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Mohindra R, Dobson LE, Schlosshan D, Khan P, Campbell B, Garbi M, Chambers B, Chambers JB. Heart valve service provision in the United Kingdom and the effect of the COVID 19 pandemic; improved but must do better. A British Heart Valve Society national survey. Echo Res Pract 2024; 11:11. [PMID: 38715102 PMCID: PMC11077841 DOI: 10.1186/s44156-024-00047-y] [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: 12/12/2023] [Accepted: 04/12/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Outpatient care for patients with heart valve disease (HVD) is best provided by valve clinics delivered by specialists. Modern day practice in the United Kingdom (UK) is currently poorly understood and has not been evaluated for nearly a decade. Furthermore, the COVID 19 pandemic changed the management of many chronic diseases, and how this has impacted patients with heart valve disease is unclear. METHODS A British Heart Valve Society survey was sent to 161 hospitals throughout the UK. RESULTS There was a general valve clinic in 46 of the 68 hospitals (68%), in 19 of 23 Heart Centres (83%) and 29 of 45 DGHs (64%). Across all settings, 3824 new patients and 17,980 follow up patients were seen in valve clinics per annum. The mean number of patients per hospital were 197 (median 150, range 48-550) for new patients and 532 (median 400, range 150-2000) for follow up. On the day echocardiography was available in 55% of valve clinics. In patients with severe HVD, serum brain natriuretic peptide (BNP) was measured routinely in 39% of clinics and exercise testing routinely performed in 49% of clinics. A patient helpline was available in 27% of clinics. 78% of centres with a valve clinic had a valve multidisciplinary team meeting (MDT). 45% centres had an MDT co-ordinator and MDT outcomes were recorded on a database in 64%. COVID-19 had a major impact on valve services in 54 (95%) hospitals. CONCLUSIONS There has been an increase in the number of valve clinics since 2015 from 21 to 68% but the penetration is still well short of the expected 100%, meaning that valve clinics only serve a small proportion of patients requiring surveillance for HVD. COVID-19 had a major impact on the care of patients with HVD in the majority of UK centres surveyed.
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Affiliation(s)
- R Mohindra
- Blackpool Victoria Hospital, Blackpool, UK.
| | - L E Dobson
- Manchester University Foundation Trust, Manchester, UK
| | | | - P Khan
- British Heart Valve Society, London, UK
| | - B Campbell
- Guys and St Thomas' NHS Foundation Trust, London, UK
| | - M Garbi
- Royal Papworth Hospital, Cambridge, UK
| | - B Chambers
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
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2
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Coisne A, Lancellotti P, Habib G, Garbi M, Dahl JS, Barbanti M, Vannan MA, Vassiliou VS, Dudek D, Chioncel O, Waltenberger JL, Johnson VL, De Paulis R, Citro R, Pibarot P. ACC/AHA and ESC/EACTS Guidelines for the Management of Valvular Heart Diseases: JACC Guideline Comparison. J Am Coll Cardiol 2023; 82:721-734. [PMID: 37587584 DOI: 10.1016/j.jacc.2023.05.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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] [Received: 03/09/2023] [Revised: 05/01/2023] [Accepted: 05/17/2023] [Indexed: 08/18/2023]
Abstract
Valvular heart disease (VHD) is common and poses important challenges from the standpoints of diagnosis and therapeutic management. Clinical practice guidelines have been developed to help health care professionals to overcome these challenges and provide optimal management to patients with VHD. The American College of Cardiology, in collaboration with the American Heart Association, and the European Society of Cardiology, in collaboration with the European Association for Cardio-Thoracic Surgery, recently updated their guidelines on the management of VHD. Although these 2 sets of guidelines are generally concordant, there are some substantial differences between these guidelines, which may have significant implications for clinical practice. This review prepared on behalf of the EuroValve Consortium describes the consistencies and discrepancies between the guidelines and highlights the gaps in these guidelines and the future research perspectives to fill these gaps.
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Affiliation(s)
- Augustin Coisne
- University Lille, Inserm, CHU Lille, Institut Pasteur de Lille, Lille, France; Cardiovascular Research Foundation, New York, New York, USA.
| | - Patrizio Lancellotti
- University of Liège Hospital, GIGA Cardiovascular Sciences, Departments of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium; Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, and Anthea Hospital, Bari, Italy
| | - Gilbert Habib
- APHM, La Timone Hospital, Cardiology Department, Aix Marseille University, Marseille, France
| | - Madalina Garbi
- Royal Papworth Hospital, Cambridge University Health Partners, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | | | | | - Mani A Vannan
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, Georgia, USA
| | - Vassilios S Vassiliou
- Department of Cardiology, Norwich Medical School, University of East Anglia and Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - Dariusz Dudek
- Institute of Cardiology, Jagiellonian University, Krakow, Poland
| | - Ovidiu Chioncel
- Emergency Institute for Cardiovascular Diseases 'Prof. C.C. Iliescu,' Bucharest, Romania; University of Medicine Carol Davila, Bucharest, Romania
| | - Johannes L Waltenberger
- University of Muenster, Medical Faculty, Muenster, Germany; Hirslanden Clinic in Park, Zurich, Switzerland
| | | | | | - Rodolfo Citro
- Cardio-Thoracic-Vascular Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona," Salerno, Italy; Department of Vascular Physiopathology, IRCCS Neuromed, Pozzilli, Italy
| | - Philippe Pibarot
- Quebec Heart and Lung Institute, Laval University, Québec City, Quebec, Canada
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3
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Ong L, Burrage M, Watson W, Garbi M, Pettit S, Bhagra S. Right Atrial Pressure and Rv-Pa Uncoupling May Improve Risk Stratification of Patients with Advanced Hf and Secondary Mitral Regurgitation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1670] [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: 04/05/2023] Open
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Surendrakumar V, Aitken E, Mark P, Motallebzadeh R, Hunter J, Amer A, Summers D, Rennie K, Rooshenas L, Garbi M, Sylvester K, Hudson C, Banks J, Sidders A, Norton A, Slater M, Bartlett M, Knight S, Pettigrew G. Cardiorespiratory Optimisation By Arteriovenous fistula Ligation after renal Transplantation (COBALT): study protocol for a multicentre randomised interventional feasibility trial. BMJ Open 2023; 13:e067668. [PMID: 36759026 PMCID: PMC9923321 DOI: 10.1136/bmjopen-2022-067668] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Cardiovascular events are a major cause of mortality following successful kidney transplantation.Arteriovenous fistulas (AVFs) are considered the best option for haemodialysis, but may contribute to this excess mortality because they promote adverse cardiac remodelling and ventricular hypertrophy. This raises the question whether recipients with a well-functioning kidney transplant should undergo elective AVF ligation. METHODS AND ANALYSIS The COBALT feasibility study is a multicentre interventional randomised controlled trial (RCT) that will randomise renal transplant patients with stable graft function and a working AVF on a 1:1 basis to standard care (continued conservative management) or to AVF ligation. All patients will perform cardiopulmonary exercise testing (CPET) on recruitment and 6 months later. Daily functioning and quality of life will be additionally assessed by questionnaire completion and objective measure of physical activity. The primary outcome-the proportion of approached patients who complete the study (incorporating rates of consent, receipt of allocated intervention and completion of both CPETs without withdrawal)-will determine progression to a full-scale RCT. Design of the proposed RCT will be informed by an embedded qualitative assessment of participant and healthcare professional involvement. ETHICS AND DISSEMINATION This study has been approved by the East Midlands-Derby Research Ethics Committee (22/EM/0002) and the Health Research Authority. The results of this work will be disseminated academically through presentation at national and international renal meetings and via open access, peer-reviewed outputs. Existing networks of renal patient groups will also be used to disseminate the study findings to other key stakeholders. TRIAL REGISTRATION NUMBER ISRCTN49033491.
