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Simon J, Smit JM, El Mahdiui M, Száraz L, van Rosendael AR, Zsarnóczay E, Nagy AI, Gellér L, van der Geest RJ, Bax JJ, Maurovich-Horvat P, Merkely B. Association of Left Atrial Appendage Morphology and Function With Stroke and Transient Ischemic Attack in Atrial Fibrillation Patients. Am J Cardiol 2024; 221:37-43. [PMID: 38552710 DOI: 10.1016/j.amjcard.2024.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/03/2024] [Accepted: 03/22/2024] [Indexed: 04/09/2024]
Abstract
We aimed to correlate left atrial appendage (LAA) structure and function with the history of stroke/transient ischemic attack (TIA) in patients with atrial fibrillation (AF). We analyzed the data of 649 patients with AF who were scheduled for catheter ablation. Patients underwent cardiac computed tomography and transesophageal echocardiography before ablation. The LAA morphologies depicted by cardiac computed tomography were categorized into 4 groups: cauliflower, chicken wing, swan, and windsock shapes. The mean age was 61.3 ± 10.5 years, 33.9% were women. The prevalence of stroke/TIA was 7.1%. After adjustment for the main risk factors, the LAA flow velocity ≤35.3 cm/s (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.09 to 4.61, p = 0.033) and the swan LAA shape (OR 2.69, 95% CI 0.96 to 6.86, p = 0.047) independently associated with a higher risk of stroke/TIA, whereas the windsock LAA morphology proved to be protective (OR 0.32, 95% CI 0.12 to 0.77, p = 0.017) compared with the cauliflower LAA shape. Comparing the differences between the LAA morphology groups, we measured a significantly smaller LAA orifice area (389.3 ± 137.7 mm2 in windsock vs 428.3 ± 158.9 ml in cauliflower, p = 0.021) and LAA volume (7.4 ± 3.0 mm2 in windsock vs 8.5 ± 4.8 mm2 in cauliflower, p = 0.012) in patients with windsock LAA morphology, whereas the LAA flow velocity did not differ significantly. Reduced LAA function and swan LAA morphology were independently associated with a higher prevalence of stroke/TIA, whereas the windsock LAA shape proved to be protective. Comparing the differences between the various LAA morphology types, significantly lower LAA volume and LAA orifice area were measured in the windsock LAA shape than in the cauliflower LAA shape.
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Affiliation(s)
- Judit Simon
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Budapest, Hungary
| | - Jeff M Smit
- Department of Cardiology, Leiden University Medical Center Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center Leiden, The Netherlands
| | - Lili Száraz
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Budapest, Hungary
| | | | - Emese Zsarnóczay
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Budapest, Hungary
| | - Anikó Ilona Nagy
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Lászlo Gellér
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Rob J van der Geest
- Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center Leiden, The Netherlands; Heart Center, Turku University Hospital Turku, Finland; University of Turku, Turku, Finland
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Budapest, Hungary.
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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Smit JM, Rocchiccioli S, Signore G, Michelucci E, Di Giorgi N, van Rosendael AR, El Mahdiui M, Neglia D, Knuuti J, Saraste A, Buechel RR, Teresinska A, Pizzi MN, Roque A, Poddighe R, Mertens BJ, Caselli C, Parodi O, Pelosi G, Scholte AJ. Plasma Lipidomics and Coronary Plaque Changes: A Substudy of the SMARTool Clinical Trial. Eur Heart J Cardiovasc Imaging 2024:jeae058. [PMID: 38445505 DOI: 10.1093/ehjci/jeae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 07/10/2023] [Revised: 01/09/2024] [Accepted: 01/25/2024] [Indexed: 03/07/2024] Open
Abstract
AIMS To date, no studies have investigated the association between lipid species and coronary plaque changes over time, quantitatively assessed by serial imaging. We aimed to prospectively determine the association between lipid species quantified by plasma lipidomic analysis, with coronary plaque changes according to composition assessed by quantitative serial analysis of coronary computed tomography angiography (CTA). METHODS AND RESULTS Patients with suspected coronary artery disease (CAD) undergoing baseline coronary CTA were prospectively enrolled by 7 EU Centers in the SMARTool study and submitted to clinical, molecular and coronary CTA re-evaluation at follow-up (interscan period 6.39 ± 1.17 years). From the 202 patients that were analysed in the SMARTool main clinical study, lipidomic analysis was performed in 154 patients before the baseline coronary CTA, and this group was included in the present study. Quantitative CTA analysis was performed by a separate core laboratory blinded from clinical data. In univariable analysis, no lipid species were significantly associated with annual total and calcified plaque changes. After adjusting for clinical variables at baseline and statin use, 3 lipid species were significantly associated with non-calcified plaque progression. In detail, cholesteryl ester (CE)(20:3), sphingomyelin (SM)(40:3) and SM(41:1) were found positively related to non-calcified plaque progression (Bonferroni adjusted P-value = 0.005, 0.016 and 0.004, respectively). CONCLUSION The current study showed an independent relationship between specific lipid species determined by plasma lipidomic analysis, and non-calcified coronary plaque progression assessed by serial, quantitative coronary CTA analysis.
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Affiliation(s)
- Jeff M Smit
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Silvia Rocchiccioli
- Institute of Clinical Physiology CNR, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | - Giovanni Signore
- Department of Biology, Biochemistry Unit, University of Pisa, 56126, Pisa, Italy
| | - Elena Michelucci
- Institute of Clinical Physiology CNR, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | - Nicoletta Di Giorgi
- Institute of Clinical Physiology CNR, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | | | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Danilo Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | - Juhani Knuuti
- Heart Center and PET Centre, Turku University Hospital and University of Turku, 20520, Turku, Finland
| | - Antti Saraste
- Heart Center and PET Centre, Turku University Hospital and University of Turku, 20520, Turku, Finland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital and University of Zurich, Switzerland
| | - Anna Teresinska
- Department of Nuclear Medicine, National Institute of Cardiology, Warsaw, Poland
| | - Maria N Pizzi
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Albert Roque
- Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Bart J Mertens
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Chiara Caselli
- Institute of Clinical Physiology CNR, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | - Oberdan Parodi
- Cardiovascular Department, Fondazione Toscana G. Monasterio, Via G. Moruzzi 1, Pisa, Italy
| | - Gualtiero Pelosi
- Institute of Clinical Physiology CNR, Pisa, Viale Giuseppe Moruzzi 1 56124, Italy
| | - Arthur J Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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Smit JM, El Mahdiui M, de Graaf MA, Montero-Cabezas JM, Reiber JHC, Jukema JW, Scholte AJ, Knuuti J, Wijns W, Narula J, Bax JJ. Relation Between Coronary Plaque Composition Assessed by Intravascular Ultrasound Virtual Histology and Myocardial Ischemia Assessed by Quantitative Flow Ratio. Am J Cardiol 2023; 186:228-235. [PMID: 36333150 DOI: 10.1016/j.amjcard.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 07/12/2022] [Revised: 09/10/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022]
Abstract
Coronary plaque composition may play an important role in the induction of myocardial ischemia. Our objective was to further clarify the relation between coronary plaque composition and myocardial ischemia in patients with chest pain symptoms. The study population consisted of 103 patients who presented to the outpatient clinic or emergency department with chest pain symptoms and were referred for diagnostic invasive coronary angiography. Intravascular ultrasound virtual histology was used for the assessment of coronary plaque composition. A noncalcified plaque was defined as a combination of necrotic core and fibrofatty tissue. Quantitative flow ratio (QFR), which is a coronary angiography-based technique used to calculate fractional flow reserve without the need for hyperemia induction or for a pressure wire, was used as the reference standard for the evaluation of myocardial ischemia. Coronary artery plaques with QFR of ≤0.80 were considered abnormal-that is, ischemia-generating. In total, 149 coronary plaques were analyzed, 21 of which (14%) were considered abnormal according to QFR. The percentage of noncalcified tissue was significantly higher in plaques with abnormal QFR (38.2 ± 6.5% vs 33.1 ± 9.0%, p = 0.014). After univariable analysis, both plaque load (odds ratio [OR] per 1% increase 1.081, p <0.001) and the percentage of noncalcified tissue (OR per 1% increase 1.070, p = 0.020) were significantly associated with reduced QFR. However, after multivariable analysis, only plaque load remained significantly associated with abnormal QFR (OR per 1% increase 1.072, p <0.001). In conclusion, the noncalcified plaque area was significantly higher in hemodynamically significant coronary lesions than in nonsignificant lesions. Although an increase in the noncalcified plaque area was significantly associated with a reduced QFR, this association lost significance after adjustment for localized plaque load.
