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8. Radical prostatectomy in elderly men: Oncological, functional and complication results

Author

Abeijon Pineiro, C., primary, Molinos Mayo, J., additional, Lojo Romero, J., additional, Fernández Docampo, J., additional, Da Cruz Soage, N., additional, Iglesias Fresco, L., additional, Mosquera Seoane, T., additional, Rey Rey, J., additional, Pereira Beceiro, J.M., additional, González Blanco, A.Á., additional, Bonelli Martín, C., additional, Rodríguez Souto, P., additional, and Rodríguez Alonso, A., additional

Published
2020
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10. Poster session Wednesday 11 December all day display: 11/12/2013, 09:30-16:00 * Location: Poster area

Author

Bertrand, PB, Grieten, L, Smeets, C, Verbrugge, FH, Mullens, W, Vrolix, M, Rivero-Ayerza, M, Verhaert, D, Vandervoort, P, Tong, L, Ramalli, A, Tortoli, P, Dhoge, J, Bajraktari, G, Lindqvist, P, Henein, MY, Obremska, M, Boratynska, MB, Kurcz, JK, Zysko, DZ, Baran, TB, Klinger, MK, Darahim, K, Mueller, H, Carballo, D, Popova, N, Vallee, J-P, Floria, M, Chistol, R, Tinica, G, Grecu, M, Rodriguez Serrano, M, Osa-Saez, A, Rueda-Soriano, J, Buendia-Fuentes, F, Domingo-Valero, D, Igual-Munoz, B, Alonso-Fernandez, P, Quesada-Carmona, A, Miro-Palau, V, Palencia-Perez, M, Bech-Hanssen, O, Polte, CL, Lagerstrand, K, Janulewicz, M, Gao, S, Erdogan, E, Akkaya, M, Bacaksiz, A, Tasal, A, Sonmez, O, Turfan, M, Kul, S, Vatankulu, MA, Uyarel, H, Goktekin, O, Mincu, RI, Magda, LS, Mihaila, S, Florescu, M, Mihalcea, D, Enescu, OE, Chiru, A, Popescu, B, Tiu, C, Vinereanu, D, 112/2011, Research grant, Broch, K, Kunszt, G, Massey, R, De Marchi, SF, Aakhus, S, Gullestad, L, Urheim, S, Yuan, L, Feng, JL, Jin, XY, Bombardini, T, Casartelli, M, Simon, D, Gaspari, MG, Procaccio, F, Hasselberg, NE, Haugaa, KH, Brunet, A, Kongsgaard, E, Donal, E, Edvardsen, T, Sahin, TAYLAN, Yurdakul, S, Cengiz, BETUL, Bozkurt, AYSEN, Aytekin, SAIDE, Cesana, F, Spano, F, Santambrogio, G, Alloni, M, Vallerio, P, Salvetti, M, Carerj, S, Gaibazzi, N, Rigo, F, Moreo, A, Group, APRES Collaborative, Wdowiak-Okrojek, K, Michalski, B, Kasprzak, JD, Shim, A, Lipiec, P, Generati, G, Pellegrino, M, Bandera, F, Donghi, V, Alfonzetti, E, Guazzi, M, Marcun, R, Stankovic, I, Farkas, J, Vlahovic-Stipac, A, Putnikovic, B, Kadivec, S, Kosnik, M, Neskovic, AN, Lainscak, M, Iliuta, L, Szymanski, P, Lipczynska, M, Klisiewicz, A, Sobieszczanska-Malek, M, Zielinski, T, Hoffman, P, Gjerdalen, G F, Hisdal, J, Solberg, EE, Andersen, TE, Radunovic, Z, Steine, K, Svanadze, A, Poteshkina, N, Krylova, N, Mogutova, P, Shim, A, Kasprzak, JD, Szymczyk, E, Wdowiak-Okrojek, K, Michalski, B, Stefanczyk, L, Lipiec, P, Benedek, T, Matei, C, Jako, B, Suciu, ZS, Benedek, I, Yaroshchuk, N A, Kochmasheva, V V, Dityatev, V P, Kerbikov, O B, Przewlocka-Kosmala, M, Orda, A, Karolko, B, Mysiak, A, Kosmala, W, Rechcinski, T, Wierzbowska-Drabik, K, Lipiec, P, Chmiela, M, Kasprzak, JD, Aziz, A, Hooper, J, Rayasamudra, S, Uppal, H, Asghar, O, Potluri, R, Zaroui, A, Mourali, MS, Rezine, Z, Mbarki, S, Jemaa, M, Aloui, H, Mechmeche, R, Farhati, A, Gripari, P, Maffessanti, F, Tamborini, G, Muratori, M, Fusini, L, Vignati, C, Bartorelli, AL, Alamanni, F, Agostoni, PG, Pepi, M, Ruiz Ortiz, M, Mesa, D, Delgado, M, Seoane, T, Carrasco, F, Martin, M, Mazuelos, F, Suarez De Lezo Herreros De Tejada, J, Romero, M, Suarez De Lezo, J, Brili, S, Stamatopoulos, I, Misailidou, M, Chrisochoou, C, Christoforatou, E, Stefanadis, C, Ruiz Ortiz, M, Mesa, D, Delgado, M, Martin, M, Seoane, T, Carrasco, F, Ojeda, S, Segura, J, Pan, M, Suarez De Lezo, J, Cammalleri, V, Ussia, GP, Muscoli, S, Marchei, M, Sergi, D, Mazzotta, E, Romeo, F, Igual Munoz, B, Bel Minguez, ABM, Perez Guillen, MPG, Maceira Gonzalez, AMG, Monmeneu Menadas, JVMM, Hernandez Acuna, CHA, Estornell Erill, JEE, Lopez Lereu, PLL, Francisco Jose Valera Martinez, FJVM, Montero Argudo, AMA, Sunbul, M, Akhundova, A, Sari, I, Erdogan, O, Mutlu, B, Cacicedo, A, Velasco Del Castillo, S, Anton Ladislao, A, Aguirre Larracoechea, U, Rodriguez Sanchez, I, Subinas Elorriaga, A, Oria Gonzalez, G, Onaindia Gandarias, J, Laraudogoitia Zaldumbide, E, Lekuona Goya, I, Ding, W, Zhao, Y, Lindqvist, P, Nilson, J, Winter, R, Holmgren, A, Ruck, A, Henein, MY, Attenhofer Jost, C H, Soyka, R, Oxenius, A, Kretschmar, O, Valsangiacomo Buechel, ER, Greutmann, M, Weber, R, Keramida, K, Kouris, N, Kostopoulos, V, Karidas, V, Damaskos, D, Makavos, G, Paraskevopoulos, K, Olympios, CD, Eskesen, K, Olsen, NT, Fritz-Hansen, T, Sogaard, P, Cameli, M, Lisi, M, Righini, FM, Curci, V, Massoni, A, Natali, B, Maccherini, M, Chiavarelli, M, Massetti, M, Mondillo, S, Mabrouk Salem Omar, A, Ahmed Abdel-Rahman, M, Khorshid, H, Rifaie, O, Santoro, C, Santoro, A, Ippolito, R, De Palma, D, De Stefano, F, Muscariiello, R, Galderisi, M, Squeri, A, Censi, S, Baldelli, M, Grattoni, C, Cremonesi, A, Bosi, S, Saura Espin, D, Gonzalez Canovas, C, Gonzalez Carrillo, J, Oliva Sandoval, MJ, Caballero Jimenez, L, Espinosa Garcia, MD, Garcia Navarro, M, Valdes Chavarri, M, De La Morena