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4. Long Term Health Related Quality of Life After Acute Type B Aortic Dissection: a Cross Sectional Survey Study

Author

Meccanici, Frederike, Thijssen, Carlijn G.E., Gökalp, Arjen L., Bom, Annemijn W., de Bruin, Jorg L., Bekkers, Jos A., van Kimmenade, Roland R.J., Geuzebroek, Guillaume S.C., Poyck, Paul, Woorst, Joost J. ter, Peels, Kathinka, Sjatskig, Jelena, Heijmen, Robin H., Post, Marco C., Mokhles, Mostafa M., Verhagen, Hence J.M., Takkenberg, Johanna J.M., and Roos-Hesselink, Jolien W.

Published
2023
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7. European Reference Network for Rare Vascular Diseases (VASCERN): When and how to use intravenous bevacizumab in Hereditary Haemorrhagic Telangiectasia (HHT)?

Author

Crocione, Claudia, Blom, Ria, Botella, Luisa Maria, Brocca, Fernando, Coxall, Caroline, Druckman, Karen T., Erasme, Didier, Federici, Paolo, Grabowski, Christina, Lundgren, Mildred, Søderman, Tone, Woods, Dara, Dupuis-Girod, Sophie, Shovlin, Claire L., Kjeldsen, Anette D., Mager, Hans-Jurgen, Sabba, Carlo, Droege, Freya, Fargeton, Anne-Emmanuelle, Fialla, Annette D., Gandolfi, Silvia, Hermann, Ruben, Lenato, Gennaro M., Manfredi, Guido, Post, Marco C., Rennie, Catherine, Suppressa, Patrizia, Sure, Ulrich, and Buscarini, Elisabetta

Published
2022
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10. Contemporary guideline‐directed medical therapy in de novo, chronic, and worsening heart failure patients: First data from the TITRATE‐HF study

Author

Malgie, Jishnu, primary, Wilde, Mariëlle I., additional, Clephas, Pascal R.D., additional, Emans, Mireille E., additional, Koudstaal, Stefan, additional, Schaap, Jeroen, additional, Mosterd, Arend, additional, van Ramshorst, Jan, additional, Wardeh, Alexander J., additional, van Wijk, Sandra, additional, van den Heuvel, Mieke, additional, Wierda, Eric, additional, Borleffs, C. Jan Willem, additional, Saraber, Colette, additional, Beeres, Saskia L.M.A., additional, van Kimmenade, Roland, additional, Jansen Klomp, Wouter, additional, Denham, Robert, additional, da Fonseca, Carlos A., additional, Klip, IJsbrand T., additional, Manintveld, Olivier C., additional, van der Boon, Robert M.A., additional, van Ofwegen, Clara E.E., additional, Yilmaz, Ayten, additional, Pisters, Ron, additional, Linssen, Gerard C.M., additional, Faber, Nikola, additional, van Heerebeek, Loek, additional, van de Swaluw, Julio E.C., additional, Bouhuijzen, Lex J., additional, Post, Marco C., additional, Kuijper, Aaf F.M., additional, Wu, Ka wai, additional, van Beek, Eugène A., additional, Hesselink, Tim, additional, Kleijn, Lennaert, additional, Kurvers, Maurice J.M., additional, Tio, René A., additional, Langerveld, Jorina, additional, van Dalen, Bas M., additional, van Eck, J.W. Martijn, additional, Handoko, M. Louis, additional, Hermans, Walter R.M., additional, Koornstra‐Wortel, Hetty J.J., additional, Szymanski, Mariusz K., additional, Rooker, Dennis, additional, Tandjung, Kenneth, additional, Eijsbouts, Sabine C.M., additional, Asselbergs, Folkert W., additional, van der Meer, Peter, additional, Brunner‐La Rocca, Hans‐Peter, additional, de Boer, Rudolf A., additional, and Brugts, Jasper J., additional

Published
2024
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11. Long-Term Health-Related Quality of Life following Acute Type A Aortic Dissection with a Focus on Male–Female Differences: A Cross Sectional Study

Author

Meccanici, Frederike, primary, Thijssen, Carlijn G. E., additional, Gökalp, Arjen L., additional, Bom, Annemijn W., additional, Geuzebroek, Guillaume S. C., additional, ter Woorst, Joost F., additional, van Kimmenade, Roland R. J., additional, Post, Marco C., additional, Takkenberg, Johanna J. M., additional, and Roos-Hesselink, Jolien W., additional

Published
2024
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15. Complications of Balloon Pulmonary Angioplasty: A Comprehensive Analysis Based on the Latest ESC Consensus Statement

Author

Circulatory Health, Team Medisch, van Leusden, Fe J., Staal, Diederik P., van Thor, Mitch C.J., Rensing, Benno J.M.W., van Kuijk, Jan Peter, Mulder, Berend M., van den Heuvel, Daniël A.F., Boerman, Sanne, Boomars, Karin A., Peper, Joyce, Mager, Johannes J., Post, Marco C., Circulatory Health, Team Medisch, van Leusden, Fe J., Staal, Diederik P., van Thor, Mitch C.J., Rensing, Benno J.M.W., van Kuijk, Jan Peter, Mulder, Berend M., van den Heuvel, Daniël A.F., Boerman, Sanne, Boomars, Karin A., Peper, Joyce, Mager, Johannes J., and Post, Marco C.

Published
2024

16. Contemporary guideline-directed medical therapy in de novo, chronic, and worsening heart failure patients: First data from the TITRATE-HF study

