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1. Adults with congenital heart disease and pulmonary arterial hypertension: Quantitative assessment of haemodynamic parameters under disease targeting therapy - A retrospective multicentre analysis

Author

Von Stein, P, primary, D'alto, M, additional, Diller, G, additional, Orwat, S, additional, Dumitrescu, D, additional, Giannakoulas, G, additional, Arvanitaki, A, additional, Momcilovic, D, additional, Hohmann, C, additional, and Rosenkranz, S, additional

Published
2023
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2. A NOVEL SIMPLE DOPPLER-ECHOCARDIOGRAPHIC PARAMETER TO ADJUDICATE STENOSIS SEVERITY IN LOW-GRADIENT AORTIC STENOSIS

Author

Hecht, S., primary, Annabi, M., additional, Stanová, V., additional, Dahou, A., additional, Burwash, I., additional, Koschutnik, M., additional, Barkto, P., additional, Mascherbauer, J., additional, Bergler-Klein, J., additional, Orwat, S., additional, Baumgartner, H., additional, Cavalcante, J., additional, Ribeiro, H., additional, Clavel, M., additional, Rodes-Cabau, J., additional, and Pibarot, P., additional

Published
2023
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9. Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease

Author

Van Hagen I. M., Baart S., Fong Soe Khioe R., Sliwa-Hahnle K., Taha N., Lelonek M., Tavazzi L., Maggioni A. P., Johnson M. R., Maniadakis N., Fordham R., Hall R., Roos-Hesselink J. W., Ferrari R., Marelli A., Webb G., Kaemmerer H., Popelova J., Sliwa K., Parsonage W. A., Stein J., Elkayam U., Thilen U., Budts W., Ruys T., Vardas P., Komajda M., Pinto F., Alonso A., Wood D., Ferreira T., Gracia G., Laroche C., Missiamenou V., Taylor C., Konte M., Andarala M., Fiorucci E., Lefrancq E. F., Glemot M., McNeill P-A., Pommier C., Lafay M., Aquieri A., Vega H. R., Blanco M. V., Lust K., Fagermo N., Gabriel H., Donhauser E., Gasimov Z., Jahangirov T., Hasanova I., De Backer J., Demulier L., de Hosson M., Beckx M., Moissens M., Kovacevic-Preradovic T., Kozic M., Lovric M., Freire C. V., Chilingirova N., Kratunkov P., Montesclaros A. R., Beaubien E., Gordon E., Walter L., Lindsay C., Wahab N., Vavera Z., El Nagar A., Ebaid H. H., El Sayed Makled W. A., Dardier A., Shabaan M., Elrakshy Y., Eltamawey K., Abd-El Aziz M. G., Saad A., Aboleineen W., Ashour Z., Sorour K., Mahdy M. A. M., Iserin L., Ladouceur M., Cohen S., Iung B., Maisuradze D., Mebus S., Gembruch U., Hammerstingl C., Merz W. M., Wald C., Baumgartner H., Orwat S., Schmidt R., Motz R., Olsson A., Berger F., Nagdyman N., Frogoudaki A., Anastasiou-Nana M., Temesvari A., Kohalmi D., Balint H., Merkely B., Liptai C., Bowen M., Cullen M., Thornton P., Husarova V., Blatt A., Elbaz-Greener G., Moravsky G., Vered Z., Fuhrmann A. V., Shotan A., Goland S., Festa P., Ali L. A., Sinagra G., Puggia I., Mottolese B. D., Carmina M. G., Romeo C., Crepaz R., Fesslova V., Azzarelli A., Baldi D., Bovenzi F., Donvito V., Vasario E., Todros T., Niwa K., Mussagaliyeva A., Mekebekova D., Sharipova S., Zaliunas R., Jonkaitiene R., Petrauskaite J., Gumbiene L., Jovanova S., Cassar A., Caruana M., Karamermer Y., Cornette J. M. J., van Dijk A., Bellersen L., Duijnhouwer T., De Groot C., Pieper E. P. G., van Oppen C., Polak P., Wajon E., Wagenaar L., Estensen M., Lesniak-Sobelga A., Podolec P., Wisniowska-Smialek S., Trybuch A., Hoffman P., Cichocka-Radwan A., Sobczak S., Faflik U., Tomaszuk-Kazberuk A., Przepiesc J., Gil M., Plaskota K., Trojnarska O., Guerra N., de Sousa L., Petrescu V., Ginghina C., Jurcut R., Coman I. M., Gaisin I. R., Shilina L. V., Sharashkina N., Tkacheva O., Ivanov D., Irtyuga O., Jovovic L., Prokselj K., Kozelj M., Elliott C., Galian-Gay L., Pijuan-Domenech A., Subirana-Domenech M. T., Tornos P., Murga N., Oliver J. M., Escribano-Subias P., Ruiz-Cano M. J., Delgado-Jimenez J., Furenas E., Dellborg M., Schwerzmann M., Bouchardy J., Rutz T., Tobler D., Sarac L., Esen O. B., Enar S. C., Al Mulla A., Bazargani N., Al Hatou E., Farook F., Almahmeed W., Salih B., Clifford P., Bowers N., Veldtman G., Kerr J., Tellett L., Hudsmith L., Thompson P., Thorne S., Bowater S., Nihoyannopoulos P., Curry R., Freeman L., Schroeder F., Wendler R., Hammond S., Talluto C., Murphy D., Perlroth M. G., Chintala K., Gupta P., Pare E., Khatri N., Scott N., De Faria-Yeh D., Bhatt A. B., Tsiaras S., Gurvitz M., Otto C., Botti J., Ting J., Davidson W. R., Cardiology, Van Hagen, I. M., Baart, S., Fong Soe Khioe, R., Sliwa-Hahnle, K., Taha, N., Lelonek, M., Tavazzi, L., Maggioni, A. P., Johnson, M. R., Maniadakis, N., Fordham, R., Hall, R., Roos-Hesselink, J. W., Ferrari, R., Marelli, A., Webb, G., Kaemmerer, H., Popelova, J., Sliwa, K., Parsonage, W. A., Stein, J., Elkayam, U., Thilen, U., Budts, W., Ruys, T., Vardas, P., Komajda, M., Pinto, F., Alonso, A., Wood, D., Ferreira, T., Gracia, G., Laroche, C., Missiamenou, V., Taylor, C., Konte, M., Andarala, M., Fiorucci, E., Lefrancq, E. F., Glemot, M., Mcneill, P-A., Pommier, C., Lafay, M., Aquieri, A., Vega, H. R., Blanco, M. V., Lust, K., Fagermo, N., Gabriel, H., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. V., Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., El Sayed Makled, W. A., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. G., Saad, A., Aboleineen, W., Ashour, Z., Sorour, K., Mahdy, M. A. M., Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Baumgartner, H., Orwat, S., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. V., Shotan, A., Goland, S., Festa, P., Ali, L. A., Sinagra, G., Puggia, I., Mottolese, B. D., Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Caruana, M., Karamermer, Y., Cornette, J. M. J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P. G., van Oppen, C., Polak, P., Wajon, E., Wagenaar, L., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. M., Gaisin, I. R., Shilina, L. V., Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subias, P., Ruiz-Cano, M. J., Delgado-Jimenez, J., Furenas, E., Dellborg, M., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Esen, O. B., Enar, S. C., Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Almahmeed, W., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., and Davidson, W. R.

Subjects
Registrie, Pediatrics, Cardiac & Cardiovascular Systems, Heart disease, global health, heart failure, Disease, 030204 cardiovascular system & hematology, Cardiovascular, 0302 clinical medicine, Pregnancy, Residence Characteristics, Prospective Studies, Registries, PREDICTORS, 1102 Cardiorespiratory Medicine and Haematology, CARDIOLOGY, 030219 obstetrics & reproductive medicine, valvular heart disease, Pregnancy Outcome, SOUTH-AFRICA, congenital heart disease, pregnancy, Adult, Analysis of Variance, Female, Global Health, Heart Diseases, Humans, Maternal Age, Pregnancy Complications, Cardiovascular, Socioeconomic Factors, EUROPEAN-SOCIETY, Heart Disease, CARDIOVASCULAR-DISEASE, RISK-ASSESSMENT, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, Human, Acute coronary syndrome, medicine.medical_specialty, ROPAC investigators, Birth rate, 03 medical and health sciences, medicine, CARDIAC-DISEASE, MATERNAL OUTCOMES, Socioeconomic status, Science & Technology, business.industry, INCOME INEQUALITY, medicine.disease, Pregnancy Complications, Prospective Studie, Cardiovascular System & Hematology, Residence Characteristic, Heart failure, REGISTRY, Cardiovascular System & Cardiology, business
Abstract

ObjectiveCardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease.MethodsThe Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention. Associations between patient characteristics, country characteristics (income inequality expressed as Gini coefficient, health expenditure, schooling, gross domestic product, birth rate and hospital beds) and cardiac endpoints were checked in a three-level model (patient–centre–country).ResultsA total of 30 countries enrolled 2924 patients from 89 centres. At least one endpoint occurred in 645 women (22.1%). Maternal age, New York Heart Association classification and modified WHO risk classification were associated with the combined endpoint and explained 37% of variance in outcome. Gini coefficient and country-specific birth rate explained an additional 4%. There were large differences between the individual countries, but the need for multilevel modelling to account for these differences disappeared after adjustment for patient characteristics, Gini and country-specific birth rate.ConclusionWhile there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome.

Published
2018

10. 6097Aminoterminal proB-type natriuretic peptide: a key parameter to optimise therapeutic management of low-flow, low-gradient aortic stenosis

Author

Annabi, M S, primary, Bergler-Klein, J, additional, Dahou, A, additional, Burwash, I G, additional, Ong, G, additional, Tastet, L, additional, Guzetti, E, additional, Orwat, S, additional, Baumgartner, H, additional, Bartko, P E, additional, Mascherbauer, J, additional, Mundigler, G, additional, Cavalcante, J, additional, Pibarot, P, additional, and Clavel, M A, additional

Published
2019
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11. 6099Impact of aortic valve replacement on outcomes of patients with low-flow, low-gradient moderate aortic stenosis

Author

Annabi, M S, primary, Dahou, A, additional, Bergler-Klein, J, additional, Burwash, I G, additional, Orwat, S, additional, Baumgartner, H, additional, Bartko, P E, additional, Mascherbauer, J, additional, Mundigler, G, additional, Cavalcante, J, additional, Ribeiro, H B, additional, Rodes-Cabau, J, additional, Clavel, M A, additional, and Pibarot, P, additional

Published
2019
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13. Classical low-flow aortic stenosis with very low left ventricular ejection fraction or no flow reserve: Do they benefit from aortic valve replacement?

