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Karady J, Apor A, Nagy AI, Kolossvary M, Szilveszter B, Simon J, Molnar L, Bartykowszki A, Jermendy AL, Panajotu AL, Suhai FI, Varga AL, Rajani R, Maurovich-Horvat P, Merkely B. P3381Quantification of hypo-attenuated leaflet thickening after transcatheter aortic valve implantation - clinical relevance of HALT volume. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Hypo-attenuated leaflet thickening (HALT) is a recently recognized phenomenon following transcatheter aortic valve implantation (TAVI) and there is no consensus over the standardized assessment of HALT and its clinical relevance is poorly understood. We sought to determine the predictors and clinical significance of HALT volume.
Methods
Patients, who previously underwent TAVI between 2011 and 2016 were prospectively enrolled in the RETORIC (Rule out Transcatheter Aortic Valve Thrombosis with Post Implantation Computed Tomography) study, a single-center observational study. At inclusion cardiac computed tomography angiography (CTA), transthoracic echocardiography (TTE) and brain magnetic resonance imaging (MRI) was performed. HALT was volumetrically quantified on cardiac CTA images by segmenting the inner volume of the TAVI frame at the level of the leaflets and applying a threshold of −200 to 200 Hounsfield units. We evaluated the clinical predictors of HALT volume, and its association with ischemic brain MRI lesions (recent and chronic large vessel ischemic focuses, microbleed/microembolization, white matter or small vessel disease) and all-cause mortality.
Results
In total, we analyzed 111 patients with CoreValve bioprosthesis (56.7% female, mean age 80.3±7.4 years). A median of 19 [IQR: 11–29] months passed between TAVI procedure and enrollment. The mean HALT volume was 111.0±163.4 mm3. Current malignant disease, prosthesis implantation depth measured on CTA images acquired at inclusion, and aortic mean gradient and aortic valve area evaluated on TTE images at inclusion predicted HALT volume by univariate analysis (all p<0.05). After multivariate adjustment, aortic mean gradient remained a significant predictor of HALT volume (beta-coefficient: 11.5, 95% CI: 5.0–18.0; p<0.001). HALT volume was not associated with ischemic brain MRI lesions (all p>0.05) and did not predict all-cause mortality (median follow-up: 20 months [IQR: 18–23]; HR: 1.0; 95% CI: 1.0–1.0; p=0.15).
Volumetric quantification of HALT.
Conclusion
Aortic mean gradient was the only predictor independently associated with HALT volume. Our results suggest that TAVI valve function is negatively affected by HALT volume, however, we found no association of HALT volume with cerebrovascular ischemic lesions or increased risk for all-cause mortality.
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Jablonkai B, Ahres A, Ruboczky G, Nagybaczoni B, Oze A, Balogh ZSD, Schrancz A, Astrid A, Szilveszter B, Kolossvary M, Simon J, Merkely B, Maurovich-Horvat P, Andrassy P. P6183Diagnostic performance of coronary computed tomography angiography-derived fractional flow reserve in patients with acute myocardial infarction and moderate non-culprit coronary stenosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Revascularisation of significant non-culprit coronary lesions (NCL) may improve clinical outcome in patients with myocardial infarction and multi vessel disease, however management of moderate NCLs is still controversial. Dobutamine stress echocardiography (DSE) and invasive fractional flow reserve (FFR) are accepted methods to detect myocardial ischemia, nevertheless coronary CT angiography-derived fractional flow reserve (CT-FFR) is a new modality, which has not been widely investigated to date in patients with NCLs.
Purpose
Our aim was to determine the diagnostic performance of CT-FFR compared to DSE and invasive FFR.
Methods
In this prospective trial, DSE, FFR and CT-FFR were performed in every patient with MI and at least one moderate NCL (30–70% diameter stenosis by visual assessment). New or worsening wall motion abnormality in at least two contiguous myocardial segments on DSE, and FFR value<0.8 in invasive FFR and CT-FFR as well were determined as abnormal. In comparison, DSE and FFR were regarded as reference standard methods.
Results
Between March of 2017 and December of 2018, 51 patients (58.2±10.4 years, 74.5% male) were enrolled and 71 NCLs (40 LAD, 13 LCx, 18 RCA) were investigated. Dobutamine stress echocardiography, FFR and CT-FFR were positive in 30.9%, 32.3% and 22.5% of all lesions, respectively. FFR values were higher with CT-FFR compared to invasive FFR (0.85±0.11 vs. 0.83±0.08, p<0.05). Compared to DSE, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of CT-FFR were 40.9%, 85.7%, 56.2%, 76.3% and 71.8%, respectively. The same values were 39.1%, 85.4%, 56.2%, 74.5% and 70.4% compared to invasive FFR, respectively. Correspondence of CT-FFR with DSE (k=0.29) and with FFR (k=0.27) was weak.
Conclusion
This is the first study that compares the three modalities in the evaluation of moderate NCLs. Our results demonstrated moderate diagnostic accuracy, excellent specificity, poor sensitivity and PPV and acceptable NPV of CT-FFR compared to DSE and FFR. At this stage, CT-FFR is probably not accurate enough to determine revascularisation strategy of moderate NCLs as a single non-invasive method.
