1
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Ricci F, Khanji MY, Garg P. Editorial for "Corrected MRI Pulmonary Transit Time for Identification of Combined Pre and PostCapillary Pulmonary Hypertension in Patients With Left Heart Disease". J Magn Reson Imaging 2022; 57:1529-1530. [PMID: 36029232 DOI: 10.1002/jmri.28411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Fondazione Villa Serena per la Ricerca, Città Sant'Angelo, Italy
| | - Mohammed Y Khanji
- Newham University Hospital, Barts Health NHS Trust, London, UK.,Barts Heart Centre, Barts Health NHS Trust, London, UK.,NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Pankaj Garg
- Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK.,Norwich Medical School, University of East Anglia, Norwich, UK.,Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
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2
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Soofi MA, Shah MA, AlQadhi AM, AlAnazi AM, Alshehri WM, Umair A. Sensitivity and Specificity of Pulmonary Artery Pressure Measurement in Echocardiography and Correlation with Right Heart Catheterization. J Saudi Heart Assoc 2021; 33:228-236. [PMID: 34595098 PMCID: PMC8439191 DOI: 10.37616/2212-5043.1262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/24/2021] [Accepted: 07/01/2021] [Indexed: 01/22/2023] Open
Abstract
Objective Echocardiography is helpful in assessment of pulmonary hemodynamic, however its correlation with Right heart catheterization (RHC) is conflicting. We conducted a study to evaluate sensitivity and specificity of pulmonary hemodynamic parameters measured in echocardiography. Furthermore its correlation with the values measured in RHC was assessed. Method Retrospective, cross-sectional study conducted at King Fahad medical City, Riyadh, Saudi Arabia. 95 adult patients referred for right heart catheterization were enrolled in the study. All the patients had echocardiography and RHC within one week of each other. Result Diabetes mellitus, hypertension and dyslipidemia were present among 55%, 66% and 41% of patients respectively. 85% of the study participants were diagnosed to have pulmonary hypertension and 79% of the study participants had postcapillary pulmonary hypertension. Sensitivity of pulmonary artery systolic pressure (PAPs), mean pulmonary artery pressure (PAPm) using PAPs and pulmonary artery acceleration velocity (PAcT) were 86%, 93% and 89% respectively. Correlation of PAPs, PAPm using PAPs and PAcT on echo with invasive hemodynamic in RHC were 0.56, 0.43 and 0.24 respectively. Among patients with moderate to severe Tricuspid Regurgitation (TR) and tricuspid annular plane systolic excursion (TAPSE) <1.5cm correlation of PAPs, PAPm using PAPs and PAcT on echocardiography with right heart catheterization were 0.31, 0.24 and 0.42 respectively. Conclusion Echocardiographic assessment of PAPs and PAPm has high sensitivity and weak to moderate correlation with hemodynamic data in RHC. PAPs measurement on echocardiogram has best correlation with invasive measurement followed by PAPm measurement using PAPs. Among patients with moderate to severe TR and TAPSE <1.5cm PAPm measurement using PAcT has better correlation than using PAPs.
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Affiliation(s)
- Muhammad Adil Soofi
- Department of Adult Cardiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Muhammad Azam Shah
- Department of Adult Cardiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | | | - Waleed M Alshehri
- Department of Internal Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Amir Umair
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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3
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Salvatore T, Ricci F, Dangas GD, Rana BS, Ceriello L, Testa L, Khanji MY, Caterino AL, Fiore C, Popolo Rubbio A, Appignani M, Di Fulvio M, Bedogni F, Gallina S, Zimarino M. Selection of the Optimal Candidate to MitraClip for Secondary Mitral Regurgitation: Beyond Mitral Valve Morphology. Front Cardiovasc Med 2021; 8:585415. [PMID: 33614745 PMCID: PMC7887290 DOI: 10.3389/fcvm.2021.585415] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 01/08/2021] [Indexed: 11/13/2022] Open
Abstract
Secondary mitral regurgitation (MR) occurs despite structurally normal valve apparatus due to an underlying disease of the myocardium leading to disruption of the balance between tethering and closing forces with ensuing failure of leaflet coaptation. In patients with heart failure (HF) and left ventricular dysfunction, secondary MR is independently associated with poor outcome, yet prognostic benefits related to the correction of MR have remained elusive. Surgery is not recommended for the correction of secondary MR outside coronary artery bypass grafting. Percutaneous mitral valve repair (PMVR) with MitraClip implantation has recently evolved as a new transcatheter treatment option of inoperable or high-risk patients with severe MR, with promising results supporting the extension of guideline recommendations. MitraClip is highly effective in reducing secondary MR in HF patients. However, the derived clinical benefit is still controversial as two randomized trials directly comparing PMVR vs. optimal medical therapy in severe secondary MR yielded virtually opposite conclusions. We reviewed current evidence to identify predictors of PMVR-related outcomes in secondary MR useful to improve the timing and the selection of patients who would derive maximal benefit from MitraClip intervention. Beyond mitral valve anatomy, optimal candidate selection should rely on a comprehensive diagnostic workup and a fine-tuned risk stratification process aimed at (i) recognizing the substantial heterogeneity of secondary MR and its complex interaction with the myocardium, (ii) foreseeing hemodynamic consequences of PMVR, (iii) anticipating futility and (iv) improving symptoms, quality of life and overall survival.
