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Duvall C, Pavlovic N, Rosen N, Wand AL, Griffin J, Okada D, Chrispin J, Tandri H, Sharp M, Kasper E, Chen E, Gilotra N. Sex Differences In Presentation And Outcomes Of Cardiac Sarcoidosis. J Card Fail 2022. [DOI: 10.1016/j.cardfail.2022.03.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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2
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Bourfiss M, Prakken NHJ, James CA, Planken RN, Boekholdt SM, Ahmetagic D, van den Berg MP, Tichnell C, Van der Heijden JF, Loh P, Murray B, Tandri H, Kamel I, Calkins H, Asselbergs FW, Zimmerman SL, Velthuis BK, Te Riele ASJM. Prognostic value of strain by feature-tracking cardiac magnetic resonance in arrhythmogenic right ventricular cardiomyopathy. Eur Heart J Cardiovasc Imaging 2022; 24:98-107. [PMID: 35152298 PMCID: PMC9762936 DOI: 10.1093/ehjci/jeac030] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/28/2022] [Indexed: 12/24/2022] Open
Abstract
AIMS Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by ventricular dysfunction and ventricular arrhythmias (VA). Adequate arrhythmic risk assessment is important to prevent sudden cardiac death. We aimed to study the incremental value of strain by feature-tracking cardiac magnetic resonance imaging (FT-CMR) in predicting sustained VA in ARVC patients. METHODS AND RESULTS CMR images of 132 ARVC patients (43% male, 40.6 ± 16.0 years) without prior VA were analysed for global and regional right and left ventricular (RV, LV) strain. Primary outcome was sustained VA during follow-up. We performed multivariable regression assessing strain, in combination with (i) RV ejection fraction (EF); (ii) LVEF; and (iii) the ARVC risk calculator. False discovery rate adjusted P-values were given to correct for multiple comparisons and c-statistics were calculated for each model. During 4.3 (2.0-7.9) years of follow-up, 19% of patients experienced sustained VA. Compared to patients without VA, those with VA had significantly reduced RV longitudinal (P ≤ 0.03) and LV circumferential (P ≤ 0.04) strain. In addition, patients with VA had significantly reduced biventricular EF (P ≤ 0.02). After correcting for RVEF, LVEF, and the ARVC risk calculator separately in multivariable analysis, both RV and LV strain lost their significance [hazard ratio 1.03-1.18, P > 0.05]. Likewise, while strain improved the c-statistic in combination with RVEF, LVEF, and the ARVC risk calculator separately, this did not reach statistical significance (P ≥ 0.18). CONCLUSION Both RV longitudinal and LV circumferential strain are reduced in ARVC patients with sustained VA during follow-up. However, strain does not have incremental value over RVEF, LVEF, and the ARVC VA risk calculator.
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Affiliation(s)
- M Bourfiss
- Corresponding author. Tel: +31 88 77570240; Fax: +31 88 7555660. E-mail:
| | - N H J Prakken
- Department of Radiology, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - C A James
- Department of Cardiology, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21218, USA
| | - R N Planken
- Department of Radiology and nuclear medicine, Amsterdam University Medical Center, Amsterdam, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - S M Boekholdt
- Department of Cardiology, Amsterdam University Medical Center, Amsterdam, Location AMC, Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - D Ahmetagic
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - M P van den Berg
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - C Tichnell
- Department of Cardiology, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21218, USA
| | - J F Van der Heijden
- Division of Cardiology, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - P Loh
- Division of Cardiology, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - B Murray
- Department of Cardiology, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21218, USA
| | - H Tandri
- Department of Cardiology, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21218, USA
| | - I Kamel
- Department of Radiology, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21218, USA
| | - H Calkins
- Department of Cardiology, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21218, USA
| | - F W Asselbergs
- Division of Cardiology, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands,Faculty of Population Health Sciences, Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,Health Data Research UK and Institute of Health Informatics, University College London, Gower St, London WC1E 6BT, UK
| | - S L Zimmerman
- Department of Radiology, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21218, USA
| | - B K Velthuis
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - A S J M Te Riele
- Division of Cardiology, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands,Netherlands Heart Institute, Moreelsepark 1, 3511 EP Utrecht, The Netherlands
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3
