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Sabbour H, Al-Humood K, Al Taha Z, Romany I, Haddadin H, Mohty D. A wolf in sheep's clothing-aortic stenosis and cardiac amyloidosis: "RAISE"ing awareness in clinical practice. Front Cardiovasc Med 2024; 11:1323023. [PMID: 38464842 PMCID: PMC10921426 DOI: 10.3389/fcvm.2024.1323023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/15/2024] [Indexed: 03/12/2024] Open
Abstract
Aesop's fable of the wolf in sheep's clothing encourages us to look beneath the exterior appearance of a situation and evaluate the truth that lies beneath. This concept should be applied when managing older patients with severe aortic stenosis. This population of patients is increasingly being identified as having concomitant cardiac amyloidosis, which is an underrecognized cause of common cardiac conditions. The presence of cardiac amyloidosis negatively affects the outcome of patients with aortic stenosis, these patients undergo transcatheter aortic valve replacement (TAVR) with increasing frequency and have a significantly higher overall mortality rate than patients with aortic stenosis alone. Although left ventricular wall hypertrophy is expected in patients with aortic stenosis, it should not be assumed that this is caused only by aortic stenosis. A suspicion of cardiac amyloidosis should be raised in patients in whom the degree of hypertrophy is disproportionate to the degree of aortic stenosis severity. The remodeling, age, injury, systemic, and electrical (RAISE) score was developed to predict the presence of cardiac amyloidosis in patients with severe aortic stenosis. This article highlights the value of increased clinical suspicion, demonstrates the use of the multiparameter RAISE score in daily clinical practice, and illustrates the scoring system with case studies. In elderly patients being considered for TAVR, systematic testing for cardiac amyloidosis should be considered as part of the preoperative workup.
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Affiliation(s)
- H Sabbour
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
- Warren Alpert School of Medicine, Brown University, Providence, RI, United States
| | - K Al-Humood
- Advanced Heart Failure and Transplantation Unit, Chest Disease Hospital, Kuwait City, Kuwait
| | - Z Al Taha
- Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - I Romany
- Pfizer Gulf FZ LLC, Dubai, United Arab Emirates
| | - H Haddadin
- Pfizer Gulf FZ LLC, Dubai, United Arab Emirates
| | - D Mohty
- Heart Center, King Faisal Specialist Hospital, Riyadh, Saudi Arabia
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2
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Mohty D, Omer MH, Ahmad O, Alayary I, Alzahrani T, Damy T, Fadel B. Transthyretin cardiac amyloidosis in Saudi Arabia and the Middle East: insights, projected prevalence and practical applications. Front Cardiovasc Med 2023; 10:1265681. [PMID: 37953763 PMCID: PMC10634293 DOI: 10.3389/fcvm.2023.1265681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023] Open
Affiliation(s)
- Dania Mohty
- Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Mohamed H. Omer
- School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Omar Ahmad
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Islam Alayary
- Rare Diseases Medical Affairs, Pfizer Inc., Jeddah, Saudi Arabia
| | - Talal Alzahrani
- Department of Medicine, College of Medicine, Taibah University, Medina, Saudi Arabia
| | - Thibaud Damy
- Referral Center for Cardiac Amyloidosis, Department of Cardiology, Mondor Amyloidosis Network, GRC Amyloid Research Institute, Clinical Investigation Center 006, DHU A-TVB INSERM U955 all at CHU Henri Mondor, UPEC, Créteil, France
| | - Bahaa Fadel
- Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
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3
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Mohty D, Nasr S, Ragy H, Farhan HA, Fadel B, Alayary I, Ghoubar M. Cardiac amyloidosis: A survey of current awareness, diagnostic modalities, treatment practices, and clinical challenges among cardiologists in selected Middle Eastern countries. Clin Cardiol 2023. [PMID: 37038634 DOI: 10.1002/clc.23985] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Cardiac amyloidosis (CA) is a chronic progressive disease caused by the deposition of amyloid fibrils in cardiac tissues. Diagnosis and management of CA are complicated and have developed over the years. HYPOTHESIS Middle Eastern countries have significant knowledge disparities in diagnosing, managing, and treating different subtypes of CA. METHODS An online survey was sent to cardiologists in four countries (Saudi Arabia, Lebanon, Egypt, and Iraq) interested in heart failure and practicing for more than a year. The survey questioned the characteristics of the participants and their institutions. It addressed their knowledge and practices in CA specifically diagnostic modalities, treatment options, and interest in education and knowledge exchange. RESULTS A total of 85 physicians participated in the survey. There was a variation in the participating cardiologists' knowledge, experience level, and readiness of their institutes to manage patients with ATTR-CM. Most participants believed that a high rate of ATTR-CM misdiagnosis existed. Participants' knowledge of the diagnostic modalities and "red flags" raising suspicion about ATTR-CM varied. Another challenge was the availability of essential diagnostic modalities among various cardiology centers. A knowledge gap was also observed regarding updates in ATTR-CM management. However, there was a high endorsement of the need for more education, physician networking, and knowledge exchange. CONCLUSIONS This survey highlighted the need for increasing awareness levels among cardiologists in the four selected Middle Eastern countries. Cardiologists are most likely to benefit from additional training and knowledge exchange on the latest management advances of this disease. Thus, measures must be taken to focus on the physician's awareness of ATTR-CM patient journey to achieve a better quality of care and outcome.
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Affiliation(s)
- Dania Mohty
- Heart Center, King Faisal Specialist Hospital and Research Center, Al-Faisal University, Riyadh, Saudi Arabia
| | - Samer Nasr
- Department of Cardiology, Mount Lebanon Hospital Balamand University Medical Center, Hazmiyeh, Lebanon
| | - Hany Ragy
- National Heart Institute, Giza, Egypt
| | - Hasan A Farhan
- Scientific Council of Cardiology, Iraqi Board for Medical Specializations, Baghdad Heart Center, Medical City, Baghdad, Iraq
| | - Bahaa Fadel
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Al-Jazairi AS, Althobaiti AM, Marek J, Devol EB, Al Halees Z, Mohty D, Fadel BM. Does Secondary Antibiotic Prophylaxis Improve Clinical Outcomes in Adult Rheumatic Heart Disease Patients Post-Valve Replacement? World J Pediatr Congenit Heart Surg 2023; 14:161-167. [PMID: 36529977 DOI: 10.1177/21501351221139834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Secondary prevention of recurrent rheumatic fever in individuals with rheumatic heart disease (RHD) requires continuous antibiotic prophylaxis. However, the impact of antibiotic prophylaxis on the outcome of patients with severe RHD who underwent heart valve replacement is unknown. The objective of the study was to assess the relationship between the use of antibiotics as secondary prophylaxis in RHD patients who underwent valve replacement and clinical outcomes including mortality, reoperation, and valve-related hospitalization. METHODS We retrospectively compared outcomes of adult patients who underwent heart valve replacement for RHD at our institution from 1990 through 2014 and who received secondary antibiotic prophylaxis (prophylaxis group) with those who did not receive prophylaxis (nonprophylaxis group) using propensity score matching analysis. RESULTS A total of 1094 patients (56% females, median age 40 years, range 31-53 years) were included with a median follow-up of 9.6 years (range 2.9-12.6 years). Antibiotic prophylaxis was prescribed in 201 patients (18%). Propensity score matching analysis demonstrated no significant difference in overall survival (95% [92%-98%] vs 97% [95%-99%], respectively; P = .7), valve-related hospitalization-independent survival (72% [range 65%-78%] vs 81% [range 76%-88%]; P = .25), and redo valve surgery-independent survival [76% [range 70%-83%] vs 75% [range 72%-79%]; P = .41) at 10-year follow-up in the nonantibiotic prophylaxis versus the antibiotic prophylaxis group. CONCLUSION Secondary antibiotic prophylaxis among adult RHD patients following valve replacement is not associated with improved clinical outcomes.
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Affiliation(s)
- Abdulrazaq S Al-Jazairi
- Clinical Trials Transformation Initiative (CTTI) Division, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Pharmaceutical Care Services, 37852King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- 101686College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ahlam M Althobaiti
- Pharmaceutical Care Services, 37852King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Josef Marek
- Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and 48230General University Hospital, Prague, Czech Republic
| | - Edward B Devol
- Biostatistics, Epidemiology & Scientific Computing, 37852King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Zohair Al Halees
- Heart Center, 37852King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Dania Mohty
- 101686College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Heart Center, 37852King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- 36715Department of Cardiology, CHU Limoges, Limoges, France
| | - Bahaa M Fadel
- 101686College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Heart Center, 37852King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Alsomali D, Mohty D, Grogan M, Dispenzieri A, Aljurf M, Kumar S, Gertz MA, Hanbali A, Hashmi SK. Treatment of amyloid light chain cardiac amyloidosis: systematic review and future directions. Clin Adv Hematol Oncol 2022; 20:609-618. [PMID: 36206073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Several treatment strategies for amyloid light chain cardiac amyloidosis (AL-CA) have been described in the literature; however, there is no consensus about the optimal approach to AL-CA. OBJECTIVE We conducted this systematic review to summarize current evidence from published studies about the safety and efficacy of various treatment regimens for patients with AL-CA, mainly focusing on autologous stem cell transplant (ASCT) and heart transplant. METHODS An electronic literature search of PubMed, Web of Science, Scopus, EBSCO, and CINAHL Plus was conducted through December 2019 using the relevant keywords and prespecified MeSH terminology. Records were screened, and eligible studies were selected and narratively discussed. Data on the hematologic and cardiac responses as well as the safety of the treatment regimens were extracted and synthesized narratively in the context of the systematic review. RESULTS Thirty published articles were included in this systematic review. The most commonly used first-line treatment in the included studies was bortezomib-based therapy followed by high-dose melphalan and ASCT, with recent evidence of improved outcome with the addition of daratumumab. Heart transplant was found to extend survival for selected patients who were not eligible for ASCT; however, it was found to affect the patients' tolerance of further chemotherapy in some studies. Published data on longterm outcomes with immunomodulatory agents were scarce. CONCLUSION Current evidence suggests several possible regimens for the treatment of AL-CA. Effective treatment approaches for AL-CA include induction therapy with bortezomib-based or immunotherapy-based combinations in moderate/severe forms of cardiac involvement, followed by high-dose melphalan and ASCT in eligible patients, and heart transplant for selected severe cases. Therefore, we highlight the necessity of conducting well-designed, randomized controlled trials to provide evidence about the efficacy of these drugs with respect to ASCT.
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Affiliation(s)
- Dunya Alsomali
- Ministry of National Guard Affairs, Jeddah, Saudi Arabia
| | - Dania Mohty
- Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, and INSERM 1094, Faculté de médecine de Limoges, Limoges, France
- Al Faisal University, Riyadh, Saudi Arabia
| | - Martha Grogan
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Angela Dispenzieri
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Mahmoud Aljurf
- Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Shaji Kumar
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Morie A Gertz
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Amr Hanbali
- Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Shahrukh K Hashmi
- Sheikh Shakhbout Medical City/Mayo Clinic, Abu Dhabi, United Arab Emirates
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6
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Kharoubi M, Bodez D, Bézard M, Zaroui A, Galat A, Guendouz S, Gendre T, Hittinger L, Attias D, Mohty D, Bergoend E, Itti E, Lebras F, Hamon D, Poullot E, Molinier-Frenkel V, Lellouche N, Deux JF, Funalot B, Fannen P, Oghina S, Arrouasse R, Lecorvoisier P, Souvannanorath S, Amiot A, Teiger E, Bougouin W, Damy T. Describing mode of death in three major cardiac amyloidosis subtypes to improve management and survival. Amyloid 2022; 29:79-91. [PMID: 35114877 DOI: 10.1080/13506129.2021.2013193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND The three main cardiac amyloidosis (CA) types have different progression and prognosis. Little is known about the mode of death (MOD) which is commonly attributed to cardiovascular causes in CA. Improving MOD's knowledge could allow to adapt patient care. OBJECTIVE This retrospective study describes the MOD that occurred during long-term follow-up in CA patients in light-chain (AL), transthyretin hereditary (ATTRv) or wild-type (ATTRwt). MATERIAL AND METHODS Patients referred to and cared for, at the French referral centre for CA, Henri Mondor Hospital, Créteil between 2010 and 2016 were included. Clinical information surrounding patient deaths were investigated and centrally evaluated by two blinded clinical committees which classified MOD as cardiovascular, non-cardiovascular or unknown and sub-classified it depending on its subtype. RESULTS From the 566 patients included, 187 had AL, 206 ATTRv and 173 ATTRwt. During the 864 patient-year follow-up, 160 (28%) deaths occurred, with median survival time of 17.3 months (interquartile range 5.1-35.4). The most frequent MOD was cardiovascular (64%) of which worsening heart failure occurred most frequently and for which, 69% were of AL subtype, 79% ATTRv and 76% ATTRwt. Sudden death also occurred more frequently in AL subtype accounting for 29% of AL deaths. Non-cardiovascular MOD occurred in 26% of patients overall. Among these, infection was the most common non-cardiovascular MOD in any type of CA (80%). CONCLUSIONS Mortality is high during natural course of CA and differs between subtypes. The main MOD were worsening heart failure, sudden death and infection, opening room to optimise management.