Author

Team Medisch, Circulatory Health, Malgie, Jishnu, Wilde, Mariëlle I, Clephas, Pascal R D, Emans, Mireille E, Koudstaal, Stefan, Schaap, Jeroen, Mosterd, Arend, van Ramshorst, Jan, Wardeh, Alexander J, van Wijk, Sandra, van den Heuvel, Mieke, Wierda, Eric, Borleffs, C Jan Willem, Saraber, Colette, Beeres, Saskia L M A, van Kimmenade, Roland, Jansen Klomp, Wouter, Denham, Robert, da Fonseca, Carlos A, Klip, IJsbrand T, Manintveld, Olivier C, van der Boon, Robert M A, van Ofwegen, Clara E E, Yilmaz, Ayten, Pisters, Ron, Linssen, Gerard C M, Faber, Nikola, van Heerebeek, Loek, van de Swaluw, Julio E C, Bouhuijzen, Lex J, Post, Marco C, Kuijper, Aaf F M, Wu, Ka Wai, van Beek, Eugène A, Hesselink, Tim, Kleijn, Lennaert, Kurvers, Maurice J M, Tio, René A, Langerveld, Jorina, van Dalen, Bas M, van Eck, J W Martijn, Handoko, M Louis, Hermans, Walter R M, Koornstra-Wortel, Hetty J J, Szymanski, Mariusz K, Rooker, Dennis, Tandjung, Kenneth, Eijsbouts, Sabine C M, Asselbergs, Folkert W, van der Meer, Peter, Brunner-La Rocca, Hans-Peter, de Boer, Rudolf A, Brugts, Jasper J, Team Medisch, Circulatory Health, Malgie, Jishnu, Wilde, Mariëlle I, Clephas, Pascal R D, Emans, Mireille E, Koudstaal, Stefan, Schaap, Jeroen, Mosterd, Arend, van Ramshorst, Jan, Wardeh, Alexander J, van Wijk, Sandra, van den Heuvel, Mieke, Wierda, Eric, Borleffs, C Jan Willem, Saraber, Colette, Beeres, Saskia L M A, van Kimmenade, Roland, Jansen Klomp, Wouter, Denham, Robert, da Fonseca, Carlos A, Klip, IJsbrand T, Manintveld, Olivier C, van der Boon, Robert M A, van Ofwegen, Clara E E, Yilmaz, Ayten, Pisters, Ron, Linssen, Gerard C M, Faber, Nikola, van Heerebeek, Loek, van de Swaluw, Julio E C, Bouhuijzen, Lex J, Post, Marco C, Kuijper, Aaf F M, Wu, Ka Wai, van Beek, Eugène A, Hesselink, Tim, Kleijn, Lennaert, Kurvers, Maurice J M, Tio, René A, Langerveld, Jorina, van Dalen, Bas M, van Eck, J W Martijn, Handoko, M Louis, Hermans, Walter R M, Koornstra-Wortel, Hetty J J, Szymanski, Mariusz K, Rooker, Dennis, Tandjung, Kenneth, Eijsbouts, Sabine C M, Asselbergs, Folkert W, van der Meer, Peter, Brunner-La Rocca, Hans-Peter, de Boer, Rudolf A, and Brugts, Jasper J

Published
2024

17. Serial cardiac biomarkers, pulmonary artery pressures and traditional parameters of fluid status in relation to prognosis in patients with chronic heart failure:Design and rationale of the BioMEMS study

Author

Allach, Youssra, de Jong, Mylene Barry-Loncq, Clephas, Pascal R. D., van Gent, Marco W. F., Brunner-La Rocca, Hans-Peter, Szymanski, Mariusz K., van Halm, Vokko P., Handoko, M. Louis, Kok, Wouter E. M., Asselbergs, Folkert W., van Kimmenade, Roland R. J., Manintveld, Olivier C., van Mieghem, Nicolas M. D. A., Beeres, Saskia L. M. A., Rienstra, Michiel, Post, Marco C., van Heerebeek, Loek, Borleffs, C. Jan Willem, Tukkie, Raymond, Mosterd, Arend, Linssen, Gerard C. M., Spee, Ruud F., Emans, Mireille E., Smilde, Tom D. J., van Ramshorst, Jan, Kirchhof, Charles J. H. J., Feenema-Aardema, Margriet W., da Fonseca, Carlos A., van den Heuvel, Mieke, Hazeleger, Ronald, van Eck, J. W. Martijn, Boersma, Eric, Kardys, Isabella, de Boer, Rudolf A., Brugts, Jasper J., Allach, Youssra, de Jong, Mylene Barry-Loncq, Clephas, Pascal R. D., van Gent, Marco W. F., Brunner-La Rocca, Hans-Peter, Szymanski, Mariusz K., van Halm, Vokko P., Handoko, M. Louis, Kok, Wouter E. M., Asselbergs, Folkert W., van Kimmenade, Roland R. J., Manintveld, Olivier C., van Mieghem, Nicolas M. D. A., Beeres, Saskia L. M. A., Rienstra, Michiel, Post, Marco C., van Heerebeek, Loek, Borleffs, C. Jan Willem, Tukkie, Raymond, Mosterd, Arend, Linssen, Gerard C. M., Spee, Ruud F., Emans, Mireille E., Smilde, Tom D. J., van Ramshorst, Jan, Kirchhof, Charles J. H. J., Feenema-Aardema, Margriet W., da Fonseca, Carlos A., van den Heuvel, Mieke, Hazeleger, Ronald, van Eck, J. W. Martijn, Boersma, Eric, Kardys, Isabella, de Boer, Rudolf A., and Brugts, Jasper J.

Abstract

Aims: Heart failure (HF), a global pandemic affecting millions of individuals, calls for adequate predictive guidance for improved therapy. Congestion, a key factor in HF-related hospitalizations, further underscores the need for timely interventions. Proactive monitoring of intracardiac pressures, guided by pulmonary artery (PA) pressure, offers opportunities for efficient early-stage intervention, since haemodynamic congestion precedes clinical symptoms. Methods: The BioMEMS study, a substudy of the MONITOR-HF trial, proposes a multifaceted approach integrating blood biobank data with traditional and novel HF parameters. Two additional blood samples from 340 active participants in the MONITOR-HF trial were collected at baseline, 3-, 6-, and 12-month visits and stored for the BioMEMS biobank. The main aims are to identify the relationship between temporal biomarker patterns and PA pressures derived from the CardioMEMS-HF system, and to identify the biomarker profile(s) associated with the risk of HF events and cardiovascular death. Conclusion: Since the prognostic value of single baseline measurements of biomarkers like N-terminal pro-B-type natriuretic peptide is limited, with the BioMEMS study we advocate a dynamic, serial approach to better capture HF progression. We will substantiate this by relating repeated biomarker measurements to PA pressures. This design rationale presents a comprehensive review on cardiac biomarkers in HF, and aims to contribute valuable insights into personalized HF therapy and patient risk assessment, advancing our ability to address the evolving nature of HF effectively.

Published
2024

18. Contemporary guideline-directed medical therapy in de novo, chronic, and worsening heart failure patients:First data from the TITRATE-HF study