Valenzuela, G, Ryu, SK, Shin, DG, Son, JW, Choi, JH, Goh, CW, Choi, JW, Park, JY, Hong, GR, Sklyanna, O, Yuan, L, Yuan, L, Planinc, I, Bagadur, G, Ljubas, J, Baricevic, Z, Skoric, B, Velagic, V, Bijnens, B, Milicic, D, Cikes, M, Gospodinova, M, Chamova, T, Guergueltcheva, V, Ivanova, R, Tournev, I, Denchev, S, Ancona, R, Comenale Pinto, S, Caso, P, Arenga, F, Coppola, MG, Calabro, R, Neametalla, H, Boitard, S, Hamdi, H, Planat-Benard, V, Casteilla, L, Li, Z, Hagege, AA, Mericskay, M, Menasche, P, Agbulut, O, Merlo, M, Stolfo, D, Anzini, M, Negri, F, Pinamonti, B, Barbati, G, Di Lenarda, A, Sinagra, G, Stolfo, D, Merlo, M, Pinamonti, B, Gigli, M, Poli, S, Porto, A, Di Nora, C, Barbati, G, Di Lenarda, A, Sinagra, G, Coppola, C, Piscopo, G, Cipresso, C, Rea, D, Maurea, C, Esposito, E, Arra, C, Maurea, N, Nemes, A, Kalapos, A, Domsik, P, Forster, T, Voilliot, D, Huttin, O, Vaugrenard, T, Schwartz, J, Sellal, J-M, Aliot, E, Juilliere, Y, Selton-Suty, C, Sanchez Millan, P J, Cabeza Lainez, P, Castillo Ortiz, J, Chueca Gonzalez, EM, Gheorghe, L, Fernandez Garcia, P, Herruzo Rojas, MS, Del Pozo Contreras, R, Fernandez Garcia, M, Vazquez Garcia, R, Rosca, M, Popescu, BA, Botezatu, D, Calin, A, Beladan, CC, Gurzun, M, Enache, R, Ginghina, C, Farouk, H, Al-Maimoony, T, Alhadad, A, El Serafi, M, Abdel Ghany, M, Poorzand, H, Mirfeizi, SZ, Javanbakht, A, center, Preventive Cardiovascular care research, center, Lupus Research, sciences, Mashhad university of medical, Tellatin, S, Famoso, G, Dassie, F, Martini, C, Osto, E, Maffei, P, Iliceto, S, Tona, F, Radunovic, Z, Steine, KS, Jedrzejewska, I, Braksator, W, Krol, W, Swiatowiec, A, Sawicki, J, Kostarska-Srokosz, E, Dluzniewski, M, Maceira Gonzalez, A M, Cosin-Sales, J, Diago, JL, Aguilar, J, Ruvira, J, Monmeneu, J, Igual, B, Lopez-Lereu, MP, Estornell, J, Olszanecka, A, Dragan, A, Kawecka-Jaszcz, K, Czarnecka, D, Scholz, F, Gaudron, PD, Hu, K, Liu, D, Florescu, C, Herrmann, S, Bijnens, B, Ertl, G, Stoerk, S, Weidemann, F, Krestjyaninov, M, Razin, VA, Gimaev, RH, Bogdanovic, Z, Burazor, I, Deljanin Ilic, M, Peluso, D, Muraru, D, Cucchini, U, Mihaila, S, Casablanca, S, Pigatto, E, Cozzi, F, Punzi, L, Badano, LP, Iliceto, S, Zhdanova, E, Rameev, VV, Safarova, AF, Moisseyev, SV, Kobalava, ZD, Magnino, C, Omede, P, Avenatti, E, Presutti, D, Losano, I, Moretti, C, Bucca, C, Gaita, F, Veglio, F, Milan, A, Bellsham-Revell, H, Bell, AJ, Miller, OI, Simpson, JM, Hwang, YM, Kim, GH, Jung, MH, Woo, GH, Medicine, Department of Internal, Hospital, St.Vincents, Korea, The Catholic University of, Suwon, Division of Cardiology, Repu, Driessen, MMP, Leiner, T, Schoof, PH, Breur, JMPJ, Sieswerda, GT, Meijboom, FJ, Bellsham-Revell, H, Hayes, N, Anderson, D, Austin, BC, Razavi, R, Greil, GF, Simpson, JM, Bell, AJ, Zhao, XX, Xu, XD, Qin, YW, Szmigielski, C A, Styczynski, G, Sobczynska, M, Placha, G, Kuch-Wocial, A, Ikonomidis, I, Voumbourakis, A, Triantafyllidi, H, Pavlidis, G, Varoudi, M, Papadakis, I, Trivilou, P, Paraskevaidis, I, Anastasiou-Nana, M, Lekakis, I, Kong, WILL, Yip, JAMES, Ling, LH, Milan, A, Tosello, F, Leone, D, Bruno, G, Losano, I, Avenatti, E, Sabia, L, Veglio, F, Zaborska, B, Baran, J, Pilichowska-Paszkiet, E, Sikora-Frac, M, Michalowska, I, Kulakowski, P, Budaj, A, Mega, S, Bono, MC, De Francesco, V, Castiglione, I, Ranocchi, F, Casacalenda, A, Goffredo, C, Patti, G, Di Sciascio, G, Musumeci, F, Kennedy, M, Waterhouse, DF, Sheahan, R, Foley, DF, Mcadam, BF, Ancona, R, Comenale Pinto, S, Caso, P, Arenga, F, Coppola, MG, Calabro, R, Remme, E W, Smedsrud, M K, Hasselberg, N E, Smiseth, O A, Edvardsen, T, Halmai, L, Nemes, A, Kardos, A, Neubauer, S, Degiovanni, A, Baduena, L, Dellera, G, Occhetta, E, Marino, P, Hotchi, J, Yamada, H, Nishio, S, Bando, M, Hayashi, S, Hirata, Y, Amano, R, Soeki, T, Wakatsuki, T, Sata, M, Lamia, B, Molano, LC, Viacroze, C, Cuvelier, A, Muir, JF, Lipczynska, M, Piotr Szymanski, PS, Anna Klisiewicz, AK, Lukasz Mazurkiewicz, LM, Piotr Hoffman, PH, Van T Sant, J, Wijers, SC, Ter Horst, IAH, Leenders, GE, Cramer, MJ, Doevendans, PA, Meine, M, Hatam, N, Goetzenich, A, Aljalloud, A, Mischke, K, Hoffmann, R, Autschbach, R, Sikora-Frac, M, Zaborska, B, Maciejewski, P, Bednarz, B, Budaj, A, Evangelista, A, Torromeo, C, Pandian, NG, Nardinocchi, P, Varano, V, Schiariti, M, Teresi, L, Puddu, PE, Storve, S, Dalen, H, Snare, SR, Haugen, BO, Torp, H, Fehri, W, Mahfoudhi, H, Mezni, F, Annabi, MS, Taamallah, K, Dahmani, R, Haggui, A, Hajlaoui, N, Lahidheb, D, Haouala, H, Colombo, A, Carminati, MC, Maffessanti, F, Gripari, P, Pepi, M, Lang, RM, Caiani, EG, Walker, JR, Abadi, S, Agmon, Y, Carasso, S, Aronson, D, Mutlak, D, Lessick, J, Saxena, A, Ramakrishnan, S, Juneja, R, Ljubas, J, Reskovic Luksic, V, Matasic, R, Pezo Nikolic, B, Lovric, D, Separovic Hanzevacki, J, Quattrone, A, Zito, C, Alongi, G, Vizzari, G, Bitto, A, De Caridi, G, Greco, M, Tripodi, R, Pizzino, G, Carerj, S, Ibrahimi, P, Jashari, F, Johansson, E, Gronlund, C, Bajraktari, G, Wester, P, Henein, MY, Kosmala, W, Marwick, TH, Souza, J R M, Zacharias, L G T, Geloneze, B, Pareja, J C, Chaim, A, Nadruz, W JR, Coelho, O R, Apostolovic, S, Stanojevic, D, Jankovic-Tomasevic, R, Salinger-Martinovic, S, Djordjevic-Radojkovic, D, Pavlovic, M, Tahirovic, E, Musial-Bright, L, Lainscak, M, Duengen, HD, group, CIBIS ELD study, Filipiak, D, Kasprzak, JD, and Lipiec, P

