefania, Sanders, Julie, Lloyd, Guy, Dudley, J. Pennell, Kellman, Peter, Hugh, E. Montgomery, Manisty, Charlotte, James, C. Moon, James, S., Waterhouse, D.F., Murphy, T.M., Kenny, C., O'Hanlon, R., Bastiaenen, Rachel, Cox, Andrew T., Wijeyeratne, Yanushi, Colbeck, Nicholas, Pakroo, Nadia, Ahmed, Hammad, Bunce, Nick, Anderson, Lisa, Prasad, Sanjay, Sharma, Sanjay, Behr, Elijah R., Reid, A. B., Miller, C., Jovanovic, A., Woolfson, P., Abidin, N., Schmitt, M., Amadu, A.M., Rodrigues, J.C.L., Dastidar, A. Ghosh, Baritussio, A., Lawton, C., Venuti, G., Meloni, G.B., Conti, M., Bucciarelli-Ducci, C., Pontone, Gianluca, Andreini, Daniele, SoLbiati, Anna, Guglielmo, Marco, Mushtaq, Saima, Baggiano, Andrea, Beltrama, Virginia, Rota, Cristina, Guaricci, Andrea I., Pepi, Mauro, Wang, Yufei, Joannic, David, Juillion, Patrick, Delassus, P., Monnet, Aurélien, Lalande, Alain, Fontaine, Jean-Francois, Zweerink, A, Allaart, CP, Wu, L, Kuijer, JPA, Beek, AM, Croisille, P, Clarysse, P, van Rossum, AC, Nijveldt, R, Bulluck, Heerajnarain, Rosmini, Stefania, Abdel-Gadir, Amna, Bhuva, Anish, Treibel, Thomas A, White, Steven K, Hammond-Haley, Matthew, Sirker, Alex, Herrey, Anna, Manisty, Charlotte, Yellon, Derek M, Kellman, Peter, Moon, James C, Hausenloy, Derek J, Garg, P., Hassell, M, Foley, J., Ripley, D.P., Dobson, L., Swoboda, P.P., Fent, G., Musa, T.A., Erhayiem, B., Haaf, P., Greenwood, J.P., Nijveldt, R., Westenberg, J.J.M., Geest, R.J.V.D., Plein, S., Rodrigues, Jonathan C L, Amadu, Antonio Matteo, Dastidar, Amardeep Ghosh, Szantho, Gergley, Lyen, Stephen, Godsave, Cattleya, Ratcliffe, Laura E K, Burchell, Amy E, Hart, Emma C, Hamilton, Mark C K, Nightingale, Angus K, Paton, Julian F R, Manghat, Nathan E, Bucciarelli-Ducci, Chiara, Hafyane, Tarik, Teixeira, Tiago, Greiser, Andreas, Mongeon, Francois Pierre, Haifa, Almutairi, Mohammed, Khanji, Redha, Boubertakh, Marc, Miquel, Steffen, Petersen, Greulich, S., Kitterer, D., Latus, J., Henes, J., Kurmann, R., Gloekler, S., Wahl, A., Buss, S., Katus, H., Bobbo, M., Lombardi, M., Braun, N., Alscher, M.D., Sechtem, U., Mahrholdt, H., Meloni, A., Neri, M.G., Preziosi, P., Grassedonio, E., Schicchi, N., Keilberg, P., Pulini, S., Facchini, E., Positano, V., Pepe, A., Nazir, Sheraz A., Shetye, Abhishek, Khan, Jamal N., Singh, Anvesha, Kanagala, Prathap, Swarbrick, Daniel, Gulsin, Gaurav, Graham-Brown, Matthew, Squire, Iain, Gershlick, Anthony, McCann, Gerry P., Stefan Biesbroek, P., Amier, Raquel P., Teunissen, Paul F.A., Robbers, Lourens F.H.J., Beek, Aernout M., van Rossum, Albert C., Hofman, Mark B.M., van Royen, Niels, Nijveldt, Robin, Arenja, Nisha, Riffel, Johannes H, Djiokou, Charly Noel, Andre, Florian, Fritz, Thomas, Halder, Manuel, Thomas, Zelniker, Korosoglou, Grigorios, Katus, Hugo A, Buss, Sebastian J, Kammerlander, Andreas A., Schwaiger, Marianne