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Mangini F, Scarcia M, Biederman RWW, Calbi R, Spinelli F, Casavecchia G, Brunetti ND, Gravina M, Fiore C, Suma S, Milo M, Turchetti C, Pesce E, Caramia R, Lombardi F, Grimaldi M. Cardiac magnetic resonance imaging in the evaluation and management of mitral valve prolapse - a comprehensive review. Echocardiography 2024; 41:e15894. [PMID: 39078395 DOI: 10.1111/echo.15894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/01/2024] [Accepted: 07/05/2024] [Indexed: 07/31/2024] Open
Abstract
Mitral valve prolapse is a common valve disorder that usually has a benign prognosis unless there is significant regurgitation or LV impairment. However, a subset of patients are at an increased risk of ventricular arrhythmias and sudden cardiac death, which has led to the recognition of "arrhythmic mitral valve prolapse" as a clinical entity. Emerging risk factors include mitral annular disjunction and myocardial fibrosis. While echocardiography remains the primary method of evaluation, cardiac magnetic resonance has become crucial in managing this condition. Cine magnetic resonance sequences provide accurate characterization of prolapse and annular disjunction, assessment of ventricular volumes and function, identification of early dysfunction and remodeling, and quantitative assessment of mitral regurgitation when integrated with flow imaging. However, the unique strength of magnetic resonance lies in its ability to identify tissue changes. T1 mapping sequences identify diffuse fibrosis, in turn related to early ventricular dysfunction and remodeling. Late gadolinium enhancement sequences detect replacement fibrosis, an independent risk factor for ventricular arrhythmias and sudden cardiac death. There are consensus documents and reviews on the use of cardiac magnetic resonance specifically in arrhythmic mitral valve prolapse. However, in this article, we propose an algorithm for the broader use of cardiac magnetic resonance in managing this condition in various scenarios. Future advancements may involve implementing techniques for tissue characterization and flow analysis, such as 4D flow imaging, to identify patients with ventricular dysfunction and remodeling, increased arrhythmic risk, and more accurate grading of mitral regurgitation, ultimately benefiting patient selection for surgical therapy.
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Affiliation(s)
- Francesco Mangini
- Department of Cardiology, Ospedale Regionale "Miulli", Acquaviva delle Fonti, BA, Italy
| | - Maria Scarcia
- Department of Cardiology, Ospedale Regionale "Miulli", Acquaviva delle Fonti, BA, Italy
| | - Robert W W Biederman
- Cardiology Department, Roper St Francis Healthcare, Charleston, South Carolina, USA
| | - Roberto Calbi
- Department of Cardiology, Ospedale Regionale "Miulli", Acquaviva delle Fonti, BA, Italy
| | - Francesco Spinelli
- Department of Cardiology, Ospedale Regionale "Miulli", Acquaviva delle Fonti, BA, Italy
| | | | | | - Matteo Gravina
- Radiology Department, University of Foggia, Foggia, Italy
| | - Corrado Fiore
- Department of Cardiology, Citta di Lecce Hospital, Novoli (Lecce), Puglia, Italy
| | - Sergio Suma
- Department of Cardiology, Azienda Ospedaliero Universitaria di Parma, Parma, Italy
| | - Maria Milo
- Department of Cardiology, Ospedale "Di Summa - Perrino," ASL Br, Brindisi, Italy
| | | | - Ernesto Pesce
- Madonna della Bruna Outpatients Clinic, Matera, Italy
| | - Remo Caramia
- Department of Anesthesiology, Ospedale "Camberlingo," ASL Br, Francavilla Fontana, Italy
| | - Francesca Lombardi
- Department of Cardiovascular Sciences, Università Cattolica del Sacro Cuore, Milano, Lombardia, Italy
| | - Massimo Grimaldi
- Department of Cardiology, Ospedale Regionale "Miulli", Acquaviva delle Fonti, BA, Italy
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2
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Altes A, Levy F, Hanet V, De Azevedo D, Krug P, Iacuzio L, Dommerc C, Silvestri V, Toledano M, Delelis F, Vancraeynest D, Pasquet A, Maréchaux S, Gerber BL. Impact of Sex on Severity Assessment and Cardiac Remodeling in Primary Mitral Regurgitation. JACC. ADVANCES 2024; 3:101023. [PMID: 39130021 PMCID: PMC11312794 DOI: 10.1016/j.jacadv.2024.101023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/20/2024] [Accepted: 03/25/2024] [Indexed: 08/13/2024]
Abstract
Background Women with severe primary mitral regurgitation (MR) have lower surgery rates than men and could suffer from delayed referral for mitral valve (MV) intervention, exposing them to an increased risk of postoperative adverse outcomes. Objectives The purpose of this study was to assess the sex-based differences in patients with primary MR. Methods The study sample consisted of 420 patients (median age: 62 years, 26% women) with primary MR due to valve prolapse referred for preoperative assessment who underwent transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) imaging. Multiple endpoints (abnormally increased left ventricular size, NYHA functional class III/IV, severe left atrial [LA] dilatation, pulmonary hypertension) were studied using areas under the curves and logistic regression models. Results Women were older than men, had higher NYHA functional class and larger indexed LA volumes (all P ≤ 0.031), despite displaying lower MR effective regurgitant orifice area, regurgitant volumes (RegVol), and ventricular volumes than men (all P ≤ 0.002). The optimal cut-off values of RegVol associated with abnormally increased left ventricular size according to reference normal values were lower in women (TTE: 67 ml, CMR: 50 ml) than in men (TTE: 77 ml, CMR: 65 ml). MR regurgitant fraction, but not RegVol, was associated in women and men with NYHA functional class III/IV, severe LA dilatation, and pulmonary hypertension (all areas under the curves, P ≤ 0.024). Conclusions Despite having hallmarks of more advanced valvular heart disease, women with significant primary MR demonstrate lower mitral RegVol and ventricular volumes than men. In contrast, the systematic calculation of MR regurgitant fraction could standardize MR quantification irrespective of sex.
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Affiliation(s)
- Alexandre Altes
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
- GCS-Groupement des Hôpitaux de l’Institut Catholique de Lille/Lille Catholic Hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Franck Levy
- Department of Cardiology, Cardio-Thoracic Center of Monaco, Monaco, Monaco
| | - Vincent Hanet
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - David De Azevedo
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Pauline Krug
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Laura Iacuzio
- Department of Cardiology, Cardio-Thoracic Center of Monaco, Monaco, Monaco
| | - Carine Dommerc
- Department of Cardiology, Cardio-Thoracic Center of Monaco, Monaco, Monaco
| | - Valentina Silvestri
- GCS-Groupement des Hôpitaux de l’Institut Catholique de Lille/Lille Catholic Hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Manuel Toledano
- GCS-Groupement des Hôpitaux de l’Institut Catholique de Lille/Lille Catholic Hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Francois Delelis
- GCS-Groupement des Hôpitaux de l’Institut Catholique de Lille/Lille Catholic Hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - David Vancraeynest
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Agnès Pasquet
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Sylvestre Maréchaux
- GCS-Groupement des Hôpitaux de l’Institut Catholique de Lille/Lille Catholic Hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, Lille, France
| | - Bernhard L. Gerber
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
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3
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Akyea RK, Figliozzi S, Lopes PM, Bauer KB, Moura-Ferreira S, Tondi L, Mushtaq S, Censi S, Pavon AG, Bassi I, Galian-Gay L, Teske AJ, Biondi F, Filomena D, Stylianidis V, Torlasco C, Muraru D, Monney P, Quattrocchi G, Maestrini V, Agati L, Monti L, Pedrotti P, Vandenberk B, Squeri A, Lombardi M, Ferreira AM, Schwitter J, Aquaro GD, Pontone G, Chiribiri A, Rodríguez Palomares JF, Yilmaz A, Andreini D, Florian AR, Francone M, Leiner T, Abecasis J, Badano LP, Bogaert J, Georgiopoulos G, Masci PG. Arrhythmic Mitral Valve Prolapse Phenotype: An Unsupervised Machine Learning Analysis Using a Multicenter Cardiac MRI Registry. Radiol Cardiothorac Imaging 2024; 6:e230247. [PMID: 38900026 PMCID: PMC11211946 DOI: 10.1148/ryct.230247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 04/09/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024]
Abstract
Purpose To use unsupervised machine learning to identify phenotypic clusters with increased risk of arrhythmic mitral valve prolapse (MVP). Materials and Methods This retrospective study included patients with MVP without hemodynamically significant mitral regurgitation or left ventricular (LV) dysfunction undergoing late gadolinium enhancement (LGE) cardiac MRI between October 2007 and June 2020 in 15 European tertiary centers. The study end point was a composite of sustained ventricular tachycardia, (aborted) sudden cardiac death, or unexplained syncope. Unsupervised data-driven hierarchical k-mean algorithm was utilized to identify phenotypic clusters. The association between clusters and the study end point was assessed by Cox proportional hazards model. Results A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 female, 230 male) with two phenotypic clusters were identified. Patients in cluster 2 (199 of 474, 42%) had more severe mitral valve degeneration (ie, bileaflet MVP and leaflet displacement), left and right heart chamber remodeling, and myocardial fibrosis as assessed with LGE cardiac MRI than those in cluster 1. Demographic and clinical features (ie, symptoms, arrhythmias at Holter monitoring) had negligible contribution in differentiating the two clusters. Compared with cluster 1, the risk of developing the study end point over a median follow-up of 39 months was significantly higher in cluster 2 patients (hazard ratio: 3.79 [95% CI: 1.19, 12.12], P = .02) after adjustment for LGE extent. Conclusion Among patients with MVP without significant mitral regurgitation or LV dysfunction, unsupervised machine learning enabled the identification of two phenotypic clusters with distinct arrhythmic outcomes based primarily on cardiac MRI features. These results encourage the use of in-depth imaging-based phenotyping for implementing arrhythmic risk prediction in MVP. Keywords: MR Imaging, Cardiac, Cardiac MRI, Mitral Valve Prolapse, Cluster Analysis, Ventricular Arrhythmia, Sudden Cardiac Death, Unsupervised Machine Learning Supplemental material is available for this article. © RSNA, 2024.