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Affiliation(s)
- Veena Surendrakumar
- Department of Thoracic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Department of Surgery, University of Cambridge, Cambridge, UK
| | - Emma Aitken
- Department of Renal Surgery, Queen Elizabeth University Hospital, Glasgow, UK
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Patrick Mark
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Reza Motallebzadeh
- Department of Nephrology and Transplantation, Royal Free London NHS Foundation Trust, London, UK
- Division of Surgery and Interventional Science, University College London, London, UK
| | - James Hunter
- Department of Transplant and Dialysis Access Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Aimen Amer
- Institute of Transplantation, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Dominic Summers
- Department of Surgery, University of Cambridge, Cambridge, UK
- Department of Transplant Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Kirsten Rennie
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Leila Rooshenas
- Bristol Population Health Science Institute, University of Bristol, Bristol, UK
| | - Madalina Garbi
- Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Karl Sylvester
- Respiratory Physiology Services, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Cara Hudson
- Statistics and Clinical Studies, NHS Blood and Transplant Organ Donation and Transplantation Directorate, Bristol, UK
| | - Jennifer Banks
- Statistics and Clinical Studies, NHS Blood and Transplant Organ Donation and Transplantation Directorate, Bristol, UK
| | - Anna Sidders
- Clinical Trials Unit, NHSBT Clinical Trials Unit, Cambridge, UK
| | - Andrew Norton
- Addenbrooke's Kidney Patients Association, Cambridge, UK
| | - Matthew Slater
- Department of Transplant Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Matthew Bartlett
- Vascular Studies, Royal Free London NHS Foundation Trust, London, UK
| | - Simon Knight
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Gavin Pettigrew
- Department of Surgery, University of Cambridge, Cambridge, UK
- Department of Transplant Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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5
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Anderson RH, Garbi M, Zugwitz D, Petersen SE, Nijveldt R. Anatomy of the mitral valve relative to controversies concerning the so-called annular disjunction. Heart 2022; 109:734-739. [PMID: 36585240 DOI: 10.1136/heartjnl-2022-322043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022]
Abstract
It is now accepted that the mitral valve functions on the basis of a complex made up of the annulus, the leaflets, the tendinous cords and the papillary muscles. So as to work properly, these components must combine together in harmonious fashion. Despite the features of the arrangement of each component having been the focus of anatomical investigation for centuries, controversies still exist in their inter-relations and how best to describe them. To a large extent, the ongoing problems reflect the fact that, again for centuries, morphologists when describing the heart have ignored the rule that its components should be described as seen in the body during life. Failure to use attitudinally appropriate descriptions underscores a particular current issue, namely the influence of the so-called disjunction within the atrioventricular junction as a potential substrate for leaflet prolapse or malignant arrhythmias. With these difficulties in mind, we have reviewed how the components of the valvar complex can best be described when comparing direct images with those obtained using three-dimensional techniques now used for clinical imaging. We submit that these show that the skirt of leaflet tissue is best described as having aortic and mural components. When the hinge of the mural leaflet is assessed within the overall atrioventricular junction, the so-called disjunction is ubiquitous, but not always in the same place. We further suggest that its significance will best be determined when clinicians describe its presence using attitudinally appropriate terms.
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Affiliation(s)
- Robert H Anderson
- Biosciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Madalina Garbi
- Department of Cardiology, Royal Papworth Hospital, Cambridge University Health Partners, Cambridge, UK
| | - Dasa Zugwitz
- Cardiovascular Surgery, University Medical Centre, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Steffen E Petersen
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Robin Nijveldt
- Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
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6
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Bartnik A, Pepke-Zaba J, Hoole SP, White P, Garbi M, Coghlan JG, Taghavi F, Tsui S, Weir-McCall J. Right ventricular-pulmonary artery coupling in chronic thromboembolic pulmonary hypertension. Heart 2022; 109:898-904. [PMID: 36549680 DOI: 10.1136/heartjnl-2022-321770] [Citation(s) in RCA: 2] [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: 08/17/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Chronic thromboembolic pulmonary hypertension occurs in a proportion of patients with prior acute pulmonary embolism and is characterised by breathlessness, persistently raised pulmonary pressures and right heart failure. Surgical pulmonary endarterectomy (PEA) offers significant prognostic and symptomatic benefits for patients with proximal disease distribution. For those with inoperable disease, management options include balloon pulmonary angioplasty (BPA) and medical therapy. Current clinical practice relies on the evaluation of pulmonary haemodynamics to assess disease severity, timing of and response to treatment. However, pulmonary haemodynamics correlate poorly with patient symptoms, which are influenced by right ventricular tolerance of the increased afterload. How best to manage symptomatic patients with chronic thromboembolic pulmonary disease (CTEPD) in the absence of pulmonary hypertension is not resolved.Right ventricular-pulmonary artery coupling (RV-PAC) describes the energy transfer within the whole cardiopulmonary unit. Thus, it can identify the earliest signs of decompensation even before pulmonary hypertension is overt. Invasive measurement of coupling using pressure volume loop technology is well established in research settings. The development of efficient and less invasive measurement methods has revived interest in coupling as a viable clinical tool. Significant improvement in RV-PAC has been demonstrated after both PEA and BPA. Further studies are required to understand its clinical utility and prognostic value, in particular, its potential to guide management in patients with CTEPD. Finally, given the reported differences in coupling between sexes in pulmonary arterial hypertension, further work is required to understand the applicability of proposed thresholds for decoupling in therapeutic decision making.
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Affiliation(s)
- Aleksandra Bartnik
- Radiology, Royal Papworth Hospital, Cambridge, UK .,University of Cambridge, Cambridge, UK.,Surgery, Royal Papworth Hospital, Cambridge, UK
| | - Joanna Pepke-Zaba
- Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK
| | | | - Paul White
- Medical Physics and Clinical Engineering, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Medical Technology Research Centre, Anglia Ruskin University, Cambridge, UK
| | | | | | | | - Steven Tsui
- Surgery, Royal Papworth Hospital, Cambridge, UK
| | - Jonathan Weir-McCall
- Radiology, Royal Papworth Hospital, Cambridge, UK.,University of Cambridge, Cambridge, UK
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7
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Sannino A, Campbell S, Grapsa J, Modine T, Barbanti M, Chambers JB, Zamorano JL, Pibarot P, Garbi M, Vannan M, Habib G, Lancellotti P. European survey on valvular heart disease clinical experience from the European Society of Cardiology council on valvular heart disease. Eur Heart J Open 2022; 2:oeac054. [PMID: 36262770 PMCID: PMC9562836 DOI: 10.1093/ehjopen/oeac054] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 08/17/2022] [Indexed: 11/14/2022]
Abstract
Aims The aim of this survey is to analyze how current recommendations on valvular heart disease (VHD) management have been adopted. Identifying potential discrepancies between recommendations and everyday clinical practice would enable us to better understand and address the remaining challenges in this controversial and complex field. Methods and results A total of 33 questions, distributed via email to all European Society of Cardiology (ESC) affiliated countries through the newsletter of the ESC council on VHD, were answered by 689 respondents, mainly from tertiary care settings. The results of this survey showed that VHD patients are mostly managed by tertiary care centres, where multi-disciplinary heart teams are frequently a reality. Cardiac computed tomography (CT) is often used in the preprocedural planning of transcatheter interventions, particularly for sizing and deliverability assessment. Echocardiography represents the most widely used imaging modality in the diagnostic, intra-operative and follow-up phase of VHD patients. Cardiac magnetic resonance (CMR) is still largely underused, also for conditions such as mitral annular disjunction, or for the assessment of left ventricle volumes where it is considered as the gold standard, despite 3D volumes by echocardiography having proved good comparability with CMR. As for endocarditis, despite still underused, transesophageal echocardiography (TEE) represents the approach of choice for the diagnosis of native and prosthesis valve endocarditis (up to 46% of the respondents use it). In this context, positron emission tomography-CT is largely underused. Conclusion There is widespread adoption of current recommendation on the evaluation of VHD and these are frequently used to guide patient management. Nonetheless, there are still many discrepancies across centres and countries which need to be addressed with the aim of improving patients' management and outcomes and ultimately positively impacting on healthcare resources.
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Affiliation(s)
- Anna Sannino
- Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Sarah Campbell
- Department of Cardiology, Guys and St Thomas NHS Trust, London, United Kingdom
| | - Julia Grapsa
- Department of Cardiology, Guys and St Thomas NHS Trust, London, United Kingdom
| | - Thomas Modine
- Service Médico-Chirurgical, Valvulopathies-Chirurgie Cardiaque-Cardiologie Interventionelle Structurelle, Hôpital Cardiologique de Haut Lévèque, Bordeaux, France
| | - Marco Barbanti
- Ferrarotto Hospital, University of Catania, Catania, Italy
| | - John B Chambers
- Department of Cardiology, Guys and St Thomas NHS Trust, London, United Kingdom
| | - Jose L Zamorano
- Department of Cardiology, Hospital Universitario Ramón y Cajal, M-607, 9, 100, 28034 Madrid, Spain
| | - Philippe Pibarot
- Institut de Cardiologie et de Pneumologie de Québec, Laval University, Québec City, Québec, Canada
| | - Madalina Garbi
- Department of Cardiology, Royal Papworth Hospital, Cambridge Biomedical Campus, Cambridge, UK
| | | | - Gilbert Habib
- Cardiology Department, AP-HM, La Timone Hospital, Marseille, France
| | - Patrizio Lancellotti
- Cardiology Department, University Hospital Centre, Centre Hospitalier Universitaire (CHU) Sart Tilman, Liège, Belgium
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8
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Giblett JP, Jara T, MacCarthy T, Vibhishanan J, Venuraju S, Garbi M, Jenkins D, Moorjani N, Williams LK, Shapiro LM, Calvert PA. Transcatheter Versus Surgical Management of Paravalvular Leak: A Single-Center Experience With Purpose-Specific Occluders. JACC Cardiovasc Interv 2022; 15:1293-1295. [PMID: 35595674 DOI: 10.1016/j.jcin.2022.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022]
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9
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Garbi M, Mariani A. Response to: Correspondence on 'Cost-effectiveness of transcatheter edge-to-edge repair in secondary mitral regurgitation does need confirmation' by Armoiry and Connock. Heart 2022; 108:1073. [PMID: 35534049 DOI: 10.1136/heartjnl-2022-321181] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Alfredo Mariani
- National Institute for Health and Care Excellence, London, UK
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10
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Lancellotti P, Pibarot P, Chambers J, La Canna G, Pepi M, Dulgheru R, Dweck M, Delgado V, Garbi M, Vannan MA, Montaigne D, Badano L, Maurovich-Horvat P, Pontone G, Vahanian A, Donal E, Cosyns B. Multi-modality imaging assessment of native valvular regurgitation: an EACVI and ESC council of valvular heart disease position paper. Eur Heart J Cardiovasc Imaging 2022; 23:e171-e232. [PMID: 35292799 DOI: 10.1093/ehjci/jeab253] [Citation(s) in RCA: 101] [Impact Index Per Article: 50.5] [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: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 01/10/2023] Open
Abstract
Valvular regurgitation represents an important cause of cardiovascular morbidity and mortality. Imaging is pivotal in the evaluation of native valve regurgitation and echocardiography is the primary imaging modality for this purpose. The imaging assessment of valvular regurgitation should integrate quantification of the regurgitation, assessment of the valve anatomy and function, and the consequences of valvular disease on cardiac chambers. In clinical practice, the management of patients with valvular regurgitation largely relies on the results of imaging. It is crucial to provide standards that aim at establishing a baseline list of measurements to be performed when assessing native valve regurgitation. The present document aims to present clinical guidance for the multi-modality imaging assessment of native valvular regurgitation.