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Affiliation(s)
- Jeff M Smit
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands
| | - Michiel A de Graaf
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands
| | | | - Johan H C Reiber
- Medis Medical Imaging, Leiden, The Netherlands; Departments of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - J Wouter Jukema
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands
| | - Arthur J Scholte
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands
| | - Juhani Knuuti
- Heart Center, University of Turku and Turku University Hospital, Turku, Finland
| | - William Wijns
- Lambe Institute for Translational Medicine and Curam, National University of Ireland Galway and Saolta University Healthcare Group, University College Hospital Galway, Galway, Ireland
| | - Jagat Narula
- Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jeroen J Bax
- Departments of Cardiology Leiden University Medical Center, Leiden, The Netherlands; Heart Center, University of Turku and Turku University Hospital, Turku, Finland.
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Caselli C, Di Giorgi N, Ragusa R, Lorenzoni V, Smit J, El Mahdiui M, Buechel RR, Teresinska A, Pizzi MN, Roque A, Poddighe R, Knuuti J, Schütte M, Parodi O, Pelosi G, Scholte A, Rocchiccioli S, Neglia D. Association of MMP9 with adverse features of plaque progression and residual inflammatory risk in patients with chronic coronary syndrome (CCS). Vascul Pharmacol 2022; 146:107098. [PMID: 36100166 DOI: 10.1016/j.vph.2022.107098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/18/2022] [Accepted: 08/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS MMP-9 is a predictor of atherosclerotic plaque instability and adverse cardiovascular events, but longitudinal data on the association between MMP9 and coronary disease progression are lacking. This study is aimed at investigating whether MMP9 is associated with atherosclerotic plaque progression and the related molecular basis in stable patients with chronic coronary syndrome (CCS). METHODS MMP9 serum levels were measured in 157 CCS patients (58 ± 8 years of age; 66% male) undergoing coronary computed tomography angiography at baseline and after a follow up period of 6.5 ± 1.1 years to assess progression of Total, Fibrous, Fibro-fatty, Necrotic Core, and Dense Calcium plaque volumes (PV). Gene expression analysis was evaluated in whole blood using a transcriptomic approach by RNA-seq. RESULTS At multivariate analysis, serum MMP9 was associated with annual change of Total and Necrotic Core PV (Coefficient 3.205, SE 1.321, P = 0.017; 1.449, SE 0.690, P = 0.038, respectively), while MMP9 gene expression with Necrotic Core PV (Coefficient 70.559, SE 32.629, P = 0.034), independently from traditional cardiovascular risk factors, medications, and presence of obstructive CAD. After transcriptomic analysis, MMP9 expression was linked to expression of genes involved in the innate immunity. CONCLUSIONS Among CCS patients, MMP9 is an independent predictive marker of progression of adverse coronary plaques, possibly reflecting the activity of inflammatory pathways conditioning adverse plaque phenotypes. Thus, blood MMP9 might be used for the identification of patients with residual risk even with optimal management of classical cardiovascular risk factors who may derive the greatest benefit from targeted anti-inflammatory drugs.
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Affiliation(s)
- Chiara Caselli
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | | | - Rosetta Ragusa
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | - Valentina Lorenzoni
- Sant'Anna School of Advanced Studies, Piazza Martiri della Libertà, 33, Pisa, Italy.
| | - Jeff Smit
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | - Mohammed El Mahdiui
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital and University of Zurich, Switzerland.
| | | | - Maria N Pizzi
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Albert Roque
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | - Juhani Knuuti
- PET Center, Turku University Hospital and University of Turku, Kiinamyllynkatu 4-8, Turku, Finland.
| | - Moritz Schütte
- Alacris Theranostics GmbH, Max-Planck-Straße 3, 12489 Berlin, Germany.
| | - Oberdan Parodi
- Fondazione Toscana G. Monasterio, Via G. Moruzzi 1, Pisa, Italy
| | - Gualtiero Pelosi
- Institute of Clinical Physiology CNR, Via G. Moruzzi 1, Pisa, Italy.
| | - Arthur Scholte
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, RC, Leiden, the Netherlands.
| | | | - Danilo Neglia
- Fondazione Toscana G. Monasterio, Via G. Moruzzi 1, Pisa, Italy.
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Szegedi N, Simon J, Szilveszter B, Salló Z, Herczeg S, Száraz L, Kolossváry M, Orbán G, Széplaki G, Nagy KV, Mahdiui ME, Smit JM, Delgado V, Bax JJ, Maurovich-Horvat P, Merkely B, Gellér L. Abutting Left Atrial Appendage and Left Superior Pulmonary Vein Predicts Recurrence of Atrial Fibrillation After Point-by-Point Pulmonary Vein Isolation. Front Cardiovasc Med 2022; 9:708298. [PMID: 35242821 PMCID: PMC8885731 DOI: 10.3389/fcvm.2022.708298] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe role of the spatial relationship between the left superior pulmonary vein (LSPV) and left atrial appendage (LAA) is unknown. We sought to evaluate whether an abutting LAA and LSPV play a role in AF recurrence after catheter ablation for paroxysmal AF.MethodsConsecutive patients, who underwent initial point-by-point radiofrequency catheter ablation for paroxysmal AF at the Heart and Vascular Center of Semmelweis University, Budapest, Hungary, between January of 2014 and December of 2017, were enrolled in the study. All patients underwent pre-procedural cardiac CT to assess left atrial (LA) and pulmonary vein (PV) anatomy. Abutting LAA-LSPV was defined as cases when the minimum distance between the LSPV and LAA was less than 2 mm.ResultsWe included 428 patients (60.7 ± 10.8 years, 35.5% female) in the analysis. AF recurrence rate was 33.4%, with a median recurrence-free time of 21.2 (8.8–43.0) months. In the univariable analysis, female sex (HR = 1.45; 95%CI = 1.04–2.01; p = 0.028), LAA flow velocity (HR = 1.01; 95%CI = 1.00–1.02; p = 0.022), LAA orifice area (HR = 1.00; 95%CI = 1.00–1.00; p = 0.028) and abutting LAA-LSPV (HR = 1.53; 95%CI = 1.09–2.14; p = 0.013) were associated with AF recurrence. In the multivariable analysis, abutting LAA-LSPV (adjusted HR = 1.55; 95%CI = 1.04–2.31; p = 0.030) was the only independent predictor of AF recurrence.ConclusionAbutting LAA-LSPV predisposes patients to have a higher chance for arrhythmia recurrence after catheter ablation for paroxysmal AF.
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Affiliation(s)
- Nándor Szegedi
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- *Correspondence: Nándor Szegedi
| | - Judit Simon
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bálint Szilveszter
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Zoltán Salló
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Szilvia Herczeg
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Lili Száraz
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Márton Kolossváry
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Gábor Orbán
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Gábor Széplaki
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Heart and Vascular Centre, Mater Private Hospital, Dublin, Ireland
| | | | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Jeff M. Smit
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Jeroen J. Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - László Gellér
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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6
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Simon J, El Mahdiui M, Smit JM, Száraz L, van Rosendael AR, Herczeg S, Zsarnóczay E, Nagy AI, Kolossváry M, Szilveszter B, Szegedi N, Nagy KV, Tahin T, Gellér L, van der Geest RJ, Bax JJ, Maurovich-Horvat P, Merkely B. Left atrial appendage size is a marker of atrial fibrillation recurrence after radiofrequency catheter ablation in patients with persistent atrial fibrillation. Clin Cardiol 2021; 45:273-281. [PMID: 34799870 PMCID: PMC8922535 DOI: 10.1002/clc.23748] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/12/2021] [Accepted: 10/29/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction There are no consistently confirmed predictors of atrial fibrillation (AF) recurrence after catheter ablation. Therefore, we aimed to study whether left atrial appendage volume (LAAV) and function influence the long‐term recurrence of AF after catheter ablation, depending on AF type. Methods AF patients who underwent point‐by‐point radiofrequency catheter ablation after cardiac computed tomography (CT) were included in this analysis. LAAV and LAA orifice area were measured by CT. Uni‐ and multivariable Cox proportional hazard regression models were performed to determine the predictors of AF recurrence. Results In total, 561 AF patients (61.9 ± 10.2 years, 34.9% females) were included in the study. Recurrence of AF was detected in 40.8% of the cases (34.6% in patients with paroxysmal and 53.5% in those with persistent AF) with a median recurrence‐free time of 22.7 (9.3–43.1) months. Patients with persistent AF had significantly higher body surface area‐indexed LAV, LAAV, and LAA orifice area and lower LAA flow velocity, than those with paroxysmal AF. After adjustment left ventricular ejection fraction (LVEF) <50% (HR = 2.17; 95% CI = 1.38–3.43; p < .001) and LAAV (HR = 1.06; 95% CI = 1.01–1.12; p = .029) were independently associated with AF recurrence in persistent AF, while no independent predictors could be identified in paroxysmal AF. Conclusion The current study demonstrates that beyond left ventricular systolic dysfunction, LAA enlargement is associated with higher rate of AF recurrence after catheter ablation in persistent AF, but not in patients with paroxysmal AF.
