1
|
Cannie DE, Protonotarios A, Bakalakos A, Syrris P, Lorenzini M, De Stavola B, Bjerregaard L, Dybro AM, Hey TM, Hansen FG, Navarro Peñalver M, Crespo-Leiro MG, Larrañaga-Moreira JM, de Frutos F, Johnson R, Slater TA, Monserrat L, Sengupta A, Mestroni L, Taylor MR, Sinagra G, Bilinska Z, Solla-Ruiz I, Arana Achaga X, Barriales-Villa R, Garcia-Pavia P, Gimeno JR, Dal Ferro M, Merlo M, Wahbi K, Fatkin D, Mogensen J, Rasmussen TB, Elliott PM. Risks of Ventricular Arrhythmia and Heart Failure in Carriers of RBM20 Variants. Circ Genom Precis Med 2023; 16:434-441. [PMID: 37593875 PMCID: PMC10581410 DOI: 10.1161/circgen.123.004059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/20/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Variants in RBM20 are reported in 2% to 6% of familial cases of dilated cardiomyopathy and may be associated with fatal ventricular arrhythmia and rapid heart failure progression. We sought to determine the risk of adverse events in RBM20 variant carriers and the impact of sex on outcomes. METHODS Consecutive probands and relatives carrying RBM20 variants were retrospectively recruited from 12 cardiomyopathy units. The primary end point was a composite of malignant ventricular arrhythmia (MVA) and end-stage heart failure (ESHF). MVA and ESHF end points were also analyzed separately and men and women compared. Left ventricular ejection fraction (LVEF) contemporary to MVA was examined. RBM20 variant carriers with left ventricular systolic dysfunction (RBM20LVSD) were compared with variant-elusive patients with idiopathic left ventricular systolic dysfunction. RESULTS Longitudinal follow-up data were available for 143 RBM20 variant carriers (71 men; median age, 35.5 years); 7 of 143 had an MVA event at baseline. Thirty of 136 without baseline MVA (22.0%) reached the primary end point, and 16 of 136 (11.8%) had new MVA with no significant difference between men and women (log-rank P=0.07 and P=0.98, respectively). Twenty of 143 (14.0%) developed ESHF (17 men and 3 women; log-rank P<0.001). Four of 10 variant carriers with available LVEF contemporary to MVA had an LVEF >35%. At 5 years, 15 of 67 (22.4%) RBM20LVSD versus 7 of 197 (3.6%) patients with idiopathic left ventricular systolic dysfunction had reached the primary end point (log-rank P<0.001). RBM20 variant carriage conferred a 6.0-fold increase in risk of the primary end point. CONCLUSIONS RBM20 variants are associated with a high risk of MVA and ESHF compared with idiopathic left ventricular systolic dysfunction. The risk of MVA in male and female RBM20 variant carriers is similar, but male sex is strongly associated with ESHF.
Collapse
Affiliation(s)
- Douglas E. Cannie
- Institute of Cardiovascular Science, University College London, United Kingdom (D.E.C., A.P., A.B., P.S., M.L., P.M.E.)
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, United Kingdom (D.E.C., A.P., A.B., M.L., P.M.E.)
| | - Alexandros Protonotarios
- Institute of Cardiovascular Science, University College London, United Kingdom (D.E.C., A.P., A.B., P.S., M.L., P.M.E.)
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, United Kingdom (D.E.C., A.P., A.B., M.L., P.M.E.)
| | - Athanasios Bakalakos
- Institute of Cardiovascular Science, University College London, United Kingdom (D.E.C., A.P., A.B., P.S., M.L., P.M.E.)
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, United Kingdom (D.E.C., A.P., A.B., M.L., P.M.E.)
| | - Petros Syrris
- Institute of Cardiovascular Science, University College London, United Kingdom (D.E.C., A.P., A.B., P.S., M.L., P.M.E.)
| | - Massimiliano Lorenzini
- Institute of Cardiovascular Science, University College London, United Kingdom (D.E.C., A.P., A.B., P.S., M.L., P.M.E.)
