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7. Prognostic Value of Follow-up Measures of Left Ventricular Global Longitudinal Strain in Patients With ST-Segment Elevation Myocardial Infarction

Author

Caunite, Laima, Myagmardorj, Rinchyenkhand, Galloo, Xavier, Laenens, Dorien, Stassen, Jan, Nabeta, Takeru, Yedidya, Idit, Meucci, Maria C., Kuneman, Jurrien H., van den Hoogen, Inge J., van Rosendael, Sophie E., Wu, Hoi Wai, van den Brand, Victor M., Giuca, Adrian, Trusinskis, Karlis, van der Bijl, Pieter, Bax, Jeroen J., and Ajmone Marsan, Nina

Published
2024
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8. mPAP/CO Slope and Oxygen Uptake Add Prognostic Value in Aortic Stenosis

Author

Hoedemakers, Sarah, Pugliese, Nicola Riccardo, Stassen, Jan, Vanoppen, Arnaud, Claessens, Jade, Gojevic, Tin, Bekhuis, Youri, Falter, Maarten, Moura Ferreira, Sara, Dhont, Sebastiaan, De Biase, Nicolò, Del Punta, Lavinia, Di Fiore, Valerio, De Carlo, Marco, Giannini, Cristina, Colli, Andrea, Dulgheru, Raluca Elena, Geers, Jolien, Yilmaz, Alaaddin, Claessen, Guido, Bertrand, Philippe, Droogmans, Steven, Lancellotti, Patrizio, Cosyns, Bernard, Verbrugge, Frederik H., Herbots, Lieven, Masi, Stefano, and Verwerft, Jan

Published
2024
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13. Managing Patients With Moderate Aortic Stenosis

Author

Stassen, Jan, Ewe, See Hooi, Pio, Stephan M., Pibarot, Philippe, Redfors, Bjorn, Leipsic, Jonathon, Genereux, Philippe, Van Mieghem, Nicolas M., Kuneman, Jurrien H., Makkar, Raj, Hahn, Rebecca T., Playford, David, Marsan, Nina Ajmone, Delgado, Victoria, Ben-Yehuda, Ori, Leon, Martin B., and Bax, Jeroen J.

Published
2023
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14. Prognostic Value of Preprocedural LV Global Longitudinal Strain for Post-TAVR-Related Morbidity and Mortality: A Meta-Analysis

Author

Stens, Niels A., van Iersel, Odette, Rooijakkers, Max J.P., van Wely, Marleen H., Nijveldt, Robin, Bakker, Esmée A., Rodwell, Laura, Pedersen, Anders L.D., Poulsen, Steen H., Kjønås, Didrik, Stassen, Jan, Bax, Jeroen J., Tanner, Felix C., Lerakis, Stamatios, Shimoni, Sara, Poulin, Frédéric, Ferreira, Vera, Reskovic Luksic, Vlatka, van Royen, Niels, and Thijssen, Dick H.J.

Published
2023
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22. Sex-Related Differences in Medically Treated Moderate Aortic Stenosis

Author

Stassen, Jan, Pio, Stephan M., Ewe, See Hooi, Amanullah, Mohammed R., Hirasawa, Kensuke, Butcher, Steele C., Singh, Gurpreet K., Sin, Kenny Y.K., Ding, Zee P., Chew, Nicholas W.S., Sia, Ching-Hui, Kong, William K.F., Poh, Kian Keong, Cohen, David J., Généreux, Philippe, Leon, Martin B., Marsan, Nina Ajmone, Delgado, Victoria, and Bax, Jeroen J.