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Affiliation(s)
- Patrizio Lancellotti
- Department of Cardiology, Valvular Disease Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, 4000 Liège, Belgium.,Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Italy.,Anthea Hospital, Via Camillo Rosalba, 35, Bari, Italy
| | - Philippe Pibarot
- Department of Medicine, Québec Heart & Lung Institute, Laval University, 2725, chemin Sainte-Foy, Québec, Canada
| | - John Chambers
- Emeritus Professor of Clinical Cardiology, Guy's and St Thomas' Hospital, London SE1 7EH, UK
| | - Giovanni La Canna
- Cardiovascular Department, IRCCS Humanitas Clinical and Research Hospital, Applied Diagnostic Echocardiography, 20089 Rozzano, Milan, Italy
| | - Mauro Pepi
- Department of Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
| | - Raluca Dulgheru
- Department of Cardiology, Valvular Disease Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, 4000 Liège, Belgium
| | - Mark Dweck
- BHF Centre for Cardiovascular Science, University of Edinburgh, Little France Crescent, Edinburgh EH16 4SB, UK
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2 2300 RC Leiden, The Netherlands
| | - Madalina Garbi
- Royal Papworth Hospital, Cambridge University Health Partner, Cambridge Biomedical Campus, CB2 0AY Cambridge, UK
| | - Mani A Vannan
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, GA, USA
| | - David Montaigne
- University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, F-59000 Lille, France
| | - Luigi Badano
- Department of Medicine and Surgery, University of Milano-Bicocca, 20089 Milan, Italy.,Department of Cardiac, Metabolic and Neural Sciences, Istituto Auxologico Italiano, IRCCS, 20089 Milan, Italy
| | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Semmelweis University, 1083 Budapest, Hungary
| | | | - Alec Vahanian
- UFR Medecine, Université de Paris, Site Bichat, 16 rue Huchard, 75018 Paris, France.,LVTS INSERM U1148, GH Bichat, 46, rue Henri Huchard, 75018 Paris, France
| | - Erwan Donal
- University of Rennes, CHU Rennes, Inserm, LTSI-UMR 1099, Rennes, France
| | - Bernard Cosyns
- Department of Cardiology, CHVZ (Centrum voor Hart en Vaatziekten), ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Universitair Ziekenhuis Brussel, 101 Laarbeeklaan, 1090 Brussels, Belgium
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11
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Watson W, Garbi M. Cardiac magnetic resonance imaging in heart failure: The added value of tissue characterization. Kardiol Pol 2022; 80:249-250. [PMID: 35178699 DOI: 10.33963/kp.a2022.0054] [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: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 11/23/2022]
Affiliation(s)
- William Watson
- Royal Papworth Hospital, Cambridge University Health Partners, Cambridge Biomedical Campus, Cambridge, United Kingdom.
| | - Madalina Garbi
- Royal Papworth Hospital, Cambridge University Health Partners, Cambridge Biomedical Campus, Cambridge, United Kingdom
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12
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Affiliation(s)
| | - Alfredo Mariani
- National Guideline Centre, Royal College of Physicians, London, UK
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13
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Garbi M. National Institute for Health and Care Excellence clinical guidelines development principles and processes. Heart 2021; 107:949-953. [PMID: 33622678 DOI: 10.1136/heartjnl-2020-318661] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 01/26/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 11/03/2022] Open
Abstract
Clinical guidelines are developed by professional societies and also, in England, by an independent non-departmental public body, the National Institute for Health and Care Excellence (NICE). Similarities and differences between these guidelines should be viewed in the context of different objectives, responsibilities and roles of guideline developers. This review describes the NICE clinical guidelines development principles and processes with the aim to provide the reader an informed perspective on the recommendations made. NICE clinical guidelines are developed by an appointed independent advisory committee comprising healthcare professionals as well as lay members, supported by a professional team comprising project managers, information specialists, systematic reviewers and health economists. Furthermore, registered stakeholders comprising organisations that have an interest in the guideline topic, or represent people whose practice or care may be directly affected by the guideline, are consulted on the draft scope and draft guidelines. NICE selects a limited number of high impact questions to be answered by the review of evidence, rather than cover a certain topic exhaustively as the clinical guidelines developed by professional societies may do. NICE clinical guidelines recommendations reflect both the clinical effectiveness and the cost-effectiveness of interventions.
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Affiliation(s)
- Madalina Garbi
- Department of Cardiology, Royal Papworth Hospital, Cambridge Biomedical Campus, Cambridge, UK
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14
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Affiliation(s)
| | - Francis Wells
- Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, UK
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15
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Garbi M, Lancellotti P. Heart Valve Specialist Core Syllabus of the ESC Council on Valvular Heart Disease. Eur Heart J 2020; 41:4156. [DOI: 10.1093/eurheartj/ehaa778] [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)
- Madalina Garbi
- Royal Papworth Hospital, Cambridge University Health Partners, Cambridge Biomedical ampus, Cambridge, CB2 0AY, UK
| | - Patrizio Lancellotti
- Chairman ESC Council Group on Valvular Heart Disease. Department of Cardiology, University of Liège Hospital, Domaine Universitaire du Sart Tilman - B.35 – 4000 Liège, Belgium
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Hua A, Garbi M, Sado D, Rajani R, Albarjas M. Nowhere to Hide. Circ Cardiovasc Imaging 2020; 13:e009643. [DOI: 10.1161/circimaging.119.009643] [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: 11/16/2022]
Affiliation(s)
- Alina Hua
- Department of Cardiology, Princess Royal University Hospital, Orpington, United Kingdom (A.H., M.G., M.A.)
| | - Madalina Garbi
- Department of Cardiology, Princess Royal University Hospital, Orpington, United Kingdom (A.H., M.G., M.A.)
| | - Daniel Sado
- Department of Cardiology, King’s College Hospital, London, United Kingdom (D.S.)
| | - Ronak Rajani
- Department of Cardiology, St. Thomas’ Hospital, London, United Kingdom (R.R.)
| | - Mohammad Albarjas
- Department of Cardiology, Princess Royal University Hospital, Orpington, United Kingdom (A.H., M.G., M.A.)
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Mancusi C, de Simone G, Brguljan Hitij J, Sudano I, Mahfoud F, Parati G, Kahan T, Barbato E, Pierard LA, Garbi M, Flachskampf FA, Gerdts E. Management of patients with combined arterial hypertension and aortic valve stenosis: a consensus document from the Council on Hypertension and Council on Valvular Heart Disease of the European Society of Cardiology, the European Association of Cardiovascular Imaging (EACVI), and the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J Cardiovasc Pharmacother 2020; 7:242-250. [PMID: 32353143 DOI: 10.1093/ehjcvp/pvaa040] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/15/2020] [Accepted: 04/23/2020] [Indexed: 12/13/2022]
Abstract
Aortic valve stenosis (AS) is the third most common cardiovascular disease. The prevalence of both AS and arterial hypertension increases with age, and the conditions therefore often co-exist. Co-existence of AS and arterial hypertension is associated with higher global left ventricular (LV) pressure overload, more abnormal LV geometry and function, and more adverse cardiovascular outcome. Arterial hypertension may also influence grading of AS, leading to underestimation of the true AS severity. Current guidelines suggest re-assessing patients once arterial hypertension is controlled. Management of arterial hypertension in AS has historically been associated with prudence and concerns, mainly related to potential adverse consequences of drug-induced peripheral vasodilatation combined with reduced stroke volume due to the fixed LV outflow obstruction. Current evidence suggests that patients should be treated with antihypertensive drugs blocking the renin-angiotensin-aldosterone system, adding further drug classes when required, to achieve similar target blood pressure (BP) values as in hypertensive patients without AS. The introduction of transcatheter aortic valve implantation has revolutionized the management of patients with AS, but requires proper BP management during and following valve replacement. The purpose of this document is to review the recent evidence and provide practical expert advice on management of hypertension in patients with AS.
