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Damas F, Nguyen Trung ML, Postolache A, Petitjean H, Lempereur M, Viva T, Oury C, Dulgheru R, Lancellotti P. Cardiac Damage and Conduction Disorders after Transcatheter Aortic Valve Implantation. J Clin Med 2024; 13:409. [PMID: 38256543 PMCID: PMC10816504 DOI: 10.3390/jcm13020409] [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: 11/28/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Recently, a staging system using 4 grades has been proposed to quantify the extent of cardiac damage associated with aortic stenosis (AS), namely AS-related cardiac damage staging (ASCDS). ASCDS is independently associated with all-cause mortality and important clinical outcomes. To evaluate whether it might be associated with the occurrence of conduction system disorders after TAVI, a total of 119 symptomatic patients with severe AS who underwent a TAVI were categorized according to ASCDS: group 1 (13.5%): no or LV damage; group 2 (58.8%): left atrial/mitral valve damage, atrial fibrillation (AF); group 3 (27.7%): low-flow state, pulmonary vasculature/tricuspid valve/RV damage. After TAVI, 34% of patients exhibited LBBB and 10% high-degree atrioventricular block (HD-AVB). No patient in group 1 developed HD-AVB whereas new LBBB was frequent in groups 2 and 3. Twenty-one patients presented with paroxysmal AF with a higher rate for each group increment (group 1: n = 0, 0%; group 2: n = 11, 15.7%; group 3: n = 10, 30.3%) (p = 0.012). Patients in group 3 had the higher rate of permanent pacemaker implantation (PPMI) (group 1: n = 1, 6.3%; group 2: n = 7, 10%; group 3: n = 9, 27.3%) (p = 0.012). In conclusion, ASCDS might help identify patients at higher risk of conduction disorders and PPMI requirement after TAVI.
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Affiliation(s)
- François Damas
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Mai-Linh Nguyen Trung
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Adriana Postolache
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Hélène Petitjean
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Mathieu Lempereur
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Tommaso Viva
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
- Department of Minimally Invasive Cardiac Surgery, University of Milan, 20122 Milan, Italy
- IRCCS Galeazzi, Sant’Ambrogio Hospital, 20157 Milan, Italy
| | - Cécile Oury
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Raluca Dulgheru
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
| | - Patrizio Lancellotti
- Department of Cardiology, CHU Sart Tilman, GIGA Cardiovascular Sciences Liège, University of Liège Hospital, 4000 Liège, Belgium; (F.D.); (M.-L.N.T.); (A.P.); (H.P.); (M.L.); (T.V.); (C.O.); (R.D.)
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Tchana-Sato V, Ancion A, Ansart F, Lardinois MJ, Dulgheru R, Somja J, Delvenne P, Defraigne JO. Constrictive pericarditis following cardiac transplantation: a report of two cases and a literature review. Acta Cardiol 2023; 78:763-772. [PMID: 37171264 DOI: 10.1080/00015385.2023.2209405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/16/2023] [Accepted: 04/25/2023] [Indexed: 05/13/2023]
Abstract
The data on constrictive pericarditis following heart transplantation are scarce. Herein, the authors present 2 patients who developed a constrictive pericarditis 19, and 55 months after heart transplantation. They underwent several diagnostic procedures and successfully recovered after a radical pericardiectomy. In addition, the authors review the literature and report the incidence, aetiology, diagnostic features, and management of this rare and challenging condition.
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Affiliation(s)
| | | | - Francois Ansart
- Department of Cardiovascular Surgery, CHU Liege, Liege, Belgium
| | | | | | - Joan Somja
- Department of Pathology, CHU Liege, Liege, Belgium
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Viva T, Postolache A, Nguyen Trung ML, Danthine P, Petitjean H, Bruno VD, Martinez C, Lempereur M, Guazzi M, Aghezzaf S, Coisne A, Oury C, Dulgheru R, Lancellotti P. A new integrative approach combining right heart catheterization and echocardiography to stage aortic stenosis-related cardiac damage. Front Cardiovasc Med 2023; 10:1184308. [PMID: 37600042 PMCID: PMC10436206 DOI: 10.3389/fcvm.2023.1184308] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 03/11/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Although staging of the extent of aortic stenosis (AS)-related cardiac damages is usually performed via echocardiography, this technique has considerable limitations in assessing pulmonary artery and right chamber pressures. The present hypothesis-generating study sought to explore the efficacy of a staging system of cardiac damage based on echocardiographic and invasive [right heart catheterization (RHC)] hemodynamic parameters in patients undergoing transcatheter aortic valve implantation (TAVI). Methods We studied 90 symptomatic patients with severe AS in whom echocardiographic and invasive evaluation by RHC was obtained prior to TAVI. Cardiac damage stages were defined as follows: no cardiac damage (stage 0), left ventricular (LV) damage (stage 1), left atrial or mitral valve damage (stage 2), pulmonary vasculature or tricuspid valve damage (stage 3), and right ventricular (RV) dysfunction or low-flow state (stage 4). With the integrative approach using RHC, pulmonary hypertension (PH) was defined as an mPAP ≥25 mmHg and the low-flow state corresponded to a cardiac index of <1.8 L/min/m2 and a right atrial pressure of >10 mmHg. Results During follow-up (median: 2.9 years), 43 patients (47.8%) died. The integrative cardiac damage staging was associated with a significant increase in all-cause and cardiovascular mortality per each increase of cardiac damage stage, whereas the outcome was similar according to the echocardiographic staging. Conclusions A staging system of cardiac lesion based on echocardiographic and invasive hemodynamic parameters in patients with severe AS undergoing TAVI predicts mortality. Patients with pre-existing PH, ≥ moderate tricuspid regurgitation and/or RV dysfunction, and a low-flow state had a markedly increased risk of death. Further larger studies are needed to validate our findings.
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Affiliation(s)
- Tommaso Viva
- GIGA Cardiovascular Sciences, CHU Sart Tilman, Cardiology Department, University of Liège Hospital, Liège, Belgium
- Department of Biomedical Sciences for Health, University of Milano, Milan, Italy
- Department of Minimally Invasive Cardiac Surgery, IRCCS Galeazzi—Sant’Ambrogio Hospital, Milan, Italy
| | - Adriana Postolache
- GIGA Cardiovascular Sciences, CHU Sart Tilman, Cardiology Department, University of Liège Hospital, Liège, Belgium
| | - Mai-Linh Nguyen Trung
- GIGA Cardiovascular Sciences, CHU Sart Tilman, Cardiology Department, University of Liège Hospital, Liège, Belgium
| | - Pauline Danthine
- GIGA Cardiovascular Sciences, CHU Sart Tilman, Cardiology Department, University of Liège Hospital, Liège, Belgium
| | - Hélène Petitjean
- GIGA Cardiovascular Sciences, CHU Sart Tilman, Cardiology Department, University of Liège Hospital, Liège, Belgium
| | - Vito Domenico Bruno
- Department of Minimally Invasive Cardiac Surgery, IRCCS Galeazzi—Sant’Ambrogio Hospital, Milan, Italy
| | - Christophe Martinez
- GIGA Cardiovascular Sciences, CHU Sart Tilman, Cardiology Department, University of Liège Hospital, Liège, Belgium
| | - Mathieu Lempereur
- GIGA Cardiovascular Sciences, CHU Sart Tilman, Cardiology Department, University of Liège Hospital, Liège, Belgium
| | - Marco Guazzi
- School of Medicine, Department of Biological Sciences, University of Milano, Milan, Italy
- CardiologyDivision, San Paolo Hospital, Milan, Italy
| | - Samy Aghezzaf
- CHU Lille, Institut Pasteur de Lille, University Lille, Inserm, Lille, France
| | - Augustin Coisne
- CHU Lille, Institut Pasteur de Lille, University Lille, Inserm, Lille, France
- Cardiovascular Research Foundation, New York, NY, United States
| | - Cécile Oury
- GIGA Cardiovascular Sciences, CHU Sart Tilman, Cardiology Department, University of Liège Hospital, Liège, Belgium
| | - Raluca Dulgheru
- GIGA Cardiovascular Sciences, CHU Sart Tilman, Cardiology Department, University of Liège Hospital, Liège, Belgium
| | - Patrizio Lancellotti
- GIGA Cardiovascular Sciences, CHU Sart Tilman, Cardiology Department, University of Liège Hospital, Liège, Belgium
- Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, and Anthea Hospital, Bari, Italy
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Lancellotti P, Postolache A, Dulgheru R. Highlights of imaging heart structure and function. Acta Cardiol 2023; 78:383-386. [PMID: 37224023 DOI: 10.1080/00015385.2023.2206690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Patrizio Lancellotti
- Department of Cardiology, CHU SartTilman, University of Liège Hospital, GIGA Cardiovascular Sciences, Liège, Belgium
- Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, and Anthea Hospital, Bari, Italy
| | - Adriana Postolache
- Department of Cardiology, CHU SartTilman, University of Liège Hospital, GIGA Cardiovascular Sciences, Liège, Belgium
| | - Raluca Dulgheru
- Department of Cardiology, CHU SartTilman, University of Liège Hospital, GIGA Cardiovascular Sciences, Liège, Belgium
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Deneye M, Marchetta S, Dulgheru R, Szecel D, Radermecker M, Lancellotti P. Sutureless bioprosthesis thrombosis. Acta Cardiol 2022; 77:976-977. [PMID: 35603592 DOI: 10.1080/00015385.2022.2078526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Manon Deneye
- Department of Cardiology, University Hospital of Liège, Liège, Belgium
| | - Stella Marchetta
- Department of Cardiology, University Hospital of Liège, Liège, Belgium
| | - Raluca Dulgheru
- Department of Cardiology, University Hospital of Liège, Liège, Belgium
| | - Delphine Szecel
- Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège, Liège, Belgium
| | - Marc Radermecker
- Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège, Liège, Belgium
| | - Patrizio Lancellotti
- Department of Cardiology, University Hospital of Liège, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
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Lancellotti P, Lempereur M, Bruls S, Tchana-Sato V, Ancion A, Dulgheru R. [Tricuspid regurgitation: transcatheter treatment by TriClip®]. Rev Med Liege 2022; 77:578-585. [PMID: 36226394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Tricuspid regurgitation (TR) is not rare and has been associated with poor clinical outcomes when severe. The etiology of TR is functional in most cases and is usually associated with left-sided valvular heart disease. Severe TR is responsible for right heart failure and may evolve to global heart failure. Current echocardiographic classification includes several grades (trivial, moderate, severe, massive, torrential TR) which influence patients' prognosis in an incremental manner. Management of patients with severe TR is discussed in Heart Team after evaluation of surgical risk. The TRI-SCORE may be used to evaluate the intra-hospital mortality risk in case of isolated tricuspid surgery. Isolated TR surgery is rarely performed as surgical risk outweighs expected clinical benefits. Transcatheter treatment of severe TR may be considered in highly selected cases. Transcatheter edge-to-edge repair (TEER) restores leaflets coaptation. First tricuspid TEER procedures were performed with the MitraClip® (Abbott, Santa Clara, CA, USA) device, but a specific device has been developed: the TriClip® (Abbott). The prospective multicenter TRILUMINATE trial evaluated the TriClip® procedure in patients with symptomatic moderate to severe TR and high surgical risk. The results show a good efficacy with reduction of post-procedural TR grade and increase in NYHA functional class, 6-minute walking test distance, right ventricular function, and quality of life at 1 year. Other devices are currently being evaluated or in development (i.e., transcatheter tricuspid implantation). Non-surgical TR management is likely to evolve and improve significantly soon.
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Affiliation(s)
| | | | - S Bruls
- Service de Chirurgie cardiovasculaire, CHU Liège, Belgique
| | - V Tchana-Sato
- Service de Chirurgie cardiovasculaire, CHU Liège, Belgique
| | - A Ancion
- Service de Cardiologie, CHU Liège, Belgique
| | - R Dulgheru
- Service de Cardiologie, CHU Liège, Belgique
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de Marneffe N, Dulgheru R, Ancion A, Moonen M, Lancellotti P. Cardiac amyloidosis: a review of the literature. Acta Cardiol 2022; 77:683-692. [PMID: 35852493 DOI: 10.1080/00015385.2021.1992990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cardiac amyloidosis is a rare disease associated with severe morbidity and mortality. There are three main types of amyloidosis associated with cardiac involvement: light chain (AL), familial or senile (ATTR) and secondary amyloidosis (AA). Cardiac amyloidosis often results in heart failure with preserved left ventricular ejection fraction, may display echocardiographic features of restrictive cardiomyopathy associated with left ventricular hypertrophy or mimic hypertrophic obstructive cardiomyopathy. However, left ventricular systolic dysfunction and normal wall thickness can sometimes be encountered. Imaging studies (echocardiography, bone scintigraphy, cardiac magnetic resonance) and blood and urine analysis are usually the main tools for the diagnosis. Sometimes, a tissue biopsy may be necessary. Treatment, which is constantly improving, will be carried out on two fronts: treatment of the symptoms and complications that the disease already caused and prevention of additional amyloid deposits while managing the concomitant complications. The purpose of this article is to review the management of cardiac amyloidosis.
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Affiliation(s)
- Nils de Marneffe
- Department of Cardiology, University Hospital of Liege, Liege, Belgium
| | - R Dulgheru
- Head of Clinic, Department of Cardiology, University Hospital of Liege, Liege, Belgium
| | - A Ancion
- Head of Clinic, Department of Cardiology, University Hospital of Liege, Liege, Belgium
| | - M Moonen
- Head of Clinic, Department of Cardiology, University Hospital of Liege, Liege, Belgium
| | - P Lancellotti
- Professor at the University of Liege, Head of the Cardiology Department, Director of the Cardiovascular GIGA, University Hospital of Liege
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Lancellotti P, Pibarot P, Chambers J, La Canna G, Pepi M, Dulgheru R, Dweck M, Delgado V, Garbi M, Vannan MA, Montaigne D, Badano L, Maurovich-Horvat P, Pontone G, Vahanian A, Donal E, Cosyns B. Multi-modality imaging assessment of native valvular regurgitation: an EACVI and ESC council of valvular heart disease position paper. Eur Heart J Cardiovasc Imaging 2022; 23:e171-e232. [PMID: 35292799 DOI: 10.1093/ehjci/jeab253] [Citation(s) in RCA: 101] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 01/10/2023] Open
Abstract
Valvular regurgitation represents an important cause of cardiovascular morbidity and mortality. Imaging is pivotal in the evaluation of native valve regurgitation and echocardiography is the primary imaging modality for this purpose. The imaging assessment of valvular regurgitation should integrate quantification of the regurgitation, assessment of the valve anatomy and function, and the consequences of valvular disease on cardiac chambers. In clinical practice, the management of patients with valvular regurgitation largely relies on the results of imaging. It is crucial to provide standards that aim at establishing a baseline list of measurements to be performed when assessing native valve regurgitation. The present document aims to present clinical guidance for the multi-modality imaging assessment of native valvular regurgitation.