Abstract

Purpose: With the advent of percutaneous transcatheter device closures in congenital heart defects and the emergence of percutaneous left atrial appendage closure, there is an increasingly important role for echocardiographic guidance and control of device position and function. Disc occluder devices frequently present as an unexplained ‘figure-of-8’ on echocardiography. The aim of this study was to clarify this ‘figure-of-8’ display and to relate its morphology to transducer position and device type. Methods: A mathematical model was developed to resemble disc occluder geometry and to allow a numerical simulation of the echocardiographic appearance. In addition, we developed an in vitro set-up for echocardiographic analysis of various disc occluders and various transducer positions. Results: In the mathematical model of an epitrochoid curve (closely resembling disc occluder geometry) a ‘figure-of-8’ display is obtained when emphasizing points with tangent vector perpendicular to the direction of ultrasound waves. Decreasing imaging depth results in a more asymmetric ‘figure-of-8’, with small upper part and wide lower part. Clinical and in vitro data are in close agreement with these results (Figure 1). Furthermore a ‘figure-of-8’ display is only obtained in a coronal imaging position, and is similar for different commercially available disc occluder types. Conclusions: The ‘figure-of-8’ display in the ultrasound image of a disc occluder is an imaging artifact due to the specific ‘epitrochoidal’ geometry of a deployed device and its interaction with ultrasound waves. The morphology of the ‘figure-of-8’ depends on transducer position, i.e. imaging depth, and is similar for different device types. Figure 1 Impact of imaging depth

Published
2013
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11. Poster session Thursday 12 December - AM: 12/12/2013, 08:30-12:30 * Location: Poster area