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Affiliation(s)
- Mounira Kharoubi
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France
| | - Diane Bodez
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France.,Centre Cardiologique du Nord, Saint Denis, France
| | - Mélanie Bézard
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France
| | - Amira Zaroui
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France
| | - Arnault Galat
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France
| | - Soulef Guendouz
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France
| | - Thierry Gendre
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Neurology, Henri Mondor University Hospital, Creteil, France
| | - Luc Hittinger
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France
| | - David Attias
- Centre Cardiologique du Nord, Saint Denis, France
| | - Dania Mohty
- Department of Cardiology, Dupuytren University Hospital, Limoges, France.,AL Amyloidosis Referral Center, Dupuytren University Hospital, Limoges, France
| | - Eric Bergoend
- AP-HP, Department of Cardiac Surgery, Henri Mondor University Hospital, Creteil, France
| | - Emmanuel Itti
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Nuclear Medicine, Henri Mondor University Hospital, Creteil, France
| | - Fabien Lebras
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Lymphoid Malignancy Unit, Henri Mondor University Hospital, Creteil, France
| | - David Hamon
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France
| | - Elsa Poullot
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Biology-Pathology, Henri Mondor Univ Paris Est Creteil, INSERM, IMRB, Creteil, France
| | - Valérie Molinier-Frenkel
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Biology-Pathology, Henri Mondor Univ Paris Est Creteil, INSERM, IMRB, Creteil, France.,AP-HP, Department of Immunobiology, Henri Mondor University Hospital, Créteil, France
| | - Nicolas Lellouche
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France
| | - Jean-François Deux
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Radiology, Henri Mondor University Hospital, Créteil, France
| | - Benoit Funalot
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Genetic, Henri Mondor Teaching Hospital, Créteil, France
| | - Pascale Fannen
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Genetic, Henri Mondor Teaching Hospital, Créteil, France
| | - Silvia Oghina
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France
| | - Raphael Arrouasse
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,Inserm, Clinical Investigations Center 1430, AP-HP, DMU Saphire, Henri Mondor University Hospital, Creteil, France
| | - Philippe Lecorvoisier
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,Inserm, Clinical Investigations Center 1430, AP-HP, DMU Saphire, Henri Mondor University Hospital, Creteil, France
| | - Sarah Souvannanorath
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Referral Center for Neuromuscular Disease Department, Henri Mondor University Hospital, Créteil, France
| | - Aurelien Amiot
- Department of Gastroenterology, Henri Mondor University Hospital, AP-HP, EA7375, University Paris-Est Creteil, Creteil, France
| | - Emmanuel Teiger
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France
| | - Wulfran Bougouin
- AP-HP, Centre de Recherche Cardiovasculaire de Paris (PARCC), INSERM U970, Centre d'Expertise Mort Subite (CEMS), Paris Descartes University, Paris, France.,Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France
| | - Thibaud Damy
- National Referral Center for Cardiac Amyloidosis, Creteil, France.,GRC Amyloid Research Institute University Paris-Est Creteil INSERM, IMRB, Creteil, France.,AP-HP, Department of Cardiology, Henri Mondor University Hospital, Creteil, France.,Inserm U955, IMRB, Creteil, France.,Inserm, Clinical Investigations Center 1430, AP-HP, DMU Saphire, Henri Mondor University Hospital, Creteil, France
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Fadel BM, Mahjoub H, Salem EJ, Kazzi BE, Echahidi N, Mohty D. Constrictive pericarditis following heart transplantation: Reality or fiction? Echocardiography 2021; 38:1973-1977. [PMID: 34755387 DOI: 10.1111/echo.15229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/02/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022] Open
Abstract
Constrictive pericarditis (CP) is a curable cause of diastolic heart failure with prior cardiac surgery being a recognizable etiology. We report a patient who developed CP one year following heart transplantation. Several clinical and imaging related factors may lead to diagnostic delays in similar patients, including the mistaken belief that transplanted hearts are devoid of pericardium and thus do not develop constriction. Post-transplantation pericardial effusion, mediastinitis, and cardiac rejection predispose to future CP. Caretakers should consider this entity in allograft recipients who develop heart failure symptoms of unclear etiology.
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Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,Alfaisal University, Riyadh, Saudi Arabia
| | - Haifa Mahjoub
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,Lebanese American University, Beirut, Lebanon
| | | | | | | | - Dania Mohty
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,Alfaisal University, Riyadh, Saudi Arabia.,Heart Center, Section of Adult Cardiology, CHU Limoges, Limoges, France
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8
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Mahmoodurrahman M, Marek J, Juhardeen HR, Al Otaibi T, Salemi VMC, Echahidi N, Al Buraiki J, Fadel BM, Mohty D. Diagnostic Accuracy of Dobutamine Stress Echocardiography for Detection of Cardiac Allograft Vasculopathy in Orthotopic Heart Transplant Patients. J Saudi Heart Assoc 2021; 33:279-283. [PMID: 35083117 PMCID: PMC8754441 DOI: 10.37616/2212-5043.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/04/2021] [Accepted: 08/01/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Josef Marek
- 2nd Department of Medicine – Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague,
Czech Republic
| | | | - Talal Al Otaibi
- King Faisal Specialist Hospital & Research Center, Riyadh,
Saudi Arabia
| | - Vera Maria Cury Salemi
- Heart Failure Clinics, Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo,
Brazil
| | | | - Jehad Al Buraiki
- King Faisal Specialist Hospital & Research Center, Riyadh,
Saudi Arabia
| | - Bahaa M. Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh,
Saudi Arabia
| | - Dania Mohty
- King Faisal Specialist Hospital & Research Center, Riyadh,
Saudi Arabia
- Corresponding author at: King Faisal Specialist Hospital & Research Center, Heart Center, PO Box: 3354, MBC # 16, Riyadh, 11211, Saudi Arabia. Fax: +966 114427482. E-mail address: (D. Mohty)
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9
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Fadel BM, Mohty D, Alassas K, Alhalees Z. The role of transcatheter approaches for the treatment of pulmonary homograft dysfunction. Ann Cardiothorac Surg 2021; 10:521-523. [PMID: 34422567 DOI: 10.21037/acs-2020-rp-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/23/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,Alfaisal University, Riyadh, Saudi Arabia
| | - Dania Mohty
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,Alfaisal University, Riyadh, Saudi Arabia.,CHU Limoges, Limoges, France
| | | | - Zohair Alhalees
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,Alfaisal University, Riyadh, Saudi Arabia
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10
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Abouelhoda M, Mohty D, Alayary I, Meyer BF, Arold ST, Fadel BM, Monies D. Established and candidate transthyretin amyloidosis variants identified in the Saudi population by data mining. Hum Genomics 2021; 15:52. [PMID: 34380564 PMCID: PMC8359098 DOI: 10.1186/s40246-021-00351-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Familial transthyretin (TTR) amyloidosis (ATTR) is an autosomal dominant disease with significant phenotypic heterogeneity. Its prevalence in Saudi Arabia has not previously been investigated. An existing exome variant database of Saudi individuals, sequenced to globally investigate rare diseases in the population, was mined for TTR variants and filtered for missense mutations resulting in single amino acid changes. A total of 13,906 Saudi exomes from unrelated individuals were analyzed blindly. RESULTS Three TTR variants known to be associated with ATTR amyloidosis were identified. Additionally, three novel TTR mutations were identified. Structural analysis of the three novel variants suggests that at least two could be amyloidogenic. The most common variant associated with amyloidosis was p.Val142Ile (allele frequency 0.001). Further investigation of these variants and their translation to clinical practice may help to diagnose, monitor, and manage patients with ATTR amyloidosis. CONCLUSION Multiple TTR variants potentially associated with systemic ATTR amyloidosis were identified in the Saudi population. Early diagnosis and intervention, facilitated by familial genetic testing of patients with ATTR amyloidosis, may benefit in the management of this disease. Early diagnosis could be enhanced through inclusion of ATTR variants in existing population-based screening programs.
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Affiliation(s)
- Mohamed Abouelhoda
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh, 11211, Saudi Arabia
| | - Dania Mohty
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- Al-Faisal University, College of Medicine, Affiliate Harvard Medical School International, Riyadh, Saudi Arabia
| | | | - Brian F Meyer
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh, 11211, Saudi Arabia
| | - Stefan T Arold
- Computational Bioscience Research Center, Division of Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Bahaa M Fadel
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- Al-Faisal University, College of Medicine, Affiliate Harvard Medical School International, Riyadh, Saudi Arabia
| | - Dorota Monies
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh, 11211, Saudi Arabia.
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11
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Fadel BM, Mohty D, Kazzi BE, Alamro B, Arshi F, Mustafa M, Echahidi N, Aboyans V. Ultrasound Imaging of the Abdominal Aorta: A Comprehensive Review. J Am Soc Echocardiogr 2021; 34:1119-1136. [PMID: 34224827 DOI: 10.1016/j.echo.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 11/28/2022]
Abstract
Ultrasound is the imaging modality of choice for the initial evaluation of disorders that involve the abdominal aorta (AA). The diagnostic value of ultrasound resides in its ability to allow assessment of the anatomy and structure of the AA using two- dimensional, three-dimensional, and contrast-enhanced imaging. Moreover, ultrasound permits evaluation of the physiologic and hemodynamic consequences of abnormalities through Doppler interrogation of blood flow, thus enabling the identification and quantification of disorders within the AA and beyond its boundaries. The approach to ultrasound imaging of the AA varies, depending on the purpose of the study and whether it is performed in a radiology or vascular laboratory or in an echocardiography laboratory. The aim of this review is to demonstrate the usefulness of ultrasound imaging for the detection and evaluation of disorders that involve the AA, detail the abnormalities that are detected or further assessed, and outline its value for echocardiographers, sonographers, and radiologists.