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Affiliation(s)
- Patrizio Lancellotti
- Department of Cardiology, Valvular Disease Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, 4000 Liège, Belgium.,Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Italy.,Anthea Hospital, Via Camillo Rosalba, 35, Bari, Italy
| | - Philippe Pibarot
- Department of Medicine, Québec Heart & Lung Institute, Laval University, 2725, chemin Sainte-Foy, Québec, Canada
| | - John Chambers
- Emeritus Professor of Clinical Cardiology, Guy's and St Thomas' Hospital, London SE1 7EH, UK
| | - Giovanni La Canna
- Cardiovascular Department, IRCCS Humanitas Clinical and Research Hospital, Applied Diagnostic Echocardiography, 20089 Rozzano, Milan, Italy
| | - Mauro Pepi
- Department of Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
| | - Raluca Dulgheru
- Department of Cardiology, Valvular Disease Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, 4000 Liège, Belgium
| | - Mark Dweck
- BHF Centre for Cardiovascular Science, University of Edinburgh, Little France Crescent, Edinburgh EH16 4SB, UK
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2 2300 RC Leiden, The Netherlands
| | - Madalina Garbi
- Royal Papworth Hospital, Cambridge University Health Partner, Cambridge Biomedical Campus, CB2 0AY Cambridge, UK
| | - Mani A Vannan
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, GA, USA
| | - David Montaigne
- University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, F-59000 Lille, France
| | - Luigi Badano
- Department of Medicine and Surgery, University of Milano-Bicocca, 20089 Milan, Italy.,Department of Cardiac, Metabolic and Neural Sciences, Istituto Auxologico Italiano, IRCCS, 20089 Milan, Italy
| | - Pal Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Semmelweis University, 1083 Budapest, Hungary
| | | | - Alec Vahanian
- UFR Medecine, Université de Paris, Site Bichat, 16 rue Huchard, 75018 Paris, France.,LVTS INSERM U1148, GH Bichat, 46, rue Henri Huchard, 75018 Paris, France
| | - Erwan Donal
- University of Rennes, CHU Rennes, Inserm, LTSI-UMR 1099, Rennes, France
| | - Bernard Cosyns
- Department of Cardiology, CHVZ (Centrum voor Hart en Vaatziekten), ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Universitair Ziekenhuis Brussel, 101 Laarbeeklaan, 1090 Brussels, Belgium
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Ilardi F, Postolache A, Dulgheru R, Trung MLN, de Marneffe N, Sugimoto T, Go YY, Oury C, Esposito G, Lancellotti P. Prognostic Value of Non-Invasive Global Myocardial Work in Asymptomatic Aortic Stenosis. J Clin Med 2022; 11:jcm11061555. [PMID: 35329881 PMCID: PMC8953091 DOI: 10.3390/jcm11061555] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/20/2022] [Accepted: 03/09/2022] [Indexed: 12/04/2022] Open
Abstract
This study aimed to evaluate the modification of non-invasive myocardial work (MW) indices related to aortic stenosis (AS) stages of cardiac damage and their prognostic value. The echocardiographic and outcome data of 170 patients, with asymptomatic moderate-to-severe AS and left ventricular ejection fraction (LVEF) ≥ 50%, and 50 age- and sex-comparable healthy controls were analysed. Primary endpoints were the occurrence of all-cause and cardiovascular death. Increased values of the global work index (GWI), global constructive work (GCW), and global wasted work (GWW) were observed in AS patients compared to controls (GWI: 2528 ± 521 vs. 2005 ± 302 mmHg%, GCW: 2948 ± 598 vs. 2360 ± 353 mmHg%, p < 0.001; GWW: 139 ± 90 vs. 90 ± 49 mmHg%, p = 0.005), with no changes in the global work efficiency. When patients were stratified according to the stages of cardiac damage, the GWI showed lower values in Stage 3−4 as compared to Stage 0 and Stage 2 (p = 0.024). During a mean follow-up of 30 months, 27 patients died. In multivariable Cox-regression analysis, adjusted for confounders, GWI (HR: 0.998, CI: 0.997−1.000; p = 0.034) and GCW (HR:0.998, CI: 0.997−0.999; p = 0.003) were significantly associated with excess mortality. When used as categorical variables, a GWI ≤ 1951 mmHg% and a GCW ≤ 2475 mmHg% accurately predicted all-cause and cardiovascular death at 4-year follow-up. In conclusion, in asymptomatic patients with moderate-to-severe AS, reduced values of GWI and GCW are associated with increased mortality. Therefore, the evaluation of MW indices may allow for a better identification of asymptomatic patients with moderate to severe AS and preserved LVEF whom are at increased risk of worse prognosis during follow-up.
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Affiliation(s)
- Federica Ilardi
- Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, Belgium; (F.I.); (A.P.); (R.D.); (M.-L.N.T.); (N.d.M.); (T.S.); (Y.Y.G.); (C.O.)
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini, 5, 80131 Napoli, Italy;
| | - Adriana Postolache
- Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, Belgium; (F.I.); (A.P.); (R.D.); (M.-L.N.T.); (N.d.M.); (T.S.); (Y.Y.G.); (C.O.)
| | - Raluca Dulgheru
- Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, Belgium; (F.I.); (A.P.); (R.D.); (M.-L.N.T.); (N.d.M.); (T.S.); (Y.Y.G.); (C.O.)
| | - Mai-Linh Nguyen Trung
- Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, Belgium; (F.I.); (A.P.); (R.D.); (M.-L.N.T.); (N.d.M.); (T.S.); (Y.Y.G.); (C.O.)
| | - Nils de Marneffe
- Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, Belgium; (F.I.); (A.P.); (R.D.); (M.-L.N.T.); (N.d.M.); (T.S.); (Y.Y.G.); (C.O.)
| | - Tadafumi Sugimoto
- Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, Belgium; (F.I.); (A.P.); (R.D.); (M.-L.N.T.); (N.d.M.); (T.S.); (Y.Y.G.); (C.O.)
- Clinical Laboratory, Mie University Hospital, Tsu 514-8507, Japan
| | - Yun Yun Go
- Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, Belgium; (F.I.); (A.P.); (R.D.); (M.-L.N.T.); (N.d.M.); (T.S.); (Y.Y.G.); (C.O.)
- Department of Cardiology, National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore 169609, Singapore
| | - Cécile Oury
- Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, Belgium; (F.I.); (A.P.); (R.D.); (M.-L.N.T.); (N.d.M.); (T.S.); (Y.Y.G.); (C.O.)
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S. Pansini, 5, 80131 Napoli, Italy;
| | - Patrizio Lancellotti
- Department of Cardiology and Radiology, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liege University Hospital, 4000 Liege, Belgium; (F.I.); (A.P.); (R.D.); (M.-L.N.T.); (N.d.M.); (T.S.); (Y.Y.G.); (C.O.)
- Gruppo Villa Maria Care and Research, Anthea Hospital, 70124 Bari, Italy
- Correspondence: ; Tel.: +32-4-366-71-94
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10
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Donis N, Jiang Z, D'Emal C, Hulin A, Debuisson M, Dulgheru R, Nguyen ML, Postolache A, Lallemand F, Coucke P, Martinive P, Herzog M, Pamart D, Terrell J, Pincemail J, Drion P, Delvenne P, Nchimi A, Lancellotti P, Oury C. Differential Biological Effects of Dietary Lipids and Irradiation on the Aorta, Aortic Valve, and the Mitral Valve. Front Cardiovasc Med 2022; 9:839720. [PMID: 35295264 PMCID: PMC8918952 DOI: 10.3389/fcvm.2022.839720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/24/2022] [Indexed: 01/12/2023] Open
Abstract
Aims Dietary cholesterol and palmitic acid are risk factors for cardiovascular diseases (CVDs) affecting the arteries and the heart valves. The ionizing radiation that is frequently used as an anticancer treatment promotes CVD. The specific pathophysiology of these distinct disease manifestations is poorly understood. We, therefore, studied the biological effects of these dietary lipids and their cardiac irradiation on the arteries and the heart valves in the rabbit models of CVD. Methods and Results Cholesterol-enriched diet led to the thickening of the aortic wall and the aortic valve leaflets, immune cell infiltration in the aorta, mitral and aortic valves, as well as aortic valve calcification. Numerous cells expressing α-smooth muscle actin were detected in both the mitral and aortic valves. Lard-enriched diet induced massive aorta and aortic valve calcification, with no detectable immune cell infiltration. The addition of cardiac irradiation to the cholesterol diet yielded more calcification and more immune cell infiltrates in the atheroma and the aortic valve than cholesterol alone. RNA sequencing (RNAseq) analyses of aorta and heart valves revealed that a cholesterol-enriched diet mainly triggered inflammation-related biological processes in the aorta, aortic and mitral valves, which was further enhanced by cardiac irradiation. Lard-enriched diet rather affected calcification- and muscle-related processes in the aorta and aortic valve, respectively. Neutrophil count and systemic levels of platelet factor 4 and ent-8-iso-15(S)-PGF2α were identified as early biomarkers of cholesterol-induced tissue alterations, while cardiac irradiation resulted in elevated levels of circulating nucleosomes. Conclusion Dietary cholesterol, palmitic acid, and cardiac irradiation combined with a cholesterol-rich diet led to the development of distinct vascular and valvular lesions and changes in the circulating biomarkers. Hence, our study highlights unprecedented specificities related to common risk factors that underlie CVD.
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Affiliation(s)
- Nathalie Donis
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Zheshen Jiang
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Céline D'Emal
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Alexia Hulin
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Margaux Debuisson
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Raluca Dulgheru
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Mai-Linh Nguyen
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Adriana Postolache
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | | | | | - Philippe Martinive
- Department Radiation Oncology, Institut Jules Bordet, Université Libre Bruxelles, Brussels, Belgium
| | - Marielle Herzog
- Belgian Volition Société à Responsabilité Limitée, Gembloux, Belgium
| | - Dorian Pamart
- Belgian Volition Société à Responsabilité Limitée, Gembloux, Belgium
| | - Jason Terrell
- Department of Oncology and Livestrong Cancer Institutes, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Volition America, Austin, TX, United States
| | | | - Pierre Drion
- Experimental Surgery Unit, Centre de Recherche du Département de Chrirurgie, Groupe Interdisciplinaire de Géno-Protéomique Appliquée Institute, University of Liège, Liège, Belgium
| | - Philippe Delvenne
- Department of Pathology, Centre Hospitalier Universitaire of Liège, Liège, Belgium
- Laboratory of Experimental Pathology, GIGA Institute, University of Liège, Liège, Belgium
| | - Alain Nchimi
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Patrizio Lancellotti
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
- Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Italy
- Anthea Hospital, Bari, Italy
| | - Cécile Oury
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
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11
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Cosyns B, Roosens B, Lancellotti P, Laroche C, Dulgheru R, Scheggi V, Vilacosta I, Pasquet A, Piper C, Reyes G, Mahfouz E, Kobalava Z, Piroth L, Kasprzak JD, Moreo A, Faucher JF, Ternacle J, Meshaal M, Maggioni AP, Iung B, Habib G. Cancer and Infective Endocarditis: Characteristics and Prognostic Impact. Front Cardiovasc Med 2021; 8:766996. [PMID: 34859076 PMCID: PMC8631931 DOI: 10.3389/fcvm.2021.766996] [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] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
Background: The interplay between cancer and IE has become of increasing interest. This study sought to assess the prevalence, baseline characteristics, management, and outcomes of IE cancer patients in the ESC EORP EURO-ENDO registry. Methods: Three thousand and eighty-five patients with IE were identified based on the ESC 2015 criteria. Three hundred and fifty-nine (11.6%) IE cancer patients were compared to 2,726 (88.4%) cancer-free IE patients. Results: In cancer patients, IE was mostly community-acquired (74.8%). The most frequently identified microorganisms were S. aureus (25.4%) and Enterococci (23.8%). The most frequent complications were acute renal failure (25.9%), embolic events (21.7%) and congestive heart failure (18.1%). Theoretical indication for cardiac surgery was not significantly different between groups (65.5 vs. 69.8%, P = 0.091), but was effectively less performed when indicated in IE patients with cancer (65.5 vs. 75.0%, P = 0.002). Compared to cancer-free IE patients, in-hospital and 1-year mortality occurred in 23.4 vs. 16.1%, P = 0.006, and 18.0 vs. 10.2%; P < 0.001, respectively. In IE cancer patients, predictors of mortality by multivariate analysis were creatinine > 2 mg/dL, congestive heart failure and unperformed cardiac surgery (when indicated). Conclusions: Cancer in IE patients is common and associated with a worse outcome. This large, observational cohort provides new insights concerning the contemporary profile, management, and clinical outcomes of IE cancer patients across a wide range of countries.
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Affiliation(s)
- Bernard Cosyns
- Centrum Voor Hart- en Vaatziekten (CHVZ), Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.,In vivo Cellular and Molecular Imaging (ICMI) Center, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Bram Roosens
- Centrum Voor Hart- en Vaatziekten (CHVZ), Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Patrizio Lancellotti
- Cardiology Department, University Hospital Centre, Centre Hospitalier Universitaire (CHU) Sart Tilman, Liège, Belgium
| | - Cécile Laroche
- EURObservational Research Programme, European Society of Cardiology, Antibes, France
| | - Raluca Dulgheru
- Cardiology Department, University Hospital Centre, Centre Hospitalier Universitaire (CHU) Sart Tilman, Liège, Belgium
| | - Valentina Scheggi
- Cardiothoracic and Vascular Department, Careggi University Hospital, Florence, Italy
| | - Isidre Vilacosta
- Department of Cardiology, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Agnès Pasquet
- Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.,Divisions of Cardiology and Cardiothoracic Surgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Cornelia Piper
- Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum Nordrhein-Westfalen (NRW), Ruhr-Universität Bochum, Bad Oeynhausen, Germany
| | - Graciela Reyes
- Echo Lab Department, Hospital de Alta Complejidad en red El Cruce, Florencio Varela, Buenos Aires, Argentina
| | - Essam Mahfouz
- Mansoura Specialized Medical Hospital, Mansoura University, Mansoura, Egypt
| | - Zhanna Kobalava
- Department of Cardiology, Rossiyskiy Universitet Druzhby Narodov (RUDN) University Moscow, Moscow, Russia
| | - Lionel Piroth
- Infectious Diseases Department, University Hospital, INSERM CIC1432, University of Burgundy, Dijon, France
| | | | - Antonella Moreo
- A. De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Jean-François Faucher
- CHU Limoges, Department of Infectious Diseases and Tropical Medicine, Limoges France INSERM, U1094, Limoges, France
| | - Julien Ternacle
- Cardiology Department, Henri Mondor Hospital, SOS Endocardites, DHU ATVB, INSERM U955 Team 8, Université Paris-Est Créteil, Créteil, France.,Fellow Equipe, Team du Dr Philippe Pibarot, Institut Universitaire de Cardiologie et de Pneumologie de Québec/Quebec Heart and Lung Institute Université Laval, Quebec City, QC, Canada
| | - Marwa Meshaal
- Cardiology Department, Kasr Al Ainy, Cairo University, Cairo, Egypt
| | - Aldo P Maggioni
- EURObservational Research Programme, European Society of Cardiology, Antibes, France.,Maria Cecilia Hospital, Gruppo Villa Maria (GVM) Care & Research, Cotignola, Italy
| | - Bernard Iung
- Bichat Hospital, APHP, DHU Fire, Paris Diderot University, Paris, France
| | - Gilbert Habib
- AP-HM, La Timone Hospital, Cardiology Department, Marseille, France.,Aix Marseille University, IRD, AP-HM, MEPHI, IHU-Mediterranean Infection, Marseille, France
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12
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Douin C, Marchetta S, Dulgheru R, Bruyère PJ, Moonen M, Lancellotti P. Case report: aortic bioprosthesis marantic endocarditis. Acta Cardiol 2021; 76:1143-1144. [PMID: 33047667 DOI: 10.1080/00015385.2020.1813995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Clara Douin
- GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, University of Liège Hospital, CHU Sart-Tilman, Liège, Belgium
| | - Stella Marchetta
- Department of Cardiology, CHC MontLegia Hospital, Liège, Belgium
| | - Raluca Dulgheru
- GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, University of Liège Hospital, CHU Sart-Tilman, Liège, Belgium
| | - Pierre-Julien Bruyère
- GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, University of Liège Hospital, CHU Sart-Tilman, Liège, Belgium
| | - Marie Moonen
- GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, University of Liège Hospital, CHU Sart-Tilman, Liège, Belgium
| | - Patrizio Lancellotti
- GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, University of Liège Hospital, CHU Sart-Tilman, Liège, Belgium
- Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, and Anthea Hospital, Bari, Italy
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13
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Bruls S, Dulgheru R, Lancellotti P, Defraigne JO. Unusual localization of vegetations in a native aortic valve infective endocarditis. Echocardiography 2021; 38:2129-2131. [PMID: 34820893 DOI: 10.1111/echo.15255] [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: 06/04/2021] [Revised: 09/06/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022] Open
Abstract
In case of valvular infective endocarditis, the infection is mainly localized on the flow side of the valves or at damaged valvular endothelium. We describe a rare case of an aortic valvular ineffective endocarditis with an aortic-valve vegetation situated on the aortic side of the valve. We believe this is the first description of this unusual localization of vegetations in a native aortic valve.
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Affiliation(s)
- Samuel Bruls
- Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège, Liège, Belgium
| | - Raluca Dulgheru
- Department of Cardiology, University Hospital of Liège, Liège, Belgium
| | | | - Jean-Olivier Defraigne
- Department of Cardiovascular and Thoracic Surgery, University Hospital of Liège, Liège, Belgium
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14
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Le Goff C, Kaux JF, Dulgheru R, Seidel L, Pincemail J, Cavalier E, Melon P. The impact of an ultra-trail on the dynamic of cardiac, inflammatory, renal and oxidative stress biological markers correlated with electrocardiogram and echocardiogram. Acta Cardiol 2021; 76:739-747. [PMID: 32539581 DOI: 10.1080/00015385.2020.1778871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The aim of this study was to describe the effects of a 64.2 km ultra-trail on the biomarkers of muscle damage, inflammation and oxidative stress, and compare the results observed with an ECG and an echocardiogram, both performed before and after the race.Thirty-three ultra-trail volunteers (45.8 ± 8.7 years old) were enrolled in our study. Three blood tests were drawn from each runner, one just before (TPRE), one just after (TPOST) and the last 3 h after the end of the race (TPOST3h).All the markers increased. The maximum concentrations observed were at TPOST3h and were significant (p < 0.001) for creatine kinase, creatine kinase isoform MB, high-sensitivity C-reactive protein, uric acid and for the ratio of reduced glutathione to oxidised glutathione. However, in the case of myoglobin, high-sensitive troponin T, N-terminal pro-brain natriuretic peptide, oxidised glutathione, myeloperoxidase, cystatin C and creatinine, the most significant increases were at TPOST (p < 0.001). Modifications were observed in the medical imaging using echocardiography such as reduction of left ventricule end-sytolic and diastolic volumes and left ventricular global longitudinal strain. ECG showed electrical criteria for left ventricular hypertrophy and incomplete right bundle branch block after the race.Endurance races cause significant physiological stress to the body that can be measured by the increase of different biomarkers. From a laboratory perspective, it is important to take into account the possible exercise performed previous to the testing to avoid a misinterpretation of the results. From a training perspective, due to these increases in biomarkers, it is recommended that runners wait at least 72 h after an ultra-trail before subsequent training. In addition a transient impairment of ventricular function due to dehydration were observed.