Published
2022
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28. Clinical Significance of Exercise Pulmonary Hypertension With a Negative Diastolic Stress Test for Suspected Heart Failure With Preserved Ejection Fraction

Author

Verwerft, Jan, Stassen, Jan, Falter, Maarten, Bekhuis, Youri, Hoedemakers, Sarah, Gojevic, Tin, Ferreira, Sara Moura, Vanhentenrijk, Simon, Stroobants, Sarah, Jogani, Siddharth, Hansen, Dominique, Jasaityte, Ruta, Cosyns, Bernard, Van De Bruaene, Alexander, Bertrand, Philippe B., de Boer, Rudolf A., Gevaert, Andreas B., Verbrugge, Frederik H., Herbots, Lieven, Claessen, Guido, Verwerft, Jan, Stassen, Jan, Falter, Maarten, Bekhuis, Youri, Hoedemakers, Sarah, Gojevic, Tin, Ferreira, Sara Moura, Vanhentenrijk, Simon, Stroobants, Sarah, Jogani, Siddharth, Hansen, Dominique, Jasaityte, Ruta, Cosyns, Bernard, Van De Bruaene, Alexander, Bertrand, Philippe B., de Boer, Rudolf A., Gevaert, Andreas B., Verbrugge, Frederik H., Herbots, Lieven, and Claessen, Guido

Abstract

BACKGROUND: Half of patients with heart failure with preserved ejection fraction (HFpEF) remain undiagnosed by resting evaluation alone. Therefore, exercise testing is proposed. The diastolic stress test (DST), however, has limited sensitivity. We aimed to determine the clinical significance of adding the mean pulmonary artery pressure over cardiac output (mPAP/CO) slope to the DST in suspected HFpEF.METHODS AND RESULTS: In this prospective cohort study, consecutive patients (n=1936) with suspected HFpEF underwent exercise echocardiography with simultaneous respiratory gas analysis. These patients were stratified by exercise E over e' (exE/e') and mPAP/CO slope, and peak oxygen uptake, natriuretic peptides (NT-proBNP [N-terminal pro-B-type natriuretic peptide]), and score-based HFpEF likelihood were compared. Twenty-two percent of patients (n=428) had exE/e'<15 despite a mPAP/CO slope>3 mm Hg/L per min, 24% (n=464) had a positive DST (exE/e'≥15), and 54% (n=1044) had a normal DST and slope. Percentage of predicted oxygen uptake was similar in the group with exE/e'<15 but high mPAP/CO slope and the positive DST group (-2% [-5% to +1%]), yet worse than in those with normal DST and slope (-12% [-14% to -9%]). Patients with exE/e'<15 but a high slope had NT-proBNP levels and H2FPEF (heavy, hypertensive, atrial fibrillation, pulmonary hypertension, elder; filling pressure) scores intermediate to the positive DST group and the group with both a normal DST and slope. CONCLUSIONS: Twenty-two percent of patients with suspected HFpEF presented with a mPAP/CO slope>3 mm Hg/L per min despite a negative DST. These patients had HFpEF characteristics and a peak oxygen uptake as low as patients with a positive DST. Therefore, an elevated mPAP/CO slope might indicate HFpEF irrespective of the DST result.

Published
2024

31. Exercise pulmonary hypertension by the mPAP/CO slope in primary mitral regurgitation.

Author

Dhont, Sebastiaan, Stassen, Jan, Herbots, Lieven, Hoedemakers, Sarah, Bekhuis, Youri, Jasaityte, Ruta, Stroobants, Sarah, Petit, Thibault, Bakelants, Elise, Falter, Maarten, Ferreira, Sara Moura, Claessen, Guido, Nijst, Petra, Vandervoort, Pieter M, Bertrand, Philippe B, and Verwerft, Jan

Subjects
PULMONARY hypertension diagnosis, EXERCISE, VENTRICULAR ejection fraction, PREDICTION models, RESEARCH funding, PULMONARY hypertension, PULMONARY artery, HOSPITAL care, SCIENTIFIC observation, CAUSES of death, DESCRIPTIVE statistics, CARDIAC output, MITRAL valve insufficiency, CARDIOPULMONARY system, LOG-rank test, LONGITUDINAL method, ATRIAL fibrillation, BLOOD pressure, EXERCISE tests, CONFIDENCE intervals, SYSTOLIC blood pressure, OXYGEN consumption, ECHOCARDIOGRAPHY, RELAXATION for health, BIOMARKERS
Abstract