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Affiliation(s)
- Bahaa M Fadel
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Alfaisal University, Riyadh, Saudi Arabia.
| | - Dania Mohty
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Alfaisal University, Riyadh, Saudi Arabia; Department of Cardiology, Dupuytren-2 University Hospital, and Inserm 1094 & IRD, Limoges University, Limoges, France
| | | | - Bandar Alamro
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Alfaisal University, Riyadh, Saudi Arabia
| | - Fatima Arshi
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Manal Mustafa
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Najmeddine Echahidi
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Department of Cardiology, Dupuytren-2 University Hospital, and Inserm 1094 & IRD, Limoges University, Limoges, France
| | - Victor Aboyans
- Department of Cardiology, Dupuytren-2 University Hospital, and Inserm 1094 & IRD, Limoges University, Limoges, France
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12
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Al-Tweigeri T, Dent S, Al Sayed A, Mohty D, Suleman K, Ajarim D, Raef H, Echahidi N. Using the appropriate formula for QT measurement can save lives. Hematol Oncol Stem Cell Ther 2021; 15:79-82. [PMID: 34181897 DOI: 10.1016/j.hemonc.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/05/2021] [Indexed: 10/21/2022] Open
Abstract
CDK 4/6 inhibitors, in combination with endocrine therapy, are the standard of care for patients with endocrine-sensitive advanced breast cancer. This class of drug, however, is associated with QT prolongation, which serves as a surrogate marker for Torsades de Pointes (TdP), a cause of life-threatening ventricular arrhythmias and sudden cardiac death. The ICH E14 guidance document uses the Bazett formula for reporting of cardio-dynamic and safety ECG data in clinical trials. While there is substantial familiarity with the Bazett (QTcB) formula (QT/(RR) 1/2), the Fridericia (QTcF) formula (QT/(RR) 1/3 ) is preferred in the cancer population as it is often more accurate at heart rate extreme. Accordingly, the Fridericia formula is currently the standard adopted by the FDA when submitting QT data for review. At the King Faisal Specialist Hospital and Research Center, a total of 82 patients with advanced breast cancer, had a baseline ECG on day 1 before the initiation of ribociclib based therapy. Of the enrolled 82 patients, 19 (23%) were initially excluded from receiving ribociclib based due to a prolonged QTc >450ms, however, when the QTc-interval was manually measured and recalculated using Fridericia and Framingham formulae using MDCalC (https//:www.mdcalc.com),17 of 19 patients successfully received their treatment without any arrhythmogenic effects. Repeat ECG on day14, and day 1 of cycle 2 demonstrated that none of these patients had QTc exceeding 480 ms. Our data highlights the complexities of evaluating the QT interval in oncology patients and the utility of the Fridericia/Framingham formulae in this population. Given these findings, we recommend the adoption of the Fridericia or Framingham formulae for measurement of QTc in all cancer patients exposed to potentially QT-prolonging cancer therapy.
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Affiliation(s)
- Taher Al-Tweigeri
- Medical Oncology Section, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | - Susan Dent
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Adher Al Sayed
- Medical Oncology Section, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Dania Mohty
- Heart Center Adult Cardiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Kausar Suleman
- Medical Oncology Section, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Dahish Ajarim
- Medical Oncology Section, Oncology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hussein Raef
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Najmeddine Echahidi
- Heart Center Adult Cardiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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13
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Salemi VMC, Mohty D, de Altavila SLL, de Melo MDT, Kalil R, Bocchi EA. Insights into the Classification of Cardiomyopathies: Past, Present, and Future Directions. Clinics (Sao Paulo) 2021; 76:e2808. [PMID: 33787660 PMCID: PMC7978844 DOI: 10.6061/clinics/2021/e2808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/24/2021] [Indexed: 02/03/2023] Open
Affiliation(s)
- Vera Maria Cury Salemi
- Unidade Clinica de Insuficiencia Cardiaca, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Unidade Coronaria, Hospital Sirio Libanes, Sao Paulo, SP, BR
| | - Dania Mohty
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Sonia Lages Lustosa de Altavila
- Unidade Clinica de Insuficiencia Cardiaca, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | - Roberto Kalil
- Unidade Clinica de Insuficiencia Cardiaca, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Unidade Coronaria, Hospital Sirio Libanes, Sao Paulo, SP, BR
| | - Edimar Alcides Bocchi
- Unidade Clinica de Insuficiencia Cardiaca, Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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14
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Fadel BM, Pibarot P, Kazzi BE, Al-Admawi M, Galzerano D, Alhumaid M, Alamro B, Mahjoub H, Echahidi N, Mohty D. Spectral Doppler Interrogation of the Pulmonary Veins for the Diagnosis of Cardiac Disorders: A Comprehensive Review. J Am Soc Echocardiogr 2021; 34:223-236. [DOI: 10.1016/j.echo.2020.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
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15
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Mohty D, Pibarot P, Damy T. Aortic stenosis and amyloid heart disease: 'the 2A dangerous liaisons'. Eur Heart J 2020; 41:2815. [PMID: 32738048 DOI: 10.1093/eurheartj/ehaa549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Dania Mohty
- Heart Center, King Faisal Specialist Hospital & Research Center, PO Box: 3354, MBC # 16, Riyadh, 11211, Saudi Arabia.,Cardiology Department, CHU Limoges, Limoges, France.,Al Faisal University, Riyadh, Saudia Arabia
| | | | - Thibaud Damy
- French Referral Center for Cardiac Amyloidosis, Mondor Network, Créteil F-94010, France
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16
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Ternacle J, Krapf L, Mohty D, Magne J, Nguyen A, Galat A, Gallet R, Teiger E, Côté N, Clavel MA, Tournoux F, Pibarot P, Damy T. Aortic Stenosis and Cardiac Amyloidosis. J Am Coll Cardiol 2019; 74:2638-2651. [DOI: 10.1016/j.jacc.2019.09.056] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 01/03/2023]
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17
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Galat A, Guellich A, Bodez D, Lipskaia L, Moutereau S, Bergoend E, Hüe S, Ternacle J, Mohty D, Monin JL, Derumeaux G, Radu C, Damy T. Causes and consequences of cardiac fibrosis in patients referred for surgical aortic valve replacement. ESC Heart Fail 2019; 6:649-657. [PMID: 31115164 PMCID: PMC6676299 DOI: 10.1002/ehf2.12451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 03/02/2019] [Accepted: 04/21/2019] [Indexed: 12/25/2022] Open
Abstract
Aims Cardiac fibrosis is associated with left ventricular (LV) remodelling and contractile dysfunction in aortic stenosis (AS). The fibrotic process in this condition is still unclear. The aim of this study was to determine the role of both local and systemic inflammation as underlying mechanisms of LV fibrosis and contractile dysfunction. The diagnostic values of 2D‐strain echocardiography and serum biomarkers in the evaluation of cardiac fibrosis in this condition were assessed through correlation analyses. Methods and results Patients with AS referred for surgical valve replacement were prospectively and consecutively included. They all had a comprehensive echocardiography including 2D strain. Blood samples were collected to measure cytokines and inflammatory biomarkers using Luminex bead‐based assays. A per‐surgical myocardial biopsy of the basal antero‐septal segment (S1) was performed. Serial sections of each biopsy were stained with Sirius red. Digital image analysis was used to quantify fibrosis. Immunostainings using specific antibodies against macrophage, glycoprotein (gp) 130, and interleukin 6 (IL‐6) were also performed. Patients were divided into tertiles reflecting the severity of fibrosis: mild, moderate, and severe load (TF1 to TF3). The mean age of the 58 included patients was 73 ± 11 years. Twenty‐four (43%) were in New York Heart Association III–IV. Mean aortic valve area was 0.8 ± 0.2 cm2. Mean aortic stenosis peak velocity and mean gradient were respectively 4.5 ± 0.8 m/s and 54 ± 15 mmHg. The mean LV ejection fraction was 54 ± 12%, and the global LV longitudinal strain was −15 ± 4%. The mean S1 strain, corresponding to the biopsied region, was −10 ± 6% and was strongly correlated to fibrosis load (R = 0.83, P < 0.0001). TF3 was associated with higher mortality (P = 0.009), higher serum C‐reactive protein and IL‐6, and lower gp130 compared with the other tertiles (P < 0.05). IL‐6 and gp130 were expressed in the heart and respectively in the plasma membrane of macrophages and in the cytoplasm of both macrophages and cardiomyocytes. During follow‐up, three patients died and were all in the third fibrosis tertile. Conclusions We found a positive correlation between elevated inflammatory markers and degree of fibrosis load. These two parameters were associated with worse outcomes in patients with severe AS. Our results may be of interest especially in patients for whom a transcatheter aortic valve implantation is indicated and myocardial biopsy is not possible. Strategies aiming at preventing inflammation might be considered to decrease or limit the progression of cardiac fibrosis in patients followed for AS.
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Affiliation(s)
- Arnault Galat
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Département Hospitalo-Universitaire Ageing Thorax-Vessels-Blood (DHU ATVB), Créteil, France.,GRC Amyloid Research Institute, IMRB/INSERM U955, Créteil, France
| | - Aziz Guellich
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Département Hospitalo-Universitaire Ageing Thorax-Vessels-Blood (DHU ATVB), Créteil, France.,GRC Amyloid Research Institute, IMRB/INSERM U955, Créteil, France
| | - Diane Bodez
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Département Hospitalo-Universitaire Ageing Thorax-Vessels-Blood (DHU ATVB), Créteil, France.,GRC Amyloid Research Institute, IMRB/INSERM U955, Créteil, France
| | - Larissa Lipskaia
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Département Hospitalo-Universitaire Ageing Thorax-Vessels-Blood (DHU ATVB), Créteil, France.,GRC Amyloid Research Institute, IMRB/INSERM U955, Créteil, France
| | - Stéphane Moutereau
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Department of Biochemistry, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France
| | - Eric Bergoend
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Département Hospitalo-Universitaire Ageing Thorax-Vessels-Blood (DHU ATVB), Créteil, France.,Department of Cardiovascular Surgery, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France
| | - Sophie Hüe
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Department of Immunology, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France
| | - Julien Ternacle
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Département Hospitalo-Universitaire Ageing Thorax-Vessels-Blood (DHU ATVB), Créteil, France.,GRC Amyloid Research Institute, IMRB/INSERM U955, Créteil, France
| | - Dania Mohty
- Department of Cardiology, Dupuytren Hospital, CHU Limoges, Pôle Cœur-Poumon-Rein, Limoges, France
| | - Jean-Luc Monin
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Département Hospitalo-Universitaire Ageing Thorax-Vessels-Blood (DHU ATVB), Créteil, France.,GRC Amyloid Research Institute, IMRB/INSERM U955, Créteil, France
| | - Geneviève Derumeaux
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Département Hospitalo-Universitaire Ageing Thorax-Vessels-Blood (DHU ATVB), Créteil, France.,GRC Amyloid Research Institute, IMRB/INSERM U955, Créteil, France
| | - Costin Radu
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Département Hospitalo-Universitaire Ageing Thorax-Vessels-Blood (DHU ATVB), Créteil, France.,Department of Cardiovascular Surgery, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France
| | - Thibaud Damy
- UPEC, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Department of Cardiology, AP-HP, Henri-Mondor Teaching Hospital, Créteil, France.,Département Hospitalo-Universitaire Ageing Thorax-Vessels-Blood (DHU ATVB), Créteil, France.,GRC Amyloid Research Institute, IMRB/INSERM U955, Créteil, France.,Inserm, Clinical Investigation Centre 1430, AP-HP, Henri Mondor Teaching Hospital, Créteil, France
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18
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Fadel BM, Vriz O, Alassas K, Galzerano D, Alamro B, Mohty D. Manifestations of Cardiovascular Disorders on Doppler Interrogation of the Hepatic Veins. JACC Cardiovasc Imaging 2019; 12:1872-1877. [PMID: 30878421 DOI: 10.1016/j.jcmg.2019.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/12/2019] [Accepted: 01/24/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Bahaa M Fadel
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Alfaisal University, Riyadh, Saudi Arabia
| | - Olga Vriz
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; San Antonio Hospital, San Daniele del Friuli, Italy
| | - Khadija Alassas
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Domenico Galzerano
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Alfaisal University, Riyadh, Saudi Arabia; San Gennaro Hospital, Naples, Italy
| | - Bandar Alamro
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Alfaisal University, Riyadh, Saudi Arabia
| | - Dania Mohty
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Alfaisal University, Riyadh, Saudi Arabia; CHU Limoges, Limoges, France.