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Affiliation(s)
- C. Le Goff
- Clinical Chemistry Department, University and University Hospital of Liège, Liège, Belgium
| | - J-F. Kaux
- Physical Medicine and Sports Traumatology Department, SportS2, FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIMS Collaborating Center of Sports Medicine, University and University Hospital of Liège, Liège, Belgium
| | - R. Dulgheru
- Department of Cardiology, University and University Hospital of Liège, Liège, Belgium
| | - L. Seidel
- Biostatistic Department, University Hosptial of Liège, Liège, Belgium
| | | | - E. Cavalier
- Clinical Chemistry Department, University and University Hospital of Liège, Liège, Belgium
| | - P. Melon
- Department of Cardiology, University and University Hospital of Liège, Liège, Belgium
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15
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Dulgheru R, Radermecker M, Hans G, Bruyère PJ, Lancellotti P. Caseous calcification of the mitral annulus: an uncommon cause of acute mitral regurgitation. Eur Heart J Cardiovasc Imaging 2021; 22:e19. [PMID: 32793963 DOI: 10.1093/ehjci/jeaa240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Raluca Dulgheru
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - Marc Radermecker
- Cardiac and Thoracic Surgery Department, University of Liège Hospital, Liège, Belgium
| | - Gregory Hans
- Anaesthesiology Department, University of Liège Hospital, Liège, Belgium
| | | | - Patrizio Lancellotti
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Italy and Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
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16
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Affiliation(s)
- Raluca Dulgheru
- Department of Cardiology and Cardiovascular Surgery, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Avenue de l'Hôpital 1, Batmiment B35, Liège, Belgium
| | - Samuel Bruls
- Department of Cardiology and Cardiovascular Surgery, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Avenue de l'Hôpital 1, Batmiment B35, Liège, Belgium
| | - Patrizio Lancellotti
- Department of Cardiology and Cardiovascular Surgery, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Avenue de l'Hôpital 1, Batmiment B35, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Camillo Rosalba, 35/37, 70124 Bari BA, Italy
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17
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Delvenne E, Khaddi S, Dulgheru R, Habbal R, Lancellotti P. [Dynamic mitral regurgitation and acute pulmonary edema]. Rev Med Liege 2021; 76:583-587. [PMID: 34357707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
We report the case of a 61-year old patient with signs and symptoms of heart failure with mid-range left ventricular ejection fraction and moderate mitral regurgitation of mixed etiology (rheumatic heart disease, toxic and ischemic). The dynamic behaviour of the mitral regurgitation was revealed by an acute episode of pulmonary edema in the context of an abrupt elevation of blood pressure inducing an increase in left ventricular afterload. Dynamic mitral regurgitation must be considered in any patient with exercise dyspnea who has a moderate mitral regurgitation in resting conditions or in patients with repeated acute pulmonary edema without an obvious cause. Exercise stress echocardiography is the best diagnostic test to explore the dynamic behaviour of the mitral regurgitation. Surgery or percutaneous treatment may be proposed in severe cases.
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Affiliation(s)
- E Delvenne
- Service de Cardiologie, CHU Liège, Belgique
| | - S Khaddi
- Service de Cardiologie, CHU IBN Rochd, Casablanca, Maroc
| | - R Dulgheru
- Service de Cardiologie, CHU Liège, Belgique
| | - R Habbal
- Service de Cardiologie, CHU IBN Rochd, Casablanca, Maroc
| | - P Lancellotti
- Service de Cardiologie, GIGA Cardiovasculaire, CHU Liège, Belgique
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18
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Manganaro R, Marchetta S, Dulgheru R, Sugimoto T, Tsugu T, Ilardi F, Cicenia M, Ancion A, Postolache A, Martinez C, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, Von Bardeleben RS, Vinereanu D, Zamorano JL, Rosca M, Calin A, Moonen M, Magne J, Cosyns B, Galli E, Donal E, Carerj S, Zito C, Santoro C, Galderisi M, Badano LP, Lang RM, Lancellotti P. Correlation between non-invasive myocardial work indices and main parameters of systolic and diastolic function: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 2021; 21:533-541. [PMID: 31408147 DOI: 10.1093/ehjci/jez203] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [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: 07/09/2019] [Accepted: 07/13/2019] [Indexed: 12/22/2022] Open
Abstract
AIMS The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE). METHODS AND RESULTS A total of 226 (85 men, mean age: 45 ± 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained. On multivariable analysis, GWI was significantly correlated with GLS (standardized beta-coefficient = -0.23, P < 0.001), ejection fraction (EF) (standardized beta-coefficient = 0.15, P = 0.02), systolic blood pressure (SBP) (standardized beta-coefficient = 0.56, P < 0.001) and GRS (standardized beta-coefficient = 0.19, P = 0.004), while GCW was correlated with GLS (standardized beta-coefficient = -0.55, P < 0.001), SBP (standardized beta-coefficient = 0.71, P < 0.001), GRS (standardized beta-coefficient = 0.11, P = 0.02), and GCS (standardized beta-coefficient = -0.10, P = 0.01). GWE was directly correlated with EF and inversely correlated with Tei index (standardized beta-coefficient = 0.18, P = 0.009 and standardized beta-coefficient = -0.20, P = 0.004, respectively), the opposite occurred for GWW (standardized beta-coefficient =--0.14, P = 0.03 and standardized beta-coefficient = 0.17, P = 0.01, respectively). CONCLUSION The non-invasive MW indices show a good correlation with traditional 2DE parameters of myocardial systolic function and myocardial strain.
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Affiliation(s)
- Roberta Manganaro
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Stella Marchetta
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Raluca Dulgheru
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Tadafumi Sugimoto
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium.,Department of Clinical Laboratory, Mie University Hospital, Mie, 2-174 Edobashi, 514-8507 Tsu, Japan
| | - Toshimitsu Tsugu
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium.,Department of Cardiology, School of Medicine, Keio University, 160-8582 Tokyo, Japan
| | - Federica Ilardi
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium.,Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S.Pansini, 5, 80131 Napoli, Italy
| | - Marianna Cicenia
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Arnaud Ancion
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Adriana Postolache
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Christophe Martinez
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - George Kacharava
- Department of Cardiology, Tbilisi Institute of Medicine (TIM), 16 Tsintsadze, 0160 Tbilisi, Georgia
| | - George D Athanassopoulos
- Noninvasive Diagnostics Department, Onassis Cardiac Surgery Center, Leof. Andrea Siggrou 356, 176 74 Kallithea, Athens, Greece
| | - Daniele Barone
- Cardiology Department, Laboratory of Cardiovascular Ecography, S. Andrea Hospital, La Spezia, Italy
| | - Monica Baroni
- Laboratorio Di Ecocardiografia Adulti, Fondazione Toscana "G.Monasterio" - Ospedale Del Cuore, Via Giuseppe Moruzzi, 1, 56124 Pisa, Massa, Italy
| | - Nuno Cardim
- Echocardiography Laboratory, Hospital da Luz, Av. Lusíada 100, 1500-650 Lisboa, Portugal
| | - Andreas Hagendorff
- Department of Cardiology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
| | - Krasimira Hristova
- Department of Noninvasive Functional Diagnostic and Imaging, University National Heart Hospital, ul. 'Konyovitsa' 65, 1309 g.k. Ilinden, Sofia, Bulgaria
| | - Teresa Lopez
- Cardiology Department, La Paz Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
| | - Gonzalo de la Morena
- Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain
| | - Bogdan A Popescu
- Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Sos. Fundeni 258, sector 2, 022328 Bucharest, Romania
| | - Martin Penicka
- Cardiovascular Center Aalst, OLV-Clinic, Moorselbaan 164, 9300 Aalst, Belgium
| | - Tolga Ozyigit
- VKV Amerikan Hastanesi, Kardiyoloji Bölümü, Tes v¸ikiye, Güzelbahçe Sok, No: 20, 34365 Nişantaşı Istanbul Turkey
| | | | - Nico van de Veire
- Echocardiography Unit, AZ Maria Middelares Gent, Buitenring-Sint-Denijs 30, 9000 Gent, Belgium
| | - Ralph Stephan Von Bardeleben
- Medical Department Cardiology, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Dragos Vinereanu
- Cardiovascular Research Unit, University and Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Sector 1, Strada Dionisie Lupu 37, 030167 Bucureşti, Romania
| | - Jose Luis Zamorano
- University Alcala, Hospital Ramón y Cajal, Ctra. De Colmenar Viejo, km. 9, 100, 28034 Madrid, Spain
| | - Monica Rosca
- Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Sos. Fundeni 258, sector 2, 022328 Bucharest, Romania
| | - Andreea Calin
- Department of Cardiology, University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Sos. Fundeni 258, sector 2, 022328 Bucharest, Romania
| | - Marie Moonen
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Julien Magne
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges F-87042, France.,INSERM 1094, Faculté de médecine de Limoges, 2, rue Marcland, 87000 Limoges, France
| | - Bernard Cosyns
- CHVZ (Centrum voor Hart en Vaatziekten), Universitair ziekenhuis Brussel and ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Avenue du Laerbeek 101, 1090 Jette, Brussels, Belgium
| | - Elena Galli
- CIC-IT U 1414, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France
| | - Erwan Donal
- CIC-IT U 1414, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France
| | - Scipione Carerj
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, 1, Via Consolare Valeria - 98125 Messina (IT), Italy
| | - Concetta Zito
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, 1, Via Consolare Valeria - 98125 Messina (IT), Italy
| | - Ciro Santoro
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S.Pansini, 5, 80131 Napoli, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S.Pansini, 5, 80131 Napoli, Italy
| | - Luigi P Badano
- Department of Medicine and Surgery, University Milano-Bicocca, and Istituto Auxologico Italiano, IRCCS, Cardiology Unit and Dept of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, P.le Brescia 20, 20149 Milano, Italy
| | - Roberto M Lang
- Department of Medicine, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, 60637 IL, USA
| | - Patrizio Lancellotti
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Via Camillo Rosalba, 35, 70124 Bari, Italy
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19
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Donis N, Jiang Z, D'Emal C, Dulgheru R, Giera M, Blomberg N, Delvenne P, Nchimi A, Lancellotti P, Oury C. Regular Dietary Intake of Palmitate Causes Vascular and Valvular Calcification in a Rabbit Model. Front Cardiovasc Med 2021; 8:692184. [PMID: 34250045 PMCID: PMC8261064 DOI: 10.3389/fcvm.2021.692184] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/24/2021] [Indexed: 01/23/2023] Open
Abstract
Aims: Palmitic acid (PA) and oleic acid (OA) are two main dietary fatty acids. Dietary intake of PA has been associated with cardiovascular disease risk, and the effect of OA remains uncertain. Our study aimed to assess the effect of a short-term intake of lard, as source of PA and OA, on aorta and aortic valve. Methods and Results: Rabbits were fed with two lard-enriched diets, containing either elevated levels of PA or of both PA and OA as compared to chow diet. After 16 weeks of each diet, calcification was observed in the aortic intima and in the aortic valve. The extent of calcification did not differ between the two diets. In contrast, rabbits fed chow diet did not develop any calcification. In blood, PA enrichment resulted in decreased lymphocyte and monocyte counts and increased levels of hemoglobin and haematocrit. Levels of the calcification inhibitor fetuin-A were also diminished, whereas creatinine levels were raised. Of note, none of the diets changed cholesterol levels in LDL or HDL. Comprehensive quantitative lipidomics analysis identified diet-related changes in plasma lipids. Dietary PA enrichment led to a drop of polyunsaturated fatty acids (PUFA), in particular of linoleic acid in cholesteryl esters, triglycerides and diacylglycerols (DAG). Ratios of PA to 18-carbon PUFA in DAG were positively correlated with the extent of aortic valve calcification, and inversely with monocyte counts. PA content in blood correlated with aorta calcification. Conclusions: Regular dietary PA intake induces vascular and valvular calcification independently of traditional risk factors. Our findings raise awareness about PA-rich food consumption and its potential deleterious effect on cardiovascular health.
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Affiliation(s)
- Nathalie Donis
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
| | - Zheshen Jiang
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
| | - Céline D'Emal
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
| | - Raluca Dulgheru
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
| | - Martin Giera
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, Netherlands
| | - Niek Blomberg
- Center for Proteomics and Metabolomics, Leiden University Medical Center, Leiden, Netherlands
| | - Philippe Delvenne
- Department of Pathology, Centre Hospitalier Universitaire (CHU) University Hospital, Liège University, Liège, Belgium.,Laboratory of Experimental Pathology, Groupe Interdisciplinaire de Géno-protéomique Appliquée (GIGA) Institute, Liege University, Liège, Belgium
| | - Alain Nchimi
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
| | - Patrizio Lancellotti
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium.,Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Italy.,Anthea Hospital, Bari, Italy
| | - Cécile Oury
- Laboratory of Cardiology, Department of Cardiology, GIGA Institute, CHU Sart Tilman, University of Liège, Liège, Belgium
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20
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Tsugu T, Nagatomo Y, Dulgheru R, Lancellotti P. Layer-specific longitudinal strain predicts left ventricular maximum wall thickness in patients with hypertrophic cardiomyopathy. Echocardiography 2021; 38:1149-1156. [PMID: 34028870 DOI: 10.1111/echo.15125] [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: 03/21/2021] [Accepted: 05/09/2021] [Indexed: 11/28/2022] Open
Abstract
AIMS The aim of this study was (a) to clarify the detailed mechanisms of structural and functional abnormalities of myocardial tissue in hypertrophic cardiomyopathy (HCM) using layer-specific strain (LSS) and compare it with healthy subjects (b) to investigate the diagnostic accuracy of LSS for HCM. METHODS AND RESULTS Forty-one patients with HCM and preserved left ventricular ejection fraction (LVEF; 66% male, 52 ± 18 years, LVEF 62.9% ± 3.7%) and 41 controls matched for age and sex (66% male, 52 ± 20 years, LVEF 63.5% ± 8.2%) underwent 2D-speckle tracking echocardiography. Absolute values of LSS were globally lower and the ratio of endocardial/epicardial layer (End/Epi ratio) was higher in HCM. LSS gradually increased from the epicardial toward the endocardial layer at all chamber views and at all levels of the LV. LSS and End/Epi ratio at the apex were higher than those at the middle or basal level of the LV. End/Epi ratio was correlated with LV maximal wall thickness both controls (r = .35, P = .03) and HCM (r = .81, P < .001). End/Epi ratio was an independent factor associated with LV maximal wall thickness (β = 0.96, P < .001). A higher End/Epi ratio (≥1.31) was associated with diagnostic criteria for HCM (sensitivity 98%, specificity 95%, area under the curve 0.99, P < .001). CONCLUSION LSS has the potential for unraveling the mechanism of impaired LV wall motion in HCM and to accurately detect HCM.
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Affiliation(s)
- Toshimitsu Tsugu
- Departments of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart Tilman, University of Liège Hospital, Liège, Belgium
| | - Yuji Nagatomo
- Department of Cardiology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Raluca Dulgheru
- Departments of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart Tilman, University of Liège Hospital, Liège, Belgium
| | - Patrizio Lancellotti
- Departments of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU Sart Tilman, University of Liège Hospital, Liège, Belgium
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21
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Bernard AC, Marchetta S, Dulgheru R, Pierard LA, Lancellotti P. Ventricular septal defect and infective endocarditis. Acta Cardiol 2021; 76:97-98. [PMID: 31762396 DOI: 10.1080/00015385.2019.1692482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Anne-Catherine Bernard
- GIGA Cardiovascular Sciences, University of Liège Hopsital, Liège, Belgium
- Department of Cardiology, Heart Valve Clinic, University Hospital Sart-Tilman, Liège, Belgium
| | - Stella Marchetta
- GIGA Cardiovascular Sciences, University of Liège Hopsital, Liège, Belgium
- Department of Cardiology, Heart Valve Clinic, University Hospital Sart-Tilman, Liège, Belgium
| | - Raluca Dulgheru
- GIGA Cardiovascular Sciences, University of Liège Hopsital, Liège, Belgium
- Department of Cardiology, Heart Valve Clinic, University Hospital Sart-Tilman, Liège, Belgium
| | - Luc A. Pierard
- GIGA Cardiovascular Sciences, University of Liège Hopsital, Liège, Belgium
- Department of Cardiology, Heart Valve Clinic, University Hospital Sart-Tilman, Liège, Belgium
| | - Patrizio Lancellotti
- GIGA Cardiovascular Sciences, University of Liège Hopsital, Liège, Belgium
- Department of Cardiology, Heart Valve Clinic, University Hospital Sart-Tilman, Liège, Belgium
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22
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Tchana-Sato V, Hans G, Frippiat F, Zekhnini I, Dulgheru R, Bruls S, Durieux R, Lavigne JP, Defraigne JO. Streptococcus agalactiae infective endocarditis: analysis of eight surgical cases from a single centre. Infect Dis (Lond) 2020; 53:189-195. [PMID: 33356719 DOI: 10.1080/23744235.2020.1863460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Streptococcus agalactiae (GBS) infective endocarditis (IE) is a rare clinical entity. It is associated with a high mortality rate compared to other streptococci endocarditis. The aim of this study is to define the clinical characteristics, treatment and outcomes of a series of eight non-pregnant adults with GBS IE managed by a combination of antibiotics and surgery at our institution. METHODS We retrospectively reviewed the medical records of all adult patients with a definite diagnosis of IE by Duke modified criteria and who underwent surgery at our centre between January 2008 and December 2018. RESULTS A total of 190 patients underwent surgery for IE during the study period. Eight cases of GBS IE were identified, including six males and two females. The mean aged was 54 years (range, 32-68). Seven cases suffered native valve endocarditis and one involved an aortic bioprosthesis. Seven patients had underlying comorbidities. Furthermore, four patients had experienced serious complications. Of these, the most common were heart failure, septic shock, and cerebral emboli. Vegetations tended to be large, very mobile, and pedunculated. Most of the patients were treated with penicillin plus an aminoglycoside. Surgery was emergently performed in one patient and urgently performed in seven patients. In- hospital mortality rate was 37.5%. CONCLUSION GBS IE is a virulent disease with an aggressive clinical course. It mostly affects patients with debilitating diseases. Early surgery should be considered to prevent the development of serious complications. However, overall mortality rate remains high despite surgical treatment.