Aims Exercise-induced pulmonary hypertension (PH), defined by a mean pulmonary arterial pressure over cardiac output (mPAP/CO) slope >3 mmHg/L/min, has important diagnostic and prognostic implications. The aim of this study is to investigate the value of the mPAP/CO slope in patients with more than moderate primary mitral regurgitation (MR) with preserved ejection fraction and no or discordant symptoms. Methods and results A total of 128 consecutive patients were evaluated with exercise echocardiography and cardiopulmonary testing. Clinical outcome was defined as the composite of mitral valve intervention, new-onset atrial fibrillation, cardiovascular hospitalization, and all-cause mortality. The mean age was 63 years, 61% were male, and the mean LVEF was 66 ± 6%. The mPAP/CO slope correlated with peak VO2 (r = −0.52, P < 0.001), while the peak systolic pulmonary artery pressure (sPAP) did not (r = −0.06, P = 0.584). Forty-six per cent (n = 59) had peak exercise sPAP ≥60 mmHg, and 37% (n = 47) had mPAP/CO slope >3 mmHg/L/min. Event-free survival was 55% at 1 year and 46% at 2 years, with reduced survival in patients with mPAP/CO slope >3 mmHg/L/min (hazard ratio, 4.9; 95% confidence interval, 2.9–8.2; P < 0.001). In 53 cases (41%), mPAP/CO slope and peak sPAP were discordant: patients with slope >3 mmHg/L/mmHg and sPAP <60 mmHg (n = 21) had worse outcome vs. peak sPAP ≥60 mmHg and normal slope (n = 32, log-rank P = 0.003). The mPAP/CO slope improved predictive models for outcome, incremental to resting and exercise sPAP, and peak VO2. Conclusion Exercise PH defined by the mPAP/CO slope >3 mmHg/L/min is associated with decreased exercise capacity and a higher risk of adverse events in significant primary MR and no or discordant symptoms. The slope provides a greater prognostic value than single sPAP measures and peak VO2. [ABSTRACT FROM AUTHOR]

Published
2024
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32. Exercise pulmonary hypertension by the mPAP/CO slope in primary mitral regurgitation

Author

Dhont, Sebastiaan, primary, Stassen, Jan, additional, Herbots, Lieven, additional, Hoedemakers, Sarah, additional, Bekhuis, Youri, additional, Jasaityte, Ruta, additional, Stroobants, Sarah, additional, Petit, Thibault, additional, Bakelants, Elise, additional, Falter, Maarten, additional, Ferreira, Sara Moura, additional, Claessen, Guido, additional, Nijst, Petra, additional, Vandervoort, Pieter M, additional, Bertrand, Philippe B, additional, and Verwerft, Jan, additional

Published
2023
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33. The short‐term effects of sacubitril/valsartan therapy on myocardial oxygen consumption and energetic efficiency of cardiac work in heart failure with reduced ejection fraction. A randomized controlled study

Author

Nesterov, Sergey V., primary, Räty, Johanna, additional, Nammas, Wail, additional, Maaniitty, Teemu, additional, Galloo, Xavier, additional, Stassen, Jan, additional, Laurila, Sanna, additional, Vasankari, Tuija, additional, Huusko, Jenni, additional, Bax, Jeroen J, additional, Saraste, Antti, additional, and Knuuti, Juhani, additional

Published
2023
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35. Changes in Left Ventricular Global Longitudinal Strain in Patients With Heart Failure and Secondary Mitral Regurgitation: The COAPT Trial

Author

Pio, Stephan M., primary, Medvedofsky, Diego, additional, Stassen, Jan, additional, Delgado, Victoria, additional, Namazi, Farnaz, additional, Weissman, Neil J., additional, Grayburn, Paul, additional, Kar, Saibal, additional, Lim, D. Scott, additional, Zhou, Zhipeng, additional, Alu, Maria C., additional, Redfors, Björn, additional, Kapadia, Samir, additional, Lindenfeld, JoAnn, additional, Abraham, William T., additional, Mack, Michael J., additional, Asch, Federico M., additional, Stone, Gregg W., additional, and Bax, Jeroen J., additional

Published
2023
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38. Short‐term effects of sacubitril/valsartan therapy on myocardial oxygen consumption and energetic efficiency of cardiac work in heart failure with reduced ejection fraction: A randomized controlled study.