L., Duca, Franz, Aschauer, Stefan, Marzluf, Beatrice A., Zotter-Tufaro, Caroline, Dalos, Daniel, Pfaffenberger, Stefan, Bonderman, Diana, Mascherbauer, Julia, Sayeed, Aatif, Fridman, Yaron, Hackman, Brianne, Kadakkal, Ajay, Maanja, Maren, Daya, Hussein Abu, Wong, Timothy C., Schelbert, Erik B., Ricci, F., Barison, A., Todiere, G., Gaeta, R., Galllina, S., Emdin, M., De Caterina, R., Aquaro, G.D., Bernhardt, Peter, Buckert, Dominik, Dyckmanns, Nils, Rottbauer, Wolfgang, Meierhofer, Christian, Kühn, Andreas, Shehu, Nerejda, Müller, Jan, Stern, Heiko, Ewert, Peter, Fratz, Sohrab, Vogt, Manfred, Devos, Daniel G.H., De Groote, Katya, Babin, Danilo, Demulier, Laurent, Taeymans, Yves, Westenberg, Jos J., Van Bortel, Luc, Segers, Patrick, Achten, Eric, De Schepper, Jean, Rietzschel, Ernst, Ruecker, Beate, Geiger, Julia, Makki, Malek, Burkhardt, Barbara, Kellenberger, Christian J., Buechel, Emanuela R. Valsangiacomo, Burkhardt, B.E.U., Kellenberger, C.J., Geiger, J., Ruecker, B., Buechel, E.R. Valsangiacomo, Kamphuis, Vivian P., Elbaz, Mohammed S.M., Kroft, Lucia J.M., van der Geest, Rob J., de Roos, Albert, Blom, Nico A., Westenberg, Jos J.M., Roest, Arno A.W., De Lazzari, Manuel, Cipriani, Alberto, Susana, Angela, Rizzo, Stefania, Giorgi, Benedetta, Carmelo, Lacognata, Bertaglia, Emanuele, Bauce, Barbara, Corrado, Domenico, Thiene, Gaetano, Marra, Martina Perazzolo, Basso, Cristina, Iliceto, Sabino, Nederend, I., Roest, A.A.W., van den Boogaard, P.J., ten Harkel, A.D.J., de Geus, J.C.N., Kroft, L.J.M., de Roos, A., Westenberg, J.J.M., Dux-Santoy, Lydia, Kale, Raquel, Teixido-Tura, Gisela, Maldonado, Giuliana, Huguet, Marina, Garcia-Dorado, David, Evangelista, Artur, Rodriguez-Palomares, Jose, Cavalcante, João L., Rijal, Shasank, Schindler, John T., Gleason, Thomas G., Lee, Joon S., Schelbert, Erik B., Rosmini, Stefania, Bulluck, Heerajnarain, Treibel, Thomas A, Bhuva, Anish, Abdel-Gadir, Amna, Culotta, Veronica, Merghani, Ahmed, Maestrini, Viviana, Herrey, Anna S, Kellman, Peter, Manisty, Charlotte, Moon, James C, Liu, B., Hayer, M.K., Baig, S., Shah, T., Rooney, S.J., Edwards, N.C., Steeds, R.P., Fent, G.J., Garg, P., Swoboda, P., Dobson, L.E., Musa, T.A., Foley, J.F., Haaf, P., Greenwood, J.P., Plein, S., Claessen, G., Schnell, F., Bogaert, J., Dymarkowski, S., Pattyn, N., Claus, P., Van Cleemput, J., Gerche, A. La, Heidbuchel, H., Behar, Jonathan, Toth, Daniel, Reiml, Sabrina, Panayiotou, Maria, Claridge, Simon, Jackson, Tom, Sohal, Manav, Webb, Jessica, O'Neill, Mark, Brost, Alexander, Mountney, Peter, Razavi, Reza, Rhode, Kawal, Rinaldi, Christopher Aldo, Oebel, S., Arya, A., Hilbert, S., Bollmann, A., Hindricks, G., Jahnke, C., Paetsch, I., Dinov, B., Baritussio, A., Perazzolo Marra, M., Ghosh Dastidar, A., Rodrigues, J., Zorzi, A., Susana, A., Scatteia, A., De