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Affiliation(s)
| | - Gregory Hans
- Department of Anesthesiology, CHU Liege, Liège, Belgium
| | | | - Ines Zekhnini
- Department of Cardiovascular Surgery, CHU Liege, Liège, Belgium
| | | | - Samuel Bruls
- Department of Cardiovascular Surgery, CHU Liege, Liège, Belgium
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23
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Cameli M, Miglioranza MH, Magne J, Mandoli GE, Benfari G, Ancona R, Sibilio G, Reskovic Luksic V, Dejan D, Griseli L, Van De Heyning CM, Mortelmans P, Michalski B, Kupczynska K, Di Giannuario G, Devito F, Dulgheru R, Ilardi F, Salustri A, Abushahba G, Morrone D, Fabiani I, Penicka M, Katbeh A, Sammarco G, Esposito R, Santoro C, Pastore MC, Comenale Pinto S, Kalinin A, Pičkure Ž, Ažman Juvan K, Zupan Mežnar A, Coisne A, Coppin A, Opris MM, Nistor DO, Paakkanen R, Biering-Sørensen T, Olsen FJ, Lapinskas T, Vaškelyté JJ, Galian-Gay L, Casas G, Motoc AI, Papadopoulos CH, Loizos S, Ágoston G, Szabó I, Hristova K, Tsonev SN, Galli E, Vinereanu D, Mihaila Baldea S, Muraru D, Mondillo S, Donal E, Galderisi M, Cosyns B, Edvardsen T, Popescu BA. Multicentric Atrial Strain COmparison between Two Different Modalities: MASCOT HIT Study. Diagnostics (Basel) 2020; 10:diagnostics10110946. [PMID: 33202837 PMCID: PMC7696899 DOI: 10.3390/diagnostics10110946] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 12/18/2022] Open
Abstract
Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume–pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference.
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Affiliation(s)
- Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy; (G.E.M.); (M.C.P.); (S.M.)
- Correspondence: ; Tel.: +39-0577585377
| | - Marcelo Haertel Miglioranza
- Institute of Cardiology, University Foundation of Cardiology, Porto Alegre 90620-000, Brazil; (M.H.M.); (L.G.)
| | - Julien Magne
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, F-87042, 87042 Limoges, France;
- Cardiology Department, INSERM U1094, Faculté de médecine de Limoges, 2, rue Marcland, 87000 Limoges, France
| | - Giulia Elena Mandoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy; (G.E.M.); (M.C.P.); (S.M.)
| | - Giovanni Benfari
- Section of Cardiology, Department of Medicine, University of Verona, 37126 Verona, Italy;
| | - Roberta Ancona
- UOC Cardiologia/UTIC—“Santa Maria delle Grazie” Hospital Pozzuoli, 80078 Pozzuoli, Italy; (R.A.); @gmail.it (G.S.); (S.C.P.)
| | - Gerolamo Sibilio
- UOC Cardiologia/UTIC—“Santa Maria delle Grazie” Hospital Pozzuoli, 80078 Pozzuoli, Italy; (R.A.); @gmail.it (G.S.); (S.C.P.)
| | - Vlatka Reskovic Luksic
- Department of Cardiovascular Diseases, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (V.R.L.); (D.D.)
| | - Dosen Dejan
- Department of Cardiovascular Diseases, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (V.R.L.); (D.D.)
| | - Leonardo Griseli
- Institute of Cardiology, University Foundation of Cardiology, Porto Alegre 90620-000, Brazil; (M.H.M.); (L.G.)
| | | | - Philippe Mortelmans
- Department of Cardiology, Antwerp University Hospital, 2650 Edegem, Belgium; (C.M.V.D.H.); (P.M.)
| | - Blazej Michalski
- Department of Cardiology, Medical University of Lodz, 91347 Lodz, Poland; (B.M.); (K.K.)
| | - Karolina Kupczynska
- Department of Cardiology, Medical University of Lodz, 91347 Lodz, Poland; (B.M.); (K.K.)
| | | | | | - Raluca Dulgheru
- Cardiology Department—Heart Valve Clinic—University Hospital Liege, B-4000 Liege, Belgium; (R.D.); (F.I.)
| | - Federica Ilardi
- Cardiology Department—Heart Valve Clinic—University Hospital Liege, B-4000 Liege, Belgium; (R.D.); (F.I.)
- Department of Advanced Biomedical Sciences, Federico II, University Hospital, 80131 Naples, Italy; (R.E.); (C.S.); (M.G.)
| | - Alessandro Salustri
- Non-Invasive Department, Heart Hospital—Hamad Medical Corporation, Doha 3050, Qatar; (A.S.); (G.A.)
| | - Galal Abushahba
- Non-Invasive Department, Heart Hospital—Hamad Medical Corporation, Doha 3050, Qatar; (A.S.); (G.A.)
| | - Doralisa Morrone
- Cardiothoracic and Vascular Department, Pisa University, 56126 Pisa, Italy; (D.M.); (I.F.)
| | - Iacopo Fabiani
- Cardiothoracic and Vascular Department, Pisa University, 56126 Pisa, Italy; (D.M.); (I.F.)
- Cardiologia e Medicina Cardiovascolare—Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Martin Penicka
- Cardiovascular Research Center Aalst, OLV Clinic, 9300 Aalst, Belgium; (M.P.); (A.K.)
| | - Asim Katbeh
- Cardiovascular Research Center Aalst, OLV Clinic, 9300 Aalst, Belgium; (M.P.); (A.K.)
| | - Giuseppe Sammarco
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35122 Padua, Italy; (G.S.); (D.M.)
| | - Roberta Esposito
- Department of Advanced Biomedical Sciences, Federico II, University Hospital, 80131 Naples, Italy; (R.E.); (C.S.); (M.G.)
| | - Ciro Santoro
- Department of Advanced Biomedical Sciences, Federico II, University Hospital, 80131 Naples, Italy; (R.E.); (C.S.); (M.G.)
| | - Maria Concetta Pastore
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy; (G.E.M.); (M.C.P.); (S.M.)
| | - Salvatore Comenale Pinto
- UOC Cardiologia/UTIC—“Santa Maria delle Grazie” Hospital Pozzuoli, 80078 Pozzuoli, Italy; (R.A.); @gmail.it (G.S.); (S.C.P.)
| | - Artem Kalinin
- Department “Gailezers”, Riga East Clinical University Hospital, LV-1038 Riga, Latvia; (A.K.); (Z.P.)
| | - Žanna Pičkure
- Department “Gailezers”, Riga East Clinical University Hospital, LV-1038 Riga, Latvia; (A.K.); (Z.P.)
| | - Katja Ažman Juvan
- Department of Cardiovascular Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia;
| | - Anja Zupan Mežnar
- Cardiology Department, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia;
| | - Augustine Coisne
- Department of Clinical Physiology and Echocardiography—Heart Valve Clinic, Lille University Hospital, 59800 Lille, France; (A.C.); (A.C.)
| | - Amandine Coppin
- Department of Clinical Physiology and Echocardiography—Heart Valve Clinic, Lille University Hospital, 59800 Lille, France; (A.C.); (A.C.)
| | - Mihaela Maria Opris
- Institute for Emergency Cardiovascular Diseases and Transplant of Targu Mures, 540136 Targu Mures, Romania; (M.M.O.); (D.O.N.)
| | - Dan Octavian Nistor
- Institute for Emergency Cardiovascular Diseases and Transplant of Targu Mures, 540136 Targu Mures, Romania; (M.M.O.); (D.O.N.)
| | - Riitta Paakkanen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, 00100 Helsinki, Finland;
| | - Tor Biering-Sørensen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, 2900 Copenhagen, Denmark; (T.B.-S.); (F.J.O.)
| | - Flemming Javier Olsen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, 2900 Copenhagen, Denmark; (T.B.-S.); (F.J.O.)
| | - Tomas Lapinskas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania; (T.L.); (J.J.V.)
| | - Jolanta Justina Vaškelyté
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania; (T.L.); (J.J.V.)
| | - Laura Galian-Gay
- Department of Cardiology, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.-G.); (G.C.)
| | - Guillem Casas
- Department of Cardiology, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain; (L.G.-G.); (G.C.)
| | - Andreea Iulia Motoc
- Centre for Cardiovascular Diseases, University Hospital of Brussels, B-1090 Brussels, Belgium; (A.I.M.); (B.C.)
| | | | - Savvas Loizos
- Korgialenio Benakio—Red Cross Hospital, 115 26 Athens, Greece; (C.H.P.); (S.L.)
| | - Gergely Ágoston
- Department of Family Medicine, University of Szeged, H-6725 Szeged, Hungary; (G.A.); (I.S.)
| | - Istvan Szabó
- Department of Family Medicine, University of Szeged, H-6725 Szeged, Hungary; (G.A.); (I.S.)
| | - Krasimira Hristova
- Department of Noninvasive Functional Diagnostic and Imaging, National Heart Hospital, 1309 Sofia, Bulgaria; (K.H.); (S.N.T.)
| | - Svetlin Netkov Tsonev
- Department of Noninvasive Functional Diagnostic and Imaging, National Heart Hospital, 1309 Sofia, Bulgaria; (K.H.); (S.N.T.)
| | - Elena Galli
- Centre Hospitalier Universitaire de Rennes, Inserm, University of Rennes, LTSI—UMR 1099, F-35000 Rennes, France; (E.G.); (E.D.)
| | - Dragos Vinereanu
- Department of Cardiology, University of Medicine and Pharmacy Carol Davila—Emergency and University Hospital, 050474 Bucharest, Romania; (D.V.); (S.M.B.)
| | - Sorina Mihaila Baldea
- Department of Cardiology, University of Medicine and Pharmacy Carol Davila—Emergency and University Hospital, 050474 Bucharest, Romania; (D.V.); (S.M.B.)
| | - Denisa Muraru
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35122 Padua, Italy; (G.S.); (D.M.)
- Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
| | - Sergio Mondillo
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy; (G.E.M.); (M.C.P.); (S.M.)
| | - Erwan Donal
- Centre Hospitalier Universitaire de Rennes, Inserm, University of Rennes, LTSI—UMR 1099, F-35000 Rennes, France; (E.G.); (E.D.)
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II, University Hospital, 80131 Naples, Italy; (R.E.); (C.S.); (M.G.)
| | - Bernard Cosyns
- Centre for Cardiovascular Diseases, University Hospital of Brussels, B-1090 Brussels, Belgium; (A.I.M.); (B.C.)
| | - Thor Edvardsen
- Center for Cardiological Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, 0372 Oslo, Norway;
- Faculty of Medicine, University of Oslo, 0315 Oslo, Norway
| | - Bogdan A. Popescu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”—Euroecolab, Emergency Institute for Cardiovascular Diseases “Prof. Dr. C. C. Iliescu”, Sos. Fundeni 258, 022328 Bucharest, Romania;
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24
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Affiliation(s)
- Adriana Postolache
- University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology and Cardiovascular Surgery, CHU SartTilman, Liège, Belgium
| | - Julien Tridetti
- University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology and Cardiovascular Surgery, CHU SartTilman, Liège, Belgium
| | - Mai-Linh Nguyen Trung
- University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology and Cardiovascular Surgery, CHU SartTilman, Liège, Belgium
| | - Raluca Dulgheru
- University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology and Cardiovascular Surgery, CHU SartTilman, Liège, Belgium
| | - Cécile Oury
- University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology and Cardiovascular Surgery, CHU SartTilman, Liège, Belgium
| | - Patrizio Lancellotti
- University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology and Cardiovascular Surgery, CHU SartTilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, and Anthea Hospital, Bari, Italy
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25
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Tsugu T, Nagatomo Y, Dulgheru R, Marchetta S, Postolache A, Tridetti J, Nguyen M, Piette C, Lancellotti P. Layer-specific strain and the degree of left ventricular thickness in patients with hypertrophic cardiomyopathy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0007] [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: 11/13/2022] Open
Abstract
Abstract
Background
Left ventricular (LV) wall thickness is an important parameter for the diagnosis of hypertrophic cardiomyopathy (HCM) and is also associated with long-term clinical outcome in HCM patients. However, conventional tools have failed to analyze the mechanisms of structural and functional abnormalities that occur at the cellular level in hypertrophied myocardial tissue. Recently, technological progression of 2D-speckle tracking echocardiography (2D-STE) has enabled the estimation of layer-specific strain (LSS), such as epicardial, mid-myocardial, and endocardial longitudinal strain, respectively. LSS may have the potential to elucidate the detailed mechanisms of myocardial dysfunction.
Purpose
The aim of this study was (i) to clarify the detailed mechanisms of structural and functional abnormalities of myocardial tissue in HCM using LSS (ii) to investigate the diagnostic accuracy of LSS for HCM.
Methods
Forty-one patients with HCM and preserved LV ejection fraction (LVEF) (66% male, 52±18 years, LVEF 62.9±3.7%) and 41 controls matched for age and sex (66% male, 52±20 years, LVEF 63.5±8.2%) underwent 2D-STE (GE-Healthcare, Vivid-E9). Quantitative strain values of epicardial, mid-myocardial, and endocardial layers were measured.
Results
LV wall thickness including interventricular septum thickness (HCM vs. Controls; 18.9±5.0 vs. 9.1±1.8, p<0.001), posterior wall thickness (11.5±2.5 vs. 8.8±1.9, p<0.001), and maximum wall thickness (20.1±4.3 vs. 9.4±0.4, p<0.001) were significantly lower in HCM than in Controls. Absolute values of LSS for all layers were lower in HCM than in Controls (HCM vs. Controls; epicardial; −13.1±3.3 vs. −19.5±1.6, p<0.001; mid-myocardial; −15.8±3.3 vs. −21.4±1.7, p<0.001; endocardial; −18.9±3.9 vs. −23.6±1.9, p<0.001). End/Epi ratio was higher in HCM than in Controls (HCM vs. Controls; 1.5±0.2 vs. 1.2±0.0, p<0.001). Next, we investigated the echocardiographic parameters that correlated with LV maximal wall thickness (MWT). End/Epi ratio was an independent predictor of LV MWT (β=0.96, p<0.001). Receiver operating characteristic analysis revealed that a higher End/Epi ratio (≥1.3) was the strongest predictor of diagnostic criteria for HCM (LV wall thickness ≥15 mm) (area under the curve 0.99, p<0.001, sensitivity 98%, specificity 97%).
Conclusions
In HCM patients with preserved LVEF, (i) LSS was lower and End/Epi ratio was higher than in controls. (ii) End/Epi ratio (≥1.3) was the strongest predictor of abnormal wall thickness of HCM. The mechanism of higher End/Epi ratio in HCM might be attributable to the more common myofibrillar disarray in mid- and epicardial layers. Variations of LSS represented by End/Epi ratio might have the potential to accurately detect HCM and to elucidate the pathophysiology of impaired LV wall motion at cellular level in HCM.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Tsugu
- Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Science, CHU Sart Tilman, Department of Cardiology, Liege, Belgium
| | - Y Nagatomo
- National Defense Medical College Hospital, Department of Cardiology, Tokorozawa, Japan
| | - R Dulgheru
- Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Science, CHU Sart Tilman, Department of Cardiology, Liege, Belgium
| | - S Marchetta
- Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Science, CHU Sart Tilman, Department of Cardiology, Liege, Belgium
| | - A Postolache
- Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Science, CHU Sart Tilman, Department of Cardiology, Liege, Belgium
| | - J Tridetti
- Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Science, CHU Sart Tilman, Department of Cardiology, Liege, Belgium
| | - M.L Nguyen
- Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Science, CHU Sart Tilman, Department of Cardiology, Liege, Belgium
| | - C Piette
- Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Science, CHU Sart Tilman, Department of Cardiology, Liege, Belgium
| | - P Lancellotti
- Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Science, CHU Sart Tilman, Department of Cardiology, Liege, Belgium
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26
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Tchana-Sato V, Hans G, Frippiat F, Zekhnini I, Dulgheru R, Lavigne JP, Defraigne JO. Surgical management of Staphylococcus capitis prosthetic valve infective endocarditis: Retrospective review of a 10-year single center experience and review of the literature. J Infect Public Health 2020; 13:1705-1709. [DOI: 10.1016/j.jiph.2020.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/21/2020] [Accepted: 09/18/2020] [Indexed: 12/17/2022] Open
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27
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Tchana-Sato V, Durieux R, Houben A, Van den Bulck M, Dulgheru R, Lancellotti P, Defraigne JO. Natural History of a Carpentier-Edwards Pericardial Aortic Valve Replaced after 25 Years for Structural Valve Degeneration. ACTA ACUST UNITED AC 2020; 4:518-522. [PMID: 33376845 PMCID: PMC7756153 DOI: 10.1016/j.case.2020.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
SVD is a main limitation of bioprostheses. Routine use of bioprostheses in younger patients (<60 years of age) is controversial. Data on the durability of surgical aortic bioprostheses beyond 20 years are limited. We report exceptional durability of an aortic bioprosthesis replaced after 25 years.