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Affiliation(s)
- Costantino Mancusi
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Advanced Biomedical Science, Federico II University of Naples, Naples, Italy
| | - Giovanni de Simone
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Advanced Biomedical Science, Federico II University of Naples, Naples, Italy
| | - Jana Brguljan Hitij
- Hypertension Division, Department of Internal Medicine, University Medical Centre Ljubljana, Medical Faculty Ljubljana, Ljubljana, Slovenia
| | - Isabella Sudano
- Department of Cardiology, University Heart Center Zurich, University Hospital of Zürich, Zürich, Switzerland
| | - Felix Mahfoud
- Department for Cardiology, Angiology, Intensive Medicine, Saarland University Hospital, Homburg/Saar, Germany
| | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milano-Bicocca & Istituto Auxologico Italiano, IRCCS, Cardiology Unit, Milan, Italy
| | - Thomas Kahan
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Emanuele Barbato
- Hypertension Research Center, Federico II University Hospital, Naples, Italy.,Department of Advanced Biomedical Science, Federico II University of Naples, Naples, Italy
| | - Luc A Pierard
- Department of Cardiology, Heart Valve Clinic, University Hospital Sart-Tilman, Liège, Belgium
| | - Madalina Garbi
- Royal Papworth Hospital NHS Foundation Trust Papworth Road, Cambridge Biomedical Campus, Cambridge, UK
| | - Frank A Flachskampf
- Department of Medical Sciences, Uppsala University, and Clinical Physiology and Cardiology, Akademiska, Uppsala, Sweden
| | - Eva Gerdts
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
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Lancellotti P, Magne J, Dulgheru R, Clavel MA, Donal E, Vannan MA, Chambers J, Rosenhek R, Habib G, Lloyd G, Nistri S, Garbi M, Marchetta S, Fattouch K, Coisne A, Montaigne D, Modine T, Davin L, Gach O, Radermecker M, Liu S, Gillam L, Rossi A, Galli E, Ilardi F, Tastet L, Capoulade R, Zilberszac R, Vollema EM, Delgado V, Cosyns B, Lafitte S, Bernard A, Pierard LA, Bax JJ, Pibarot P, Oury C. Outcomes of Patients With Asymptomatic Aortic Stenosis Followed Up in Heart Valve Clinics. JAMA Cardiol 2019; 3:1060-1068. [PMID: 30285058 DOI: 10.1001/jamacardio.2018.3152] [Citation(s) in RCA: 159] [Impact Index Per Article: 31.8] [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: 12/18/2022]
Abstract
Importance The natural history and the management of patients with asymptomatic aortic stenosis (AS) have not been fully examined in the current era. Objective To determine the clinical outcomes of patients with asymptomatic AS using data from the Heart Valve Clinic International Database. Design, Setting, and Participants This registry was assembled by merging data from prospectively gathered institutional databases from 10 heart valve clinics in Europe, Canada, and the United States. Asymptomatic patients with an aortic valve area of 1.5 cm2 or less and preserved left ventricular ejection fraction (LVEF) greater than 50% at entry were considered for the present analysis. Data were collected from January 2001 to December 2014, and data were analyzed from January 2017 to July 2018. Main Outcomes and Measures Natural history, need for aortic valve replacement (AVR), and survival of asymptomatic patients with moderate or severe AS at entry followed up in a heart valve clinic. Indications for AVR were based on current guideline recommendations. Results Of the 1375 patients included in this analysis, 834 (60.7%) were male, and the mean (SD) age was 71 (13) years. A total of 861 patients (62.6%) had severe AS (aortic valve area less than 1.0 cm2). The mean (SD) overall survival during medical management (mean [SD] follow up, 27 [24] months) was 93% (1%), 86% (2%), and 75% (4%) at 2, 4, and 8 years, respectively. A total of 104 patients (7.6%) died under observation, including 57 patients (54.8%) from cardiovascular causes. The crude rate of sudden death was 0.65% over the duration of the study. A total of 542 patients (39.4%) underwent AVR, including 388 patients (71.6%) with severe AS at study entry and 154 (28.4%) with moderate AS at entry who progressed to severe AS. Those with severe AS at entry who underwent AVR did so at a mean (SD) of 14.4 (16.6) months and a median of 8.7 months. The mean (SD) 2-year and 4-year AVR-free survival rates for asymptomatic patients with severe AS at baseline were 54% (2%) and 32% (3%), respectively. In those undergoing AVR, the 30-day postprocedural mortality was 0.9%. In patients with severe AS at entry, peak aortic jet velocity (greater than 5 m/s) and LVEF (less than 60%) were associated with all-cause and cardiovascular mortality without AVR; these factors were also associated with postprocedural mortality in those patients with severe AS at baseline who underwent AVR (surgical AVR in 310 patients; transcatheter AVR in 78 patients). Conclusions and Relevance In patients with asymptomatic AS followed up in heart valve centers, the risk of sudden death is low, and rates of overall survival are similar to those reported from previous series. Patients with severe AS at baseline and peak aortic jet velocity of 5.0 m/s or greater or LVEF less than 60% have increased risks of all-cause and cardiovascular mortality even after AVR. The potential benefit of early intervention should be considered in these high-risk patients.
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Affiliation(s)
- Patrizio Lancellotti
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Julien Magne
- Cardiology Department, Centre Hospitalier Universitaire de Limoges, Hôpital Dupuytren, Pôle Coeur-Poumon-Rein, Limoges, France
| | - Raluca Dulgheru
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Marie-Annick Clavel
- Québec Heart and Lung Institute, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Québec, Canada
| | - Erwan Donal
- Cardiologie and LTSI INSERM U 1099, Centre Hospitalier Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Mani A Vannan
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, Georgia
| | - John Chambers
- Guy's and St Thomas Hospitals, London, United Kingdom
| | - Raphael Rosenhek
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Gilbert Habib
- Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Marseille, France.,Assistance Publique-Hopitaux Marseille, La Timone Hospital, Cardiology Department, Marseille, France
| | - Guy Lloyd
- Barts Heart Centre Echo Lab, St Bartholomew's Hospital, London, United Kingdom
| | - Stefano Nistri
- Cardiology Service, CMSR Veneto Medica, Altavilla Vicentina, Italy
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Stella Marchetta
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Khalil Fattouch
- Department of Cardiovascular Surgery, GVM Care and Research, Maria Eleonora Hospital, Palermo, Italy.,Department of Surgery and Cancer, University of Palermo, Palermo, Italy
| | - Augustin Coisne
- Centre Hospitalier Universitaire de Lille, Departments of Clinical Physiology and Echocardiography and Cardiovascular Surgery, Lille, France
| | - David Montaigne
- Centre Hospitalier Universitaire de Lille, Departments of Clinical Physiology and Echocardiography and Cardiovascular Surgery, Lille, France
| | - Thomas Modine
- Centre Hospitalier Universitaire de Lille, Departments of Clinical Physiology and Echocardiography and Cardiovascular Surgery, Lille, France
| | - Laurent Davin
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Olivier Gach
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Marc Radermecker
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Shizhen Liu
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, Georgia
| | - Linda Gillam
- Morristown Medical Center, Morristown, New Jersey
| | - Andrea Rossi
- Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Galli
- Cardiologie and LTSI INSERM U 1099, Centre Hospitalier Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Federica Ilardi
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Lionel Tastet
- Québec Heart and Lung Institute, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Québec, Canada
| | - Romain Capoulade
- Québec Heart and Lung Institute, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Québec, Canada
| | - Robert Zilberszac
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - E Mara Vollema
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Bernard Cosyns
- Centrum voor Hart en Vaatziekten, Universitair Ziekenhuis Brussel and In Vivo Cellular and Molecular Imaging Laboratory, Brussels, Belgium
| | - Stephane Lafitte
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Cardiologique Haut-Lévêque, Pessac, France
| | - Anne Bernard
- Cardiology Department, University of Tours Hospital, Tours, France.,University François Rabelais, Tours, France
| | - Luc A Pierard
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Philippe Pibarot
- Québec Heart and Lung Institute, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Québec, Canada
| | - Cécile Oury
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
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Abstract
Secondary regurgitation caused by the remodeling and dysfunction of the left or right heart chamber may complicate heart failure, worsening both symptoms and prognosis. Outcome studies have shown that patients' prognosis worsened as the severity of secondary regurgitation increases. Imaging and more specifically echocardiography plays a central role for diagnosis and serial assessment of secondary regurgitation as well as for timing the intervention and guiding the procedure.
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Affiliation(s)
- Patrizio Lancellotti
- Department of Cardiology, Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, Liege, Belgium; Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy.
| | - Raluca Dulgheru
- Department of Cardiology, Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, Liege, Belgium
| | - Stella Marchetta
- Department of Cardiology, Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, Liege, Belgium
| | - Cécile Oury
- Department of Cardiology, Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, Liege, Belgium
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, King's College Hospital, Denmark Hill, London SE5 9RS, UK
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Chambers JB, Garbi M, Briffa N, Sharma V, Steeds RP. Indications for echocardiography of replacement heart valves: a joint statement from the British Heart Valve Society and British Society of Echocardiography. Echo Res Pract 2019; 6:G9-G15. [PMID: 30763277 PMCID: PMC6410760 DOI: 10.1530/erp-18-0079] [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: 11/14/2018] [Accepted: 02/13/2019] [Indexed: 11/08/2022] Open
Abstract
Echocardiography plays a vital role in the follow-up of patients with replacement heart valves. However, there is considerable variation in international guidelines regarding the recommended time points after implantation at which routine echocardiography should be performed. The purpose of routine echocardiography is to detect early structural valve deterioration in biological valves to improve the timing of redo interventions. However, the risk of valve deterioration depends on many valve-related factors (valve design and patient prosthesis mismatch) and patient-related factors (age, diabetes, systemic hypertension, renal dysfunction and smoking). In this statement, the British Heart Valve Society and the British Society of Echocardiography suggest practical guidance. A plan should be made soon after implantation, but this may need to be modified for individual patients and as circumstances change. It is important that patients are managed in a multidisciplinary valve clinic.