Author

Malgie, Jishnu, Wilde, Mariëlle I., Clephas, Pascal R.D., Emans, Mireille E., Koudstaal, Stefan, Schaap, Jeroen, Mosterd, Arend, van Ramshorst, Jan, Wardeh, Alexander J., van Wijk, Sandra, van den Heuvel, Mieke, Wierda, Eric, Borleffs, C. Jan Willem, Saraber, Colette, Beeres, Saskia L.M.A., van Kimmenade, Roland, Jansen Klomp, Wouter, Denham, Robert, da Fonseca, Carlos A., Klip, IJsbrand T., Manintveld, Olivier C., van der Boon, Robert M.A., van Ofwegen, Clara E.E., Yilmaz, Ayten, Pisters, Ron, Linssen, Gerard C.M., Faber, Nikola, van Heerebeek, Loek, van de Swaluw, Julio E.C., Bouhuijzen, Lex J., Post, Marco C., Kuijper, Aaf F.M., Wu, Ka wai, van Beek, Eugène A., Hesselink, Tim, Kleijn, Lennaert, Kurvers, Maurice J.M., Tio, René A., Langerveld, Jorina, van Dalen, Bas M., van Eck, J. W.Martijn, Handoko, M. Louis, Hermans, Walter R.M., Koornstra-Wortel, Hetty J.J., Szymanski, Mariusz K., Rooker, Dennis, Tandjung, Kenneth, Eijsbouts, Sabine C.M., Asselbergs, Folkert W., van der Meer, Peter, Brunner-La Rocca, Hans Peter, de Boer, Rudolf A., Brugts, Jasper J., Malgie, Jishnu, Wilde, Mariëlle I., Clephas, Pascal R.D., Emans, Mireille E., Koudstaal, Stefan, Schaap, Jeroen, Mosterd, Arend, van Ramshorst, Jan, Wardeh, Alexander J., van Wijk, Sandra, van den Heuvel, Mieke, Wierda, Eric, Borleffs, C. Jan Willem, Saraber, Colette, Beeres, Saskia L.M.A., van Kimmenade, Roland, Jansen Klomp, Wouter, Denham, Robert, da Fonseca, Carlos A., Klip, IJsbrand T., Manintveld, Olivier C., van der Boon, Robert M.A., van Ofwegen, Clara E.E., Yilmaz, Ayten, Pisters, Ron, Linssen, Gerard C.M., Faber, Nikola, van Heerebeek, Loek, van de Swaluw, Julio E.C., Bouhuijzen, Lex J., Post, Marco C., Kuijper, Aaf F.M., Wu, Ka wai, van Beek, Eugène A., Hesselink, Tim, Kleijn, Lennaert, Kurvers, Maurice J.M., Tio, René A., Langerveld, Jorina, van Dalen, Bas M., van Eck, J. W.Martijn, Handoko, M. Louis, Hermans, Walter R.M., Koornstra-Wortel, Hetty J.J., Szymanski, Mariusz K., Rooker, Dennis, Tandjung, Kenneth, Eijsbouts, Sabine C.M., Asselbergs, Folkert W., van der Meer, Peter, Brunner-La Rocca, Hans Peter, de Boer, Rudolf A., and Brugts, Jasper J.

Abstract

Aims: Despite clear guideline recommendations for initiating four drug classes in all patients with heart failure (HF) with reduced ejection fraction (HFrEF) and the availability of rapid titration schemes, information on real-world implementation lags behind. Closely following the 2021 ESC HF guidelines and 2023 focused update, the TITRATE-HF study started to prospectively investigate the use, sequencing, and titration of guideline-directed medical therapy (GDMT) in HF patients, including the identification of implementation barriers. Methods and results: TITRATE-HF is an ongoing long-term HF registry conducted in the Netherlands. Overall, 4288 patients from 48 hospitals were included. Among these patients, 1732 presented with de novo, 2240 with chronic, and 316 with worsening HF. The median age was 71 years (interquartile range [IQR] 63–78), 29% were female, and median ejection fraction was 35% (IQR 25–40). In total, 44% of chronic and worsening HFrEF patients were prescribed quadruple therapy. However, only 1% of HFrEF patients achieved target dose for all drug classes. In addition, quadruple therapy was more often prescribed to patients treated in a dedicated HF outpatient clinic as compared to a general cardiology outpatient clinic. In each GDMT drug class, 19% to 36% of non-use in HFrEF patients was related to side-effects, intolerances, or contraindications. In the de novo HF cohort, 49% of patients already used one or more GDMT drug classes for other indications than HF. Conclusion: This first analysis of the TITRATE-HF study reports relatively high use of GDMT in a contemporary HF cohort, while still showing room for improvement regarding quadruple therapy. Importantly, the use and dose of GDMT were suboptimal, with the reasons often remaining unclear. This underscores the urgency for further optimization of GDMT and implementation strategies within HF management.

Published
2024

19. Serial cardiac biomarkers, pulmonary artery pressures and traditional parameters of fluid status in relation to prognosis in patients with chronic heart failure: Design and rationale of the BioMEMS study

Author

Team Medisch, Circulatory Health, Allach, Youssra, Barry-Loncq de Jong, Mylene, Clephas, Pascal R D, van Gent, Marco W F, Brunner-La Rocca, Hans-Peter, Szymanski, Mariusz K, van Halm, Vokko P, Handoko, M Louis, Kok, Wouter E M, Asselbergs, Folkert W, van Kimmenade, Roland R J, Manintveld, Olivier C, van Mieghem, Nicolas M D A, Beeres, Saskia L M A, Rienstra, Michiel, Post, Marco C, van Heerebeek, Loek, Borleffs, C Jan Willem, Tukkie, Raymond, Mosterd, Arend, Linssen, Gerard C M, Spee, Ruud F, Emans, Mireille E, Smilde, Tom D J, van Ramshorst, Jan, Kirchhof, Charles J H J, Feenema-Aardema, Margriet W, da Fonseca, Carlos A, van den Heuvel, Mieke, Hazeleger, Ronald, van Eck, J W Martijn, Boersma, Eric, Kardys, Isabella, de Boer, Rudolf A, Brugts, Jasper J, Team Medisch, Circulatory Health, Allach, Youssra, Barry-Loncq de Jong, Mylene, Clephas, Pascal R D, van Gent, Marco W F, Brunner-La Rocca, Hans-Peter, Szymanski, Mariusz K, van Halm, Vokko P, Handoko, M Louis, Kok, Wouter E M, Asselbergs, Folkert W, van Kimmenade, Roland R J, Manintveld, Olivier C, van Mieghem, Nicolas M D A, Beeres, Saskia L M A, Rienstra, Michiel, Post, Marco C, van Heerebeek, Loek, Borleffs, C Jan Willem, Tukkie, Raymond, Mosterd, Arend, Linssen, Gerard C M, Spee, Ruud F, Emans, Mireille E, Smilde, Tom D J, van Ramshorst, Jan, Kirchhof, Charles J H J, Feenema-Aardema, Margriet W, da Fonseca, Carlos A, van den Heuvel, Mieke, Hazeleger, Ronald, van Eck, J W Martijn, Boersma, Eric, Kardys, Isabella, de Boer, Rudolf A, and Brugts, Jasper J

Published
2024

20. Complications of Balloon Pulmonary Angioplasty:A Comprehensive Analysis Based on the Latest ESC Consensus Statement

Author

van Leusden, Fe J., Staal, Diederik P., van Thor, Mitch C.J., Rensing, Benno J.M.W., van Kuijk, Jan Peter, Mulder, Berend M., van den Heuvel, Daniël A.F., Boerman, Sanne, Boomars, Karin A., Peper, Joyce, Mager, Johannes J., Post, Marco C., van Leusden, Fe J., Staal, Diederik P., van Thor, Mitch C.J., Rensing, Benno J.M.W., van Kuijk, Jan Peter, Mulder, Berend M., van den Heuvel, Daniël A.F., Boerman, Sanne, Boomars, Karin A., Peper, Joyce, Mager, Johannes J., and Post, Marco C.