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Affiliation(s)
| | | | - Alan Houben
- Department of Anesthesiology, CHU Liege, Liege, Belgium
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28
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Manganaro R, Marchetta S, Dulgheru R, Ilardi F, Sugimoto T, Robinet S, Cimino S, Go YY, Bernard A, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, López-Fernández T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, Von Bardeleben RS, Vinereanu D, Zamorano JL, Rosca M, Calin A, Moonen M, Magne J, Cosyns B, Galli E, Donal E, Carerj S, Zito C, Santoro C, Galderisi M, Badano LP, Lang RM, Oury C, Lancellotti P. Echocardiographic reference ranges for normal non-invasive myocardial work indices: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 2020; 20:582-590. [PMID: 30590562 DOI: 10.1093/ehjci/jey188] [Citation(s) in RCA: 181] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/07/2018] [Indexed: 12/31/2022] Open
Abstract
AIMS To obtain the normal ranges for 2D echocardiographic (2DE) indices of myocardial work (MW) from a large group of healthy volunteers over a wide range of ages and gender. METHODS AND RESULTS A total of 226 (85 men, mean age: 45 ± 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from left ventricle (LV) pressure-strain loops. Peak LV systolic pressure was non-invasively derived from brachial artery cuff pressure. The lowest values of MW indices in men and women were 1270 mmHg% and 1310 mmHg% for GWI, 1650 mmHg% and 1544 mmHg% for GCW, and 90% and 91% for GWE, respectively. The highest value for GWW was 238 mmHg% in men and 239 mmHg% in women. Men had significant lower values of GWE and higher values of GWW. GWI and GCW significantly increased with age in women. CONCLUSION The NORRE study provides useful 2DE reference ranges for novel indices of non-invasive MW.
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Affiliation(s)
- Roberta Manganaro
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Department of Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
| | - Stella Marchetta
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Department of Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
| | - Raluca Dulgheru
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Department of Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
| | - Federica Ilardi
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Department of Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
| | - Tadafumi Sugimoto
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Clinical Laboratory, Mie University Hospital, Mie, 2-174 Edobashi, Tsu, Japan
| | - Sébastien Robinet
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Department of Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
| | - Sara Cimino
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Department of Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
| | - Yun Yun Go
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Department of Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, Singapore
| | - Anne Bernard
- Cardiology Department, CHU Tours, France et Université de Tours, Tours, France
| | - George Kacharava
- Cardiology Department, Tbilisi Institute of Medicine (TIM), 16 Tsintsadze, Tbilisi, Georgia
| | | | - Daniele Barone
- Laboratory of Cardiovascular Ecography, Cardiology Department, S. Andrea Hospital, La Spezia, Italy
| | - Monica Baroni
- Laboratorio Di Ecocardiografia Adulti, Fondazione Toscana "G.Monasterio" - Ospedale Del Cuore, Massa, Italy
| | - Nuno Cardim
- Echocardiography Laboratory, Hospital da Luz, Lisbon, Portugal
| | | | - Krasimira Hristova
- Department of Noninvasive Functional Diagnostic and Imaging, University National Heart Hospital, Sofia, Bulgaria
| | - Teresa López-Fernández
- Cardiology Department, La Paz University Hospital, IdiPAz, Ciber CV, Paseo de la Castellana 261, Madrid, Spain
| | - Gonzalo de la Morena
- Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | - Bogdan A Popescu
- Department of Cardiology, University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Emergency Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, Sector 2, Bucharest, Romania
| | - Martin Penicka
- Cardiovascular Center Aalst, OLV-Clinic Moorselbaan 164, Aalst, Belgium
| | - Tolga Ozyigit
- VKV Amerikan Hastanesi, Kardiyoloji Bölümü, Istanbul, Turkey
| | | | | | | | - Dragos Vinereanu
- Department of Cardiology, Splaiul Independentei 169, Bucharest, Romania
| | | | - Monica Rosca
- Department of Cardiology, University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Emergency Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, Sector 2, Bucharest, Romania
| | - Andreea Calin
- Department of Cardiology, University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Emergency Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, Sector 2, Bucharest, Romania
| | - Marie Moonen
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Department of Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
| | - Julien Magne
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges, France. INSERM 1094, Faculté de Médecine de Limoges, Limoges, France
| | - Bernard Cosyns
- CHVZ (Centrum voor Hart en Vaatziekten), Universitair ziekenhuis Brussel, ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Brussels, Belgium
| | - Elena Galli
- CIC-IT U 1414, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU Rennes, France
| | - Erwan Donal
- CIC-IT U 1414, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU Rennes, France
| | - Scipione Carerj
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, 1, Via Consolare Valeria - Messina (IT), Italy
| | - Concetta Zito
- Department of Clinical and Experimental Medicine, Section of Cardiology, University of Messina, 1, Via Consolare Valeria - Messina (IT), Italy
| | - Ciro Santoro
- Department of Advanced Biomedical Sciences, Federico II University Hospital Via S. Pansini 5, Naples, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital Via S. Pansini 5, Naples, Italy
| | - Luigi P Badano
- Department of Cardiac, Thoracic and Vascular Sciences University of Padova, School of Medicine, Padova, Italy
| | - Roberto M Lang
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Cecile Oury
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Department of Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium
| | - Patrizio Lancellotti
- Departments of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Department of Heart Valve Clinic, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
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29
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Tsugu T, Postolache A, Dulgheru R, Sugimoto T, Tridetti J, Nguyen Trung ML, Piette C, Moonen M, Manganaro R, Ilardi F, Chitroceanu AM, Sperlongano S, Go YY, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, Von Bardeleben RS, Vinereanu D, Zamorano JL, Rosca M, Calin A, Magne J, Cosyns B, Galli E, Donal E, Santoro C, Galderisi M, Badano LP, Lang RM, Lancellotti P. Echocardiographic reference ranges for normal left ventricular layer-specific strain: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 2020; 21:896-905. [PMID: 32259844 DOI: 10.1093/ehjci/jeaa050] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 02/28/2020] [Accepted: 03/03/2020] [Indexed: 10/16/2023] Open
Abstract
AIMS To obtain the normal range for 2D echocardiographic (2DE) measurements of left ventricular (LV) layer-specific strain from a large group of healthy volunteers of both genders over a wide range of ages. METHODS AND RESULTS A total of 287 (109 men, mean age: 46 ± 14 years) healthy subjects were enrolled at 22 collaborating institutions of the EACVI Normal Reference Ranges for Echocardiography (NORRE) study. Layer-specific strain was analysed from the apical two-, three-, and four-chamber views using 2DE software. The lowest values of layer-specific strain calculated as ±1.96 standard deviations from the mean were -15.0% in men and -15.6% in women for epicardial strain, -16.8% and -17.7% for mid-myocardial strain, and -18.7% and -19.9% for endocardial strain, respectively. Basal-epicardial and mid-myocardial strain decreased with age in women (epicardial; P = 0.008, mid-myocardial; P = 0.003) and correlated with age (epicardial; r = -0.20, P = 0.007, mid-myocardial; r = -0.21, P = 0.006, endocardial; r = -0.23, P = 0.002), whereas apical-epicardial, mid-myocardial strain increased with the age in women (epicardial; P = 0.006, mid-myocardial; P = 0.03) and correlated with age (epicardial; r = 0.16, P = 0.04). End/Epi ratio at the apex was higher than at the middle and basal levels of LV in men (apex; 1.6 ± 0.2, middle; 1.2 ± 0.1, base 1.1 ± 0.1) and women (apex; 1.6 ± 0.1, middle; 1.1 ± 0.1, base 1.2 ± 0.1). CONCLUSION The NORRE study provides useful 2DE reference ranges for novel indices of layer-specific strain.
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Affiliation(s)
- Toshimitsu Tsugu
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
- Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan
| | - Adriana Postolache
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
| | - Raluca Dulgheru
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
| | - Tadafumi Sugimoto
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
- Clinical Laboratory, Mie University Hospital, Mie, Japan
| | - Julien Tridetti
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
| | - Mai-Linh Nguyen Trung
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
| | - Caroline Piette
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
| | - Marie Moonen
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
| | - Roberta Manganaro
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
- Department of Clinical and Experimental Medicine, Cardiology Unit, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy
| | - Federica Ilardi
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Alexandra Maria Chitroceanu
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
- Cardiovascular Research Unit, University and Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Simona Sperlongano
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
- Unit of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Monaldi Hospital, Naples, Italy
| | - Yun Yun Go
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore
| | - George Kacharava
- Department of the Cardiology, Tbilisi Institute of Medicine (TIM), 16 Tsintsadze, 0160 Tbilisi, Georgia
| | | | - Daniele Barone
- Laboratory of Cardiovascular Ecography, Department of Cardiology, S. Andrea Hospital, La Spezia, Italy
| | - Monica Baroni
- Laboratorio Di Ecocardiografia Adulti, Fondazione Toscana "G.Monasterio" - Ospedale Del Cuore, Massa, Italy
| | - Nuno Cardim
- Hospital da Luz, Echocardiography Laboratory, Lisbon, Portugal
| | | | - Krasimira Hristova
- Department of Noninvasive Functional Diagnostic and Imaging, University National Heart Hospital, Sofia, Bulgaria
| | - Teresa Lopez
- Cardiology Department, La Paz Hospital, IdiPAz, Ciber, Madrid, Spain
| | - Gonzalo de la Morena
- Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Murcia, Spain
| | - Bogdan A Popescu
- University of Medicine and Pharmacy "Carol Davila" - Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, 022328, Bucharest, Romania
| | | | - Tolga Ozyigit
- VKV Amerikan Hastanesi, Kardiyoloji Bölümü, Istanbul, Turkey
| | | | | | - Ralph Stephan Von Bardeleben
- Emergency Medical Department Cardiology, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Dragos Vinereanu
- Cardiovascular Research Unit, University and Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Jose Luis Zamorano
- Department of Cardiology, University Alcala, Hospital Ramón y Cajal, Madrid, Spain
| | - Monica Rosca
- University of Medicine and Pharmacy "Carol Davila" - Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, 022328, Bucharest, Romania
| | - Andreea Calin
- University of Medicine and Pharmacy "Carol Davila" - Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Sos. Fundeni 258, 022328, Bucharest, Romania
| | - Julien Magne
- CHU Limoges, Hôpital Dupuytren, Service Cardiologie, Limoges, F-87042 France
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, GEIST, 2, rue Marcland, 87000 Limoges, France
| | - Bernard Cosyns
- CHVZ (Centrum voor Hart en Vaatziekten) - Universitair ziekenhuis Brussel; and ICMI (In Vivo Cellular and Molecular Imaging) laboratory, 101 Laarbeeklaan, 1090b Brussels, Belgium
| | - Elena Galli
- Service de Cardiologie, INSERM 1414, CHU Pontchaillou - and- LTSI, Université de Rennes 1 - INSERM, UMR 1099, Rennes, France
| | - Erwan Donal
- Service de Cardiologie, INSERM 1414, CHU Pontchaillou - and- LTSI, Université de Rennes 1 - INSERM, UMR 1099, Rennes, France
| | - Ciro Santoro
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Luigi P Badano
- Department of Cardiological, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Roberto M Lang
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Patrizio Lancellotti
- Department of Cardiology, GIGA Cardiovascular Sciences, University of Liège Hospital, Heart Valve Clinic, CHU Sart Tilman, CHU Sart Tilman, 4000 Liège, Belgium
- Gruppo Villa Maria Care and Research, Maria Cecilia Hospital, Cotignola, Italy
- Anthea Hospital, Bari, Italy
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30
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Anwer S, Oğuz D, Galian-Gay L, Peovska Mitevska I, Baghdassarian L, Dulgheru R, Lapinskas T, Santoro C, Loizos S, Cameli M, Srbinovska E, Grapsa J, Magne J, Donal E. Echocardiographic findings on aortic stenosis: an observational, prospective, and multi-center registry. Perfusion 2020; 36:269-276. [PMID: 32650695 DOI: 10.1177/0267659120924921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim of this aortic stenosis registry was to investigate the changes of routine echocardiographic indices and strain in patients with moderate-to-severe aortic stenosis over a 6-month follow-up period. METHODS Our aortic stenosis registry is observational, prospective, multicenter registry of nine countries, with 197 patients with aortic valve area less than 1.5 cm2. The enrolment took place from January to August 2017. We excluded patients with uncontrolled atrial arrhythmias, pulmonary hypertension or cardiomyopathies, as well as those with hemodynamically significant valvular disease other than aortic stenosis. We included patients who did not require intervention and who had a complete follow-up study. RESULTS In patients with preserved ejection fraction, left ventricular mass has significantly increased between baseline and follow-up studies (218 ± 34 grams vs 253 ± 29 grams, p = 0.02). However, when indexed to body surface area, there was no significant difference. Left ventricular global longitudinal strain significantly decreased (-19.7 ± -4.8 vs (-16.4 vs -3.8, p = 0.01). Left atrial volume was significantly higher at follow-up (p = 0.035). Right ventricular basal diameter and mid-cavity diameter were greater at the follow-up (p = 0.04 and p = 0.035, respectively). Patients with low-flow low-gradient aortic stenosis had significantly lower global longitudinal strain (-12.3% ± -3.9% vs -19.7% ± -4.8%, p = 0.01). CONCLUSION Left atrial dilatation is one of the first changes to take place in low-flow low-gradient aortic stenosis patients even when left ventricular dimensions and function remains intact. Global longitudinal strain is an important determinant of left ventricular systolic and diastolic dysfunction and right ventricular function is an important parameter of aortic stenosis assessment. Accordingly, our registry has further shed the light on these indices role as multisite follow-up of aortic stenosis.
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Affiliation(s)
- Shehab Anwer
- Zurich Heart Center, University of Zurich, Zurich, Switzerland
| | - Didem Oğuz
- Department of Cardiology, Baskent University, Ankara, Turkey.,Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Laura Galian-Gay
- Hospital Universitari Vall d'Hebron, Barcelona, Catalunya, Spain
| | | | - Lilit Baghdassarian
- Department of Cardiology, Saint Grigor Lusavorich Medical Center, Yerevan, Armenia
| | - Raluca Dulgheru
- Department of Cardiology, University of Liege, Brussels, Belgium
| | - Tomas Lapinskas
- Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Savvas Loizos
- Hammersmith Hospital, Imperial College NHS Trust, London, UK
| | - Matteo Cameli
- Department of Cardiology, Università degli Studi di Siena, Siena, Italy
| | | | - Julia Grapsa
- Department of Cardiology, Bart's Health Trust, London, UK
| | - Julien Magne
- Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Erwan Donal
- Centre Hospitalier Universitaire de Rennes, Rennes, France
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Martinez C, Cicenia M, Sprynger M, Postolache A, Ilardi F, Dulgheru R, Radermecker M, Esposito G, Marechal P, Marechal V, Donis N, Tridetti J, Nguyen Trung ML, Sugimoto T, Tsugu T, Go YY, Coisne A, Montaigne D, Fattouch K, Nchimi A, Oury C, Lancellotti P. Myocardial Function in Patients With Radiation-Associated Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement: A Layer-Specific Strain Analysis Study. JACC Cardiovasc Imaging 2020; 13:1450-1452. [PMID: 32199837 DOI: 10.1016/j.jcmg.2020.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/28/2022]
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Reskovic Luksic V, Postolache A, Martinez C, Dulgheru R, Ilardi F, Tridetti J, Nguyen ML, Piette C, Pasalic M, Bulum J, Separovic Hanzevacki J, Lancellotti P. Global and regional myocardial function and outcomes after transcatheter aortic valve implantation for aortic stenosis and preserved ejection fraction. J Cardiovasc Med (Hagerstown) 2020; 21:238-245. [DOI: 10.2459/jcm.0000000000000918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Manganaro R, Dulgheru R, Marchetta S, Cozza F, Zito C, Carerj S, Lancellotti P. P938 Myocardial work analysis in hypertrophic cardiomyopathy: low work or high work? Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.571] [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: 11/12/2022] Open
Abstract
Abstract
Background
Myocardial Work (MW) is an interesting novel non-invasive parameter to evaluate cardiac performance by left ventricle (LV) pressure-strain loops.