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19
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Ikonomidis I, Aboyans V, Blacher J, Brodmann M, Brutsaert DL, Chirinos JA, De Carlo M, Delgado V, Lancellotti P, Lekakis J, Mohty D, Nihoyannopoulos P, Parissis J, Rizzoni D, Ruschitzka F, Seferovic P, Stabile E, Tousoulis D, Vinereanu D, Vlachopoulos C, Vlastos D, Xaplanteris P, Zimlichman R, Metra M. The role of ventricular-arterial coupling in cardiac disease and heart failure: assessment, clinical implications and therapeutic interventions. A consensus document of the European Society of Cardiology Working Group on Aorta & Peripheral Vascular Diseases, European Association of Cardiovascular Imaging, and Heart Failure Association. Eur J Heart Fail 2019; 21:402-424. [PMID: 30859669 DOI: 10.1002/ejhf.1436] [Citation(s) in RCA: 172] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 02/06/2023] Open
Abstract
Ventricular-arterial coupling (VAC) plays a major role in the physiology of cardiac and aortic mechanics, as well as in the pathophysiology of cardiac disease. VAC assessment possesses independent diagnostic and prognostic value and may be used to refine riskstratification and monitor therapeutic interventions. Traditionally, VAC is assessed by the non-invasive measurement of the ratio of arterial (Ea) to ventricular end-systolic elastance (Ees). With disease progression, both Ea and Ees may become abnormal and the Ea/Ees ratio may approximate its normal values. Therefore, the measurement of each component of this ratio or of novel more sensitive markers of myocardial (e.g. global longitudinal strain) and arterial function (e.g. pulse wave velocity) may better characterize VAC. In valvular heart disease, systemic arterial compliance and valvulo-arterial impedance have an established diagnostic and prognostic value and may monitor the effects of valve replacement on vascular and cardiac function. Treatment guided to improve VAC through improvement of both or each one of its components may delay incidence of heart failure and possibly improve prognosis in heart failure. In this consensus document, we describe the pathophysiology, the methods of assessment as well as the clinical implications of VAC in cardiac diseases and heart failure. Finally, we focus on interventions that may improve VAC and thus modify prognosis.
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Affiliation(s)
- Ignatios Ikonomidis
- Second Cardiology Department, Echocardiography Department and Laboratory of Preventive Cardiology, Athens University Hospital Attikon, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Victor Aboyans
- Department of Cardiology, Dupuytren University Hospital, Limoges, France.,Inserm 1094, Limoges School of Medicine, Limoges, France
| | - Jacque Blacher
- Diagnosis and Therapeutic Center, Hypertension and Cardiovascular Prevention Unit, Paris-Descartes University, Hôtel-Dieu Hospital, AP-HP, Paris, France
| | - Marianne Brodmann
- Division of Angiology, Department of Internal Medicine, Medical University Graz, Graz, Austria
| | - Dirk L Brutsaert
- Department of Cardiology, University Hospital Antwerp, Edegem, Belgium
| | - Julio A Chirinos
- Perelman School of Medicine and Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA, USA
| | - Marco De Carlo
- Cardiac Catheterization Laboratory, Cardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Patrizio Lancellotti
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU SantTilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - John Lekakis
- Second Cardiology Department, Echocardiography Department and Laboratory of Preventive Cardiology, Athens University Hospital Attikon, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dania Mohty
- Department of Cardiology, Dupuytren University Hospital, Limoges, France.,Inserm 1094, Limoges School of Medicine, Limoges, France
| | - Petros Nihoyannopoulos
- NHLI - National Heart and Lung Institute, Imperial College London, London, UK.,1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - John Parissis
- Heart Failure Unit, School of Medicine and Department of Cardiology, National and Kapodistrian University of Athens, Athens University Hospital Attikon, Athens, Greece
| | - Damiano Rizzoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Frank Ruschitzka
- Department of Cardiology, University Hospital, Zurich, University Heart Center, Zurich, Switzerland
| | - Petar Seferovic
- Cardiology Department, Clinical Centre Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Eugenio Stabile
- Department of Advanced Biomedical Sciences, 'Federico II' University, Naples, Italy
| | - Dimitrios Tousoulis
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dragos Vinereanu
- University of Medicine and Pharmacy 'Carol Davila', and Department of Cardiology, University and Emergency Hospital, Bucharest, Romania
| | - Charalambos Vlachopoulos
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Dimitrios Vlastos
- Second Cardiology Department, Echocardiography Department and Laboratory of Preventive Cardiology, Athens University Hospital Attikon, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Panagiotis Xaplanteris
- 1st Department of Cardiology, Hippokration Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Reuven Zimlichman
- Department of Medicine and Hypertension Institute, Brunner Institute for Cardiovascular Research, Sackler Faculty of Medicine, The E. Wolfson Medical Center, Institute for Quality in Medicine, Israeli Medical Association, Tel Aviv University, Tel Aviv, Israel
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
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Magne J, Cosyns B, Popescu BA, Carstensen HG, Dahl J, Desai MY, Kearney L, Lancellotti P, Marwick TH, Sato K, Takeuchi M, Zito C, Casalta AC, Mohty D, Piérard L, Habib G, Donal E. Distribution and Prognostic Significance of Left Ventricular Global Longitudinal Strain in Asymptomatic Significant Aortic Stenosis. JACC Cardiovasc Imaging 2019; 12:84-92. [DOI: 10.1016/j.jcmg.2018.11.005] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 02/06/2023]
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21
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Le Bivic L, Magne J, Blossier JD, Piccardo A, Wojtyna H, Lacroix P, Mohty D, Cornu E, Le Guyader A, Aboyans V. Mid- and long-term prognosis of off- vs. on-pump coronary artery bypass graft in patients with multisite artery disease. J Cardiovasc Surg (Torino) 2018; 60:388-395. [PMID: 30465418 DOI: 10.23736/s0021-9509.18.10697-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Among patients with coronary artery disease (CAD), around 25% have multisite artery disease (MSAD). Patients with CAD and MSAD are at higher risk of peri-operative and long-term cardiovascular events. Whether off-pump coronary bypass grafting (CABG) can improve their prognosis is unknown. We aimed to assess the benefits of off- vs. on-pump cardiac surgery in patients undergoing CABG, according to coexistence of extra-cardiac artery disease. METHODS Between April 1998 and September 2008, 1221 patients undergoing CABG without any other intervention were enrolled. Overall death and major cardiovascular events were recorded at 1-month and during long-term follow-up. A propensity score (PS), derived from all relevant variables (P<0.25) associated with on-pump as compared to off-pump CABG, and representing the likelihood for each individual patient to receive off-pump CABG, was calculated. RESULTS MSAD was observed in 279 patients (23%). Off-pump CABG was performed in 208 (17%) patients. The median follow-up was 7.6 years. The 10-year mortality was significantly lower in off- vs. on-pump CABG group (74±4% vs. 68±2%, P=0.024). In patients with MSAD, there was a trend for better survival for off- vs. on-pump CABG (63±8% vs. 50±4%, P=0.078). After adjustment for PS, we found no further difference between on- and off-pump CABG both in the whole cohort (HR=1.30, P=0.10), as well as in MSAD patients (HR=1.51, P=0.14). CONCLUSIONS Patients with MSAD receiving CABG are at worst prognostic than those with isolated CAD. In these patients, we found no significant difference in the long-term mortality and cardiovascular events between on- and off-pump CABG.
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Affiliation(s)
- Louis Le Bivic
- CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France.,INSERM 1094, Faculty of Medicine, Limoges, France.,CHU Limoges, Service of Thoracic and Cardiovascular Surgery, Dupuytren Hospital, Limoges, France
| | - Julien Magne
- CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France.,INSERM 1094, Faculty of Medicine, Limoges, France.,CHU Limoges, Service of Thoracic and Cardiovascular Surgery, Dupuytren Hospital, Limoges, France
| | - Jean-David Blossier
- CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France.,INSERM 1094, Faculty of Medicine, Limoges, France.,CHU Limoges, Service of Thoracic and Cardiovascular Surgery, Dupuytren Hospital, Limoges, France
| | - Alessandro Piccardo
- CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France.,INSERM 1094, Faculty of Medicine, Limoges, France.,CHU Limoges, Service of Thoracic and Cardiovascular Surgery, Dupuytren Hospital, Limoges, France
| | - Hélène Wojtyna
- CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France.,INSERM 1094, Faculty of Medicine, Limoges, France.,CHU Limoges, Service of Thoracic and Cardiovascular Surgery, Dupuytren Hospital, Limoges, France
| | - Philippe Lacroix
- CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France.,INSERM 1094, Faculty of Medicine, Limoges, France.,CHU Limoges, Service of Thoracic and Cardiovascular Surgery, Dupuytren Hospital, Limoges, France
| | - Dania Mohty
- CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France.,INSERM 1094, Faculty of Medicine, Limoges, France.,CHU Limoges, Service of Thoracic and Cardiovascular Surgery, Dupuytren Hospital, Limoges, France
| | - Elisabeth Cornu
- CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France.,INSERM 1094, Faculty of Medicine, Limoges, France.,CHU Limoges, Service of Thoracic and Cardiovascular Surgery, Dupuytren Hospital, Limoges, France
| | - Alexandre Le Guyader
- CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France.,INSERM 1094, Faculty of Medicine, Limoges, France.,CHU Limoges, Service of Thoracic and Cardiovascular Surgery, Dupuytren Hospital, Limoges, France
| | - Victor Aboyans
- CHU Limoges, Service of Cardiology, Dupuytren Hospital, Limoges, France - .,INSERM 1094, Faculty of Medicine, Limoges, France.,CHU Limoges, Service of Thoracic and Cardiovascular Surgery, Dupuytren Hospital, Limoges, France
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22
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Marek J, Palecek T, Magne J, Lavergne D, Boulogne C, Fadel BM, Jaccard A, Linhart A, Mohty D. Comparison of echocardiographic parameters in Fabry cardiomyopathy and light-chain cardiac amyloidosis. Echocardiography 2018; 35:1755-1763. [PMID: 30247786 DOI: 10.1111/echo.14144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/06/2018] [Accepted: 08/25/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Fabry cardiomyopathy (FC) and light-chain amyloid cardiomyopathy (AL) present with concentric left ventricular (LV) hypertrophy/remodeling and diastolic rather than systolic dysfunction. Direct comparisons are difficult due to rarity and confounded by variability of LV thickness. AIMS To compare LV diastolic and systolic properties between patients with FC and AL in a cohort matched for interventricular septal thickness (IVS). METHODS A two-center echocardiographic analysis was performed, comprising 118 patients with IVS ≥12 mm (FC and AL 59 patients each) matched by IVS. RESULTS Fabry cardiomyopathy patients had larger LV end-diastolic diameter (47.7 [44.0-50.9] vs 45.0 [41.5-49.0] mm, P = 0.002), better LV ejection fraction (EF 68.7 [63.4-74.0] vs 63.0 [54.0-70.0]%, P = 0.001) and midwall fractional shortening (midFS 14.8 [13.0-16.1] vs 12.1 [8.9-15.0]%, P = 0.006). LV EF <40% was rare in both (2% vs 7%, P = 0.17). AL patients expressed higher LV diastolic dysfunction grade (III in 26% vs 4%, II in 21% vs 12% and I in 54% vs 84%, P = 0.004), with higher E/e' ratio (13.6 [10.2-18.8] vs 9.8 [7.5-12.3], P < 0.0001). Average E/e' ratio and midFS were significantly associated with NYHA severity in both groups (P < 0.05 for all). CONCLUSIONS Matched AL patients had worse LV diastolic function than FC, driven by E/e'. Significant LV systolic dysfunction was rare overall. MidFS and E/e' were associated with heart failure severity in both groups.
