European Journal of Echocardiography最新文献

{"title":"Non-invasive assessment of cardiac percutaneous occluders healing process using computed tomography imaging: a proof of concept study","authors":"E. Perdreau, Z. Jalal, R. Walton, M. Sigler, H. Cochet, J. Naulin, B. Quesson, O. Bernus, J. Thambo","doi":"10.1093/EHJCI/JEAA356.246","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.246","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: Other. Main funding source(s): National Research Agency (ANR) French Federation of Cardiology : “Aide à la recherche par équipe 2018, Cardiopathies de l’enfant”\u0000 \u0000 \u0000 \u0000 After percutaneous implantation of an atrial septal defect (ASD) occluder device, a complex healing process leads to the device coverage within several months. However, an unexplained incomplete device coverage is at risk of complications such as thrombosis or infectious endocarditis.\u0000 \u0000 \u0000 \u0000 The aim of the study was to assess the device coverage process of ASD occluder devices in a chronic sheep model using micro-CT technology.\u0000 \u0000 \u0000 \u0000 After percutaneous creation of an ASD by catheterization, 8 ewes (mean age 5.4 ± 0.7 yo and mean weight 55.6 ± 7.9 kg) were implanted with a 16-mm Nit-Occlud ASD-R occluder (PFM medical, Cologne, Germany) and were followed for 1 month (N = 3) and 3 months (N =5). After heart explantation, a iodine contrast agent was used to enhance the tissue signal. The device coverage was then assessed by micro-CT and the results were compared to histology, used as the gold standard for healing evaluation. The micro-CT image resolution was 41.7 µm. Reconstruction was performed in 2D and 3D with Amira® software, allowing to obtain images that were exploited by a code to measure the surface for each disk of the analyzed devices. Histological study was performed after resin embedding and Richardson blue staining was used.  The pathologist was blinded to the duration of animals’ follow-up and micro-CT results.\u0000 \u0000 \u0000 \u0000 ASD creation and device closure was successful in 100% animals without complications. Following heart explantation, macroscopic assessment of devices showed that the coverage was complete for the left-side disk regardless of the duration of the follow-up and variable for the right-side disk, depending of the protrusion of this disk. 2D and 3D micro-CT analysis allowed an accurate evaluation of device coverage of each disk and was overall well correlated to histology slices (cf Figure). Surface calculation from micro-CT images showed that the median surface of coverage was 93 ± 8% for the left-side disk and 55 ± 31% for the right-side disk.\u0000 \u0000 \u0000 \u0000 This preliminary study made the proof of concept that micro-CT is a reliable tool to assess the coverage of intra-cardiac occluders in vitro. The translation to clinical practice is challenging but would allow an individual follow-up, to avoid thrombotic or infective complications.\u0000 Abstract Figure.\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84843238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay of systemic atrial and ventricular function in patients with transposition of the great arteries after arterial switch operation","authors":"A. Schoeber, M. Jerosch-Herold, P. Wegner, I. Voges, D. Gabbert, H. Pham, J. Scheewe, H. Kramer, C. Rickers","doi":"10.1093/EHJCI/JEAA356.413","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.413","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 Background/Introduction: The role of systemic atrial (LA) function and its interplay with the systemic ventricle (LV) in patients with transposition of the great arteries (TGA) after arterial switch operation (ASO) is currently not well defined.\u0000 \u0000 \u0000 \u0000 Investigate the role of LA function and its interplay with the LV.