1
|
Karsenty C, Alattar Y, Mousseaux E, Marcilhacy G, Gencer U, Craiem D, Iserin L, Ladouceur M, Legendre A, Laredo M, Bonnet D, Malekzadeh-Milani S, Soulat G. 4D flow magnetic resonance imaging to assess right ventricular outflow tract in patients undergoing transcatheter pulmonary valve replacement. Rev Esp Cardiol (Engl Ed) 2023; 76:793-802. [PMID: 36921915 DOI: 10.1016/j.rec.2023.02.010] [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] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/22/2023] [Indexed: 03/14/2023]
Abstract
INTRODUCTION AND OBJECTIVES Magnetic resonance imaging (MRI) including 4D flow is used before percutaneous pulmonary valve implantation (PPVI). As PPVI is limited by the size of the right ventricular outflow tract (RVOT), accurate sizing is needed to plan the intervention. The aim of this study was to compare different MRI modalities and invasive angiography to balloon sizing of RVOT. METHODS Single-center prospective study of patients who underwent PPVI for isolated pulmonary regurgitation assessed by 4D flow MRI, 3D steady-state free precession/gradient echo (3D SSFP/GRE) and contrast magnetic resonance angiography. Balloon sizing was considered as the reference. RESULTS A total of 23 adults were included (mean age, 38.4±12.5 years). Eighteen patients underwent successful primary PPVI. The average of the narrowest RVOT diameter was 25.4±4.3 mm by balloon sizing. Compared to balloon sizing, RVOT diameters were better correlated when estimated by systolic 4D flow MRI (r=0.89, P<.001) than by diastolic 4D flow MRI (r=0.71, P <.001), 3D contrast magnetic resonance angiography (r=0.73; P <.001) and 3D SSFP/GRE (r=0.50; P=.04) and was not significantly correlated when estimated by 2D in diastole and systole. The mean difference between systolic 4D flow MRI and balloon sizing was 0.2 mm (95%CI, -3.5 to 3.9 mm), whereas it was wider with other techniques. CONCLUSIONS Beyond the quantification of pulmonary valve regurgitation, 4D flow allows accurate estimation of RVOT diameters, especially in systole, which is fundamental before planning PPVI.
Collapse
Affiliation(s)
- Clément Karsenty
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Pediatric and Congenital Cardiology, Children's Hospital, CHU Toulouse, Toulouse, France; Institut des Maladies Métaboliques et Cardiovasculaires, Université de Toulouse, Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Toulouse, France; Adult Congenital Cardiology Department, Clinique Pasteur, Toulouse, France.
| | - Yousef Alattar
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Elie Mousseaux
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
| | - Gabrielle Marcilhacy
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Umit Gencer
- Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
| | - Damian Craiem
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Laurence Iserin
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Magalie Ladouceur
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
| | - Antoine Legendre
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Mikael Laredo
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Institut de Cardiologie, Assistance Publique Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Damien Bonnet
- Pediatric and Congenital Department, M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Paris, France; Institut IMAGINE, Université de Paris, Paris, France
| | - Sophie Malekzadeh-Milani
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Pediatric and Congenital Department, M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Paris, France
| | - Gilles Soulat
- Adult Congenital Cardiology Department, Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France; Paris Centre de Recherche Cardiovasculaire (PARCC), Université de Paris, Institut National de la Santé et de la Recherche Médicale (INSERM) Paris, France
| |
Collapse
|
2
|