Garate, E., Mattesi, G., Strange, J., Corrado, D., Bucciarelli-Ducci, C., Ranjit Arnold, J., Jerosch-Herold, Michael, Karamitsos, Theodoros D., Francis, Jane M., Bhamra-Ariza, Paul, Sarwar, Rizwan, Choudhury, Robin, Selvanayagam, Joseph B., Neubauer, Stefan, Tayal, Upasana, Scott, Andrew D, Wage, Rick, Ferreira, Pedro, Pennell, Dudley, Zhong, Xiaodong, Epstein, Fred, Firmin, David, Prasad, Sanjay, Kallifatidis, Alexandros, Prousalis, Anastasios, Mouratoglou, Sophia-Anastasia, Giannakoulas, George, Deligianni, Xenia, Bakaloudis, Michail, Magganaris, Nikolaos, Sianos, George, Karvounis, Haralampos, Santini, Francesco, Garg, P., Aziz, R., Foley, J.R.J., Fent, G., Musa, T.A., Haaf, P., Dobson, L., Swoboda, P.P., Greenwood, J.P., Plein, S., Geest, R.J.V.D., Westenberg, J.J.M., Beitzke, D., Rasul, S., Wadsak, W., Mitterhauser, M., Nolz, R., Stelzmueller, M., Loewe, C., Hacker, M., Funk, Stephanie, Kermer, Josephine, Dogangüzel, Serkan, von Knobelsdorff-Brenkenhoff, Florian, Schulz-Menger, Jeanette, Kolker, Shimon, Weisz, Giora, Bogot, Naama, Halpern, Irit Hadas, Wolak, Arik, Rutz, Tobias, Ginami, Giulia, Piccini, Davide, Coppo, Simone, Vincenti, Gabriella, Stuber, Matthias, Schwitter, Jürg, Safdar, Komal S, Gao, Xuexin, Ambach, Stephanie, Taylor, Michal D, Moore, Ryan, Taylor, Robin J, Toro-Salazar, Olga, Jeffries, John L, Bartone, Cheryl, Raman, Subha V, Mazur, Wojciech, Valente, F., Rodriguez-Palomares, J.F., Gutierrez, L., Pineda, V., Agliano, B., Galian, L., Teixido, G., Gonzalez-Alujas, M.T., Evangelista, A., Garcia-Dorado, D., Murdoch, R., Gandy, S., Nicholas, R., Houston, G., Martin, P., Muir, J., Matthew, S., Ramkumar, P. Guntur-, Cavin, I., Macaione, F., Barison, A., Pescetelli, I., Pali, F., Pizzino, F., Terrizzi, A., Di Lisi, D., Novo, G., Todiere, G., Assennato, P., Novo, S., Aquaro, G.D., Dastidar, Amardeep Ghosh, McAlindon, Elisa, Rodrigues, Jonathan, Baritussio, Anna, Scatteia, Alessandra, De Garate, Estefania, Benny Lawton, Chris, Erdei, Tamas, Szantho, Gergely, Hamilton, Mark, Bucciarelli-Ducci, Chiara, Pontone, Gianluca, Andreini, Daniele, Rota, Cristina, Guglielmo, Marco, Mushtaq, Saima, Baggiano, Andrea, Beltrama, Virginia, Solbiati, Anna, Guaricci, Andrea I., Pepi, Mauro, Grigoratos, Chrysanthos, Bratis, Konstantinos, Henningson, Markus, Dell'Omodarme, Matteo, Puntmann, Valentina O., Nagel, Eike, Meloni, Antonella, Giunta, Nicola, Giuliano, Pietro, Neri, Maria Giovanna, Restaino, Gennaro, Renne, Stefania, Quota, Alessandra, Positano, Vincenzo, De Marchi, Daniele, Pepe, Alessia, Pedrotti, Patrizia, Campadello, Paola, Masciocco, Gabriella, Facchetti, Rita, Milazzo, Angela, Quattrocchi, Giuseppina, Giannattasio, Cristina, Frigerio, Maria, Roghi, Alberto, Rimoldi, Ornella, De Garate, Estefania, Ghosh Dastidar, Amardeep, Baritussio, Anna, Scatteia, Alessandra, Amadu, Antonio, Venuti, Giuseppe, Rodrigues, Jonathan