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Affiliation(s)
| | | | - Pedro M. Lopes
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Klemens B. Bauer
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Sara Moura-Ferreira
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Lara Tondi
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Saima Mushtaq
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Stefano Censi
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Anna Giulia Pavon
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Ilaria Bassi
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Laura Galian-Gay
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Arco J. Teske
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Federico Biondi
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Domenico Filomena
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Vasileios Stylianidis
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Camilla Torlasco
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Denisa Muraru
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Pierre Monney
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Giuseppina Quattrocchi
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Viviana Maestrini
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Luciano Agati
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Lorenzo Monti
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Patrizia Pedrotti
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Bert Vandenberk
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Angelo Squeri
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Massimo Lombardi
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - António M. Ferreira
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Juerg Schwitter
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Giovanni Donato Aquaro
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Gianluca Pontone
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Amedeo Chiribiri
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - José F. Rodríguez Palomares
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Ali Yilmaz
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Daniele Andreini
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Anca-Rezeda Florian
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Marco Francone
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Tim Leiner
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - João Abecasis
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Luigi Paolo Badano
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | - Jan Bogaert
- From the Primary Care Stratified Medicine Research Group, Centre for
Academic Primary Care, Lifespan and Population Health Unit, School of Medicine,
University of Nottingham, Nottingham, England (R.K.A.); IRCCS Humanitas Research
Hospital, Rozzano, Italy (S.F., L.M., M.F.); School of Biomedical Engineering
and Imaging Sciences–Faculty of Life Sciences and Medicine, King’s
College London, Westminster Bridge Rd, London SE1 7EH, England (S.F.,
V.S., A.C., G.G., P.G.M.); Department of Cardiology, Hospital de Santa Cruz,
Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L.,
A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster,
Germany (K.B.B., A.Y., A.R.F.); Department of Cardiology, Hartcentrum, Jessa
Hospital, Hasselt, Belgium (S.M.F.); Faculty of Medicine and Life Sciences,
Hasselt University, Hasselt, Belgium (S.M.F.); Multimodality Cardiac Imaging
Section, IRCSS Policlinico San Donato, San Donato Milanese, Italy (L.T., M.L.);
Department of Radiology, Ca’ Granda Ospedale Maggiore Policlinico,
University of Milan, Milan, Italy (L.T.); Department of Perioperative Cardiology
and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy
(S.M., G.P.); GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy
(S.C., A.S.); Center for Cardiac MR, Lausanne University Hospital, CHUV,
Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento
Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano
Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital
Universitario Vall d’Hebron, Institut de Recerca (VHIR), Universitat
Autònoma de Barcelona, Barcelona, Spain (L.G.G., J.F.R.P.); Centro de
Investigación Biomédica en Red, CIBERCV, Madrid, Spain (L.G.G.,
J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University
Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Fondazione
CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., C.D.A.); Department of
Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza
University of Rome, Rome, Italy (D.F., V.M., L.A.); Department of Cardiology,
Istituto Auxologico Italiano, IRCCS, Milan, Italy (C.T., D.M., L.P.B.);
Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
(D.M., L.P.B.); Faculty of Biology and Medicine, University of Lausanne,
Lausanne, Switzerland (P.M., J.S.); Gasthuisberg University Hospital, Leuven,
Belgium (B.V., J.B.); Department of Biomedical, Surgical and Dental Sciences
(G.P.) and Department of Clinical Sciences and Community Health, Cardiovascular
Section (D.A.), University of Milan, Milan, Italy; and Department of Clinical
Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
(G.G.)
| | | | | |
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4
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Pandis D, David N, EI-Eshmawi A, Miller MA, Boateng P, Costa AC, Robson P, Trivieri MG, Fayad Z, Anyanwu AC, Adams DH. Noncomplex ventricular arrhythmia associated with greater freedom from recurrent ectopy at 1 year after mitral repair surgery. JTCVS OPEN 2024; 19:94-113. [PMID: 39015439 PMCID: PMC11247206 DOI: 10.1016/j.xjon.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 03/10/2024] [Accepted: 04/01/2024] [Indexed: 07/18/2024]
Abstract
Objective The effect of mitral valve (MV) surgery on the natural history of ventricular arrhythmia (VA) in patients with arrhythmic MV prolapse remains unknown. We sought to evaluate the cumulative incidence of VA at 1 year after surgical mitral repair. Methods A retrospective review of progressively captured data identified 204 consecutive patients who underwent elective MV repair for significant degenerative mitral regurgitation as a first-time cardiovascular intervention in a quaternary reference center between January 2018 and December 2020. A subset of 62 consecutive patients with diagnosed arrhythmic MV prolapse was further evaluated for recurrent VA after MV repair. Results The median age was 62 years (range, 27-77 years) and 26 of 62 (41.9%) were female. The median time from initial mitral regurgitation/MV prolaspe diagnosis-to-referral was 13.8 years (interquartile range [IQR], 5.4-25) and from VA diagnosis-to-referral was 8 years (IQR, 3-10.6). Using the Lown-Wolf classification, complex VA (Lown grade ≥3) was identified in 36 of 62 patients (58%) at baseline, whereas 8 of 62 (13%) had a cardioverter/defibrillator implanted for primary (4/8) or secondary (4/8) prevention. Left ventricular myocardial scar was confirmed in 23 of 34 (68%) of patients scanned at baseline. The prevailing valve phenotype was bileaflet Barlow (59/62; 95.2%). All patients underwent surgical MV repair by the same team. Surgical repair was stabilized with an annuloplasty prosthesis (median size 36 mm [IQR, 34-38]). Concomitant procedures included tricuspid valve repair (51/62; 82.3%), cryo-maze ± left atrial appendage exclusion (14/62, 23%), and endocardial cryoablation of VA ectopy (4/62; 6.5%). The 30-day and 1-year freedom from recurrent VA were 98.4% and 75.9%, respectively. Absent VA after mitral repair was uniformly observed in patients with minor VA at baseline. Absent VA after mitral repair was uniformly observed in patients with minor VA preoperatively. Complex baseline VA was the strongest predictor of recurrent VA (hazard ratio, 10.8; 95% confidence interval, 1.4-84.2; P = .024), irrespective of myocardial fibrosis. Conclusions In a series of 62 consecutive patients operated electively for arrhythmic mitral prolapse, VA remained undetected in 75.9% of patients at 1 year. Freedom from recurrent VA was greater among patients without complex VA preoperatively, whereas baseline Lown grade ≥3 was the strongest independent risk factor for recurrent VA at 1 year. These findings attest to the importance of early recognition and prompt referral of patients with mitral prolapse and progressive VA to specialty interdisciplinary care.
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Affiliation(s)
- Dimosthenis Pandis
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Navindra David
- The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ahmed EI-Eshmawi
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Marc A. Miller
- Helmsley Electrophysiology Center, Mount Sinai Hospital, New York, NY
| | - Percy Boateng
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ana Claudia Costa
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Philip Robson
- The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Maria Giovanna Trivieri
- The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Zahi Fayad
- The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Anelechi C. Anyanwu
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - David H. Adams
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
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Dhont S, Bertrand PB. Left Atrium in Mitral Valve Prolapse: An Additional Piece to the Complex Puzzle. Circ Cardiovasc Imaging 2024; 17:e017014. [PMID: 38860388 DOI: 10.1161/circimaging.124.017014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Affiliation(s)
- Sebastiaan Dhont
- Faculty of Medicine and Life Sciences, Hasselt University, Belgium (S.D., P.B.B.)
- Department of Cardiology, Ziekenhuis Oost-Limburg, Belgium (S.D., P.B.B.)
- Department of Future Health, Genk (S.D., P.B.B.)
| | - Philippe B Bertrand
- Faculty of Medicine and Life Sciences, Hasselt University, Belgium (S.D., P.B.B.)
- Department of Cardiology, Ziekenhuis Oost-Limburg, Belgium (S.D., P.B.B.)
- Department of Future Health, Genk (S.D., P.B.B.)