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Affiliation(s)
- Tanya Salvatore
- Institute of Cardiology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Department of Cardiology, IRCCS Pol. S. Donato, S. Donato Milanese, Milan, Italy
| | - Fabrizio Ricci
- Department of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden.,Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Casa di Cura Villa Serena, Città Sant'Angelo, Pescara, Italy
| | - George D Dangas
- Icahn School of Medicine at Mount Sinai, The Zena and Michael A. Wiener Cardiovascular Institute, New York, NY, United States
| | - Bushra S Rana
- Imperial College Healthcare Trust, Hammersmith and Charing Cross Hospitals, London, United Kingdom
| | - Laura Ceriello
- Institute of Cardiology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Luca Testa
- Department of Cardiology, IRCCS Pol. S. Donato, S. Donato Milanese, Milan, Italy
| | - Mohammed Y Khanji
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom.,Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Anna Laura Caterino
- Institute of Cardiology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | | | | | - Marianna Appignani
- Institute of Cardiology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Maria Di Fulvio
- Institute of Cardiology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Francesco Bedogni
- Department of Cardiology, IRCCS Pol. S. Donato, S. Donato Milanese, Milan, Italy
| | - Sabina Gallina
- Institute of Cardiology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Marco Zimarino
- Institute of Cardiology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Interventional Cath Lab, Chieti, Italy
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4
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Subramani S, Sharma A, Arora L, Hanada S, Krishnan S, Ramakrishna H. Perioperative Right Ventricular Dysfunction: Analysis of Outcomes. J Cardiothorac Vasc Anesth 2021; 36:309-320. [PMID: 33593648 DOI: 10.1053/j.jvca.2021.01.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 11/11/2022]
Abstract
Right ventricular dysfunction (RVD) is a well-known prognostic factor for adverse outcomes in cardiovascular medicine. The right ventricle (RV) in medically managed heart failure patients and in surgical patients perioperatively generally is overshadowed by left ventricular disease. However, with advancement of various diagnostic tools and better understanding of its functional anatomy, the role of the RV is emerging in many clinical conditions. The failure of one ventricle has significant effect on the function of the other ventricle and it is predominantly due to ventricular interdependence.1 The etiology of RVD is multifactorial and irrespective of etiology. RVD has been associated with significant increases in morbidity and mortality in various clinical scenarios.2,3 The primary objective of this comprehensive review is to analyze various etiology-related outcomes of RVD in the perioperative population.