C., Bucciarelli-Ducci, Chiara, Careri, Giulia, Castelvecchio, Serenella, Camporeale, Antonia, Secchi, Francesco, Menicanti, Lorenzo, Lombardi, Massimo, Kockova, R., Sedlacek, K., Wichterle, D., Sikula, V., Tintera, J., Sukupova, L., Kautznerova, D., Segetova, M., Praveckova, A., Langova, R., Kryze, L., El-Husseini, W., Kautzner, J., Oebel, S., Dinov, B., Arya, A., Hilbert, S., Sommer, P., Bollmann, A., Hindricks, G., Paetsch, I., Jahnke, C., Nazir, Sheraz A., Greenwood, John P., Shetye, Abhishek, Khan, Jamal N., Singh, Anvesha, Kanagala, Prathap, Swarbrick, Daniel, Gulsin, Gaurav, Graham-Brown, Matthew, Gershlick, Anthony, McCann, Gerry P., Grigoratos, Chrysanthos, Liga, Riccardo, Bennatti, Elena, Barison, Andrea, Todiere, Giancarlo, Aquaro, Giovanni Donato, Dell'Omodarme, Matteo, Lombardi, Massimo, Emdin, Michele, Masci, Pier Giorgio, Barison, A, Ortalda, A, Todiere, G, Grigoratos, C, Vergaro, G, Mirizzi, G, Martini, N, De Marchi, D, Keilberg, P, Passino, C, Aquaro, GD, Emdin, M, Swoboda, Peter P, McDiarmid, Adam K, Erhayiem, Bara, Fent, Graham J, Dobson, Laura E, Garg, Pankaj, Musa, Tarique A, Foley, James R, Page, Stephen P, Greenwood, John P, Plein, Sven, Bulluck, Heerajnarain, Rosmini, Stefania, Abdel-Gadir, Amna, Bhuva, Anish, Treibel, Thomas A, White, Steven K, Fontana, Marianna, Ramlall, Manish, Hamarneh, Ashraf, Sirker, Alex, Herrey, Anna, Manisty, Charlotte, Yellon, Derek M, Kellman, Peter, Moon, James C, Hausenloy, Derek J, Broncano, J., Luna, A., Noguerol, T. Martin –, Caro, P., Toro-Cebada, R., Gonzalez, J. Sanchez –, Desroche, L.M., Milleron, O., Safar, B., Lavie-Badie, Y., Millischer, D., Abtan, J., Jondeau, G., Bermejo, Zorba Blázquez, Cuesta, Emilio, Rosillo, Sandra O., Guzmán, Gabriela, Pinilla, Inmaculada, González, Óscar, Caro, Juan, Ponz, Inés, López, Teresa, Refoyo, Elena, Kozor, Rebecca, Nordin, Sabrina, Treibel, Thomas A, Rosmini, Stefania, Castelleti, Silvia, Fontana, Marianna, Captur, Gabriella, Steeds, Rick, Baig, Shanat, Manisty, Charlotte, Grieve, Stuart M, Figtree, Gemma A, Moon, James C, Dastidar, Amardeep Ghosh, Rodrigues, Jonathan, De Garate, Estefania, Singhal, Priyanka, McAlindon, Elisa, Baritussio, Anna, Scatteia, Alessandra, Erdei, Tamas, Strange, Julian, Nightingale, Angus, Baumbach, Andreas, Johnson, Tom, Delgado, Victoria, Bucciarelli-Ducci, Chiara, Lapinskas, Tomas, Bucius, Paulius, Fedaravicius, Augustinas P., Urbonaite, Laura, Stabinskaite, Agnieta, Zaliunas, Remigijus, Elisabetta, Chiodi, Teresa, Cannizzaro Maria, Daniele, De Falco Alfano, Righi, Riccardo, Zerbini, Michela, Vincenzo, Positano, Cittanti, Corrado, Giganti, Melchiore, Giorgio, Benea, Grigoratos, Chrysanthos, Genovesi, Dario, Giorgetti, Assuero, Chiappino, Sara, Barison, Andrea, Vergaro, Giuseppe, Todiere, Giancarlo, Emdin, Michele, Marzullo, Paolo, Aquaro, Giovanni