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6
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Tastet L, Lim LJ, Bibby D, Hu G, Cristin L, Rich AH, Jhawar R, Fang Q, Arya F, Delling FN. Primary Atriopathy in Mitral Valve Prolapse: Echocardiographic Evidence and Clinical Implications. Circ Cardiovasc Imaging 2024; 17:e016319. [PMID: 38860362 PMCID: PMC11187656 DOI: 10.1161/circimaging.123.016319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/29/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Prominent multi-scallop systolic leaflet displacement toward the left atrium (atrialization) is typically observed in bileaflet mitral valve prolapse (MVP) with mitral annular disjunction. We hypothesized that mitral leaflet atrialization is associated with an underlying left atrial (LA) myopathy characterized by progressive structural and functional abnormalities, irrespective of mitral regurgitation (MR) severity. METHODS We identified 334 consecutive patients with MVP, no prior atrial fibrillation, and comprehensive clinical and echocardiographic data. LA function was assessed by LA reservoir strain, LA function index, and LA emptying fraction. We also classified the stage of LA remodeling based on LA enlargement and LA reservoir strain (stage 1: no remodeling; stage 2: mild remodeling; stage 3: moderate remodeling; and stage 4: severe remodeling). The primary end point was the composite risk of sudden arrhythmic death, heart failure hospitalization, or the new onset of atrial fibrillation. RESULTS Bileaflet MVP with no or mild MR had a lower LA reservoir strain (P=0.04) and LA function index (P<0.001) compared with other MVP subtypes. In multivariable linear regression adjusted for cardiovascular risk factors and MR ≥moderate, bileaflet MVP remained significantly associated with lower LA function parameters (all P<0.05). There was a significant increase in the risk of events as the LA reservoir strain and LA remodeling stage increased (P<0.001). In multivariable analysis, stage 4 of LA remodeling remained significantly associated with a higher risk of events compared with stage 1 (hazard ratio, 6.09 [95% CI, 1.69-21.9]; P=0.006). CONCLUSIONS In a large MVP registry, bileaflet involvement is associated with reduced LA function regardless of MR severity, suggesting a primary atriopathy in this MVP subtype. Abnormal LA function, particularly when assessed through a multiparametric approach, is linked to a higher risk of cardiovascular events and may improve risk stratification in MVP, even in those without significant MR.
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Affiliation(s)
- Lionel Tastet
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| | - Lisa J. Lim
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| | - Dwight Bibby
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| | - Gene Hu
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| | - Luca Cristin
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| | - Amy H. Rich
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| | - Rohit Jhawar
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| | - Qizhi Fang
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| | - Farzin Arya
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| | - Francesca N. Delling
- Department of Medicine, Division of Cardiology, University of California, San Francisco
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7
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Dziadosz D, Daniłowicz-Szymanowicz L, Wejner-Mik P, Budnik M, Brzezińska B, Duchnowski P, Golińska-Grzybała K, Jaworski K, Jedliński I, Kamela M, Kasprzak J, Kowalczyk-Domagała M, Kurnicka K, Kustrzycka-Kratochwil D, Mickiewicz K, Możeńska O, Oko-Sarnowska Z, Plewka M, Polewczyk A, Uziębło-Życzkowska B, Wierzbowska-Drabik K, Wachnicka-Truty R, Wołoszyn-Horák E, Szymański P, Gackowski A, Mizia-Stec K. What Do We Know So Far About Ventricular Arrhythmias and Sudden Cardiac Death Prediction in the Mitral Valve Prolapse Population? Could Biomarkers Help Us Predict Their Occurrence? Curr Cardiol Rep 2024; 26:245-268. [PMID: 38507154 PMCID: PMC11136782 DOI: 10.1007/s11886-024-02030-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE OF THE REVIEW To summarize currently available data on the topic of mitral valve prolapse (MVP) and its correlation to the occurrence of atrial and ventricular arrhythmias. To assess the prognostic value of several diagnostic methods such as transthoracic echocardiography, transesophageal echocardiography, cardiac magnetic resonance, cardiac computed tomography, electrocardiography, and electrophysiology concerning arrhythmic episodes. To explore intra and extracellular biochemistry of the cardiovascular system and its biomarkers as diagnostic tools to predict rhythm disturbances in the MVP population. RECENT FINDINGS MVP is a common and mainly benign valvular disorder. It affects 2-3% of the general population. MVP is a heterogeneous and highly variable phenomenon with three structural phenotypes: myxomatous degeneration, fibroelastic deficiency, and forme fruste. Exercise intolerance, supraventricular tachycardia, and chest discomfort are the symptoms that are often paired with psychosomatic components. Though MVP is thought to be benign, the association between isolated MVP without mitral regurgitation (MR) or left ventricle dysfunction, with ventricular arrhythmia (VA) and sudden cardiac death (SCD) has been observed. The incidence of SCD in the MVP population is around 0.6% per year, which is 6 times higher than the occurrence of SCD in the general population. Often asymptomatic MVP population poses a challenge to screen for VA and prevent SCD. Therefore, it is crucial to carefully assess the risk of VA and SCD in patients with MVP with the use of various tools such as diagnostic imaging and biochemical and genetic screening.
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Affiliation(s)
- D Dziadosz
- 1st Department of Cardiology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland
- Centre of European Reference Network of Heart Diseases - ERN GUARD-HEART, 47 Ziołowa St, 40-635, Katowice, Poland
| | - L Daniłowicz-Szymanowicz
- Department of Cardiology and Electrotherapy, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - P Wejner-Mik
- 1st Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Łódź, Poland
| | - M Budnik
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Central Clinical Hospital, 1a Banacha St, 02-97, Warsaw, Poland
| | - B Brzezińska
- Department of Cardiology, T. Marciniak Hospital, Wrocław, Poland
| | - P Duchnowski
- Cardinal Wyszynski National Institute of Cardiology, 04-628, Warsaw, Poland
| | - K Golińska-Grzybała
- Dept of Coronary Disease and Heart Failure, Noninvasive Cardiovascular Laboratory, Medical College, Jagiellonian University, St. John Paul II Hospital, Cracow, Poland
| | - K Jaworski
- Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, Warsaw, Poland
| | - I Jedliński
- Medicor, Powstańców Wielkopolskich 4, 61-895, Poznań, Poland
| | - M Kamela
- Department of Cardiology, Hospital of the Ministry of Interior and Administration, Rzeszów, Poland
| | - J Kasprzak
- 1st Department of Cardiology, Medical University of Lodz, Bieganski Hospital, Łódź, Poland
| | - M Kowalczyk-Domagała
- Pediatric Cardiology Department, The Children's Memorial Health Institute, Warsaw, Poland
| | - K Kurnicka
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Infant Jesus Clinical Hospital, Lindleya str. 4, 02-005, Warsaw, Poland
| | - D Kustrzycka-Kratochwil
- Department of Cardiology, Center for Heart Diseases, 4th Military Clinical Hospital, Weigla 5, 50-981, Wrocław, Poland
| | - K Mickiewicz
- Department of Cardiology, Medical University of Bialystok, 15-276, Białystok, Poland
| | - O Możeńska
- JO Medical Center, Quo Vadis 1/U6, 02-495, Warsaw, Poland
| | - Z Oko-Sarnowska
- Department of Cardiology, Poznań University of Medical Sciences, Wielkopolskie, 60-355, Poznań, Poland
| | - M Plewka
- Department of Interventional Cardiology and Cardiac Arrhythmias, Military Medical Academy Memorial Teaching Hospital of the Medical University of Lodz, Łódź, Poland
| | - A Polewczyk
- Department of Physiology, Pathophysiology and Clinical Immunology, Institute of Medical Sciences, Jan Kochanowski University, Żeromskiego 5, 25-369, Kielce, Poland
- Department of Cardiac Surgery, Świętokrzyskie Cardiology Center, Grunwaldzka 45, 25-736, Kielce, Poland
| | - B Uziębło-Życzkowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine - National Research Institute, Warsaw, Poland
| | - K Wierzbowska-Drabik
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Lodz, Łódź, Poland
| | - R Wachnicka-Truty
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland
| | - E Wołoszyn-Horák
- Second Department of Cardiology. Specialist Hospital in Zabrze, Medical University of Silesia, Curie-Sklodowskiej str. 10, Zabrze, Poland
| | - P Szymański
- Center of Clinical Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland
| | - A Gackowski
- Dept of Coronary Disease and Heart Failure, Noninvasive Cardiovascular Laboratory, Medical College, Jagiellonian University, St. John Paul II Hospital, Cracow, Poland
| | - K Mizia-Stec
- 1st Department of Cardiology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland.
- Centre of European Reference Network of Heart Diseases - ERN GUARD-HEART, 47 Ziołowa St, 40-635, Katowice, Poland.
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8
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Huttin O, Le Tourneau T, Filippetti L, Pace N, Sellal JM, Beaumont M, Mandry D, Marie PY, Selton-Suty C, Girerd N. A new evidence-based echocardiographic approach to predict cardiovascular events and myocardial fibrosis in mitral valve prolapse: The STAMP algorithm. Arch Cardiovasc Dis 2024; 117:173-176. [PMID: 38368159 DOI: 10.1016/j.acvd.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/19/2024]
Affiliation(s)
- Olivier Huttin
- Service de cardiologie, institut lorrain du cœur et des vaisseaux, CHRU de Nancy, 54500 Vandœuvre-lès-Nancy, France.