Author

Annabi, M.S., primary, Dahou, A., additional, Bartko, P.E., additional, Burwash, I.G., additional, Bergler-Klein, J., additional, Mascherbauer, J., additional, Orwat, S., additional, Mundigler, G., additional, Baumgartner, H., additional, Ribeiro, H.B., additional, Rodes-Cabau, J., additional, Cavalcante, J., additional, Clavel, M.A., additional, and Pibarot, P., additional

Published
2019
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14. Aortic Valve Replacement is Superior to Conservative Management in Low-Flow, Low-Gradient Aortic Stenosis independently of the presence of true severe stenosis

Author

Annabi, M.S., primary, Dahou, A., additional, Burwash, I.G., additional, Bartko, P.E., additional, Bergler-Klein, J., additional, Mascherbauer, J., additional, Mundigler, G., additional, Orwat, S., additional, Baumgartner, H., additional, Cavalcante, J., additional, Ribeiro, H.B., additional, Rodes-Cabau, J., additional, Clavel, M.A., additional, and Pibarot, P., additional

Published
2019
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15. Risk Stratifying Low-Flow, Low-Gradient Aortic Stenosis using N-Terminal Pro B-Type Natriuretic Peptide: Results from TOPAS study

Author

Annabi, M.S., primary, Bergler-Klein, J., additional, Dahou, A., additional, Burwash, I.G., additional, Ong, G., additional, Tastet, L., additional, Guzzetti, E., additional, Orwat, S., additional, Baumgartner, H., additional, Bartko, P.E., additional, Mascherbauer, J., additional, Mundigler, G., additional, Cavalcante, J., additional, Ribeiro, H.B., additional, Rodes-Cabau, J., additional, Pibarot, P., additional, and Clavel, M.A., additional

Published
2019
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16. Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease

Author

Van Hagen, Iris M., Baart, Sara, Fong Soe Khioe, Rebekah, Sliwa-Hahnle, Karen, Taha, Nasser, Lelonek, Malgorzata, Tavazzi, Luigi, Maggioni, Aldo Pietro, Johnson, Mark R., Maniadakis, Nikolaos, Fordham, Richard, Hall, Roger, Roos-Hesselink, Jolien W., Ferrari, Roberto, Marelli, Ariane, Webb, Gary, Kaemmerer, Harald, Popelova, Jana, Sliwa, Karen, Parsonage, William Anthony, Stein, Joerg, Elkayam, Uri, Thilen, Ulf, Budts, Werner, Ruys, Titia, Vardas, Panos, Komajda, Michel, Pinto, Fausto, Alonso, Angeles, Wood, David, Ferreira, Thierry, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Andarala, Maryna, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti Ann, Pommier, Caroline, Lafay, Myriam, Aquieri, A., Vega, H. Ruda, Blanco, M. Vázquez, Lust, K., Fagermo, N., Gabriel, H., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. Vilas, Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., El Sayed Makled, W. A., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. Gamal, Saad, A., Aboleineen, W., Ashour, Z., Sorour, K., Mahdy, M. A.Meguid, Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Baumgartner, H., Orwat, S., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. Vazan, Shotan, A., Goland, S., Festa, P., Ali, L. Ait, Sinagra, G., Puggia, I., Mottolese, B. D.Agata, Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Caruana, M., Karamermer, Y., Cornette, J. M.J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P.G., van Oppen, C., Polak, P., Wajon, E., Wagenaar, L., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. Mircea, Gaisin, I. Ravilevich, Shilina, L. Valeryevna, Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subías, P., Ruiz-Cano, M. J., Delgado-Jiménez, J., Furenas, E., Dellborg, M., Thilén, U., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Esen, O. Batukan, Enar, S. Catirli, Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Almahmeed, W., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., Davidson, W. R., Van Hagen, Iris M., Baart, Sara, Fong Soe Khioe, Rebekah, Sliwa-Hahnle, Karen, Taha, Nasser, Lelonek, Malgorzata, Tavazzi, Luigi, Maggioni, Aldo Pietro, Johnson, Mark R., Maniadakis, Nikolaos, Fordham, Richard, Hall, Roger, Roos-Hesselink, Jolien W., Ferrari, Roberto, Marelli, Ariane, Webb, Gary, Kaemmerer, Harald, Popelova, Jana, Sliwa, Karen, Parsonage, William Anthony, Stein, Joerg, Elkayam, Uri, Thilen, Ulf, Budts, Werner, Ruys, Titia, Vardas, Panos, Komajda, Michel, Pinto, Fausto, Alonso, Angeles, Wood, David, Ferreira, Thierry, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Andarala, Maryna, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti Ann, Pommier, Caroline, Lafay, Myriam, Aquieri, A., Vega, H. Ruda, Blanco, M. Vázquez, Lust, K., Fagermo, N., Gabriel, H., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. Vilas, Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., El Sayed Makled, W. A., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. Gamal, Saad, A., Aboleineen, W., Ashour, Z., Sorour, K., Mahdy, M. A.Meguid, Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Baumgartner, H., Orwat, S., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. Vazan, Shotan, A., Goland, S., Festa, P., Ali, L. Ait, Sinagra, G., Puggia, I., Mottolese, B. D.Agata, Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Caruana, M., Karamermer, Y., Cornette, J. M.J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P.G., van Oppen, C., Polak, P., Wajon, E., Wagenaar, L., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. Mircea, Gaisin, I. Ravilevich, Shilina, L. Valeryevna, Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subías, P., Ruiz-Cano, M. J., Delgado-Jiménez, J., Furenas, E., Dellborg, M., Thilén, U., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Esen, O. Batukan, Enar, S. Catirli, Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Almahmeed, W., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., and Davidson, W. R.

Abstract

Objective Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease. Methods The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention. Associations between patient characteristics, country characteristics (income inequality expressed as Gini coefficient, health expenditure, schooling, gross domestic product, birth rate and hospital beds) and cardiac endpoints were checked in a three-level model (patient-centre-country). Results A total of 30 countries enrolled 2924 patients from 89 centres. At least one endpoint occurred in 645 women (22.1%). Maternal age, New York Heart Association classification and modified WHO risk classification were associated with the combined endpoint and explained 37% of variance in outcome. Gini coefficient and country-specific birth rate explained an additional 4%. There were large differences between the individual countries, but the need for multilevel modelling to account for these differences disappeared after adjustment for patient characteristics, Gini and country-specific birth rate. Conclusion While there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome.

Published
2018

19. Risk of Pregnancy in Moderate and Severe Aortic Stenosis: From the Multinational ROPAC Registry

Author

Orwat, S, Diller, G-P, Van Hagen, IM, Schmidt, R, Tobler, D, Greutmann, M, Jonkaitiene, R, Elnagar, A, Johnson, MR, Hall, R, Roos-Hesselink, JW, Baumgartner, H, University of Zurich, Baumgartner, Helmut, and Cardiology

Subjects
Adult, ROPAC Investigators, Cardiac & Cardiovascular Systems, Internationality, Pregnancy Complications, Cardiovascular, MULTICENTER, fetal outcome, ESC, heart failure, 610 Medicine & health, HEART-DISEASE, COLLABORATION, GUIDELINES, Risk Assessment, Severity of Illness Index, 2705 Cardiology and Cardiovascular Medicine, 1117 Public Health and Health Services, ECHOCARDIOGRAPHIC-ASSESSMENT, Pregnancy, FAILURE, Humans, risk factors, Prospective Studies, Registries, 1102 Cardiorespiratory Medicine and Haematology, OUTCOMES, Science & Technology, Pregnancy Outcome, WOMEN, Aortic Valve Stenosis, maternal outcome, EUROPEAN-SOCIETY, Fetal Diseases, Cardiovascular System & Hematology, Cardiovascular System & Cardiology, 10209 Clinic for Cardiology, Female, Life Sciences & Biomedicine
Abstract

BACKGROUND Controversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). OBJECTIVES The authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. METHODS The Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient $64 mm Hg) were analyzed. RESULTS Of 2,966 pregnancies in ROPAC, the authors identified 96 women who had at least moderate AS (34 with severe AS). No deaths were observed during pregnancy and in the first week after delivery. However, 20.8% of women were hospitalized for cardiac reasons during pregnancy. This was significantly more common in severe AS compared with moderate AS (35.3% vs. 12.9%; p ¼ 0.02), and reached the highest rate (42.1%) in severe, symptomatic AS. Pregnancy was complicated by heart failure in 6.7% of asymptomatic and 26.3% of symptomatic patients, but could be managed medically, except for 1 patient who was symptomatic before pregnancy and underwent balloon valvotomy. Children of patients with severe AS had a significantly higher percentage of low birth weight (35.0% vs. 6.0%; p ¼ 0.006). CONCLUSIONS Mortality in pregnant women with AS, including those with severe AS, appears to be close to zero in the current era. Symptomatic and severe AS does, however, carry a substantial risk of heart failure and is associated with high rates of hospitalization for cardiac reasons, although heart failure can nearly always be managed medically. The results highlight the importance of appropriate pre-conceptional patient evaluation and counseling. (J Am Coll Cardiol 2016;68:1727–37) © 2016 by the American College of Cardiology Foundation.

Published
2016

20. ARE N-TERMINAL PRO-B-TYPE NATRIURETIC PEPTIDE AND B-TYPE NATRIURETIC PEPTIDE EQUIVALENT IN PREDICTING OUTCOME IN LOW EJECTION FRACTION, LOW GRADIENT AORTIC STENOSIS?

Author

Annabi, M., primary, Dahou, A., additional, Bergler-Klein, J., additional, Burwash, I., additional, Orwat, S., additional, Baumgartner, H., additional, Bartko, P., additional, Mascherbauer, J., additional, Mundigler, G., additional, Pibarot, P., additional, and Clavel, M., additional

Published
2017
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23. 4797Annulus rupture after ballon-expandable transcatheter aortic valve implantation. Can we eliminate this complication by advanced practice?

Author

De Torres Alba, F., primary, Kaleschke, G., additional, Vormbrock, J., additional, Feurle, M., additional, Stepper, W., additional, Schmidt, R., additional, Radke, R., additional, Orwat, S., additional, Fischer, D., additional, Reinecke, H., additional, Deschka, H., additional, Diller, G.-P., additional, and Baumgartner, H., additional

Published
2017
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25. Pulmonary hypertension and pregnancy outcomes: Data from the Registry of Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiology