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Affiliation(s)
- Judit Simon
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.,Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeff M Smit
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lili Száraz
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | - Szilvia Herczeg
- Heat and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Emese Zsarnóczay
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Anikó Ilona Nagy
- Heat and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bálint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Nándor Szegedi
- Heat and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | - Tamás Tahin
- Heat and Vascular Center, Semmelweis University, Budapest, Hungary
| | - László Gellér
- Heat and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Rob J van der Geest
- Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.,Heart Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary.,Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Béla Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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7
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Simon J, Mahdiui ME, Smit JM, Szaraz L, Herczeg SZ, Van Rosendael AR, Zsarnoczay E, Nagy AI, Kolossvary M, Szilveszter B, Szegedi N, Geller L, Bax JJ, Maurovich-Horvat P, Merkely B. Left atrial appendage size is a marker of atrial fibrillation recurrence after radiofrequency catheter ablation in patients with persistent atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/14/2022] Open
Abstract
Abstract
Background
Catheter ablation is an established therapy for rhythm control in patients with drug-refractory atrial fibrillation (AF), however, recurrence is frequent particularly in persistent AF. There are no consistently confirmed predictors of AF recurrence after catheter ablation. The left atrial appendage (LAA) potentially plays an important role in AF recurrence, although the exact mechanism and pathophysiology are still unclear.
Purpose
We aimed to study whether LAA volume (LAAV) and function influence the long-term recurrence of AF after point-by-point radiofrequency catheter ablation, depending on AF type.
Methods
AF patients who underwent point-by-point radiofrequency catheter ablation after preprocedural cardiac computed tomography (CT) and transthoracic and transesophageal echocardiography (TEE) were included in this retrospective analysis. LAAV and LAA orifice area were measured by CT and LAA flow velocity assessed by TEE and was used as a surrogate marker of LAA function. Uni- and multivariable Cox proportional hazard regression models were performed to determine the predictors of AF recurrence.
Results
In total, 561 AF patients (61.9±10.2 years, 34.9% females) were included in the study. Recurrence of AF was detected in 40.8% of the cases (34.6% in patients with paroxysmal and 53.5% in those with persistent AF) with a median recurrence-free time of 22.7 [9.3–43.1] months. Patients with AF recurrence had significantly higher body surface area-indexed left atrial volume (iLAV), LAAV and LAA orifice area, as compared to those without recurrence. Moreover, patients with persistent AF had significantly higher iLAV, LAAV, LAA orifice area and lower LAA flow velocity, than those with paroxysmal AF. After adjustment for the main cardiovascular risk factors and comorbidities left ventricular ejection fraction (LVEF) <50% (HR=2.17; 95% CI=1.38–3.43; p<0.001) and LAAV (HR=1.06; 95% CI=1.01–1.12; p=0.029) were independently associated with AF recurrence in persistent AF, while no independent predictors could be identified in paroxysmal AF.
Conclusions
The current study demonstrates that beyond left ventricular systolic dysfunction, LAA enlargement is associated with higher rate of AF recurrence after catheter ablation in persistent AF, but not in patients with paroxysmal AF. Our results suggest that preprocedural assessment of LVEF and LAAV might contribute to optimal patient selection and aid to improve long-term results of ablation procedures in patients with persistent AF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Simon
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - M E Mahdiui
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - J M Smit
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - L Szaraz
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - S Z Herczeg
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | | | - E Zsarnoczay
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - A I Nagy
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - M Kolossvary
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - B Szilveszter
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - N Szegedi
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - L Geller
- Semmelweis University Heart and Vascular Center, Budapest, Hungary
| | - J J Bax
- Leiden University Medical Center, Leiden, Netherlands (The)
| | - P Maurovich-Horvat
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
| | - B Merkely
- Semmelweis University, MTA-SE Cardiovascular Research Group, Heart and Vascular Center, Budapest, Hungary
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8
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Lustosa RP, Fortuni F, van der Bijl P, Goedemans L, El Mahdiui M, Montero-Cabezas JM, Kostyukevich MV, Ajmone Marsan N, Bax JJ, Delgado V, Knuuti J. Left ventricular myocardial work in the culprit vessel territory and impact on left ventricular remodelling in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention. Eur Heart J Cardiovasc Imaging 2021; 22:339-347. [PMID: 32642755 DOI: 10.1093/ehjci/jeaa175] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/21/2020] [Accepted: 06/07/2020] [Indexed: 12/18/2022] Open
Abstract
AIMS Adverse left ventricular (LV) remodelling after ST-segment elevation myocardial infarction (STEMI) is associated with poor outcome. Global and regional LV myocardial work (LVMW) derived from speckle tracking echocardiographic strain data in combination with non-invasive blood pressure recordings could provide information for prediction of LV remodelling after STEMI. The aim of the study was to assess the predictive value of global and regional LVMW for LV remodelling before discharge in patients with STEMI. METHODS AND RESULTS Three-hundred and fifty STEMI patients treated with primary percutaneous coronary intervention (PCI) were included [265 men (76%), mean age: 61 ± 10 years]. Clinical variables, conventional echocardiographic parameters, global and regional measures of myocardial work index (MWI), and myocardial work efficiency were recorded before discharge. The primary endpoint was early LV remodelling defined as increase in LV end-diastolic volume (LVEDV) ≥20% at 3 months after STEMI. Eighty-seven patients (25%) showed early LV remodelling. The global and regional LVMW in the culprit territory were significantly lower in patients with early LV remodelling. Peak troponin I (OR 1.109, 95% CI 1.046-1.177; P = 0.001), LVEDV (OR 0.972, 95% CI 0.959-0.984; P < 0.001) and regional MWI in the culprit vessel territory (OR 0.602, 95% CI 0.383-0.945; P = 0.027) were independently associated with early LV remodelling. CONCLUSION In STEMI patients treated with primary PCI and optimal medical therapy, the regional cardiac work index in the culprit vessel territory before discharge is independently associated with early adverse LV remodelling.
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Affiliation(s)
- Rodolfo P Lustosa
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Federico Fortuni
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Pieter van der Bijl
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Laurien Goedemans
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Jose M Montero-Cabezas
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Marina V Kostyukevich
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Victoria Delgado
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands
| | - Juhani Knuuti
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300 RC Leiden, The Netherlands.,Turku PET Centre, Turku University Hospital and University of Turku, Kiinamllynkatu 4-8, 20520, Turku, Finland
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9
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Butcher SC, Fortuni F, Montero-Cabezas JM, Abou R, El Mahdiui M, van der Bijl P, van der Velde ET, Ajmone Marsan N, Bax JJ, Delgado V. Right ventricular myocardial work: proof-of-concept for non-invasive assessment of right ventricular function. Eur Heart J Cardiovasc Imaging 2021; 22:142-152. [PMID: 33184656 DOI: 10.1093/ehjci/jeaa261] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [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: 07/11/2020] [Accepted: 09/04/2020] [Indexed: 01/22/2023] Open
Abstract
AIMS Right ventricular myocardial work (RVMW) is a novel method for non-invasive assessment of right ventricular (RV) function utilizing RV pressure-strain loops. This study aimed to explore the relationship between RVMW and invasive indices of right heart catheterization (RHC) in a cohort of patients with heart failure with reduced left ventricular ejection fraction (HFrEF), and to compare values of RVMW with those of a group of patients without cardiovascular disease. METHODS AND RESULTS Non-invasive analysis of RVMW was performed in 22 HFrEF patients [median age 63 (59-67) years] who underwent echocardiography and invasive RHC within 48 h. Conventional RV functional measurements, RV global constructive work (RVGCW), RV global work index (RVGWI), RV global wasted work (RVGWW), and RV global work efficiency (RVGWE) were analysed and compared with invasively measured stroke volume and stroke volume index. Non-invasive analysis of RVMW was also performed in 22 patients without cardiovascular disease to allow for comparison between groups. None of the conventional echocardiographic parameters of RV systolic function were significantly correlated with stroke volume or stroke volume index. In contrast, one of the novel indices derived non-invasively by pressure-strain loops, RVGCW, demonstrated a moderate correlation with invasively measured stroke volume and stroke volume index (r = 0.63, P = 0.002 and r = 0.59, P = 0.004, respectively). RVGWI, RVGCW, and RVGWE were significantly lower in patients with HFrEF compared to a healthy cohort, while values of RVGWW were significantly higher. CONCLUSION RVGCW is a novel parameter that provides an integrative analysis of RV systolic function and correlates more closely with invasively measured stroke volume and stroke volume index than other standard echocardiographic parameters.