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Affiliation(s)
- Sudhakar Subramani
- Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Archit Sharma
- Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Lovkesh Arora
- Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Satoshi Hanada
- Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Sundar Krishnan
- Department of Anesthesia, Duke University School of Medicine, Durham, NC
| | - Harish Ramakrishna
- Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
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5
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Gavazzoni M, Taramasso M, Zuber M, Pozzoli A, Miura M, Oliveira D, Maisano F. Functional mitral regurgitation and cardiac resynchronization therapy in the "era" of trans-catheter interventions: Is it time to move from a staged strategy to a tailored therapy? Int J Cardiol 2020; 315:15-21. [PMID: 32456957 DOI: 10.1016/j.ijcard.2020.03.071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/19/2020] [Accepted: 03/27/2020] [Indexed: 01/15/2023]
Abstract
Cardiac resynchronization therapy (CRT) has been associated to left ventricle (LV) remodelling, reduction of functional mitral regurgitation (FMR) and clinical improvement in patients with heart failure and reduced ejection fraction (HFrEF). The prevalence of significant FMR in patients with LV dyssynchrony that are candidate to CRT is up to 40%. Current approach in patients with FMR undergoing CRT consists of re-evaluation of the amount of FMR following a waiting period of at least 3 months after the implant. In case of persistent significant FMR despite CRT and guideline directed medical therapy, trancatheter Mitral Valve repair (TMVR) is an important option to improve quality of life and prognosis. This stepwise approach does not take into account the probability of the individual response to CRT and the availability of TMVR solutions that are safe and effective in high risk patients. We reviewed the effects of CRT on FMR, the prognostic role of persistence of FMR after CRT treatment and the impact of treatment of FMR in patients CRT non responders. We aimed to point out the limits of current step-wised approach in light on more recent evidence regarding FMR treatment. A new, "tailored" approached is proposed.
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Affiliation(s)
- Mara Gavazzoni
- Heart Valve Clinic, University Hospital of Zurich, Ramistrasse 100, 8091 Zurich, Switzerland.
| | - Maurizio Taramasso
- Heart Valve Clinic, University Hospital of Zurich, Ramistrasse 100, 8091 Zurich, Switzerland
| | - Michel Zuber
- Heart Valve Clinic, University Hospital of Zurich, Ramistrasse 100, 8091 Zurich, Switzerland
| | - Alberto Pozzoli
- Heart Valve Clinic, University Hospital of Zurich, Ramistrasse 100, 8091 Zurich, Switzerland
| | - Mizuki Miura
- Heart Valve Clinic, University Hospital of Zurich, Ramistrasse 100, 8091 Zurich, Switzerland
| | | | - Francesco Maisano
- Heart Valve Clinic, University Hospital of Zurich, Ramistrasse 100, 8091 Zurich, Switzerland
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6
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Bragança B, Trêpa M, Santos R, Silveira I, Fontes-Oliveira M, Sousa MJ, Reis H, Torres S, Santos M. Echocardiographic Assessment of Right Ventriculo-arterial Coupling: Clinical Correlates and Prognostic Impact in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy. J Cardiovasc Imaging 2020; 28:109-120. [PMID: 32052609 PMCID: PMC7114448 DOI: 10.4250/jcvi.2019.0094] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/30/2019] [Accepted: 12/17/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Right ventriculo-arterial coupling (RV-PA) can be estimated by echocardiography using the ratio between tricuspid annular plane systolic excursion (TAPSE) and pulmonary artery systolic pressure (PASP) and it has prognostic value in the general heart failure (HF) population. We aimed to study the clinical correlates and prognostic value of RV-PA in HF patients undergoing cardiac resynchronization therapy (CRT). METHODS We retrospectively studied 70 HF patients undergoing CRT implantation. RESULTS RV-PA coupling was estimated by TAPSE/PASP ratio using baseline echocardiography. Non-response to CRT was defined as improvement of left ventricular ejection fraction < 5% in a follow-up echo 6-12 months after CRT. Those with lower TAPSE/PASP ratios (worse RV-PA coupling) had higher NT-proBNP concentrations and increased E/e' ratio. TAPSE/PASP ratio and PASP, but not TAPSE, predicted nonresponse to CRT with TAPSE/PASP ratio showing the best discriminative ability with a sensitivity of 76% and specificity of 71%. Among these parameters, PASP independently predicted all-cause mortality. CONCLUSIONS RV-PA coupling estimated by TAPSE/PASP ratio was associated with established prognostic markers in HF. It numerically outperformed PASP and TAPSE in predicting the response to CRT. Our data suggest that this simple and widely available echocardiographic parameter conveys significant pathophysiological and prognostic meaning in HF patients undergoing CRT.