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Affiliation(s)
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
| | | | - Vishal Sharma
- Royal Liverpool and Broadgreen University Hospitals, Liverpool, UK
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Pinciroli M, Domínguez-Perles R, Garbi M, Abellán A, Oger C, Durand T, Galano JM, Ferreres F, Gil-Izquierdo A. Impact of Salicylic Acid Content and Growing Environment on Phytoprostane and Phytofuran (Stress Biomarkers) in Oryza sativa L. J Agric Food Chem 2018; 66:12561-12570. [PMID: 30384603 DOI: 10.1021/acs.jafc.8b04975] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Phytoprostanes (PhytoPs) and phytofurans (PhytoFs) are oxylipins synthesized by nonenzymatic peroxidation of α-linolenic acid. These compounds are biomarkers of oxidative degradation in plant foods. In this research, the effect of environment and supplementation with salicylic acid (SA) on PhytoPs and PhytoFs was monitored by ultra-high-performance liquid chromatography coupled to electrospray ionization and triple quadrupole mass spectrometry (UHPLC-ESI-QqQ-MS/MS) on seven rice genotypes from Oryza sativa L. subsp. japonica. The plastic cover environment and spray application with 1 and 15 mM SA produced a reduction in the concentration of most of these newly established stress biomarkers [9-F1t-PhytoP, ent-16-F1t-PhytoP, ent-16- epi-16-F1t-PhytoP, 9-D1t-PhytoP, 9- epi-9-D1t-PhytoP, 16-B1-PhytoP, 9-L1-PhytoP, ent-16( RS)-9- epi-ST-Δ14-10-PhytoF, ent-9( RS)-12- epi-ST-Δ10-13-PhytoF, and ent-16( RS)-13- epi-ST-Δ14-9-PhytoF] by 60.7% on average. The modification observed in the level of PhytoPs and PhytoFs differed according to the specific oxylipins and genotype, demonstrating a close linkage between genetic features and resistance to abiotic stress, to some extent mediated by the sensitivity of plants to the plant hormone SA that participates in the physiological response of higher plants to stress. Thus, in plants exposed to stressing factors, SA contribute to modulating the redox balance, minimizing the oxidation of fatty acids and thus the syntheis of oxylipins. These results indicated that SA could be a promising tool for managing the thermotolerance of rice crop. However, it remains necessary to study the mechanism of action of PhytoPs and PhytoFs in biochemical processes related to the defense of plants and define their role as stress biomarkers through a nonenzymatic pathway.
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Affiliation(s)
- M Pinciroli
- Cátedra de Climatología y Fenología Agrícola, Facultad de Ciencias Agrarias y Forestales , Universidad Nacional de la Plata , Calle 60 y 119 , 1900 La Plata , Buenos Aires , Argentina
| | - R Domínguez-Perles
- Research Group on Quality, Safety and Bioactivity of Plant Foods. Department of Food Science and Technology , Centro de Edafología y Biología Aplicada del Segura, Consejo Superior de Investigaciones Científicas , Campus de Espinardo 25 , 30100 Espinardo , Spain
| | - M Garbi
- Cátedra de Climatología y Fenología Agrícola, Facultad de Ciencias Agrarias y Forestales , Universidad Nacional de la Plata , Calle 60 y 119 , 1900 La Plata , Buenos Aires , Argentina
| | - A Abellán
- Research Group on Quality, Safety and Bioactivity of Plant Foods. Department of Food Science and Technology , Centro de Edafología y Biología Aplicada del Segura, Consejo Superior de Investigaciones Científicas , Campus de Espinardo 25 , 30100 Espinardo , Spain
| | - C Oger
- Institut des Biomolécules Max Mousseron, Unité Mixte de Recherche 5247 , University of Montpellier, Centre National de la Recherche Scientifique, and École Nationale Supérieure de Chimie de Montpellier , Montpellier , France
| | - T Durand
- Institut des Biomolécules Max Mousseron, Unité Mixte de Recherche 5247 , University of Montpellier, Centre National de la Recherche Scientifique, and École Nationale Supérieure de Chimie de Montpellier , Montpellier , France
| | - J M Galano
- Institut des Biomolécules Max Mousseron, Unité Mixte de Recherche 5247 , University of Montpellier, Centre National de la Recherche Scientifique, and École Nationale Supérieure de Chimie de Montpellier , Montpellier , France
| | - F Ferreres
- Research Group on Quality, Safety and Bioactivity of Plant Foods. Department of Food Science and Technology , Centro de Edafología y Biología Aplicada del Segura, Consejo Superior de Investigaciones Científicas , Campus de Espinardo 25 , 30100 Espinardo , Spain
| | - A Gil-Izquierdo
- Research Group on Quality, Safety and Bioactivity of Plant Foods. Department of Food Science and Technology , Centro de Edafología y Biología Aplicada del Segura, Consejo Superior de Investigaciones Científicas , Campus de Espinardo 25 , 30100 Espinardo , Spain
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24
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Čelutkienė J, Plymen CM, Flachskampf FA, de Boer RA, Grapsa J, Manka R, Anderson L, Garbi M, Barberis V, Filardi PP, Gargiulo P, Zamorano JL, Lainscak M, Seferovic P, Ruschitzka F, Rosano GMC, Nihoyannopoulos P. Innovative imaging methods in heart failure: a shifting paradigm in cardiac assessment. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2018; 20:1615-1633. [PMID: 30411833 DOI: 10.1002/ejhf.1330] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [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: 01/29/2018] [Revised: 09/02/2018] [Accepted: 09/11/2018] [Indexed: 12/28/2022] Open
Abstract
Myriad advances in all fields of cardiac imaging have stimulated and reflected new understanding of cardiac performance, myocardial damage and the mechanisms of heart failure. In this paper, the Heart Failure Association assesses the potential usefulness of innovative imaging modalities in enabling more precise diagnostic and prognostic evaluation, as well as in guiding treatment strategies. Many new methods have gradually penetrated clinical practice and are on their way to becoming a part of routine evaluation. This paper focuses on myocardial deformation and three-dimensional ultrasound imaging; stress tests for the evaluation of contractile and filling function; the progress of magnetic resonance techniques; molecular imaging and other sound innovations. The Heart Failure Association aims to highlight the ways in which paradigms have shifted in several areas of cardiac assessment. These include reassessing of the simplified concept of ejection fraction and implementation of the new parameters of cardiac performance applicable to all heart failure phenotypes; switching from two-dimensional to more accurate and reproducible three-dimensional ultrasound volumetric evaluation; greater tissue characterization via recently developed magnetic resonance modalities; moving from assessing cardiac function and congestion at rest to assessing it during stress; from invasive to novel non-invasive hybrid techniques depicting coronary anatomy and myocardial perfusion; as well as from morphometry to the imaging of pathophysiologic processes such as inflammation and apoptosis. This position paper examines the specific benefits of imaging innovations for practitioners dealing with heart failure aetiology, risk stratification and monitoring, and, in addition, for scientists involved in the development of future research.
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Affiliation(s)
- Jelena Čelutkienė
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,State Research Institute Centre For Innovative Medicine, Vilnius, Lithuania
| | - Carla M Plymen
- Cardiology Department, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Frank A Flachskampf
- Department of Medical Sciences, Uppsala University, and Clinical Physiology, University Hospital, Uppsala, Sweden
| | - Rudolf A de Boer
- University Medical Center Groningen, University of Groningen, Department of Cardiology, Groningen, The Netherlands
| | - Julia Grapsa
- Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Robert Manka
- Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.,Institute of Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland
| | - Lisa Anderson
- Cardiovascular Sciences Research Centre, St George's University Hospitals NHS Trust, University of London, London, UK
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
| | | | | | - Paola Gargiulo
- IRCCS SDN, Institute of Nuclear and Diagnostic Sciences, Naples, Italy
| | - Jose Luis Zamorano
- Cardiology Department, University Hospital Ramón y Cajal, Madrid, Spain; University Alcala, Madrid, Spain; CIBERCV, Instituto de Salud Carlos III (ISCIII), Spain
| | - Mitja Lainscak
- Department of Internal Medicine, General Hospital Murska Sobota, Faculty of Medicine, University of Ljubljana, Murska Sobota, Slovenia
| | - Petar Seferovic
- University of Belgrade, Faculty of Medicine, Clinical Center of Serbia, Belgrade, Serbia
| | - Frank Ruschitzka
- University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Petros Nihoyannopoulos
- Cardiovascular Sciences, National Heart and Lung Institute, Imperial College London, London, UK; Cardiology Department, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.,1st Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
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25
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Affiliation(s)
- Patrizio Lancellotti
- Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Avenue de l'hôpital, n1, 4000 Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
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Garbi M, Lancellotti P, Sheppard MN. Mitral valve and left ventricular features in malignant mitral valve prolapse. Open Heart 2018; 5:e000925. [PMID: 30364469 PMCID: PMC6196952 DOI: 10.1136/openhrt-2018-000925] [Citation(s) in RCA: 29] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 09/04/2018] [Accepted: 09/26/2018] [Indexed: 11/20/2022] Open
Abstract
Objective Mitral valve prolapse is a benign condition, however with occasional reports of sudden cardiac death or out-of-hospital cardiac arrest in the absence of severe mitral regurgitation or coronary artery disease, suggesting the existence of a malignant form. The objective of our study was to contribute to the characterisation of malignant mitral valve prolapse. Methods We performed a retrospective analysis of pathology findings in 68 consecutive cases of sudden cardiac death with mitral valve prolapse as lone abnormal finding, reported as cause of death. Results All mitral valve prolapse sudden death cases had mitral valve characteristics of Barlow disease, with extensive bileaflet multisegmental prolapse and dilatation of the annulus. The majority of cases (80.9%) had microscopic left ventricular fibrosis with associated hypertrophy and degenerative features of the myocytes, and some cases (10.9%) had right ventricular fibrosis as well. Conclusions Malignant mitral valve prolapse is Barlow disease. Sudden cardiac death in mitral valve prolapse is due to Barlow disease, which besides the typical mitral valve degeneration may comprise a distinct Barlow disease cardiomyopathy, as suggested by myocyte degeneration and bi-ventricular involvement.