\u0000 \u0000 \u0000 \u0000 Between 2007 and 2018 patients with TGA corrected by ASO and control patients of comparable age, sex, height but without known cardiovascular disease were included in this prospective single centre analysis of 3 Tesla cardiac magnetic resonance cine imaging studies of atrial and ventricular function. Additionally, in TGA patients extracellular volume fraction (ECV) was assessed by T1 mapping and global longitudinal strain (GLS) by feature tracking.\u0000 \u0000 \u0000 \u0000 Overall, 81 TGA (16.3 [IQR 10.5-21.2] years, 32% female) and 30 control patients (11.9 [IQR 8.7-22.5] years, 63% female) were included in the current analysis. TGA patients had smaller LA maximum volume index, and reduced total atrial and conduit volume emptying. This resulted in a reduced LA reservoir and conduit function compared to controls. In TGA, a higher LA active/conduit and active/total ratio indicated impaired passive filling of the LV. (Table 1)\u0000 The median ECV was 28.3% (IQR 25.8-33.9) and the median GLS -24.2% (IQR -28.6- -20.4) in TGA patients. LA reservoir (Fig. 1A), conduit and contractile function showed a negative correlation with GLS (r=-0.470, p < 0.001, r=-0.270, p = 0.022 and r=-0.257, p = 0.030, respectively). Interestingly, the LA active/conduit ratio (Fig. 1B) and the active/total ratio showed a positive correlation with ECV (r = 0.418, p = 0.002 and r = 0.339, p = 0.013, respectively).\u0000 \u0000 \u0000 \u0000 Impaired LA function is frequent among patients with TGA following ASO. The impairment of LA function is linked to both LV dysfunction and fibrosis.\u0000 Table 1 Variable TGA (n = 81) Control (n = 30) p-value LAVI max.[ml/m²] 37.8 (29.9-42.9) 42.02 (38.3-51.6) 0.002 LAVI total emptying [ml/m²] 16.8 (13.7-20.8) 24.3 (20.6-29.4) <0.001 LAVI conduit emptying [ml/m²] 10.3 (8.1-13.9) 17.5 (15.2-20.8) <0.001 LAVI active [ml/m²] 6.7 (4.1-8.6) 6.4 (5.0-7.9) 0.984 LA-EF-reservoir [%] 46.6 (42.0-50.5) 57.2 (51.2-60.1) <0.001 LA-EF-conduit [%] 28.1 (23.4-34.3) 42.5 (35.4-45.8) <0.001 LA-EF-active [%] 24.11 (17.9-29.1) 25.7 (21.5-29.7) 0.339 LA active/conduit ratio 0.60 (0.41-0.90) 0.37 (0.28-0.44) <0.001 LA active/total ratio 0.38 (0.29-0.47) 0.27 (0.22-0.30) <0.001 Differences in left atrial function between TGA and control patients Abstract Figure. Fig. 1A and B\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87238712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the CHA2DS2-VASc score in predicting ischemic stroke and death in patients with acute myocardial infarction without atrial fibrillation","authors":"A. Marques, A. Briosa, A. R. Pereira, S. Alegria, J. Santos, I. Rangel, I. João, H. Pereira","doi":"10.1093/EHJCI/JEAA356.432","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.432","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 \u0000 \u0000 \u0000 on behalf of the investigators of the Portuguese Registry of Acute Coronary Syndromes\u0000 \u0000 \u0000 \u0000 The CHA2DS2-VASc score is used in clinical practice to stratify the risk of stroke in patients (pts) with atrial fibrillation (AF). Its usefulness in the population of pts with acute myocardial infarction without AF is not well known.\u0000 \u0000 \u0000 \u0000 To investigate whether CHA2DS2-VASc predicts ischemic stroke and death during hospital stay in pts with acute myocardial infarction without known AF. To determine independent predictors of ischemic stroke in this population.\u0000 \u0000 \u0000 \u0000 A multicentre, retrospective study was performed during 01/10/2010-04/09/2019 period, and included all pts admitted due to acute myocardial infarction. Pts with previous AF, AF rhythm in the electrocardiogram at admission or AF during hospital stay were excluded. Statistical analysis with Kaplan-Mayer and Cox regression was applied.