Author

Sliwa, Karen, van Hagen, Iris M., Budts, Werner, Swan, Lorna, Sinagra, Gianfranco, Caruana, Maryanne, Blanco, Manuel Vazquez, Wagenaar, Lodewijk J., Johnson, Mark R., Webb, Gary, Hall, Roger, Roos-Hesselink, Jolien W., Ferrari, Roberto, Maggioni, Aldo P., Marelli, Ariane, Kaemmerer, Harald, Popelova, Jana, Tavazzi, Luigi, Parsonage, William Anthony, Stein, Joerg, Elkayam, Uri, Thilen, Ulf, Ruys, Titia, Vardas, Panos, Komajda, Michel, Pinto, Fausto, Alonso, Angeles, Wood, David, Maniadakis, Nikolaos, Ferreira, Thierry, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Andarala, Maryna, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti Ann, Pommier, Caroline, Lafay, Myriam, Aquieri, A., Vega, H. Ruda, Lust, K., Fagermo, N., Gabriel, H., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. Vilas, Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., El Sayed Makled, W. A., Taha, N., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. Gamal, Saad, Aly, Aboleineen, W., Ashour, Z., Sorour, K., Mahdy, M. A.Meguid, Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Baumgartner, H., Orwat, S., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. Vazan, Shotan, A., Goland, S., Festa, P., Ali, L. Ait, Puggia, I., Mottolese, B. D.Agata, Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Karamermer, Y., Cornette, J. M.J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P.G., van Oppen, C., Polak, P., Wajon, E., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Lelonek, M., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. Mircea, Gaisin, I. Ravilevich, Shilina, L. Valeryevna, Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subías, P., Ruiz-Cano, M. J., Delgado-Jiménez, J., Furenas, E., Dellborg, M., Thilén, U., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Esen, O. Batukan, Enar, S. Catirli, Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Almahmeed, W., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., Davidson, W. R., Sliwa, Karen, van Hagen, Iris M., Budts, Werner, Swan, Lorna, Sinagra, Gianfranco, Caruana, Maryanne, Blanco, Manuel Vazquez, Wagenaar, Lodewijk J., Johnson, Mark R., Webb, Gary, Hall, Roger, Roos-Hesselink, Jolien W., Ferrari, Roberto, Maggioni, Aldo P., Marelli, Ariane, Kaemmerer, Harald, Popelova, Jana, Tavazzi, Luigi, Parsonage, William Anthony, Stein, Joerg, Elkayam, Uri, Thilen, Ulf, Ruys, Titia, Vardas, Panos, Komajda, Michel, Pinto, Fausto, Alonso, Angeles, Wood, David, Maniadakis, Nikolaos, Ferreira, Thierry, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Andarala, Maryna, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti Ann, Pommier, Caroline, Lafay, Myriam, Aquieri, A., Vega, H. Ruda, Lust, K., Fagermo, N., Gabriel, H., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. Vilas, Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A., Ebaid, H. H., El Sayed Makled, W. A., Taha, N., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. Gamal, Saad, Aly, Aboleineen, W., Ashour, Z., Sorour, K., Mahdy, M. A.Meguid, Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Merz, W. M., Wald, C., Baumgartner, H., Orwat, S., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Balint, H., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. Vazan, Shotan, A., Goland, S., Festa, P., Ali, L. Ait, Puggia, I., Mottolese, B. D.Agata, Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Karamermer, Y., Cornette, J. M.J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P.G., van Oppen, C., Polak, P., Wajon, E., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Lelonek, M., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Trojnarska, O., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. Mircea, Gaisin, I. Ravilevich, Shilina, L. Valeryevna, Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subías, P., Ruiz-Cano, M. J., Delgado-Jiménez, J., Furenas, E., Dellborg, M., Thilén, U., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Esen, O. Batukan, Enar, S. Catirli, Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Almahmeed, W., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., and Davidson, W. R.

Abstract

Aims: To describe the outcomes of pregnancy in women with pulmonary hypertension. Methods and results: In 2007 the European Registry on Pregnancy and Heart Disease was initiated by the European Society of Cardiology. Consecutive patients with all forms of cardiovascular disease, presenting with pregnancy, were enrolled with the aim of investigating the pregnancy outcomes. This subgroup of the cohort included 151 women with pulmonary hypertension (PH) either diagnosed by right heart catheterization or diagnosed as possible PH by echocardiographic signs, with 26% having pulmonary arterial hypertension (PAH), in three subgroups: idiopathic (iPAH), associated with congenital heart disease (CHD-PAH), or associated with other disease (oPAH), and 74% having PH caused by left heart disease (LHD-PH, n = 112). Maternal mean age was 29.2 ± 5.6 years and 37% were nulliparous. Right ventricular systolic pressure was <50 mmHg in 59.6% of patients, 50–70 mmHg in 28.5% and >70 mmHg in 11.9%. In more than 75% of patients, the diagnosis of PH had been made before pregnancy. Maternal death up to 1 week after delivery occurred in five patients (3.3%), with another two out of 78 patients who presented for follow-up (2.6%), dying within 6 months after delivery. The highest mortality was found in iPAH (3/7, 43%). During pregnancy, heart failure occurred in 27%. Caesarean section was performed in 63.4% (23.9% as emergency). Therapeutic abortion was performed in 4.0%. Complications included miscarriage (5.6%), fetal mortality (2%), premature delivery (21.7%), low birth weight (19.0%), and neonatal mortality (0.7%). Conclusion: Mortality in this group of patients with various forms of PH was lower than previously reported as specialized care during pregnancy and delivery was available. However, maternal and fetal mortality remains prohibitively high in women with iPAH, although this conclusion is restricted by limited numbers. Early advice on c

Published
2016

26. Pregnancy in women with a mechanical heart valve: Data of the European Society of Cardiology Registry of Pregnancy and Cardiac Disease (ROPAC)

Author

Van Hagen, Iris M., Roos-Hesselink, Jolien W., Ruys, Titia P.E., Merz, Waltraut M., Goland, Sorel, Gabriel, Harald, Lelonek, Malgorzata, Trojnarska, Olga, Al Mahmeed, Wael Abdulrahman, Balint, Hajnalka Olga, Ashour, Zeinab, Baumgartner, Helmut, Boersma, Eric, Johnson, Mark R., Hall, Roger, Ferrari, Roberto, Maggioni, Aldo P., Marelli, Ariane, Webb, Gary, Kaemmerer, Harald, Popelova, Jana, Sliwa, Karen, Tavazzi, Luigi, Parsonage, William Anthony, Stein, Joerg, Elkayam, Uri, Thilen, Ulf, Budts, Werner, Vardas, Panos, Komajda, Michel, Pinto, Fausto, Alonso, Angeles, Wood, David, Maniadakis, Nikolaos, Ferreira, Thierry, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Andarala, Maryna, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti Ann, Pommier, Caroline, Lafay, Myriam, Aquieri, A., Vega, H. Ruda, Blanco, M. Vázquez, Lust, K., Fagermo, N., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. Vilas, Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A. E., Ebaid, H. H., El Sayed Makled, W. A., Taha, N., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. Gamal, Saad, A., Aboleineen, W., Sorour, K., Mahdy, M. A.Meguid, Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Wald, C., Orwat, S., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. Vazan, Shotan, A., Festa, P., Ali, L. Ait, Sinagra, G., Puggia, I., Mottolese, B. D.Agata, Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Caruana, M., Karamermer, Y., Cornette, J. M.J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P.G., van Oppen, C., Polak, P., Wajon, E., Wagenaar, L., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. Mircea, Gaisin, I. Ravilevich, Shilina, L. Valeryevna, Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subías, P., Ruiz-Cano, M. J., Delgado-Jiménez, J., Furenas, E., Dellborg, M., Thilén, U., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Esen, O. B., Enar, S. C., Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., Davidson, W. R., Van Hagen, Iris M., Roos-Hesselink, Jolien W., Ruys, Titia P.E., Merz, Waltraut M., Goland, Sorel, Gabriel, Harald, Lelonek, Malgorzata, Trojnarska, Olga, Al Mahmeed, Wael Abdulrahman, Balint, Hajnalka Olga, Ashour, Zeinab, Baumgartner, Helmut, Boersma, Eric, Johnson, Mark R., Hall, Roger, Ferrari, Roberto, Maggioni, Aldo P., Marelli, Ariane, Webb, Gary, Kaemmerer, Harald, Popelova, Jana, Sliwa, Karen, Tavazzi, Luigi, Parsonage, William Anthony, Stein, Joerg, Elkayam, Uri, Thilen, Ulf, Budts, Werner, Vardas, Panos, Komajda, Michel, Pinto, Fausto, Alonso, Angeles, Wood, David, Maniadakis, Nikolaos, Ferreira, Thierry, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Andarala, Maryna, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti Ann, Pommier, Caroline, Lafay, Myriam, Aquieri, A., Vega, H. Ruda, Blanco, M. Vázquez, Lust, K., Fagermo, N., Donhauser, E., Gasimov, Z., Jahangirov, T., Hasanova, I., De Backer, J., Demulier, L., de Hosson, M., Beckx, M., Moissens, M., Kovacevic-Preradovic, T., Kozic, M., Lovric, M., Freire, C. Vilas, Chilingirova, N., Kratunkov, P., Montesclaros, A. R., Beaubien, E., Gordon, E., Walter, L., Lindsay, C., Wahab, N., Vavera, Z., El Nagar, A. E., Ebaid, H. H., El Sayed Makled, W. A., Taha, N., Dardier, A., Shabaan, M., Elrakshy, Y., Eltamawey, K., Abd-El Aziz, M. Gamal, Saad, A., Aboleineen, W., Sorour, K., Mahdy, M. A.Meguid, Iserin, L., Ladouceur, M., Cohen, S., Iung, B., Maisuradze, D., Mebus, S., Gembruch, U., Hammerstingl, C., Wald, C., Orwat, S., Schmidt, R., Motz, R., Olsson, A., Berger, F., Nagdyman, N., Frogoudaki, A., Anastasiou-Nana, M., Temesvari, A., Kohalmi, D., Merkely, B., Liptai, C., Bowen, M., Cullen, M., Thornton, P., Husarova, V., Blatt, A., Elbaz-Greener, G., Moravsky, G., Vered, Z., Fuhrmann, A. Vazan, Shotan, A., Festa, P., Ali, L. Ait, Sinagra, G., Puggia, I., Mottolese, B. D.Agata, Carmina, M. G., Romeo, C., Crepaz, R., Fesslova, V., Azzarelli, A., Baldi, D., Bovenzi, F., Donvito, V., Vasario, E., Todros, T., Niwa, K., Mussagaliyeva, A., Mekebekova, D., Sharipova, S., Zaliunas, R., Jonkaitiene, R., Petrauskaite, J., Gumbiene, L., Jovanova, S., Cassar, A., Caruana, M., Karamermer, Y., Cornette, J. M.J., van Dijk, A., Bellersen, L., Duijnhouwer, T., De Groot, C., Pieper, E. P.G., van Oppen, C., Polak, P., Wajon, E., Wagenaar, L., Estensen, M., Lesniak-Sobelga, A., Podolec, P., Wisniowska-Smialek, S., Trybuch, A., Hoffman, P., Cichocka-Radwan, A., Sobczak, S., Faflik, U., Tomaszuk-Kazberuk, A., Przepiesc, J., Gil, M., Plaskota, K., Guerra, N., de Sousa, L., Petrescu, V., Ginghina, C., Jurcut, R., Coman, I. Mircea, Gaisin, I. Ravilevich, Shilina, L. Valeryevna, Sharashkina, N., Tkacheva, O., Ivanov, D., Irtyuga, O., Jovovic, L., Prokselj, K., Kozelj, M., Elliott, C., Galian-Gay, L., Pijuan-Domenech, A., Subirana-Domenech, M. T., Tornos, P., Murga, N., Oliver, J. M., Escribano-Subías, P., Ruiz-Cano, M. J., Delgado-Jiménez, J., Furenas, E., Dellborg, M., Thilén, U., Schwerzmann, M., Bouchardy, J., Rutz, T., Tobler, D., Sarac, L., Esen, O. B., Enar, S. C., Al Mulla, A., Bazargani, N., Al Hatou, E., Farook, F., Salih, B., Clifford, P., Bowers, N., Veldtman, G., Kerr, J., Tellett, L., Hudsmith, L., Thompson, P., Thorne, S., Bowater, S., Nihoyannopoulos, P., Curry, R., Freeman, L., Schroeder, F., Wendler, R., Hammond, S., Talluto, C., Murphy, D., Perlroth, M. G., Chintala, K., Gupta, P., Pare, E., Khatri, N., Scott, N., De Faria-Yeh, D., Bhatt, A. B., Tsiaras, S., Gurvitz, M., Otto, C., Botti, J., Ting, J., and Davidson, W. R.