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, United Kingdom (D.E.C., A.P., A.B., M.L., P.M.E.)
| | - Bianca De Stavola
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, United Kingdom (B.D.S.)
| | - Louise Bjerregaard
- Department of Cardiology, Aarhus University Hospital, Denmark (L.B., A.M.D., T.B.R.)
| | - Anne M. Dybro
- Department of Cardiology, Aarhus University Hospital, Denmark (L.B., A.M.D., T.B.R.)
| | - Thomas M. Hey
- Department of Cardiology, Odense University Hospital, Denmark (T.M.H., F.G.H.)
| | | | - Marina Navarro Peñalver
- Inherited Cardiac Disease Unit, Hospital Universitario Virgen Arrixaca, Murcia, Spain (M.N.P., J.R.G.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV) (M.N.P.,F.d.F., R.B.-V., M.G.C.-L., J.M.L.-M., P.G.-P., J.R.G.)
- Unit for Screening Studies in Inherited Cardiovascular Diseases, Cardinal Stefan Wyszynski Institute of Cardiology, Warsaw, Poland (Z.B.)
| | - Maria G. Crespo-Leiro
- Unidad de Cardiopatías Familiares e Insuficiencia Cardíaca Avanzada, Complexo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica de A Coruña, Servizo Galego de Saúde, Universidade da Coruña, Spain (R.B.-V., M.G.C.-L., J.M.L.-M.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV) (M.N.P.,F.d.F., R.B.-V., M.G.C.-L., J.M.L.-M., P.G.-P., J.R.G.)
| | - Jose M. Larrañaga-Moreira
- Unidad de Cardiopatías Familiares e Insuficiencia Cardíaca Avanzada, Complexo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica de A Coruña, Servizo Galego de Saúde, Universidade da Coruña, Spain (R.B.-V., M.G.C.-L., J.M.L.-M.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV) (M.N.P.,F.d.F., R.B.-V., M.G.C.-L., J.M.L.-M., P.G.-P., J.R.G.)
| | - Fernando de Frutos
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, the Netherlands (M.N.P.,F.d.F., P.G.-P., J.R.G., M.D.F., M.M., G.S.)
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Instituto Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHISA), Madrid, Spain (F.d.F., P.G.-P.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV) (M.N.P.,F.d.F., R.B.-V., M.G.C.-L., J.M.L.-M., P.G.-P., J.R.G.)
| | - Renee Johnson
- Victor Chang Cardiac Research Institute, Darlinghurst (R.J., D.F.)
- School of Clinical Medicine, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Kensington, Australia (R.J., D.F.)
| | - Thomas A. Slater
- Yorkshire Heart Centre, Leeds General Infirmary, United Kingdom (T.A.S., A.S.)
| | - Lorenzo Monserrat
- Medical Department, Dilemma Solutions, A Coruña, Spain (L. Monserrat)
| | - Anshuman Sengupta
- Yorkshire Heart Centre, Leeds General Infirmary, United Kingdom (T.A.S., A.S.)
| | - Luisa Mestroni
- Cardiovascular Institute and Adult Medical Genetics Program, University of Colorado Anschutz Medical Campus, Aurora (L. Mestroni, M.R.G.T.)
| | - Matthew R.G. Taylor
- Cardiovascular Institute and Adult Medical Genetics Program, University of Colorado Anschutz Medical Campus, Aurora (L. Mestroni, M.R.G.T.)
| | - Gianfranco Sinagra
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, the Netherlands (M.N.P.,F.d.F., P.G.-P., J.R.G., M.D.F., M.M., G.S.)