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Affiliation(s)
- Josef Marek
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Tomas Palecek
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Julien Magne
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - David Lavergne
- Department of Hematology, National Reference Center for Light-chain Systemic Amyloidosis, Dupuytren University Hospital, Limoges, France
| | - Cyrille Boulogne
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Bahaa M Fadel
- Section of Adult Cardiology, Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Arnaud Jaccard
- Department of Hematology, National Reference Center for Light-chain Systemic Amyloidosis, Dupuytren University Hospital, Limoges, France
| | - Ales Linhart
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Dania Mohty
- Department of Cardiology, Dupuytren University Hospital, Limoges, France.,Section of Adult Cardiology, Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
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23
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Mohty D, Petitalot V, Magne J, Fadel BM, Boulogne C, Rouabhia D, Hamel CE, Lavergne D, Damy T, Aboyans V, Jaccard A. Author's reply. J Cardiol 2018; 72:368. [PMID: 30122209 DOI: 10.1016/j.jjcc.2018.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 02/14/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Dania Mohty
- Department of Cardiology, Dupuytren University Hospital, Limoges, France.
| | - Vincent Petitalot
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Julien Magne
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Bahaa M Fadel
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Cyrille Boulogne
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | | | - Chahrazed El Hamel
- Department of Nephrology, Dupuytren University Hospital, Limoges, France
| | - David Lavergne
- Department of Hematology, National Reference Center of Light-chain Systemic Amyloidosis, Dupuytren University Hospital, Limoges, France
| | - Thibaud Damy
- Department of Cardiology, AP-HP, Henri Mondor University Hospital, Creteil, France
| | - Victor Aboyans
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Arnaud Jaccard
- Department of Hematology, National Reference Center of Light-chain Systemic Amyloidosis, Dupuytren University Hospital, Limoges, France
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24
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Mohty D, Duhamel S, Magne J, Lavergne D, Bordessoule D, Aboyans V, Guthrie S, Jaccard A. P1813Incidence and prevalence of light chain amyloidosis: a population-based study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Mohty
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
| | - S Duhamel
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
| | - J Magne
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
| | - D Lavergne
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
| | | | - V Aboyans
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
| | - S Guthrie
- Biopharma Consulting, San Fransisco, United States of America
| | - A Jaccard
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
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25
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Magne J, Serena C, Salerno B, Mohty D, Marsaud JP, Blossier JD, Piccardo A, Cornu E, Le Guyader A, Aboyans V. Which echocardiographic parameters improve the risk prediction for peri-operative outcomes in patients undergoing coronary bypass surgery: a prospective study. Eur Heart J Acute Cardiovasc Care 2018; 9:504-512. [PMID: 29629598 DOI: 10.1177/2048872618768004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the performance of transthoracic echocardiographic parameters to predict operative mortality and morbidity in patients undergoing coronary artery bypass grafting, and to assess its incremental prognostic value as compared to the Society of Thoracic Surgeons (STS) score. MATERIALS AND METHODS We prospectively collected the clinical and biological data required to calculate the STS score in patients hospitalised for coronary artery bypass grafting. Preoperative transthoracic echocardiography was performed for each patient. The primary endpoint was 30-day mortality or major morbidity (i.e. stroke, renal failure, prolonged ventilation, deep sternal wound infection, reoperation) as defined by the STS. The secondary endpoint was prolonged hospitalisation for over 14 days. RESULTS A total of 172 patients was included (mean age 66.1±10.2 years, 12.2% were women). The primary endpoint occurred in 33 patients (19.2%), and 28 patients (16.3%) had a prolonged hospital stay. Independent predictive factors for the primary endpoint were an increased left atrial volume (>31 mL/m²; odds ratio (OR) 3.55, 95% confidence interval (CI) 1.38-9.12; P=0.004) and a decreased tricuspid annular plane systolic excursion (<20 mm; OR 3.45, 95% CI 1.47-8.21; P=0.008). The predictive value of the multivariate model increased when the two echocardiographic parameters were added to the STS score (area under the curve 0.598 vs. 0.695, P=0.001; integrated discrimination improvement 7.44%). CONCLUSION In patients undergoing coronary artery bypass grafting, preoperative assessment of left atrial size and tricuspid annular plane systolic excursion should be performed systematically, as it provides additional prognostic information to the STS score.
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Affiliation(s)
- Julien Magne
- Service Cardiologie, CHU Limoges, France.,Faculté de médecine de Limoges, INSERM 1094, France
| | - Claire Serena
- Service d'Anesthésie-Réanimation, CHU Limoges, France
| | | | - Dania Mohty
- Service Cardiologie, CHU Limoges, France.,Faculté de médecine de Limoges, INSERM 1094, France
| | | | | | | | - Elisabeth Cornu
- Service de Chirurgie Thoracique et Cardio-Vasculaire, CHU Limoges, France
| | | | - Victor Aboyans
- Service Cardiologie, CHU Limoges, France.,Faculté de médecine de Limoges, INSERM 1094, France
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26
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Magne J, Guinot B, Le Guyader A, Bégot E, Marsaud JP, Mohty D, Aboyans V. Relation Between Renin-Angiotensin System Blockers and Survival Following Isolated Aortic Valve Replacement for Aortic Stenosis. Am J Cardiol 2018; 121:455-460. [PMID: 29254679 DOI: 10.1016/j.amjcard.2017.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/03/2017] [Accepted: 11/07/2017] [Indexed: 11/30/2022]
Abstract
Renin-angiotensin system blockers (RASb) improve cardiac remodeling, but their clinical utility after surgical aortic valve replacement (SAVR) for aortic stenosis (AS) is unclear. We aimed to assess the impact of RASb on short- and long-term survival following isolated SAVR for severe AS. From January 2005 to January 2014, 508 consecutive patients had isolated SAVR for severe AS. Patients with RASb (n = 286; 53%) were more often female (p = 0.039), hypertensive (p < 0.0001), and diabetic (p = 0.004), with higher body mass index (p < 0.0001) and EuroSCORE II (p = 0.025), and lower mean aortic pressure gradient (p = 0.011). The 30-day mortality was similar in both groups (RASb: 3% vs no RASb: 5.8%, p = 0.13), but lower under angiotensin receptor blockers (ARB) than angiotensin-converting enzyme inhibitors (ACEi; 0.7% vs 5.6%, p = 0.017). Patients under RASb had a better 8-year survival than those without RASb (83 ± 3% vs 52 ± 5%, p < 0.0001), confirmed in a propensity score-matched pairs analysis (82 ± 4% vs 50 ± 7%, p < 0.0001). Regarding different types of RASb, patients under ARB had lower mortality than those under ACEi (87 ± 3% vs 79 ± 4%, p = 0.028). In multivariate analysis, the use of RASb was associated with improved survival (hazard ratio = 0.31, 95% confidence interval 0.20 to 0.47, p < 0.0001), with lower mortality under ARB than under ACEi (hazard ratio = 0.39, 95% confidence interval 0.18 to 0.85, p = 0.018). In this observational study, the use of RASb was associated with improved long-term outcome after isolated SAVR for severe AS. A randomized clinical trial is mandatory.
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Affiliation(s)
- Julien Magne
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges, France; INSERM 1094, Faculté de médecine de Limoges, Limoges, France
| | - Barthélémy Guinot
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges, France
| | | | - Emmanuelle Bégot
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges, France
| | | | - Dania Mohty
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges, France; INSERM 1094, Faculté de médecine de Limoges, Limoges, France
| | - Victor Aboyans
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges, France; INSERM 1094, Faculté de médecine de Limoges, Limoges, France.
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27
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Bodez D, Guellich A, Vergeylen U, Alonso E, Guendouz S, Galat A, Itti E, Planté-Bordeneuve V, Dubois-Randé J, Hittinger L, Deux J, Mohty D, Damy T. Usefulness of longitudinal left atrial dysfunction assessed by 2D-strain echocardiography for thromboembolic events evaluation in patients with cardiac amyloidosis. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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28
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Jarlan L, Magne J, Desormais I, Rolle F, Lacroix P, Mohty D, Aboyans V. Risk stratification for silent coronary artery disease in patients with type-2 diabetes mellitus: Contribution of vascular duplex ultrasound. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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29
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Keraval S, Magne J, Desormais I, Mohty D, Lacroix P, Aboyans V. Pulmonary embolism: Association between deep vein thrombosis, clinical profile and long-term outcome. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Goudelin M, Magne J, Bonnaud P, Mohty D, Aboyans V. Impact of cardiac rehabilitation on exercise oscillatory ventilation in patients with chronic heart failure and reduced left ventricular ejection fraction. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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31
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Mohty D, Petitalot V, Magne J, Fadel BM, Boulogne C, Rouabhia D, ElHamel C, Lavergne D, Damy T, Aboyans V, Jaccard A. Left atrial function in patients with light chain amyloidosis: A transthoracic 3D speckle tracking imaging study. J Cardiol 2017; 71:419-427. [PMID: 29153741 DOI: 10.1016/j.jjcc.2017.10.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 09/27/2017] [Accepted: 10/07/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Systemic light chain amyloidosis (AL) is characterized by the extracellular deposition of amyloid fibrils. Transthoracic echocardiography is the modality of choice to assess cardiac function in patients with AL. Whereas left ventricular (LV) function has been well studied in this patient population, data regarding the value of left atrial (LA) function in AL patients are lacking. In this study, we aim to examine the impact of LA volumes and function on survival in AL patients as assessed by real-time 3D echocardiography. METHODS A total of 77 patients (67±10 years, 60% men) with confirmed AL and 39 healthy controls were included. All standard 2D echocardiographic and 3D-LA parameters were obtained. RESULTS Fourteen patients (18%) were in Mayo Clinic (MC) stage I, 30 (39%) in stage II, and 33 (43%) in stage III at initial evaluation. There was no significant difference among the MC stages groups in terms of age, gender, or cardiovascular risk factors. As compared to patients in MC II and MC I, those in MC III had significantly larger indexed 3D-LA volumes (MCIII: 46±15mL/m2, MC II: 38±12mL/m2, and MC I: 23±9mL/m2, p<0.0001), lower 3D-LA total emptying fraction (3D-tLAEF) (21±13% vs. 31±15% vs. 43±7%, respectively, p<0.0001), and worse 3D peak atrial longitudinal strain (3D-PALS) (11±9% vs. 18±13% vs. 20±7%, respectively, p=0.007). Two-year survival was significantly lower in patients with 3D-tLAEF <+34% (p=0.003) and in those with 3D-PALS <+14% (p=0.034). Both parameters provided incremental prognostic value over maximal LA volume in multivariate analysis. CONCLUSION Functional LA parameters are progressively altered in AL patients according to the MC stage. A decrease in 3D-PALS is associated with worse outcome, independently of LA volume.
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Affiliation(s)
- Dania Mohty
- Department of Cardiology, Dupuytren University Hospital, Limoges, France; Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
| | - Vincent Petitalot
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Julien Magne
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Bahaa M Fadel
- Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Cyrille Boulogne
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | | | - Chahrazed ElHamel
- Department of Nephrology, Dupuytren University Hospital, Limoges, France
| | - David Lavergne
- Department of Hematology, National Reference Center of Light-chain Systemic Amyloidosis, Dupuytren University Hospital, Limoges, France
| | - Thibaud Damy
- Department of Cardiology, AP-HP, Henri Mondor University Hospital, Creteil, France
| | - Victor Aboyans
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Arnaud Jaccard
- Department of Hematology, National Reference Center of Light-chain Systemic Amyloidosis, Dupuytren University Hospital, Limoges, France
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32
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Desormais I, Aboyans V, Guerchet M, Ndamba-Bandzouzi B, Mbelesso P, Mohty D, Marin B, Dartigues JF, Preux PM, Lacroix P. Ankle-Brachial Index: An Ubiquitous Marker of Cognitive Impairment-The EPIDEMCA Study. Angiology 2017; 69:497-506. [PMID: 29096531 DOI: 10.1177/0003319717736608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Epidemiological research on the implication of atherosclerosis in the development of cognitive impairment is lacking in low- and middle-income countries, where two-thirds of the individuals affected by dementia live. Individuals aged ≥65 years living in urban and rural areas of 2 countries in Central Africa were invited. Demographic, clinical, and biological data were collected, and the ankle-brachial index (ABI) was measured. Cognitive impairment was defined according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Among 1662 participants (age 72.9 years, 59.3% females), the prevalence of cognitive impairment was 13.6%, which is higher in individuals with ABI ≤ 0.90 and ABI ≥ 1.40 than those with 0.90 < ABI < 1.40 (20.1% and 17% vs 12%, P = .0024). Cognitive impairment was significantly associated with the factors such as age (odds ratio [OR]: 1.09; 95% confidence interval [CI]: 1.07-1.12, P < .0001), female gender (OR: 2.36, 95% CI: 1.59-3.49, P < .0001), smoking (OR: 1.54, 95% CI: 1.06-2.23, P = .0026), and low ABI (≤0.90; OR: 1.52, 95% CI: 1.03-2.25, P = .0359). The ABI, a ubiquitous marker of atherosclerosis, provides independent and incremental information on susceptibility to present with cognitive disorders.