Soulat G, Alattar Y, Ladouceur M, Craiem D, Pascaner A, Gencer U, Malekzadeh-Milani S, Iserin L, Karsenty C, Mousseaux E. Discordance between 2D and 4D flow in the assessment of pulmonary regurgitation severity: a right ventricular remodeling follow-up study. Eur Radiol 2023; 33:5455-5464. [PMID: 36905468 DOI: 10.1007/s00330-023-09502-6] [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: 08/12/2022] [Revised: 12/06/2022] [Accepted: 02/06/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVES Pulmonary regurgitation (PR) is common in adult congenital heart disease (ACHD). 2D phase contrast MRI is the reference method for the quantification of PR and helps in the decision of pulmonary valve replacement (PVR). 4D flow MRI can be an alternative method to estimate PR but more validation is still needed. Our purpose was to compare 2D and 4D flow in PR quantification using the degree of right ventricular remodeling after PVR as the reference standard. METHODS In 30 adult patients with a pulmonary valve disease recruited between 2015 and 2018, PR was assessed using both 2D and 4D flow. Based on the clinical standard of care, 22 underwent PVR. The pre PVR estimate of PR was compared using the post-operative decrease in right ventricle end-diastolic volume on follow-up exam as reference. RESULTS In the overall cohort, regurgitant volume (Rvol) and regurgitant fraction (RF) of PR measured by 2D and 4D flow were well correlated but with moderate agreement in the overall cohort (r = 0.90, mean diff. -14 ± 12.5 mL; and r = 0.72, mean diff. -15 ± 13%; all p < 0.0001). Correlations between Rvol estimates and right ventricle end-diastolic volume decrease after PVR was higher with 4D flow (r = 0.80, p < 0.0001) than with 2D flow (r = 0.72, p < 0.0001). CONCLUSIONS In ACHD, PR quantification from 4D flow better predicts post-PVR right ventricle remodeling than that from 2D flow. Further studies are needed to evaluate the added value of this 4D flow quantification for guiding replacement decision. KEY POINTS • Using 4D flow MRI allows a better quantification of pulmonary regurgitation in adult congenital heart disease than 2D flow when taking right ventricle remodeling after pulmonary valve replacement as a reference. • A plane positioned perpendicular to the ejected flow volume as allowed by 4D flow provides better results to estimate pulmonary regurgitation.
Collapse
Affiliation(s)
- Gilles Soulat
- Université Paris cité, PARCC (Paris-Cardiovascular Research Center), INSERM 970, 20 rue Leblanc, F-75015, Paris, France.
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015, Paris, France.
| | - Yousef Alattar
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015, Paris, France
| | - Magalie Ladouceur
- Université Paris cité, PARCC (Paris-Cardiovascular Research Center), INSERM 970, 20 rue Leblanc, F-75015, Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015, Paris, France
| | - Damian Craiem
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Ariel Pascaner
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Umit Gencer
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015, Paris, France
| | - Sophie Malekzadeh-Milani
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015, Paris, France
| | - Laurence Iserin
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015, Paris, France
| | - Clement Karsenty
- Université Paris cité, PARCC (Paris-Cardiovascular Research Center), INSERM 970, 20 rue Leblanc, F-75015, Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015, Paris, France
| | - Elie Mousseaux
- Université Paris cité, PARCC (Paris-Cardiovascular Research Center), INSERM 970, 20 rue Leblanc, F-75015, Paris, France
- Assistance Publique Hôpitaux de Paris, Hôpital Européen Georges Pompidou, F-75015, Paris, France
| |
Collapse
|
3
|
El Kadri M, Al Falasi O, Ahmed R, Al Awadhi A, Altaha Z, Hillis A, Panikkaveetil B, Abdalla S, Ansel Benette H, Almubarak A, Saifuddin M, Alattar Y, Oulhaj A, AlKaabi S. Changes in QTc interval after hydroxychloroquine therapy in patients with COVID-19 infection: a large, retrospective, multicentre cohort study. BMJ Open 2022; 12:e051579. [PMID: 35140148 PMCID: PMC8829836 DOI: 10.1136/bmjopen-2021-051579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To evaluate the extent of hydroxychloroquine-induced corrected QT (QTc) prolongation and its relation to COVID-19 infection severity and incidence of polymorphic ventricular arrhythmias and sudden arrhythmic deaths. DESIGN A large-scale cohort study with retrospective analysis of baseline and on-therapy QT interval corrected using Bazett and Fridericia formulas. SETTING A multicentre study involving eight secondary and tertiary care hospitals