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, University of Trieste, Italy (G.S., M.D.F., M.M.)
| | - Zofia Bilinska
- Unit for Screening Studies in Inherited Cardiovascular Diseases, Cardinal Stefan Wyszynski Institute of Cardiology, Warsaw, Poland (Z.B.)
| | - Itziar Solla-Ruiz
- Department of Cardiology, Hospital Universitario Donostia, Spain (I.S.-R., X.A.A.)
| | - Xabier Arana Achaga
- Department of Cardiology, Hospital Universitario Donostia, Spain (I.S.-R., X.A.A.)
| | - Roberto Barriales-Villa
- Unidad de Cardiopatías Familiares e Insuficiencia Cardíaca Avanzada, Complexo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica de A Coruña, Servizo Galego de Saúde, Universidade da Coruña, Spain (R.B.-V., M.G.C.-L., J.M.L.-M.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV) (M.N.P.,F.d.F., R.B.-V., M.G.C.-L., J.M.L.-M., P.G.-P., J.R.G.)
| | - Pablo Garcia-Pavia
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, the Netherlands (M.N.P.,F.d.F., P.G.-P., J.R.G., M.D.F., M.M., G.S.)
- Heart Failure and Inherited Cardiac Diseases Unit, Department of Cardiology, Hospital Universitario Puerta de Hierro, Instituto Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHISA), Madrid, Spain (F.d.F., P.G.-P.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV) (M.N.P.,F.d.F., R.B.-V., M.G.C.-L., J.M.L.-M., P.G.-P., J.R.G.)
| | - Juan R. Gimeno
- Inherited Cardiac Disease Unit, Hospital Universitario Virgen Arrixaca, Murcia, Spain (M.N.P., J.R.G.)
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, the Netherlands (M.N.P.,F.d.F., P.G.-P., J.R.G., M.D.F., M.M., G.S.)
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV) (M.N.P.,F.d.F., R.B.-V., M.G.C.-L., J.M.L.-M., P.G.-P., J.R.G.)
| | - Matteo Dal Ferro
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, the Netherlands (M.N.P.,F.d.F., P.G.-P., J.R.G., M.D.F., M.M., G.S.)
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, University of Trieste, Italy (G.S., M.D.F., M.M.)
| | - Marco Merlo
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart, Amsterdam, the Netherlands (M.N.P.,F.d.F., P.G.-P., J.R.G., M.D.F., M.M., G.S.)
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria Integrata Giuliano Isontina, University of Trieste, Italy (G.S., M.D.F., M.M.)
| | - Karim Wahbi
- Assistance Publique–Hôpitaux de Paris, Cochin Hospital, Cardiology Department, Université de Paris, Institut Imagine, France (K.W.)
| | - Diane Fatkin
- Victor Chang Cardiac Research Institute, Darlinghurst (R.J., D.F.)
- School of Clinical Medicine, University of New South Wales (UNSW) Medicine and Health, UNSW Sydney, Kensington, Australia (R.J., D.F.)
- Cardiology Department, St Vincent’s Hospital, Sydney, Australia (D.F.)
| | - Jens Mogensen
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark (J.M.)
| | - Torsten B. Rasmussen
- Department of Cardiology, Aarhus University Hospital, Denmark (L.B., A.M.D., T.B.R.)
| | - Perry M. Elliott
- Institute of Cardiovascular Science, University College London, United Kingdom (D.E.C., A.P., A.B., P.S., M.L., P.M.E.)
- Department of Inherited Cardiovascular Diseases, Barts Heart Centre, St Bartholomew’s Hospital, London, United Kingdom (D.E.C., A.P., A.B., M.L., P.M.E.)