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Griffin JM, Chasler J, Wand AL, Okada DR, Smith JN, Saad E, Tandri H, Chrispin J, Sharp M, Kasper EK, Chen ES, Gilotra NA. Management of Cardiac Sarcoidosis Using Mycophenolate Mofetil as a Steroid-Sparing Agent. J Card Fail 2021; 27:1348-1358. [PMID: 34166800 DOI: 10.1016/j.cardfail.2021.06.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Cardiac sarcoidosis (CS) is a major cause of morbidity and mortality in patients with systemic sarcoidosis. Steroid-sparing agents are increasingly used, despite a lack of randomized trials or published guidelines to direct treatment. METHODS AND RESULTS This retrospective study included 77 patients with CS treated with prednisone monotherapy (n = 32) or a combination with mycophenolate mofetil (n = 45) between 2003 and 2018. Baseline characteristics and clinical outcomes were evaluated. The mean patient age was 53 ± 11 years at CS diagnosis, 66.2% were male, and 35.1% were Black. The total exposure to maximum prednisone dose (initial prednisone dose × days at dose) was lower in the combination therapy group (1440 mg [interquartile range (IQR), 1200-2760 mg] vs 2710 mg [IQR, 1200-5080 mg]; P = .06). On 18F-fluorodeoxyglucose positron emission tomography scans, both groups demonstrated a significant decrease in the cardiac maximum standardized uptake value after treatment: a median decrease of 3.9 (IQR 2.7-9.0, P = .002) and 2.9 (IQR 0-5.0, P = .001) for prednisone monotherapy and combination therapy, respectively. Most patients experienced improvement or complete resolution in qualitative cardiac 18F-fluorodeoxyglucose uptake (92.3% and 70.4% for the prednisone and combination therapy groups, respectively). Mycophenolate mofetil was well tolerated. CONCLUSIONS Mycophenolate mofetil in combination with prednisone for the treatment of CS may minimize corticosteroid exposure and decrease cardiac inflammation without significant adverse effects.
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Affiliation(s)
- Jan M Griffin
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York
| | - Jessica Chasler
- Department of Pharmacy, Johns Hopkins Hospital, Baltimore, Maryland
| | - Alison L Wand
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - David R Okada
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - J Nikolhaus Smith
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elie Saad
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hari Tandri
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonathan Chrispin
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michelle Sharp
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Edward K Kasper
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Edward S Chen
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nisha A Gilotra
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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4
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Corrado D, van Tintelen PJ, McKenna WJ, Hauer RNW, Anastastakis A, Asimaki A, Basso C, Bauce B, Brunckhorst C, Bucciarelli-Ducci C, Duru F, Elliott P, Hamilton RM, Haugaa KH, James CA, Judge D, Link MS, Marchlinski FE, Mazzanti A, Mestroni L, Pantazis A, Pelliccia A, Marra MP, Pilichou K, Platonov PGA, Protonotarios A, Rampazzo A, Saffitz JE, Saguner AM, Schmied C, Sharma S, Tandri H, Te Riele ASJM, Thiene G, Tsatsopoulou A, Zareba W, Zorzi A, Wichter T, Marcus FI, Calkins H. Arrhythmogenic right ventricular cardiomyopathy: evaluation of the current diagnostic criteria and differential diagnosis. Eur Heart J 2021; 41:1414-1429. [PMID: 31637441 PMCID: PMC7138528 DOI: 10.1093/eurheartj/ehz669] [Citation(s) in RCA: 138] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 01/04/2019] [Accepted: 09/05/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Peter J van Tintelen
- Department of Clinical Genetics, Academic Medical Center, University of Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.,Department of Genetics, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
| | - William J McKenna
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation, 7GR5+RW Doha, Qatar.,Institute of Cardiovascular Science, University College London, 62 Huntley St, Fitzrovia, London WC1E 6DD, UK
| | - Richard N W Hauer
- Department of Cardiology, Netherlands Heart Institute, University Medical Center Utrecht, Moreelsepark 1, 3511 EP Utrecht, Netherlands
| | - Aris Anastastakis
- Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Centre, Leof. Andrea Siggrou 356, Kallithea 176 74, Greece
| | - Angeliki Asimaki
- Molecular and Clinical Sciences Research Institute, St. George's University of London NHS Trust, Cranmer Terrace, London SW17 0RE, UK
| | - Cristina Basso
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Barbara Bauce
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Corinna Brunckhorst
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Chiara Bucciarelli-Ducci
- Department of Cardiology, Bristol Heart Institute, University Hospitals Bristol NHS Foundation, Trust Headquarters, Marlborough St, Bristol BS1 3NU, UK
| | - Firat Duru