Abstract

Background - Pregnant women with a mechanical heart valve (MHV) are at a heightened risk of a thrombotic event, and their absolute need for adequate anticoagulation puts them at considerable risk of bleeding and, with some anticoagulants, fetotoxicity. Methods and Results - Within the prospective, observational, contemporary, worldwide Registry of Pregnancy and Cardiac disease (ROPAC), we describe the pregnancy outcome of 212 patients with an MHV. We compare them with 134 patients with a tissue heart valve and 2620 other patients without a prosthetic valve. Maternal mortality occurred in 1.4% of the patients with an MHV, in 1.5% of patients with a tissue heart valve (P=1.000), and in 0.2% of patients without a prosthetic valve (P=0.025). Mechanical valve thrombosis complicated pregnancy in 10 patients with an MHV (4.7%). In 5 of these patients, the valve thrombosis occurred in the first trimester, and all 5 patients had been switched to some form of heparin. Hemorrhagic events occurred in 23.1% of patients with an MHV, in 5.1% of patients with a tissue heart valve (P<0.001), and in 4.9% of patients without a prosthetic valve (P<0.001). Only 58% of the patients with an MHV had a pregnancy free of serious adverse events compared with 79% of patients with a tissue heart valve (P<0.001) and 78% of patients without a prosthetic valve (P<0.001). Vitamin K antagonist use in the first trimester compared with heparin was associated with a higher rate of miscarriage (28.6% versus 9.2%; P<0.001) and late fetal death (7.1% versus 0.7%; P=0.016). Conclusions - Women with an MHV have only a 58% chance of experiencing an uncomplicated pregnancy with a live birth. The markedly increased mortality and morbidity warrant extensive prepregnancy counseling and centralization of care.

Published
2015

29. Kardiovaskuläre Phänotypisierung eines Kleintiermodells mit autosomal dominanter polyzystischer Nierenerkrankung Typ 2 (ADPKD2)

Author

Orwat, S. (Stefan), Breithardt, G. (Günter), and Universitäts- und Landesbibliothek Münster

Subjects
polyzystische Nierenerkrankung, Pkd2-Maus, kardiovaskuläre Veränderungen, Echokardiographie, kardiovaskuläre Phänotypisierung, Medicine and health, ddc:610
Abstract

Die autosomal dominante polyzystische Nierenerkrankung (ADPKD) ist die häufigste hereditäre Nierenerkrankung. Bei dieser Erkrankung kommt es im höheren Alter zu Veränderungen der kardiovaskulären Funktion. Unter dieser Voraussetzung untersuchte diese Arbeit die kardiovaskulären Veränderungen bei Pkd2+/-LacZ+/- Mäusen und Wildtyp-Pkd2+/+LacZ-/- Mäusen. Ausgangspunkt für diese Untersuchung war die Hypothese, dass es bei heterozygoten Mäusen zu ähnlichen kardiovaskulären Veränderungen kommen würde, wie sie bei Menschen mit ADPKD auftreten. Die zugrunde liegende Hypothese konnte nicht bestätigt werden. Es wurden 104 Echokardiographisch untersucht. Alle Mäuse hatten eine ähnliche Herzfrequenz und ähnliche linksventrikuläre Parameter. Fraktionelle Verkürzung und Ejektionsfraktion waren bei den männlichen Tieren höher als bei den Weiblichen. Im Genotypenvergleich konnten bis auf tendenziell höhere E- und A-Wellen Werte bei den Wildtyp-Mäusen keine signifikanten Unterschiede ermittelt werden.

Published
2004

30. Oral Abstract session * Congenital heart diseases: 13/12/2013, 11:00-12:30 * Location: Bursa

Author

Saxena, A., primary, Khanna, N., additional, Ramakrishnan, S., additional, Gupta, S., additional, Kothari, S., additional, Juneja, R., additional, Bahl, V., additional, Cruz, C., additional, Lebreiro, A., additional, Pinho, T., additional, Dias, C., additional, Silva Cardoso, J., additional, Julia Maciel, M., additional, Grosse-Wortmann, L., additional, Nyns, E., additional, Yoo, S.-J., additional, Dragulescu, A., additional, Marinov, R., additional, Hristova, K., additional, Georgiev, S., additional, Kaneva, A., additional, Pilosoff, V., additional, Orwat, S., additional, Diller, G., additional, Radke, R., additional, Bauerschmitz, P., additional, Schmidt, R., additional, and Baumgartner, H., additional

Published
2013
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31. Erste Ergebnisse aus der Multizentrischen Resynchronisationstherapie Studie bei Angeborenen Herzfehlern (CARE-CHD-Studie) im Rahmen des Kompetenznetzes für Angeborene Herzfehler (KNAHF)

Author

Abdul-Khaliq, H, primary, Hosse, M, additional, Rädle Hurst, T, additional, Rentzsch, A, additional, Abd El Rahman, M, additional, Zartner, P, additional, Laser, K, additional, Seliger, T, additional, Dittrich, S, additional, Nürnberg, J, additional, Hessling, G, additional, Hager, A, additional, Pees, C, additional, Orwat, S, additional, Baumgartner, H, additional, Issa, H, additional, Kerst, G, additional, Hövels-Gürich, H, additional, Hebe, A, additional, Mir, TS, additional, Stiller, B, additional, Will, A, additional, Berger, F, additional, and Peters, B, additional

Published
2013
Full Text
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33. Poster session III * Friday 10 December 2010, 08:30-12:30