Purpose
The present study sought to investigate MW in patients with both non-obstructive (NOHCM) and obstructive hypertrophic cardiomyopathy (OHCM).
Methods
Forty-four patients with hypertrophic cardiomyopathy (HCM) and twenty controls (mean age 53 ± 20 years vs 52 ± 17 years, respectively, p = 0.8) underwent standard two-dimensional and speckle-tracking echocardiography. Global Work Index (GWI), global constructive work (GCW), global work waste (GWW) and global work efficiency (GWE) were estimated by LV pressure-strain loops. In OHCM group, MW was evaluated by adding LVOT peak gradient to SBP. Analysis of multilayer LV longitudinal strain (LS) and left atrial (LA) LS was performed.
Results
Global LS (GLS), endocardial LS, epicardial LS and LA LS were significantly reduced in patients compared to controls (p < 0.001 for all). All patient population had significantly lower GWI, GCW and GWE and higher GWW respect to controls. Regional GLS, endocardial LS, epicardial LS and regional WI were significantly reduced in hypertrophic area compared to no-hypertrophic area in the patient population (p < 0.001 for all). OHCM group ( n = 14) had higher values of GWI and GCW compared to NOHCM ( n = 30) (2160 (1877-2250) vs 1547 (1148-1767)mmHg% and 2285 ± 411 vs 1755 ± 584 mmHg% respectively, p < 0.05 for both, Figure).
Conclusions
GWI and GCW are reduced in patients with NOHCM. Patients with OHCM, have higher GWI and GCW compared to non-obstructive ones, as expression of work at higher level of energy necessary to counteract high afterload. Our proposed method to estimate MW in OHCM needs to be validated in invasive studies.
Abstract P938 Figure.
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Affiliation(s)
- R Manganaro
- University of Messina, Department of Clinical and Experimental Medicine, Cardiology Unit, Polyclinic G. Martino, Messina, Italy
| | - R Dulgheru
- University Hospital of Liege (CHU), Department of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic , Liege, Belgium
| | - S Marchetta
- University Hospital of Liege (CHU), Department of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic , Liege, Belgium
| | - F Cozza
- University Hospital of Liege (CHU), Department of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic , Liege, Belgium
| | - C Zito
- University of Messina, Department of Clinical and Experimental Medicine, Cardiology Unit, Polyclinic G. Martino, Messina, Italy
| | - S Carerj
- University of Messina, Department of Clinical and Experimental Medicine, Cardiology Unit, Polyclinic G. Martino, Messina, Italy
| | - P Lancellotti
- University Hospital of Liege (CHU), Department of Cardiology, GIGA Cardiovascular Sciences, Heart Valve Clinic , Liege, Belgium
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Ilardi F, Santoro C, Lembo M, Dulgheru R, Esposito R, Sorrentino R, Marchetta S, Sellitto V, Lancellotti P, Esposito G, Galderisi M. P1404 Additional power of automated longitudinal strain during dobutamine stress echo for detecting inducible ischemia in left anterior descending artery stenosis. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.837] [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
Dobutamine stress echo (DSE) is a sensitive but subjective test of inducible ischemia. Speckle tracking allows now a quantitative assessment of regional wall motion, even during DSE.
Purpose
To investigate the feasibility and accuracy of global and regional longitudinal strain during DSE to detect significant CAD.
Methods
This is a prospective, observational study, including 88 patients undergoing DSE for suspected CAD. Thirthy-three patients with negative DSE were excluded from analysis. The remaining 50 patients (82% males, mean age 66.3 ± 8.2 years) with positive DSE underwent subsequent invasive coronary angiography (CA). Besides visual regional wall motion score index (WMSI), global longitudinal strain (GLS) and regional longitudinal strain (RLS) were determined at rest, at peak stress and at early recovery by a dedicated software (Automated Function Imaging) incorporated in a quoad-screen of the echo machine and activated by automatic quantification. Obstructive CAD was defined as >70% stenosis or intermediate stenosis combined with fractional flow reserve <0.80.
Results
The feasibility of DES regional longitudinal strain was 100% (n = 50/50) in the pooled population. Fifteen patients did not show coronary stenosis whereas obstructive CAD was detected in 35 patients (12 with multi-vessel disease). Among these patients, 18 patients had left anterior descending artery (LAD) stenosis, 18 left circumflex coronary artery (LCX) stenosis and 15 right coronary artery (RCA) stenosis. GLS reduction at peak stress (k = 0.253, p = 0.037) and WMSI increase at peak stress (k = 0.217, p = 0.04) showed mild but significant agreement with CA for detecting significant coronary stenosis, whereas the agreement of GLS at recovery (k=-0.087, p = 0.518) was poor. When single lesion territory was considered, GLS at peak stress (17.4 ± 5.5 vs 20.5 ± 4.4%, p = 0.034) and LAD longitudinal strain (= average of 8 myocardial segments: middle and apical posterior septum, basal, middle and apical anterior septum, basal, middle and apical anterior wall) at peak stress showed significantly lower values in the obstructed LAD regions than the territories perfused by non-obstructed coronary arteries (17.1 ± 7.6 vs 21.6 ± 5.5% p = 0.021). Conversely, in presence of significant LCX or RCA stenosis, visual regional wall motion of LCX and RCA territories were higher at peak stress (WMSI LCX = 1.80 ± 0.65 in presence of LCX stenosis vs. 1.38 ± 0.44 in absence of stenosis, p < 0.01; WMSI RCA = 1.89 ± 0.52 in presence of RCA stenosis vs. 1.42 ± 0.42 in absence of stenosis, p = 0.002), but RLS at peak stress showed a trend to increase, without achieving the statistical significance (RLS RCA: p = 0.128, RLS LCX: p = 0.103).
Conclusion
AFI-based strain quantitative analysis appears to be highly feasible during DSE. It appears also to be more accurate than the visual wall motion for the detection of myocardial ischemia in presence of LAD while the accuracy is suboptimal in patients with LCX and RCA stenosis.
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Affiliation(s)
- F Ilardi
- University Hospital Federico II, Naples, Italy
| | - C Santoro
- University Hospital Federico II, Naples, Italy
| | - M Lembo
- University Hospital Federico II, Naples, Italy
| | | | - R Esposito
- University Hospital Federico II, Naples, Italy
| | | | | | - V Sellitto
- University Hospital Federico II, Naples, Italy
| | | | - G Esposito
- University Hospital Federico II, Naples, Italy
| | - M Galderisi
- University Hospital Federico II, Naples, Italy
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Lancellotti P, Magne J, Dulgheru R, Clavel MA, Donal E, Vannan MA, Chambers J, Rosenhek R, Habib G, Lloyd G, Nistri S, Garbi M, Marchetta S, Fattouch K, Coisne A, Montaigne D, Modine T, Davin L, Gach O, Radermecker M, Liu S, Gillam L, Rossi A, Galli E, Ilardi F, Tastet L, Capoulade R, Zilberszac R, Vollema EM, Delgado V, Cosyns B, Lafitte S, Bernard A, Pierard LA, Bax JJ, Pibarot P, Oury C. Outcomes of Patients With Asymptomatic Aortic Stenosis Followed Up in Heart Valve Clinics. JAMA Cardiol 2019; 3:1060-1068. [PMID: 30285058 DOI: 10.1001/jamacardio.2018.3152] [Citation(s) in RCA: 159] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Importance The natural history and the management of patients with asymptomatic aortic stenosis (AS) have not been fully examined in the current era. Objective To determine the clinical outcomes of patients with asymptomatic AS using data from the Heart Valve Clinic International Database. Design, Setting, and Participants This registry was assembled by merging data from prospectively gathered institutional databases from 10 heart valve clinics in Europe, Canada, and the United States. Asymptomatic patients with an aortic valve area of 1.5 cm2 or less and preserved left ventricular ejection fraction (LVEF) greater than 50% at entry were considered for the present analysis. Data were collected from January 2001 to December 2014, and data were analyzed from January 2017 to July 2018. Main Outcomes and Measures Natural history, need for aortic valve replacement (AVR), and survival of asymptomatic patients with moderate or severe AS at entry followed up in a heart valve clinic. Indications for AVR were based on current guideline recommendations. Results Of the 1375 patients included in this analysis, 834 (60.7%) were male, and the mean (SD) age was 71 (13) years. A total of 861 patients (62.6%) had severe AS (aortic valve area less than 1.0 cm2). The mean (SD) overall survival during medical management (mean [SD] follow up, 27 [24] months) was 93% (1%), 86% (2%), and 75% (4%) at 2, 4, and 8 years, respectively. A total of 104 patients (7.6%) died under observation, including 57 patients (54.8%) from cardiovascular causes. The crude rate of sudden death was 0.65% over the duration of the study. A total of 542 patients (39.4%) underwent AVR, including 388 patients (71.6%) with severe AS at study entry and 154 (28.4%) with moderate AS at entry who progressed to severe AS. Those with severe AS at entry who underwent AVR did so at a mean (SD) of 14.4 (16.6) months and a median of 8.7 months. The mean (SD) 2-year and 4-year AVR-free survival rates for asymptomatic patients with severe AS at baseline were 54% (2%) and 32% (3%), respectively. In those undergoing AVR, the 30-day postprocedural mortality was 0.9%. In patients with severe AS at entry, peak aortic jet velocity (greater than 5 m/s) and LVEF (less than 60%) were associated with all-cause and cardiovascular mortality without AVR; these factors were also associated with postprocedural mortality in those patients with severe AS at baseline who underwent AVR (surgical AVR in 310 patients; transcatheter AVR in 78 patients). Conclusions and Relevance In patients with asymptomatic AS followed up in heart valve centers, the risk of sudden death is low, and rates of overall survival are similar to those reported from previous series. Patients with severe AS at baseline and peak aortic jet velocity of 5.0 m/s or greater or LVEF less than 60% have increased risks of all-cause and cardiovascular mortality even after AVR. The potential benefit of early intervention should be considered in these high-risk patients.
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Affiliation(s)
- Patrizio Lancellotti
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Julien Magne
- Cardiology Department, Centre Hospitalier Universitaire de Limoges, Hôpital Dupuytren, Pôle Coeur-Poumon-Rein, Limoges, France
| | - Raluca Dulgheru
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Marie-Annick Clavel
- Québec Heart and Lung Institute, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Québec, Canada
| | - Erwan Donal
- Cardiologie and LTSI INSERM U 1099, Centre Hospitalier Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Mani A Vannan
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, Georgia
| | - John Chambers
- Guy's and St Thomas Hospitals, London, United Kingdom
| | - Raphael Rosenhek
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - Gilbert Habib
- Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Marseille, France.,Assistance Publique-Hopitaux Marseille, La Timone Hospital, Cardiology Department, Marseille, France
| | - Guy Lloyd
- Barts Heart Centre Echo Lab, St Bartholomew's Hospital, London, United Kingdom
| | - Stefano Nistri
- Cardiology Service, CMSR Veneto Medica, Altavilla Vicentina, Italy
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Stella Marchetta
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Khalil Fattouch
- Department of Cardiovascular Surgery, GVM Care and Research, Maria Eleonora Hospital, Palermo, Italy.,Department of Surgery and Cancer, University of Palermo, Palermo, Italy
| | - Augustin Coisne
- Centre Hospitalier Universitaire de Lille, Departments of Clinical Physiology and Echocardiography and Cardiovascular Surgery, Lille, France
| | - David Montaigne
- Centre Hospitalier Universitaire de Lille, Departments of Clinical Physiology and Echocardiography and Cardiovascular Surgery, Lille, France
| | - Thomas Modine
- Centre Hospitalier Universitaire de Lille, Departments of Clinical Physiology and Echocardiography and Cardiovascular Surgery, Lille, France
| | - Laurent Davin
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Olivier Gach
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Marc Radermecker
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Shizhen Liu
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, Georgia
| | - Linda Gillam
- Morristown Medical Center, Morristown, New Jersey
| | - Andrea Rossi
- Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Galli
- Cardiologie and LTSI INSERM U 1099, Centre Hospitalier Universitaire de Rennes, Université de Rennes 1, Rennes, France
| | - Federica Ilardi
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Lionel Tastet
- Québec Heart and Lung Institute, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Québec, Canada
| | - Romain Capoulade
- Québec Heart and Lung Institute, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Québec, Canada
| | - Robert Zilberszac
- Department of Cardiology, Medical University of Vienna, Vienna, Austria
| | - E Mara Vollema
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Victoria Delgado
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Bernard Cosyns
- Centrum voor Hart en Vaatziekten, Universitair Ziekenhuis Brussel and In Vivo Cellular and Molecular Imaging Laboratory, Brussels, Belgium
| | - Stephane Lafitte
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Cardiologique Haut-Lévêque, Pessac, France
| | - Anne Bernard
- Cardiology Department, University of Tours Hospital, Tours, France.,University François Rabelais, Tours, France
| | - Luc A Pierard
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
| | - Jeroen J Bax
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Philippe Pibarot
- Québec Heart and Lung Institute, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec City, Québec, Canada
| | - Cécile Oury
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire du Sart Tilman, Liège, Belgium
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Vollema EM, Sugimoto T, Shen M, Tastet L, Ng ACT, Abou R, Marsan NA, Mertens B, Dulgheru R, Lancellotti P, Clavel MA, Pibarot P, Genereux P, Leon MB, Delgado V, Bax JJ. Association of Left Ventricular Global Longitudinal Strain With Asymptomatic Severe Aortic Stenosis: Natural Course and Prognostic Value. JAMA Cardiol 2019; 3:839-847. [PMID: 30140889 DOI: 10.1001/jamacardio.2018.2288] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [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]
Abstract
Importance The optimal timing to operate in patients with asymptomatic severe aortic stenosis (AS) remains controversial. Left ventricular global longitudinal strain (LV GLS) may help to identify patients who might benefit from undergoing earlier aortic valve replacement. Objective To investigate the prevalence of impaired LV GLS, the natural course of LV GLS, and its prognostic implications in patients with asymptomatic severe AS with preserved left ventricular ejection fraction (LVEF). Design, Setting, and Participants This registry-based study included the institutional registries of 3 large tertiary referral centers and 220 patients with asymptomatic severe AS and preserved LVEF (>50%) who were matched for age and sex with 220 controls without structural heart disease. The echocardiograms of patients and controls were performed between 1998 and 2017. Exposures Both clinical and echocardiographic data were assessed retrospectively. Severe AS was defined by an indexed aortic valve area less than 0.6 cm2/m2. Left ventricular global longitudinal strain was evaluated on transthoracic echocardiography using speckle tracking imaging. Main Outcomes and Measures The prevalence of impaired LV GLS, the natural course of LV GLS, and the association of impaired LV GLS with symptom onset and the need for aortic valve intervention. Results Two hundred twenty patients (mean [SD] age, 68 [13] years; 126 men [57%]) were included. Despite comparable LVEF, LV GLS was significantly impaired in patients with asymptomatic severe AS compared with age- and sex-matched controls without AS (mean [SD] LV GLS, -17.9% [2.5%] vs -19.6% [2.1%]; P < .001). After a median follow-up of 12 (interquartile range, 7-23) months, mean (SD) LV GLS significantly deteriorated (-18.0% [2.6%] to -16.3% [2.8%]; P < .001) while LVEF remained unchanged. Patients with impaired LV GLS at baseline (>-18.2%) showed a higher risk for developing symptoms (P = .02) and needing aortic valve intervention (P = .03) at follow-up compared with patients with more preserved LV GLS (≤-18.2%). Conclusions and Relevance Subclinical myocardial dysfunction that is characterized by impaired LV GLS is often present in patients with asymptomatic severe AS with preserved LVEF. Left ventricular global longitudinal strain further deteriorates over time and impaired LV GLS at baseline is associated with an increased risk for progression to the symptomatic stage and the need for aortic valve intervention.
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Affiliation(s)
- E Mara Vollema
- Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands
| | - Tadafumi Sugimoto
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium
| | - Mylène Shen
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Lionel Tastet
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Arnold C T Ng
- Department of Cardiology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia
| | - Rachid Abou
- Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands
| | - Nina Ajmone Marsan
- Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands
| | - Bart Mertens
- Department of Medical Statistics, Leiden University Medical Center, Leiden, the Netherlands
| | - Raluca Dulgheru
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium
| | - Patrizio Lancellotti
- GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, University of Liège Hospital, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Marie-Annick Clavel
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Philippe Genereux
- Cardiovascular Research Foundation, New York, New York.,New York-Presbyterian Hospital, Columbia University, Medical Center, New York.,Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey.,Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Quebec, Canada
| | - Martin B Leon
- Cardiovascular Research Foundation, New York, New York.,New York-Presbyterian Hospital, Columbia University, Medical Center, New York
| | - Victoria Delgado
- Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeroen J Bax
- Heart Lung Center, Leiden University Medical Center, Leiden, the Netherlands
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Cicenia M, Marchetta S, Dulgheru R, Ilardi F, Bouziane M, Cimino S, Mancone M, Fedele F, Lancellotti P. P5981Impact of radiotherapy on myocardial function and paravalvular leaks after transcatheter aortic valve implantation (TAVI). Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0702] [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
Introduction
Thanks to the anticancer therapies, the life expectancy of the oncologic patients has noticeably increased, but several cardiac diseases can be observed in these patients as the result of the cardiotoxic effects.