Author

Nesterov, Sergey V., Räty, Johanna, Nammas, Wail, Maaniitty, Teemu, Galloo, Xavier, Stassen, Jan, Laurila, Sanna, Vasankari, Tuija, Huusko, Jenni, Bax, Jeroen J., Saraste, Antti, and Knuuti, Juhani

Subjects
OXYGEN consumption, HEART failure, VENTRICULAR ejection fraction, POSITRON emission tomography, ENTRESTO
Abstract

Aims: We sought to evaluate the mechanism of angiotensin receptor–neprilysin inhibitor (ARNI) sacubitril/valsartan therapy and compare it with a valsartan‐only control group in patients with heart failure with reduced ejection fraction (HFrEF). Methods and results: The study was a phase IV, prospective, randomized, double‐blind, parallel‐group study in patients with New York Heart Association class II–III heart failure and left ventricular ejection fraction (LVEF) ≤35%. During a 6‐week run‐in period, all patients received valsartan therapy, which was up‐titrated to the highest tolerated dose level (80 mg bid or 160 mg bid) and then randomized to either valsartan or sacubitril/valsartan. Myocardial oxygen consumption, energetic efficiency of cardiac work, cardiac and systemic haemodynamics were quantified using echocardiography and 11C‐acetate positron emission tomography before and after 6 weeks of therapy (on stable dose) in 55 patients (ARNI group: n = 27, mean age 63 ± 10 years, LVEF 29.2 ± 10.4%; and valsartan‐only control group: n = 28, mean age 64 ± 8 years, LVEF 29.0 ± 7.3%; all p = NS). The energetic efficiency of cardiac work remained unchanged in both treatment arms. However, both diastolic (−4.5 mmHg; p = 0.026) and systolic blood pressure (−9.8 mmHg; p = 0.0007), myocardial perfusion (−0.054 ml/g/min; p = 0.045), and left ventricular mechanical work (−296; p = 0.038) decreased significantly in the ARNI group compared to the control group. Although myocardial oxygen consumption decreased in the ARNI group (−5.4%) compared with the run‐in period and remained unchanged in the control group (+0.5%), the between‐treatment group difference was not significant (p = 0.088). Conclusions: We found no differences in the energetic efficiency of cardiac work between ARNI and valsartan‐only groups in HFrEF patients. However, ARNI appears to have haemodynamic and cardiac mechanical effects over valsartan in heart failure patients. [ABSTRACT FROM AUTHOR]

Published
2024
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39. Right Ventricular to Pulmonary Artery Coupling and Prognosis in Transthyretin Cardiac Amyloidosis

Author

Meucci, Maria Chiara, Laenens, Dorien, Lillo, Rosa, Lombardo, Antonella, Burzotta, Francesco, Stassen, Jan, Debonnaire, Philippe, Claeys, Mathias, Donal, Erwan, Droogmans, Steven, Cosyns, Bernard, Jurcut, Ruxandra, Pinto, Fausto J., Brito, Dulce, Yedidya, Idit, Van De Heyning, Caroline, Sturkenboom, Nicole, Graziani, Francesca, and Ajmone Marsan, Nina

Published
2024
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40. PREDIABETES IN STEMI PATIENTS: ASSOCIATION WITH LEFT VENTRICULAR REMODELING AND OUTCOME