Author

Guldbrand, D., primary, Goetzsche, O., additional, Eika, B., additional, Watanabe, N., additional, Taniguchi, M., additional, Akagi, T., additional, Koide, N., additional, Sano, S., additional, Orbovic, B., additional, Obrenovic-Kircanski, B., additional, Ristic, S., additional, Soskic, L. J., additional, Alhabshan, F., additional, Jijeh, A., additional, Abo Remsh, H., additional, Alkhaldi, A., additional, Najm, H. K., additional, Gasior, Z., additional, Skowerski, M., additional, Kulach, A., additional, Szymanski, L., additional, Sosnowski, M., additional, Wang, M., additional, Siu, C. W., additional, Lee, K., additional, Yue, W. S., additional, Yan, G. H., additional, Lee, S., additional, Lau, C. P., additional, Tse, H. F., additional, O'connor, K., additional, Rosca, M., additional, Magne, J., additional, Romano, G., additional, Moonen, M., additional, Pierard, L. A., additional, Lancellotti, P., additional, Floria, M., additional, De Roy, L., additional, Blommaert, D., additional, Jamart, J., additional, Dormal, F., additional, Lacrosse, M., additional, Arsenescu Georgescu, C., additional, Mizariene, V., additional, Bucyte, S., additional, Bertasiute, A., additional, Pociute, E., additional, Zaliaduonyte-Peksiene, D., additional, Baronaite-Dudoniene, K., additional, Sileikiene, R., additional, Vaskelyte, J., additional, Jurkevicius, R., additional, Dencker, M., additional, Thorsson, O., additional, Karlsson, M. K., additional, Linden, C., additional, Wollmer, P., additional, Andersen, L. B., additional, Catalano, O., additional, Perotti, M. R., additional, Colombo, E., additional, De Giorgi, M., additional, Cattaneo, M., additional, Cobelli, F., additional, Priori, S. G., additional, Ober, C., additional, Iancu Adrian, I. A., additional, Andreea Parv, P. A., additional, Cadis Horatiu, C. H., additional, Ober Mihai, O. M., additional, Chmielecki, M., additional, Fijalkowski, M., additional, Galaska, R., additional, Dubaniewicz, W., additional, Lewicki, L., additional, Targonski, R., additional, Ciecwierz, D., additional, Puchalski, W., additional, Koprowski, A., additional, Rynkiewicz, A., additional, Hristova, K., additional, La Gerche, A., additional, Katova, T. Z., additional, Kostova, V., additional, Simova, Y., additional, Kempny, A., additional, Diller, G. P., additional, Orwat, S., additional, Kaleschke, G., additional, Kerckhoff, G., additional, Schmidt, R., additional, Radke, R. M., additional, Baumgartner, H., additional, Smarz, K., additional, Zaborska, B., additional, Jaxa-Chamiec, T., additional, Maciejewski, P., additional, Budaj, A., additional, Kiotsekoglou, A., additional, Govind, S. C., additional, Gadiyaram, V., additional, Moggridge, J. C., additional, Govindan, M., additional, Gopal, A. S., additional, Ramesh, S. S., additional, Brodin, L. A., additional, Saha, S. K., additional, Ramzy, I. S., additional, Lindqvist, P., additional, Lam, Y. Y., additional, Duncan, A. M., additional, Henein, M. Y., additional, Craciunescu, I. S., additional, Serban, M., additional, Iancu, M., additional, Revnic, C., additional, Popescu, B. A., additional, Alexandru, D., additional, Rogoz, D., additional, Uscatescu, V., additional, Ginghina, C., additional, Careri, G., additional, Di Monaco, A., additional, Nerla, R., additional, Tarzia, P., additional, Lamendola, P., additional, Sestito, A., additional, Lanza, G. A., additional, Crea, F., additional, Giannini, F., additional, Pinamonti, B., additional, Santangelo, S., additional, Perkan, A., additional, Vitrella, G., additional, Rakar, S., additional, Merlo, M., additional, Della Grazia, E., additional, Salvi, A., additional, Sinagra, G., additional, Scislo, P., additional, Kochanowski, J., additional, Piatkowski, R., additional, Roik, M., additional, Postula, M., additional, Opolski, G., additional, Castillo, J., additional, Herszkowicz, N., additional, Ferreira, C., additional, Lonnebakken, M. T., additional, Staal, E. M., additional, Nordrehaug, J. E., additional, Gerdts, E., additional, Przewlocka-Kosmala, M., additional, Orda, A., additional, Karolko, B., additional, Bajraktari, G., additional, Gustafsson, U., additional, Holmgren, A., additional, Frattini, S., additional, Faggiano, P., additional, Zilioli, V., additional, Locantore, E., additional, Longhi, S., additional, Bellandi, F., additional, Faden, G., additional, Triggiani, M., additional, Dei Cas, L., additional, Seo, S. M., additional, Jung, H. O., additional, An, S. H., additional, Jung, S. Y., additional, Park, C. S., additional, Jeon, H. K., additional, Youn, H. J., additional, Chung, W. B., additional, Kim, J. H., additional, Uhm, J. S., additional, Mampuya, W., additional, Brochu, M. C., additional, Do, D. H., additional, Essadiqi, B., additional, Farand, P., additional, Lepage, S., additional, Daly, M. J., additional, Monaghan, M., additional, Hamilton, A., additional, Lockhart, C., additional, Kodoth, V., additional, Maguire, C., additional, Morton, A., additional, Manoharan, G., additional, Spence, M. S., additional, Streb, W., additional, Mitrega, K., additional, Nowak, J., additional, Duszanska, A., additional, Szulik, M., additional, Kalinowski, M., additional, Kukulski, T., additional, Kalarus, Z., additional, Calvo Iglesias, F. E., additional, Solla-Ruiz, I., additional, Villanueva-Benito, I., additional, Paredes-Galan, E., additional, Bravo-Amaro, M., additional, Iniguez-Romo, A., additional, Yildirimturk, O., additional, Helvacioglu, F. F., additional, Tayyareci, Y., additional, Yurdakul, S., additional, Demiroglu, I. C., additional, Aytekin, S., additional, Enache, R., additional, Piazza, R., additional, Muraru, D., additional, Roman-Pognuz, A., additional, Calin, A., additional, Leiballi, E., additional, Antonini-Canterin, F., additional, Nicolosi, G. L., additional, Ridard, C., additional, Bellouin, A., additional, Thebault, C., additional, Laurent, M., additional, Donal, E., additional, Sutandar, A., additional, Siswanto, B. B., additional, Irmalita, I., additional, Harimurti, G., additional, Saxena, A., additional, Ramakrishnan, S., additional, Roy, A., additional, Krishnan, A., additional, Misra, P., additional, Bhargava, B., additional, Poole-Wilson, P. A., additional, Loegstrup, B. B., additional, Andersen, H. R., additional, Poulsen, S. H., additional, Klaaborg, K. E., additional, Egeblad, H. E., additional, Gu, X., additional, Gu, X. Y., additional, He, Y. H., additional, Li, Z. A., additional, Han, J. C., additional, Chen, J., additional, Mansencal, N., additional, Mitry, E., additional, Rougier, P., additional, Dubourg, O., additional, Villarraga, H., additional, Adjei-Twum, K., additional, Cudjoe, T. K. M., additional, Clavell, A., additional, Schears, R. M., additional, Cabrera Bueno, F., additional, Molina Mora, M. J., additional, Fernandez Pastor, J., additional, Linde Estrella, A., additional, Pena Hernandez, J. L., additional, Isasti Aizpurua, G., additional, Carrasco Chinchilla, F., additional, Barrera Cordero, A., additional, Alzueta Rodriguez, F. J., additional, De Teresa Galvan, E., additional, Gaetano Contegiacomo, G. C., additional, Francesco Pollice, F. P., additional, Paolo Pollice, P. P., additional, Kontos, M. C., additional, Shin, D. H., additional, Yoo, S. Y., additional, Lee, C. K., additional, Jang, J. K., additional, Jung, S. I., additional, Song, S. I., additional, Seo, S. I., additional, Cheong, S. S., additional, Peteiro, J., additional, Perez-Perez, A., additional, Bouzas-Mosquera, A., additional, Pineiro, M., additional, Pazos, P., additional, Campo, R., additional, Castro-Beiras, A., additional, Gaibazzi, N., additional, Rigo, F., additional, Sartorio, D., additional, Reverberi, C., additional, Sitia, S., additional, Tomasoni, L., additional, Gianturco, L., additional, Ghio, L., additional, Stella, D., additional, Greco, P., additional, De Gennaro Colonna, V., additional, Turiel, M., additional, Cicala, S., additional, Magagnin, V., additional, Caiani, E., additional, Kyrzopoulos, S., additional, Tsiapras, D., additional, Domproglou, G., additional, Avramidou, E., additional, Voudris, V., additional, Wierzbowska-Drabik, K., additional, Lipiec, P., additional, Chrzanowski, L., additional, Roszczyk, N., additional, Kupczynska, K., additional, Kasprzak, J. D., additional, Sachpekidis, V., additional, Bhan, A., additional, Gianstefani, S., additional, Reiken, J., additional, Paul, M., additional, Pearson, P., additional, Harries, D., additional, Monaghan, M. J., additional, Dale, K., additional, Stoylen, A., additional, Kodali, V., additional, Toole, R., additional, Raju, P., additional, Mcintosh, R. A., additional, Silberbauer, J., additional, Baumann, O., additional, Patel, N. R., additional, Sulke, N., additional, Trivedi, U., additional, Hyde, J., additional, Venn, G., additional, Lloyd, G., additional, Wejner-Mik, P., additional, Wierzbowska, K., additional, Lowenstein, J. A., additional, Caniggia, C., additional, Garcia, A., additional, Amor, M., additional, Casso, N., additional, Lowenstein Haber, D., additional, Porley, C., additional, Zambrana, G., additional, Daru, V., additional, Deljanin Ilic, M., additional, Ilic, S., additional, Kalimanovska Ostric, D., additional, Stoickov, V., additional, Zdravkovic, M., additional, Paraskevaidis, I., additional, Ikonomidis, I., additional, Parissis, J., additional, Papadopoulos, C., additional, Stasinos, V., additional, Bistola, V., additional, Anastasiou-Nana, M., additional, Gudin Uriel, M., additional, Balaguer Malfagon, J. R., additional, Perez Bosca, J. L., additional, Ridocci Soriano, F., additional, Martinez Alzamora, N., additional, Paya Serrano, R., additional, Ciampi, Q., additional, Pratali, L., additional, Della Porta, M., additional, Petruzziello, B., additional, Villari, B., additional, Picano, E., additional, Sicari, R., additional, Rosner, A., additional, Avenarius, D., additional, Malm, S., additional, Iqbal, A., additional, Baltabaeva, A., additional, Sutherland, G. R., additional, Bijnens, B., additional, Myrmel, T., additional, Andersen, M., additional, Gustafsson, F., additional, Secher, N. H., additional, Brassard, P., additional, Jensen, A. S., additional, Hassager, C., additional, Madsen, P. L., additional, Moller, J. E., additional, Coutu, M., additional, Greentree, D., additional, Normandin, D., additional, Brun, H., additional, Dipchand, A., additional, Koopman, L., additional, Fackoury, C. T., additional, Truong, S., additional, Manlhiot, C., additional, Mertens, L., additional, Baroni, M., additional, Mariani, M., additional, Chabane, H. K., additional, Berti, S., additional, Ripoli, A., additional, Storti, S., additional, Glauber, M., additional, Scopelliti, P. A., additional, Antongiovanni, G. B., additional, Personeni, D., additional, Saino, A., additional, Tespili, M., additional, Jung, P., additional, Mueller, M., additional, Jander, F., additional, Sohn, H. Y., additional, Rieber, J., additional, Schneider, P., additional, Klauss, V., additional, Agricola, E., additional, Slavich, M., additional, Stella, S., additional, Ancona, M., additional, Oppizzi, M., additional, Bertoglio, L., additional, Melissano, G., additional, Margonato, A., additional, Chiesa, R., additional, Cejudo Diaz Del Campo, L., additional, Mesa Rubio, D., additional, Ruiz Ortiz, M., additional, Delgado Ortega, M., additional, Villanueva Fernandez, E., additional, Lopez Aguilera, J., additional, Toledano Delgado, F., additional, Pan Alvarez-Ossorio, M., additional, Suarez De Lezo Cruz Conde, J., additional, Lafuente, M., additional, Butz, T., additional, Meissner, A., additional, Lang, C. N., additional, Prull, M. W., additional, Plehn, G., additional, Trappe, H. J., additional, Nair, S. V., additional, Lee, L., additional, Mcleod, I., additional, Whyte, G., additional, Shrimpton, J., additional, Hildick Smith, D., additional, James, P. R., additional, Slikkerveer, J., additional, Appelman, Y. E. A., additional, Veen, G., additional, Porter, T. R., additional, Kamp, O., additional, Colonna, P., additional, Ten Cate, F. J., additional, Bokor, D., additional, Daponte, A., additional, Cocciolo, M., additional, Bona, M., additional, Sacchi, S., additional, Becher, H., additional, Chai, S. C., additional, Tan, P. J., additional, Goh, Y. S., additional, Ong, S. H., additional, Chow, J., additional, Lee, L. L., additional, Goh, P. P., additional, Tong, K. L., additional, Kakihara, R., additional, Naruse, C., additional, Hironaka, H., additional, Tsuzuku, T., additional, Ozawa, K., additional, Tomaszuk-Kazberuk, A., additional, Sobkowicz, B., additional, Malyszko, J., additional, Malyszko, J. S., additional, Sawicki, R., additional, Hirnle, T., additional, Dobrzycki, S., additional, Mysliwiec, M., additional, Musial, W. J., additional, Mathias, W., additional, Kowatsch, I., additional, Saroute, A. L. R., additional, Osorio, A. F. F., additional, Sbano, J. C. N., additional, Ramires, J. A. F., additional, Tsutsui, J. M., additional, Sakata, K., additional, Ito, H., additional, Ishii, K., additional, Sakuma, T., additional, Iwakura, K., additional, Yoshino, H., additional, Yoshikawa, J., additional, Shahgaldi, K., additional, Lopez, A., additional, Fernstrom, B., additional, Sahlen, A., additional, Winter, R., additional, Kovalova, S., additional, Necas, J., additional, Amundsen, B. H., additional, Jasaityte, R., additional, Kiss, G., additional, Barbosa, D., additional, D'hooge, J., additional, Torp, H., additional, Szmigielski, C. A., additional, Newton, J. D., additional, Rajpoot, K., additional, Noble, J. A., additional, Kerber, R., additional, Koopman, L. P., additional, Slorach, C., additional, Chahal, N., additional, Hui, W., additional, Sarkola, T., additional, Bradley, T. J., additional, Jaeggi, E. T., additional, Mccrindle, B. W., additional, Staron, A., additional, Jasinski, M., additional, Wos, S., additional, Sengupta, P., additional, Hayat, D., additional, Kloeckner, M., additional, Nahum, J., additional, Dussault, C., additional, Dubois Rande, J. L., additional, Gueret, P., additional, Lim, P., additional, King, G. J., additional, Brown, A., additional, Ho, E., additional, Amuntaser, I., additional, Bennet, K., additional, Mc Elhome, N., additional, Murphy, R. T., additional, Cooper, R. M., additional, Somauroo, J. D., additional, Shave, R. E., additional, Williams, K. L., additional, Forster, J., additional, George, C., additional, Bett, T., additional, George, K. P., additional, D'andrea, A., additional, Riegler, L., additional, Cocchia, R., additional, Golia, E., additional, Gravino, R., additional, Salerno, G., additional, Citro, R., additional, Caso, P. I. O., additional, Bossone, E., additional, Calabro', R., additional, Crispi, F., additional, Figueras, F., additional, Bartrons, J., additional, Eixarch, E., additional, Le Noble, F., additional, Ahmed, A., additional, Gratacos, E., additional, Shang, Q., additional, Yip, W. K., additional, Tam, L. S., additional, Zhang, Q., additional, Li, C. M., additional, Wang, T., additional, Ma, C. Y., additional, Li, K. M., additional, Yu, C. M., additional, Dahlslett, T., additional, Helland, I., additional, Edvardsen, T., additional, Skulstad, H., additional, Magda, L. S., additional, Florescu, M., additional, Ciobanu, A., additional, Dulgheru, R., additional, Mincu, R., additional, Vinereanu, D., additional, Luckie, M., additional, Chacko, S., additional, Nair, S., additional, Mamas, M., additional, Khattar, R. S., additional, El-Omar, M., additional, Kuch-Wocial, A., additional, Pruszczyk, P., additional, Szulc, M., additional, Styczynski, G., additional, Sinski, M., additional, Kaczynska, A., additional, Vela, Z., additional, Haliti, E., additional, Hyseni, V., additional, Olloni, R., additional, Rexhepaj, N., additional, Elezi, S., additional, Onaindia, J. J., additional, Quintana, O., additional, Cacicedo, A., additional, Velasco, S., additional, Alarcon, J. J., additional, Morillas, M., additional, Rumoroso, J. R., additional, Zumalde, J., additional, Lekuona, I., additional, Laraudogoitia Zaldumbide, E., additional, Poniku, A., additional, Ahmeti, A., additional, Duncan, R. F., additional, Mccomb, J. M., additional, Pemberton, J., additional, Lord, S. W., additional, Leong, D., additional, Plummer, C., additional, Macgowan, G., additional, Grubb, N., additional, Leung, M., additional, Kenny, A., additional, Prinz, C., additional, Voigt, J. U., additional, Zaidi, A., additional, Heatley, M., additional, Abildstrom, S. Z., additional, Hvelplund, A., additional, Berning, J., additional, Govind, S., additional, Brodin, L., additional, Gopal, A., additional, Castaldi, B., additional, Di Salvo, G., additional, Santoro, G., additional, Gaio, G., additional, Palladino, M. T., additional, Iacono, C., additional, Pacileo, G., additional, Russo, M. G., additional, Calabro, R., additional, Wang, Y. S., additional, Dong, L. L., additional, Shu, X. H., additional, Pan, C. Z., additional, Zhou, D. X., additional, Sen, T., additional, Tufekcioglu, O., additional, Ozdemir, M., additional, Tuncez, A., additional, Uygur, B., additional, Golbasi, Z., additional, Kisacik, H., additional, Delfino, L., additional, De Leo, F. D., additional, Chiappa, L. C., additional, Abdel Ghani, B., additional, Schiavina, R., additional, Salvade, P., additional, Morganti, A., additional, Bedogni, F., additional, Mahia, P., additional, Gutierrez, L., additional, Pineda, V., additional, Garcia, B., additional, Otaegui, I., additional, Rodriguez, J. F., additional, Gonzalez, M. T., additional, Descalzo, M., additional, Evangelista, A., additional, Garcia-Dorado, D., additional, Bruin De- Bon, H. A. C. M., additional, Van Den Brink, R. B. A., additional, Surie, S., additional, Bresser, P., additional, Vleugels, J., additional, Eckmann, H. M., additional, Samson, D. A., additional, Bouma, B. J., additional, Dedobbeleer, C., additional, Antoine, M., additional, Remmelink, M., additional, Unger, P., additional, Roosens, B., additional, Hmila, I., additional, Hernot, S., additional, Droogmans, S., additional, Van Camp, G., additional, Lahoutte, T., additional, Muyldermans, S., additional, Cosyns, B., additional, Feltes, G., additional, Serra, V., additional, Azevedo, O., additional, Barbado, J., additional, Herrera, J., additional, Rivera, A., additional, Paniagua, J., additional, Valverde, V., additional, Torras, J., additional, Arriba, G., additional, Christodoulides, T., additional, Ioannides, M., additional, Simamonian, K., additional, Yiangou, K., additional, Myrianthefs, M., additional, Nicolaides, E., additional, Pandolfo, M., additional, Kleijn, S. A., additional, Aly, M. F. A. A., additional, Terwee, C. B., additional, Van Rossum, A. C., additional, Delgado, V., additional, Shanks, M., additional, Siebelink, H. M., additional, Sieders, A., additional, Lamb, H., additional, Ajmone Marsan, N., additional, Westenberg, J., additional, De Roos, A., additional, Schuijf, J. D., additional, Bax, J. J., additional, Anwar, A. M., additional, Nosir, Y., additional, Chamsi-Pasha, H., additional, Tschernich, H. D., additional, Seeburger, J., additional, Borger, M., additional, Mukherjee, C., additional, Mohr, F. W., additional, Ender, J., additional, Obase, K., additional, Okura, H., additional, Yamada, R., additional, Miyamoto, Y., additional, Saito, K., additional, Imai, K., additional, Hayashida, A., additional, and Yoshida, K., additional