Author

Abdovic, E, Abdovic, S, Hristova, K, Hristova, K, Katova, TZ, Katova, TZ, Gocheva, N, Gocheva, N, Pavlova, M, Pavlova, M, Gurzun, M M, Ionescu, A, Canpolat, U, Yorgun, H, Sunman, H, Sahiner, L, Kaya, EB, Ozer, N, Tokgozoglu, L, Kabakci, G, Aytemir, K, Oto, A, Gonella, A, Dascenzo, F, Casasso, F, Conte, E, Margaria, F, Grosso Marra, W, Frea, S, Morello, M, Bobbio, M, Gaita, F, Seo, HY, Lee, SP, Lee, JM, Yoon, YE, Park, E, Kim, HK, Park, SJ, Lee, H, Kim, YJ, Sohn, DW, Nemes, A, Domsik, P, Kalapos, A, Orosz, A, Lengyel, C, Forster, T, Enache, R, Muraru, D, Popescu, BA, Calin, A, Nastase, O, Botezatu, D, Purcarea, F, Rosca, M, Beladan, CC, Ginghina, C, Canpolat, U, Aytemir, K, Ozer, N, Yorgun, H, Sahiner, L, Kaya, EB, Oto, A, Trial, Turkish Atrial Fibrosis, Muraru, D, Piasentini, E, Mihaila, S, Padayattil Jose, S, Peluso, D, Ucci, L, Naso, P, Puma, L, Iliceto, S, Badano, LP, Cikes, M, Jakus, N, Sutherland, GR, Haemers, P, Dhooge, J, Claus, P, Yurdakul, S, Oner, FATMA, Direskeneli, HANER, Sahin, TAYLAN, Cengiz, BETUL, Ercan, G, Bozkurt, AYSEN, Aytekin, SAIDE, Osa Saez, A M, Rodriguez-Serrano, M, Lopez-Vilella, R, Buendia-Fuentes, F, Domingo-Valero, D, Quesada-Carmona, A, Miro-Palau, VE, Arnau-Vives, MA, Palencia-Perez, M, Rueda-Soriano, J, Lipczynska, M, Piotr Szymanski, PS, Anna Klisiewicz, AK, Lukasz Mazurkiewicz, LM, Piotr Hoffman, PH, Kim, KH, Cho, SK, Ahn, Y, Jeong, MH, Cho, JG, Park, JC, Chinali, M, Franceschini, A, Matteucci, MC, Doyon, A, Esposito, C, Del Pasqua, A, Rinelli, G, Schaefer, F, group, the 4C study, Kowalik, E, Klisiewicz, A, Rybicka, J, Szymanski, P, Biernacka, EK, Hoffman, P, Lee, S, Kim, W, Yun, H, Jung, L, Kim, E, Ko, J, Ruddox, V, Norum, IB, Edvardsen, T, Baekkevar, M, Otterstad, JE, Erdei, T, Edwards, J, Braim, D, Yousef, Z, Fraser, AG, Cardiff, Investigators, MEDIA, Melcher, A, Reiner, B, Hansen, A, Strandberg, LE, Caidahl, K, Wellnhofer, E, Kriatselis, C, Gerd-Li, H, Furundzija, V, Thnabalasingam, U, Fleck, E, Graefe, M, Park, YJ, Moon, JG, Ahn, TH, Baydar, O, Kadriye Kilickesmez, KK, Ugur Coskun, UC, Polat Canbolat, PC, Veysel Oktay, VO, Umit Yasar Sinan, US, Okay Abaci, OA, Cuneyt Kocas, CK, Sinan Uner, SU, Serdar Kucukoglu, SK, Ferferieva, V, Claus, P, Rademakers, F, Dhooge, J, Le, T T, Wong, P, Tee, N, Huang, F, Tan, RS, Altman, M, Logeart, D, Bergerot, C, Gellen, B, Pare, C, Gerard, S, Sirol, M, Vicaut, E, Mercadier, JJ, Derumeaux, G A, investigators, PREGICA, Park, T-H, Park, J-I, Shin, S-W, Yun, S-H, Lee, J-E, Makavos, G, Kouris, N, Keramida, K, Dagre, A, Ntarladimas, I, Kostopoulos, V, Damaskos, D, Olympios, CD, Leong, DP, Piers, SRD, Hoogslag, GE, Hoke, U, Thijssen, J, Ajmone Marsan, N, Schalij, MJ, Bax, JJ, Zeppenfeld, K, Delgado, V, Rio, P, Branco, L, Galrinho, A, Cacela, D, Abreu, J, Timoteo, A, Teixeira, P, Pereira-Da-Silva, T, Selas, M, Cruz Ferreira, R, Popa, B A, Zamfir, L, Novelli, E, Lanzillo, G, Karazanishvili, L, Musica, G, Stelian, E, Benea, D, Diena, M, Cerin, G, Fusini, L, Mirea, O, Tamborini, G, Muratori, M, Gripari, P, Ghulam Ali, S, Cefalu, C, Maffessanti, F, Andreini, D, Pepi, M, Mamdoo, F, Goncalves, A, Peters, F, Matioda, H, Govender, S, Dos Santos, C, Essop, MR, Kuznetsov, V A, Yaroslavskaya, E I, Pushkarev, G S, Krinochkin, D V, Kolunin, G V, Bennadji, A, Hascoet, S, Dulac, Y, Hadeed, K, Peyre, M, Ricco, L, Clement, L, Acar, P, Ding, WH, Zhao, Y, Lindqvist, P, Nilson, J, Winter, R, Holmgren, A, Ruck, A, Henein, MY, Illatopa, V, Cordova, F, Espinoza, D, Ortega, J, Cavalcante, JL, Patel, MT, Katz, W, Schindler, J, Crock, F, Khanna, MK, Khandhar, S, Tsuruta, H, Kohsaka, S, Murata, M, Yasuda, R, Tokuda, H, Kawamura, A, Maekawa, Y, Hayashida, K, Fukuda, K, Le Tourneau, T, Kyndt, F, Lecointe, S, Duval, D, Rimbert, A, Merot, J, Trochu, JN, Probst, V, Le Marec, H, Schott, JJ, Veronesi, F, Addetia, K, Corsi, C, Lamberti, C, Lang, RM, Mor-Avi, V, Gjerdalen, G F, Hisdal, J, Solberg, EE, Andersen, TE, Radunovic, Z, Steine, K, Maffessanti, F, Gripari, P, Tamborini, G, Muratori, M, Fusini, L, Ferrari, C, Caiani, EG, Alamanni, F, Bartorelli, AL, Pepi, M, Dascenzi, F, Cameli, M, Iadanza, A, Lisi, M, Reccia, R, Curci, V, Sinicropi, G, Henein, M, Pierli, C, Mondillo, S, Rekhraj, S, Hoole, SP, Mcnab, DC, Densem, CG, Boyd, J, Parker, K, Shapiro, LM, Rana, BS, Kotrc, M, Vandendriessche, T, Bartunek, J, Claeys, MJ, Vanderheyden, M, Paelinck, B, De Bock, D, De Maeyer, C, Vrints, C, Penicka, M, Silveira, C, Albuquerque, ESA, Lamprea, DL, Larangeiras, VL, Moreira, CRPM, Victor Filho, MVF, Alencar, BMA, Silveira, AQMS, Castillo, JMDC, Zambon, E, Iorio, A, Carriere, C, Pantano, A, Barbati, G, Bobbo, M, Abate, E, Pinamonti, B, Di Lenarda, A, Sinagra, G, Salemi, V M C, Tavares, L, Ferreira Filho, JCA, Oliveira, AM, Pessoa, FG, Ramires, F, Fernandes, F, Mady, C, Cavarretta, E, Lotrionte, M, Abbate, A, Mezzaroma, E, De Marco, E, Peruzzi, M, Loperfido, F, Biondi-Zoccai, G, Frati, G, Palazzoni, G, Park, T-H, Lee, J-E, Lee, D-H, Park, J-S, Park, K, Kim, M-H, Kim, Y-D, Van T