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Perry Elliott
- Institute of Cardiovascular Science, University College London, 62 Huntley St, Fitzrovia, London WC1E 6DD, UK
| | - Robert M Hamilton
- The Labatt Family Heart Centre and Division of Cardiology, Department of Pediatrics, the Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, Canada
| | - Kristina H Haugaa
- Department of Cardiology, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372 Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Problemveien 7, 0315 Oslo, Norway
| | - Cynthia A James
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Daniel Judge
- Department of Medicine, Medical University of South Carolina (MUSC), 30 Courtenay Drive Room 326 Gazes, Charleston, MSC 592, USA
| | - Mark S Link
- Department of Medicine, Division of Cardiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, USA
| | - Francis E Marchlinski
- Cardiac Electrophysiology Program, Cardiovascular Division Hospital of the University of Pennsylvania, 9 Founders Pavilion - Cardiology, 3400 Spruce St., Philadelphia, PA, 19104, USA
| | - Andrea Mazzanti
- Department of Molecular Medicine, University of Pavia, Corso Str. Nuova 25, Pavia, Italy
| | - Luisa Mestroni
- Molecular Genetics, Cardiovascular Institute, University of Colorado, Denver Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA
| | - Antonis Pantazis
- Inherited Cardiovascular Conditions services, The Royal Brompton and Harefield Hospitals, Sydney St, Chelsea, London SW3 6NP, UK
| | - Antonio Pelliccia
- Department of Cardiology, Institute of Sports Medicine and Science, Largo Piero Gabrielli, 1, 00197 Roma, Italy
| | - Martina Perazzolo Marra
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Kalliopi Pilichou
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Pyotr G A Platonov
- Department of Cardiology, Lund University Arrhythmia Clinic, Skåne University Hospital, Entrégatan 7, 222 42 Lund, Sweden
| | - Alexandros Protonotarios
- Inherited Cardiovascular Disease Unit, Barts Heart Centre, St Bartholomew's Hospital, W Smithfield, London EC1A 7BE, UK
| | - Alessandra Rampazzo
- Department of Biology, University of Padua, Viale Giuseppe Colombo, 3, 35131 Padova PD, Italy
| | - Jeffry E Saffitz
- Department of Pathology, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA
| | - Ardan M Saguner
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Sanjay Sharma
- Cardiology Clinical Academic Group, St George's University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK
| | - Hari Tandri
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
| | - Anneline S J M Te Riele
- Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands.,Netherlands Heart Institute, Utrecht, Moreelsepark 1, 3511 EP Utrecht, Netherlands
| | - Gaetano Thiene
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | | | - Wojciech Zareba
- Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 150 Lucius Gordon Dr, West Henrietta, NY 14586, USA
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35121, Padova, Italy
| | - Thomas Wichter
- Heart Center Osnabrück, Bad Rothenfelde Niels-Stensen-Kliniken Marienhospital Osnabrück, Ulmenallee 5 - 11, 49214 Bad Rothenfelde, Germany
| | - Frank I Marcus
- Sarver Heart Center, The University of Arizona, 1501 N Campbell Ave, Tucson, AZ 85724, USA
| | - Hugh Calkins
- Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA
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5
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Elliott PM, Anastasakis A, Asimaki A, Basso C, Bauce B, Brooke MA, Calkins H, Corrado D, Duru F, Green KJ, Judge DP, Kelsell D, Lambiase PD, McKenna WJ, Pilichou K, Protonotarios A, Saffitz JE, Syrris P, Tandri H, Te Riele A, Thiene G, Tsatsopoulou A, van Tintelen JP. Definition and treatment of arrhythmogenic cardiomyopathy: an updated expert panel report. Eur J Heart Fail 2019; 21:955-964. [PMID: 31210398 DOI: 10.1002/ejhf.1534] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [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: 03/13/2019] [Revised: 05/14/2019] [Accepted: 05/18/2019] [Indexed: 12/13/2022] Open
Abstract
It is 35 years since the first description of arrhythmogenic right ventricular cardiomyopathy (ARVC) and more than 20 years since the first reports establishing desmosomal gene mutations as a major cause of the disease. Early advances in the understanding of the clinical, pathological and genetic architecture of ARVC resulted in consensus diagnostic criteria, which proved to be sensitive but not entirely specific for the disease. In more recent years, clinical and genetic data from families and the recognition of a much broader spectrum of structural disorders affecting both ventricles and associated with a propensity to ventricular arrhythmia have raised many questions about pathogenesis, disease terminology and clinical management. In this paper, we present the conclusions of an expert round table that aimed to summarise the current state of the art in arrhythmogenic cardiomyopathies and to define future research priorities.