Published
2010
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34. Oral session V: New Insights on left ventricular function in aortic stenosis * Friday 10 December 2010, 08:30-10:00

Author

Calin, A., primary, Popescu, B. A., additional, Beladan, C. C., additional, Rosca, M., additional, Muraru, D., additional, Lupascu, L., additional, Calin, C., additional, Jurcut, R., additional, Sandu, C., additional, Ginghina, C., additional, O'Connor, K., additional, Romano, G., additional, Magne, J., additional, Calin, A., additional, Pierard, L., additional, Lancellotti, P., additional, Attias, D., additional, Dreyfus, J., additional, Brochet, E., additional, Berjeb, N., additional, Cueff, C., additional, Cimadevilla, C., additional, Lepage, L., additional, Iung, B., additional, Vahanian, A., additional, Messika-Zeitoun, D., additional, Kempny, A., additional, Diller, G. P., additional, Orwat, S., additional, Kaleschke, G., additional, Kerckhoff, G., additional, Radke, R. M., additional, Schmidt, R., additional, Mascherbauer, J., additional, Reinecke, H., additional, Baumgartner, H., additional, Di Bello, V., additional, Giannini, C., additional, Talini, E., additional, De Carlo, M., additional, Delle Donne, M. G., additional, Guarracino, F., additional, Nardi, C., additional, Dini, F. L., additional, Marzilli, M., additional, and Petronio, A. S., additional

Published
2010
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36. T1-weighted MRI for the detection of coronary artery plaque haemorrhage.

Author

Oei ML, Ozgun M, Seifarth H, Bunck A, Fischbach R, Orwat S, Heindel W, Botnar R, Maintz D, Oei, May Lin, Ozgun, Murat, Seifarth, Harald, Bunck, Alexander, Fischbach, Roman, Orwat, Stefan, Heindel, Walter, Botnar, Rene, and Maintz, David

Abstract

Objective: Hyperintense areas in atherosclerotic plaques on pre-contrast T1-weighted MRI have been shown to correlate with intraplaque haemorrhage. We evaluated the presence of T1 hyperintensity in coronary artery plaques in coronary artery disease (CAD) patients and correlated results with multi-detector computed tomography (MDCT) findings.Methods: Fifteen patients with CAD were included. Plaques detected by MDCT were categorised based on their Hounsfield number. T1-weighted inversion recovery (IR) MRI prepared coronary MRI for the detection of plaque and steady-state free-precession coronary MR-angiography for anatomical correlation was performed. After registration of MDCT and MRI, regions of interest were defined on MDCT-visible plaques and in corresponding vessel segments acquired with MRI. MDCT density and MR signal measurement were performed in each plaque.Results: Forty-three plaques were identified with MDCT. With IR-MRI 5/43 (12%) plaques were hyperintense, 2 of which were non-calcified and 3 mixed. Average signal-to-noise and contrast-to-noise ratios of hyperintense plaques were 15.7 and 9.1, compared with 5.6 and 1.2 for hypointense plaques. Hyperintense plaques exhibited a significantly lower CT density than hypointense plaques (63.6 vs. 140.8). There was no correlation of plaque signal intensity with degree of stenosis.Conclusion: T1-weighted IR-MRI may be useful for non-invasive detection and characterisation of intraplaque haemorrhage in coronary artery plaques. [ABSTRACT FROM AUTHOR]

Published
2010
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37. Correspondence:.

Author

Kempny A, Diller GP, Kaleschke G, Orwat S, Funke A, Schmidt R, Kerckhoff G, Ghezelbash F, Rukosujew A, Reinecke H, Scheld HH, and Baumgartner H

Published
2013
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38. Quantification of biventricular myocardial function using cardiac magnetic resonance feature tracking, endocardial border delineation and echocardiographic speckle tracking in patients with repaired tetralogy of fallot and healthy controls

Author

Kempny Aleksander, Fernández-Jiménez Rodrigo, Orwat Stefan, Schuler Pia, Bunck Alexander C, Maintz David, Baumgartner Helmut, and Diller Gerhard-Paul

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Parameters of myocardial deformation have been suggested to be superior to conventional measures of ventricular function in patients with tetralogy of Fallot (ToF), but have required non-routine, tagged cardiovascular magnetic resonance (CMR) techniques. We assessed biventricular myocardial function using CMR cine-based feature tracking (FT) and compared it to speckle tracking echocardiography (STE) and to simple endocardial border delineation (EBD). In addition, the relation between parameters of myocardial deformation and clinical parameters was assessed. Methods Overall, 28 consecutive adult patients with repaired ToF (age 40.4 ± 13.3 years) underwent standard steady-state-free precession sequence CMR, echocardiography, and cardiopulmonary exercise testing. In addition, 25 healthy subjects served as controls. Myocardial deformation was assessed by CMR based FT (TomTec Diogenes software), CMR based EBD (using custom written software) and STE (TomTec Cardiac Performance Analysis software). Results Feature tracking was feasible in all subjects. A close agreement was found between measures of global left (LV) and right ventricular (RV) global strain. Interobserver agreement for FT and STE was similar for longitudinal LV global strain, but FT showed better inter-observer reproducibility than STE for circumferential or radial LV and longitudinal RV global strain. Reproducibility of regional strain on FT was, however, poor. The relative systolic length change of the endocardial border measured by EBD yielded similar results to FT global strain. Clinically, biventricular longitudinal strain on FT was reduced compared to controls (P 2-slope. Conclusions Although neither the inter-study reproducibility nor accuracy of FT software were investigated, and its inter-observer reproducibility for regional strain calculation was poor, its calculations of global systolic strain showed similar or better inter-oberver reproducibility than those by STE, and could be applied across RV image regions inaccessible to echo. ‘Global strain’ calculated by EBD gave similar results to FT. Measurements made using FT related to exercise tolerance in ToF patients suggesting that the approach could have clinical relevance and deserves further study.