| | - Thierry Le Tourneau
- CIC 1413, université de Nantes, CHU de Nantes, 44000 Nantes, France; Inserm, CNRS, institut du thorax, université de Nantes, CHU de Nantes, 44000 Nantes, France
| | - Laure Filippetti
- Service de cardiologie, institut lorrain du cœur et des vaisseaux, CHRU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | - Nathalie Pace
- Service de cardiologie, institut lorrain du cœur et des vaisseaux, CHRU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | - Jean-Marc Sellal
- Service de cardiologie, institut lorrain du cœur et des vaisseaux, CHRU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | - Marine Beaumont
- U1433, CIC-IT, CHRU de Nancy, 54000 Vandœuvre-lès-Nancy, France; Inserm U1254, IADI, université de Lorraine, 54500 Vandœuvre-lès-Nancy, France
| | - Damien Mandry
- Service de cardiologie, institut lorrain du cœur et des vaisseaux, CHRU de Nancy, 54500 Vandœuvre-lès-Nancy, France; U1433, CIC-IT, CHRU de Nancy, 54000 Vandœuvre-lès-Nancy, France; Inserm U1254, IADI, université de Lorraine, 54500 Vandœuvre-lès-Nancy, France
| | - Pierre-Yves Marie
- Service de cardiologie, institut lorrain du cœur et des vaisseaux, CHRU de Nancy, 54500 Vandœuvre-lès-Nancy, France; U1433, CIC-IT, CHRU de Nancy, 54000 Vandœuvre-lès-Nancy, France; Inserm U1254, IADI, université de Lorraine, 54500 Vandœuvre-lès-Nancy, France
| | - Christine Selton-Suty
- Service de cardiologie, institut lorrain du cœur et des vaisseaux, CHRU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | - Nicolas Girerd
- Inserm, CIC 1433, université de Lorraine, CHRU de Nancy, 54000 Vandœuvre-lès-Nancy, France; Inserm U1116, université de Lorraine, 54505 Vandœuvre-lès-Nancy, France; Investigation Network Initiative-Cardiovascular and Renal Clinical Trialists (INI-CRCT), F-CRIN, CHRU de Nancy, 54000 Nancy, France
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9
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Ajmone Marsan N, Graziani F, Meucci MC, Wu HW, Lillo R, Bax JJ, Burzotta F, Massetti M, Jukema JW, Crea F. Valvular heart disease and cardiomyopathy: reappraisal of their interplay. Nat Rev Cardiol 2024; 21:37-50. [PMID: 37563454 DOI: 10.1038/s41569-023-00911-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/12/2023]
Abstract
Cardiomyopathies and valvular heart diseases are typically considered distinct diagnostic categories with dedicated guidelines for their management. However, the interplay between these conditions is increasingly being recognized and they frequently coexist, as in the paradigmatic examples of dilated cardiomyopathy and hypertrophic cardiomyopathy, which are often complicated by the occurrence of mitral regurgitation. Moreover, cardiomyopathies and valvular heart diseases can have a shared aetiology because several genetic or acquired diseases can affect both the cardiac valves and the myocardium. In addition, the association between cardiomyopathies and valvular heart diseases has important prognostic and therapeutic implications. Therefore, a better understanding of their shared pathophysiological mechanisms, as well as of the prevalence and predisposing factors to their association, might lead to a different approach in the risk stratification and management of these diseases. In this Review, we discuss the different scenarios in which valvular heart diseases and cardiomyopathies coexist, highlighting the need for an improved classification and clustering of these diseases with potential repercussions in the clinical management and, particularly, personalized therapeutic approaches.
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Affiliation(s)
- Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Francesca Graziani
- Department of Cardiovascular Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Chiara Meucci
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Cardiovascular Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Hoi W Wu
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Rosa Lillo
- Department of Cardiovascular Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of the Sacred Heart, Rome, Italy
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Heart Center, University of Turku and Turku University Hospital, Turku, Finland
| | - Francesco Burzotta
- Department of Cardiovascular Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of the Sacred Heart, Rome, Italy
| | - Massimo Massetti
- Department of Cardiovascular Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of the Sacred Heart, Rome, Italy
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
| | - Filippo Crea
- Department of Cardiovascular Science, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Catholic University of the Sacred Heart, Rome, Italy
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10
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Delgado V, Ajmone Marsan N, Bonow RO, Hahn RT, Norris RA, Zühlke L, Borger MA. Degenerative mitral regurgitation. Nat Rev Dis Primers 2023; 9:70. [PMID: 38062018 DOI: 10.1038/s41572-023-00478-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/18/2023]
Abstract
Degenerative mitral regurgitation is a major threat to public health and affects at least 24 million people worldwide, with an estimated 0.88 million disability-adjusted life years and 34,000 deaths in 2019. Improving access to diagnostic testing and to timely curative therapies such as surgical mitral valve repair will improve the outcomes of many individuals. Imaging such as echocardiography and cardiac magnetic resonance allow accurate diagnosis and have provided new insights for a better definition of the most appropriate timing for intervention. Advances in surgical techniques allow minimally invasive treatment with durable results that last for ≥20 years. Transcatheter therapies can provide good results in select patients who are considered high risk for surgery and have a suitable anatomy; the durability of such repairs is up to 5 years. Translational science has provided new knowledge on the pathophysiology of degenerative mitral regurgitation and may pave the road to the development of medical therapies that could be used to halt the progression of the disease.
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Affiliation(s)
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Robert O Bonow
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rebecca T Hahn
- Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Russell A Norris
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC, USA
| | - Liesl Zühlke
- South African Medical Research Council, Cape Town, South Africa
- Division of Paediatric Cardiology, Department of Paediatrics, Institute of Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Michael A Borger
- University Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany
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11
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Meyer TE, Chen K, Parker MW, Shih J, Rahban Y. Perspectives on Secondary Mitral Regurgitation in Heart Failure. Curr Heart Fail Rep 2023; 20:417-428. [PMID: 37695505 DOI: 10.1007/s11897-023-00627-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE OF THE REVIEW This review focuses on broader perspectives of mitral regurgitation (MR) in patients with heart failure. RECENT FINDINGS The ratio of regurgitant volume to end-diastolic volume appears to help identify patients who may benefit from valve interventions. Secondary MR is not only attributed to geometric changes of the LV but also related to the structural changes in the mitral valve that include fibrosis of the mitral leaflets and changes in the extracellular matrix. The transition from mild to severe secondary MR can occur at different rates, from a slow LV remodeling process to a more abrupt process precipitated by an inciting event such as atrial fibrillation. Septal flash and apical rocking, two new visual markers of LV mechanical dyssynchrony, appear to be predictive of MR reduction following cardiac resynchronization therapy. Optimal guideline-directed medical therapy has been shown to decrease the severity of secondary MR effectively. A theoretical framework to characterize secondary MR as it relates to the onset of MR is proposed. Type A: Early onset of MR contemporaneous with myocardial injury. The maladaptive LV remodeling occurs in parallel with MR. Type B: LV remodeling proceeds without significant MR until the LV is moderately dilated, which coincides with or without inciting factors such as atrial fibrillation. Type C: LV remodeling proceeds after myocardial injury without significant MR until the LV is severely dilated. MR is a late manifestation of LV remodeling.
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Affiliation(s)
- Theo E Meyer
- Division of Cardiology, University of Massachusetts Chan Medical School, UMassMemorial Medical Center, Worcester, MA, USA.
| | - Kai Chen
- Division of Cardiology, University of Massachusetts Chan Medical School, UMassMemorial Medical Center, Worcester, MA, USA
| | - Matthew W Parker
- Division of Cardiology, University of Massachusetts Chan Medical School, UMassMemorial Medical Center, Worcester, MA, USA
| | - Jeff Shih
- Division of Cardiology, University of Massachusetts Chan Medical School, UMassMemorial Medical Center, Worcester, MA, USA
| | - Youssef Rahban
- Division of Cardiology, University of Massachusetts Chan Medical School, UMassMemorial Medical Center, Worcester, MA, USA
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12
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Huttin O, Girerd N, Jobbe-Duval A, Constant Dit Beaufils AL, Senage T, Filippetti L, Cueff C, Duarte K, Fraix A, Piriou N, Mandry D, Pace N, Le Scouarnec S, Capoulade R, Echivard M, Sellal JM, Marrec M, Beaumont M, Hossu G, Trochu JN, Sadoul N, Marie PY, Guenancia C, Schott JJ, Roussel JC, Serfaty JM, Selton-Suty C, Le Tourneau T. Machine Learning-Based Phenogrouping in MVP Identifies Profiles Associated With Myocardial Fibrosis and Cardiovascular Events. JACC Cardiovasc Imaging 2023; 16:1271-1284. [PMID: 37204382 DOI: 10.1016/j.jcmg.2023.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 02/23/2023] [Accepted: 03/10/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Structural changes and myocardial fibrosis quantification by cardiac imaging have become increasingly important to predict cardiovascular events in patients with mitral valve prolapse (MVP). In this setting, it is likely that an unsupervised approach using machine learning may improve their risk assessment. OBJECTIVES This study used machine learning to improve the risk assessment of patients with MVP by identifying echocardiographic phenotypes and their respective association with myocardial fibrosis and prognosis. METHODS Clusters were constructed using echocardiographic variables in a bicentric cohort of patients with MVP (n = 429, age 54 ± 15 years) and subsequently investigated for their association with myocardial fibrosis (assessed by cardiac magnetic resonance) and cardiovascular outcomes. RESULTS Mitral regurgitation (MR) was severe in 195 (45%) patients. Four clusters were identified: cluster 1 comprised no remodeling with mainly mild MR, cluster 2 was a transitional cluster, cluster 3 included significant left ventricular (LV) and left atrial (LA) remodeling with severe MR, and cluster 4 included remodeling with a drop in LV systolic strain. Clusters 3 and 4 featured more myocardial fibrosis than clusters 1 and 2 (P < 0.0001) and were associated with higher rates of cardiovascular events. Cluster analysis significantly improved diagnostic accuracy over conventional analysis. The decision tree identified the severity of MR along with LV systolic strain <21% and indexed LA volume >42 mL/m2 as the 3 most relevant variables to correctly classify participants into 1 of the echocardiographic profiles. CONCLUSIONS Clustering enabled the identification of 4 clusters with distinct echocardiographic LV and LA remodeling profiles associated with myocardial fibrosis and clinical outcomes. Our findings suggest that a simple algorithm based on only 3 key variables (severity of MR, LV systolic strain, and indexed LA volume) may help risk stratification and decision making in patients with MVP. (Genetic and Phenotypic Characteristics of Mitral Valve Prolapse, NCT03884426; Myocardial Characterization of Arrhythmogenic Mitral Valve Prolapse [MVP STAMP], NCT02879825).