\u0000 \u0000 \u0000 \u0000 Of 29851 pts admitted with acute myocardial infarction, were included in our study 19218 pts (74% male, mean age of 65 ± 14 years). \u0000 During hospital stay, 78 (0.4%) pts had an ischemic stroke and 462 (2.4%) pts died. \u0000 The event-free survival analysis showed significant differences according to the CHA2DS2-VASc score at admission (log rank test p = 0.015 for ischemic stroke; log rank test p < 0.001 for in-hospital mortality). (Figure) \u0000 The CHA2DS2-VASc score demonstrated a good predictive accuracy for in-hospital mortality (area under the ROC curve 0.69; 95% CI 0.67-0.72; p < 0.001). The area under the ROC curve indicates that the CHA2DS2-VASc score performed modestly for ischemic stroke (0.62; 95% CI 0.56-0.68; p < 0.001). \u0000 In univariate analysis, the factors that were positively associated with ischemic stroke during hospital stay were CHA2DS2-VASc, absence of previous therapy with statin, time between cardiac symptoms and hospital admission, absence of chest pain, Killip-Kimball class, cardiorespiratory arrest, complete left ventricular block and left ventricle ejection fraction <50% (p < 0.05). \u0000 After multivariate analysis, CHA2DS2-VASc≥3 (HR 2.25; 95% CI 1.37-3.71; p = 0.001), absence of chest pain (HR 3.17; CI 1.44-6.14, p < 0.001) and previous therapy with statin (HR 0.39; 95% CI 0.22-0.67; p = 0.001) were independent predictors of ischemic stroke.\u0000 \u0000 \u0000 \u0000  Among patients with acute myocardial infarction without known atrial fibrillation, the CHA2DS2-VASc score was associated with risk of ischemic stroke and death during hospital stay. This score may be useful for estimating the risk of stroke and in-hospital mortality in these population without known atrial fibrillation.\u0000 Abstract Figure.\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87584542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular adaptation after liver transplantation. Ventricular changes detect by 2d echocardiography and by speckle tracking","authors":"SM Alharbi, A. Alfehaid, A. Eltayeb, A. Alsomali, D. Galzerano, B. Alamro, M. Pirisi, R. Troisi, O. Vriz","doi":"10.1093/EHJCI/JEAA356.150","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.150","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 Background. Patients who underwent liver transplantation (LT) may suffer from heart disease that can be related to the liver disease itself or to other  associated pathologies.  It has been suggested that there is a specific heart disease associated with cirrhosis, termed cirrhotic cardiomyopathy which  is characterized by the presence of increased baseline cardiac output, systolic and diastolic left ventricular (LV) dysfunction and increased in pulmonary artery systolic pressure (PASP). The aim of the study was to evaluate the cardiac structural and functional changes after LT and eventually to determine the improvement in PASP.\u0000 Method. 51 patients were considered for the analysis who had a good quality pre and post LT echocardiograms.  The echo-study was done preLT and  repeated within 4 months and 3 years after LT. All studies were red of-line, global longitudinal stains (GLS) of the LV and right ventricle (RV) were analyzed using TOMTEC application. A Paired T-test was used to compare the echocardiographic parameters.  The group was also divided according to tertiles of pre LT PASP for the evaluation of pulmonary pressure.\u0000 Results . Patients` mean age was 58.1 ± 7.8 years, 32 (62.6%) men, mean time between the 2 echocardiographic studies was 529.2 ± 471 days. After LT all the patients were on immunosuppressant therapy (calcineurin inhibitors, ciclosporin and/or tacrolimus).  