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Affiliation(s)
- Steele C Butcher
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands.,Department of Cardiology, Royal Perth Hospital, 197 Wellington St, Perth WA 6000, Australia
| | - Federico Fortuni
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands.,Department of Molecular Medicine, Unit of Cardiology, University of Pavia, via Forlanini, 27100 Pavia, Italy
| | - Jose M Montero-Cabezas
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Rachid Abou
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Pieter van der Bijl
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Enno T van der Velde
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300RC Leiden, The Netherlands
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10
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El Mahdiui M, Smit JM, van Rosendael AR, Jukema JW, Bax JJ, Scholte AJHA. Relationship between coronary artery calcification and myocardial ischemia on computed tomography myocardial perfusion in patients with stable chest pain. J Nucl Cardiol 2021; 28:1707-1714. [PMID: 31529386 PMCID: PMC8421270 DOI: 10.1007/s12350-019-01869-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 08/14/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Coronary artery calcium (CAC) score has shown to provide incremental prognostic information when added to the Framingham risk score. Although the relation between CAC and myocardial ischemia has been evaluated, there has been little evaluation of the relationship between CAC score and inducible myocardial ischemia on computed tomography myocardial perfusion (CTP). METHODS AND RESULTS Patients who were referred with stable chest pain from the outpatient clinic and who underwent non-contrast computed tomography scan, coronary computed tomography angiography, and adenosine stress CTP were included in this study. CAC score was subdivided in four groups (1 to 99; 100 to 399, 400 to 999, and ≥ 1000). Inducible myocardial ischemia was considered when reversible perfusion defects were observed in ≥ 1 segment. A total of 131 patients (age 62 ± 9.4 years; 56% male) were included. The median CAC score was 241 (73 to 539). Forty-nine patients (37%) had evidence of inducible myocardial ischemia. The presence of inducible myocardial ischemia increased with increasing CAC score from 22% in the CAC score 1 to 99 subgroup to 35, 47, and 65% in the 100 to 399, 400 to 999, and ≥ 1000 CAC score subgroup, respectively. In multivariable analysis CAC score was the only determinant that significantly predicted the presence of inducible myocardial ischemia on CTP. CONCLUSIONS In a population of symptomatic patients, the majority of patients with extensive calcification had evidence of inducible myocardial ischemia on CTP. CAC score was the only independent predictor of inducible myocardial ischemia on CTP.
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Affiliation(s)
- Mohammed El Mahdiui
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Jeff M Smit
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Alexander R van Rosendael
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Arthur J H A Scholte
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
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11
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Smit JM, Simon J, El Mahdiui M, Szaraz L, van Rosendael PJ, Kolassváry M, Szilveszter B, Delgado V, Merkely B, Maurovich-Horvat P, Bax JJ. Anatomical Characteristics of the Left Atrium and Left Atrial Appendage in Relation to the Risk of Stroke in Patients With Versus Without Atrial Fibrillation. Circ Arrhythm Electrophysiol 2021; 14:e009777. [PMID: 34279121 DOI: 10.1161/circep.121.009777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Jeff M Smit
- Department of Cardiology, Leiden University Medical Center, the Netherlands (J.M.S., M.E.M., P.J.v.R., V.D., J.J.B.)
| | - Judit Simon
- Cardiovascular Imaging Research Group, Heart and Vascular Center (J.S., L.S., M.K., B.S., B.M., P.M.-H.), Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, the Netherlands (J.M.S., M.E.M., P.J.v.R., V.D., J.J.B.)
| | - Lili Szaraz
- Cardiovascular Imaging Research Group, Heart and Vascular Center (J.S., L.S., M.K., B.S., B.M., P.M.-H.), Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Philippe J van Rosendael
- Department of Cardiology, Leiden University Medical Center, the Netherlands (J.M.S., M.E.M., P.J.v.R., V.D., J.J.B.)
| | - Márton Kolassváry
- Cardiovascular Imaging Research Group, Heart and Vascular Center (J.S., L.S., M.K., B.S., B.M., P.M.-H.), Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Balint Szilveszter
- Cardiovascular Imaging Research Group, Heart and Vascular Center (J.S., L.S., M.K., B.S., B.M., P.M.-H.), Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, the Netherlands (J.M.S., M.E.M., P.J.v.R., V.D., J.J.B.)
| | - Béla Merkely
- Cardiovascular Imaging Research Group, Heart and Vascular Center (J.S., L.S., M.K., B.S., B.M., P.M.-H.), Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Pál Maurovich-Horvat
- Cardiovascular Imaging Research Group, Heart and Vascular Center (J.S., L.S., M.K., B.S., B.M., P.M.-H.), Medical Imaging Centre, Semmelweis University, Budapest, Hungary.,Department of Radiology (P.M.-H.), Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, the Netherlands (J.M.S., M.E.M., P.J.v.R., V.D., J.J.B.).,Heart Center, University of Turku, Turku University Hospital, Finland (J.J.B.)
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12
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Abou R, Prihadi EA, Goedemans L, van der Geest R, El Mahdiui M, Schalij MJ, Ajmone Marsan N, Bax JJ, Delgado V. Left ventricular mechanical dispersion in ischaemic cardiomyopathy: association with myocardial scar burden and prognostic implications. Eur Heart J Cardiovasc Imaging 2021; 21:1227-1234. [PMID: 32734280 DOI: 10.1093/ehjci/jeaa187] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/12/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS Left ventricular (LV) mechanical dispersion (MD) may result from heterogeneous electrical conduction and is associated with adverse events. The present study investigated (i) the association between LV MD and the extent of LV scar as assessed with contrast-enhanced cardiac magnetic resonance (CMR) and (ii) the prognostic implications of LV MD in patients after ST-segment elevation myocardial infarction. METHODS AND RESULTS LV MD was calculated by echocardiography and myocardial scar was analysed on CMR data retrospectively. Infarct core and border zone were defined as ≥50% and 35-50% of maximal signal intensity, respectively. Patients were followed for the occurrence of the combined endpoint (all-cause mortality and appropriate implantable cardioverter-defibrillator therapy). In total, 96 patients (87% male, 57 ± 10 years) were included. Median LV MD was 53.5 ms [interquartile range (IQR) 43.4-62.8]. On CMR, total scar burden was 11.4% (IQR 3.8-17.1%), infarct core tissue 6.2% (IQR 2.0-12.7%), and border zone was 3.5% (IQR 1.5-5.7%). Correlations were observed between LV MD and infarct core (r = 0.517, P < 0.001), total scar burden (r = 0.497, P < 0.001), and border zone (r = 0.298, P = 0.003). In total, 14 patients (15%) reached the combined endpoint. Patients with LV MD >53.5 ms showed higher event rates as compared to their counterparts. Finally, LV MD showed the highest area under the curve for the prediction of the combined endpoint. CONCLUSION LV MD is correlated with LV scar burden. In addition, patients with prolonged LV MD showed higher event rates. Finally, LV MD provided the highest predictive value for the combined endpoint when compared with other parameters.