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Affiliation(s)
- Madalina Garbi
- King's Health Partners, King’s College Hospital NHS Foundation Trust, London, UK
| | - Patrizio Lancellotti
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Liège, Belgium
- Anthea Hospital, Gruppo Villa Maria Care and Research, Bari, Italy
| | - Mary N Sheppard
- Cardiovascular Pathology Unit, St Georges Hospital Medical School, London, UK
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Affiliation(s)
- Patrizio Lancellotti,
- University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Belgium (P.L.)
- Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy (P.L.)
| | - Madalina Garbi
- King’s Health Partners, King’s College Hospital NHS Foundation Trust, London, United Kingdom (M.G.)
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Affiliation(s)
- Patrizio Lancellotti
- From the University of Liège Hospital, GIGA Cardiovascular Sciences, Departments of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium (P.L.); Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy (P.L.); and King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK (M.G.).
| | - Madalina Garbi
- From the University of Liège Hospital, GIGA Cardiovascular Sciences, Departments of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium (P.L.); Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy (P.L.); and King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK (M.G.)
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Galderisi M, Cosyns B, Edvardsen T, Cardim N, Delgado V, Di Salvo G, Donal E, Sade LE, Ernande L, Garbi M, Grapsa J, Hagendorff A, Kamp O, Magne J, Santoro C, Stefanidis A, Lancellotti P, Popescu B, Habib G. Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2018; 18:1301-1310. [PMID: 29045589 DOI: 10.1093/ehjci/jex244] [Citation(s) in RCA: 390] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/11/2017] [Indexed: 12/28/2022] Open
Abstract
Aims This European Association Cardiovascular Imaging (EACVI) Expert Consensus document aims at defining the main quantitative information on cardiac structure and function that needs to be included in standard echocardiographic report following recent ASE/EACVI chamber quantification, diastolic function, and heart valve disease recommendations. The document focuses on general reporting and specific pathological conditions such as heart failure, coronary artery and valvular heart disease, cardiomyopathies, and systemic diseases. Methods and results Demographic data (age, body surface area, blood pressure, and heart rhythm and rate), type (vendor and model) of ultrasound system used and image quality need to be reported. In addition, measurements should be normalized for body size. Reference normal values, derived by ASE/EACVI recommendations, shall always be reported to differentiate normal from pathological conditions. This Expert Consensus document suggests avoiding the surveillance of specific variable using different ultrasound techniques (e.g. in echo labs with high expertise in left ventricular ejection fraction by 3D and not by 2D echocardiography). The report should be also tailored in relation with different cardiac pathologies, quality of images, and needs of the caregivers. Conclusion The conclusion should be concise reflecting the status of left ventricular structure and function, the presence of left atrial and/or aortic dilation, right ventricular dysfunction, and pulmonary hypertension, leading to an objective communication with the patient health caregiver. Variation over time should be considered carefully, taking always into account the consistency of the parameters used for comparison.
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Affiliation(s)
- Maurizio Galderisi
- Interdepartmental Laboratory of Cardiac Imaging, Federico II University Hospital, Naples, Italy
| | - Bernard Cosyns
- CHVZ (Centrum voor Hart en Vaatziekten)-Universitair ziekenhuis Brussel; and ICMI (In Vivo Cellular and Molecular Imaging) laboratory, Brussels, Belgium
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway
| | - Nuno Cardim
- Echocardiography Laboratory, Hospital da Luz, Lisbon, Portugal
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Centre, Leiden 2300RC, The Netherlands
| | - Giovanni Di Salvo
- Pediatric Cardiology, Royal Brompton Hospital, London, United Kingdom
| | - Erwan Donal
- Cardiologie, LTSI-INSERM U 1099, CHU Rennes, Université Rennes 1, Rennes, France
| | | | - Laura Ernande
- Department of Physiology, INSERM U955, Université Paris-Est Creteil, Henri Mondor Hospital, DHU-ATVB, AP-HP, Créteil, France
| | - Madalina Garbi
- King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS UK
| | - Julia Grapsa
- Department of Cardiovascular Sciences, Imperial College of London, London, UK
| | - Andreas Hagendorff
- Department of Cardiology-Angiology, Echokardiographie-Labore des Universitätsklinikums AöR, University of Leipzig, Leipzig, Germany
| | - Otto Kamp
- Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands
| | - Julien Magne
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges, F-87042 France
| | - Ciro Santoro
- Interdepartmental Laboratory of Cardiac Imaging, Federico II University Hospital, Naples, Italy
| | - Alexandros Stefanidis
- 1st Department of Cardiology, General Hospital of Nikea, 3 P. Mela str., 184 54, Athens, Greece
| | - Patrizio Lancellotti
- University of Liège Hospital, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Bogdan Popescu
- University of Medicine and Pharmacy 'Carol Davila'-Euroecolab, Institute of Cardiovascular Diseases, Bucharest, Romania
| | - Gilbert Habib
- Aix- Aix-Marseille Univ, URMITE, Aix Marseille Université-UM63, CNRS 7278, IRD 198, INSERM 1095.,Cardiology Department, APHM, La Timone Hospital, Boulevard Jean Moulin, Marseille 13005, France
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Lancellotti P, Garbi M. The need for appropriate use criteria: the proof of the pudding. Eur Heart J Cardiovasc Imaging 2018; 19:269-270. [PMID: 29206929 DOI: 10.1093/ehjci/jex311] [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)
- Patrizio Lancellotti
- Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, CHU du Sart Tilman, 4000 Liège, Belgium.,Department of Cardiovascular Research, Gruppo Villa Maria Care and Research, Anthea Hospital, Via Camillo Rosalba, 35, 70124 Bari, Italy
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, Princess Royal University Hospital, Farnborough Common, Orpington, BR6 8ND London, UK
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Lancellotti P, Dulgheru R, Go YY, Sugimoto T, Marchetta S, Oury C, Garbi M. Stress echocardiography in patients with native valvular heart disease. Heart 2017; 104:807-813. [DOI: 10.1136/heartjnl-2017-311682] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/30/2017] [Accepted: 11/15/2017] [Indexed: 12/20/2022] Open
Abstract
Valve stress echocardiography (VSE) can be performed as exercise stress echocardiography (ESE) or dobutamine stress echocardiography (DSE) depending on the patient’s clinical status, severity and type of valve disease. ESE combines exercise testing with two-dimensional grey scale and Doppler echocardiography during exercise. Thus, it provides objective assessment of symptomatic status (exercise test), as well as exercise-induced changes of a series of echocardiographic parameters (different depending on the valve disease type), which yield prognostic information in individual patients and help in a better treatment planning. DSE is useful in symptomatic patients with low-gradient aortic stenosis. It clarifies its severity and helps in assessing surgical risk in patients with severe disease and systolic dysfunction. It can be also used to test valve haemodynamics in asymptomatic patients with significant mitral stenosis unable to perform an exercise test or to test the left ventricle response, namely to test viability, in patients with ischaemic secondary mitral regurgitation. VSE has taught us that history taking, clinical examination and resting echocardiography give an ‘incomplete picture’ of the disease in patients presenting with a severe valve disease. Therefore, its use should be encouraged in such patients.