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Affiliation(s)
- Ileana Desormais
- 1 INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France.,2 Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, Limoges, France
| | - Victor Aboyans
- 1 INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France.,3 Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Maëlenn Guerchet
- 1 INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France.,4 Department of Health Service and Population Research, Centre for Global Mental Health, Institute of Psychiatry, King's College London, London, United Kingdom
| | | | - Pascal Mbelesso
- 6 Department of Neurology, Amitié Hospital, Bangui, Central African Republic
| | - Dania Mohty
- 1 INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France.,3 Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Benoît Marin
- 1 INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France.,7 Department of Medical Information and Evaluation, Clinical Research and Biostatistic Unit, Dupuytren University Hospital, Limoges, France
| | | | - Pierre-Marie Preux
- 1 INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France.,7 Department of Medical Information and Evaluation, Clinical Research and Biostatistic Unit, Dupuytren University Hospital, Limoges, France
| | - Philippe Lacroix
- 1 INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France.,2 Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, Limoges, France
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Guinot B, Magne J, Le Guyader A, Bégot E, Bourgeois A, Piccardo A, Marsaud JP, Mohty D, Aboyans V. Usefulness of Electrocardiographic Strain to Predict Survival After Surgical Aortic Valve Replacement for Aortic Stenosis. Am J Cardiol 2017; 120:1359-1365. [PMID: 28823481 DOI: 10.1016/j.amjcard.2017.06.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/15/2017] [Accepted: 06/30/2017] [Indexed: 11/28/2022]
Abstract
Electrocardiographic (ECG) strain has been reported as a specific marker of midwall left ventricular (LV) myocardial fibrosis, predictive of adverse clinical outcomes in aortic stenosis (AS), but its prognostic impact after aortic valve replacement (AVR) is unknown. We aimed to assess the impact of ECG strain on long-term mortality after surgical AVR for AS. From January 2005 to January 2014, patients with interpretable preoperative ECG who underwent isolated AVR for AS were included. ECG strain was defined as ≥1-mm concave downslopping ST-segment depression with asymmetrical T-wave inversion in lateral leads. Mortality was assessed over a follow-up period of 4.8 ± 2.7 years. Among the 390 patients included, 110 had ECG strain (28%). They had significantly lower body mass index, higher mean transaortic pressure gradient and Cornell-product ECG LV hypertrophy than in those without ECG strain. There was also a trend for lower LV ejection fraction in patients with ECG strain as compared with those without. Patients with ECG strain had significantly lower 8-year survival than those without. ECG strain remained associated with reduced survival both in patients with and without LV hypertrophy (p <0.0001 for both). After adjustment, ECG strain remained a strong and independent determinant of long-term survival (hazard ratio 4.4, p <0.0001). Similar results were found in patients with LV hypertrophy or without LV hypertrophy. In the multivariate model, the addition of ECG strain provided incremental prognostic value (p <0.0001). In conclusion, in patients with AS, ECG strain is associated with 4-fold increased risk of long-term mortality after isolated AVR, regardless of preoperative LV hypertrophy.
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Affiliation(s)
- Barthélémy Guinot
- Hôpital Dupuytren, Service Cardiologie, CHU Limoges, Limoges, France
| | - Julien Magne
- Hôpital Dupuytren, Service Cardiologie, CHU Limoges, Limoges, France; Faculté de médecine de Limoges, INSERM 1094, Limoges, France
| | | | - Emmanuelle Bégot
- Hôpital Dupuytren, Service Cardiologie, CHU Limoges, Limoges, France
| | - Antoine Bourgeois
- Hôpital Dupuytren, Service Cardiologie, CHU Limoges, Limoges, France
| | - Alessandro Piccardo
- Hôpital Dupuytren, Service de Chirurgie cardiaque, CHU Limoges, Limoges, France
| | | | - Dania Mohty
- Hôpital Dupuytren, Service Cardiologie, CHU Limoges, Limoges, France; Faculté de médecine de Limoges, INSERM 1094, Limoges, France
| | - Victor Aboyans
- Hôpital Dupuytren, Service Cardiologie, CHU Limoges, Limoges, France; Faculté de médecine de Limoges, INSERM 1094, Limoges, France.
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Aboyans V, Desormais I, Magne J, Morange G, Mohty D, Lacroix P. Renal Artery Stenosis in Patients with Peripheral Artery Disease: Prevalence, Risk Factors and Long-term Prognosis. Eur J Vasc Endovasc Surg 2017; 53:380-385. [DOI: 10.1016/j.ejvs.2016.10.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 10/30/2016] [Indexed: 12/31/2022]
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Aboyans V, Magne J, Guinot B, Bourgeois A, Piccardo A, Guyader AL, Mohty D. IMPACT OF RENIN-ANGIOTENSIN SYSTEM BLOCKERS ON LONG TERM SURVIVAL FOLLOWING ISOLATED AORTIC VALVE REPLACEMENT FOR AORTIC STENOSIS. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)35312-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Magne J, Guinot B, Mohty D, Bourgeois A, Piccardo A, Guyader AL, Aboyans V. ELECTROCARDIOGRAPHIC STRAIN IS ASSOCIATED WITH REDUCED SURVIVAL AFTER SURGICAL AORTIC VALVE REPLACEMENT FOR AORTIC STENOSIS. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)35321-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Maurer M, Lousada I, Hanna M, Ruberg F, Mohty D, Dispenzieri A, Liedtke M, Paulson I, Vest J, Grogan M. Recommendations from the Amyloidosis Research Consortium Educational Roundtable at the American College of Cardiology Annual Meeting, 1 April 2016. Amyloid 2017; 24:165-166. [PMID: 28434366 DOI: 10.1080/13506129.2017.1286582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mathew Maurer
- a Clinical Cardiovascular Research Laboratory for the Elderly, Columbia University Medical Center, Columbia University , New York , NY, USA
| | | | - Mazen Hanna
- c Heart Failure Intensive Care Unit, Cleveland Clinic , Cleveland , OH , USA
| | - Frederick Ruberg
- d Advanced Cardiovascular Imaging Program, Boston University , Boston , MA , USA
| | - Dania Mohty
- e Department of Cardiology , Université de Limoges , Limoges , France
| | | | | | - Ingrid Paulson
- h Prothena Biosciences Inc. , South San Francisco , CA , USA , and
| | - John Vest
- i Alnylam Pharmaceuticals , Cambridge , MA , USA
| | - Martha Grogan
- f Mayo Clinic College of Medicine , Rochester , MN , USA
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Magne J, Mohty D, Aboyans V. Small aortic root in aortic stenosis: a bystander of atherosclerotic burden? Eur Heart J Cardiovasc Imaging 2017; 18:413-414. [DOI: 10.1093/ehjci/jew318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mohty D, Magne J, Aboyans V. Global longitudinal strain: mature for early detection of anthracyclines-induced cardiotoxicity? Eur Heart J Cardiovasc Imaging 2017; 18:402-403. [DOI: 10.1093/ehjci/jew310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Magne J, Salerno B, Mohty D, Serena C, Rolle F, Piccardo A, Echahidi N, Le Guyader A, Aboyans V. Echocardiography is useful to predict postoperative atrial fibrillation in patients undergoing isolated coronary bypass surgery: A prospective study. European Heart Journal: Acute Cardiovascular Care 2017; 8:104-113. [DOI: 10.1177/2048872616688419] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Postoperative atrial fibrillation is a major complication following coronary artery bypass graft. We hypothesized that, beyond clinical and electrocardiogram (ECG) data, transthoracic echocardiography could improve the prediction of postoperative atrial fibrillation. Methods: We prospectively studied 169 patients in sinus rhythm who underwent isolated coronary artery bypass graft in our institution. Clinical, biological, ECG and transthoracic echocardiography data were collected within 24 h before surgery. The patients were continuously monitored during the first five days, and then had daily 12-lead ECG afterwards until discharge. Postoperative atrial fibrillation was defined by any episode >10 min. Results: Postoperative atrial fibrillation was found in 65 patients (38%). Compared with those without, patients with postoperative atrial fibrillation were significantly older ( p=0.008), had more frequently a history of hypertension ( p=0.009), history of atrial fibrillation ( p<0.001) and New York Heart Association class ⩾III ( p=0.004). They also had longer PR interval ( p=0.005), higher preoperative NT-pro brain natriuretic peptide level ( p=0.006), left ventricle end-diastolic volume ( p=0.002), indexed left ventricle mass ( p<0.0001), indexed maximal left atrial volume ( p<0.0001), maximal right atrial area ( p<0.001) and lower left ventricle ejection fraction ( p=0.04). In multivariate analysis, history of atrial fibrillation (odds ratio =6.1, 95% confidence interval: 1.4–26.0, p=0.02) and indexed maximal left atrial volume (odds ratio =1.13, 95% confidence interval: 1.1–1.2, p=0.001) were the only two independent predictive factors of postoperative atrial fibrillation. The addition of echocardiographic parameters improved the predictive value (χ2) of the model, from 34 to 57. Conclusion: A history of atrial fibrillation and indexed left atrial maximal volume are the best predictors of the occurrence of postoperative atrial fibrillation following coronary artery bypass graft. The identification of high risk population of postoperative atrial fibrillation using these two factors could lead to the development of targeted strategies to limit this frequent complication in these patients.