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Affiliation(s)
- Rachid Abou
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Edgard A Prihadi
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Laurien Goedemans
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Rob van der Geest
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Martin J Schalij
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, 2300RC Leiden, The Netherlands
| | - Victoria Delgado
- Department of Cardiology, Heart Lung Center, Leiden University Medical Centre, Albinusdreef 2, 2300RC Leiden, The Netherlands
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13
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Kuneman J, Mahdiui ME, van Rosendael A, Patel M, Norgaard B, Fairbairn T, Nieman K, Akasaka T, Berman D, Koweek L, Pontone G, Kawasaki T, Sand NPR, Jensen J, Amano T, Poon M, Ovrehus KA, Sonck J, Rabbat M, De Bruyne B, Rogers C, Matsuo H, Bax J, Leipsic J, Knuuti J. CORONARY VOLUME TO LEFT VENTRICULAR MASS RATIO DERIVED FROM CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY IN PATIENTS WITH DIABETES MELLITUS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02679-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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de Paula Lustosa R, Chimed S, Yedidya I, Fortuni F, van der Bijl P, Mahdiui ME, Cabezas JMM, Kostyukevich MV, Knuuti J, Marsan NA, Bax J, Delgado V. LEFT VENTRICULAR MYOCARDIAL WORK INDICES ACCORDING TO DIFFERENT REMODELING PATTERNS AFTER ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02696-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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El Mahdiui M, Simon J, Smit JM, Kuneman JH, van Rosendael AR, Steyerberg EW, van der Geest RJ, Száraz L, Herczeg S, Szegedi N, Gellér L, Delgado V, Merkely B, Bax JJ, Maurovich-Horvat P. Posterior Left Atrial Adipose Tissue Attenuation Assessed by Computed Tomography and Recurrence of Atrial Fibrillation After Catheter Ablation. Circ Arrhythm Electrophysiol 2021; 14:e009135. [PMID: 33720759 DOI: 10.1161/circep.120.009135] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Mohammed El Mahdiui
- Department of Cardiology (M.E.M., J.M.S., J.H.K., A.R.v.R., V.D., J.J.B.), Leiden University Medical Center, the Netherlands
| | - Judit Simon
- MTA-SE Cardiovascular Imaging Research Group, Heart & Vascular Center (J.S., L.S., S.H., N.S., L.G., B.M., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - Jeff M Smit
- Department of Cardiology (M.E.M., J.M.S., J.H.K., A.R.v.R., V.D., J.J.B.), Leiden University Medical Center, the Netherlands
| | - Jurrien H Kuneman
- Department of Cardiology (M.E.M., J.M.S., J.H.K., A.R.v.R., V.D., J.J.B.), Leiden University Medical Center, the Netherlands
| | - Alexander R van Rosendael
- Department of Cardiology (M.E.M., J.M.S., J.H.K., A.R.v.R., V.D., J.J.B.), Leiden University Medical Center, the Netherlands
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences (E.W.S.), Leiden University Medical Center, the Netherlands
| | - Rob J van der Geest
- Division of Image Processing (R.J.v.d.G.), Leiden University Medical Center, the Netherlands
| | - Lili Száraz
- MTA-SE Cardiovascular Imaging Research Group, Heart & Vascular Center (J.S., L.S., S.H., N.S., L.G., B.M., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - Szilvia Herczeg
- MTA-SE Cardiovascular Imaging Research Group, Heart & Vascular Center (J.S., L.S., S.H., N.S., L.G., B.M., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - Nándor Szegedi
- MTA-SE Cardiovascular Imaging Research Group, Heart & Vascular Center (J.S., L.S., S.H., N.S., L.G., B.M., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - László Gellér
- MTA-SE Cardiovascular Imaging Research Group, Heart & Vascular Center (J.S., L.S., S.H., N.S., L.G., B.M., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - Victoria Delgado
- Department of Cardiology (M.E.M., J.M.S., J.H.K., A.R.v.R., V.D., J.J.B.), Leiden University Medical Center, the Netherlands
| | - Bela Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart & Vascular Center (J.S., L.S., S.H., N.S., L.G., B.M., P.M.-H.), Semmelweis University, Budapest, Hungary
| | - Jeroen J Bax
- Department of Cardiology (M.E.M., J.M.S., J.H.K., A.R.v.R., V.D., J.J.B.), Leiden University Medical Center, the Netherlands
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart & Vascular Center (J.S., L.S., S.H., N.S., L.G., B.M., P.M.-H.), Semmelweis University, Budapest, Hungary.,Department of Radiology, Medical Imaging Centre (P.M.-H.), Semmelweis University, Budapest, Hungary
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16
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El Mahdiui M, Smit JM, van Rosendael AR, Neglia D, Knuuti J, Saraste A, Buechel RR, Teresinska A, Pizzi MN, Roque A, Magnacca M, Mertens BJ, Caselli C, Rocchiccioli S, Parodi O, Pelosi G, Scholte AJ. Sex differences in coronary plaque changes assessed by serial computed tomography angiography. Int J Cardiovasc Imaging 2021; 37:2311-2321. [PMID: 33694122 PMCID: PMC8286938 DOI: 10.1007/s10554-021-02204-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/22/2021] [Indexed: 01/03/2023]
Abstract
Long-term data on sex-differences in coronary plaque changes over time is lacking in a low-to-intermediate risk population of stable coronary artery disease (CAD). The aim of this study was to evaluate the role of sex on long-term plaque progression and evolution of plaque composition. Furthermore, the influence of menopause on plaque progression and composition was also evaluated. Patients that underwent a coronary computed tomography angiography (CTA) were prospectively included to undergo a follow-up coronary CTA. Total and compositional plaque volumes were normalized using the vessel volume to calculate a percentage atheroma volume (PAV). To investigate the influence of menopause on plaque progression, patients were divided into two groups, under and over 55 years of age. In total, 211 patients were included in this analysis, 146 (69%) men. The mean interscan period between baseline and follow-up coronary CTA was 6.2 ± 1.4 years. Women were older, had higher HDL levels and presented more often with atypical chest pain. Men had 434 plaque sites and women 156. On a per-lesion analysis, women had less fibro-fatty PAV compared to men (β -1.3 ± 0.4%; p < 0.001), with no other significant differences. When stratifying patients by 55 years age threshold, fibro-fatty PAV remained higher in men in both age groups (p < 0.05) whilst women younger than 55 years demonstrated more regression of fibrous (β -0.8 ± 0.3% per year; p = 0.002) and non-calcified PAV (β -0.7 ± 0.3% per year; p = 0.027). In a low-to-intermediate risk population of stable CAD patients, no significant sex differences in total PAV increase over time were observed. Fibro-fatty PAV was lower in women at any age and women under 55 years demonstrated significantly greater reduction in fibrous and non-calcified PAV over time compared to age-matched men. (ClinicalTrials.gov number, NCT04448691.)
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Affiliation(s)
- Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Jeff M Smit
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Alexander R van Rosendael
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands
| | - Danilo Neglia
- Fondazione Toscana Gabriele Monasterio, Viale Giuseppe Moruzzi 1 56124, Pisa, Italy
| | - Juhani Knuuti
- Heart Center and PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Antti Saraste
- Heart Center and PET Centre, Turku University Hospital and University of Turku, Turku, Finland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital and University of Zurich, Zurich, Switzerland
| | | | - Maria N Pizzi
- Department of Cardiology, Hospital Universitari Vall D'Hebron, Barcelona, Spain
| | - Albert Roque
- Department of Radiology, Hospital Universitari Vall D'Hebron, Barcelona, Spain
| | | | - Bart J Mertens
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Chiara Caselli
- Institute of Clinical Physiology CNR, Viale Giuseppe Moruzzi 1 56124, Pisa, Italy
| | - Silvia Rocchiccioli
- Institute of Clinical Physiology CNR, Viale Giuseppe Moruzzi 1 56124, Pisa, Italy
| | - Oberdan Parodi
- Institute of Clinical Physiology CNR, Viale Giuseppe Moruzzi 1 56124, Pisa, Italy.,Institute of Information Science and Technologies CNR, Pisa, Italy
| | - Gualtiero Pelosi
- Institute of Clinical Physiology CNR, Viale Giuseppe Moruzzi 1 56124, Pisa, Italy
| | - Arthur J Scholte
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
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17
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Lustosa RP, Butcher SC, van der Bijl P, El Mahdiui M, Montero-Cabezas JM, Kostyukevich MV, Rocha De Lorenzo A, Knuuti J, Ajmone Marsan N, Bax JJ, Delgado V. Global Left Ventricular Myocardial Work Efficiency and Long-Term Prognosis in Patients After ST-Segment-Elevation Myocardial Infarction. Circ Cardiovasc Imaging 2021; 14:e012072. [PMID: 33653082 DOI: 10.1161/circimaging.120.012072] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Left ventricular (LV) global longitudinal strain has demonstrated incremental prognostic value over LV ejection fraction in patients with ST-segment-elevation myocardial infarction. However, LV global longitudinal strain does not take into consideration the effect of afterload. Novel speckle-tracking echocardiographic indices of myocardial work integrate blood pressure measurements (afterload) with LV global longitudinal strain. The present study aimed to investigate the prognostic value of global LV myocardial work efficiency (GLVMWE; reflecting LV performance) obtained from pressure-strain loops with echocardiography in patients with ST-segment-elevation myocardial infarction. METHODS A total of 507 ST-segment-elevation myocardial infarction patients (mean age, 61±11 years; 76% men) were retrospectively analyzed. LV ejection fraction and GLVMWE were measured by transthoracic echocardiography within 48 hours of admission. GLVMWE was defined as the ratio of constructive work divided by the sum of constructive and wasted work in all LV segments and expressed as a percentage. Spline curve analysis was used to define the association between reduced GLVMWE and all-cause death. RESULTS After a median follow-up of 80 months (interquartile range, 67-97 months), 40 (8%) patients died. Patients with reduced GLVMWE (<86%) showed higher cumulative rates of all-cause mortality (17.5% versus 4.7%; log-rank P<0.001) in comparison with patients with preserved GLVMWE (≥86%). Reduced GLVMWE (<86%) showed an independent association with all-cause mortality (hazard ratio, 3.167 [95% CI, 1.679-5.972]; P<0.001). CONCLUSIONS Reduced GLVMWE (<86%) measured by transthoracic echocardiography within 48 hours of admission in ST-segment-elevation myocardial infarction patients is associated with worse long-term survival.