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Steeds RP, Garbi M, Cardim N, Kasprzak JD, Sade E, Nihoyannopoulos P, Popescu BA, Stefanidis A, Cosyns B, Monaghan M, Aakhus S, Edvardsen T, Flachskampf F, Galiuto L, Athanassopoulos G, Lancellotti P, Delgado V, Donal E, Galderisi M, Lombardi M, Muraru D, Haugaa K. EACVI appropriateness criteria for the use of transthoracic echocardiography in adults: a report of literature and current practice review. Eur Heart J Cardiovasc Imaging 2017; 18:1191-1204. [DOI: 10.1093/ehjci/jew333] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 12/19/2016] [Accepted: 12/21/2016] [Indexed: 12/19/2022] Open
Affiliation(s)
- Richard P. Steeds
- University Hospital Birmingham NHS Foundation Trust, Mindelsohn Road, Edgbaston, Birmingham, UK B15 2GW and Honorary Reader, Institute of Cardiovascular Sciences, University of Birmingham; UK
| | - Madalina Garbi
- King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS UK
| | - Nuno Cardim
- Echocardiography Laboratory, Hospital da Luz Av. Lus죡, n° 100 - 1500-650, Lisbon, Portugal
| | - Jaroslaw D. Kasprzak
- Department of Cardiology, Bieganski Hospital Medical University of Lodz, Kniaziewicza 1/5, 91-347, Lodz, Poland
| | - Elif Sade
- Department of Cardiology, Baskent University School of Medicine, Fevzi ơkmak Cad. 10. Sok. Bahcelievler 06490 Ankara, Turkey
| | - Petros Nihoyannopoulos
- Imperial College London, NHLI Hammersmith Hospital, Du Cane Road, London W12 0NN, UK and University of Athens, Greece
| | - Bogdan Alexandru Popescu
- University of Medicine and Pharmacy “Carol Davila”–Euroecolab, Institute of Cardiovascular Diseases, Sos. Fundeni 258, sector 2, 022328, Bucharest, Romania
| | - Alexandros Stefanidis
- 1st Department of Cardiology, General Hospital of Nikea, 3 P. Mela str., 184 54, Athens, Greece
| | - Bernard Cosyns
- Department of Cardiology, CHVZ (Centrum voor Hart en Vaatziekten) Universitair Ziekenhuis, VUB, Laarbeeklaan 101, 1090 Jette, Brussel, Belgium
| | - Mark Monaghan
- King's College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS UK
| | - Svend Aakhus
- Department of Cardiology, Oslo University Hospital, postboks 4950 Nydalen, 0424 Oslo and Faculty of Medicine, Norwegian University of Science and Technology, NTNU, 7491 Trondheim
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, NO-0027 Oslo , Norway
| | - Frank Flachskampf
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Akademiska ingang 40, 751 85 Uppsala, Sweden
| | - Leonarda Galiuto
- Department of Cardiovascular Sciences, Catholic University of the Sacred Heart, Policlinico Agostino Gemelli, Largo A Gemelli 8, 00168 Roma, Italy
| | | | - Patrizio Lancellotti
- Departments of Cardiology, University of Lie`ge Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart Tilman, Lie‘ge, Belgium and Gruppo Villa Maria Care and Research, Anthea, Hospital, Bari, Italy
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Chambers JB, Garbi M, Nieman K, Myerson S, Pierard LA, Habib G, Zamorano JL, Edvardsen T, Lancellotti P, Delgado V, Cosyns B, Donal E, Dulgheru R, Galderisi M, Lombardi M, Muraru D, Kauffmann P, Cardim N, Haugaa K, Rosenhek R. Appropriateness criteria for the use of cardiovascular imaging in heart valve disease in adults: a European Association of Cardiovascular Imaging report of literature review and current practice. Eur Heart J Cardiovasc Imaging 2017; 18:489-498. [DOI: 10.1093/ehjci/jew309] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [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: 10/06/2016] [Accepted: 11/17/2016] [Indexed: 01/16/2023] Open
Affiliation(s)
- John B. Chambers
- Cardiothoracic Centre, Guy’s and St Thomas Hospitals, London, UK
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
| | - Koen Nieman
- Departments of Cardiology and Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | | | - Gilbert Habib
- Aix-Marseille University, URMITE, Marseille, France
- Department of Cardiology, APHM, La Timone Hospital, Marseille, France
| | | | - Thor Edvardsen
- Department of Cardiology and Centre of Cardiological Innovation, Oslo University Hospital, Rikshospitalet and University of Oslo, Oslo, Norway
| | - Patrizio Lancellotti
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium
- Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
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Lancellotti P, Pellikka PA, Budts W, Chaudhry FA, Donal E, Dulgheru R, Edvardsen T, Garbi M, Ha JW, Kane GC, Kreeger J, Mertens L, Pibarot P, Picano E, Ryan T, Tsutsui JM, Varga A. The Clinical Use of Stress Echocardiography in Non-Ischaemic Heart Disease: Recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. J Am Soc Echocardiogr 2017; 30:101-138. [DOI: 10.1016/j.echo.2016.10.016] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Affiliation(s)
- Mathivathana Indrajith
- Cardiac Non-Invasive Diagnostics Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Madalina Garbi
- Cardiac Non-Invasive Diagnostics Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Mark J Monaghan
- Cardiac Non-Invasive Diagnostics Department, King's College Hospital NHS Foundation Trust, London, UK
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Lancellotti P, Pellikka PA, Budts W, Chaudhry FA, Donal E, Dulgheru R, Edvardsen T, Garbi M, Ha JW, Kane GC, Kreeger J, Mertens L, Pibarot P, Picano E, Ryan T, Tsutsui JM, Varga A. The clinical use of stress echocardiography in non-ischaemic heart disease: recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging 2016; 17:1191-1229. [DOI: 10.1093/ehjci/jew190] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 08/12/2016] [Indexed: 12/20/2022] Open
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Lancellotti P, Pibarot P, Chambers J, Edvardsen T, Delgado V, Dulgheru R, Pepi M, Cosyns B, Dweck MR, Garbi M, Magne J, Nieman K, Rosenhek R, Bernard A, Lowenstein J, Vieira MLC, Rabischoffsky A, Vyhmeister RH, Zhou X, Zhang Y, Zamorano JL, Habib G. Recommendations for the imaging assessment of prosthetic heart valves: a report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography, and the Brazilian Department of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2016; 17:589-90. [PMID: 27143783 DOI: 10.1093/ehjci/jew025] [Citation(s) in RCA: 337] [Impact Index Per Article: 42.1] [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: 01/06/2016] [Accepted: 01/07/2016] [Indexed: 01/04/2023] Open
Abstract
Prosthetic heart valve (PHV) dysfunction is rare but potentially life-threatening. Although often challenging, establishing the exact cause of PHV dysfunction is essential to determine the appropriate treatment strategy. In clinical practice, a comprehensive approach that integrates several parameters of valve morphology and function assessed with 2D/3D transthoracic and transoesophageal echocardiography is a key to appropriately detect and quantitate PHV dysfunction. Cinefluoroscopy, multidetector computed tomography, cardiac magnetic resonance imaging, and to a lesser extent, nuclear imaging are complementary tools for the diagnosis and management of PHV complications. The present document provides recommendations for the use of multimodality imaging in the assessment of PHVs.
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Affiliation(s)
- Patrizio Lancellotti
- Department of Cardiology, GIGA-Cardiovascular Sciences, University of Liège Hospital, Liège, Belgium Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Philippe Pibarot
- Québec Heart and Lung Institute/Institut Universitaire de Cardiology et de Pneumologie de Québec, Québec, Canada Department of Cardiology, Laval University and Canada Research Chair in Valvular Heart Disease, Québec, Canada
| | | | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Oslo, Norway
| | - Victoria Delgado
- Department of Cardiology, Heart Lung Center Leiden University Medical Center, Leiden, The Netherlands
| | - Raluca Dulgheru
- Department of Cardiology, GIGA-Cardiovascular Sciences, University of Liège Hospital, Liège, Belgium
| | - Mauro Pepi
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Bernard Cosyns
- Cardiology, Centrum voor Hart en Vaatziekten, UZ Brussel, Bruxelles, Belgium
| | - Mark R Dweck
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
| | - Julien Magne
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges F-87042, France INSERM 1094, Faculté de médecine de Limoges, 2, rue Marcland, 87000 Limoges, France
| | - Koen Nieman
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Raphael Rosenhek
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Anne Bernard
- Cardiology department, CHRU de Tours, F-37000 Tours, France François Rabelais University, Faculty of Medicine, F-37000 Tours, France
| | - Jorge Lowenstein
- Servicio Cardiodiagnostico Investigaciones Médicas de Buenos Aires, Argentina
| | - Marcelo Luiz Campos Vieira
- Heart Institute (InCor), São Paulo University Medical School, São Paulo, Brazil Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Arnaldo Rabischoffsky
- Hospital Pro Cardíaco Echocardiography Department Coordinator, Rio de Janeiro, Brazil
| | | | - Xiao Zhou
- Cardiology, Chinese PLA General Hospital in Beijing, China
| | - Yun Zhang
- Shandong University Qilu Hospital in Jinan, Shandong, China
| | | | - Gilbert Habib
- Aix-Marseille Université, 13005 - Marseille, France Cardiology Department, APHM, La Timone Hospital, 13005 - Marseille, France
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Garbi M, Edvardsen T, Bax J, Petersen SE, McDonagh T, Filippatos G, Lancellotti P. EACVI appropriateness criteria for the use of cardiovascular imaging in heart failure derived from European National Imaging Societies voting. Eur Heart J Cardiovasc Imaging 2016; 17:711-21. [DOI: 10.1093/ehjci/jew081] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 03/26/2016] [Indexed: 01/08/2023] Open
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Donal E, Lip GYH, Galderisi M, Goette A, Shah D, Marwan M, Lederlin M, Mondillo S, Edvardsen T, Sitges M, Grapsa J, Garbi M, Senior R, Gimelli A, Potpara TS, Van Gelder IC, Gorenek B, Mabo P, Lancellotti P, Kuck KH, Popescu BA, Hindricks G, Habib G, Cosyns B, Delgado V, Haugaa KH, Muraru D, Nieman K, Cohen A. EACVI/EHRA Expert Consensus Document on the role of multi-modality imaging for the evaluation of patients with atrial fibrillation. Eur Heart J Cardiovasc Imaging 2016; 17:355-83. [DOI: 10.1093/ehjci/jev354] [Citation(s) in RCA: 187] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Abstract
Quantitative analysis is an important part of the morphological assessment of the diseased mitral valve. It can be used to describe valve anatomy, pathology, function and the mechanisms of disease. Echocardiography is the main source of indirect quantitative data that is comparable with direct anatomic or surgical measurements. Furthermore, it can relate morphology with function. This review provides an account of current mitral valve quantification techniques and clinical applications.