of the Abu Dhabi Health Services Company (SEHA), United Arab Emirates. PARTICIPANTS 2014 patients consecutively admitted with PCR-confirmed SARS-CoV-2 infection between 1 March 2020 and 1 June 2020. INTERVENTIONS Treatment with hydroxychloroquine alone or in combination with azithromycin for at least 24 hours and with a baseline ECG and at least one ECG after 24 hours of therapy. MAIN OUTCOME MEASURES Maximal QTc interval prolongation and its relationship to clinical severity, polymorphic ventricular tachycardia and sudden arrhythmic death while on treatment. RESULTS The baseline QTc(Bazett) was 427.6±25.4 ms and the maximum QTc(Bazett) during treatment was 439.2±30.4 ms (p<0.001). Severe QTc prolongation (QTc ≥500 ms) was observed in 1.7%-3.3% of patients (Fridericia and Bazett, respectively). There were no cases of polymorphic ventricular arrhythmia or hydroxychloroquine-related arrhythmic death. QTc prolongation was more pronounced in combination therapy compared with hydroxychloroquine alone (22.2 ms vs 11.0 ms, p<0.001) and in patients with higher COVID-19 clinical severity (asymptomatic: 428.4±25.4 ms, severe COVID-19 infection: 452.7±35.7 ms, p<0.001). The overall in-hospital mortality was 3.97% and deceased patients had longer on-therapy QTc(Bazett) than survivors (459.8±21.4 ms vs 438.4±29.9 ms, p<0.001). CONCLUSIONS The incidence of severe QTc prolongation with hydroxychloroquine was low and not associated with ventricular arrhythmia. The safety concerns surrounding the use of hydroxychloroquine may have been overestimated; however, caution should be exercised when using hydroxychloroquine in patients with risk factors for QT prolongation.
Collapse
Affiliation(s)
- Moutaz El Kadri
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, UAE
| | - Omar Al Falasi
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Rizwan Ahmed
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, UAE
| | - Ahlam Al Awadhi
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Zainab Altaha
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Amany Hillis
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Basheer Panikkaveetil
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Sara Abdalla
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Honey Ansel Benette
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Adhba Almubarak
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | | | - Yousef Alattar
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Abderrahim Oulhaj
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, UAE
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Salem AlKaabi
- Cardiology Department, Sheikh Khalifa Medical City, Abu Dhabi, UAE
- Cardiology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| |
Collapse
|
4
|
Alattar Y, Soulat G, Gencer U, Messas E, Bollache E, Kachenoura N, Mousseaux E. Left ventricular diastolic early and late filling quantified from 4D flow magnetic resonance imaging. Diagn Interv Imaging 2022; 103:345-352. [DOI: 10.1016/j.diii.2022.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/17/2022] [Accepted: 02/09/2022] [Indexed: 01/02/2023]
|
5
|
Alattar Y, Kember G, Cada M. Closed-form approximation of symmetric thin-film multi-layer plasmonic dispersion equation solutions. Opt Express 2021; 29:5741-5754. [PMID: 33726107 DOI: 10.1364/oe.415870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/21/2021] [Indexed: 06/12/2023]
Abstract
An original asymptotic method is developed and used to find closed-form approximations to the symmetric thin-film three- and multi-layer plasmonic dispersion equations. Closed-form analysis of three-layer metal-insulator-metal (MIM: "M" is metal and "I" is insulator) and IMI devices shows a complementary physics underpinning their properties. Analysis of multi-layer symmetric devices, considered for a seven-layer MIMIMIM example, uncovers a remarkable departure from the physics governing MIM and IMI features. Multi-layer propagation length and attenuation are determined by proximity, in the space of cladding thickness and wavelength, to singularities that exist in the limit of vanishing imaginary part of the cladding dielectric constant. Exploitation of this phenomenon will expand the development of a broader range of thin-film applications in optoelectronics.