Author

Caunite, Laima, primary, Galloo, Xavier, additional, Myagmardorj, Rinchyenkhand, additional, Laenens, Dorien, additional, Stassen, Jan, additional, yedidya, idit, additional, Nabeta, Takeru, additional, Meucci, Maria Chiara, additional, Chimed, Surenjav, additional, Kuneman, Jurrien, additional, van den Hoogen, Inge J., additional, Van Rosendael, Sophie Elisabeth, additional, Wu, Hoi Wai, additional, Van Den Brand, Victor, additional, Giuca, Adrian, additional, Marsan, Nina Ajmone, additional, and Bax, Jeroen J., additional

Published
2023
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43. Prognostic Value of Preprocedural LV Global Longitudinal Strain for Post-TAVR-Related Morbidity and Mortality:A Meta-Analysis

Author

Stens, Niels A, van Iersel, Odette, Rooijakkers, Max J P, van Wely, Marleen H, Nijveldt, Robin, Bakker, Esmée A, Rodwell, Laura, Pedersen, Anders L D, Poulsen, Steen H, Kjønås, Didrik, Stassen, Jan, Bax, Jeroen J, Tanner, Felix C, Lerakis, Stamatios, Shimoni, Sara, Poulin, Frédéric, Ferreira, Vera, Reskovic Luksic, Vlatka, van Royen, Niels, and Thijssen, Dick H J

Subjects
Ventricular Dysfunction, Left, Aortic Valve Stenosis/diagnostic imaging, Predictive Value of Tests, Transcatheter Aortic Valve Replacement/adverse effects, Humans, Stroke Volume, Prognosis, Ventricular Function, Left, Global Longitudinal Strain, Retrospective Studies
Abstract

BACKGROUND: Left ventricular ejection fraction (LVEF) demonstrates limited prognostic value for post-transcatheter aortic valve replacement (TAVR) outcomes. Evidence regarding the potential role of left ventricular global longitudinal strain (LV-GLS) in this setting is inconsistent.OBJECTIVES: The aim of this systematic review and meta-analysis of aggregated data was to evaluate the prognostic value of preprocedural LV-GLS for post-TAVR-related morbidity and mortality.METHODS: The authors searched PubMed, Embase, and Web of Science for studies investigating the association between preprocedural 2-dimensional speckle-tracking-derived LV-GLS and post-TAVR clinical outcomes. An inversely weighted random effects meta-analysis was adopted to investigate the association between LV-GLS vs primary (ie, all-cause mortality) and secondary (ie, major cardiovascular events [MACE]) post-TAVR outcomes.RESULTS: Of the 1,130 identified records, 12 were eligible, all of which had a low-to-moderate risk of bias (Newcastle-Ottawa scale). On average, 2,049 patients demonstrated preserved LVEF (52.6% ± 1.7%), but impaired LV-GLS (-13.6% ± 0.6%). Patients with a lower LV-GLS had a higher all-cause mortality (pooled HR: 2.01; 95% CI: 1.59-2.55) and MACE (pooled odds ratio [OR]: 1.26; 95% CI: 1.08-1.47) risk compared with patients with higher LV-GLS. In addition, each percentage point decrease of LV-GLS (ie, toward 0%) was associated with an increased mortality (HR: 1.06; 95% CI: 1.04-1.08) and MACE risk (OR: 1.08; 95% CI: 1.01-1.15).CONCLUSIONS: Preprocedural LV-GLS was significantly associated with post-TAVR morbidity and mortality. This suggests a potential clinically important role of pre-TAVR evaluation of LV-GLS for risk stratification of patients with severe aortic stenosis. (Prognostic value of left ventricular global longitudinal strain in patients with aortic stenosis undergoing Transcatheter Aortic Valve Implantation: a meta-analysis; CRD42021289626).

Published
2023

44. Prognostic value of left atrial volume index in degenerative mitral stenosis

Author

Yedidya, Idit, Butcher, Steele C., Stassen, Jan, van der Bijl, Pieter, Ngiam, Jinghao Nicholas, Chew, Nicholas W. S., Sia, Ching-Hui, Leow, Ryan, Li, Tony Yi-Wei, Kong, William K. F., Poh, Kian Keong, Kornowski, Ran, Marsan, Nina Ajmone, Delgado, Victoria, and Bax, Jeroen J.