Abstract

Background/Objectives: The literature reports high complication rates in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who undergo balloon pulmonary angioplasty (BPA), especially in patients with poor pulmonary hemodynamics. Here, we describe the complications of BPA based on the new definitions. Methods: All patients with CTEPH who completed BPA treatment before 15 September 2023 were selected from the CTEPH database. Peri-procedural complications were collected and classified according to the 2023 consensus paper on BPA treatment. Complications were analyzed in subgroups of patients with pulmonary vascular resistance (PVR), ≤ or >6.6 WU, and mean pulmonary artery pressure (mPAP), ≤ or >45 mmHg, at first BPA. Results: In this analysis, 87 patients (63% women; mean age 61.1 ± 14.0 years; 62% on dual PH targeted medical therapy) underwent 426 (mean 4.9 ± 1.6 per patient) BPAs. Only non-severe complications occurred in 14% of BPA treatments and in 47% of the patients; 31% patients had a thoracic complication. The thoracic complications were mild (71%) or moderate (29%). Patients with a PVR > 6.6 WU (n = 8) underwent more BPA treatments (6.6 ± 1.5 versus 4.6 ± 1.5, p = 0.002), had more complications (88% versus 41% of patients, p = 0.020), and had more thoracic complications (17% vs. 7% of BPAs, p = 0.013) than patients with PVR ≤ 6.6 WU. Patients with mPAP > 45 mmHg (n = 13) also had more BPA treatments (6.5 ± 1.7 versus 4.6 ± 1.4, p < 0.001), more complications (77% versus 44% of patients, p = 0.027) and more thoracic complications (14% versus 8% of BPAs, p = 0.039) than patients with mPAP ≤ 45 mmHg. Conclusions: Complications occurred in 14% of BPAs and were mostly mild. Patients with severe pulmonary hemodynamics suffered more (thoracic) complications.

Published
2024

21. Male-Female Differences in Acute Type B Aortic Dissection

Author

Meccanici, Frederike, Thijssen, Carlijn G.E., Heijmen, Robin H., Geuzebroek, Guillaume S.C., Ter Woorst, Joost F., Gökalp, Arjen L., de Bruin, Jorg L., Gratama, Daantje N., Bekkers, Jos A., van Kimmenade, Roland R.J., Poyck, Paul, Peels, Kathinka, Post, Marco C., Mokhles, Mostafa M., Takkenberg, Johanna J.M., Roos-Hesselink, Jolien W., Verhagen, Hence J.M., Meccanici, Frederike, Thijssen, Carlijn G.E., Heijmen, Robin H., Geuzebroek, Guillaume S.C., Ter Woorst, Joost F., Gökalp, Arjen L., de Bruin, Jorg L., Gratama, Daantje N., Bekkers, Jos A., van Kimmenade, Roland R.J., Poyck, Paul, Peels, Kathinka, Post, Marco C., Mokhles, Mostafa M., Takkenberg, Johanna J.M., Roos-Hesselink, Jolien W., and Verhagen, Hence J.M.

Abstract

BACKGROUND: Acute type B aortic dissection is a cardiovascular emergency with considerable mortality and morbidity risk. Male-female differences have been observed in cardiovascular disease; however, literature on type B aortic dissection is scarce. METHODS AND RESULTS: A retrospective cohort study was conducted including all consecutive patients with acute type B aortic dissection between 2007 and 2017 in 4 tertiary hospitals using patient files and questionnaires for late morbidity. In total, 384 patients were included with a follow-up of 6.1 (range, 0.02-14.8) years, of which 41% (n=156) were female. Women presented at an older age than men (67 [interquartile range (IQR), 57-73] versus 62 [IQR, 52-71]; P=0.015). Prior abdominal aortic aneurysm (6% versus 15%; P=0.009), distally extending dissections (71 versus 85%; P=0.001), and clinical malperfusion (18% versus 32%; P=0.002) were less frequently observed in women. Absolute maximal descending aortic diameters were smaller in women (36 [IQR: 33-40] mm versus 39 [IQR, 36-43] mm; P<0.001), while indexed for body surface area diameters were larger in women (20 [IQR, 18-23] mm/m2 versus 19 [IQR, 17-21] mm/m2). No male-female differences were found in treatment choice; however, indications for invasive treatment were different (P<0.001). Early mortality rate was 9.6% in women and 11.8% in men (P=0.60). The 5-year survival was 83% (95% CI, 77-89) for women and 84% (95% CI, 79-89) for men (P=0.90). No male-female differences were observed in late (re)interventions. CONCLUSIONS: No male-female differences were found in management, early or late death, and morbidity in patients presenting with acute type B aortic dissection, despite distinct clinical profiles at presentation. More details on the impact of age and type of intervention are warranted in future studies.

Published
2024

22. Long-Term Health-Related Quality of Life following Acute Type A Aortic Dissection with a Focus on Male-Female Differences: A Cross Sectional Study

Author

R&D Onderzoek, Cardiologie Arts-onderzoekers, Team Medisch, Circulatory Health, Meccanici, Frederike, Thijssen, Carlijn G E, Gökalp, Arjen L, Bom, Annemijn W, Geuzebroek, Guillaume S C, Ter Woorst, Joost F, van Kimmenade, Roland R J, Post, Marco C, Takkenberg, Johanna J M, Roos-Hesselink, Jolien W, R&D Onderzoek, Cardiologie Arts-onderzoekers, Team Medisch, Circulatory Health, Meccanici, Frederike, Thijssen, Carlijn G E, Gökalp, Arjen L, Bom, Annemijn W, Geuzebroek, Guillaume S C, Ter Woorst, Joost F, van Kimmenade, Roland R J, Post, Marco C, Takkenberg, Johanna J M, and Roos-Hesselink, Jolien W

Published
2024

23. Male-Female Differences in Acute Type B Aortic Dissection

Author

Team Medisch, Circulatory Health, CTC, Meccanici, Frederike, Thijssen, Carlijn G E, Heijmen, Robin H, Geuzebroek, Guillaume S C, Ter Woorst, Joost F, Gökalp, Arjen L, de Bruin, Jorg L, Gratama, Daantje N, Bekkers, Jos A, van Kimmenade, Roland R J, Poyck, Paul, Peels, Kathinka, Post, Marco C, Mokhles, Mostafa M, Takkenberg, Johanna J M, Roos-Hesselink, Jolien W, Verhagen, Hence J M, Team Medisch, Circulatory Health, CTC, Meccanici, Frederike, Thijssen, Carlijn G E, Heijmen, Robin H, Geuzebroek, Guillaume S C, Ter Woorst, Joost F, Gökalp, Arjen L, de Bruin, Jorg L, Gratama, Daantje N, Bekkers, Jos A, van Kimmenade, Roland R J, Poyck, Paul, Peels, Kathinka, Post, Marco C, Mokhles, Mostafa M, Takkenberg, Johanna J M, Roos-Hesselink, Jolien W, and Verhagen, Hence J M

Published
2024

24. Long-Term Health-Related Quality of Life following Acute Type A Aortic Dissection with a Focus on Male–Female Differences:A Cross Sectional Study

Author

Meccanici, Frederike, Thijssen, Carlijn G.E., Gökalp, Arjen L., Bom, Annemijn W., Geuzebroek, Guillaume S.C., ter Woorst, Joost F., van Kimmenade, Roland R.J., Post, Marco C., Takkenberg, Johanna J.M., Roos-Hesselink, Jolien W., Meccanici, Frederike, Thijssen, Carlijn G.E., Gökalp, Arjen L., Bom, Annemijn W., Geuzebroek, Guillaume S.C., ter Woorst, Joost F., van Kimmenade, Roland R.J., Post, Marco C., Takkenberg, Johanna J.M., and Roos-Hesselink, Jolien W.