Donato, Ladeiras-Lopes, Ricardo, Turin-Moreira, Henrique, Bettencourt, Nuno, Fontes-Carvalho, Ricardo, Sampaio, Francisco, Ambale-Venkatesh, Bharath, Wu, Colin, Liu, Kiang, Bertoni, Alain, Ouyang, Pamela, Bluemke, David, Lima, João, Fent, GJ., Garg, P., Dobson, LE., Musa, TA., Foley, JF., Haaf, P., Greenwood, JP., Plein, S., Swoboda, PP., Abdul Rahman, E., Ismail, JR., Najme Khir, R., Lim, CW., Chua, N., Ibrahim, ZO., Zainal Abidin, HA., Mohd Arshad, MK., Kasim, SS., Rodrigues, Jonathan, Rooms, Ben, Hyde, Katie, Rohan, Stephen, Dastidar, Amardeep Ghosh, Hamilton, Mark, Bucciarelli-Ducci, Chiara, Nightingale, Angus, Paton, Julian, Manghat, Nathan, MacIver, David, Gibelli, Giuseppe, Demolli, Walter, Russo, Alessandra, Minoia, Chiara, Biasi, Salvatore, Mkrtchyan, Naira, Eltschkner, Christin, Christian, Meierhofer, Ewert, Peter, Martinoff, Stefan, Stern, Heiko, Fratz, Sohrab, Valinoti, Maddalena, Fabbri, Claudio, Mantovan, Roberto, Severi, Stefano, Corsi, Cristiana, Nyktari, E., Vassiliou, V., Arzanauskaite, M., Izgi, C., Lam, W., Prasad, S., Reindl, Martin, Reinstadler, Sebastian Johannes, Feistritzer, Hans-Josef, Klug, Gert, Mair, Johannes, Mayr, Agnes, Jaschke, Werner, Franz, Wolfgang-Michael, Metzler, Bernhard, Arnhold, K., Muehlberg, F., Fritschi, S., Funk, S., Prothmann, M., von Knobelsdorff-Brenkenhoff, F., Schulz-Menger, J., Lakhani, Zeeshan S. A., Mohan, B., karthik, G A., Raj, Vimal, Weir-McCall, Jonathan, Cassidy, Deirdre B, Belch, Jill JF, Gandy, Stephen J, Houston, Graeme, Lambert, Matthew A, Littleford, Roberta, Rowland, Janice, Struthers, Allan D, Khan, Faisel, Camaioni, Claudia, Salel, Marjorie, Hennig, Alexia, Corneloup, Olivier, Montaudon, Michel, Laurent, Francois, Cochet, Hubert, Kan, Rachel, Erhayiem, Bara, McDiarmid, Adam K., Garg, Pankaj, Dobson, Laura E., Musa, Tarique A., Ripley, David, Ajjan, Ramzi, Greenwood, John P., Plein, Sven, Swoboda, Peter P., Reinstadler, Sebastian J., Fuernau, Georg, Eitel, Charlotte, de Waha, Suzanne, Desch, Steffen, Metzler, Bernhard, Schuler, Gerhard, Thiele, Holger, Eitel, Ingo, Feistritzer, Hans-Josef, Reinstadler, Sebastian Johannes, Klug, Gert, Reindl, Martin, Mair, Johannes, Mayr, Agnes, Franz, Wolfgang-Michael, Metzler, Bernhard, Feistritzer, Hans-Josef, Klug, Gert, Reinstadler, Sebastian Johannes, Reindl, Martin, Mayr, Agnes, Franz, Wolfgang-Michael, Metzler, Bernhard, Festa, P., Cadoni, A., D'andrea, C., Costa, S., Keilberg, P., Lunardini, A., Ali, L. Ait, Ali, L. Ait, Aquaro, GD., Peritore, G., Ricci, F., De Marchi, D., Passino, C., Festa, P., Martínez, A. Tercero, Cuartero, J. Navarro, Soriano, J.G. Córdoba, Núñez, S. Calero, de Galarreta, T. Cros Ruiz, García, M. Villar, Page, J.C. Gallego, López, J.C. García, Ruiz, M. 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Abstract