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Affiliation(s)
- Rodolfo P Lustosa
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands (R.P.L., S.C.B., P.v.d.B., M.E.M., J.M.M.-C., M.V.K., J.K., N.A.M., J.J.B., V.D.).,National Institute of Cardiology, Rio de Janeiro, Brazil (R.P.L., A.R.D.L.)
| | - Steele C Butcher
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands (R.P.L., S.C.B., P.v.d.B., M.E.M., J.M.M.-C., M.V.K., J.K., N.A.M., J.J.B., V.D.).,Department of Cardiology, Royal Perth Hospital, Western Australia, Australia (S.C.B.)
| | - Pieter van der Bijl
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands (R.P.L., S.C.B., P.v.d.B., M.E.M., J.M.M.-C., M.V.K., J.K., N.A.M., J.J.B., V.D.)
| | - Mohammed El Mahdiui
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands (R.P.L., S.C.B., P.v.d.B., M.E.M., J.M.M.-C., M.V.K., J.K., N.A.M., J.J.B., V.D.)
| | - Jose M Montero-Cabezas
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands (R.P.L., S.C.B., P.v.d.B., M.E.M., J.M.M.-C., M.V.K., J.K., N.A.M., J.J.B., V.D.)
| | - Marina V Kostyukevich
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands (R.P.L., S.C.B., P.v.d.B., M.E.M., J.M.M.-C., M.V.K., J.K., N.A.M., J.J.B., V.D.)
| | | | - Juhani Knuuti
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands (R.P.L., S.C.B., P.v.d.B., M.E.M., J.M.M.-C., M.V.K., J.K., N.A.M., J.J.B., V.D.).,Heart Center, Turku University Hospital and University of Turku, Turku, Finland (J.K., J.J.B.)
| | - Nina Ajmone Marsan
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands (R.P.L., S.C.B., P.v.d.B., M.E.M., J.M.M.-C., M.V.K., J.K., N.A.M., J.J.B., V.D.)
| | - Jeroen J Bax
- Heart Center, Turku University Hospital and University of Turku, Turku, Finland (J.K., J.J.B.)
| | - Victoria Delgado
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands (R.P.L., S.C.B., P.v.d.B., M.E.M., J.M.M.-C., M.V.K., J.K., N.A.M., J.J.B., V.D.)
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18
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Smit JM, Koning G, van Rosendael AR, El Mahdiui M, Mertens BJ, Schalij MJ, Jukema JW, Delgado V, Reiber JHC, Bax JJ, Scholte AJ. Referral of patients for fractional flow reserve using quantitative flow ratio. Eur Heart J Cardiovasc Imaging 2020; 20:1231-1238. [PMID: 30535361 DOI: 10.1093/ehjci/jey187] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 07/10/2018] [Accepted: 11/10/2018] [Indexed: 01/11/2023] Open
Abstract
AIMS Quantitative flow ratio (QFR) is a recently developed technique to calculate fractional flow reserve (FFR) based on 3D quantitative coronary angiography and computational fluid dynamics, obviating the need for a pressure-wire and hyperaemia induction. QFR might be used to guide patient selection for FFR and subsequent percutaneous coronary intervention (PCI) referral in hospitals not capable to perform FFR and PCI. We aimed to investigate the feasibility to use QFR to appropriately select patients for FFR referral. METHODS AND RESULTS Patients who underwent invasive coronary angiography in a hospital where FFR and PCI could not be performed and were referred to our hospital for invasive FFR measurement, were included. Angiogram images from the referring hospitals were retrospectively collected for QFR analysis. Based on QFR cut-off values of 0.77 and 0.86, our patient cohort was reclassified to 'no referral' (QFR ≥0.86), referral for 'FFR' (QFR 0.78-0.85), or 'direct PCI' (QFR ≤0.77). In total, 290 patients were included. Overall accuracy of QFR to detect an invasive FFR of ≤0.80 was 86%. Based on a QFR cut-off value of 0.86, a 50% reduction in patient referral for FFR could be obtained, while only 5% of these patients had an invasive FFR of ≤0.80 (thus, these patients were incorrectly reclassified to the 'no referral' group). Furthermore, 22% of the patients that still need to be referred could undergo direct PCI, based on a QFR cut-off value of 0.77. CONCLUSION QFR is feasible to use for the selection of patients for FFR referral.
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Affiliation(s)
- Jeff M Smit
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Gerhard Koning
- Medis Medical Imaging Systems B.V., Schuttersveld 9, XG Leiden, The Netherlands
| | - Alexander R van Rosendael
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Bart J Mertens
- Department of Medical Statistics, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Martin J Schalij
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Johan H C Reiber
- Medis Medical Imaging Systems B.V., Schuttersveld 9, XG Leiden, The Netherlands.,Department of Radiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Arthur J Scholte
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, ZA Leiden, The Netherlands
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19
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Hiemstra YL, van der Bijl P, El Mahdiui M, Bax JJ, Delgado V, Marsan NA. Myocardial Work in Nonobstructive Hypertrophic Cardiomyopathy: Implications for Outcome. J Am Soc Echocardiogr 2020; 33:1201-1208. [PMID: 32680744 DOI: 10.1016/j.echo.2020.05.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Noninvasive left ventricular (LV) pressure-strain loop analysis is emerging as a new echocardiographic method to evaluate LV function, integrating longitudinal strain by speckle-tracking analysis and sphygmomanometrically measured blood pressure to estimate myocardial work. The aims of this study were (1) to describe global and segmental myocardial work in patients with hypertrophic cardiomyopathy (HCM), (2) to assess the correlation between myocardial work and other echocardiographic parameters, and (3) to evaluate the association of myocardial work with adverse outcomes. METHODS One hundred ten patients with nonobstructive HCM (mean age, 55 ± 15 years; 66% men), with different phenotypes (apical, concentric, and septal hypertrophy), and 35 age- and sex-matched healthy control subjects were included. The following myocardial work indices were included: myocardial work index, constructive work (CW), wasted work, and cardiac efficiency. The combined end point included all-cause mortality, heart transplantation, heart failure hospitalization, aborted sudden cardiac death, and appropriate implantable cardioverter-defibrillator therapy. RESULTS Mean global CW (1,722 ± 602 vs 2,274 ± 574 mm Hg%, P < .001), global cardiac efficiency (93% [89%-95%] vs 96% [96%-97%], P < .001), and global MWI (1,534 ± 551 vs 1,929 ± 473 mm Hg%) were significantly reduced, while global wasted work (104 mm Hg% [66-137 mm Hg%] vs 71 mm Hg% [49-92 mm Hg%], P < .001) was increased in patients with HCM compared with control subjects. Segmental impairment in CW colocalized with maximal wall thickness (HCM phenotype), and global CW correlated with LV wall thickness (r = -0.41, P < .001), diastolic function (r = -0.27, P = .001), and QRS duration (r = -0.28, P = .001). Patients with global CW > 1,730 mm Hg% (the median value) experienced better event-free survival than those with global CW < 1,730 mm Hg% (P < .001). CONCLUSIONS Myocardial work, assessed noninvasively using echocardiography and blood pressure measurement, is reduced in patients with nonobstructive HCM; it correlates with maximum LV wall thickness and is significantly associated with a worse long-term outcome.