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Affiliation(s)
- Perry M Elliott
- University College London & St. Bartholomew's Hospital, London, UK
| | - Aris Anastasakis
- Unit of Inherited and Rare Cardiovascular Diseases, Onassis Cardiac Surgery Centre, Athens, Greece
| | - Angeliki Asimaki
- Molecular and Clinical Sciences Research Institute, St Georges University, London, UK
| | - Cristina Basso
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Padua, Italy
| | - Barbara Bauce
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Padua, Italy
| | - Matthew A Brooke
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Hugh Calkins
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Domenico Corrado
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Padua, Italy
| | - Firat Duru
- Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland
| | - Kathleen J Green
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniel P Judge
- Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - David Kelsell
- Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Pier D Lambiase
- University College London & St. Bartholomew's Hospital, London, UK
| | - William J McKenna
- Institute of Cardiovascular Science, University College London, London, UK
| | - Kalliopi Pilichou
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Padua, Italy
| | | | - Jeffrey E Saffitz
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, USA
| | - Petros Syrris
- Institute of Cardiovascular Science, University College London, London, UK
| | - Hari Tandri
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anneline Te Riele
- Division of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gaetano Thiene
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Padua, Italy
| | | | - J Peter van Tintelen
- Department of Clinical Genetics, Amsterdam Cardiovascular Sciences, University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
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6
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Griffin JM, Chen E, Tandri H, Kasper EK, Gilotra NA. Combination Therapy with Prednisone and Mycophenolate Mofetil in the Management of Cardiac Sarcoidosis. J Card Fail 2018. [DOI: 10.1016/j.cardfail.2018.07.385] [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: 10/28/2022]
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Crawford TC, Okada DR, Magruder JT, Fraser C, Patel N, Houston BA, Whitman GJ, Mandal K, Zehr KJ, Higgins RS, Chen ES, Tandri H, Kasper EK, Tedford RJ, Russell SD, Gilotra NA. A Contemporary Analysis of Heart Transplantation and Bridge-to-Transplant Mechanical Circulatory Support Outcomes in Cardiac Sarcoidosis. J Card Fail 2018; 24:384-391. [DOI: 10.1016/j.cardfail.2018.02.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 02/11/2018] [Accepted: 02/13/2018] [Indexed: 10/17/2022]
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8
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Brosnan M, Te Riele A, Tichnell C, Murray B, Tandri H, Bosman P, Hoortntje E, Van Den Berg M, Van Tintelen J, Prior D, Calkins H, La Gerche A, James C. 303J-point elevation in subjects with TWI V1-V4 does not differentiate between arrhythmogenic right ventricular cardiomyopathy (ARVC) and healthy athletes when matched for age, sex and ethnicity. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.303] [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: 11/14/2022] Open
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9
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Ventetuolo CE, Mitra N, Wan F, Manichaikul A, Barr RG, Johnson C, Bluemke DA, Lima JAC, Tandri H, Ouyang P, Kawut SM. Oestradiol metabolism and androgen receptor genotypes are associated with right ventricular function. Eur Respir J 2015; 47:553-63. [PMID: 26647441 DOI: 10.1183/13993003.01083-2015] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 10/09/2015] [Indexed: 11/05/2022]
Abstract
Sex hormones are linked to right ventricular (RV) function, but the relationship between genetic variation in these pathways and RV function is unknown.We performed a cross-sectional study of 2761 genotyped adults without cardiovascular disease. The relationships between RV measures and single nucleotide polymorphisms (SNPs) in 10 candidate genes were assessed. Urinary oestradiol (E2) metabolites produced by cytochrome P4501B1 (CYP1B1) and serum testosterone were measured in women and men respectively.In African-American (AA) women, the CYP1B1 SNP rs162561 was associated with RV ejection fraction (RVEF), such that each copy of the A allele was associated with a 2.0% increase in RVEF. Haplotype analysis revealed associations with RVEF in AA (global p<7.2×10(-6)) and white (global p=0.05) women. In white subjects, higher E2 metabolite levels were associated with significantly higher RVEF. In men, androgen receptors SNPs (rs1337080; rs5918764) were significantly associated with all RV measures and modified the relationship between testosterone and RVEF.Genetic variation in E2 metabolism and androgen signalling was associated with RV morphology in a sex-specific manner. The CYP1B1 SNP identified is in tight linkage disequilibrium with SNPs associated with pulmonary hypertension and oncogenesis, suggesting these pathways may underpin sexual dimorphism in RV failure.