After LT  blood pressure (BP) (83.4 ± 16 vs 91.5 ± 14 mmHg, p = 0.009 for mean BP ), heart rate (72.5 ± 15.2 vs 80.6 ± 15.3 bpm, p = 0.004), increased as LV mass index (78.6 ± 21.1 to 91.4 ± 29,  p= 0.003) and relative wall thickness (0.34 ± 0.06 to 0.39 ± 0.08,  p = 0.001).  LV ejection fraction did not change while there was a significant decrease in LV GLS (-20.9 ± 4.4% vs -17.4 ± 3.9%, p < 0.0001), impaired diastolic function (E/A 1.12 ± 0.5 vs 0.94 ± 0.4, p = 0.002) and increase in LV diastolic filling pressure (E/E’ 7.7 ± 3.6 vs 8.9 ± 3.6, p = 0.018).  PASP increased (26.6 ± 8 vs 30.8 ± 11 mmHg, p = 0.018)  and  TAPSE (24.1 ± 4.5 vs 21.6 ± 3.9 mm, p = 0.002) decresed.  The pre and post echo data, were divided in preLT PASP to see if there was any tendency to decrease in PASP after LT. A progressive increase in LV remodeling and impaired diastolic function, RV- pulmonary arterial coupling decreased as an index of RV maladaptation to the increase PASP as tertiles of in PASP increased.\u0000 Conclusion. Increased in BP has been found in patients after LT , likely related to immensuppressive therapy. LV remodeling, impaired diastolic function were likely a conseguence of increase in BP and the increased in PASP and worst RV- pulmonary circulation coupling was secondary to impaired diastolic function and increased filling pressure. After LT, patients require particular clinical attention and echocardiographic monitoring included GLS for target organ damage and  prompt adequate therapy at least in terms of BP control to avoid later cardi","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88240190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac resynchronization therapy improves left atrial reservoir function through resynchronization of the left atrium in patients with heart failure","authors":"Kumiko Dokuni, Kensuke Matsumoto, Kazuhiro Tatsumi, Ayu Shono, Makiko Suzuki, Keiko Sumimoto, Yusuke Tanaka, Kentarou Yamashita, Nao Shibata, S. Yokota, M. Sutou, Hiroshi Tanaka, K. Kiuchi, K. Fukuzawa, K. Hirata","doi":"10.1093/EHJCI/JEAA356.123","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.123","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 \u0000 \u0000 \u0000 The structural remodeling of the left atrium (LA) has been proposed as an important determinant of adverse outcomes in patients with heart failure (HF). However, little is known about the potential impact of LA mechanical dyssynchrony on its reservoir function and the prognosis of patients with HF. In addition, it has not been fully investigated whether cardiac resynchronization therapy (CRT) is also beneficial to LA function.\u0000 \u0000 \u0000 \u0000 The purposes of this study were to test whether left ventricular (LV) dyssynchrony may negatively affect LA synchronicity and reservoir function, and to assess whether residual LA dyssynchrony after CRT affects the prognosis in patients with HF with reduced ejection fraction (HFrEF).\u0000 \u0000 \u0000 \u0000 This study included total of 90 subjects: 40 HFrEF with a wide-QRS complex (≧130 ms), 28 HFrEF with a narrow-QRS, and 22 age- and sex-matched normal controls. LA global longitudinal strain (LA-GLS) and LA dyssynchrony were quantified using speckle-tracking strain analysis. LA dyssynchrony was defined as the maximal difference of time-to-peak strain (LA time-diff). All wide-QRS HFrEF received CRT, and event-free survival was tracked for 24 months.