| |
Collapse
|
2
|
Hey TM, Rasmussen TB, Madsen T, Aagaard MM, Harbo M, Mølgaard H, Nielsen SK, Haas J, Meder B, Møller JE, Eiskjær H, Mogensen J. Clinical and Genetic Investigations of 109 Index Patients With Dilated Cardiomyopathy and 445 of Their Relatives. Circ Heart Fail 2020; 13:e006701. [PMID: 33019804 DOI: 10.1161/circheartfailure.119.006701] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND It was the aim to investigate the frequency and genetic basis of dilated cardiomyopathy (DCM) among relatives of index patients with unexplained heart failure at a tertiary referral center. METHODS Clinical investigations were performed in 109 DCM index patients and 445 of their relatives. All index patients underwent genetic investigations of 76 disease-associated DCM genes. A family history of DCM occurred in 11% (n=12) while clinical investigations identified familial DCM in a total of 32% (n=35). One-fifth of all relatives (n=95) had DCM of whom 60% (n=57) had symptoms of heart failure at diagnosis, whereas 40% (n=38) were asymptomatic. Symptomatic relatives had a shorter event-free survival than asymptomatic DCM relatives (P<0.001). RESULTS Genetic investigations identified 43 pathogenic (n=27) or likely pathogenic (n=16) variants according to the American College of Medical Genetics and Genomics and the Association for Molecular Pathology criteria. Forty-four percent (n=48/109) of index patients carried a pathogenic/likely pathogenic variant of whom 36% (n=27/74) had sporadic DCM, whereas 60% (21/35) were familial cases. Thirteen of the pathogenic/likely pathogenic variants were also present in ≥7 affected individuals and thereby considered to be of sufficient high confidence for use in predictive genetic testing. CONCLUSIONS A family history of DCM identified only 34% (n=12/35) of hereditary DCM, whereas systematic clinical screening identified the remaining 66% (n=23) of DCM families. This emphasized the importance of clinical investigations to identify familial DCM. The high number of pathogenic/likely pathogenic variants identified in familial DCM provides a firm basis for offering genetic investigations in affected families. This should also be considered in sporadic cases since adequate family evaluation may not always be possible and the results of the genetic investigations may carry prognostic information with an impact on individual management.
Collapse
Affiliation(s)
- Thomas M Hey
- Department of Cardiology, Odense University Hospital, Denmark (T.M.H., S.K.N., J.E.M., J.M.)
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Denmark (T.M.H., .K.N., J.E.M., J.M.)
| | - Torsten B Rasmussen
- Department of Cardiology, Aarhus University Hospital, Denmark (T.B.R., H.M., H.E.)
| | - Trine Madsen
- Department of Cardiology Aalborg University Hospital, Denmark (T.M.)
| | | | - Maria Harbo
- Department of Clinical Genetics, Vejle Hospital, Denmark (M.H., M.M.A.)
| | - Henning Mølgaard
- Department of Cardiology, Aarhus University Hospital, Denmark (T.B.R., H.M., H.E.)
| | - Søren K Nielsen
- Department of Cardiology, Odense University Hospital, Denmark (T.M.H., S.K.N., J.E.M., J.M.)
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Denmark (T.M.H., .K.N., J.E.M., J.M.)
| | - Jan Haas
- Institue for Cardiomyopathies Heidelberg, Department of Internal Medicine III (J.H., B.M.), University of Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Germany (J.H., B.M.)
| | - Benjamin Meder
- Institue for Cardiomyopathies Heidelberg, Department of Internal Medicine III (J.H., B.M.), University of Heidelberg, Germany
- Klaus Tschira Institute für Computational Cardiology (B.M.), University of Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Germany (J.H., B.M.)
| | - Jacob E Møller
- Department of Cardiology, Odense University Hospital, Denmark (T.M.H., S.K.N., J.E.M., J.M.)
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Denmark (T.M.H., .K.N., J.E.M., J.M.)
| | - Hans Eiskjær
- Department of Cardiology, Aarhus University Hospital, Denmark (T.B.R., H.M., H.E.)
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, Denmark (T.M.H., S.K.N., J.E.M., J.M.)