Sant, J, Gathier, WA, Leenders, GE, Meine, M, Doevendans, PA, Cramer, MJ, Poyhonen, P, Kivisto, S, Holmstrom, M, Hanninen, H, Schnell, F, Betancur, J, Daudin, M, Simon, A, Carre, F, Tavard, F, Hernandez, A, Garreau, M, Donal, E, Calore, C, Muraru, D, Badano, LP, Melacini, P, Mihaila, S, Denas, G, Naso, P, Casablanca, S, Santi, F, Iliceto, S, Aggeli, C, Venieri, E, Felekos, I, Anastasakis, A, Ritsatos, K, Kakiouzi, V, Kastellanos, S, Cutajar, I, Stefanadis, C, Palecek, T, Honzikova, J, Poupetova, H, Vlaskova, H, Kuchynka, P, Linhart, A, Elmasry, O, Mohamed, MH, Elguindy, WM, Bishara, PNI, Garcia-Gonzalez, P, Cozar-Santiago, P, Bochard-Villanueva, B, Fabregat-Andres, O, Cubillos-Arango, A, Valle-Munoz, A, Ferrer-Rebolleda, J, Paya-Serrano, R, Estornell-Erill, J, Ridocci-Soriano, F, Jensen, M, Havndrup, O, Christiansen, M, Andersen, PS, Axelsson, A, Kober, L, Bundgaard, H, Karapinar, H, Kaya, A, Uysal, EB, Guven, AS, Kucukdurmaz, Z, Oflaz, MB, Deveci, K, Sancakdar, E, Gul, I, Yilmaz, A, Tigen, M K, Karaahmet, T, Dundar, C, Yalcinsoy, M, Tasar, O, Bulut, M, Takir, M, Akkaya, E, Jedrzejewska, I, Braksator, W, Krol, W, Swiatowiec, A, Dluzniewski, M, Lipari, P, Bonapace, S, Zenari, L, Valbusa, F, Rossi, A, Lanzoni, L, Molon, G, Canali, G, Campopiano, E, Barbieri, E, Rueda Calle, E, Alfaro Rubio, F, Gomez Gonzalez, J, Gonzalez Santos, P, Cameli, M, Lisi, M, Focardi, M, Dascenzi, F, Solari, M, Galderisi, M, Mondillo, S, Pratali, L, Bruno, R M, Corciu, AI, Comassi, M, Passera, M, Gastaldelli, A, Mrakic-Sposta, S, Vezzoli, A, Picano, E, Perry, R, Penhall, A, De Pasquale, C, Selvanayagam, J, Joseph, M, Simova, I I, Katova, T M, Kostova, V, Hristova, K, Lalov, I, Dascenzi, F, Pelliccia, A, Natali, BM, Cameli, M, Alvino, F, Zorzi, A, Corrado, D, Bonifazi, M, Mondillo, S, Rees, E, Rakebrandt, F, Rees, DA, Halcox, JP, Fraser, AG, Odriscoll, J, Lau, N, Perez-Lopez, M, Sharma, R, Lichodziejewska, B, Goliszek, S, Kurnicka, K, Kostrubiec, M, Dzikowska Diduch, O, Krupa, M, Grudzka, K, Ciurzynski, M, Palczewski, P, Pruszczyk, P, Gheorghe, LL, Castillo Ortiz, J, Del Pozo Contreras, R, Calle Perez, G, Sancho Jaldon, M, Cabeza Lainez, P, Vazquez Garcia, R, Fernandez Garcia, P, Chueca Gonzalez, E, Arana Granados, R, Zhao, XX, Xu, XD, Bai, Y, Qin, YW, Leren, IS, Hasselberg, NE, Saberniak, J, Leren, TP, Edvardsen, T, Haugaa, KH, Daraban, A M, Sutherland, GR, Claus, P, Werner, B, Gewillig, M, Voigt, JU, Santoro, A, Ierano, P, De Stefano, F, Esposito, R, De Palma, D, Ippolito, R, Tufano, A, Galderisi, M, Costa, R, Fischer, C, Rodrigues, A, Monaco, C, Lira Filho, E, Vieira, M, Cordovil, A, Oliveira, E, Mohry, S, Gaudron, P, Niemann, M, Herrmann, S, Strotmann, J, Beer, M, Hu, K, Bijnens, B, Ertl, G, Weidemann, F, Baktir, AO, Sarli, B, Cicek, M, Karakas, MS, Saglam, H, Arinc, H, Akil, MA, Kaya, H, Ertas, F, Bilik, MZ, Yildiz, A, Oylumlu, M, Acet, H, Aydin, M, Yuksel, M, Alan, S, Odriscoll, J, Gravina, A, Di Fino, S, Thompson, M, Karthigelasingham, A, Ray, K, Sharma, R, De Chiara, B, Russo, CF, Alloni, M, Belli, O, Spano, F, Botta, L, Palmieri, B, Martinelli, L, Giannattasio, C, Moreo, A, Mateescu, AD, La Carrubba, S, Vriz, O, Di Bello, V, Carerj, S, Zito, C, Ginghina, C, Popescu, BA, Nicolosi, GL, Antonini-Canterin, F, Malev, E, Omelchenko, M, Vasina, L, Luneva, E, Zemtsovsky, E, Cikes, M, Velagic, V, Gasparovic, H, Kopjar, T, Colak, Z, Hlupic, LJ, Biocina, B, Milicic, D, Tomaszewski, A, Kutarski, A, Poterala, M, Tomaszewski, M, Brzozowski, W, Kijima, Y, Akagi, T, Nakagawa, K, Ikeda, M, Watanabe, N, Ueoka, A, Takaya, Y, Oe, H, Toh, N, Ito, H, Bochard Villanueva, B, Paya-Serrano, R, Fabregat-Andres, O, Garcia-Gonzalez, P, Perez-Bosca, JL, Cubillos-Arango, A, Chacon-Hernandez, N, Higueras-Ortega, L, De La Espriella-Juan, R, Ridocci-Soriano, F, Noack, T, Mukherjee, C, Ionasec, RI, Voigt, I, Kiefer, P, Hoebartner, M, Misfeld, M, Mohr, F-W, Seeburger, J, Daraban, A M, Baltussen, L, Amzulescu, MS, Bogaert, J, Jassens, S, Voigt, JU, Duchateau, N, Giraldeau, G, Gabrielli, L, Penela, D, Evertz, R, Mont, L, Brugada, J, Berruezo, A, Bijnens, BH, Sitges, M, Yoshikawa, H, Suzuki, M, Hashimoto, G, Kusunose, Y, Otsuka, T, Nakamura, M, Sugi, K, Ruiz Ortiz, M, Mesa, D, Romo, E, Delgado, M, Seoane, T, Martin, M, Carrasco, F, Lopez Granados, A, Arizon, JM, Suarez De Lezo, J, Magalhaes, A, Cortez-Dias, N, Silva, D, Menezes, M, Saraiva, M, Santos, L, Costa, A, Costa, L, Nunes Diogo, A, Fiuza, M, Ren, B, De Groot-De Laat, LE, Mcghie, J, Vletter, WB, Geleijnse, ML, Toda, H, Oe, H, Osawa, K, Miyoshi, T, Ugawa, S, Toh, N, Nakamura, K, Kohno, K, Morita, H, Ito, H, El Ghannudi, S, Germain, P, Samet, H, Jeung, M, Roy, C, Gangi, A, Orii, M, Hirata, K, Yamano, T, Tanimoto, T, Ino, Y, Yamaguchi, T, Kubo, T, Imanishi, T, Akasaka, T, Sunbul, M, Kivrak, T, Oguz, M, Ozguven, S, Gungor, S, Dede, F, Turoglu, HT, Yildizeli, B, Mutlu, B, Mihaila, S, Muraru, D, Piasentini, E, Peluso, D, Cucchini, U, Casablanca, S, Naso, P, Iliceto, S, Vinereanu, D, Badano, LP, Rodriguez Munoz, DA, Moya Mur, JL, Becker Filho, D, Gonzalez, A, Casas Rojo, E, Garcia Martin, A, Recio Vazquez, M, Rincon, LM, Fernandez Golfin, C, Zamorano Gomez, JL, Ledakowicz-Polak, A, Polak, L, Zielinska, M, Kamiyama, T, Nakade, T, Nakamura, Y, Ando, T, Kirimura, M, Inoue, Y, Sasaki, O, Nishioka, T, Farouk, H, Sakr, B, Elchilali, K, Said, K, Sorour, K, Salah, H, Mahmoud, G, Casanova Rodriguez, C, Cano Carrizal, R, Iglesias Del Valle, D, Martin Penato Molina, A, Garcia Garcia, A, Prieto Moriche, E, Alvarez Rubio, J, De Juan Bagua, J, Tejero Romero, C, Plaza Perez, I, Korlou, P, Stefanidis, A, Mpikakis, N, Ikonomidis, I, Anastasiadis, S, Komninos, K, Nikoloudi, P, Margos, P, and Pentzeridis, P