\u0000 \u0000 \u0000 \u0000 At baseline, HFrEF patients showed significant LA remodeling coupled with the reduced LA reservoir function, as evidenced by larger LA volume index (LAVi: 46 ± 16 vs. 30 ± 14 mL/m², P < 0.01) and smaller LA-GLS (13.0 ± 4.8 vs. 30.6 ± 10.7%, P < 0.01). Of note was that, not only LV dyssynchrony (381 ± 178 vs. 177 ± 62 ms, P < 0.01) but also LA dyssynchrony (298 ± 136 vs. 186 ± 78 ms, P < 0.01) were significantly larger in patients with HFrEF compared to normal subjects and this applied even more to patients with a wide-QRS complex. All patients with a wide-QRS complex underwent CRT, and only responders exhibited the significant decrease in LA time-diff (from 338 ± 123 to 245 ± 141 ms, P < 0.05) and increase in LA-GLS (from 11.9 ± 4.7 to 19.6 ± 10.1%, P < 0.05) in parallel with the reduction in LAVi (from 48 ± 17 to 37 ± 18 mL/m², P < 0.05) at 6 months after CRT. Receiver operating characteristic curve analysis identified the optimal cut-off value of LA time-diff at 6 months after CRT as 202 ms (P < 0.05) and that of LA-GLS as 14.6% (P < 0.05) for predicting adverse cardiac events. The patients whose LA time-diff reduced <202 ms after CRT showed significantly favorable event-free survival than the others. Similarly, the patients whose LA-GLS improved >14.6% after CRT exhibited significantly favorable event-free survival than the others (P < 0.05, respectively). Of note was that, when the patients were restricted to CRT responders only, those who showed LA time-diff less than 202 ms at 6 months after CRT almost never experienced cardiac events (P < 0.05).\u0000 \u0000 \u0000 \u0000 The improved LV coordination by CRT also resulted in resynchronization of discoordinated LA wall motion and a consecutive improvement of LA reservoir function, which ultimately lead ","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87158260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of heat-not-burn compared to combustible cigarettes on coronary flow, myocardial work index and vascular function","authors":"I. Ikonomidis, K. Katogiannis, D. Vlastos, G. Kostelli, Kallirrhoe Kourea, M. Tsoumani, J. Parissis, J. Thymis, I. Andreadou, D. Alexopoulos","doi":"10.1093/EHJCI/JEAA356.098","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.098","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 Aim/Introduction:\u0000 Heat-not-burn cigarette (HNBC) constitutes a non-combustible smoke product.\u0000 \u0000 \u0000 \u0000 We compare the effects of heat-not-burn and conventional cigarettes on coronary flow, myocardial and vascular function, platelet activation and oxidative stress.\u0000 \u0000 \u0000 \u0000 We compared the effects of HNBC to those of tobacco cigarette (TCig), on arterial stiffness, oxidative stress, and platelet activation, acutely and after 1 month of switching to HNBC, as well as on endothelial, myocardial, and coronary function after 1 month of switching to HNBC. In the acute study, 50 smokers were randomized into smoking a single Tcig or an HNBC and after 60 minutes were crossed over to the alternate smoking (HNBC or Tcig). For the chronic phase, 75 smokers were examined. Of those, 50 were switched to HNBC and 25 continued Tcig for 1 month. Pulse wave velocity (PWV) and biomarkers [malondialdehyde (MDA), protein carbonyls (PC), and thromboxane B2 (TXB2)] were assessed in the acute and chronic study. Myocardial deformation [global longitundinal strain (GLS), myocardial work index (GWI) and wasted myocardial work (GWW)], coronary flow reserve (CFR) by Doppler echocardiography, total arterial compliance (TAC), and flow-mediated dilation (FMD) were additionally assessed in the chronic study.\u0000 \u0000 \u0000 \u0000 Compared to baseline, TCig smoking acutely increased exhaled CO, PWV, MDA, and TxB2 (p < 0.05), while no changes were observed after HNBC. Compared to resuming Tcig smoking, switching to HNBC for 1 month improved CO (mean change: -55% vs -2.4%), FMD ( +55% vs +15%), CFR (+46% vs +4%), TAC (+9% vs -0.5%), GLS (+6% vs +1%), GWW (-19% vs +0.5%), MDA (-19% vs 1 %), and TxB2 (-12% vs 4%) (p < 0.05 for all comparisons).\u0000 \u0000 \u0000 \u0000 HNBCs exert a less detrimental effect on vascular, cardiac and platelet function than combustible tobacco.