Abstract

Purpose: Degenerative mitral stenosis (DMS) is associated with a poor prognosis. Although mean transmitral gradient (TMG) has shown a good correlation with outcome, little is known about the association between other echocardiographic parameters and prognosis in patients with DMS. The current study aimed to evaluate the prognostic value of left atrial volume index (LAVI) in patients with DMS. Methods: A total of 155 patients with DMS (72[63–80] years, 67% female) were included. The population was divided according to LAVI: normal-sized LAVI (LAVI ≤ 34 ml/m2); and enlarged LAVI (> 34 ml/m2). Results: Patients with enlarged LAVI had a higher left ventricular mass index (120[96–146] vs. 91[70–112] g/m2 p &lt; 0.001), as well as a higher prevalence of significant mitral regurgitation and severe aortic stenosis (23% vs. 10% p = 0.046 and 38% vs. 15% p=0.001, respectively) compared to patients with normal-sized LAVI. During a median follow-up of 25 months, 56 (36%) patients died. Patients with enlarged LAVI had worse prognosis compared to patients with normal-sized LAVI (p = 0.026). In multivariable Cox regression model, an enlarged LAVI was independently associated with all-cause mortality (HR 2.009, 95% CI 1.040 to 3.880, P = 0.038). Conclusion: An enlarged LAVI (> 34 ml/m2) is significantly associated with excess mortality in patients with DMS. After adjusting for potential confounders, an enlarged LAVI was the only parameter that remained independently associated with prognosis.

Published
2024
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45. The impact of atrial fibrillation on prognosis in aortic stenosis

Author

Laenens, Dorien, Stassen, Jan, Galloo, Xavier, Ewe, See Hooi, Singh, Gurpreet K, Ammanullah, Mohammed R, Hirasawa, Kensuke, Sia, Ching-Hui, Butcher, Steele C, Chew, Nicholas W S, Kong, William K F, Poh, Kian Keong, Ding, Zee P, Ajmone Marsan, Nina, and Bax, Jeroen J

Abstract

Graphical Abstract

Published
2023
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46. Introduction to hemodynamic forces by echocardiography

Author

Laenens, Dorien, van der Bijl, Pieter, Stassen, Jan, Rossi, Alessandro C, Pedrizzetti, Gianni, Reiber, Johan H C, Marsan, Nina Ajmone, Bax, Jeroen J, Laenens, Dorien, van der Bijl, Pieter, Stassen, Jan, Rossi, Alessandro C, Pedrizzetti, Gianni, Reiber, Johan H C, Marsan, Nina Ajmone, and Bax, Jeroen J

Subjects
Fluid dynamics, Advanced cardiac imaging, Hemodynamic forces, Cardiology and Cardiovascular Medicine, Fluid dynamic
Abstract

Hemodynamic force (HDF) analysis represents a novel approach to quantify intraventricular pressure gradients, responsible for blood flow. A new mathematical model allows the derivation of HDF parameters from routine transthoracic echocardiography, making this tool more accessible for clinical use. HDF analysis is considered the fluid dynamics correlate of deformation imaging and may be even more sensitive to detect mechanical abnormalities. This has the potential to add incremental clinical value, allowing earlier detection of pathology or immediate evaluation of response to treatment. In this article, the theoretical background and physiological patterns of HDF in the left ventricle are provided. In pathological situations, the HDF pattern might alter, which is illustrated with a case of ST segment elevation myocardial infarction and non-ischemic cardiomyopathy with typical left bundle branch block.

Published
2022

50. Introduction to hemodynamic forces by echocardiography

Author

Laenens, Dorien, primary, van der Bijl, Pieter, additional, Stassen, Jan, additional, Rossi, Alessandro C., additional, Pedrizzetti, Gianni, additional, Reiber, Johan H.C., additional, Marsan, Nina Ajmone, additional, and Bax, Jeroen J., additional

Published
2023
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