Abstract

Objectives: Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency, of which the long-term impact on health-related quality of life (HRQoL) and male–female-specific insights remain inadequately clarified. Methods: Consecutive adult ATAAD patients who underwent surgery were retrospectively included between 2007 and 2017 in four referral centers in the Netherlands, and baseline data were collected. The 36-Item Short-Form (SF-36) Health Survey was sent to all survivors between 2019 and 2021 and compared to validated SF-36 scores of the Dutch general population stratified by age group and sex. Results: In total, 324/555 surviving patients returned the SF-36 questionnaire (response rate 58%), of which 40.0% were female; the median follow-up was 6.5 years (range: 1.7–13.9, IQR: 4.0–9.4) after surgery for ATAAD. In comparison to the general population, ATAAD patients scored significantly lower on 6/8 SF-36 subdomains and higher on bodily pain. Differences in HRQoL domains compared to the sex-matched data were largely comparable between sexes, apart from bodily pain. In the age-matched subgroups impaired HRQoL was most pronounced in younger patients aged 41–60 (5/8 impaired domains). Female ATAAD patients scored significantly worse on 5/8 SF-36 subdomains and the physical component summary (PCS) scores than male patients. Age at ATAAD, female sex, hypertension, COPD, and prior thoracic aortic aneurysm were associated with worse PCS scores. Conclusions: Long-term HRQoL was impaired in both male and female ATAAD patients when compared to the general population. Further studies on the nature of this impairment and on interventions to improve HRQoL after ATAAD are clearly warranted, with special attention to females and younger patients.

Published
2024

25. Pulmonary artery pressure monitoring in chronic heart failure: effects across clinically relevant subgroups in the MONITOR-HF trial.

Author

Clephas, Pascal R D, Zwartkruis, Victor W, Malgie, Jishnu, Gent, Marco W F van, Rocca, Hans-Peter Brunner-La, Szymanski, Mariusz K, Halm, Vokko P van, Handoko, M Louis, Kok, Wouter E M, Asselbergs, Folkert W, Kimmenade, Roland R J van, Manintveld, Olivier C, Mieghem, Nicolas M D A van, Beeres, Saskia L M A, Post, Marco C, Borleffs, C Jan Willem, Tukkie, Raymond, Mosterd, Arend, Linssen, Gerard C M, and Spee, Ruud F

Subjects
CARDIAC pacing, PULMONARY artery, VENTRICULAR ejection fraction, OLDER patients, IMPLANTABLE cardioverter-defibrillators
Abstract

Background and Aims In patients with chronic heart failure (HF), the MONITOR-HF trial demonstrated the efficacy of pulmonary artery (PA)-guided HF therapy over standard of care in improving quality of life and reducing HF hospitalizations and mean PA pressure. This study aimed to evaluate the consistency of these benefits in relation to clinically relevant subgroups. Methods The effect of PA-guided HF therapy was evaluated in the MONITOR-HF trial among predefined subgroups based on age, sex, atrial fibrillation, diabetes mellitus, left ventricular ejection fraction, HF aetiology, cardiac resynchronization therapy, and implantable cardioverter defibrillator. Outcome measures were based upon significance in the main trial and included quality of life-, clinical-, and PA pressure endpoints, and were assessed for each subgroup. Differential effects in relation to the subgroups were assessed with interaction terms. Both unadjusted and multiple testing adjusted interaction terms were presented. Results The effects of PA monitoring on quality of life, clinical events, and PA pressure were consistent in the predefined subgroups, without any clinically relevant heterogeneity within or across all endpoint categories (all adjusted interaction P -values were non-significant). In the unadjusted analysis of the primary endpoint quality-of-life change, weak trends towards a less pronounced effect in older patients (P interaction =.03; adjusted P interaction =.33) and diabetics (P interaction =.01; adjusted P interaction =.06) were observed. However, these interaction effects did not persist after adjusting for multiple testing. Conclusions This subgroup analysis confirmed the consistent benefits of PA-guided HF therapy observed in the MONITOR-HF trial across clinically relevant subgroups, highlighting its efficacy in improving quality of life, clinical, and PA pressure endpoints in chronic HF patients. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Complications of Balloon Pulmonary Angioplasty: A Comprehensive Analysis Based on the Latest ESC Consensus Statement.

Author

van Leusden, Fe J., Staal, Diederik P., van Thor, Mitch C. J., Rensing, Benno J. M. W., van Kuijk, Jan-Peter, Mulder, Berend M., van den Heuvel, Daniël A. F., Boerman, Sanne, Boomars, Karin A., Peper, Joyce, Mager, Johannes J., and Post, Marco C.

Subjects
TRANSLUMINAL angioplasty, PULMONARY artery, VASCULAR resistance, PULMONARY hypertension, PULMONARY embolism
Abstract

Background/Objectives: The literature reports high complication rates in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who undergo balloon pulmonary angioplasty (BPA), especially in patients with poor pulmonary hemodynamics. Here, we describe the complications of BPA based on the new definitions. Methods: All patients with CTEPH who completed BPA treatment before 15 September 2023 were selected from the CTEPH database. Peri-procedural complications were collected and classified according to the 2023 consensus paper on BPA treatment. Complications were analyzed in subgroups of patients with pulmonary vascular resistance (PVR), ≤ or >6.6 WU, and mean pulmonary artery pressure (mPAP), ≤ or >45 mmHg, at first BPA. Results: In this analysis, 87 patients (63% women; mean age 61.1 ± 14.0 years; 62% on dual PH targeted medical therapy) underwent 426 (mean 4.9 ± 1.6 per patient) BPAs. Only non-severe complications occurred in 14% of BPA treatments and in 47% of the patients; 31% patients had a thoracic complication. The thoracic complications were mild (71%) or moderate (29%). Patients with a PVR > 6.6 WU (n = 8) underwent more BPA treatments (6.6 ± 1.5 versus 4.6 ± 1.5, p = 0.002), had more complications (88% versus 41% of patients, p = 0.020), and had more thoracic complications (17% vs. 7% of BPAs, p = 0.013) than patients with PVR ≤ 6.6 WU. Patients with mPAP > 45 mmHg (n = 13) also had more BPA treatments (6.5 ± 1.7 versus 4.6 ± 1.4, p < 0.001), more complications (77% versus 44% of patients, p = 0.027) and more thoracic complications (14% versus 8% of BPAs, p = 0.039) than patients with mPAP ≤ 45 mmHg. Conclusions: Complications occurred in 14% of BPAs and were mostly mild. Patients with severe pulmonary hemodynamics suffered more (thoracic) complications. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Serial cardiac biomarkers, pulmonary artery pressures and traditional parameters of fluid status in relation to prognosis in patients with chronic heart failure: Design and rationale of the BioMEMS study.