\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85537113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of cardiac amyloidosis in patients with aortic stenosis: a systematic review and meta-analysis","authors":"F. Ricci, L. Ceriello, M. Khanji, G. Dangas, C. Ducci, M. Mauro, A. Fedorowski, M. Zimarino, S. Gallina","doi":"10.1093/EHJCI/JEAA356.364","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.364","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 \u0000 \u0000 \u0000  Cardiac amyloidosis (CA) has been increasingly recognized in elderly patients with aortic stenosis (AS), but with uncertain prognostic significance.\u0000 \u0000 \u0000 \u0000 We performed a systematic review and meta-analysis to clarify whether concurrent CA portends excess mortality in patients with aortic stenosis AS.\u0000 \u0000 \u0000 \u0000 Our systematic review of the literature published through June 2020, sought observational studies reporting summary-level outcome data of all-cause mortality in AS patients with or without concurrent CA. Pooled estimate of Mantel-Haenszel odds ratio (OR) and 95% confidence intervals (CIs) for all-cause death was assessed as the primary endpoint. We performed subgroup analysis stratified by severity of left ventricular hypertrophy (LVH) and study-level meta-regression analysis to explore the effect of covariates on summary effect size and to address statistical heterogeneity.\u0000 \u0000 \u0000 \u0000 We identified 4 studies including 609 AS patients (9% AS-CA; 69% men; age, 84 ± 5 years). The average follow-up was 20 ± 5 months. Compared with lone AS, AS-CA was associated with 2-fold increase in all-cause mortality (pooled OR: 2.30; 95% CI: 1.02-5.18; I2 = 62%). When analysed according to LVH severity, pooled ORs (95% CI) for all-cause mortality were 1.29 (0.65-2.22) for mild LVH (≤16 mm), and 4.81 (2.19-10.56) for moderate/severe LVH (>16 mm). Meta-regression analysis confirmed a stronger relationship proportional to the degree of LVH, regardless of age and aortic valve replacement, explaining between-study heterogeneity variance.\u0000 \u0000 \u0000 \u0000 CA heralds significantly higher risk of all-cause death in elderly patients with AS. Severity of LVH appears to be a major prognostic determinant in patients with dual AS-CA pathology.\u0000 Abstract Figure.\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82381038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global longitudinal strain in patients with severe aortic stenosis: a comparison between cardiac magnetic resonance imaging feature tracking and speckle tracking echocardiography","authors":"Minna M Kylmälä, S. Syvaranta, R. Halva, R. Orn, H. Rajala, M. Holmström, S. Kivistö, J. Lommi, S. Suihko, V. Uusitalo","doi":"10.1093/EHJCI/JEAA356.270","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.270","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: None.\u0000 \u0000 \u0000 \u0000 Global longitudinal strain (GLS) by echocardiography is a sensitive method for measuring left ventricular (LV) function, and of better prognostic value in valvular heart disease than ejection fraction (EF). Cardiac magnetic resonance imaging (CMR) is the most accurate method for measuring LV volume and EF, but GLS has not been possible to measure by CMR until recently.\u0000 \u0000 \u0000 \u0000 This study compares GLS obtained by CMR and echocardiography in patients with severe aortic valve stenosis. Normal values for GLS by CMR are reported as well.\u0000 \u0000 \u0000 \u0000 GLS was measured in 32 patients with severe aortic valve stenosis with speckle tracking echocardiography, using GE Vivid E95 (n = 15) and Philips EPIQ (n = 17) ultrasound machines, as well as with CMR (Avanto 1.5T FIT, Siemens Medical Solutions). For normal values, GLS was measured by CMR in 9 healthy controls. Endo- and epicardial borders of two, three and four chamber cine images were traced for CMR GLS using dedicated software (Qstrain 2.0, Medis, NL). Both CMR and Vivid E95 measured midmyocardial strain, whereas the EPIQ AutoStrain method measures endomyocardial strain. Absolute values of GLS are reported. Pearson correlation coefficient was calculated and paired Student’s t-test was used for comparisons.