Abstract

Purpose: Atrial fibrillation (AF) is the most prevalent sustained arrhythmia. It is a disease of the elderly and it is common in patients (pts) with structural heart disease. Hypertension (HA), hypertensive heart disease (HHD), diabetes mellitus (DM), coronary artery disease (CAD), heart failure (HF), and valvular heart disease (VHD) are recognized predisposing factors to AF. Objectives: To echocardiographicly disclose the most common predisposing morbidities to AF in our population sample. Methods: From June 2000 to February 2013, 3755 consecutive pts with AF were studied during echocardiographic check-up. According to transthoracic echo, pts were divided in groups based on dominative underlying heart diseases. Electrocardiographically documented AF was subdivided in two groups: transitory and chronic. Transitory AF fulfilled criteria for paroxysmal or persistent AF. Chronic AF were cases of long-standing persistent or permanent AF. Results: The median age was 72 years, age range between 16 and 96 years. There were 51.4% of females. Chronic AF was observed in 68.3% pts. Distribution of underlying heart diseases is shown in figure. Lone AF was diagnosed in only 25 pts, mostly in younger males (median age 48 years, range 29–59, men 80%). Chronic AF was predominant in groups with advanced cardiac remodeling such as dilatative cardiomyopaty (DCM) and VHD, mostly in elderly. HA and DM were found in 75.4% and 18.8%, respectively. Almost 1/2 of pts with AF had HF and 59.2% had diastolic HF. Conclusion: Up to now, echocardiographic categorization of the predisposing factors to AF was not reported. Echocardiographic evaluation of patients with AF could facilitate in identification and well-timed treatment of predisposing comorbidites. Figure Etiological distribution of AF

Published
2013
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12. Lower Urinary Tract Symptoms (LUTS) as a New Clinical Presentation of Histamine Intolerance: A Prevalence Study of Genetic Diamine Oxidase Deficiency.

Author

Ponce Díaz-Reixa J, Aller Rodríguez M, Martínez Breijo S, Suanzes Hernández J, Ruiz Casares E, Perucho Alcalde T, Bohorquez Cruz M, Mosquera Seoane T, Sánchez Merino JM, Freire Calvo J, Fernández Suárez P, and Chantada Abal V

Abstract

Lower urinary tract symptoms (LUTS) are highly prevalent, and their treatment is mainly focused on the control of symptoms. Histamine intolerance (HIT) has been related to a variety of systemic symptoms. DAO deficiency has been identified as a significant factor contributing to histamine intolerance (HIT). Preclinical evidence indicates the involvement of histamine in the lower urinary tract. This study aimed to assess the prevalence of diamine oxidase deficiency ( DAO ) in a prospective cohort of 100 patients with at least moderate LUTS. A genetic study of four single nucleotide polymorphisms (SNPs) (c.-691G>T, c.47C>T, c.995C>T, and c.1990C>G) was performed. HIT was found in 85.9% of patients. The prevalence of at least one minor allele in the SNPs analyzed was 88%, without gender differences. Storage symptoms were more intense in the presence of HIT as well as asthenia and neurological and musculoskeletal symptoms. The presence of minor alleles of the AOC1 gene was associated with a higher intensity of symptoms. Minor alleles from c.-691G>T and c.47C>T SNPs were also associated with a greater severity of obstructive symptoms. Thirty-one percent of patients presented the four SNPS with at least one associated minor allele. The relationship between HIT and LUTS in a mixed population of men and women found in this study supports further investigations to define the pathophysiology of histamine in LUTS.

Published
2023
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13. Periodontitis and Other Risk Factors Related to Myocardial Infarction and Its Follow-Up.

Author

Seoane T, Bullon B, Fernandez-Riejos P, Garcia-Rubira JC, Garcia-Gonzalez N, Villar-Calle P, Quiles JL, Battino M, and Bullon P

Abstract

The main issue in the prevention of myocardial infarction (MI) is to reduce risk factors. Periodontal disease is related to cardiovascular disease and both share risk factors. The purpose of this study is to investigate whether periodontitis can be considered a risk factor for MI and common risk factors in a case-control study and in a prospective follow-up study in patients with MI. The test group (MIG) was made up of 144 males who had MI in the previous 48 h. The control group (CG) was composed of 138 males without MI. Both groups were subdivided according to the presence or absence of stage III and IV of periodontitis. General data; Mediterranean diet and physical activity screening; periodontal data; and biochemical, microbiological and cardiological parameters were recorded. ANOVA, Mann-Whitney U and Kruskal-Wallis statistical tests and binary logistic regression analysis were applied. No differences in anthropometric variables were observed between the four groups. The average weekly exercise hours have a higher value in CG without periodontitis. The number of leukocytes was higher in MIG, the number of monocytes was higher in CG and the number of teeth was lower in MIG with periodontitis. Adherence to the Mediterranean diet was higher in CG. Porphyromonas gingivalis and Tannerella forsythia were higher in CG with periodontitis and in MIG with and without periodontitis. At follow-up, the left ventricular ejection fraction (LVEF) data were better in the non-periodontitis group: 15 patients had Mayor Cardiovascular Adverse Events (MACE), 13 of them had periodontitis and 2 did not show periodontitis. Periodontitis, exercise, diet and smoking are risk factors related to MI. MACE presented in the 'MI follow-up' shows periodontitis, weight, exercise hours and dyslipidemia as risk factors. LVEF follow-up values are preserved in patients without periodontitis. Our data suggest that periodontitis can be considered a risk factor for MI and MACE in the studied population.