Collapse
|
6
|
Daou D, Sabbah R, Coaguila C, Alattar Y, Boulahdour H. A new era in gated myocardial perfusion imaging: Feasibility of data-driven cardiac contraction gating with multiple pinhole CZT SPECT. J Nucl Cardiol 2018; 25:257-268. [PMID: 28776313 DOI: 10.1007/s12350-017-1010-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/17/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND We previously validated the use of a data-driven cardiac respiratory-motion (RM) correction method (REGAT) applicable to CZT SPECT myocardial perfusion imaging (MPI). In this study, we adapted the same process used with REGAT for RM to generate data-driven cardiac contraction triggers and corresponding cardiac contraction-gated SPECT studies (GSPECT-DD). We aimed to study its feasibility and compare its performances to GSPECT studies generated with ECG monitor-based triggers (GSPECT-ECG). METHODS We included seven non-consecutive randomly chosen patients addressed for 1-day 99mTc-Tetrofosmin stress/rest MPI acquired with multi-pinhole CZT SPECT. We studied the degree of agreement between GSPECT-DD and GSPECT-ECG for the classification of acquired images into the 16 categories of mean cardiac cycle, and compared between the two methods the cine image quality and global LV systolic function of reconstructed studies. RESULTS We found almost perfect agreement between cardiac contraction triggers generated with data-driven and ECG monitor-based methods. As compared to GSPECT-ECG, GSPECT-DD provided comparable and well-correlated LV global systolic function parameters and similar cine image quality at both stress and rest. CONCLUSIONS Data-driven cardiac contraction gating using REGAT is feasible with low-dose and high-dose MPI CZT SPECT. It provides GSPECT-DD studies comparable to GSPECT-ECG.
Collapse
Affiliation(s)
- Doumit Daou
- EA 7334 REMES, Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France.
- Nuclear Medicine Department, Cochin University Hospital, AP-HP, 27 rue du Faubourg Saint-Jacques, 75679, Paris Cedex 14, France.
| | - Rémy Sabbah
- Nuclear Medicine Department, CHU Jean Minjoz, Besançon, France
| | - Carlos Coaguila
- Nuclear Medicine Department, Centre Hospitalier de Bigorre, Tarbes, France
| | - Yousef Alattar
- Cardiology Department, Cochin University Hospital, AP-HP, Paris, France
| | - Hatem Boulahdour
- Nuclear Medicine Department, CHU Jean Minjoz, Besançon, France
- EA 4662, Université de Franche-Comté, Besançon, France
| |
Collapse
|
7
|
Ma Y, Alattar Y, Zhou J, Eldlio M, Maeda H, Pištora J, Cada M. Semiconductor-based plasmonic interferometers for ultrasensitive sensing in a terahertz regime. Opt Lett 2017; 42:2338-2341. [PMID: 28614346 DOI: 10.1364/ol.42.002338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 05/18/2017] [Indexed: 06/07/2023]
Abstract
A robust plasmonic semiconductor-based Mach-Zehnder interferometer (MZI), which consists of a semiconductor layer with a microslit flanked by two identical microgrooves, is proposed and investigated for the terahertz sensing. The microgrooves reflect the surface plasmon polariton waves toward the microslit, where they interfere with the transmitted terahertz wave. The interference pattern is determined by the permittivities of the sensing material and semiconductor (i.e., temperature dependent), making the structure useful for the refractive index (RI) and temperature detection. A quantitative theoretical model is also developed for performance prediction and validated with a finite element method. The numerical results show that the Mach-Zehnder interferometer sensor possesses an RI sensitivity as high as 140000 nm/RIU (or 0.42 THz/RIU) and a relative intensity sensitivity of 1200%RIU-1. In addition, a temperature sensitivity of 1470 nm/K (or 4.7×10-3 THz/K) is determined. Theoretical calculations indicate that the further improvement in sensing performance is still possible through optimization of the structure. The proposed sensing scheme may pave the way for applications in terahertz sensing and integrated terahertz circuits.
Collapse
|
8
|
Soulat G, Gencer U, Kachenoura N, Stampoulis K, Alattar Y, Messas E, Villemain O, Laurent S, Mousseaux E. 9.7 THORACIC AORTA PWV ASSESSMENT BY USING 4D FLOW IN MRI. Artery Res 2016. [DOI: 10.1016/j.artres.2016.10.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
9
|
Thompson A, Alattar Y, Beshara CS, Burley RK, Stanley Cameron T, Robertson KN. Isolation and characterization of a novel tetrahydro-[2,2′]bipyrrolyl dimer as an impurity from a knorr reaction. J Heterocycl Chem 2004. [DOI: 10.1002/jhet.5570410521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|