Published
2012
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39. Oral Abstract session * Congenital heart diseases: 13/12/2013, 11:00-12:30 * Location: Bursa

Author

Saxena, A, Khanna, N, Ramakrishnan, S, Gupta, S, Kothari, SS, Juneja, R, Bahl, VK, Cruz, C, Lebreiro, A, Pinho, T, Dias, CC, Silva Cardoso, J, Julia Maciel, M, Grosse-Wortmann, L, Nyns, E, Yoo, S-J, Dragulescu, A, Marinov, R, Hristova, K, Georgiev, ST, Kaneva, A, Pilosoff, V, Orwat, S, Diller, GP, Radke, RM, Bauerschmitz, PB, Schmidt, RM, and Baumgartner, H

Abstract

Background: Aortic valve Balloon Dilatation (AVBD) is the procedure of choice in children and adolescents with congenital aortic valve stenosis. Predictors for the success or failure of AVBD have not been well defined. Three-dimensional (3D) echocardiography has the ability to align well with aortic valve and produce good quality en face images of valve cusps. We conducted this study to evaluate the 3 D echocardiographic predictors of successful AVBD. Methods: We studied 27 patients with a diagnosis of severe congenital aortic stenosis, aged 6 months – 21 years, who underwent AVBD at our institute. Routine 2D and 3D transthoracic echocardiography was done before AVBD. Morphological details of the aortic valve as seen on 3 D echocardiography were recorded including mobility, thickness, area of the cusps and calcification, if any. Presence or absence of aortic regurgitation (AR) was also recorded. We calculated a leaflet score by addition of grades of calcium, mobility, and thickness. All patients underwent AVBD as per institutional protocol. A repeat echo including 3D echocardiography was performed within 24 hours of AVBD. The pre AVBD parameters were then correlated with success/failure of AVBD procedure. Successful AVBD was defined as more than 50% reduction in peak gradient with final gradient < 40 mmHg in the absence of any complication including more than mild AR. Results: AVBD could be performed in all 27 patients. Aortic valve orifice area increased from 0.67 ± 0.22 cm2 to 1.56 ± 0.36 cm2 with a fall in peak gradients from 97.2 ± 41.0 mmHg to 38.0 ± 18.3 mm of Hg. A total of 7 patients had unsuccessful procedure as defined by pre-specified criteria described above. Valves with restricted mobility and increased thickness had statistically significant chances of failed procedure. Mean leaflet score in patients who had a successful AVBD was 3.80 ± 1.24 as compared to a mean leaflet score of 5.57 ± 0.78 in patients who had an unsuccessful AVBD (p = 0.002). Conclusions: Balloon aortic valvuloplasty provides safe and effective gradient relief in majority of children and adolescents with congenital AS. Good enface images of the aortic valves are possible with 3D echocardiography and it complements 2D echocardiographic findings. Aortic leaflet score derived from morphological features like mobility, thickness, and calcium of the aortic cusps by 3 D echocardiography may be helpful in predicting the outcomes of AVBD. These findings need to be evaluated in larger studies.

Published
2013
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40. A Novel Echocardiographic Parameter to Confirm Low-Gradient Aortic Stenosis Severity.

Author

Hecht S, Annabi MS, Stanová V, Dahou A, Burwash IG, Koschutnik M, Bartko PE, Bergler-Klein J, Mascherbauer J, Donà C, Orwat S, Baumgartner H, Cavalcante JL, Ribeiro HB, Théron A, Rodes-Cabau J, Clavel MA, and Pibarot P

Abstract

Background: In patients with low-gradient (LG) aortic stenosis (AS), confirming disease severity and indication of intervention often requires dobutamine stress echocardiography (DSE) or aortic valve calcium scoring by computed tomography. We hypothesized that the mean transvalvular pressure gradient to effective orifice area ratio (MG/EOA, in mm Hg/cm 2 ) measured during rest echocardiography identifies true-severe AS (TSAS) and is associated with clinical outcomes in patients with low-flow, LG-AS., Objectives: The purpose of this study was to evaluate the diagnostic and prognostic value of MG/EOA ratio., Methods: The diagnostic accuracy of MG/EOA ratio to identify TSAS was retrospectively assessed in: 1) an in vitro data set obtained in a circulatory model including 93 experimental conditions; and 2) an in vivo data set of 188 patients from the TOPAS (True or Pseudo-Severe Aortic Stenosis) study (NCT01835028). Receiver operating characteristic curves were used to assess the diagnostic accuracy of MG/EOA ratio for identifying TSAS, and Cox proportional hazards regression analyses were performed to assess its association with clinical outcomes., Results: The optimal cutoff of MG/EOA ratio to identify TSAS in patients with low-flow, LG-AS was ≥25 mm Hg/cm 2 (correct classification 85%), as well as in vitro (100%). During a median follow-up of 1.41 ± 0.75 years, 146 (78%) patients met the composite endpoint of aortic valve replacement or all-cause mortality. A MG/EOA ratio ≥25 mm Hg/cm 2 was independently associated with an increased risk of the composite endpoint (adjusted HR: 2.36 [95% CI: 1.63-3.42], P  < 0.001). The Harell's C-index of MG/EOA was 0.68, equaling projected EOA (0.67) measured by DSE., Conclusions: MG/EOA ratio can be useful in low-flow, LG-AS to confirm AS severity and may complement DSE or aortic valve calcium scoring., Competing Interests: This work was supported by a grant (# MOP-57445 for TOPAS-II and # MOP-126072 and FDN-143225 for TOPAS-III) from the 10.13039/501100000024Canadian Institutes of Health Research, Ottawa, Canada. Dr Dahou was supported by a fellowship grant from “L’Agence de la santé et des services sociaux de la Capitale nationale-ADLSSS”, Québec, Québec, Canada. Dr Clavel is recopied of a national new investigator award from the heart and stroke foundation of Canada and received funding from 10.13039/100006520Edwards Lifesciences for computed tomography CoreLab analyses with no personal compensation and research grant from 10.13039/100004374Medtronic. Dr Rodes-Cabau has received institutional research grants from 10.13039/100006520Edwards Lifesciences, 10.13039/100004374Medtronic, and 10.13039/100008497Boston Scientific. Dr Pibarot holds the Canada Research Chair in Valvular Heart Diseases, 10.13039/501100000024Canadian Institutes of Health Research; and has received funding from 10.13039/100006520Edwards Lifesciences and 10.13039/100004374Medtronic for echocardiography CoreLab analyses with no personal compensation. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)

Published
2024
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41. Utility of Coronary Computed Tomography Angiography in Patients Undergoing Transcatheter Aortic Valve Implantation: A Meta-Analysis and Meta-Regression Based on Published Data from 7458 Patients.

Author

Diller GP, Gerwing M, Boroni Grazioli S, De-Torres-Alba F, Radke RM, Vormbrock J, Baumgartner H, Kaleschke G, and Orwat S

Abstract

Background: Coronary CT angiography (CCTA) may detect coronary artery disease (CAD) in transcatheter aortic valve implantation (TAVI) patients and may obviate invasive coronary angiography (ICA) in selected patients. We assessed the diagnostic accuracy of CCTA for detecting CAD in TAVI patients based on published data., Methods: Meta-analysis and meta-regression were performed based on a comprehensive electronic search, including relevant studies assessing the diagnostic accuracy of CCTA in the setting of TAVI patients compared to ICA. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated on a patient and per segment level., Results: Overall, 27 studies (total of 7458 patients) were included. On the patient level, the CCTA's pooled sensitivity and NPV were 95% (95% CI: 93-97%) and 97% (95% CI: 95-98%), respectively, while the specificity and PPV were at 73% (95% CI: 62-82%) and 64% (95% CI: 57-71%), respectively. On the segmental coronary vessel level, the sensitivity and NPV were 90% (95% CI: 79-96%) and 98% (95% CI: 97-99%)., Conclusions: This meta-analysis highlights CCTA's potential as a first-line diagnostic tool although its limited PPV and specificity may pose challenges when interpreting heavily calcified arteries. This study underscores the need for further research and protocol standardization in this area.

Published
2024
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42. Immunodeficiency is prevalent in congenital heart disease and associated with increased risk of emergency admissions and death.

Author

Diller GP, Lammers AE, Fischer A, Orwat S, Nienhaus K, Schmidt R, Radke RM, De-Torres-Alba F, Kaleschke G, Marschall U, Bauer UM, Roth J, Gerß J, Bormann E, and Baumgartner H

Subjects
Humans, Risk Factors, Risk Assessment, Proportional Hazards Models, Hospitalization, Heart Defects, Congenital complications, Heart Defects, Congenital epidemiology
Abstract

Aims: To provide population-based data on the prevalence and clinical significance of immune deficiency syndromes (IDS) associated with congenital heart disease (CHD)., Methods and Results: Utilizing administrative German Health System data the prevalence of increased susceptibility to infection (ISI) or confirmed IDS was assessed in CHD patients and compared with an age-matched non-congenital control group. Furthermore, the prognostic significance of IDS was assessed using all-cause mortality and freedom from emergency hospital admission. A total of 54 449 CHD patients were included. Of these 14 998 (27.5%) had ISI and 3034 (5.6%) had a documented IDS (compared with 2.9% of the age-matched general population). During an observation period of 394 289 patient-years, 3824 CHD patients died, and 31 017 patients experienced a combined event of all-cause mortality or emergency admission. On multivariable Cox proportional-hazard analysis, the presence of ISI [hazard ratio (HR): 2.14, P < 0.001] or documented IDS (HR: 1.77, P = 0.035) emerged as independent predictors of all-cause mortality. In addition, ISI and confirmed IDS were associated with a significantly higher risk of emergency hospital admission (P = 0.01 for both on competing risk analysis) during follow-up., Conclusion: Limited immune competence is common in CHD patients and associated with an increased risk of morbidity and mortality. This highlights the need for structured IDS screening and collaboration with immunology specialists as immunodeficiency may be amenable to specific therapy. Furthermore, studies are required to assess whether IDS patients might benefit from intensified antibiotic shielding or tailored prophylaxis., Competing Interests: Conflict of Interest Statement: All authors declare no conflict of interest for this contribution., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2023
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43. Alternative access for transapical transcatheter mitral valve implantation.

Author

Deschka H, Orwat S, Bleiziffer S, and Kaleschke G

Abstract

Competing Interests: Dr Bleiziffer is a proctor for Abbot. All other authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest.

Published
2023
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44. A framework of deep learning networks provides expert-level accuracy for the detection and prognostication of pulmonary arterial hypertension.

Author

Diller GP, Benesch Vidal ML, Kempny A, Kubota K, Li W, Dimopoulos K, Arvanitaki A, Lammers AE, Wort SJ, Baumgartner H, Orwat S, and Gatzoulis MA

Subjects
Humans, Familial Primary Pulmonary Hypertension, Ventricular Function, Right, Pulmonary Arterial Hypertension, Ventricular Dysfunction, Right etiology, Hypertension, Pulmonary diagnostic imaging, Deep Learning
Abstract

Aims: To test the hypothesis that deep learning (DL) networks reliably detect pulmonary arterial hypertension (PAH) and provide prognostic information., Methods and Results: Consecutive patients with PAH, right ventricular (RV) dilation (without PAH), and normal controls were included. An ensemble of deep convolutional networks incorporating echocardiographic views and estimated RV systolic pressure (RVSP) was trained to detect (invasively confirmed) PAH. In addition, DL-networks were trained to segment cardiac chambers and extracted geometric information throughout the cardiac cycle. The ability of DL parameters to predict all-cause mortality was assessed using Cox-proportional hazard analyses. Overall, 450 PAH patients, 308 patients with RV dilatation (201 with tetralogy of Fallot and 107 with atrial septal defects) and 67 normal controls were included. The DL algorithm achieved an accuracy and sensitivity of detecting PAH on a per patient basis of 97.6 and 100%, respectively. On univariable analysis, automatically determined right atrial area, RV area, RV fractional area change, RV inflow diameter and left ventricular eccentricity index (P &lt; 0.001 for all) were significantly related to mortality. On multivariable analysis DL-based RV fractional area change (P &lt; 0.001) and right atrial area (P = 0.003) emerged as independent predictors of outcome. Statistically, DL parameters were non-inferior to measures obtained manually by expert echocardiographers in predicting prognosis., Conclusion: The study highlights the utility of DL algorithms in detecting PAH on routine echocardiograms irrespective of RV dilatation. The algorithms outperform conventional echocardiographic evaluation and provide prognostic information at expert-level. Therefore, DL methods may allow for improved screening and optimized management of PAH., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Published
2022
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46. Incidence and Predictors of Left Atrial Appendage Thrombus before Catheter Ablation of Thrombogenic Arrhythmias.