Author

Allach, Youssra, Barry‐Loncq de Jong, Mylene, Clephas, Pascal R.D., van Gent, Marco W.F., Brunner‐La Rocca, Hans‐Peter, Szymanski, Mariusz K., van Halm, Vokko P., Handoko, M. Louis, Kok, Wouter E.M., Asselbergs, Folkert W., van Kimmenade, Roland R.J., Manintveld, Olivier C., van Mieghem, Nicolas M.D.A., Beeres, Saskia L.M.A., Rienstra, Michiel, Post, Marco C., van Heerebeek, Loek, Borleffs, C. Jan Willem, Tukkie, Raymond, and Mosterd, Arend

Subjects
PULMONARY artery, HEART failure, HEART failure patients, CARDIOVASCULAR disease related mortality, DESIGN failures, PROGNOSIS
Abstract

Aims: Heart failure (HF), a global pandemic affecting millions of individuals, calls for adequate predictive guidance for improved therapy. Congestion, a key factor in HF‐related hospitalizations, further underscores the need for timely interventions. Proactive monitoring of intracardiac pressures, guided by pulmonary artery (PA) pressure, offers opportunities for efficient early‐stage intervention, since haemodynamic congestion precedes clinical symptoms. Methods: The BioMEMS study, a substudy of the MONITOR‐HF trial, proposes a multifaceted approach integrating blood biobank data with traditional and novel HF parameters. Two additional blood samples from 340 active participants in the MONITOR‐HF trial were collected at baseline, 3‐, 6‐, and 12‐month visits and stored for the BioMEMS biobank. The main aims are to identify the relationship between temporal biomarker patterns and PA pressures derived from the CardioMEMS‐HF system, and to identify the biomarker profile(s) associated with the risk of HF events and cardiovascular death. Conclusion: Since the prognostic value of single baseline measurements of biomarkers like N‐terminal pro‐B‐type natriuretic peptide is limited, with the BioMEMS study we advocate a dynamic, serial approach to better capture HF progression. We will substantiate this by relating repeated biomarker measurements to PA pressures. This design rationale presents a comprehensive review on cardiac biomarkers in HF, and aims to contribute valuable insights into personalized HF therapy and patient risk assessment, advancing our ability to address the evolving nature of HF effectively. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: a clinical consensus statement of the ESC working group on pulmonary circulation and right ventricular function

Author

Lang, Irene M, primary, Andreassen, Arne K, additional, Andersen, Asger, additional, Bouvaist, Helene, additional, Coghlan, Gerry, additional, Escribano-Subias, Pilar, additional, Jansa, Pavel, additional, Kopec, Grzegorz, additional, Kurzyna, Marcin, additional, Matsubara, Hiromi, additional, Meyer, Bernhard Christian, additional, Palazzini, Massimiliano, additional, Post, Marco C, additional, Pruszczyk, Piotr, additional, Räber, Lorenz, additional, Roik, Marek, additional, Rosenkranz, Stephan, additional, Wiedenroth, Christoph B, additional, Redlin-Werle, Carlo, additional, and Brenot, Philippe, additional

Published
2023
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35. Clinical Characteristics and Outcomes of Patients With Cutibacterium acnes Endocarditis

Author

Heinen, Floris J., primary, Arregle, Florent, additional, van den Brink, Floris S., additional, Ajmone Marsan, Nina, additional, Bernts, Lucas, additional, Houthuizen, Patrick, additional, Kamp, Otto, additional, Roescher, Nienke, additional, Timmermans, Naomi, additional, Verkaik, Nelianne, additional, Roos-Hesselink, Jolien, additional, Post, Marco C, additional, Habib, Gilbert, additional, and Tanis, Wilco, additional

Published
2023
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36. European Reference Network for Rare Vascular Diseases (VASCERN) position statement on cerebral screening in adults and children with hereditary haemorrhagic telangiectasia (HHT)

Author

Eker, Omer F., Boccardi, Edoardo, Sure, Ulrich, Patel, Maneesh C., Alicante, Saverio, Alsafi, Ali, Coote, Nicola, Droege, Freya, Dupuis, Olivier, Fialla, Annette Dam, Jones, Bryony, Kariholu, Ujwal, Kjeldsen, Anette D., Lefroy, David, Lenato, Gennaro M., Mager, Hans Jurgen, Manfredi, Guido, Nielsen, Troels H., Pagella, Fabio, Post, Marco C., Rennie, Catherine, Sabbà, Carlo, Suppressa, Patrizia, Toerring, Pernille M., Ugolini, Sara, Buscarini, Elisabetta, Dupuis-Girod, Sophie, and Shovlin, Claire L.

Published
2020
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37. Prednisone vs methotrexate in treatment naïve cardiac sarcoidosis

Author

Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, PECP – Centre for Clinical Therapeutics, Vis, Roeland, Mathijssen, Harold, Keijsers, Ruth G M, van de Garde, Ewoudt M W, Veltkamp, Marcel, Akdim, Fatima, Post, Marco C, Grutters, Jan C, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, PECP – Centre for Clinical Therapeutics, Vis, Roeland, Mathijssen, Harold, Keijsers, Ruth G M, van de Garde, Ewoudt M W, Veltkamp, Marcel, Akdim, Fatima, Post, Marco C, and Grutters, Jan C

Published
2023

38. Long Term Health Related Quality of Life After Acute Type B Aortic Dissection:a Cross Sectional Survey Study

Author

Meccanici, Frederike, Thijssen, Carlijn G.E., Gökalp, Arjen L., Bom, Annemijn W., de Bruin, Jorg L., Bekkers, Jos A., van Kimmenade, Roland R.J., Geuzebroek, Guillaume S.C., Poyck, Paul, Woorst, Joost J.ter, Peels, Kathinka, Sjatskig, Jelena, Heijmen, Robin H., Post, Marco C., Mokhles, Mostafa M., Verhagen, Hence J.M., Takkenberg, Johanna J.M., Roos-Hesselink, Jolien W., Meccanici, Frederike, Thijssen, Carlijn G.E., Gökalp, Arjen L., Bom, Annemijn W., de Bruin, Jorg L., Bekkers, Jos A., van Kimmenade, Roland R.J., Geuzebroek, Guillaume S.C., Poyck, Paul, Woorst, Joost J.ter, Peels, Kathinka, Sjatskig, Jelena, Heijmen, Robin H., Post, Marco C., Mokhles, Mostafa M., Verhagen, Hence J.M., Takkenberg, Johanna J.M., and Roos-Hesselink, Jolien W.