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Affiliation(s)
- Yasmine L Hiemstra
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Pieter van der Bijl
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
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20
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Lustosa RP, van der Bijl P, El Mahdiui M, Montero-Cabezas JM, Kostyukevich MV, Ajmone Marsan N, Bax JJ, Delgado V. Noninvasive Myocardial Work Indices 3 Months after ST-Segment Elevation Myocardial Infarction: Prevalence and Characteristics of Patients with Postinfarction Cardiac Remodeling. J Am Soc Echocardiogr 2020; 33:1172-1179. [PMID: 32651125 DOI: 10.1016/j.echo.2020.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 02/16/2020] [Revised: 04/20/2020] [Accepted: 05/02/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Assessment of left ventricular (LV) remodeling after ST-segment elevation myocardial infarction (STEMI) is pivotal for patient management. Noninvasive myocardial work indices obtained from echocardiography-derived strain-pressure loops provide a new tool that permits characterization of LV mechanics. We aimed at characterizing myocardial work indices in patients with LV remodeling after STEMI versus patients without remodeling. METHODS Six-hundred STEMI patients were retrospectively analyzed (456 men, mean age: 61 ± 11 years) and divided according to the presence of LV remodeling 3 months after the index admission (≥20% increase in LV end-diastolic volume). Noninvasive myocardial work indices were measured at 3 months after STEMI. RESULTS LV remodeling was observed in 150 patients (25%) who showed more impaired global myocardial work indices compared with their counterparts: work index (1,708 ± 522 mm Hg% vs 1,979 ± 450 mm Hg%; P < .001), constructive work (1,941 ± 598 mm Hg% vs 2,272 ± 519 mm Hg%; P < .001), and work efficiency (92% [range 88%-96%] vs 95% [range 93%-96%]; P < .001). In addition, patients with LV remodeling had significantly increased wasted work (116 mm Hg% [range 73-184 mm Hg%] vs 91 mm Hg% [range 61-132 mm Hg%]; P < .001). The frequency of impaired global work index, constructive and work efficiency, and increased wasted work was significantly higher among patients with LV remodeling compared with their counterparts: 21.3%, 34.7%, 34.7%, and 14.0%, respectively, versus 5.3%, 9.6%, 8.9%, and 4.9%, respectively (P < .001). CONCLUSIONS At 3-month follow-up after STEMI, patients with LV remodeling revealed more impaired myocardial work indices compared with patients without LV remodeling. The prevalence of impaired myocardial work indices was higher among patients with LV remodeling compared with patients without.
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Affiliation(s)
- Rodolfo P Lustosa
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
| | - Pieter van der Bijl
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jose M Montero-Cabezas
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
| | - Marina V Kostyukevich
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands
| | - Victoria Delgado
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Leiden, The Netherlands.
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21
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Smit JM, van Rosendael AR, El Mahdiui M, Neglia D, Knuuti J, Saraste A, Buechel RR, Teresinska A, Pizzi MN, Roque A, Poddighe R, Mertens BJ, Caselli C, Rocchiccioli S, Parodi O, Pelosi G, Scholte AJ. Impact of Clinical Characteristics and Statins on Coronary Plaque Progression by Serial Computed Tomography Angiography. Circ Cardiovasc Imaging 2020; 13:e009750. [DOI: 10.1161/circimaging.119.009750] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 12/12/2022]
Abstract
Background
Progression of coronary artery disease using serial coronary computed tomography angiography (CTA) is of clinical interest. Our primary aim was to prospectively assess the impact of clinical characteristics and statin use on quantitatively assessed coronary plaque progression in a low-risk study population during long-term follow-up.
Methods
Patients who previously underwent coronary CTA for suspected coronary artery disease were prospectively included to undergo follow-up coronary CTA. The primary end point was coronary artery disease progression, defined as the absolute annual increase in total, calcified, and noncalcified plaque volume by quantitative CTA analysis.
Results
In total, 202 patients underwent serial coronary CTA with a mean interscan period of 6.2±1.4 years. On a per-plaque basis, increasing age (β=0.070;
P
=0.058) and hypertension (β=1.380;
P
=0.075) were nonsignificantly associated with annual total plaque progression. Male sex (β=1.676;
P
=0.009), diabetes mellitus (β=1.725;
P
=0.012), and statin use (β=1.498;
P
=0.046) showed an independent association with annual progression of calcified plaque. While hypertension (β=2.259;
P
=0.015) was an independent determinant of noncalcified plaque progression, statin use (β=−2.178;
P
=0.050) was borderline significantly associated with a reduced progression of noncalcified plaque.
Conclusions
Statin use was associated with an increased progression of calcified coronary plaque and a reduced progression of noncalcified coronary plaque, potentially reflecting calcification of the noncalcified plaque component. Whereas hypertension was the only modifiable risk factor predictive of noncalcified plaque progression, diabetes mellitus mainly led to an increase in calcified plaque. These findings could yield the need for intensified preventive treatment of patients with diabetes mellitus and hypertension to slow and stabilize coronary artery disease progression and improve clinical outcome.
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Affiliation(s)
- Jeff M. Smit
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.M.S., A.R.v.R., M.E.M., A.J.S.)
| | - Alexander R. van Rosendael
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.M.S., A.R.v.R., M.E.M., A.J.S.)
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.M.S., A.R.v.R., M.E.M., A.J.S.)
| | - Danilo Neglia
- Fondazione Toscana Gabriele Monasterio, Pisa, Italy (D.N.)
| | - Juhani Knuuti
- Heart Center and PET Centre, Turku University Hospital, University of Turku, Finland (J.K., A.S.)
| | - Antti Saraste
- Heart Center and PET Centre, Turku University Hospital, University of Turku, Finland (J.K., A.S.)
| | - Ronny R. Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital and University of Zurich, Switzerland (R.R.B.)
| | - Anna Teresinska
- Instytut Kardiologii im. Prymasa Tysiąclecia Stefana Kardynała Wyszyńskiego, ul. Alpejska, Warszawa, Poland (A.T.)
| | | | - Albert Roque
- Department of Radiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain (A.R.)
| | | | - Bart J. Mertens
- Department of Medical Statistics, Leiden University Medical Center, The Netherlands (B.J.M.)
| | - Chiara Caselli
- Institute of Clinical Physiology CNR, Pisa, Italy (C.C., S.R., G.P.)
| | | | - Oberdan Parodi
- Institute of Clinical Physiology CNR, Pisa, Italy (C.C., S.R., G.P.)
- Institute of Information Science and Technologies CNR, Pisa, Italy (O.P.)
| | - Gualtiero Pelosi
- Institute of Clinical Physiology CNR, Pisa, Italy (C.C., S.R., G.P.)
| | - Arthur J. Scholte
- Department of Cardiology, Leiden University Medical Center, The Netherlands (J.M.S., A.R.v.R., M.E.M., A.J.S.)
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22
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van der Bijl P, Kostyukevich M, El Mahdiui M, Hansen G, Samset E, Ajmone Marsan N, Bax JJ, Delgado V. A Roadmap to Assess Myocardial Work. JACC Cardiovasc Imaging 2019; 12:2549-2554. [DOI: 10.1016/j.jcmg.2019.05.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/20/2019] [Accepted: 05/23/2019] [Indexed: 11/29/2022]
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23
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El Mahdiui M, Smit JM, van Rosendael AR, Delgado V, Marsan NA, Jukema JW, Scholte AJHA, Bax JJ. Correction to: Characterization of the left ventricular arrhythmogenic substrate with multimodality imaging: role of innervation imaging and left ventricular global longitudinal strain. Eur J Hybrid Imaging 2019; 3:19. [PMID: 34196849 PMCID: PMC8218130 DOI: 10.1186/s41824-019-0069-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The original publication of this article El Mahdiui et al., 2019 contained 2 errors that could not be updated prior to publication. The correct and incorrect information is shown below for clarification. The changed information is shown in bold. These changes do not affect the interpretation and conclusion of the article.
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Affiliation(s)
- Mohammed El Mahdiui
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300, RC, Leiden, The Netherlands
| | - Jeff M Smit
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300, RC, Leiden, The Netherlands
| | - Alexander R van Rosendael
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300, RC, Leiden, The Netherlands
| | - Victoria Delgado
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300, RC, Leiden, The Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300, RC, Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300, RC, Leiden, The Netherlands
| | - Arthur J H A Scholte
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300, RC, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Heart Lung Centre, Leiden University Medical Centre, Albinusdreef 2, 2300, RC, Leiden, The Netherlands.
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24
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El Mahdiui M, van der Bijl P, Abou R, Ajmone Marsan N, Delgado V, Bax JJ. Global Left Ventricular Myocardial Work Efficiency in Healthy Individuals and Patients with Cardiovascular Disease. J Am Soc Echocardiogr 2019; 32:1120-1127. [PMID: 31279618 DOI: 10.1016/j.echo.2019.05.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [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: 02/19/2019] [Revised: 04/22/2019] [Accepted: 05/04/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Global left ventricular (LV) myocardial work efficiency, the ratio of constructive to wasted work in all LV segments, reflects the efficiency by which mechanical energy is expended during the cardiac cycle. Global LV myocardial work efficiency can be derived from LV pressure-strain loop analysis incorporating both noninvasively estimated blood pressure recordings and echocardiographic strain data. The aim of this study was to characterize global LV myocardial work efficiency in healthy individuals and patients with cardiovascular (CV) risk factors or overt cardiac disease. METHODS We retrospectively included healthy individuals without structural heart disease or CV risk factors, who were selected from an ongoing database of normal individuals, and matched for age and sex with (1) individuals without structural heart disease but with CV risk factors, (2) postinfarct patients without heart failure, and (3) heart failure patients with reduced ejection fraction (HFrEF). Global LV myocardial work efficiency was estimated with a proprietary algorithm from speckle-tracking strain analyses, as well as noninvasive blood pressure measurements. RESULTS In total, 120 individuals (44% male, 53 ± 13 years) were included (n = 30 per group). In healthy individuals without structural heart disease or CV risk factors, global LV myocardial work efficiency was 96.0% (interquartile range, 95.0%-96.3%). Myocardial efficiency of the LV did not differ significantly between individuals without structural heart disease and those with CV risk factors (96.0% vs 96.0%; P = .589). Global LV myocardial work efficiency, however, was significantly decreased in postinfarct patients (96.0% vs 93.0%, P < .001) and in those with HFrEF (96.0% vs 69.0%; P < .001). CONCLUSIONS While global LV myocardial work efficiency was similar in normal individuals and in those with CV risk factors, it was decreased in postinfarct and HFrEF patients. The global LV myocardial work efficiency values presented here show distinct patterns in different cardiac pathologies.