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Affiliation(s)
- Julien Magne
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, France
- INSERM 1094, Faculté de médecine de Limoges, France
| | | | - Dania Mohty
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, France
- INSERM 1094, Faculté de médecine de Limoges, France
| | - Claire Serena
- CHU Limoges, Hôpital Dupuytren, Service de Chirurgie thoracique et cardiovasculaire, France
| | - Florence Rolle
- CHU Limoges, Hôpital Dupuytren, Service de Chirurgie thoracique et cardiovasculaire, France
| | - Alessandro Piccardo
- CHU Limoges, Hôpital Dupuytren, Service de Chirurgie thoracique et cardiovasculaire, France
| | | | - Alexandre Le Guyader
- CHU Limoges, Hôpital Dupuytren, Service de Chirurgie thoracique et cardiovasculaire, France
| | - Victor Aboyans
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, France
- INSERM 1094, Faculté de médecine de Limoges, France
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Martins E, Magne J, Pradelle V, Faugeras G, Caillloce D, Mohty D, Fleurant E, Karam H, Petitcolin P, Virot P, Aboyans V. Analysis of mortality rate in patients with ST-segment elevation myocardial infarction: the SCALIM registry. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30063-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Soufiani A, Ougnou H, Elhattab F, Bendagha N, Mahfoudi L, Lachhab F, Tribak M, Moughil S, Mohty D. Can significant mitral stenosis be a cause of paradoxical low gradient, low flow in patients with severe aortic stenosis? An echocardiographic and outcome study. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30217-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lebivic L, Magne J, Desormais I, Piccardo A, Lacroix P, Mohty D, Aboyans V. Prognostic value of ankle-brachial index according to methods of its calculation in patients undergoing coronary bypass surgery. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30280-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Koschutnik M, Ionin VA, Boeckstaens S, Zakhama L, Hinojar R, Chiu DYY, Kovacs A, Kochmareva EA, Saliba E, Stanojevic D, Aalen J, Chen XH, Zito C, Demerouti E, Smarz K, Krljanac G, Christensen NL, Cavalcante JL, Pal M, Magne J, Giannakopoulos G, Liu D, Chien CY, Moustafa TAMER, Schwaiger M, Zotter-Tufaro C, Aschauer S, Duca F, Kammerlander A, Bonderman D, Mascherbauer J, Zaslavskaya EL, Soboleva AV, Listopad OV, Malikov KN, Baranova EI, Shlyakhto EV, Van Der Hoogstraete M, Coltel N, De Laet N, Beernaerts C, Desmet K, Gillis K, Droogmans S, Cosyns B, Antit S, Herbegue B, Slama I, Belaouer A, Chenik S, Boussabah E, Thameur M, Masmoudi M, Benyoussef S, Fernandez-Golfin C, Gonzalez-Gomez A, Casas E, Garcia Martin A, Pardo A, Del Val D, Ruiz S, Moya JL, Barrios V, Jimenez Nacher JJ, Zamorano JL, Kalra PA, Green D, Hughes J, Sinha S, Abidin N, Muraru D, Lakatos BK, Surkova E, Peluso D, Toser Z, Tokodi M, Merkely B, Badano LP, Volkova AL, Rusina VA, Kokorin VA, Gordeev IG, Baudet M, Chartrand Lefebvre C, Chen-Tournoux A, Hodzic A, Tournoux F, Apostolovic S, Jankovic-Tomasevic R, Djordjevic-Radojkovic D, Salinger-Martinovic S, Kostic T, Tahirovic E, Dungen HD, Andersen OS, Gude E, Andreassen A, Aalen OO, Larsen CK, Remme EW, Smiseth OA, Xu HG, Liu FC, Zha DG, Cui K, Zhang AD, Trio O, Soraci E, Cusma Piccione M, D'amico G, Ioppolo A, Alibani L, Falanga G, Todaro MC, Oreto L, Nucifora G, Vizzari G, Pizzino F, Di Bella G, Carerj S, Boutsikou M, Perreas K, Katselis CH, Samanidis G, Antoniou TH, Karatasakis G, Zaborska B, Jaxa-Chamiec T, Maciejewski P, Bartoszewicz Z, Budaj A, Trifunovic D, Asanin M, Savic L, Matovic D, Petrovic M, Zlatic N, Mrdovic I, Dahl JS, Carter-Storch R, Bakkestroem R, Soendergaard E, Videbaek L, Moeller JE, Rijal S, Abdelkarim I, Althouse AD, Sharbaugh MS, Fridman Y, Han W, Soman P, Forman DE, Schindler JT, Gleason TG, Lee JE, Schelbert EB, Dekany G, Mandzak A, Chaurasia AK, Gyovai J, Hegedus N, Piroth ZS, Szabo GY, Fontos G, Andreka P, Cosyns B, Popescu BA, Carstensen HG, Dahl J, Desai M, Kearney L, Marwick T, Sato K, Takeuchi M, Zito C, Mohty D, Lancellotti P, Habib G, Noble S, Frei A, Mueller H, Hu K, Liebner E, Weidemann F, Herrmann S, Ertl G, Voelker W, Gorski A, Leyh R, Stoerk S, Nordbeck P, Tsai WC, Moustafa TAMER, Aldydamony MOHAMD, Aldydamony MOHAMD. Poster Session 5The imaging examination and quality assessmentP1064The natural course of heart failure with preserved ejection fraction (HFpEF) - insights from an exploratory echocardiographic registryP1065Epicardial fat and effectiveness of catheter radiofrequency ablation in patients with atrial fibrillation and metabolic syndromeP1066Systematic disinfection of echocardiographic probe after each examination to reduce the persistence of pathogens as a potential source of nosocomial infectionsP1067Left atrial mechanical function assessed by two-dimensional echocardiography in hypertensive patientsP1068Real live applications of three-dimensional echocardiographic quantification of the left ventricular volumes and function using an automated adaptive analytics algorithmP10693D echocardiographic left ventricular dyssynchrony indices in end stage kidney disease: associations and outcomesP1070Relative contribution of right ventricular longitudinal shortening and radial displacement to global pump function in healthy volunteersP1071ECHO-parameters, associated with short-term mortality and long-term complications in patients with pulmonary embolism of high and intermediate riskP1072Increased epicardial fat is an independent marker of heart failure with preserved ejection fraction.P1073Influence of optimized beta-blocker therapy on diastolic dysfunction determined echocardiographically in heart failure patientsP1074Early diastolic mitral flow velocity/ annular velocity ratio is a sensitive marker of elevated filling pressure in left ventricular dyssynchronyP1075Left ventricular diastolic function in STEMI patients receiving early and late reperfusion by percutaneous coronary intervention P1076Could anatomical and functional features predict cerebrovascular events in patients with patent foramen ovale?P1077Efficacy of endarterectomy of the left anterior descending artery: evaluation by adenosine echocardiography?P1078Left ventricular diastolic dysfunction after acute myocardial infarction with preserved ejection fraction is related to lower exercise capacityP1079Potentially predictors of ventricular arrhythmia during six months follow up in STEMI patientsP1080Association between left atrial dilatation and invasive haemodynamics at rest and during exercise in asymptimatic aortic stenosisP1081Cardiac amyloidosis and aortic stenosis - the convergence of two aging processes and its association with outcomesP1082Prognostic impact of initial left ventricular dysfunction and mean gradient after transcatheter aortic valve implantationP1083Distribution and prognostic significance of left ventricular global longitudinal strain in asymptomatic significant aortic stenosis: an individual participant data meta-analysisP1084Discrepancies between echocardiographic and invasive assessment of aortic stenosis in multimorbid elderly patientsP1085Echocardiographic determinants and outcome of patients with low-gradient moderate and severe aortic valve stenosis: implications for aortic valve replacementP1086Atrial deformation correlated with functional capacity in mitral stenosisP1087Net atrioventricular compliance can predict reduction of pulmonary artery pressure after percutaneous mitral balloon commissurotomy. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jung IH, Kurnicka K, Enache R, Nagy AI, Martins E, Cereda A, Vitiello G, Magda SL, Styczynski G, Lo Iudice F, De Barros Viegas H, Shahab F, Trunina I, Mata Caballero R, De Barros Viegas H, Marques A, Shimoni S, Generati G, Generati G, Bendix Salkvist Jorgensen T, Chen TE, Andrianova A, Fernandez-Golfin C, Corneli MC, Ali M, Seo HS, Kim MJ, Lichodziejewska B, Goliszek S, Dzikowska-Diduch O, Zdonczyk O, Kozlowska M, Kostrubiec M, Ciurzynski M, Palczewski P, Pruszczyk P, Popa E, Coman IM, Badea R, Platon P, Calin A, Beladan CC, Rosca M, Ginghina C, Popescu BA, Jurcut R, Venkateshvaran AI, Sola SC, Govind SC, Dash PK, Lund L, Manouras AI, Merkely B, Magne J, Aboyans V, Boulogne C, Lavergne D, Jaccard A, Mohty D, Casadei F, Spano F, Santambrogio G, Musca F, Belli O, De Chiara B, Bokor D, Giannattasio C, Corradi E, Colombo CA, Moreo A, Vicario ML, Castellani S, Cammelli D, Gallini C, Needleman L, Cruz BK, Maggi E, Marchionni N, Bratu VD, Mincu RI, Mihai CM, Gherghe AM, Florescu M, Cinteza M, Vinereanu D, Sobieraj P, Bielicki P, Krenke R, Szmigielski CA, Petitto M, Ferrone M, Esposito R, Vaccaro A, Buonauro A, Trimarco B, Galderisi M, Mendes L, Dores H, Melo I, Madeira V, Patinha J, Encarnacao C, Ferreia Santos J, Habib F, Soesanto AM, Sedyawan J, Abdurrazak G, Sharykin A, Popova NE, Karelina EV, Telezhnikova ND, Hernandez Jimenez V, Saavedra J, Molina L, Alberca MT, Gorriz J, L Pais J, Pavon I, Navea C, Alonso JJ, Mendes L, Sonia S, Madeira V, Encarnacao C, Patinha J, Melo I, Ferreia Santos J, Cruz I, Joao I, Gomes AC, Caldeira D, Lopes L, Fazendas P, Pereira H, Edri O, Edri O, Schneider N, Schneider N, Abaye N, Abaye N, Goerge J, Goerge J, Gandelman G, Gandelman G, Bandera F, Alfonzetti E, Guazzi M, Bandera F, Villani S, Ferraro O, Alfonzetti E, Guazzi M, Ramberg E, Bhardwaj P, Nepper ML, Binko TS, Olausson M, Fink-Jensen T, Andersen AM, Roland J, Gleerup Fornitz G, Ong K, Suri RM, Enrique-Sarano M, Michelena HI, Burkhart HM, Gillespie SM, Cha S, Mankad SV, Saidova MA, Bolotova MN, Salido Tahoces L, Izurieta C, Villareal G, Esteban A, Urena Vacas A, Ayala A, Jimenez Nacher JJ, Hinojar Baydes R, Gonzalez Gomez A, Garcia A, Mestre JL, Hernandez Antolin R, Zamorano Gomez JJ, Perea G, Covelli Y, Henquin R, Ronderos R, Hepinstall MJ, Cassidy CS, Pellikka PA, Pislaru SV, Kane G. P569Diastolic dyssynchrony is associated with exercise intolerance in hypertensive patients with left ventricular hypertrophyP570Echocardiographic pattern of acute pulmonary embolism, analysis of consecutive 511 patientsP571Clinical significance of ventricular interdependence and left ventricular function in patients with pulmonary hypertension receiving specific vasodilator therapyP572Haemodynamic characteristics and ventricular mechanics in post-capillary and combined pre- and post-capillary pulmonary hypertensionP573Relationship between hematological response and echocardiographic features in patients with light chains systemic amyloidosisP574Myocardial changes in patients with anorexia nervosaP575Giant cell arteritis presenting as fever of unknown origin: role of clinical history, early positron emission tomography and ultrasound screeningP576Subclinical systolic dysfunction in systemic sclerosis is not influenced by standard rheumatologic therapy - a 4D echocardiographic studyP577Cardiac index correlates with the degree of hepatic steathosis in obese patients with obstructive sleep apneaP578Myocardial mechanics in top-level endurance athletes: a three-dimensional speckle tracking studyP579The athlete heart: what happens to myocardial deformation in physiological adaptation to sportsP580Association between left ventricle intrinsic function and urine protein-creatinine ratio in preeclampsia before and after deliveryP581Dilatation of the aorta in children with bicuspid aortic valveP582Cardiovascular functional abnormalities in patients with osteogenesis imperfectaP583Dobutamine stress test fast protocol: diagnostic accuracy and securityP584Prognostic value of non-positive exercise echocardiography in the patients submitted to percutaneous coronary interventionP585The use of myocardial strain imaging in the detection of coronary artery disease during stress echocardiographyP586Preserved O2 extraction exercise response in heart failure patients with chronotropic insufficiency: evidence for a central cardiac rather than peripheral oxygen uptake limitationP587Major determinant of O2 artero-venous difference at peak exercise in heart failure and healthy subjectsP588Stress echocardiography with contrast perfusion analysis for a more sensitive test for ischemic heart diseaseP589Assessment of mitral annular physiology in myxomatous mitral disease with 3D transesophageal echocardiography: comparison between early severe mitral regurgitation and decompensated groupP590Three-dimensional transesophageal echocardiographic assessment of the mitral valve geometry in patients with mild, moderate and severe chronic ischemic mitral regurgitationP591Left atrial appendage closure. Multimodality imaging in device size selectionP592Contributions of three-dimensional transesophageal echocardiography in the evaluation of aortic atherosclerotic plaquesP593Agitated blood-saline is superior to agitated air-saline for echocardiographic shunt studies. Eur Heart J Cardiovasc Imaging 2016; 17:ii102-ii109. [DOI: 10.1093/ehjci/jew248.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zamorano JL, Lancellotti P, Muñoz DR, Aboyans V, Asteggiano R, Galderisi M, Habib G, Lenihan DJ, Lip GY, Lyon AR, Fernandez TL, Mohty D, Piepoli MF, Tamargo J, Torbicki A, Suter TM. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines. Kardiol Pol 2016; 74:1193-1233. [DOI: 10.5603/kp.2016.0156] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Indexed: 11/25/2022]