Abstract

Objective: Acute type B aortic dissection (ATBD) is a rare yet serious cardiovascular event that potentially has an impact on health related quality of life (HRQoL). However, long term follow up data on this topic are scarce. This study aimed to review the long term HRQoL among patients treated for ATBD. Methods: In this multicentre, cross sectional survey study, consecutive treated patients with ATBD between 2007 and 2017 in four referral centres in the Netherlands were retrospectively included and baseline data were collected. Between 2019 and 2021 the 36 Item Short Form Survey (SF-36) was sent to all surviving patients (n = 263) and was compared with validated SF-36 scores in the Dutch general population stratified by age and sex. Results: In total, 144 of 263 surviving patients completed the SF-36 (response rate 55%). Median (IQR) age was 68 (61, 76) years at completion of the questionnaire, and 40% (n = 58) were female. Initial treatment was medical in 55% (n = 79), endovascular in 41% (n = 59), and surgical in 4% (n = 6) of ATBD patients. Median follow up time was 6.1 (range 1.7–13.9; IQR 4.0, 9.0) years. Compared with the general population, patients scored significantly worse on six of eight SF-36 subdomains, particularly physical domains. Apart from bodily pain, there were no substantial differences in HRQoL between male and female ATBD patients. Compared with sex matched normative data, females scored significantly worse on five of eight subdomains, whereas males scored significantly lower on six subdomains. Younger patients aged 41–60 years seemed more severely impaired in HRQoL compared with the age matched general population. Treatment strategy did not influence HRQoL outcomes. Follow up time was associated with better Physical and Mental Component Summary scores. Conclusion:Long term HRQoL was impaired in ATBD patients compared with the Dutch general population, especially

Published
2023

39. Clinical Characteristics and Outcomes of Patients With Cutibacterium acnes Endocarditis

Author

Heinen, Floris J., Arregle, Florent, van den Brink, Floris S., Ajmone Marsan, Nina, Bernts, Lucas, Houthuizen, Patrick, Kamp, Otto, Roescher, Nienke, Timmermans, Naomi, Verkaik, Nelianne, Roos-Hesselink, Jolien, Post, Marco C., Habib, Gilbert, Tanis, Wilco, Heinen, Floris J., Arregle, Florent, van den Brink, Floris S., Ajmone Marsan, Nina, Bernts, Lucas, Houthuizen, Patrick, Kamp, Otto, Roescher, Nienke, Timmermans, Naomi, Verkaik, Nelianne, Roos-Hesselink, Jolien, Post, Marco C., Habib, Gilbert, and Tanis, Wilco

Abstract

Importance: It is suggested that patients with Cutibacterium acnes endocarditis often present without fever or abnormal inflammatory markers. However, no study has yet confirmed this statement. Objective: To assess the clinical characteristics and outcomes of patients with C acnes endocarditis. Design, Setting, and Participants: A case series of 105 patients presenting to 7 hospitals in the Netherlands and France (4 university hospitals and 3 teaching hospitals) with definite endocarditis according to the modified Duke criteria between January 1, 2010, and December 31, 2020, was performed. Clinical characteristics and outcomes were retrieved from medical records. Cases were identified by blood or valve and prosthesis cultures positive for C acnes, retrieved from the medical microbiology databases. Infected pacemaker or internal cardioverter defibrillator lead cases were excluded. Statistical analysis was performed in November 2022. Main Outcomes and Measures: Main outcomes included symptoms at presentation, presence of prosthetic valve endocarditis, laboratory test results at presentation, time to positive results of blood cultures, 30-day and 1-year mortality rates, type of treatment (conservative or surgical), and endocarditis relapse rates. Results: A total of 105 patients (mean [SD] age, 61.1 [13.9] years; 96 men [91.4%]; 93 patients [88.6%] with prosthetic valve endocarditis) were identified and included. Seventy patients (66.7%) did not experience fever prior to hospital admission, nor was it present at hospitalization. The median C-reactive protein level was 3.6 mg/dL (IQR, 1.2-7.5 mg/dL), and the median leukocyte count was 10.0 × 103/µL (IQR, 8.2-12.2 × 103/µL). The median time to positive blood culture results was 7 days (IQR, 6-9 days). Surgery or reoperation was indicated for 88 patients and performed for 80 patients. Not performing the indicated surgical procedure was associated with high mortality rates. Seventeen patients were treated conservatively

Published
2023

40. Prednisone vs methotrexate in treatment naïve cardiac sarcoidosis

Author

Informatisering, Longziekten, Cardiologie, Team Medisch, Circulatory Health, Infection & Immunity, Vis, Roeland, Mathijssen, Harold, Keijsers, Ruth G.M., van de Garde, Ewoudt M.W., Veltkamp, Marcel, Akdim, Fatima, Post, Marco C., Grutters, Jan C., Informatisering, Longziekten, Cardiologie, Team Medisch, Circulatory Health, Infection & Immunity, Vis, Roeland, Mathijssen, Harold, Keijsers, Ruth G.M., van de Garde, Ewoudt M.W., Veltkamp, Marcel, Akdim, Fatima, Post, Marco C., and Grutters, Jan C.

Published
2023

41. Common genetic variants improve risk stratification after the atrial switch operation for transposition of the great arteries

Author

Cardiologie, Team Medisch, Circulatory Health, Woudstra, Odilia I., Skoric-Milosavljevic, Doris, Mulder, Barbara J.M., Meijboom, Folkert J., Post, Marco C., Jongbloed, Monique R.M., van Dijk, Arie P.J., van Melle, Joost P., Konings, Thelma C., Postma, Alex V., Bezzina, Connie R., Bouma, Berto J., Tanck, Michael W.T., Cardiologie, Team Medisch, Circulatory Health, Woudstra, Odilia I., Skoric-Milosavljevic, Doris, Mulder, Barbara J.M., Meijboom, Folkert J., Post, Marco C., Jongbloed, Monique R.M., van Dijk, Arie P.J., van Melle, Joost P., Konings, Thelma C., Postma, Alex V., Bezzina, Connie R., Bouma, Berto J., and Tanck, Michael W.T.

Published
2023

42. Cardiovascular magnetic resonance-derived left ventricular intraventricular pressure gradients among patients with precapillary pulmonary hypertension

Author

Circulatory Health, Researchgr. Cardiovasculaire Radiologie, Vos, Jacqueline L., Leiner, Tim, van Dijk, Arie P.J., Pedrizzetti, Gianni, Alenezi, Fawaz, Rodwell, Laura, van der Wegen, Constantijn T.P.M., Post, Marco C., Driessen, Mieke M.P., Nijveldt, Robin, Circulatory Health, Researchgr. Cardiovasculaire Radiologie, Vos, Jacqueline L., Leiner, Tim, van Dijk, Arie P.J., Pedrizzetti, Gianni, Alenezi, Fawaz, Rodwell, Laura, van der Wegen, Constantijn T.P.M., Post, Marco C., Driessen, Mieke M.P., and Nijveldt, Robin