Purpose
To investigate the impact of radiotherapy on the clinical and echocardiographic outcomes, in patients with severe aortic stenosis (AS) and preserved left ventricle ejection fraction (LVEF) treated with transcatheter aortic valve implantation (TAVI).
Methods
We recruited patients with severe AS and left ventricular ejection fraction (LVEF) ≥50‰ treated with TAVI and who received prior radiotheraphy. Patients with LVEF <50‰, treated with valve in valve, with inadequate acoustic windows or the absence of echocardiographic images pre-TAVI and after 3–6 months were excluded. Demographic, clinical and echocardiographic data were recorded.
Results
102 patients were included in the present analysis. They were divided in two groups: 19 (18‰) with an oncologic history treated with previous left thoracic/mediastinal radiotherapy and 83 (82‰) patients without an oncologic history. The two groups were homogeneous in terms of demographic and clinical data, brain natriuretic peptide (BNP), echocardiographic data pre-TAVI. They only differed for a greater prevalence of mitral stenosis and calcifications in the oncologic patients versus the non-oncologics (respectively 36‰ vs. 12‰ p=0,016; 73‰ vs. 29‰ p=0,001). No differences in terms of in-hospital clinical outcomes were observed. The echocardiographic evaluation in both groups showed a significant decrease of the peak velocities and of the transprosthetic gradients. There was a higher incidence of at least moderate degree paraprosthetic leaks in the oncologic group vs. the non-oncologic one: 6 (31‰ total leaks, 37‰ leaks >2+) vs. 7 (8‰ total leaks, 12‰ leaks >2+); p=0.029. After 3–6 months, there was not a statistically significant improvement of ejection fraction (EF) in neither of the two groups but there was a statistically significant improvement of transmural, subepicardial and subendocardial longitudinal strain values in the non-oncologic group compared to pre-TAVI values, respectively −19±4 vs. −17±4 (p<0.001); −17±3 vs. −15±3 (p<0.001); −22±4 vs. −19.8±4 (p<0.001). Any statistically significant improvement was detected in the group with history of anticancer treatments between the longitudinal strain values post and pre-TAVI (−18±3‰ vs. −16±3‰; −14±3‰ vs. −20±5‰; −20 ±± 5‰ vs. −19±4‰).
Conclusions
Patients affected by severe AS treated with TAVI and who received received prior radiotheraphy, showed the absence of statistically significant improvement of multilayer strain values, at 3–6 months after TAVI. Oncologic patients also had a higher incidence of haemodynamically relevant paravalvular leaks after the intervention, compared to the non-oncologic patients.
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Affiliation(s)
- M Cicenia
- Bambino Gesù Children's Hospital and Research Institute, Department of Pediatric Cardiology and Cardiac Surgery, Rome, Italy
| | - S Marchetta
- University of Liège Hospital (CHU), GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, Liège, Belgium
| | - R Dulgheru
- University of Liège Hospital (CHU), GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, Liège, Belgium
| | - F Ilardi
- University of Liège Hospital (CHU), GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, Liège, Belgium
| | - M Bouziane
- University of Liège Hospital (CHU), GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, Liège, Belgium
| | - S Cimino
- University of Liège Hospital (CHU), GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, Liège, Belgium
| | - M Mancone
- “Sapienza” University of Rome, Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic, and Geriatric Sciences, Rome, Italy
| | - F Fedele
- “Sapienza” University of Rome, Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic, and Geriatric Sciences, Rome, Italy
| | - P Lancellotti
- University of Liège Hospital (CHU), GIGA Cardiovascular Sciences, Department of Cardiology and Radiology, Liège, Belgium
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Ilardi F, Marchetta S, Martinez C, Sprynger M, Ancion A, Manganaro R, Sugimoto T, Tsugu T, Postolache A, Piette C, Cicenia M, Esposito G, Galderisi M, Oury C, Dulgheru R, Lancellotti P. Impact of aortic stenosis on layer-specific longitudinal strain: relationship with symptoms and outcome. Eur Heart J Cardiovasc Imaging 2019; 21:408-416. [DOI: 10.1093/ehjci/jez215] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 08/01/2019] [Accepted: 08/05/2019] [Indexed: 12/17/2022] Open
Abstract
Abstract
Aims
The present study sought to assess the impact of aortic stenosis (AS) on myocardial function as assessed by layer-specific longitudinal strain (LS) and its relationship with symptoms and outcome.
Methods and results
We compared 211 patients (56% males, mean age 73 ± 12 years) with severe AS and left ventricular ejection fraction (LVEF) ≥50% (114 symptomatic, 97 asymptomatic) with 50 controls matched for age and sex. LS was assessed from endocardium, mid-myocardium, and epicardium by 2D speckle-tracking echocardiography. Despite similar LVEF, multilayer strain values were significantly lower in symptomatic patients, compared to asymptomatic and controls [global LS: 17.9 ± 3.4 vs. 19.1 ± 3.1 vs. 20.7 ± 2.1%; endocardial LS: 20.1 ± 4.9 vs. 21.7 ± 4.2 vs. 23.4 ± 2.5%; epicardial LS: 15.8 ± 3.1 vs. 16.8 ± 2.8 vs. 18.3 ± 1.8%; P < 0.001 for all]. On multivariable logistic regression analysis, endocardial LS was independently associated to symptoms (P = 0.012), together with indexed left atrial volume (P = 0.006) and LV concentric remodelling (P = 0.044). During a mean follow-up of 22 months, 33 patients died of a cardiovascular event. On multivariable Cox-regression analysis, age (P = 0.029), brain natriuretic peptide values (P = 0.003), LV mass index (P = 0.0065), LV end-systolic volume (P = 0.012), and endocardial LS (P = 0.0057) emerged as independently associated with cardiovascular death. The best endocardial LS values associated with outcome was 20.6% (sensitivity 70%, specificity 52%, area under the curve = 0.626, P = 0.022). Endocardial LS (19.1 ± 3.3 vs. 20.7 ± 3.3, P = 0.02) but not epicardial LS (15.2 ± 2.8 vs. 15.9 ± 2.5, P = 0.104) also predicted the outcome in patients who were initially asymptomatic.
Conclusion
In patients with severe AS, LS impairment involves all myocardial layers and is more prominent in the advanced phases of the disease, when the symptoms occur. In this setting, the endocardial LS is independently associated with symptoms and patient outcome.
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Affiliation(s)
- Federica Ilardi
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
- Department of Advanced Biomedical Sciences, University Federico II of Via S. Pansini, 5, 80131 Naples, Naples, Italy
| | - Stella Marchetta
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
| | - Christophe Martinez
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
| | - Muriel Sprynger
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
| | - Arnaud Ancion
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
| | - Roberta Manganaro
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
| | - Tadafumi Sugimoto
- Department of Clinical Laboratory, Mie University Hospital, Mie, 2-174 Edobashi, Tsu, 514-8507, Japan
| | - Toshimitsu Tsugu
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
- Department of Cardiology, School of Medicine, Keio University, Tokyo, 160-8582, Japan
| | - Adriana Postolache
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
| | - Caroline Piette
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
| | - Marianna Cicenia
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, University Federico II of Via S. Pansini, 5, 80131 Naples, Naples, Italy
| | - Maurizo Galderisi
- Department of Advanced Biomedical Sciences, University Federico II of Via S. Pansini, 5, 80131 Naples, Naples, Italy
| | - Cécile Oury
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
| | - Raluca Dulgheru
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
| | - Patrizio Lancellotti
- Department of Cardiology and Radiology, University of Liège Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman - B.35, 4000 Liège, Belgium
- Gruppo Villa Maria Care and Research, Via Camillo Rosalba, 35, 70124 Bari BA, Italy
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Lempereur M, Davin L, Dulgheru R, Lancellotti P. [Percutaneous left atrial appendage occlusion for thromboembolism protection in patients with atrial fibrillation]. Rev Med Liege 2019; 74:S97-S103. [PMID: 31070323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Atrial fibrillation (AF) is the most common clinical arrythmia and can be associated with severe thromboembolic complications. For different reasons, a large number of AF patients who would benefit from oral anticoagulation (OAC) are not treated. In case of contra-indications to long-term OAC, left atrial appendage (LAA) closure allows the exclusion of the LAA from the systemic circulation and significantly reduces the thromboembolism risk. Results from large randomized trials show that this technique is non-inferior in terms of efficacy compared to OAC and that it can significantly reduce the rate of haemorrhagic complications. Large-scale registries show promising results in patients with contra-indications to long-term OAC. Clinical trials are under way to define the role and spectrum of LAA occlusion and to optimize post-procedural treatment.
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Affiliation(s)
| | - L Davin
- Service de Cardiologie, CHU Liège, Belgique
| | - R Dulgheru
- Service de Cardiologie, CHU Liège, Belgique
| | - P Lancellotti
- Service de Cardiologie et GIGA Cardiovasculaire, CHU Liège, Belgique
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40
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Lancellotti P, Ancion A, Davin L, Dulgheru R, Gach O, Lempereur M, Marchetta S, Marechal P, Martinez C. [The heart team : definition and organization. Point of view of the cardiologist]. Rev Med Liege 2019; 74:S5-S9. [PMID: 31070309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The management of complex cardiovascular disease has changed considerably with the development of new care strategies. In cardiology, the «Heart Team» or literally «Equipe du cœur» occupies a prominent place in the latest European and American recommendations, particularly in the management of complex coronary or valvular diseases and in heart failure patients. The concept of «Heart Team» is based on the need for a multidisciplinary holistic approach based on evidence (respect of the recommendations of the scientific societies), the patient as a whole (comorbidities, preferences), risks and long-term benefits of the treatment selected and performed, as well as on the level of local expertise. It aims to determine the best management strategy for the patient, and perhaps to guarantee a better result (prognosis).
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Affiliation(s)
- P Lancellotti
- Service de Cardiologie et GIGA Cardiovasculaire, CHU Liège, Belgique
| | - A Ancion
- Cardiologie, CHU de Liège, Belgique
| | - L Davin
- Cardiologie, CHU de Liège, Belgique
| | | | - O Gach
- Cardiologie, CHU de Liège, Belgique
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41
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Lancellotti P, Gach O, Davin L, Marchetta S, Dulgheru R. [Alcohol septal ablation for obstructive hypertrophic cardiomopathy]. Rev Med Liege 2019; 74:S51-S56. [PMID: 31070317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Alcohol septal ablation has become an attractive alternative to surgical myomectomy in symptomatic patients with obstructive hypertrophic cardiomyopathy. Its purpose is to achieve a therapeutic infarction in the sub-aortic territory responsible of the obstruction. It is indicated in symptomatic patients resistant to optimal medical treatment and having a left intraventricular gradient equal or higher than 50 mmHg, spontaneous or with exercise. The selection of candidates must be rigorous and the procedure must be performed in an experienced center, associating interventionalists and echocardiographists. Alcohol septal ablation is preferred in cases of favourable coronary anatomy, sub-aortic obstruction and absence of associated mitral valve defect. The septal alcohol technique is fast, effective and safe. The per-procedural contrast echocardiography helps identifying whether the myocardial segment is vascularized by the septal branch to be occluded. The benefits of alcohol septal ablation are comparable to those seen with surgical myectomy in terms of functional class, exercise capacity, and gradient regression. The morbidity and mortality observed in the short and mid terms are globally equivalent to that of the surgical intervention. The major complication is dominated by the occurrence of complete atrioventricular block requiring the implantation of a definitive pacemaker, a complication in sharp decline since the contrast ultrasound-guided technique has become widespread.
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Affiliation(s)
- P Lancellotti
- Service de Cardiologie et GIGA Cardiovasculaire, CHU Liège, Belgique
| | - O Gach
- Service de Cardiologie , CHU Liège, Belgique
| | - L Davin
- Service de Cardiologie , CHU Liège, Belgique
| | - S Marchetta
- Service de Cardiologie , CHU Liège, Belgique
| | - R Dulgheru
- Service de Cardiologie , CHU Liège, Belgique
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42
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Lancellotti P, Lempereur M, Marchetta S, Dulgheru R. [Percutaneous closure of paravalvular leak]. Rev Med Liege 2019; 74:S82-S86. [PMID: 31070321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Paravalvular leaks (PVL) are a serious complication after surgical or transcatheter aortic valve replacement. They are mostly small and unimportant. When they manifest clinically (1 to 5 % of PVL), they can become responsible for severe hemolytic anaemia or cause congestive heart failure. For years, surgical re-intervention has been considered the treatment of choice for symptomatic patients with PVL. However, surgical re-intervention is associated with a high risk of morbidity and mortality. Percutaneous PVL closure is a less invasive alternative to surgical re-intervention. The safety and feasibility of percutaneous PVL closure has been confirmed in several studies. In this article, we discuss the issue of PVL and their percutaneous management.
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Affiliation(s)
- P Lancellotti
- Service de Cardiologie et GIGA Cardiovasculaire, CHU Liège, Belgique
| | - M Lempereur
- Service de Cardiologie , CHU Liège, Belgique
| | - S Marchetta
- Service de Cardiologie , CHU Liège, Belgique
| | - R Dulgheru
- Service de Cardiologie , CHU Liège, Belgique
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43
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Lempereur M, Dulgheru R, Marchetta S, Davin L, Lancellotti P. [Percutaneous mitral interventions]. Rev Med Liege 2019; 74:S73-S81. [PMID: 31070320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
After aortic valve diseases, mitral valve diseases represent the most numerous indications of surgical or percutaneous valvular intervention. Surgical management is favoured in severe symptomatic mitral regurgitation. In case of high or prohibitive surgical risk, new techniques are developed to allow percutaneous, less invasive management. In these circumstances, MitraClip® allows the treatment of mitral regurgitation in case of adequate valve morphology. Percutaneous balloon valvuloplasty is currently the first-line treatment of mitral stenosis related to rheumatic disease when anatomical features are favourable. Alongside the Inoue technique, which remains the classical procedure, other approaches are available with encouraging results.
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Affiliation(s)
- M Lempereur
- Service de Cardiologie , CHU Liège, Belgique
| | - R Dulgheru
- Service de Cardiologie , CHU Liège, Belgique
| | - S Marchetta
- Service de Cardiologie , CHU Liège, Belgique
| | - L Davin
- Service de Cardiologie , CHU Liège, Belgique
| | - P Lancellotti
- Service de Cardiologie et GIGA Cardiovasculaire, CHU Liège, Belgique
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44
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Davin L, Dulgheru R, Marchetta S, Lancellotti P. [Non-invasive imaging and interventional cardiology]. Rev Med Liege 2019; 74:S10-S16. [PMID: 31070310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In the last decades, interventional cardiology has received fast and wide implementation as an effective alternative treatment to surgery for several congenital and acquired diseases. Imaging provides solutions for most clinical needs, from diagnosis to prognosis and risk stratification, as well as anatomical and functional assessment. In this article, we present recent innovations in medical imaging for structural heart disease and coronary artery disease, emphasizing the progress achieved in the field of multimodality imaging. Intra-procedural guidance can be facilitated by established multimodality cardiac imaging such as transesophageal 2D and 3D echocardiography and by novel techniques as echo-fluoroscopy overlay and 3D imaging fusion. Computed tomography and magnetic resonance imaging are particularly helpful for preprocedural morphology assessment and device sizing. Successful planning, guidance, and monitoring of interventions depend heavily on accurate imaging for both structural heart disease and complex coronary artery disease.
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Affiliation(s)
- L Davin
- Service de Cardiologie, CHU Liège, Belgique
| | - R Dulgheru
- Service de Cardiologie, CHU Liège, Belgique
| | | | - P Lancellotti
- Service de Cardiologie et GIGA Cardiovasculaire, CHU Liège, Belgique
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45
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Abstract
Secondary regurgitation caused by the remodeling and dysfunction of the left or right heart chamber may complicate heart failure, worsening both symptoms and prognosis. Outcome studies have shown that patients' prognosis worsened as the severity of secondary regurgitation increases. Imaging and more specifically echocardiography plays a central role for diagnosis and serial assessment of secondary regurgitation as well as for timing the intervention and guiding the procedure.