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Affiliation(s)
- Olivier Huttin
- Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France.
| | - Nicolas Girerd
- Université de Lorraine, INSERM, Centre d'Investigations Cliniques-1433 and INSERM U1116, CHRU Nancy, French Clinical Research Infrastructure Network Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Antoine Jobbe-Duval
- CHU Nantes, Université de Nantes, l'Institut du Thorax, Centre Investigation Clinique 1413, Nantes, France
| | | | - Thomas Senage
- CHU Nantes, Université de Nantes, l'Institut du Thorax, Centre Investigation Clinique 1413, Nantes, France; Department of Thoracic and CardioVascular Surgery, Thorax Institut, University of Nantes, Nantes, France
| | - Laura Filippetti
- Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Caroline Cueff
- CHU Nantes, Université de Nantes, l'Institut du Thorax, Centre Investigation Clinique 1413, Nantes, France; Université de Nantes, CHU de Nantes, CNRS, INSERM, l'Institut du Thorax, Nantes, France
| | - Kevin Duarte
- Université de Lorraine, INSERM, Centre d'Investigations Cliniques-1433 and INSERM U1116, CHRU Nancy, French Clinical Research Infrastructure Network Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Antoine Fraix
- Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Nicolas Piriou
- CHU Nantes, Université de Nantes, l'Institut du Thorax, Centre Investigation Clinique 1413, Nantes, France
| | - Damien Mandry
- Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Nathalie Pace
- Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Solena Le Scouarnec
- Université de Nantes, CHU de Nantes, CNRS, INSERM, l'Institut du Thorax, Nantes, France
| | - Romain Capoulade
- Université de Nantes, CHU de Nantes, CNRS, INSERM, l'Institut du Thorax, Nantes, France
| | - Matthieu Echivard
- Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Jean Marc Sellal
- Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Marie Marrec
- CHU Nantes, Université de Nantes, l'Institut du Thorax, Centre Investigation Clinique 1413, Nantes, France
| | | | - Gabriella Hossu
- CIC-IT, U1433, CHRU de Nancy, France; INSERM U1254, Imagerie Adaptative Diagnostique et Interventionnelle, Université de Lorraine, Nancy, France
| | - Jean-Noel Trochu
- CHU Nantes, Université de Nantes, l'Institut du Thorax, Centre Investigation Clinique 1413, Nantes, France; Université de Nantes, CHU de Nantes, CNRS, INSERM, l'Institut du Thorax, Nantes, France
| | - Nicolas Sadoul
- Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Pierre-Yves Marie
- Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | | | - Jean-Jacques Schott
- Université de Nantes, CHU de Nantes, CNRS, INSERM, l'Institut du Thorax, Nantes, France
| | - Jean-Christian Roussel
- CHU Nantes, Université de Nantes, l'Institut du Thorax, Centre Investigation Clinique 1413, Nantes, France; Université de Nantes, CHU de Nantes, CNRS, INSERM, l'Institut du Thorax, Nantes, France
| | - Jean-Michel Serfaty
- Université de Nantes, CHU de Nantes, CNRS, INSERM, l'Institut du Thorax, Nantes, France
| | - Christine Selton-Suty
- Service de Cardiologie, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France
| | - Thierry Le Tourneau
- CHU Nantes, Université de Nantes, l'Institut du Thorax, Centre Investigation Clinique 1413, Nantes, France; Université de Nantes, CHU de Nantes, CNRS, INSERM, l'Institut du Thorax, Nantes, France
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Kubala M, Essayagh B, Michelena HI, Enriquez-Sarano M, Tribouilloy C. Arrhythmic mitral valve prolapse in 2023: Evidence-based update. Front Cardiovasc Med 2023; 10:1130174. [PMID: 37144062 PMCID: PMC10153002 DOI: 10.3389/fcvm.2023.1130174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/03/2023] [Indexed: 05/06/2023] Open
Abstract
Patients with mitral valve prolapse (MVP) may develop ventricular arrhythmias, ranging from premature ventricular contractions through more complex non-sustained ventricular tachycardia to sustained life-threatening ventricular arrhythmias. The prevalence of MVP in autopsy series of young adults who died suddenly has been estimated to be between 4% and 7%. Thus, "arrhythmic MVP" has been reported as an underappreciated cause of sudden cardiac death, leading to a renewed interest in the study of this association. The term "arrhythmic MVP" refers to a small subset of patients who have, in the absence of any other arrhythmic substrate, MVP, with or without mitral annular disjunction, and frequent or complex ventricular arrhythmias. Our understanding of their coexistence in terms of contemporary management and prognosis is still incomplete. While literature regarding the arrhythmic MVP may be contrasting despite recent consensus document, the present review summarizes the relevant evidence concerning the diagnostic approach, prognostic implications, and targeted therapies for MVP-related ventricular arrhythmias. We also summarize recent data supporting left ventricular remodeling, which complicates the coexistence of MVP with ventricular arrhythmias. As the evidence for a putative link between MVP-associated ventricular arrhythmias and sudden cardiac death is scarce and based on scant and retrospective data, risk prediction remains a challenge. Thus, we aimed at listing potential risk factors from available seminal reports for further use in a more reliable prediction model that requires additional prospective data. Finally, we summarize evidence and guidelines on targeted therapies of ventricular arrhythmias in the setting of MVP, including implantable cardioverter defibrillators and catheter ablation. Our review highlights current knowledge gaps and provides an action plan for structured research on the pathophysiological genesis, diagnosis, prognostic impact, and optimal management of patients with arrhythmic MVP.
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Affiliation(s)
- Maciej Kubala
- Department of Cardiology, Amiens University Hospital, Amiens, France
- EA 7517, Jules Verne University of Picardie, Amiens, France
| | - Benjamin Essayagh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
- Department of Echocardiography, Cardio X Clinic, France
| | - Hector I. Michelena
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | | | - Christophe Tribouilloy
- Department of Cardiology, Amiens University Hospital, Amiens, France
- EA 7517, Jules Verne University of Picardie, Amiens, France
- Correspondence: Christophe Tribouilloy
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Ajmone Marsan N, Delgado V, Shah DJ, Pellikka P, Bax JJ, Treibel T, Cavalcante JL. Valvular heart disease: shifting the focus to the myocardium. Eur Heart J 2023; 44:28-40. [PMID: 36167923 PMCID: PMC9805407 DOI: 10.1093/eurheartj/ehac504] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/12/2022] [Accepted: 08/26/2022] [Indexed: 01/05/2023] Open
Abstract
Adverse cardiac remodelling is the main determinant of patient prognosis in degenerative valvular heart disease (VHD). However, to give an indication for valvular intervention, current guidelines include parameters of cardiac chamber dilatation or function which are subject to variability, do not directly reflect myocardial structural changes, and, more importantly, seem to be not sensitive enough in depicting early signs of myocardial dysfunction before irreversible myocardial damage has occurred. To avoid irreversible myocardial dysfunction, novel biomarkers are advocated to help refining indications for intervention and risk stratification. Advanced echocardiographic modalities, including strain analysis, and magnetic resonance imaging have shown to be promising in providing new tools to depict the important switch from adaptive to maladaptive myocardial changes in response to severe VHD. This review, therefore, summarizes the current available evidence on the role of these new imaging biomarkers in degenerative VHD, aiming at shifting the clinical perspective from a valve-centred to a myocardium-focused approach for patient management and therapeutic decision-making.