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Affiliation(s)
- Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Pieter van der Bijl
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Rachid Abou
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nina Ajmone Marsan
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
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25
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Smit JM, El Mahdiui M, van Rosendael AR, Jukema JW, Koning G, Reiber JHC, Bax JJ, Scholte AJ. Comparison of Diagnostic Performance of Quantitative Flow Ratio in Patients With Versus Without Diabetes Mellitus. Am J Cardiol 2019; 123:1722-1728. [PMID: 30853082 DOI: 10.1016/j.amjcard.2019.02.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/10/2019] [Accepted: 02/13/2019] [Indexed: 12/21/2022]
Abstract
Quantitative flow ratio (QFR) is a novel technique to calculate fractional flow reserve (FFR), without hyperemia induction or a pressure wire, and has not yet been validated in patients with diabetes mellitus (DM), who are at increased risk of coronary microvascular dysfunction. The purpose of our study was to compare the diagnostic performance of QFR in diabetic and nondiabetic patients. Patients who underwent invasive coronary angiography and subsequent invasive FFR measurement within 6 months were included. QFR was determined in all coronary arteries in which invasive FFR was performed, using a dedicated software package. Diagnostic accuracy and the area under the receiver-operating characteristic curve (AUC) were determined for QFR, using an invasive FFR cut-off value of ≤0.80 as the reference standard. In total, 320 coronary arteries from 66 (25%) diabetic and 193 (75%) nondiabetic patients were analyzed. On a vessel-based analysis, diagnostic accuracy, sensitivity, and specificity showed no significant difference between diabetic and nondiabetic patients: 88% versus 85% (p = 0.47), 71% versus 69% (p = 0.72), and 95% versus 91% (p = 0.24). Moreover, the AUC was not significantly different between patients with and without DM, 0.91 versus 0.93 (p = 0.74). The per-vessel AUC was significantly higher for QFR compared with percent diameter stenosis in both diabetic and nondiabetic patients, 0.91 versus 0.76 (p <0.05) and 0.93 versus 0.77 (p <0.001), respectively. In conclusion, we showed a good diagnostic performance of QFR which was independent of the presence of DM.
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Affiliation(s)
- Jeff M Smit
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Gerhard Koning
- Medis Medical Imaging Systems B.V., Leiden, the Netherlands
| | - Johan H C Reiber
- Medis Medical Imaging Systems B.V., Leiden, the Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Arthur J Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
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Hensen LCR, Mahdiui ME, van Rosendael AR, Smit JM, Jukema JW, Bax JJ, Delgado V. Prevalence and Prognostic Implications of Mitral and Aortic Valve Calcium in Patients With Chronic Kidney Disease. Am J Cardiol 2018; 122:1732-1737. [PMID: 30270179 DOI: 10.1016/j.amjcard.2018.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/28/2018] [Accepted: 08/02/2018] [Indexed: 11/19/2022]
Abstract
Calcium in the cardiac valves can be observed in patients with severe chronic kidney disease (CKD). However, the prevalence and prognostic implications of left-sided cardiac valve calcium in patients with stage 2 and 3 CKD (estimated glomerular filtration rate (eGFR) of 60 to 89 and 30 to 59 ml/min/1.73 m² respectively) is unknown. The present study investigates the prevalence of mitral and aortic valve calcium in patients with stage 2 and 3 CKD and evaluates its association with all-cause mortality. In patients with stage 2 and 3 CKD who underwent clinically indicated coronary computed tomography angiography, the presence of mitral and/or aortic valve calcium was assessed. Patients were divided into 2 groups according to the presence of mitral and/or aortic valve calcium on coronary computed tomography angiography. Patients were followed for the occurrence of all-cause mortality (primary end point). Of 204 stage 2 and 3 CKD patients (54% men, mean age 60 ± 10 years), 66 (32%) patients had mitral and/or aortic valve calcium. During a median follow-up of 6 years (IQR; 2, 9 years), 29 (14%) patients died. Patients with mitral and/or aortic valve calcium showed significantly higher mortality rates compared with patients without left-sided valve calcium (log-rank p = 0.009). Mitral valve calcium was independently associated with increased risk of all-cause mortality, whereas aortic valve calcium was not. In conclusion, the prevalence of left-sided valve calcium in patients with stage 2 and 3 CKD is high. Mitral valve calcium was independently associated with increased risk of all-cause mortality, whereas aortic valve calcium was not.
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Affiliation(s)
- Liselotte C R Hensen
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Jeff M Smit
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.
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Manabe O, Kikuchi T, Scholte AJHA, El Mahdiui M, Nishii R, Zhang MR, Suzuki E, Yoshinaga K. Correction to: Radiopharmaceutical tracers for cardiac imaging. J Nucl Cardiol 2018; 25:1237-1241. [PMID: 29368086 PMCID: PMC6828419 DOI: 10.1007/s12350-018-1184-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Regrettably the original version of the above article contained errors in the three chemical structures presented in the 'Atherosclerosis imaging' section of Table 5, namely: 99mTc annexin V, 68Ga DOTATATE, and 64Cu DOTATATE; the chemical structures have been corrected in Table presented here. In addition, the radiopharmaceutical for isotope 67Ga has been corrected to 67Ga citrate, and many of the radiopharmaceuticals presented at the end of the table have been corrected.
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Affiliation(s)
- Osamu Manabe
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tatsuya Kikuchi
- Department of Radiopharmaceutical Development, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, Chiba, Japan
| | - Arthur J H A Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ryuichi Nishii
- Diagnostic and Therapeutic Nuclear Medicine, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan
| | - Ming-Rong Zhang
- Department of Radiopharmaceutical Development, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, Chiba, Japan
| | - Eriko Suzuki
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Keiichiro Yoshinaga
- Diagnostic and Therapeutic Nuclear Medicine, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan.
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Manabe O, Kikuchi T, Scholte AJHA, El Mahdiui M, Nishii R, Zhang MR, Suzuki E, Yoshinaga K. Radiopharmaceutical tracers for cardiac imaging. J Nucl Cardiol 2018; 25:1204-1236. [PMID: 29196910 PMCID: PMC6133155 DOI: 10.1007/s12350-017-1131-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 11/05/2017] [Indexed: 12/13/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disease burden worldwide. Nuclear myocardial perfusion imaging with either single-photon emission computed tomography or positron emission tomography has been used extensively to perform diagnosis, monitor therapies, and predict cardiovascular events. Several radiopharmaceutical tracers have recently been developed to evaluate CVD by targeting myocardial perfusion, metabolism, innervation, and inflammation. This article reviews old and newer used in nuclear cardiac imaging.
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Affiliation(s)
- Osamu Manabe
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Tatsuya Kikuchi
- Department of Radiopharmaceutical Development, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, Chiba, Japan
| | - Arthur J H A Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mohammed El Mahdiui
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ryuichi Nishii
- Diagnostic and Therapeutic Nuclear Medicine, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan
| | - Ming-Rong Zhang
- Department of Radiopharmaceutical Development, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, Chiba, Japan
| | - Eriko Suzuki
- Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Keiichiro Yoshinaga
- Diagnostic and Therapeutic Nuclear Medicine, National Institutes for Quantum and Radiological Science and Technology, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555, Japan.
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van Rosendael A, Smit J, Van Rosendael P, Leung M, Mahdiui ME, Scholte A, Delgado V, Min JK, Bax JJ. ATRIAL FIBRILLATION RECURRENCE AFTER CATHETER ABLATION: THE VALUE OF EPICARDIAL FAT LOCATED POSTERIOR TO THE LEFT ATRIUM. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32125-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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