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Kiss N, Sulz I, Bauer P, Simon J, Mouhieddine M, Hiesmayr M. OR38: Nutrition-Related Factors Associated with Length of Hospital Stay Following Nutritionday. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32510-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Spänig S, Kirchberg J, Simon J, Magin T, Kunz M. 443 Mechanisms of Keratinocyte-Melanoma Cell Interaction. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Moick S, Simon J, Hiesmayr M. Nutrition care quality indicators in hospitals and nursing homes: A systematic literature review and critical appraisal of current evidence. Clin Nutr 2019; 39:1667-1680. [PMID: 31447247 DOI: 10.1016/j.clnu.2019.07.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/01/2019] [Accepted: 07/24/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Quality indicators (QIs) can be used to assess and improve the quality of care in health care institutions. Although QIs about nutrition care in hospitals and nursing homes have been used in studies, no systematic catalogue exists to date. This systematic literature review identifies nutrition care QIs in hospitals and nursing homes and maps them according to QI type, stakeholder level and nutrition care theme. We also assess the level of consensus between studies and critically appraise the QIs presented therein based on two conceptual frameworks. METHODS Ovid, Scopus and grey literature were searched from 1995 to 2016 including studies in English and German. Papers were considered if they presented, developed, assessed, rated or applied nutrition care QIs in hospitals or nursing homes. We used Donabedian's framework to define structure, process and outcome indicators, the WHO (World Health Organization) definition to describe stakeholder levels, and a structured table to map indicators within themes. Further, we used the Institute of Medicine (IOM) and the Organisation for Economic Cooperation and Development (OECD) frameworks' key dimensions to measure the conceptual quality of the QIs. Results are summarised and presented tabulated and narratively. RESULTS From 536 identified studies, 46 were included. Eight hundred and twenty-two QIs were extracted and mapped into 19 themes and 151 sub-themes. Half were process indicators (49%) and about a quarter were outcome (28%) and structure (23%) indicators, respectively. The vast majority (71%) targeted micro level, while 28% meso level and only 1% macro level information. The nutrition themes meals/mealtimes (12%), treatment (adherence) (12%), nutrition screening (7%), assessment (7%) and monitoring (7%) were most frequently covered. 69% of indicators were cited by more than one study. Most frequent framework dimensions were patient-centeredness (33%), timeliness (30%), validity (30%) and actionability/feasibility (30%). CONCLUSION The large number of nutrition care QIs in hospitals and nursing homes indicates the high interest in and importance of better nutrition care provision in institutions. However, the great variability indicates little consensus of the nutrition community on how to best assess and measure the quality of nutrition care. The limited methodological and conceptual validity of presented QIs and the low representation of QIs at macro and meso levels make international consensus finding complicated. Increased efforts including all stakeholder levels and using conceptual frameworks to define a limited number of key QIs with high methodological validity, actionability and stakeholder relevance are needed. Registration in clinicaltrials.gov: Identifier: NCT02820246.
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Simon J, Goldstein I, Goldstein S, Altomare C, Maroun C, Schaffer S, Soulban G. 094 Phase III Study Evaluating Efficacy and Safety of Ospemifene in Menopausal Women with Moderate to Severe Vaginal Dryness: Overall Patient Satisfaction with Treatment. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Szaraz L, Simon J, Kolossvary M, Szilveszter B, Drobni ZD, Merkely B, Maurovich-Horvat P. 82Optimal Calcium Score Threshold for 256-slice Coronary CT Angiography. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez143.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Simon J, Szilveszter B, Ahres A, Jablonkai B, Kolossvary M, Merkely B, Andrassy P, Maurovich-Horvat P. P116On-site coronary CT - derived FFR for the assessment of non-culprit lesions in patients who suffered myocardial infarction. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez147.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sicard E, Clayton A, Simon J, Parish S, Kingsberg S, Millheiser L. 103 The Effect of Evening Alcohol Consumption and Bedtime Administration of Flibanserin on the Safety of Flibanserin. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Vecsey-Nagy M, Szilveszter B, Jermendy Á, Kolossvary M, Simon J, Drobni ZS, Merkely B, Maurovich-Horvat P. P375Heart rate dependent degree of motion artifacts in coronary CT angiography acquired by a dedicated cardiac CT scanner. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sicard E, Clayton A, Simon J, Parish S, Millheiser L, Apfel S. 033 Effects of Alcohol Administered with Flibanserin in Healthy Premenopausal Women: A Randomized, Double-Blind, Single Dose, Seven-Way Crossover Study. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Parish S, Simon J, Lynn B, Bernick B, Mirkin S, Sitruk-Ware R. 015 Evidence of Low Androgenicity and Little Impact on Sexual Function or Activity with Annovera™, a Novel Contraceptive Vaginal System Releasing Segesterone Acetate and Ethinyl Estradiol. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Clayton A, Simon J, Kingsberg S, Jordan R, Lucas J, Williams L, Krop J. 029 Bremelanotide for Hypoactive Sexual Desire Disorders in the RECONNECT Studies: Analysis of Baseline Free Testosterone Level Quartile Subgroups. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Borzsak S, Papp S, Simon J, Karady J, Kolossvary M, Szilveszter B, Drobni ZD, Merkely B, Maurovich-Horvat P. P114The effect of myocardial bridge on the amount of atherosclerotic plaques and on the local hemodynamic changes. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez147.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Goldstein I, Simon J, Kaunitz A, Altomare C, Yoshida Y, Zhu J, Schaffer S, Soulban G. 143 Randomized, Double-blind, Placebo-Controlled Multicenter Study to Evaluate Efficacy and Safety of Ospemifene in Patients with Moderate to Severe Vaginal Dryness, Including Evaluation of Vulvar Health by Photographic Images. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sicard E, Clayton A, Simon J, Parish S, Millheiser L, Apfel S. 139 Effects of Alcohol Administered With Flibanserin in Healthy Premenopausal Women: A Randomized, Double-Blind, Single-Dose, Seven-Way Crossover Study. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sicard E, Clayton A, Simon J, Parish S, Kingsberg S, Millheiser L. 140 The Impact of the Timing of Alcohol Consumption on the Safety and Tolerability of Flibanserin. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Clayton A, Kingsberg S, DeRogatis L, Simon J, Jordan R, Lucas J. 138 Bremelanotide for Hypoactive Sexual Desire Disorder in the RECONNECT Study: Analysis of Co-Primary Endpoints According to Baseline FSFI Total Scores. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Meillan N, Vernerey D, Lefèvre J, Manceau G, Svrcek M, Augustin J, Fléjou J, Lascols O, Simon J, Cohen R, Maingon P, Bachet J, Huguet F. PV-0626 Mismatch Repair System Deficiency increases response to neoadjuvant chemoradiation in rectal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31046-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Simon J, Maingon P, Francois E, Labib E, Vincent M, Alain N, Mihaï L, Christian M, Didier P. 1PV-0251 Inuit radiotherapy utilization: a multinational study of low-income regions in highincome countries. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30671-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Grössmann N, Robausch M, Rosian K, Wild C, Simon J. Monitoring evidence on overall survival benefits of anticancer drugs approved by the European Medicines Agency between 2009 and 2015. Eur J Cancer 2019; 110:1-7. [DOI: 10.1016/j.ejca.2018.12.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 12/21/2018] [Accepted: 12/21/2018] [Indexed: 02/01/2023]
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Simon J, Bui H, Nazeyrollas P, Metz D. Predictive factors of cardiac rehabilitation's failure in patients undergoing a continuous endurance training program.A retrospective study. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2019. [DOI: 10.1016/j.acvdsp.2018.10.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Smith M, Eagle L, Lachenmayr S, Simon J. LINKING A BRIEF INTERVENTION TO EVIDENCE-BASED PROGRAMS TO COMBAT MALNUTRITION AMONG OLDER ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kiss N, Sultz I, Hiesmayr M, Bauer P, Mouhieddine M, Moick S, Simon J. Assessing country variability in hospital length of stay and analyzing variability in nutrition-related modifying factors based on 10 years of nutritionday data. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.2036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Weber C, Simon J, Mailänder V, Morsbach S, Landfester K. Preservation of the soft protein corona in distinct flow allows identification of weakly bound proteins. Acta Biomater 2018; 76:217-224. [PMID: 29885856 DOI: 10.1016/j.actbio.2018.05.057] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/25/2018] [Accepted: 05/31/2018] [Indexed: 12/22/2022]
Abstract
Nanocarriers that are used for targeted drug delivery come in contact with biological liquids and subsequently proteins will adsorb to the nanocarriers' surface to form the so called 'protein corona'. The protein corona defines the biological identity and determines the biological response towards the nanocarriers in the body. To make nanomedicine safe and reliable it is required to get a better insight into this protein corona and, therefore, the adsorbed proteins have to be characterized. Currently, centrifugation is the common method to isolate the protein corona for further investigations. However, with this method it is only possible to investigate the strongly bound proteins, also referred to as 'hard protein corona'. Therefore, we want to introduce a new separation technique to separate nanoparticles including the soft protein corona containing also loosely bound proteins for further characterization. The used separation technique is the asymmetric flow field-flow fractionation (AF4). We were able to separate the nanoparticles with proteins forming the soft protein corona and were able to show that in our system only the hard protein corona directly influenced the cell uptake behavior. STATEMENT OF SIGNIFICANCE Currently, there is an ongoing debate whether only strongly bound proteins (hard corona) or also loosely bound proteins (soft corona) contribute to the biological identity of nanocarriers, because up to now isolation of the soft corona was not possible. Here, asymmetric flow field-flow fractionation was used to isolate nanoparticles with a preserved soft corona from the biological medium. This enabled the characterization of the soft corona composition and to evaluate its influence on cellular uptake. For our system we found that only the strongly bound proteins (hard corona) determined cell internalization. This method can now be used to evaluate the impact of the soft corona further and to characterize nanomaterials that cannot be separated from blood plasma by other means.
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