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Affiliation(s)
- Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust , London , UK
| | - Mark J Monaghan
- King's Health Partners, King's College Hospital NHS Foundation Trust , London , UK
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Garbi M, Chambers J, Vannan MA, Lancellotti P. Valve Stress Echocardiography. JACC Cardiovasc Imaging 2015; 8:724-36. [DOI: 10.1016/j.jcmg.2015.02.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 01/22/2015] [Accepted: 02/12/2015] [Indexed: 11/29/2022]
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Lancellotti P, P o ska-Go ciniak E, Garbi M, Bucciarelli-ducci C, Cosyns B, Cardim N, Galderisi M, Edvardsen T, Neglia D, Plein S, Kitsiou A, Nieman K, Stefanidis A, Maurer G, Popescu BA, Habib G. Cardiovascular imaging practice in Europe: a report from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015; 16:697-702. [DOI: 10.1093/ehjci/jev116] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 04/13/2015] [Indexed: 11/12/2022] Open
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Garbi M, McDonagh T, Cosyns B, Bucciarelli-Ducci C, Edvardsen T, Kitsiou A, Nieman K, Lancellotti P. Appropriateness criteria for cardiovascular imaging use in heart failure: report of literature review. Eur Heart J Cardiovasc Imaging 2014; 16:147-53. [PMID: 25550363 DOI: 10.1093/ehjci/jeu299] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [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: 01/04/2023] Open
Abstract
The Imaging Task Force appointed by the European Society of Cardiology (ESC) and the European Association of Cardiovascular Imaging (EACVI) identified the need to develop appropriateness criteria for the use of cardiovascular imaging in heart failure as a result of continuously increasing demand for imaging in diagnosis, definition of aetiology, follow-up, and treatment planning. This article presents the report of literature review performed in order to inform the process of definition of clinical indications and to aid the decisions of the appropriateness criteria voting panel. The report is structured according to identified common heart failure clinical scenarios.
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Affiliation(s)
- Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
| | - Theresa McDonagh
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
| | - Bernard Cosyns
- Universitair Ziekenhuis van Brussel, CHVZ and ICMI Laboratory, CHIREC, Brussels, Belgium
| | - Chiara Bucciarelli-Ducci
- Bristol NIHR Cardiovascular Biomedical Research Unit (BRU), Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Norway
| | | | - Koen Nieman
- Department of Cardiology and Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Patrizio Lancellotti
- Department of GIGA Cardiovascular Sciences, Heart Valve Clinic, Department of Cardiology, University of Liège Hospital, University Hospital SartTilman, Liège, Belgium Department of GVM Care and Research, Bologna, Italy
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Neskovic AN, Edvardsen T, Galderisi M, Garbi M, Gullace G, Jurcut R, Dalen H, Hagendorff A, Lancellotti P, Popescu BA, Sicari R, Stefanidis A. Focus cardiac ultrasound: the European Association of Cardiovascular Imaging viewpoint. Eur Heart J Cardiovasc Imaging 2014; 15:956-60. [PMID: 24866902 DOI: 10.1093/ehjci/jeu081] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [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: 12/19/2022] Open
Abstract
The concept of point-of-care, problem-oriented focus cardiac ultrasound examination (FoCUS) is increasingly applied in the settings of medical emergencies, including cardiac diseases. The European Association of Cardiovascular Imaging (EACVI) recognizes that cardiologists are not the only medical professionals dealing with cardiovascular emergencies. In reality, emergency cardiac diagnostics and treatment are also carried out by a wide range of specialists. For the benefit of the patients, the EACVI encourages any medical professional, sufficiently trained to obtain valuable information from FoCUS, to use it in emergency settings. These medical professionals need to have the necessary knowledge to understand the obtained information entirely, and to use it correctly, thoughtfully and with care. In this document, the EACVI underlines major differences between echocardiography and FoCUS, and underscores the need for specific education and training in order to fully utilize advantages and minimize drawbacks of this type of cardiac ultrasound examination in the critically ill patients.
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Affiliation(s)
- Aleksandar N Neskovic
- Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Maurizio Galderisi
- Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
| | - Giuseppe Gullace
- Cardiovascular Department of Azienda Ospedaliera della Provincia di Lecco, Lecco, Italy
| | - Ruxandra Jurcut
- Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila', Emergency Institute of Cardiovascular Diseases, Bucharest, Romania
| | - Havard Dalen
- MI Lab and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
| | - Andreas Hagendorff
- Department of Cardiology-Angiology, University of Leipzig, Leipzig, Germany
| | - Patrizio Lancellotti
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium
| | | | - Bogdan A Popescu
- Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia Department of Cardiology, Oslo University Hospital and University of Oslo, Oslo, Norway Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK Cardiovascular Department of Azienda Ospedaliera della Provincia di Lecco, Lecco, Italy Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila', Emergency Institute of Cardiovascular Diseases, Bucharest, Romania MI Lab and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway Department of Cardiology-Angiology, University of Leipzig, Leipzig, Germany Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium
| | - Rosa Sicari
- Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia Department of Cardiology, Oslo University Hospital and University of Oslo, Oslo, Norway Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK Cardiovascular Department of Azienda Ospedaliera della Provincia di Lecco, Lecco, Italy Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila', Emergency Institute of Cardiovascular Diseases, Bucharest, Romania MI Lab and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway Department of Cardiology-Angiology, University of Leipzig, Leipzig, Germany Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium
| | - Alexander Stefanidis
- Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia Department of Cardiology, Oslo University Hospital and University of Oslo, Oslo, Norway Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK Cardiovascular Department of Azienda Ospedaliera della Provincia di Lecco, Lecco, Italy Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila', Emergency Institute of Cardiovascular Diseases, Bucharest, Romania MI Lab and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway Department of Internal Medicine, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway Department of Cardiology-Angiology, University of Leipzig, Leipzig, Germany Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium
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Garbi M, Habib G, Plein S, Neglia D, Kitsiou A, Donal E, Pinto F, Bax J, Achenbach S, Popescu BA, Edvardsen T, Badano LP, Stefanidis A, Bucciarelli-Ducci C, Derumeaux G, Luis Zamorano J, Lüscher TF, Maurer G, Lancellotti P. Appropriateness criteria for cardiovascular imaging use in clinical practice: a position statement of the ESC/EACVI taskforce. Eur Heart J Cardiovasc Imaging 2014; 15:477-82. [PMID: 24639554 DOI: 10.1093/ehjci/jeu031] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [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: 11/14/2022] Open
Abstract
There is a growing interest from the scientific community in the appropriate use of cardiovascular imaging techniques for diagnosis and decision making in Europe. To develop appropriateness criteria for cardiovascular imaging use in clinical practice in Europe, a dedicated taskforce has been appointed by the European Society of Cardiology (ESC) and the European Association of Cardiovascular Imaging (EACVI). The present paper describes the appropriateness criteria development process.
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Affiliation(s)
- Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, UK
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Cosyns B, Garbi M, Separovic J, Pasquet A, Lancellotti P. Update of the Echocardiography Core Syllabus of the European Association of Cardiovascular Imaging (EACVI). Eur Heart J Cardiovasc Imaging 2013; 14:837-9. [DOI: 10.1093/ehjci/jet140] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Garbi M, Rubinstein S, Lax Y, Breitbart H. Activation of protein kinase calpha in the lysophosphatidic acid-induced bovine sperm acrosome reaction and phospholipase D1 regulation. Biol Reprod 2000; 63:1271-7. [PMID: 11058529 DOI: 10.1095/biolreprod63.5.1271] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Protein kinase C (PKC) has been implicated in the sperm acrosome reaction. In the present study, we demonstrate induction of the acrosome reaction and activation of sperm PKCalpha by lysophosphatidic acid (LPA), which is known to induce signal transduction cascades in many cell types via binding to specific cell-surface receptors. Under conditions by which LPA activates PKCalpha, there is significant stimulation of the acrosome reaction, which is inhibited by PKC inhibitors. Protein kinase Calpha belongs to the Ca(2+)-dependent classical PKC family of isoforms, and indeed we show that its activation depends upon the presence of Ca(2+) in the incubation medium. Protein kinase Calpha is a known regulator of phospholipase D (PLD). We investigated the possible regulatory relationships between PKCalpha and PLD1. Using specific antibodies against PLD1, we demonstrate for the first time its presence in bovine sperm. Furthermore, PLD1 coimmunoprecipitates with PKCalpha and the PKCalpha-PLD1 complex decomposes after treatment of the cells with LPA or 12-O:-tetradecanoyl phorbol-13-acetate, resulting in the translocation of PKCalpha to the plasma membrane and translocation of PLD1 to the particulate fraction. A possible bilateral regulation of PKCalpha and PLD1 activation during the sperm acrosome reaction is suggested.
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Affiliation(s)
- M Garbi
- Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan 52900, Israel
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