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Bodez D, Galat A, Guellich A, Deux JF, Rosso J, Le Bras F, Funalot B, Fanen P, Benhaiem N, Planté-Bordeneuve V, Dubois-Randé JL, Lellouche N, Guendouz S, Molinier-Frenkel V, Mohty D, Damy T. Les amyloses cardiaques : les reconnaître et les prendre en charge. Presse Med 2016; 45:845-855. [DOI: 10.1016/j.lpm.2016.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 07/04/2016] [Indexed: 01/15/2023] Open
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Bodez D, Ternacle J, Guellich A, Galat A, Lim P, Radu C, Guendouz S, Bergoend E, Couetil JP, Hittinger L, Dubois-Randé JL, Plante-Bordeneuve V, Deux JF, Mohty D, Damy T. Prognostic value of right ventricular systolic function in cardiac amyloidosis. Amyloid 2016; 23:158-167. [PMID: 27348696 DOI: 10.1080/13506129.2016.1194264] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Right ventricular (RV) dysfunction is a strong predictor of poor outcomes in heart failure. Its prognostic meaning in cardiac amyloidosis (CA) is under-investigated. METHODS Hundred and twenty nine patients with suspected CA and an interventricular septum thickness (IVST) ≥ 12 mm underwent echocardiography with measurement of left ventricular (LV) and RV longitudinal strain (LS), late gadolinium-enhancement (LGE) cardiac MRI, and standard evaluation. RESULTS Among 82 confirmed CA, types were immunoglobulin light chain (AL, n = 26), hereditary transthyretin (m-TTR, n = 37) and senile (WT-TTR, n = 19). Compared to those without, CA patients had significantly lower RV fractional shortening (RV-FS), tricuspid annular plane systolic excursion (TAPSE), tissue Doppler systolic velocity, and global RV-LS, without any difference among the CA types. RV-LGE, observed in 62% of CA patients, was associated with lower global and basal RV-FS. Median follow-up was 8(2; 16) months. Using multivariate analysis, NYHA-class and low TAPSE independently predicted major adverse cardiac event (MACE) defined as death, heart transplantation and acute heart failure. Independent determinants of TAPSE < 14 mm, the best cut-off value, were LV ejection fraction (LVEF), estimated filling pressure (E/E'), NT-proBNP and pulmonary artery pressure, but not RV-LGE. CONCLUSIONS RV dysfunction is common in CA. Its routine evaluation by a simple TAPSE may be an aid in assessing the prognosis of CA patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Jean-François Deux
- d Department of Radiology, AP-HP, Henri-Mondor Teaching Hospital, UPEC; IMRB-GRC Amyloid Research Institute , DHU A-TVB and Mondor Amyloidosis Network, Inserm U955, Inserm Clinical Investigation Center 1430 , Créteil , France , and
| | - Dania Mohty
- e Department of Cardiology, Dupuytren Hospital, CHU Limoges , Pôle Cœur-Poumon-Rein, Limoges , France
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Damy T, Jaccard A, Guellich A, Lavergne D, Galat A, Deux JF, Hittinger L, Dupuis J, Frenkel V, Rigaud C, Plante-Bordeneuve V, Bodez D, Mohty D. Identification of prognostic markers in transthyretin and AL cardiac amyloidosis. Amyloid 2016; 23:194-202. [PMID: 27647161 DOI: 10.1080/13506129.2016.1221815] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The prognosis of amyloidosis is known to depend heavily on cardiac function and may be improved by identifying patients at highest risk for adverse cardiac events. AIMS Identify predictors of mortality in patients with cardiac light-chain amyloidosis (AL), hereditary transthyretin amyloidosis (m-TTR), or wild-type transthyretin amyloidosis (WT-TTR) to prompt physician to refer these patients to dedicated centers. METHODS AND RESULTS Observational study. About 266 patients referred for suspected cardiac amyloidosis (CA) in two French university centers were included. About 198 patients had CA (AL = 118, m-TTR = 57, and WT-TTR = 23). Their median (25th-75th percentile) age, NT-proBNP left ventricular ejection fraction were, respectively, 68 years (59-76), 2339 pg mL-1 (424-5974), and 60% (48-66). About 31% were in NYHA class III-IV. Interventricular septal thickness was greater in the m-TTR and WT-TTR groups than in the AL group (p < 0.0001). Median follow-up in survivor was 26 months (15-44) and 87 (44%) patients died. By multivariate analysis, independent predictors of mortality for AL amyloidosis were the following: age, cardiac output and NT-proBNP; for TTR amyloidosis was: NT-proBNP. When all amyloidosis were combined NT-proBNP, low cardiac output and pericardial effusion were independently associated with mortality. CONCLUSION NT-proBNP is a strong prognosticator in the three types of cardiac amyloidosis. High NT-proBNP, low cardiac output, and pericardial effusion at the time of screening should prompt physician to refer the patients to amyloidosis referral center.
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Affiliation(s)
- Thibaud Damy
- a Department of Cardiology , AP-HP, Henri Mondor Teaching Hospital , Créteil , France.,b University Paris-East (UPEC) School of Medicine , Créteil , France.,c GRC Amyloid Research Institute, IMRB INSERM U955 , Créteil , France.,d Mondor Amyloidosis Network, Henri Mondor Teaching Hospital , Créteil , France.,e AP-HP, INSERM, Clinical Investigations Center 1430, Henri Mondor Teaching Hospital , Créteil , France.,f Department of Clinical Research and Public Health , Clinical Investigations Center 006, Henri Mondor Teaching Hospital , Créteil , France
| | - Arnaud Jaccard
- g Department of Cardiology , Dupuytren Teaching Hospital , Limoges , France.,h Dupuytren Teaching Hospital, AL Amyloidosis Referral Center , Limoges , France
| | - Aziz Guellich
- a Department of Cardiology , AP-HP, Henri Mondor Teaching Hospital , Créteil , France.,b University Paris-East (UPEC) School of Medicine , Créteil , France.,c GRC Amyloid Research Institute, IMRB INSERM U955 , Créteil , France.,d Mondor Amyloidosis Network, Henri Mondor Teaching Hospital , Créteil , France
| | - David Lavergne
- g Department of Cardiology , Dupuytren Teaching Hospital , Limoges , France.,h Dupuytren Teaching Hospital, AL Amyloidosis Referral Center , Limoges , France
| | - Arnault Galat
- a Department of Cardiology , AP-HP, Henri Mondor Teaching Hospital , Créteil , France.,b University Paris-East (UPEC) School of Medicine , Créteil , France.,c GRC Amyloid Research Institute, IMRB INSERM U955 , Créteil , France.,d Mondor Amyloidosis Network, Henri Mondor Teaching Hospital , Créteil , France
| | - Jean-François Deux
- a Department of Cardiology , AP-HP, Henri Mondor Teaching Hospital , Créteil , France.,b University Paris-East (UPEC) School of Medicine , Créteil , France.,c GRC Amyloid Research Institute, IMRB INSERM U955 , Créteil , France.,i Department of Radiology , AP-HP, Henri Mondor Teaching Hospital , Créteil , France
| | - Luc Hittinger
- a Department of Cardiology , AP-HP, Henri Mondor Teaching Hospital , Créteil , France.,b University Paris-East (UPEC) School of Medicine , Créteil , France.,c GRC Amyloid Research Institute, IMRB INSERM U955 , Créteil , France.,d Mondor Amyloidosis Network, Henri Mondor Teaching Hospital , Créteil , France
| | - Jehan Dupuis
- b University Paris-East (UPEC) School of Medicine , Créteil , France.,d Mondor Amyloidosis Network, Henri Mondor Teaching Hospital , Créteil , France.,e AP-HP, INSERM, Clinical Investigations Center 1430, Henri Mondor Teaching Hospital , Créteil , France.,j Department of Hematology , AP-HP, Henri Mondor Teaching Hospital , Créteil , France
| | - Valérie Frenkel
- b University Paris-East (UPEC) School of Medicine , Créteil , France.,c GRC Amyloid Research Institute, IMRB INSERM U955 , Créteil , France.,l Department of Immunohematolgy , AP-HP, Henri Mondor Teaching Hospital , Créteil , France
| | - Charlotte Rigaud
- g Department of Cardiology , Dupuytren Teaching Hospital , Limoges , France.,h Dupuytren Teaching Hospital, AL Amyloidosis Referral Center , Limoges , France
| | - Violaine Plante-Bordeneuve
- b University Paris-East (UPEC) School of Medicine , Créteil , France.,c GRC Amyloid Research Institute, IMRB INSERM U955 , Créteil , France.,d Mondor Amyloidosis Network, Henri Mondor Teaching Hospital , Créteil , France.,e AP-HP, INSERM, Clinical Investigations Center 1430, Henri Mondor Teaching Hospital , Créteil , France.,f Department of Clinical Research and Public Health , Clinical Investigations Center 006, Henri Mondor Teaching Hospital , Créteil , France.,k Department of Neurology , AP-HP, Henri Mondor Teaching Hospital , Créteil , France , and
| | - Diane Bodez
- a Department of Cardiology , AP-HP, Henri Mondor Teaching Hospital , Créteil , France.,b University Paris-East (UPEC) School of Medicine , Créteil , France.,c GRC Amyloid Research Institute, IMRB INSERM U955 , Créteil , France.,d Mondor Amyloidosis Network, Henri Mondor Teaching Hospital , Créteil , France
| | - Dania Mohty
- g Department of Cardiology , Dupuytren Teaching Hospital , Limoges , France.,h Dupuytren Teaching Hospital, AL Amyloidosis Referral Center , Limoges , France
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Zamorano JL, Lancellotti P, Rodriguez Muñoz D, Aboyans V, Asteggiano R, Galderisi M, Habib G, Lenihan DJ, Lip GYH, Lyon AR, Lopez Fernandez T, Mohty D, Piepoli MF, Tamargo J, Torbicki A, Suter TM, Zamorano JL, Aboyans V, Achenbach S, Agewall S, Badimon L, Barón‐Esquivias G, Baumgartner H, Bax JJ, Bueno H, Carerj S, Dean V, Erol Ç, Fitzsimons D, Gaemperli O, Kirchhof P, Kolh P, Lancellotti P, Lip GYH, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Roffi M, Torbicki A, Vaz Carneiro A, Windecker S, Achenbach S, Minotti G, Agewall S, Badimon L, Bueno H, Cardinale D, Carerj S, Curigliano G, de Azambuja E, Dent S, Erol C, Ewer MS, Farmakis D, Fietkau R, Fitzsimons D, Gaemperli O, Kirchhof P, Kohl P, McGale P, Ponikowski P, Ringwald J, Roffi M, Schulz‐Menger J, Stebbing J, Steiner RK, Szmit S, Vaz Carneiro A, Windecker S. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines. Eur J Heart Fail 2016; 19:9-42. [DOI: 10.1002/ejhf.654] [Citation(s) in RCA: 227] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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