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Affiliation(s)
- Bruno Bragança
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - Maria Trêpa
- Centro Hospitalar Universitário do Porto, Porto, Portugal.
| | - Raquel Santos
- Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Inês Silveira
- Centro Hospitalar Universitário do Porto, Porto, Portugal
| | | | | | - Hipólito Reis
- Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Severo Torres
- Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Mário Santos
- Centro Hospitalar Universitário do Porto, Porto, Portugal
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7
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Arrigo M, Huber LC, Winnik S, Mikulicic F, Guidetti F, Frank M, Flammer AJ, Ruschitzka F. Right Ventricular Failure: Pathophysiology, Diagnosis and Treatment. Card Fail Rev 2019; 5:140-146. [PMID: 31768270 PMCID: PMC6848943 DOI: 10.15420/cfr.2019.15.2] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 07/05/2019] [Indexed: 12/20/2022] Open
Abstract
The prognostic significance of the right ventricle (RV) has recently been recognised in several conditions, primarily those involving the left ventricle, the lungs and their vascular bed, or the right-sided chambers. Recent advances in imaging techniques have created new opportunities to study RV anatomy, physiology and pathophysiology, and contemporary research efforts have opened the doors to new treatment possibilities. Nevertheless, the treatment of RV failure remains challenging. Optimal management should consider the anatomical and physiological particularities of the RV and include appropriate imaging techniques to understand the underlying pathophysiological mechanisms. Treatment should include rapid optimisation of volume status, restoration of perfusion pressure and improvement of myocardial contractility and rhythm, and, in case of refractory RV failure, mechanical circulatory support.
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Affiliation(s)
- Mattia Arrigo
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Lars Christian Huber
- Department of Internal Medicine, Clinic for Internal Medicine, City Hospital Triemli Zurich, Switzerland
| | - Stephan Winnik
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Fran Mikulicic
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Federica Guidetti
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Michelle Frank
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Andreas J Flammer
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
| | - Frank Ruschitzka
- Department of Cardiology, University Hospital Zurich Zurich, Switzerland
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8
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Willemen E, Schreurs R, Huntjens PR, Strik M, Plank G, Vigmond E, Walmsley J, Vernooy K, Delhaas T, Prinzen FW, Lumens J. The Left and Right Ventricles Respond Differently to Variation of Pacing Delays in Cardiac Resynchronization Therapy: A Combined Experimental- Computational Approach. Front Physiol 2019; 10:17. [PMID: 30774598 PMCID: PMC6367498 DOI: 10.3389/fphys.2019.00017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/10/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction: Timing of atrial, right (RV), and left ventricular (LV) stimulation in cardiac resynchronization therapy (CRT) is known to affect electrical activation and pump function of the LV. In this study, we used computer simulations, with input from animal experiments, to investigate the effect of varying pacing delays on both LV and RV electrical dyssynchrony and contractile function. Methods: A pacing protocol was performed in dogs with atrioventricular block (N = 6), using 100 different combinations of atrial (A)-LV and A-RV pacing delays. Regional LV and RV electrical activation times were measured using 112 electrodes and LV and RV pressures were measured with catheter-tip micromanometers. Contractile response to a pacing delay was defined as relative change of the maximum rate of LV and RV pressure rise (dP/dtmax) compared to RV pacing with an A-RV delay of 125 ms. The pacing protocol was simulated in the CircAdapt model of cardiovascular system dynamics, using the experimentally acquired electrical mapping data as input. Results: Ventricular electrical activation changed with changes in the amount of LV or RV pre-excitation. The resulting changes in dP/dtmax differed markedly between the LV and RV. Pacing the LV 10–50 ms before the RV led to the largest increases in LV dP/dtmax. In contrast, RV dP/dtmax was highest with RV pre-excitation and decreased up to 33% with LV pre-excitation. These opposite patterns of changes in RV and LV dP/dtmax were reproduced by the simulations. The simulations extended these observations by showing that changes in steady-state biventricular cardiac output differed from changes in both LV and RV dP/dtmax. The model allowed to explain the discrepant changes in dP/dtmax and cardiac output by coupling between atria and ventricles as well as between the ventricles. Conclusion: The LV and the RV respond in a opposite manner to variation in the amount of LV or RV pre-excitation. Computer simulations capture LV and RV behavior during pacing delay variation and may be used in the design of new CRT optimization studies.