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Denmark (T.M.H., .K.N., J.E.M., J.M.)
| |
Collapse
|
3
|
Al-Saaidi RA, Rasmussen TB, Birkler RID, Palmfeldt J, Beqqali A, Pinto YM, Nissen PH, Baandrup U, Mølgaard H, Hey TM, Eiskjaer H, Bross P, Mogensen J. The clinical outcome of LMNA missense mutations can be associated with the amount of mutated protein in the nuclear envelope. Eur J Heart Fail 2018; 20:1404-1412. [PMID: 29943882 DOI: 10.1002/ejhf.1241] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/18/2018] [Accepted: 05/21/2018] [Indexed: 12/17/2022] Open
Abstract
AIMS Lamin A/C mutations are generally believed to be associated with a severe prognosis. The aim of this study was to investigate disease expression in three affected families carrying different LMNA missense mutations. Furthermore, the potential molecular disease mechanisms of the mutations were investigated in fibroblasts obtained from mutation carriers. METHODS AND RESULTS A LMNA-p.Arg216Cys missense mutation was identified in a large family with 36 mutation carriers. Disease expression was unusual with a late onset and a favourable prognosis. Two smaller families with severe disease expression were shown to carry a LMNA-p.Arg471Cys and LMNA-p.Arg471His mutation, respectively. LMNA gene and protein expression was investigated in eight different mutation carriers by quantitative reverse transcriptase polymerase chain reaction, Western blotting, immunohistochemistry, and protein mass spectrometry. The results showed that all mutation carriers incorporated mutated lamin protein into the nuclear envelope. Interestingly, the ratio of mutated to wild-type protein was only 30:70 in LMNA-p.Arg216Cys carriers with a favourable prognosis while LMNA-p.Arg471Cys and LMNA-p.Arg471His carriers with a more severe outcome expressed significantly more of the mutated protein by a ratio of 50:50. CONCLUSION The clinical findings indicated that some LMNA mutations may be associated with a favourable prognosis and a low risk of sudden death. Protein expression studies suggested that a severe outcome was associated with the expression of high amounts of mutated protein. These findings may prove to be helpful in counselling and risk assessment of LMNA families.
Collapse
Affiliation(s)
- Rasha A Al-Saaidi
- Research Unit for Molecular Medicine, Aarhus University and University Hospital, Aarhus, Denmark
| | | | - Rune I D Birkler
- Research Unit for Molecular Medicine, Aarhus University and University Hospital, Aarhus, Denmark
| | - Johan Palmfeldt
- Research Unit for Molecular Medicine, Aarhus University and University Hospital, Aarhus, Denmark
| | - Abdelaziz Beqqali
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Yigal M Pinto
- Heart Failure Research Center, Academic Medical Center, Amsterdam, The Netherlands
| | - Peter H Nissen
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Ulrik Baandrup
- Centre for Clinical Research, North Denmark Regional Hospital/Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Henning Mølgaard
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas M Hey
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Hans Eiskjaer
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Bross
- Research Unit for Molecular Medicine, Aarhus University and University Hospital, Aarhus, Denmark
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| |
Collapse
|
5
|
Dahl JS, Christensen NL, Videbæk L, Poulsen MK, Carter-Storch R, Hey TM, Pellikka PA, Steffensen FH, Møller JE. Left Ventricular Diastolic Function Is Associated With Symptom Status in Severe Aortic Valve Stenosis. Circ Cardiovasc Imaging 2014; 7:142-8. [DOI: 10.1161/circimaging.113.000636] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [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: 11/16/2022]
Abstract
Background—
In aortic valve stenosis (AS), the occurrence of heart failure symptoms does not always correlate with severity of valve stenosis and left ventricular (LV) function. Therefore, we tested the hypothesis that symptomatic patients with AS have impaired diastolic, longitudinal systolic function, and left atrial dilatation compared with asymptomatic patients.