Objectives: Myocardial fibrosis in noninfarcted myocardium is emerging as a principal phenotype of vulnerability to adverse events such as mortality and hospitalization for heart failure (HHF), but its optimal noninvasive measurement remains uncertain despite consistently robust histologic validation data for extracellular volume fraction (ECV). We therefore compared ECV, native T1, post contrast T1, the gadolinium contrast partition coefficient (lambda), and the presence of nonischemic scar in their associations with mortality and HHF outcomes. Method: To quantify of myocardial fibrosis, we performed T1 mapping (MOLLI) in basal and mid short axis slices with cardiovascular magnetic resonance (CMR) before contrast and 12-30 minutes post contrast bolus in 1185 consecutive patients without amyloidosis, hypertrophic or stress cardiomyopathy. We assessed associations with outcomes using Kaplan-Meier plots and chi square values from univariable Cox regression models. All standard T1 mapping parameters were obtained: native and post contrast myocardial T1, the partition coefficient lambda, and ECV. ECV = (1-hematocrit) · [ΔR1myocardium]/[ΔR1bloodpool], where R1 = 1/T1 Late gadolinium enhancement imaging with phase sensitive reconstruction identified nonischemic scar. Results: Over a median of 1.7 years, 111 individuals experienced events after CMR: 55 HHF events and 74 deaths. ECV yielded better separation of Kaplan-Meier curves in a dose dependent fashion (Figure) and also stronger associations with the combined endpoint of death or HHF. The ECV chi square (77.3, p < 0.001) was at least twice as large as the Native T1 chi square (37.5, p < 0.001), the lambda chi square (34.8, p < 0.001) and nonischemic scar (chi square = 20.5, p<0.001). Post-contrast T1 was not associated with outcomes, even when adjusting further for time after contrast bolus, renal function, and patient weight (chi square <3, p >0.10). Conclusion: Analogous to histologic previously published validation data, quantitative ECV myocardial fibrosis measures associated with outcomes far stronger than other surrogate measures outcome measures such as native T1, post contrast T1 and nonischemic scar on LGE images. These data suggest that ECV is the noninvasive metric of choice to measure myocardial fibrosis. Figure. Kaplan-Meier Plots for T1 mapping parameters.