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Affiliation(s)
- Erik Willemen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Rick Schreurs
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Peter R Huntjens
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands.,IHU-LIRYC Electrophysiology and Heart Modeling Institute, Pessac, France
| | - Marc Strik
- Department of Cardiology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Gernot Plank
- Institute of Biophysics, Medical University of Graz, Graz, Austria
| | | | - John Walmsley
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Kevin Vernooy
- Department of Cardiology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Tammo Delhaas
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Frits W Prinzen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Joost Lumens
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands.,IHU-LIRYC Electrophysiology and Heart Modeling Institute, Pessac, France
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9
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Schmeisser A, Rauwolf T, Ghanem A, Groscheck T, Adolf D, Grothues F, Fischbach K, Kosiek O, Huth C, Kropf S, Lange S, Luani B, Smid J, Schäfer MH, Schreiber J, Tanev I, Wengler F, Yeritsyan NB, Steendijk P, Braun-Dullaeus RC. Right heart function interacts with left ventricular remodeling after CRT: A pressure volume loop study. Int J Cardiol 2018; 268:156-161. [DOI: 10.1016/j.ijcard.2018.03.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/20/2018] [Accepted: 03/06/2018] [Indexed: 10/17/2022]
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10
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Mele D, Bertini M, Malagù M, Nardozza M, Ferrari R. Current role of echocardiography in cardiac resynchronization therapy. Heart Fail Rev 2018; 22:699-722. [PMID: 28714039 DOI: 10.1007/s10741-017-9636-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cardiac resynchronization therapy (CRT) is an established treatment for patients with heart failure and left ventricular systolic dysfunction. Patients are usually assessed by echocardiography, which provides a number of anatomical and functional information used for cardiac dyssynchrony assessment, prognostic stratification, identification of the optimal site of pacing in the left ventricle, optimization of the CRT device, and patient follow-up. Compared to other cardiac imaging techniques, echocardiography has the advantage to be non-invasive, repeatable, and safe, without exposure to ionizing radiation or nefrotoxic contrast. In this article, we review current evidence about the role of echocardiography before, during, and after the implantation of a CRT device.
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Affiliation(s)
- Donato Mele
- Centro Cardiologico Universitario and LTTA Centre, University of Ferrara, Ferrara, Italy. .,Noninvasive Cardiology Unit, Azienda Ospedaliero-Universitaria, Via Aldo Moro 8, 44124, Ferrara, Cona, Italy.
| | - Matteo Bertini
- Centro Cardiologico Universitario and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Michele Malagù
- Centro Cardiologico Universitario and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Marianna Nardozza
- Centro Cardiologico Universitario and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Roberto Ferrari
- Centro Cardiologico Universitario and LTTA Centre, University of Ferrara, Ferrara, Italy.,Maria Cecilia Hospital, GVM Care & Research, E.S. Health Science Foundation, Cotignola, RA, Italy
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11
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Mele D, Luisi GA, Malagù M, Laterza A, Ferrari R, Bertini M. Echocardiographic evaluation of cardiac dyssynchrony: Does it still matter? Echocardiography 2018; 35:707-715. [PMID: 29719067 DOI: 10.1111/echo.13902] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Cardiac resynchronization therapy (CRT) is an established treatment for patients with heart failure and left ventricular systolic dysfunction. For many years, cardiac mechanical dyssynchrony assessed by echocardiography has been considered as a key evaluation to characterize CRT candidates and predict CRT response. In current guidelines, however, CRT implant indications rely only on electrical dyssynchrony. The aim of this article was to clarify whether and how the evaluation of cardiac mechanical dyssynchrony should be performed today by echocardiography.
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Affiliation(s)
- Donato Mele
- Cardiology Unit and LTTA Center, University of Ferrara, Ferrara, Italy
| | | | - Michele Malagù
- Cardiology Unit and LTTA Center, University of Ferrara, Ferrara, Italy
| | - Anna Laterza
- Cardiology Unit and LTTA Center, University of Ferrara, Ferrara, Italy
| | - Roberto Ferrari
- Cardiology Unit and LTTA Center, University of Ferrara, Ferrara, Italy.,Maria Cecilia Hospital, GVM Care & Research, E.S. Health Science Foundation, Cotignola, Italy
| | - Matteo Bertini
- Cardiology Unit and LTTA Center, University of Ferrara, Ferrara, Italy
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