Methods and Results—
In a retrospective descriptive study, we compared clinical characteristics and echocardiographic parameters in 99 symptomatic and 139 asymptomatic patients with severe AS and LV ejection fraction ≥50%. Independent predictors of symptomatic state were identified using logistic regression analysis. Symptomatic patients were younger (72±10 versus 76±12 years of age;
P
=0.002), presented less often with atrial fibrillation (13% versus 24%;
P
=0.05) and chronic obstructive pulmonary disease (2% versus 19%;
P
<0.001), and had a lower prevalence of hypertension (73% versus 40%;
P
<0.001). Despite similar AS severity, symptomatic patients had higher LV mass index (120±39 versus 95±25 g/m
2
;
P
<0.0001), increased relative wall thickness (0.61±0.15 versus 0.50±0.11;
P
<0.0001), shorter mitral deceleration time (199±58 versus 268±62 ms;
P
<0.0001), and increased left atrial volume index (49±18 versus 42±15 mL/m
2
;
P
=0.02). When adjusting for age, history of hypertension, atrial fibrillation, and chronic obstructive pulmonary disease in a multivariable logistic regression analysis, LV mass index, relative wall thickness, left atrial volume index, and deceleration time were still associated with the presence of symptoms.
Conclusions—
The present study demonstrates that symptomatic status in severe AS is associated with impaired diastolic function, LV hypertrophy, concentric remodeling, and left atrial dilatation when corrected for indices of AS severity.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00294775.
Collapse
Affiliation(s)
- Jordi S. Dahl
- From the Department of Cardiology, Odense University Hospital, Odense, Denmark (J.S.D., N.L.C., L.V., M.K.P., R.C.-S., T.M.H., J.E.M.); Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (P.A.P.); and Department of Cardiology, Vejle Hospital, Vejle, Denmark (F.H.S.)
| | - Nicolaj L. Christensen
- From the Department of Cardiology, Odense University Hospital, Odense, Denmark (J.S.D., N.L.C., L.V., M.K.P., R.C.-S., T.M.H., J.E.M.); Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (P.A.P.); and Department of Cardiology, Vejle Hospital, Vejle, Denmark (F.H.S.)
| | - Lars Videbæk
- From the Department of Cardiology, Odense University Hospital, Odense, Denmark (J.S.D., N.L.C., L.V., M.K.P., R.C.-S., T.M.H., J.E.M.); Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (P.A.P.); and Department of Cardiology, Vejle Hospital, Vejle, Denmark (F.H.S.)
| | - Mikael K. Poulsen
- From the Department of Cardiology, Odense University Hospital, Odense, Denmark (J.S.D., N.L.C., L.V., M.K.P., R.C.-S., T.M.H., J.E.M.); Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (P.A.P.); and Department of Cardiology, Vejle Hospital, Vejle, Denmark (F.H.S.)
| | - Rasmus Carter-Storch
- From the Department of Cardiology, Odense University Hospital, Odense, Denmark (J.S.D., N.L.C., L.V., M.K.P., R.C.-S., T.M.H., J.E.M.); Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (P.A.P.); and Department of Cardiology, Vejle Hospital, Vejle, Denmark (F.H.S.)
| | - Thomas M. Hey
- From the Department of Cardiology, Odense University Hospital, Odense, Denmark (J.S.D., N.L.C., L.V., M.K.P., R.C.-S., T.M.H., J.E.M.); Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (P.A.P.); and Department of Cardiology, Vejle Hospital, Vejle, Denmark (F.H.S.)
| | - Patricia A. Pellikka
- From the Department of Cardiology, Odense University Hospital, Odense, Denmark (J.S.D., N.L.C., L.V., M.K.P., R.C.-S., T.M.H., J.E.M.); Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (P.A.P.); and Department of Cardiology, Vejle Hospital, Vejle, Denmark (F.H.S.)
| | - Flemming H. Steffensen
- From the Department of Cardiology, Odense University Hospital, Odense, Denmark (J.S.D., N.L.C., L.V., M.K.P., R.C.-S., T.M.H., J.E.M.); Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (P.A.P.); and Department of Cardiology, Vejle Hospital, Vejle, Denmark (F.H.S.)
| | - Jacob E. Møller
- From the Department of Cardiology, Odense University Hospital, Odense, Denmark (J.S.D., N.L.C., L.V., M.K.P., R.C.-S., T.M.H., J.E.M.); Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (P.A.P.); and Department of Cardiology, Vejle Hospital, Vejle, Denmark (F.H.S.)
| |
Collapse
|