Published
2022
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14. Body fat and metabolic age as indicators of inflammation and cardiovascular risk.

Author

Garcia-Rubira JC, Cano-Garcia FJ, Bullon B, Seoane T, Villar PV, Cordero MD, and Bullon P

Subjects
Age Factors, Biomarkers blood, Cardiovascular Diseases blood, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Health Status, Humans, Inflammasomes metabolism, Inflammation blood, Inflammation diagnosis, Inflammation epidemiology, Inflammation Mediators blood, Interleukin-1beta blood, Male, Obesity blood, Obesity diagnosis, Obesity epidemiology, Predictive Value of Tests, Prognosis, Risk Assessment, Risk Factors, Spain epidemiology, Adiposity, Cardiovascular Diseases physiopathology, Energy Metabolism, Inflammation physiopathology, Obesity physiopathology
Published
2018
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15. Right Ventricular Dysfunction Impairs Effort Tolerance Independent of Left Ventricular Function Among Patients Undergoing Exercise Stress Myocardial Perfusion Imaging.

Author

Kim J, Di Franco A, Seoane T, Srinivasan A, Kampaktsis PN, Geevarghese A, Goldburg SR, Khan SA, Szulc M, Ratcliffe MB, Levine RA, Morgan AE, Maddula P, Rozenstrauch M, Shah T, Devereux RB, and Weinsaft JW

Subjects
Aged, Coronary Artery Disease epidemiology, Coronary Artery Disease physiopathology, Female, Humans, Male, Middle Aged, Myocardial Contraction, New York City epidemiology, Predictive Value of Tests, Prevalence, Reproducibility of Results, Time Factors, Ventricular Dysfunction, Left epidemiology, Ventricular Dysfunction, Left physiopathology, Ventricular Dysfunction, Right epidemiology, Ventricular Dysfunction, Right physiopathology, Coronary Artery Disease diagnostic imaging, Coronary Circulation, Echocardiography, Doppler, Echocardiography, Stress methods, Exercise Test, Exercise Tolerance, Myocardial Perfusion Imaging methods, Tomography, Emission-Computed, Single-Photon, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Function, Left, Ventricular Function, Right
Abstract

Background: Right ventricular (RV) and left ventricular (LV) function are closely linked due to a variety of factors, including common coronary blood supply. Altered LV perfusion holds the potential to affect the RV, but links between LV ischemia and RV performance, and independent impact of RV dysfunction on effort tolerance, are unknown., Methods and Results: The population comprised 2051 patients who underwent exercise stress myocardial perfusion imaging and echo (5.5±7.9 days), among whom 6% had echo-evidenced RV dysfunction. Global summed stress scores were ≈3-fold higher among patients with RV dysfunction, attributable to increments in inducible and fixed LV perfusion defects (all P≤0.001). Regional inferior and lateral wall ischemia was greater among patients with RV dysfunction (both P<0.01), without difference in corresponding anterior defects (P=0.13). In multivariable analysis, inducible inferior and lateral wall perfusion defects increased the likelihood of RV dysfunction (both P<0.05) independent of LV function, fixed perfusion defects, and pulmonary artery pressure. Patients with RV dysfunction demonstrated lesser effort tolerance whether measured by exercise duration (6.7±2.8 versus 7.9±2.9 minutes; P<0.001) or peak treadmill stage (2.6±0.9 versus 3.1±1.0; P<0.001), paralleling results among patients with LV dysfunction (7.0±2.9 versus 8.0±2.9; P<0.001|2.7±1.0 versus 3.1±1.0; P<0.001 respectively). Exercise time decreased stepwise in relation to both RV and LV dysfunction (P<0.001) and was associated with each parameter independent of age or medication regimen., Conclusions: Among patients with known or suspected coronary artery disease, regional LV ischemia involving the inferior and lateral walls confers increased likelihood of RV dysfunction. RV dysfunction impairs exercise tolerance independent of LV dysfunction., (© 2016 American Heart Association, Inc.)

Published
2016
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16. Echocardiographic Linear Dimensions for Assessment of Right Ventricular Chamber Volume as Demonstrated by Cardiac Magnetic Resonance.

Author

Kim J, Srinivasan A, Seoane T, Di Franco A, Peskin CS, McQueen DM, Paul TK, Feher A, Geevarghese A, Rozenstrauch M, Devereux RB, and Weinsaft JW

Subjects
Causality, Comorbidity, Female, Heart Ventricles diagnostic imaging, Humans, Male, Middle Aged, New York epidemiology, Organ Size, Reproducibility of Results, Risk Factors, Sensitivity and Specificity, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease epidemiology, Echocardiography methods, Magnetic Resonance Imaging, Cine methods, Stroke Volume, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Dysfunction, Right epidemiology
Abstract

Background: Echocardiography-derived linear dimensions offer straightforward indices of right ventricular (RV) structure but have not been systematically compared with RV volumes on cardiac magnetic resonance (CMR)., Methods: Echocardiography and CMR were interpreted among patients with coronary artery disease imaged via prospective (90%) and retrospective (10%) registries. For echocardiography, American Society of Echocardiography-recommended RV dimensions were measured in apical four-chamber (basal RV width, mid RV width, and RV length), parasternal long-axis (proximal RV outflow tract [RVOT]), and short-axis (distal RVOT) views. For CMR, RV end-diastolic volume and RV end-systolic volume were quantified using border planimetry., Results: Two hundred seventy-two patients underwent echocardiography and CMR within a narrow interval (0.4 ± 1.0 days); complete acquisition of all American Society of Echocardiography-recommended dimensions was feasible in 98%. All echocardiographic dimensions differed between patients with and those without RV dilation on CMR (P < .05). Basal RV width (r = 0.70), proximal RVOT width (r = 0.68), and RV length (r = 0.61) yielded the highest correlations with RV end-diastolic volume on CMR; end-systolic dimensions yielded similar correlations (r = 0.68, r = 0.66, and r = 0.65, respectively). In multivariate regression, basal RV width (regression coefficient = 1.96 per mm; 95% CI, 1.22-2.70; P < .001), RV length (regression coefficient = 0.97; 95% CI, 0.56-1.37; P < .001), and proximal RVOT width (regression coefficient = 2.62; 95% CI, 1.79-3.44; P < .001) were independently associated with CMR RV end-diastolic volume (r = 0.80). RV end-systolic volume was similarly associated with echocardiographic dimensions (basal RV width: 1.59 per mm [95% CI, 1.06-2.13], P < .001; RV length: 1.00 [95% CI, 0.66-1.34], P < .001; proximal RVOT width: 1.80 [95% CI, 1.22-2.39], P < .001) (r = 0.79)., Conclusions: RV linear dimensions provide readily obtainable markers of RV chamber size. Proximal RVOT and basal width are independently associated with CMR volumes, supporting the use of multiple linear dimensions when assessing RV size on echocardiography., Competing Interests: Conflicts of Interests Disclosure: None, (Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)