Author

Wegner FK, Radke RM, Ellermann C, Wolfes J, Willy K, Lange PS, Frommeyer G, Baumgartner H, Eckardt L, Diller GP, and Orwat S

Abstract

Introduction: Transesophageal echocardiography (TEE) is routinely performed before catheter ablation of atrial tachyarrhythmias to rule out the presence of left atrial thrombi. However, data to support this practice are inconsistent. Methods: We analyzed consecutive pre-procedural TEE in a high-volume electrophysiology center for the presence of left atrial thrombi and a relevant flow reduction in the left atrial appendage (LAA) defined as LAA sludge or LAA emptying velocity (LAAEV) < 20 cm/s. The possible predictors of reduced flow were recorded and compared in a multivariate logistic regression analysis. Results: 1676 TEE were included (1122 before pulmonary vein isolation, 436 before atrial flutter ablation, 166 before other ablations). 543 patients (32%) were female and 991 (59%) were on DOAC. Nine patients (0.5%) had an LAA thrombus on pre-procedural TEE. Ninety-five further patients (5.7%) had a relevant reduction in LAA flow. The underlying rhythm showed a significant association with the presence of LAA thrombus or reduced LAA flow (p = 0.003). Patients in sinus rhythm and cavotricuspid isthmus-dependent atrial flutter exhibited the lowest risk. Additionally, reduced kidney function was associated with a reduction in LAA flow velocities (p = 0.04). Of note, two LAA thrombi occurred in patients in sinus rhythm and six out of nine patients with an LAA thrombus were on vitamin-K antagonists. Conclusions: LAA thrombus is a rare occurrence before an elective catheter ablation. The underlying rhythm and kidney function may serve as markers of a higher likelihood of significantly reduced LAAEV and LAA thrombus.

Published
2022
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47. Incidence and predictors of left atrial appendage thrombus on transesophageal echocardiography before elective cardioversion.

Author

Wegner FK, Radke R, Ellermann C, Wolfes J, Fischer AJ, Baumgartner H, Eckardt L, Diller GP, and Orwat S

Subjects
Aged, Anticoagulants therapeutic use, Echocardiography, Transesophageal, Electric Countershock adverse effects, Female, Humans, Incidence, Male, Atrial Appendage diagnostic imaging, Atrial Fibrillation complications, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation therapy, Heart Diseases, Thrombosis diagnostic imaging, Thrombosis epidemiology, Thrombosis etiology
Abstract

Guidelines recommend transesophageal echocardiography (TEE) before cardioversion in thrombogenic arrhythmias when the requirement of ≥ 3 weeks of anticoagulation is not met. Current data to support this approach, especially with direct oral anticoagulants (DOAC), are scarce. We analyzed consecutive elective pre-cardioversion TEE in a high-volume electrophysiology center for the occurrence of left atrial appendage (LAA) thrombi or reduced LAA flow velocity. Possible predictors were recorded and compared in a multivariate logistic regression analysis. Consecutive pre-cardioversion TEE in 512 patients (148 female, median age 69 years) were included. In all patients, indication for TEE was either intake of anticoagulation < 3 weeks before cardioversion or uncertain adherence to the prescribed anticoagulation regimen. Of the 512 TEE, 19 (3.7%) depicted a LAA thrombus. An additional 41 patients (8.0%) showed either a reduced LAA flow velocity (≤ 20 cm/s), LAA sludge, or both. In a multivariate logistic regression analysis, QRS width on admission 12-lead ECG emerged as a possible predictor of LAA thrombus and reduced LAA flow (p = 0.008). Noteworthy, a high CHA 2 DS 2 -VASc score was not associated with an increased risk of reduced LAA emptying velocity and LAA thrombi were even found in patients with a CHA 2 DS 2 -VASc score of 0 (n = 1) and 1 (n = 1). The presence of LAA thrombus before an elective cardioversion is a rare event in the age of direct oral anticoagulants. However, LAA thrombi occurred even in supposed low-risk individuals according to the CHA 2 DS 2 -VASc score. QRS width may aid in identifying patients at risk of reduced LAA flow velocity., (© 2022. The Author(s).)

Published
2022
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48. Accuracy of Deep Learning Echocardiographic View Classification in Patients with Congenital or Structural Heart Disease: Importance of Specific Datasets.

Author

Wegner FK, Benesch Vidal ML, Niehues P, Willy K, Radke RM, Garthe PD, Eckardt L, Baumgartner H, Diller GP, and Orwat S

Abstract

Introduction: Automated echocardiography image interpretation has the potential to transform clinical practice. However, neural networks developed in general cohorts may underperform in the setting of altered cardiac anatomy., Methods: Consecutive echocardiographic studies of patients with congenital or structural heart disease (C/SHD) were used to validate an existing convolutional neural network trained on 14,035 echocardiograms for automated view classification. In addition, a new convolutional neural network for view classification was trained and tested specifically in patients with C/SHD., Results: Overall, 9793 imaging files from 262 patients with C/SHD (mean age 49 years, 60% male) and 62 normal controls (mean age 45 years, 50.0% male) were included. Congenital diagnoses included among others, tetralogy of Fallot (30), Ebstein anomaly (18) and transposition of the great arteries (TGA, 48). Assessing correct view classification based on 284,250 individual frames revealed that the non-congenital model had an overall accuracy of 48.3% for correct view classification in patients with C/SHD compared to 66.7% in patients without cardiac disease. Our newly trained convolutional network for echocardiographic view detection based on over 139,910 frames and tested on 35,614 frames from C/SHD patients achieved an accuracy of 76.1% in detecting the correct echocardiographic view., Conclusions: The current study is the first to validate view classification by neural networks in C/SHD patients. While generic models have acceptable accuracy in general cardiology patients, the quality of image classification is only modest in patients with C/SHD. In contrast, our model trained in C/SHD achieved a considerably increased accuracy in this particular cohort.

Published
2022
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49. Lack of specialist care is associated with increased morbidity and mortality in adult congenital heart disease: a population-based study.

Author

Diller GP, Orwat S, Lammers AE, Radke RM, De-Torres-Alba F, Schmidt R, Marschall U, Bauer UM, Enders D, Bronstein L, Kaleschke G, and Baumgartner H

Subjects
Adult, Delivery of Health Care, Female, Humans, Male, Morbidity, Proportional Hazards Models, Cardiology, Heart Defects, Congenital therapy
Abstract

Aims: The aim of this study was to provide population-based data on the healthcare provision for adults with congenital heart disease (ACHD) and the impact of cardiology care on morbidity and mortality in this vulnerable population., Methods and Results: Based on administrative data from one of the largest German Health Insurance Companies, all insured ACHD patients (<70 years of age) were included. Patients were stratified into those followed exclusively by primary care physicians (PCPs) and those with additional cardiology follow-up between 2014 and 2016. Associations between level of care and outcome were assessed by multivariable/propensity score Cox analyses. Overall, 24 139 patients (median age 43 years, 54.8% female) were included. Of these, only 49.7% had cardiology follow-up during the 3-year period, with 49.2% of patients only being cared for by PCPs and 1.1% having no contact with either. After comprehensive multivariable and propensity score adjustment, ACHD patients under cardiology follow-up had a significantly lower risk of death [hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.67-0.98; P = 0.03) or major events (HR 0.85, 95% CI 0.78-0.92; P < 0.001) compared to those only followed by PCPs. At 3-year follow-up, the absolute risk difference for mortality was 0.9% higher in ACHD patients with moderate/severe complexity lesions cared by PCPs compared to those under cardiology follow-up., Conclusion: Cardiology care compared with primary care is associated with superior survival and lower rates of major complications in ACHD. It is alarming that even in a high resource setting with well-established specialist ACHD care approximately 50% of contemporary ACHD patients are still not linked to regular cardiac care. Almost all patients had at least one contact with a PCP during the study period, suggesting that opportunities to refer patients to cardiac specialists were missed at PCP level. More efforts are required to alert PCPs and patients to appropriate ACHD care., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)

Published
2021
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50. Clinical Value of Stress Transaortic Flow Rate During Dobutamine Echocardiography in Reduced Left Ventricular Ejection Fraction, Low-Gradient Aortic Stenosis: A Multicenter Study.

Author

Vamvakidou A, Annabi MS, Pibarot P, Plonska-Gosciniak E, Almeida AG, Guzzetti E, Dahou A, Burwash IG, Koschutnik M, Bartko PE, Bergler-Klein J, Mascherbauer J, Orwat S, Baumgartner H, Cavalcante J, Pinto F, Kukulski T, Kasprzak JD, Clavel MA, Flachskampf FA, and Senior R

Subjects
Aged, Aortic Valve physiopathology, Aortic Valve Stenosis diagnosis, Cardiotonic Agents pharmacology, Female, Follow-Up Studies, Humans, Male, Prognosis, Retrospective Studies, Risk Factors, Severity of Illness Index, Aortic Valve diagnostic imaging, Aortic Valve Stenosis physiopathology, Blood Flow Velocity physiology, Dobutamine pharmacology, Echocardiography, Stress methods, Stroke Volume physiology, Ventricular Function, Left physiology
Abstract

Background: Low rest transaortic flow rate (FR) has been shown previously to predict mortality in low-gradient aortic stenosis. However limited prognostic data exists on stress FR during low-dose dobutamine stress echocardiography. We aimed to assess the value of stress FR for the detection of aortic valve stenosis (AS) severity and the prediction of mortality., Methods: This is a multicenter cohort study of patients with reduced left ventricular ejection fraction and low-gradient aortic stenosis (aortic valve area <1 cm 2 and mean gradient <40 mm Hg) who underwent low-dose dobutamine stress echocardiography to identify the AS severity and presence of flow reserve. The outcome assessed was all-cause mortality., Results: Of the 287 patients (mean age, 75±10 years; males, 71%; left ventricular ejection fraction, 31±10%) over a mean follow-up of 24±30 months there were 127 (44.3%) deaths and 147 (51.2%) patients underwent aortic valve intervention. Higher stress FR was independently associated with reduced risk of mortality (hazard ratio, 0.97 [95% CI, 0.94-0.99]; P =0.01) after adjusting for age, chronic kidney disease, heart failure symptoms, aortic valve intervention, and rest left ventricular ejection fraction. The minimum cutoff for prediction of mortality was stress FR 210 mL/s. Following adjustment to the same important clinical and echocardiographic parameters, among the three criteria of AS severity during stress, ie, the guideline definition of aortic valve area <1cm 2 and aortic valve mean gradient ≥40 mm Hg, or aortic valve mean gradient ≥40 mm Hg, or the novel definition of aortic valve area <1 cm 2 at stress FR ≥210 mL/s, only the latter was independently associated with mortality (hazard ratio, 1.72 [95% CI, 1.05-2.82]; P =0.03). Furthermore aortic valve area <1cm 2 at stress FR ≥210 mL/s was the only severe aortic stenosis criterion that was associated with improved outcome following aortic valve intervention ( P <0.001). Guideline-defined stroke volume flow reserve did not predict mortality., Conclusions: Stress FR during low-dose dobutamine stress echocardiography was useful for the detection of both AS severity and flow reserve and was associated with improved prediction of outcome following aortic valve intervention.

Published
2021
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