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Affiliation(s)
- Nina Ajmone Marsan
- Department of Cardiology, Leiden Univesity Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Victoria Delgado
- Department of Cardiology, Leiden Univesity Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
- Department of Cardiology, Germans Trias i Pujol Hospital, Carretera de Canyet s/n. 08916 Badalona, Barcelona, Spain
| | - Dipan J Shah
- Division of Cardiovascular Imaging, Weill Cornell Medical College, Houston Methodist DeBakey Heart & Vascular Center, 6565 Fannin St, Houston, TX 77030, USA
| | - Patricia Pellikka
- Department of Cardiovascular Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Jeroen J Bax
- Department of Cardiology, Leiden Univesity Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Thomas Treibel
- Department of Cardiology, Barts Heart Centre and University College London, West Smithfield, London EC1A 7BE, UK
| | - João L Cavalcante
- Department of Cardiology, Minneapolis Heart Institute at Abbott Northwestern Hospital, 800 E 28th St, Minneapolis, MN 55407, USA
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15
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Figliozzi S, Georgiopoulos G, Lopes PM, Bauer KB, Moura-Ferreira S, Tondi L, Mushtaq S, Censi S, Pavon AG, Bassi I, Servato ML, Teske AJ, Biondi F, Filomena D, Pica S, Torlasco C, Muraru D, Monney P, Quattrocchi G, Maestrini V, Agati L, Monti L, Pedrotti P, Vandenberk B, Squeri A, Lombardi M, Ferreira AM, Schwitter J, Aquaro GD, Chiribiri A, Rodríguez Palomares JF, Yilmaz A, Andreini D, Florian A, Leiner T, Abecasis J, Badano LP, Bogaert J, Masci PG. Myocardial Fibrosis at Cardiac MRI Helps Predict Adverse Clinical Outcome in Patients with Mitral Valve Prolapse. Radiology 2023; 306:112-121. [PMID: 36098639 DOI: 10.1148/radiol.220454] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Patients with mitral valve prolapse (MVP) may develop adverse outcomes even in the absence of mitral regurgitation or left ventricular (LV) dysfunction. Purpose To investigate the prognostic value of mitral annulus disjunction (MAD) and myocardial fibrosis at late gadolinium enhancement (LGE) cardiac MRI in patients with MVP without moderate-to-severe mitral regurgitation or LV dysfunction. Materials and Methods In this longitudinal retrospective study, 118 144 cardiac MRI studies were evaluated between October 2007 and June 2020 at 15 European tertiary medical centers. Follow-up was from the date of cardiac MRI examination to June 2020; the minimum and maximum follow-up intervals were 6 months and 156 months, respectively. Patients were excluded if at least one of the following conditions was present: cardiomyopathy, LV ejection fraction less than 40%, ischemic heart disease, congenital heart disease, inflammatory heart disease, moderate or worse mitral regurgitation, participation in competitive sport, or electrocardiogram suggestive of channelopathies. In the remainder, cardiac MRI studies were reanalyzed, and patients were included if they were aged 18 years or older, MVP was diagnosed at cardiac MRI, and clinical information and electrocardiogram monitoring were available within 3 months from cardiac MRI examination. The end point was a composite of adverse outcomes: sustained ventricular tachycardia (VT), sudden cardiac death (SCD), or unexplained syncope. Multivariable Cox regression analysis was performed. Results A total of 474 patients (mean age, 47 years ± 16 [SD]; 244 women) were included. Over a median follow-up of 3.3 years, 18 patients (4%) reached the study end point. LGE presence (hazard ratio, 4.2 [95% CI: 1.5, 11.9]; P = .006) and extent (hazard ratio, 1.2 per 1% increase [95% CI: 1.1, 1.4]; P = .006), but not MAD presence (P = .89), were associated with clinical outcome. LGE presence had incremental prognostic value over MVP severity and sustained VT and aborted SCD at baseline (area under the receiver operating characteristic curve, 0.70 vs 0.62; P = .03). Conclusion In contrast to mitral annulus disjunction, myocardial fibrosis determined according to late gadolinium enhancement at cardiac MRI was associated with adverse outcome in patients with mitral valve prolapse without moderate-to-severe mitral regurgitation or left ventricular dysfunction. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gerber in this issue.
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Affiliation(s)
- Stefano Figliozzi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Georgios Georgiopoulos
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Pedro M Lopes
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Klemens B Bauer
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Sara Moura-Ferreira
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Lara Tondi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Saima Mushtaq
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Stefano Censi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Anna Giulia Pavon
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Ilaria Bassi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Maria Luz Servato
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Arco J Teske
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Federico Biondi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Domenico Filomena
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Silvia Pica
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Camilla Torlasco
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Denisa Muraru
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Pierre Monney
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Giuseppina Quattrocchi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Viviana Maestrini
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Luciano Agati
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Lorenzo Monti
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Patrizia Pedrotti
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Bert Vandenberk
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Angelo Squeri
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Massimo Lombardi
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - António M Ferreira
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Juerg Schwitter
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Giovanni Donato Aquaro
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Amedeo Chiribiri
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - José F Rodríguez Palomares
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Ali Yilmaz
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Daniele Andreini
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Anca Florian
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Tim Leiner
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - João Abecasis
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Luigi Paolo Badano
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Jan Bogaert
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
| | - Pier-Giorgio Masci
- From the Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy (S.F., L.M.); School of Biomedical Engineering and Imaging Sciences-Faculty of Life Sciences and Medicine, King's College London, Westminster Bridge Rd, London SE1 7EH, England (S.F., G.G., A.C., P.G.M.); Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece (G.G.); Department of Cardiology, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Lisbon, Portugal (P.M.L., A.M.F., J.A.); Department of Cardiology, University Hospital Muenster, Muenster, Germany (K.B.B., A.Y., A.F.); Department of Radiology, Gasthuisberg University Hospital, Leuven, Belgium (S.M.F., B.V., J.B.); Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Italy (L.T., S.P., M.L.); Department of Cardiovascular Imaging, Radiology and Cardiovascular CT Unit, Centro Cardiologico Monzino, IRCCS, Milan, Italy (S.M., D.A.); GVM Care&Research, Maria Cecilia Hospital, Cotignola, Italy (S.C., A.S.); Center for Cardiac MRI, Lausanne University Hospital, Lausanne, Switzerland (A.G.P., P.M., J.S.); Cardiologia-4, Dipartimento Cardio-toraco-vascolare A. De Gasperis, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy (I.B., G.Q., P.P.); Department of Cardiology, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain (M.L.S., J.F.R.P.); Centro de Investigación Biomédica en Red-CV, Barcelona, Spain (M.L.S., J.F.R.P.); Department of Cardiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands (A.J.T., T.L.); Unità Operativa Imaging Multimodale Cardiovascolare e Neuroradiologico, Fondazione CNR/Regione Toscana G. Monasterio, Pisa, Italy (F.B., G.D.A.); Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Italy (D.F., V.M., L.A.); Institute of Sport Medicine, CONI, Rome, Italy (D.F., V.M.); Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy (C.T., D.M., L.P.B.); Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy (D.M., L.P.B.); and Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy (D.A.)
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16
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Mitral Annular Disjunction: Associated Pathologies and Clinical Consequences. Curr Cardiol Rep 2022; 24:1933-1944. [PMID: 36331783 DOI: 10.1007/s11886-022-01806-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE OF REVIEW To provide an overview of mitral annular disjunction (MAD) and to discuss important challenges in diagnosis and management of MAD. RECENT FINDINGS MAD has regained interest in the context of sudden cardiac death (SCD) in patients with mitral valve prolapse (MVP), coined as the "arrhythmic" MVP syndrome. In addition, MAD in isolation was recently suggested to be associated with severe arrhythmia and SCD. There is a lack of consensus on the definition of MAD and the imaging modality to be used for diagnosing MAD, and the therapeutic implications of MAD remain uncertain. Furthermore, the exact mechanism underlying the association of MAD with SCD remains largely unexplored.
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17
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Adabifirouzjaei F, Hsiao A, DeMaria AN. Mitral Valve Prolapse-The Role of Cardiac Imaging Modalities. STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2022; 6:100024. [PMID: 37273735 PMCID: PMC10236887 DOI: 10.1016/j.shj.2022.100024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/22/2021] [Accepted: 10/28/2021] [Indexed: 06/06/2023]
Abstract
Mitral valve prolapse (MVP) is the most common nonischemic mitral regurgitation etiology and mitral abnormality requiring surgery in the Western world. There is an increasing awareness that pathological findings in MVP are not confined to the valve tissue; rather, it is a complex disease, involving the mitral valve apparatus, cardiac hemodynamics, and cardiac structure. Imaging has played a fundamental role in the understanding of the diagnosis, prevalence, and consequences of MVP. The diagnosis of MVP by imaging is based upon demonstrating valve leaflets ascending into the left atrium through the saddle-shaped annulus. Transthoracic and transesophageal echocardiography are the primary modalities in the diagnosis and assessment of MVP patients and must include careful assessment of the leaflets, annulus, chords, and papillary muscles. High-spatial-resolution imaging modalities such as cardiac magnetic resonance images and cardiac computed tomography play a secondary role in this regard and can demonstrate the anatomical relation between the mitral valve annulus and leaflet excursion for appropriate diagnosis. Ongoing development of new methods of cardiac imaging can help us to accurately understand the mechanism, diagnose the disease, develop an appropriate treatment plan, and estimate the risk for sudden death. Recently, several new observations with respect to prolapse have been derived from cardiac imaging including three-dimensional echocardiography and tissue-Doppler imaging. The aim of this article is to present these new imaging-derived insights for the diagnosis, risk assessment, treatment, and follow-up of patients with MVP.
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Affiliation(s)
- Fatemeh Adabifirouzjaei
- Department of Cardiology, Sulpizio Cardiovascular Center, University of California San Diego, San Diego, California, USA
| | - Albert Hsiao
- Department of Radiology, University of California San Diego, San Diego, California, USA
| | - Anthony N. DeMaria
- Department of Cardiology, Sulpizio Cardiovascular Center, University of California San Diego, San Diego, California, USA
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18
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Pype LL, Bertrand PB, Paelinck BP, Heidbuchel H, Van Craenenbroeck EM, Van De Heyning CM. Left Ventricular Remodeling in Non-syndromic Mitral Valve Prolapse: Volume Overload or Concomitant Cardiomyopathy? Front Cardiovasc Med 2022; 9:862044. [PMID: 35498019 PMCID: PMC9039519 DOI: 10.3389/fcvm.2022.862044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/07/2022] [Indexed: 01/11/2023] Open
Abstract
Mitral valve prolapse (MVP) is a common valvular disorder that can be associated with mitral regurgitation (MR), heart failure, ventricular arrhythmias and sudden cardiac death. Given the prognostic impact of these conditions, it is important to evaluate not only mitral valve morphology and regurgitation, but also the presence of left ventricular (LV) function and remodeling. To date, several possible hypotheses have been proposed regarding the underlying mechanisms of LV remodeling in the context of non-syndromic MVP, but the exact pathophysiological explanation remains elusive. Overall, volume overload related to severe MR is considered the main cause of LV dilatation in MVP. However, significant LV remodeling has been observed in patients with MVP and no/mild MR, particularly in patients with bileaflet MVP or Barlow’s disease, generating several new hypotheses. Recently, the concept of “prolapse volume” was introduced, adding a significant volume load to the LV on top of the transvalvular MR volume. Another possible hypothesis is the existence of a concomitant cardiomyopathy, supported by the link between MVP and myocardial fibrosis. The origin of this cardiomyopathy could be either genetic, a second hit (e.g., on top of genetic predisposition) and/or frequent ventricular ectopic beats. This review provides an overview of the different mechanisms and remaining questions regarding LV remodeling in non-syndromic MVP. Since technical specifications of imaging modalities impact the evaluation of MR severity and LV remodeling, and therefore might influence clinical decision making in these patients, this review will also discuss assessment of MVP using different imaging modalities.