Published
2023

44. Latent Pulmonary Vascular Disease May Alter the Response to Therapeutic Atrial Shunt Device in Heart Failure

Author

Borlaug, Barry A., Blair, John, Bergmann, Martin W., Bugger, Heiko, Burkhoff, Dan, Bruch, Leonhard, Celermajer, David S., Claggett, Brian, Cleland, John G. F., Cutlip, Donald E., Dauber, Ira, Eicher, Jean-Christophe, Gao, Qi, Gorter, Thomas M., Gustafsson, Finn, Hayward, Chris, Van der Heyden, Jan, Hasenfuß, Gerd, Hummel, Scott L., Kaye, David M., Komtebedde, Jan, Massaro, Joseph M., Mazurek, Jeremy A., McKenzie, Scott, Mehta, Shamir R., Petrie, Mark C., Post, Marco C., Nair, Ajith, Rieth, Andreas, Silvestry, Frank E., Solomon, Scott D., Trochu, Jean-Noël, Veldhuisen, Dirk J. Van, Westenfeld, Ralf, Leon, Martin B., Shah, Sanjiv J., and Cardiovascular Centre (CVC)

Subjects
Male, Cardiac Catheterization, Pulmonary Circulation, hypertension, pulmonary, hypertension, pulmonary, heart failure, EXERCISE, PRESSURE, Article, Physiology (medical), therapeutics, Humans, Heart Atria, lung diseases, OUTCOMES, REST, Stroke Volume, clinical trial, TIME, Treatment Outcome, PRESERVED EJECTION FRACTION, Female, vascular diseases, Cardiology and Cardiovascular Medicine, INTERATRIAL SHUNT
Abstract

Background: In REDUCE LAP-HF II (A Study to Evaluate the Corvia Medical, Inc IASD System II to Reduce Elevated Left Atrial Pressure in Patients With Heart Failure), implantation of an atrial shunt device did not provide overall clinical benefit for patients with heart failure with preserved or mildly reduced ejection fraction. However, prespecified analyses identified differences in response in subgroups defined by pulmonary artery systolic pressure during submaximal exercise, right atrial volume, and sex. Shunt implantation reduces left atrial pressures but increases pulmonary blood flow, which may be poorly tolerated in patients with pulmonary vascular disease (PVD). On the basis of these results, we hypothesized that patients with latent PVD, defined as elevated pulmonary vascular resistance during exercise, might be harmed by shunt implantation, and conversely that patients without PVD might benefit. Methods: REDUCE LAP-HF II enrolled 626 patients with heart failure, ejection fraction ≥40%, exercise pulmonary capillary wedge pressure ≥25 mm Hg, and resting pulmonary vascular resistance Results: Compared with patients without PVD (n=382), those with latent PVD (n=188) were older, had more atrial fibrillation and right heart dysfunction, and were more likely to have elevated left atrial pressure at rest. Shunt treatment was associated with worse outcomes in patients with PVD (win ratio, 0.60 [95% CI, 0.42, 0.86]; P =0.005) and signal of clinical benefit in patients without PVD (win ratio, 1.31 [95% CI, 1.02, 1.68]; P =0.038). Patients with larger right atrial volumes and men had worse outcomes with the device and both groups were more likely to have pacemakers, heart failure with mildly reduced ejection fraction, and increased left atrial volume. For patients without latent PVD or pacemaker (n=313; 50% of randomized patients), shunt treatment resulted in more robust signal of clinical benefit (win ratio, 1.51 [95% CI, 1.14, 2.00]; P =0.004). Conclusions: In patients with heart failure with preserved or mildly reduced ejection fraction, the presence of latent PVD uncovered by invasive hemodynamic exercise testing identifies patients who may worsen with atrial shunt therapy, whereas those without latent PVD may benefit.

Published
2022
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45. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: a clinical consensus statement of the ESC working group on pulmonary circulation and right ventricular function

Author

Lang, Irene M, Andreassen, Arne K, Andersen, Asger, Bouvaist, Helene, Coghlan, Gerry, Escribano-Subias, Pilar, Jansa, Pavel, Kopec, Grzegorz, Kurzyna, Marcin, Matsubara, Hiromi, Meyer, Bernhard Christian, Palazzini, Massimiliano, Post, Marco C, Pruszczyk, Piotr, Räber, Lorenz, Roik, Marek, Rosenkranz, Stephan, Wiedenroth, Christoph B, Redlin-Werle, Carlo, and Brenot, Philippe

Subjects
610 Medicine & health
Abstract

The current treatment algorithm for chronic thromboembolic pulmonary hypertension (CTEPH) as depicted in the 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines on the diagnosis and treatment of pulmonary hypertension (PH) includes a multimodal approach of combinations of pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA) and medical therapies to target major vessel pulmonary vascular lesions, and microvasculopathy. Today, BPA of >1700 patients has been reported in the literature from centers in Asia, the US, and also Europe; many more patients have been treated outside literature reports. As BPA becomes part of routine care of patients with CTEPH, benchmarks for safe and effective care delivery become increasingly important. In light of this development, the ESC Working Group on Pulmonary Circulation and Right Ventricular Function has decided to publish a document that helps standardize BPA to meet the need of uniformity in patient selection, procedural planning, technical approach, materials and devices, treatment goals, complications including their management, and patient follow-up, thus complementing the guidelines. Delphi methodology was utilized for statements that were not evidence based. First, an anatomical nomenclature and a description of vascular lesions are provided. Second, treatment goals and definitions of complete BPA are outlined. Third, definitions of complications are presented which may be the basis for a standardized reporting in studies involving BPA. The document is intended to serve as a companion to the official ESC/ERS guidelines.

Published
2023
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48. European Reference Network for Rare Vascular Diseases (VASCERN): When and how to use intravenous bevacizumab in Hereditary Haemorrhagic Telangiectasia (HHT)?

Author

Dupuis-Girod, Sophie, primary, Shovlin, Claire L., additional, Kjeldsen, Anette D., additional, Mager, Hans-Jurgen, additional, Sabba, Carlo, additional, Droege, Freya, additional, Fargeton, Anne-Emmanuelle, additional, Fialla, Annette D., additional, Gandolfi, Silvia, additional, Hermann, Ruben, additional, Lenato, Gennaro M., additional, Manfredi, Guido, additional, Post, Marco C., additional, Rennie, Catherine, additional, Suppressa, Patrizia, additional, Sure, Ulrich, additional, Buscarini, Elisabetta, additional, Crocione, Claudia, additional, Blom, Ria, additional, Botella, Luisa Maria, additional, Brocca, Fernando, additional, Coxall, Caroline, additional, Druckman, Karen T., additional, Erasme, Didier, additional, Federici, Paolo, additional, Grabowski, Christina, additional, Lundgren, Mildred, additional, Søderman, Tone, additional, and Woods, Dara, additional

Published
2022
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49. The evolution of survival of pulmonary arterial hypertension over 15 years

Author

Hendriks, Paul M., primary, Staal, Diederik P., additional, van de Groep, Liza D., additional, van den Toorn, Leon M., additional, Chandoesing, Prewesh P., additional, Kauling, Robert M., additional, Mager, Hans‐Jurgen, additional, van den Bosch, Annemien E., additional, Post, Marco C., additional, and Boomars, Karin A., additional

Published
2022
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