Published
2016
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35. Hypertrophic cardiomyopathy detection with artificial intelligence electrocardiography in international cohorts: an external validation study.

Author

Siontis KC, Wieczorek MA, Maanja M, Hodge DO, Kim HK, Lee HJ, Lee H, Lim J, Park CS, Ariga R, Raman B, Mahmod M, Watkins H, Neubauer S, Windecker S, Siontis GCM, Gersh BJ, Ackerman MJ, Attia ZI, Friedman PA, and Noseworthy PA

Abstract

Aims: Recently, deep learning artificial intelligence (AI) models have been trained to detect cardiovascular conditions, including hypertrophic cardiomyopathy (HCM), from the 12-lead electrocardiogram (ECG). In this external validation study, we sought to assess the performance of an AI-ECG algorithm for detecting HCM in diverse international cohorts., Methods and Results: A convolutional neural network-based AI-ECG algorithm was developed previously in a single-centre North American HCM cohort (Mayo Clinic). This algorithm was applied to the raw 12-lead ECG data of patients with HCM and non-HCM controls from three external cohorts (Bern, Switzerland; Oxford, UK; and Seoul, South Korea). The algorithm's ability to distinguish HCM vs. non-HCM status from the ECG alone was examined. A total of 773 patients with HCM and 3867 non-HCM controls were included across three sites in the merged external validation cohort. The HCM study sample comprised 54.6% East Asian, 43.2% White, and 2.2% Black patients. Median AI-ECG probabilities of HCM were 85% for patients with HCM and 0.3% for controls ( P < 0.001). Overall, the AI-ECG algorithm had an area under the receiver operating characteristic curve (AUC) of 0.922 [95% confidence interval (CI) 0.910-0.934], with diagnostic accuracy 86.9%, sensitivity 82.8%, and specificity 87.7% for HCM detection. In age- and sex-matched analysis (case-control ratio 1:2), the AUC was 0.921 (95% CI 0.909-0.934) with accuracy 88.5%, sensitivity 82.8%, and specificity 90.4%., Conclusion: The AI-ECG algorithm determined HCM status from the 12-lead ECG with high accuracy in diverse international cohorts, providing evidence for external validity. The value of this algorithm in improving HCM detection in clinical practice and screening settings requires prospective evaluation., Competing Interests: Conflict of interest: P.A.F., Z.I.A., P.A.N., M.J.A., and K.C.S. are co-inventors of the HCM AI-ECG algorithm. Mayo Clinic has licensed the algorithm to Anumana, Inc., with potential for commercialization. K.C.S. has received research funding from Anumana, Inc., for work related to the HCM AI-ECG algorithm (via the institution). M.J.A. is also a consultant for Abbott, Boston Scientific, Bristol Myers Squibb, Daiichi Sankyo, Invitae, LQT Therapeutics, and Medtronic. M.J.A. and Mayo Clinic also have licensing agreements with AliveCor, ARMGO Pharma, Pfizer, and UpToDate. S.W. reports research, travel, or educational grants to the institution from Abbott, Abiomed, Amgen, Astra Zeneca, Bayer, Biotronik, Boehringer Ingelheim, Boston Scientific, Bristol Myers Squibb, Cardinal Health, CardioValve, Corflow Therapeutics, CSL Behring, Daiichi Sankyo, Edwards Lifesciences, Guerbet, InfraRedx, Janssen-Cilag, Johnson & Johnson, Medicure, Medtronic, Merck Sharp & Dohm, Miracor Medical, Novartis, Novo Nordisk, Organon, OrPha Suisse, Pfizer, Polares, Regeneron, Sanofi-Aventis, Servier, Sinomed, Terumo, Vifor, and V-Wave. He serves as advisory board member and/or member of the steering/executive group of trials funded by Abbott, Abiomed, Amgen, Astra Zeneca, Bayer, Boston Scientific, Biotronik, Bristol Myers Squibb, Edwards Lifesciences, Janssen, MedAlliance, Medtronic, Novartis, Polares, Recardio, Sinomed, Terumo, V-Wave, and Xeltis with payments to the institution but no personal payments. He is also a member of the steering/executive committee group of several investigator-initiated trials that receive funding by industry without impact on his personal remuneration. B.R. is funded by the BHF Oxford Centre of Research Excellence (RE/18/3/34214). S.N. acknowledges support from the Oxford NIHR Biomedical Research Centre and the Oxford British Heart Foundation Centre of Research Excellence., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2024
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36. Heart age gap estimated by explainable advanced electrocardiography is associated with cardiovascular risk factors and survival.

Author

Lindow T, Maanja M, Schelbert EB, Ribeiro AH, Ribeiro ALP, Schlegel TT, and Ugander M