Published
2016
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17. Risk factors for positive margins in conservative surgery for breast cancer after neoadjuvant chemotherapy.

Author

Bouzón A, Acea B, García A, Iglesias Á, Mosquera J, Santiago P, and Seoane T

Subjects
Adult, Aged, Breast Neoplasms drug therapy, Carcinoma, Ductal, Breast drug therapy, Chemotherapy, Adjuvant, Conservative Treatment, Female, Humans, Mastectomy, Middle Aged, Neoadjuvant Therapy, Retrospective Studies, Risk Factors, Breast Neoplasms surgery, Carcinoma, Ductal, Breast surgery, Margins of Excision
Abstract

Background: Breast conservative surgery after neoadjuvant chemotherapy intends to remove any residual tumor with negative margins. The purpose of this study was to analyze the preoperative clinical-pathological factors influencing the margin status after conservative surgery in breast cancer patients receiving neoadjuvant chemotherapy., Methods: A retrospective study of 91 breast cancer patients undergoing neoadjuvant chemotherapy (92 breast lesions) during the period 2006 to 2013. A Cox regression analysis to identify baseline tumor characteristics associated with positive margins after breast conservative surgery was performed., Results: Of all cases, 71 tumors were initially treated with conservative surgery after neoadjuvant chemotherapy. Pathologic exam revealed positive margins in 16 of the 71 cases (22.5%). The incidence of positive margins was significantly higher in cancers with initial size >5cm (P=.021), in cancers with low tumor grade (P=.031), and in patients with hormone receptor-positive cancer (P=.006). After a median follow-up of 45.2 months, 7 patients of the 71 treated with conservative surgery had disease recurrence (9.8%). There was no significant difference in terms of disease-free survival according to the margin status (P=.596)., Conclusions: A baseline tumor size >5cm, low tumor grade and hormone receptor-positive status increase the risk for surgical margin involvement in breast conservative surgery after neoadjuvant chemotherapy., (Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)

Published
2016
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18. Prostatitis and acute urinary retention as first manifestations of Wegnener's granulomatosis.

Author

Pereira Beceiro J, Rodríguez Alonso A, Bonelli Martín C, Pérez Valcárcel J, Mosquera Seoane T, and Cuerpo Pérez MÁ

Subjects
Acute Disease, Granulomatosis with Polyangiitis complications, Humans, Male, Middle Aged, Granulomatosis with Polyangiitis diagnosis, Prostatitis etiology, Urinary Retention etiology
Abstract

Objectives: We present a case of prostatitis with acute urinary retention as a rare initial manifestation of Wegener' Granulomatosis., Methods: The case was a 48-year-old male with symptoms of prostatitis over ten days. The patient presented urinary retention, with partial response to antibiotic treatment. High levels of cytoplasmic antineutrophil cytoplasmic antibody and a prostatic biopsy were compatible with Wegener' Granulomatosis., Results: After starting treatment with glucocorticoids and cyclophosphamide, a significant improvement to the point of disappearance of symptoms was observed. At 3 months pulmonary and upper airway symptoms began, requiring higher doses of cyclophosphamide to control symptoms., Conclusions: Wegener's Granulomatosis is a multisystem entity whose presentation as prostatitis with urinary retention is rare., (Copyright © 2012 Elsevier España, S.L.U. All rights reserved.)

Published
2014
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19. Benzodiazepines in generalized anxiety disorder: heterogeneity of outcomes based on a systematic review and meta-analysis of clinical trials.

Author

Martin JL, Sainz-Pardo M, Furukawa TA, Martín-Sánchez E, Seoane T, and Galán C

Subjects
Adolescent, Adult, Aged, Anti-Anxiety Agents adverse effects, Benzodiazepines adverse effects, Humans, Middle Aged, Patient Dropouts, Publication Bias, Randomized Controlled Trials as Topic, Time Factors, Treatment Outcome, Anti-Anxiety Agents therapeutic use, Anxiety Disorders drug therapy, Benzodiazepines therapeutic use
Abstract

No systematic review or meta-analysis using a hard outcome has been conducted on the role of benzodiazepines for generalized anxiety disorder (GAD). The objective of this study was to assess the effectiveness and efficacy of benzodiazepines in the treatment of GAD based on trial drop-out rates. We used a systematic review of randomized controlled trials that compared any of the three best established benzodiazepines (diazepam, Lorazepam and aLprazolam) against placebo. Our primary outcome for effectiveness was withdrawal for any reason. Our secondary outcome tapping efficacy was withdrawal due to lack of efficacy, and that tapping side effects was withdrawals due to adverse events. We included 23 trials. Pooled analysis indicated less risk of treatment discontinuation due to lack of efficacy for benzodiazepines, compared to placebo, relative risk (RR) 0.29 (95% CI 0.18-0.45; p < 0.00001). Nevertheless, pooled analysis showed no conclusive results for risk of all-cause patient discontinuation, RR 0.78 (95% CI 0.62-1.00; p = 0.05). Meta-regression model showed that 74% of the variation in logRR across the studies was explained by year of publication (p <0.001). This systematic review did not find convincing evidence of the short-term effectiveness of the benzodiazepines in the treatment of GAD. On the other hand, for the outcome of efficacy, this review found robust evidence in favour of benzodiazepines. Due to the heterogeneity induced by year of publication, three hypotheses are plausibLe when it comes to being able to account for the differences between efficacy and effectiveness observed in the outcomes (publication bias, quality of the trial literature and a non-differential response to the placebo effect).

Published
2007
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