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Affiliation(s)
- Corey E Ventetuolo
- Depts of Medicine and Health Services, Policy and Practice, Alpert Medical School of Brown University, Providence, RI, USA
| | - Nandita Mitra
- Dept of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Fei Wan
- Dept of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Ani Manichaikul
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - R Graham Barr
- Dept of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Craig Johnson
- Dept of Biostatistics, University of Washington, Seattle, WA, USA
| | - David A Bluemke
- Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, National Institute for Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Joao A C Lima
- Dept of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Hari Tandri
- Dept of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Pamela Ouyang
- Dept of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Steven M Kawut
- Dept of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA Dept of Medicine, University of Pennsylvania, Philadelphia, PA, USA Penn Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Liang HY, Tops L, Tandri H, James C, Tichnell C, Bax J, Judge D, Calkins H, Abraham T. Presence of plakophilin-2 mutation in arrhythmogenic right ventricular dysplasia cardiomyopathy is associated with worse left ventricular mechanics. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p2911] [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: 11/14/2022] Open
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11
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Bhonsale A, James C, Tichnell C, Murray B, Philips B, Russell S, Abraham T, Tandri H, Judge D, Calkins H. Arrhythmic Risk Stratification in Patients With Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy Associated Desmosomal Mutations. Heart Rhythm 2011. [DOI: 10.1016/j.hrthm.2011.09.052] [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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12
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Bhonsale A, Gagarin D, Dalal D, Philips B, Tichnell C, James C, Dye B, Tandri H, Judge D, Calkins H. Incidence and Prdictors of Appropriate ICD Intervention in ARVD Patients Undergoing Primary Prevention ICD Implantation. Heart Rhythm 2010. [DOI: 10.1016/j.hrthm.2010.09.050] [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: 11/15/2022]
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Jain R, Dalal D, Daly A, Tichnell C, James C, Evenson A, Jain R, Abraham T, Tan BY, Tandri H, Russell SD, Judge D, Calkins H. Electrocardiographic features of arrhythmogenic right ventricular dysplasia. Circulation 2009; 120:477-87. [PMID: 19635971 DOI: 10.1161/circulationaha.108.838821] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The purpose of this study was to reevaluate the ECG features of arrhythmogenic right ventricular dysplasia (ARVD). The second objective was to evaluate the sensitivity and specificity of the standard and newly proposed diagnostic ECG markers in the presence of a right bundle-branch block (RBBB). METHODS AND RESULTS One hundred patients with ARVD (57 men; aged 39+/-15 years) and 57 controls (21 men; aged 40+/-17 years) were included. Among the 100 patients with ARVD, a complete RBBB was present in 17 patients, and 15 patients had an incomplete RBBB. T-wave inversion through V(3) demonstrated optimal sensitivity and specificity in both ARVD patients without a complete RBBB or incomplete RBBB (71% [95% confidence interval, 58% to 81%] and 96% [95% confidence interval, 81% to 100%], respectively) and in ARVD patients with incomplete RBBB (73% [95% confidence interval, 45% to 92%] and 95% [95% confidence interval, 77% to 100%], respectively). Between ARVD patients and controls with a complete RBBB, the only 2 parameters that differed were the prevalence of T-wave inversion through V(4) (59% versus 12%, respectively; P<0.05) and an r'/s ratio in V(1) <1 (88% versus 14%, respectively; P<0.005). In ARVD patients with complete RBBB, the most sensitive and specific parameter was an r'/s ratio <1. CONCLUSIONS We evaluated comprehensively the diagnostic value of ECG markers for ARVD. On the basis of the findings, we propose an algorithm, with examination of QRS morphology being the first step, for ECG evaluation of ARVD patients. Definite criteria are then applied on the basis of the presence of no RBBB, incomplete RBBB, and complete RBBB to obtain the best diagnostic utility of the ECG.
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Affiliation(s)
- Rahul Jain
- Carnegie 530, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore MD 21287, USA
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