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Affiliation(s)
- Lobke L. Pype
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Genetics, Pharmacology and Physiopathology of Heart, Vasculature and Skeleton (GENCOR) Research Group, University of Antwerp, Antwerp, Belgium
| | - Philippe B. Bertrand
- Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium
- Cardio and Organ Systems (COST) Resarch Group, Hasselt University, Hasselt, Belgium
| | - Bernard P. Paelinck
- Genetics, Pharmacology and Physiopathology of Heart, Vasculature and Skeleton (GENCOR) Research Group, University of Antwerp, Antwerp, Belgium
- Department of Cardiac Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Hein Heidbuchel
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Genetics, Pharmacology and Physiopathology of Heart, Vasculature and Skeleton (GENCOR) Research Group, University of Antwerp, Antwerp, Belgium
| | - Emeline M. Van Craenenbroeck
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Genetics, Pharmacology and Physiopathology of Heart, Vasculature and Skeleton (GENCOR) Research Group, University of Antwerp, Antwerp, Belgium
| | - Caroline M. Van De Heyning
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
- Genetics, Pharmacology and Physiopathology of Heart, Vasculature and Skeleton (GENCOR) Research Group, University of Antwerp, Antwerp, Belgium
- *Correspondence: Caroline M. Van De Heyning,
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19
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Jain CC, Miranda WR, Connolly HM, Madhavan M, Egbe AC. Clinical Features and Outcomes in Adults With Childhood Repair of Partial Atrioventricular Septal Defect. JACC. ADVANCES 2022; 1:100007. [PMID: 38939082 PMCID: PMC11198577 DOI: 10.1016/j.jacadv.2022.100007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 06/29/2024]
Abstract
Background Partial atrioventricular septal defects (pAVSDs) are mostly repaired in childhood; however, there are limited data describing these patients in adulthood. Objectives The objective of this study was to describe clinical course and associations with outcomes in adults with repaired pAVSDs. Methods A retrospective review of adults (≥18 years) with pAVSDs repaired in childhood who presented to the Adult Congenital Heart Disease Clinic at our institution was conducted. Results Of 121 patients, the median age was 31 years (IQR: 22-43 years) and 71.9% were female. The median number of operations at the time of presentation was 1 (IQR: 1-2). Left atrioventricular valve (LAVV) replacement had been performed in 19.8% of patients. Among those with native LAVV, 41.2% had ≥ moderate regurgitation. Atrial arrhythmias were present in 34.7% and were associated with later age at repair (P = 0.02) and a high number of prior surgeries (P = 0.005). Estimated systolic pulmonary artery pressure >40 mmHg was seen in 19.8%. Over 4 (IQR: 1-12) years of follow-up, death occurred in 13 (10.7%) patients and reoperation was required in 39.7%. One-third had a LAVV prosthesis by the end of the study. Atrial fibrillation was independently associated with death or hospitalization on multivariable analysis. Conclusions In this cohort of adults with pAVSDs repaired in childhood, atrial fibrillation was common at a young age and associated with worse outcomes. Thus, more studies are needed evaluating the cause of this arrhythmia burden and possible associated atrial myopathy. While many require surgery in adulthood, more information is needed regarding indications for and impacts of LAVV intervention as one-third had an LAVV prosthesis by the end of follow-up.
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Affiliation(s)
- C. Charles Jain
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - William R. Miranda
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Heidi M. Connolly
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Malini Madhavan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Alexander C. Egbe
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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20
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Kubala M, de Chillou C, Bohbot Y, Lancellotti P, Enriquez-Sarano M, Tribouilloy C. Arrhythmias in Patients With Valvular Heart Disease: Gaps in Knowledge and the Way Forward. Front Cardiovasc Med 2022; 9:792559. [PMID: 35242822 PMCID: PMC8885812 DOI: 10.3389/fcvm.2022.792559] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
The prevalence of both organic valvular heart disease (VHD) and cardiac arrhythmias is high in the general population, and their coexistence is common. Both VHD and arrhythmias in the elderly lead to an elevated risk of hospitalization and use of health services. However, the relationships of the two conditions is not fully understood and our understanding of their coexistence in terms of contemporary management and prognosis is still limited. VHD-induced left ventricular dysfunction/hypertrophy and left atrial dilation lead to both atrial and ventricular arrhythmias. On the other hand, arrhythmias can be considered as an independent condition resulting from a coexisting ischemic or non-ischemic substrate or idiopathic ectopy. Both atrial and ventricular VHD-induced arrhythmias may contribute to clinical worsening and be a turning point in the natural history of VHD. Symptoms developed in patients with VHD are not specific and may be attributable to hemodynamical consequences of valve disease but also to other cardiac conditions including arrhythmias which are notably prevalent in this population. The issue how to distinguish symptoms related to VHD from those related to atrial fibrillation (AF) during decision making process remains challenging. Moreover, AF is a traditional limit of echocardiography and an important source of errors in assessment of the severity of VHD. Despite recent progress in understanding the pathophysiology and prognosis of postoperative AF, many questions remain regarding its prevention and management. Furthermore, life-threatening ventricular arrhythmias can predispose patients with VHD to sudden cardiac death. Evidence for a putative link between arrhythmias and outcome in VHD is growing but available data on targeted therapies for VHD-related arrhythmias, including monitoring and catheter ablation, is scarce. Despite growing evidences, more research focused on the prognosis and optimal management of VHD-related arrhythmias is still required. We aimed to review the current evidence and identify gaps in knowledge about the prevalence, prognostic considerations, and treatment of atrial and ventricular arrhythmias in common subtypes of organic VHD.
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Affiliation(s)
- Maciej Kubala
- Department of Cardiology, Amiens University Hospital, Amiens, France
- Jules Verne University of Picardie, Amiens, France
| | - Christian de Chillou
- Department of Cardiology, University Hospital Nancy, Vandœuvre lès Nancy, France
| | - Yohann Bohbot
- Department of Cardiology, Amiens University Hospital, Amiens, France
- Jules Verne University of Picardie, Amiens, France
| | - Patrizio Lancellotti
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Valvular Disease Clinic, CHU Sart Tilman, Liège, Belgium
| | - Maurice Enriquez-Sarano
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Christophe Tribouilloy
- Department of Cardiology, Amiens University Hospital, Amiens, France
- Jules Verne University of Picardie, Amiens, France
- *Correspondence: Christophe Tribouilloy
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21
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Influence of Prolapse Volume in Mitral Valve Prolapse. Am J Cardiol 2021; 157:64-70. [PMID: 34389154 DOI: 10.1016/j.amjcard.2021.07.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 11/21/2022]
Abstract
Mitral valve prolapse (MVP) is characterized by excessive leaflet tissue leading to a wide spectrum of mitral regurgitation (MR) ranging from trivial to severe. The prolapse volume (PV) below the prolapsing leaflets in end-systole was suspected to impact both chamber remodeling and MR grading in MVP. Based on 157 consecutive patients (45 women; mean age 62±15) referred for CMR assessment of MR, either from MVP (n = 91; 58%) or fibroelastic disease (FED) (n = 66; 42%), we sought to study (i) the interaction between PV and cardiac chamber geometry (ii) to study the impact of PV on MR quantification in MVP. Despite similar left ventricular (LV) size, PV was larger in MVP (11±9ml) than in FED (2±2ml). PV progressively increased with the severity of MR in MVP but not in FED. Despite a low regurgitant volume (32±18ml), some MVP patients with less than moderate MR exhibit significant cardiac chambers remodeling compared to 52 age and sex-matched controls. PV correlated significantly (r = 0.52) with the LV dilatation in severe MR but also in less than moderate MR. In MVP, PV>14ml was associated with a significant underestimation (Bias=-26±32ml) of regurgitant volume by PISA compared to CMR. In conclusion, in MVP, PV may play a role in left cardiac chambers remodeling, even in patients without severe MR, and in discordant grading of MR between echocardiography and CMR.
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22
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Morningstar JE, Nieman A, Wang C, Beck T, Harvey A, Norris RA. Mitral Valve Prolapse and Its Motley Crew-Syndromic Prevalence, Pathophysiology, and Progression of a Common Heart Condition. J Am Heart Assoc 2021; 10:e020919. [PMID: 34155898 PMCID: PMC8403286 DOI: 10.1161/jaha.121.020919] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/21/2021] [Indexed: 01/01/2023]
Abstract
Mitral valve prolapse (MVP) is a commonly occurring heart condition defined by enlargement and superior displacement of the mitral valve leaflet(s) during systole. Although commonly seen as a standalone disorder, MVP has also been described in case reports and small studies of patients with various genetic syndromes. In this review, we analyzed the prevalence of MVP within syndromes where an association to MVP has previously been reported. We further discussed the shared biological pathways that cause MVP in these syndromes, as well as how MVP in turn causes a diverse array of cardiac and noncardiac complications. We found 105 studies that identified patients with mitral valve anomalies within 18 different genetic, developmental, and connective tissue diseases. We show that some disorders previously believed to have an increased prevalence of MVP, including osteogenesis imperfecta, fragile X syndrome, Down syndrome, and Pseudoxanthoma elasticum, have few to no studies that use up-to-date diagnostic criteria for the disease and therefore may be overestimating the prevalence of MVP within the syndrome. Additionally, we highlight that in contrast to early studies describing MVP as a benign entity, the clinical course experienced by patients can be heterogeneous and may cause significant cardiovascular morbidity and mortality. Currently only surgical correction of MVP is curative, but it is reserved for severe cases in which irreversible complications of MVP may already be established; therefore, a review of clinical guidelines to allow for earlier surgical intervention may be warranted to lower cardiovascular risk in patients with MVP.