Abstract

Aims: Deep neural network artificial intelligence (DNN-AI)-based Heart Age estimations have been presented and used to show that the difference between an electrocardiogram (ECG)-estimated Heart Age and chronological age is associated with prognosis. An accurate ECG Heart Age, without DNNs, has been developed using explainable advanced ECG (A-ECG) methods. We aimed to evaluate the prognostic value of the explainable A-ECG Heart Age and compare its performance to a DNN-AI Heart Age., Methods and Results: Both A-ECG and DNN-AI Heart Age were applied to patients who had undergone clinical cardiovascular magnetic resonance imaging. The association between A-ECG or DNN-AI Heart Age Gap and cardiovascular risk factors was evaluated using logistic regression. The association between Heart Age Gaps and death or heart failure (HF) hospitalization was evaluated using Cox regression adjusted for clinical covariates/comorbidities. Among patients [ n = 731, 103 (14.1%) deaths, 52 (7.1%) HF hospitalizations, median (interquartile range) follow-up 5.7 (4.7-6.7) years], A-ECG Heart Age Gap was associated with risk factors and outcomes [unadjusted hazard ratio (HR) (95% confidence interval) (5 year increments): 1.23 (1.13-1.34) and adjusted HR 1.11 (1.01-1.22)]. DNN-AI Heart Age Gap was associated with risk factors and outcomes after adjustments [HR (5 year increments): 1.11 (1.01-1.21)], but not in unadjusted analyses [HR 1.00 (0.93-1.08)], making it less easily applicable in clinical practice., Conclusion: A-ECG Heart Age Gap is associated with cardiovascular risk factors and HF hospitalization or death. Explainable A-ECG Heart Age Gap has the potential for improving clinical adoption and prognostic performance compared with existing DNN-AI-type methods., Competing Interests: Conflict of interest: T.T.S. is owner and founder of Nicollier-Schlegel SARL, which performs ECG interpretation consultancy using software that can quantify the advanced ECG measures used in the current study. T.T.S. and M.U. are owners and founders of Advanced ECG Systems, a company that is developing commercial applications of advanced ECG technology used in the current study., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2023
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37. Diffuse myocardial fibrosis associates with incident ventricular arrhythmia in implantable cardioverter defibrillator recipients.

Author

Olausson E, Wertz J, Fridman Y, Bering P, Maanja M, Niklasson L, Wong TC, Fukui M, Cavalcante JL, Cater G, Kellman P, Bukhari S, Miller CA, Saba S, Ugander M, and Schelbert EB

Abstract

Background: Diffuse myocardial fibrosis (DMF) quantified by extracellular volume (ECV) may represent a vulnerable phenotype and associate with life threatening ventricular arrhythmias more than focal myocardial fibrosis. This principle remains important because 1) risk stratification for implantable cardioverter defibrillators (ICD) remains challenging, and 2) DMF may respond to current or emerging medical therapies (reversible substrate)., Objectives: To evaluate the association between quantified by ECV in myocardium without focal fibrosis by late gadolinium enhancement (LGE) with time from ICD implantation to 1) appropriate shock, or 2) shock or anti-tachycardia pacing., Methods: Among patients referred for cardiovascular magnetic resonance (CMR) without congenital disease, hypertrophic cardiomyopathy, or amyloidosis who received ICDs (n=215), we used Cox regression to associate ECV with incident ICD therapy., Results: After a median of 2.9 (IQR 1.5-4.2) years, 25 surviving patients experienced ICD shock and 44 experienced shock or anti-tachycardia pacing. ECV ranged from 20.2% to 39.4%. No patient with ECV<25% experienced an ICD shock. ECV associated with both endpoints, e.g., hazard ratio 2.17 (95%CI 1.17-4.00) for every 5% increase in ECV, p=0.014 in a stepwise model for ICD shock adjusting for ICD indication, age, smoking, atrial fibrillation, and myocardial infarction, whereas focal fibrosis by LGE and global longitudinal strain (GLS) did not., Conclusions: DMF measured by ECV associates with ventricular arrhythmias requiring ICD therapy in a dose-response fashion, even adjusting for potential confounding variables, focal fibrosis by LGE, and GLS. ECV-based risk stratification and DMF representing a therapeutic target to prevent ventricular arrhythmia warrant further investigation., Competing Interests: Conflict of Interest Disclosures: Dr. Miller received research support from Roche and Guerbet and serves as Scientific Advisor to Haya Therapeutics. Dr. Schelbert has accepted contrast material from Bracco Diagnostics for research purposes and serves as Scientific Advisor to Haya Therapeutics. Dr. Ugander is principal investigator on a research and development agreement regarding CMR between Siemens and Karolinska University Hospital. Dr. Saba has received research support from Boston Scientific. Dr. Cavalcante has received consulting fees from Boston Scientific, Medtronic and Abbott Vascular; and research grant support from Abbott Vascular, Edwards Lifesciences, Medtronic, Boston Scientific, Circle Cardiovascular Imaging and Medis. The remaining authors have nothing to disclose.

Published
2023
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