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Affiliation(s)
- Patrizio Lancellotti
- Department of Cardiology, Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, Liege, Belgium; Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy.
| | - Raluca Dulgheru
- Department of Cardiology, Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, Liege, Belgium
| | - Stella Marchetta
- Department of Cardiology, Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, Liege, Belgium
| | - Cécile Oury
- Department of Cardiology, Heart Valve Clinic, University of Liege Hospital, GIGA Cardiovascular Sciences, CHU Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, Liege, Belgium
| | - Madalina Garbi
- King's Health Partners, King's College Hospital NHS Foundation Trust, King's College Hospital, Denmark Hill, London SE5 9RS, UK
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46
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Guiot J, Parzibut G, Weber T, Davin L, Dulgheru R, Lancellotti P, Louis R, Vachiery JL. [Pulmonary arterial hypertension]. Rev Med Liege 2019; 74:139-145. [PMID: 30897313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Pulmonary arterial hypertension (PAH) is a rare vascular lung disease with a complex etiopathogeny characterized by an increased pulmonary arterial pressure of 25 mmHg or above assessed by right heart catheterization. The diagnosis is difficult due to the atypical presentation with shortness of breath requiring a sequential approach bringing at the end the clinician to perform a right heart catheterization. Nowadays, several therapies have proven to be efficient for treating PAH. Recently, international recommendations have moved to an initial combination therapy reducing the overall morbi-mortality of the patients. Therefore, early therapy appears to be a priority in PAH underlying the need for increasing the global knowledge around PAH.
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Affiliation(s)
- J Guiot
- Service de Pneumologie, CHU Liège, Belgique
| | - G Parzibut
- Service de Pneumologie, CHU Liège, Belgique
| | - T Weber
- Service de Pneumologie, CHR Citadelle, Liège, Belgique
| | - L Davin
- Service de Cardiologie, CHU Liège, Liège, Belgique
| | - R Dulgheru
- Service de Cardiologie, CHU Liège, Liège, Belgique
| | | | - R Louis
- Service de Pneumologie, CHU Liège, Belgique
| | - J L Vachiery
- Service de Cardiologie, Cliniques Universitaires de Bruxelles - Hôpital Erasme, Bruxelles, Belgique
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47
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Radermecker M, Dulgheru R, Hans G, Marchetta S, Lancellotti P. Misplaced mid-septal infarction aggravating sub aortic obstruction in hypertrophic obstructive cardiomyopathy. Eur Heart J Cardiovasc Imaging 2019; 20:121. [PMID: 30380043 DOI: 10.1093/ehjci/jey161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Radermecker
- Cardiac and Thoracic Surgery Department, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - R Dulgheru
- Domaine Universitaire du Sart Tilman, Batiment B35, Department of Cardiology, University Hospital, Université de Liège, CHU du Sart Tilman, Liège, Belgium
| | - G Hans
- Anaesthesiology Department, University of Liège Hospital, CHU Sart Tilman, Liège, Belgium
| | - S Marchetta
- Domaine Universitaire du Sart Tilman, Batiment B35, Department of Cardiology, University Hospital, Université de Liège, CHU du Sart Tilman, Liège, Belgium
| | - P Lancellotti
- Domaine Universitaire du Sart Tilman, Batiment B35, Department of Cardiology, University Hospital, Université de Liège, CHU du Sart Tilman, Liège, Belgium.,GIGA Cardiovascular Sciences, Liège, Belgium
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48
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Abstract
Findings from early percutaneous tricuspid intervention trials have shown that the severity of tricuspid regurgitation (TR) far exceeded the current definition of severe TR. Also, the improvement in the amount of TR following tricuspid intervention is not accounted for by the current definition of TR as different degrees of severity at the severe end was grouped under the same umbrella term of "severe." There has been a recent call to expand the TR grading system, encompassing two more grades, namely "massive" and "torrential" TR, in the order of increasing severity. This seems appropriate as the patients enrolled in tricuspid intervention trials were found to have TR severity up to 2 grades above the current severe thresholds of effective regurgitant orifice area (EROA) 40 mm2, regurgitant volume (R Vol) 45 ml and vena contracta (VC) width 7 mm. The proposed grade of "massive" is defined by EROA 60-79 mm2, R Vol 60-74 ml and VC 14-20 mm, while "torrential" is defined by EROA ≥80 mm2, R Vol ≥75 ml, and VC ≥21 mm. The grading of TR requires a comprehensive, multi-parametric approach. In particular, quantitative assessment of TR should be performed in patients who require serial monitoring and quantification of treatment effect.
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Affiliation(s)
- Yun Yun Go
- National Heart Centre Singapore, National Heart Research Institute Singapore, Singapore, Singapore
| | - Raluca Dulgheru
- Department of Cardiology, University Hospital Sart Tilman, Heart Valve Clinic, University of Liège, Liège, Belgium.,GIGA Cardiovascular Sciences, University Hospital Sart Tilman, Liège, Belgium
| | - Patrizio Lancellotti
- Department of Cardiology, University Hospital Sart Tilman, Heart Valve Clinic, University of Liège, Liège, Belgium.,GIGA Cardiovascular Sciences, University Hospital Sart Tilman, Liège, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
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49
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Lancellotti P, Galderisi M, Edvardsen T, Donal E, Goliasch G, Cardim N, Magne J, Laginha S, Hagendorff A, Haland TF, Aaberge L, Martinez C, Rapacciuolo A, Santoro C, Ilardi F, Postolache A, Dulgheru R, Mateescu AD, Beladan CC, Deleanu D, Marchetta S, Auffret V, Schwammenthal E, Habib G, Popescu BA. Echo-Doppler estimation of left ventricular filling pressure: results of the multicentre EACVI Euro-Filling study. Eur Heart J Cardiovasc Imaging 2018; 18:961-968. [PMID: 28444160 DOI: 10.1093/ehjci/jex067] [Citation(s) in RCA: 221] [Impact Index Per Article: 36.8] [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: 03/07/2017] [Accepted: 03/13/2017] [Indexed: 11/13/2022] Open
Abstract
Aims The present Euro-Filling report aimed at comparing the diagnostic accuracy of the 2009 and 2016 echocardiographic grading algorithms for predicting invasively measured left ventricular filling pressure (LVFP). Method and results A total of 159 patients who underwent simultaneous evaluation of echo estimates of LVFP and invasive measurements of LV end-diastolic pressure (LVEDP) were enrolled at nine EACVI centres. Thirty-nine (25%) patients had a reduced LV ejection fraction (<50%), 77 (64%) were in NYHA ≥ II, and 85 (53%) had coronary artery disease. Sixty-four (40%) patients had elevated LVEDP (≥15 mmHg). Taken individually, all echocardiographic Doppler estimates of LVFP (E/A, E/e', left atrial volume, tricuspid regurgitation jet velocity) were marginally correlated with LVEDP. By using the 2016 recommendations, 65% of patients with normal non-invasive estimate of LVFP had normal LVEDP, while 79% of those with elevated non-invasive LVFP had elevated invasive LVEDP. By using 2009 recommendations, 68% of the patients with normal non-invasive LVFP had normal LVEDP, while 55% of those with elevated non-invasive LVFP had elevated LVEDP. The 2016 recommendations (sensitivity 75%, specificity 74%, positive predictive value 39%, negative predictive value 93%, AUC 0.78) identified slightly better patients with elevated invasive LVEDP (≥ 15 mmHg) as compared with the 2009 recommendations (sensitivity 43%, specificity 75%, positive predictive value 49%, negative predictive value 71%, AUC 0.68). Conclusion The present Euro-Filling study demonstrates that the new 2016 recommendations for assessing LVFP non-invasively are fairly reliable and clinically useful, as well as superior to the 2009 recommendations in estimating invasive LVEDP.
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Affiliation(s)
- Patrizio Lancellotti
- GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, University of Liège Hospital, B-4000 Liege, Belgium.,Gruppo Villa Maria Care and Research, Anthea Hospital, Bari, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Centre of Cardiological Innovation, Oslo, Norway
| | - Erwan Donal
- Cardiologie, CHU Rennes and LTSI-INSERM U 1099, Université Rennes 1, France
| | - Georg Goliasch
- Division of Cardiology, Second Department of Medicine, Medical University of Vienna, Vienna, Austria
| | - Nuno Cardim
- Multimodality Cardiac Imaging Department, Sports Cardiology and Cardiomyopathies centre Hospital da Luz, Lisbon, Portugal
| | - Julien Magne
- CHU Limoges, Hôpital Dupuytren, Pôle Coeur-Poumon-Rein, Cardiology Department, Limoges, France
| | - Sara Laginha
- Multimodality Cardiac Imaging Department, Sports Cardiology and Cardiomyopathies centre Hospital da Luz, Lisbon, Portugal
| | - Andreas Hagendorff
- Echokardiographie-Labore des Universitätsklinikums AöR, Department of Cardiology-Angiology, University of Leipzig, Leipzig, Germany
| | - Trine F Haland
- Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Centre of Cardiological Innovation, Oslo, Norway
| | - Lars Aaberge
- Department of Cardiology, Oslo University Hospital, Rikshospitalet and University of Oslo, Centre of Cardiological Innovation, Oslo, Norway
| | - Christophe Martinez
- GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, University of Liège Hospital, B-4000 Liege, Belgium
| | - Antonio Rapacciuolo
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Ciro Santoro
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Federica Ilardi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Adriana Postolache
- GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, University of Liège Hospital, B-4000 Liege, Belgium
| | - Raluca Dulgheru
- GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, University of Liège Hospital, B-4000 Liege, Belgium
| | - Anca D Mateescu
- University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania
| | - Carmen C Beladan
- University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania
| | - Dan Deleanu
- University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania
| | - Stella Marchetta
- GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, University of Liège Hospital, B-4000 Liege, Belgium
| | - Vincent Auffret
- Cardiologie, CHU Rennes and LTSI-INSERM U 1099, Université Rennes 1, France
| | - Ehud Schwammenthal
- Heart Center, Sheba Medical Center, Tel Hashomer, and Tel Aviv University, Ramat Aviv, Israel
| | - Gilbert Habib
- URMITE, Aix Marseille Université UM63, CNRS 7278, IRD 198, INSERM 1095 IHU - Méditerranée Infection.,APHM, La Timone Hospital, Cardiology Department, Marseille, France
| | - Bogdan A Popescu
- University of Medicine and Pharmacy "Carol Davila"-Euroecolab, Institute of Cardiovascular Diseases "Prof. Dr. C. C. Iliescu", Bucharest, Romania
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Sugimoto T, Robinet S, Dulgheru R, Bernard A, Ilardi F, Contu L, Addetia K, Caballero L, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Hagendorff A, Hristova K, Lopez T, de la Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, van de Veire N, Von Bardeleben RS, Vinereanu D, Zamorano JL, Go YY, Marchetta S, Nchimi A, Rosca M, Calin A, Moonen M, Cimino S, Magne J, Cosyns B, Galli E, Donal E, Habib G, Esposito R, Galderisi M, Badano LP, Lang RM, Lancellotti P. Echocardiographic reference ranges for normal left atrial function parameters: results from the EACVI NORRE study. Eur Heart J Cardiovasc Imaging 2018; 19:630-638. [PMID: 29529180 DOI: 10.1093/ehjci/jey018] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 01/18/2018] [Indexed: 10/16/2023] Open
Abstract
AIMS To obtain the normal ranges for echocardiographic measurements of left atrial (LA) function from a large group of healthy volunteers accounting for age and gender. METHODS AND RESULTS A total of 371 (median age 45 years) healthy subjects were enrolled at 22 collaborating institutions collaborating in the Normal Reference Ranges for Echocardiography (NORRE) study of the European Association of Cardiovascular Imaging (EACVI). Left atrial data sets were analysed with a vendor-independent software (VIS) package allowing homogeneous measurements irrespective of the echocardiographic equipment used to acquire data sets. The lowest expected values of LA function were 26.1%, 48.7%, and 41.4% for left atrial strain (LAS), 2D left atrial emptying fraction (LAEF), and 3D LAEF (reservoir function); 7.7%, 24.2%, and -0.53/s for LAS-active, LAEF-active, and LA strain rate during LA contraction (SRa) (pump function) and 12.0% and 21.6% for LAS-passive and LAEF-passive (conduit function). Left atrial reservoir and conduit function were decreased with age while pump function was increased. All indices of reservoir function and all LA strains had no difference in both gender and vendor. However, inter-vendor differences were observed in LA SRa despite the use of VIS. CONCLUSION The NORRE study provides contemporary, applicable echocardiographic reference ranges for LA function. Our data highlight the importance of age-specific reference values for LA functions.
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Affiliation(s)
- Tadafumi Sugimoto
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Sébastien Robinet
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Raluca Dulgheru
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Anne Bernard
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
- Cardiology Department, CHU Tours, France et Université de Tours, 2 Boulevard Tonnellé, 37000 Tours, France
| | - Federica Ilardi
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Laura Contu
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Karima Addetia
- Department of Medicine University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, 60637 IL, USA
| | - Luis Caballero
- Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain
| | - George Kacharava
- Echocardiography Laboratory of Adult Cardiology Department of the JO ANN Medical Center, 21 Lubliana str. 0159, Tbilisi, Georgia
| | - George D Athanassopoulos
- Noninvasive Diagnostics Department, Onassis Cardiac Surgery Center, Leof. Andrea Siggrou 356, 176 74 Kallithea, Athens, Greece
| | - Daniele Barone
- Laboratory of Cardiovascular Ecography, Cardiology Department, S. Andrea Hospital, Via Vittorio Veneto, 197, 19121 La Spezia SP, Italy
| | - Monica Baroni
- Laboratorio Di Ecocardiografia Adulti, Fondazione Toscana 'G.Monasterio'-Ospedale Del Cuore, Via Giuseppe Moruzzi, 1, 56124 Pisa PI, Massa, Italy
| | - Nuno Cardim
- Echocardiography Laboratory, Hospital da Luz, Av. Lusíada 100, 1500-650 Lisboa, Portugal
| | - Andreas Hagendorff
- Department of Cardiology, University of Leipzig, Liebigstraße 20, 04103 Leipzig, Germany
| | - Krasimira Hristova
- Department of Noninvasive Functional Diagnostic and Imaging, University National Heart Hospital, ul. "Konyovitsa" 65, 1309 g.k. Ilinden, Sofia, Bulgaria
| | - Teresa Lopez
- Cardiology Department, La Paz Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain
| | - Gonzalo de la Morena
- Unidad de Imagen Cardiaca, Servicio de Cardiologia, Hospital Clinico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 El Palmar, Murcia, Spain
| | - Bogdan A Popescu
- University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Sector 1, Strada Dionisie Lupu 37, 030167 Bucuresti, Romania
| | - Martin Penicka
- Cardiovascular Center Aalst, OLV-Clinic, Moorselbaan 164, 9300 Aalst, Belgium
| | - Tolga Ozyigit
- VKV Amerikan Hastanesi, Kardiyoloji Bölümü, Tesvikiye, Güzelbahçe Sk. No:20, 34365 Sisli/Istanbul, Turkey
| | | | - Nico van de Veire
- Echocardiography Unit, AZ Maria Middelares Gent, Buitenring-Sint-Denijs 30, 9000 Gent, Belgium
| | - Ralph Stephan Von Bardeleben
- Medical Department Cardiology, Universitätsmedizin of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - Dragos Vinereanu
- Cardiovascular Research Unit, University and Emergency Hospital, University of Medicine and Pharmacy Carol Davila, Sector 1, Strada Dionisie Lupu 37, 030167 Bucuresti, Romania
| | - Jose Luis Zamorano
- University Alcala, Hospital Ramón y Cajal, Ctra. De Colmenar Viejo, km. 9, 100, 28034 Madrid, Spain
| | - Yun Yun Go
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Stella Marchetta
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Alain Nchimi
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Monica Rosca
- University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Sector 1, Strada Dionisie Lupu 37, 030167 Bucuresti, Romania
| | - Andreea Calin
- University of Medicine and Pharmacy 'Carol Davila', Euroecolab, Institute of Cardiovascular Diseases 'Prof. Dr. C. C. Iliescu', Sector 1, Strada Dionisie Lupu 37, 030167 Bucuresti, Romania
| | - Marie Moonen
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Sara Cimino
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
| | - Julien Magne
- CHU Dupuytren, 2 Avenue Martin Luther King, 87000 Limoges, France
| | - Bernard Cosyns
- CHVZ (Centrum voor Hart en Vaatziekten), Universitair ziekenhuis Brussel and ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, Avenue du Laerbeek 101, 1090 Jette, Brussels, Belgium
| | - Elena Galli
- CIC-IT U 1414, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France
| | - Erwan Donal
- CIC-IT U 1414, CHU Rennes, Université Rennes 1, Service de Cardiologie, CHU Rennes, 2 Rue Henri le Guilloux, 35000 Rennes, France
| | - Gilbert Habib
- APHM, La Timone Hospital, Cardiology Department, Marseille France
- Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Roberta Esposito
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S.Pansini, 5, 80131 Napoli NA, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Via S.Pansini, 5, 80131 Napoli NA, Italy
| | - Luigi P Badano
- Department of Cardiac, Thoracic and Vascular Sciences University of Padova, School of Medicine, Via 8 Febbraio 1848, 2, 35122 Padova PD, Italy
| | - Roberto M Lang
- Department of Medicine University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, 60637 IL, USA
| | - Patrizio Lancellotti
- Department of Cardiology, University of Liège Hospital, GIGA Cardiovascular Sciences, Heart Valve Clinic, CHU du Sart Tilman, Domaine Universitaire du Sart Tilman, Batiment B35, 4000 Liège, Belgium
- Gruppo Villa Maria Care and Research, Anthea Hospital, Via Camillo Rosalba, 35, 70124 Bari BA, Italy
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