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Affiliation(s)
- Jordan E. Morningstar
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
| | - Annah Nieman
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
| | - Christina Wang
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
| | - Tyler Beck
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
| | - Andrew Harvey
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
| | - Russell A. Norris
- Department of Regenerative Medicine and Cell BiologyMedical University of South CarolinaCharlestonSC
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23
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Constant Dit Beaufils AL, Huttin O, Jobbe-Duval A, Senage T, Filippetti L, Piriou N, Cueff C, Venner C, Mandry D, Sellal JM, Le Scouarnec S, Capoulade R, Marrec M, Thollet A, Beaumont M, Hossu G, Toquet C, Gourraud JB, Trochu JN, Warin-Fresse K, Marie PY, Schott JJ, Roussel JC, Serfaty JM, Selton-Suty C, Le Tourneau T. Replacement Myocardial Fibrosis in Patients With Mitral Valve Prolapse: Relation to Mitral Regurgitation, Ventricular Remodeling, and Arrhythmia. Circulation 2021; 143:1763-1774. [PMID: 33706538 DOI: 10.1161/circulationaha.120.050214] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Mitral valve prolapse (MVP) is a frequent disease that can be complicated by mitral regurgitation (MR), heart failure, arterial embolism, rhythm disorders, and death. Left ventricular (LV) replacement myocardial fibrosis, a marker of maladaptive remodeling, has been described in patients with MVP, but the implications of this finding remain scarcely explored. We aimed at assessing the prevalence, pathophysiological and prognostic significance of LV replacement myocardial fibrosis through late gadolinium enhancement (LGE) by cardiac magnetic resonance in patients with MVP. METHODS Four hundred patients (53±15 years of age, 55% male) with MVP (trace to severe MR by echocardiography) from 2 centers, who underwent a comprehensive echocardiography and LGE cardiac magnetic resonance, were included. Correlates of replacement myocardial fibrosis (LGE+), influence of MR degree, and ventricular arrhythmia were assessed. The primary outcome was a composite of cardiovascular events (cardiac death, heart failure, new-onset atrial fibrillation, arterial embolism, and life-threatening ventricular arrhythmia). RESULTS Replacement myocardial fibrosis (LGE+) was observed in 110 patients (28%; 91 with myocardial wall including 71 with basal inferolateral wall, 29 with papillary muscle). LGE+ prevalence was 13% in trace-mild MR, 28% in moderate MR, and 37% in severe MR, and was associated with specific features of mitral valve apparatus, more dilated LV and more frequent ventricular arrhythmias (45% versus 26%, P<0.0001). In trace-mild MR, despite the absence of significant volume overload, abnormal LV dilatation was observed in 16% of patients and ventricular arrhythmia in 25%. Correlates of LGE+ in multivariable analysis were LV mass (odds ratio, 1.01 [95% CI, 1.002-1.017], P=0.009) and moderate-severe MR (odds ratio, 2.28 [95% CI, 1.21-4.31], P=0.011). LGE+ was associated with worse 4-year cardiovascular event-free survival (49.6±11.7 in LGE+ versus 73.3±6.5% in LGE-, P<0.0001). In a stepwise multivariable Cox model, MR volume and LGE+ (hazard ratio, 2.6 [1.4-4.9], P=0.002) were associated with poor outcome. CONCLUSIONS LV replacement myocardial fibrosis is frequent in patients with MVP; is associated with mitral valve apparatus alteration, more dilated LV, MR grade, and ventricular arrhythmia; and is independently associated with cardiovascular events. These findings suggest an MVP-related myocardial disease. Last, cardiac magnetic resonance provides additional information to echocardiography in MVP.
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Affiliation(s)
- Anne-Laure Constant Dit Beaufils
- Université de Nantes, CHU de Nantes, CNRS, INSERM, l'institut du thorax, France (A.-L.C.D.B., C.C., S.L.S., R.C., A.T., C.T., J.-B.G., J.-N.T., J.-J.S., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Olivier Huttin
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, France (O.H., L.F., C.V., D.M., J.-M. Sellal, P.-Y.M., C.S.-S.)
| | - Antoine Jobbe-Duval
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Thomas Senage
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.).,Biostatistic Department, Université de Nantes, France (T.S.)
| | - Laura Filippetti
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, France (O.H., L.F., C.V., D.M., J.-M. Sellal, P.-Y.M., C.S.-S.)
| | - Nicolas Piriou
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Caroline Cueff
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.).,Université de Nantes, CHU de Nantes, CNRS, INSERM, l'institut du thorax, France (A.-L.C.D.B., C.C., S.L.S., R.C., A.T., C.T., J.-B.G., J.-N.T., J.-J.S., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Clément Venner
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, France (O.H., L.F., C.V., D.M., J.-M. Sellal, P.-Y.M., C.S.-S.)
| | - Damien Mandry
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, France (O.H., L.F., C.V., D.M., J.-M. Sellal, P.-Y.M., C.S.-S.)
| | - Jean-Marc Sellal
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, France (O.H., L.F., C.V., D.M., J.-M. Sellal, P.-Y.M., C.S.-S.)
| | - Solena Le Scouarnec
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, France (O.H., L.F., C.V., D.M., J.-M. Sellal, P.-Y.M., C.S.-S.)
| | - Romain Capoulade
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, France (O.H., L.F., C.V., D.M., J.-M. Sellal, P.-Y.M., C.S.-S.)
| | - Marie Marrec
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Aurélie Thollet
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.).,Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, France (O.H., L.F., C.V., D.M., J.-M. Sellal, P.-Y.M., C.S.-S.)
| | | | - Gabriella Hossu
- CIC-IT, U1433, CHRU de Nancy, France; INSERM U1254, Imagerie Adaptative Diagnostique et Interventionnelle, Université de Lorraine, France (G.H.)
| | - Claire Toquet
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.).,Université de Nantes, CHU de Nantes, CNRS, INSERM, l'institut du thorax, France (A.-L.C.D.B., C.C., S.L.S., R.C., A.T., C.T., J.-B.G., J.-N.T., J.-J.S., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Jean-Baptiste Gourraud
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.).,Université de Nantes, CHU de Nantes, CNRS, INSERM, l'institut du thorax, France (A.-L.C.D.B., C.C., S.L.S., R.C., A.T., C.T., J.-B.G., J.-N.T., J.-J.S., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Jean-Noël Trochu
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.).,Université de Nantes, CHU de Nantes, CNRS, INSERM, l'institut du thorax, France (A.-L.C.D.B., C.C., S.L.S., R.C., A.T., C.T., J.-B.G., J.-N.T., J.-J.S., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Karine Warin-Fresse
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Pierre-Yves Marie
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, France (O.H., L.F., C.V., D.M., J.-M. Sellal, P.-Y.M., C.S.-S.)
| | - Jean-Jacques Schott
- Université de Nantes, CHU de Nantes, CNRS, INSERM, l'institut du thorax, France (A.-L.C.D.B., C.C., S.L.S., R.C., A.T., C.T., J.-B.G., J.-N.T., J.-J.S., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Jean-Christian Roussel
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.).,Université de Nantes, CHU de Nantes, CNRS, INSERM, l'institut du thorax, France (A.-L.C.D.B., C.C., S.L.S., R.C., A.T., C.T., J.-B.G., J.-N.T., J.-J.S., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Jean-Michel Serfaty
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.).,Université de Nantes, CHU de Nantes, CNRS, INSERM, l'institut du thorax, France (A.-L.C.D.B., C.C., S.L.S., R.C., A.T., C.T., J.-B.G., J.-N.T., J.-J.S., J.-C.R., J.-M. Serfaty, T.L.T.)
| | - Christine Selton-Suty
- Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, France (O.H., L.F., C.V., D.M., J.-M. Sellal, P.-Y.M., C.S.-S.)
| | - Thierry Le Tourneau
- CHU de Nantes, Université de Nantes, l'institut du thorax, CIC 1413, France (A.J.-D., T.S., N.P., C.C., M.M., A.T., C.T., J.-B.G., J.-N.T., K.W.-F., J.-C.R., J.-M. Serfaty, T.L.T.).,Université de Nantes, CHU de Nantes, CNRS, INSERM, l'institut du thorax, France (A.-L.C.D.B., C.C., S.L.S., R.C., A.T., C.T., J.-B.G., J.-N.T., J.-J.S., J.-C.R., J.-M. Serfaty, T.L.T.)
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24
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Bach DS. Dead Pool: A Non-Regurgitant Volume Overload Among Patients With Barlow Mitral Valve Prolapse. JACC Cardiovasc Imaging 2020; 14:585-587. [PMID: 33129737 DOI: 10.1016/j.jcmg.2020.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- David S Bach
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.
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