\u0000 \u0000 \u0000 \u0000 A significant correlation (r = 0.45, p = 0.01) was found between echocardiographic and CMR GLS (Figure). GLS by Vivid E95 had a very good correlation with CMR GLS (r = 0.84, p = 0.0001), whereas GLS by Philips EPIQ did not correlate significantly (r = 0.14, p = 0.01). In patients with aortic stenosis and healthy controls, the average GLS by CMR was 18.3 ± 3% and 20.9 ± 2% respectively. The average GLS by CMR was comparable to that obtained by GE Vivid E95 (17.3 ± 4% vs. 17.2 ± 3%, p = 0.92), and higher than by Philips EPIQ (19.2 ± 2% vs. 15.4 ± 2%, p < 0.0001).\u0000 \u0000 \u0000 \u0000 This study shows that GLS by CMR is feasible and correlates with GLS obtained by echocardiography, especially when quantifying midmyocardial strain. Echocardiographic GLS values based on endomyocardial strain were lower.\u0000 Patient characteristics Age 75 ± 14 y NYHA 1 1 (3 %) NYHA 2 20 (67 %) NYHA 3 8 (27 %) NYHA 4 1 (3 %) CMR EF 66 ± 8 % AVA 0.7 ± 0.2 cm² NYHA = NYHA class of symptoms, EF = ejection fraction by CMR, AVA = aortic valve area by echocardiography Abstract Figure. GLS by CMR vs. Echocardiography\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82675009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular systolic function decreases in lamin a/c cardiomyopathy wihout concomitant ventricular dilatation","authors":"ES Eystein Skjolsvik, Øyvind H. Lie, M. Chivulescu, M. Ribe, Aic Anna Isotta Castrini, T. Edvardsen, K. Haugaa","doi":"10.1093/EHJCI/JEAA356.385","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.385","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: Foundation. Main funding source(s): This work was supported by the Norwegian Research Council [203489/030]\u0000 \u0000 \u0000 \u0000 Department of Cardiology, Research group for genetic cardiac diseases and sudden cardiac death, Oslo University Hospital, Rikshospitalet, Oslo, Norwa\u0000 \u0000 \u0000 \u0000 Lamin A/C disease is an inheritable cardiomyopathy characterized by conduction abnormalities, ventricular arrhythmias and end stage heart failure with complete age-related penetrance.\u0000 \u0000 \u0000 \u0000 To assess left ventricular structural and functional progression in patients with lamin A/C cardiomyopathy.\u0000 \u0000 \u0000 \u0000 We included and followed consecutive lamin A/C genotype positive patients with clinical examination and echocardiography at every visit. We evaluated progression of left- ventricular size and function by mixed model statistics.\u0000 \u0000 \u0000 \u0000 We included 101 consecutive lamin A/C genotype positive patients (age 44 [29-54] years, 39% probands, 51%female) with 576 echocardiographic exams during 4.9 (IQR 2.5-8.1) years of follow-up. LV ejection fraction (LVEF) declined from 50 ± 12% to 47 ± 13%, p < 0.001 (rate -0.5%/year). LV end diastolic volumes (LVEDV) remained stationary with no significant dilatation in the total population (136 ± 45ml to 138 ± 43ml, p = 0.60), (Figure). In the subgroup of patients >58 years, we observed a decline in LV volumes 148, SE 9 ml to 140, SE 9 ml p < 0.001 (rate -2.7 ml/year) towards end stage heart failure.\u0000 \u0000 \u0000 \u0000 LVEF deteriorated, while LV size remained unchanged during 4.9 years of follow-up in patients with lamin A/C cardiomyopathy. In patients <58 years, we observed a reduction in LV volumes. These findings represent loss of LV function without the necessary compensatory dilation to preserve stroke volume indicating high risk of decompensated end stage heart failure in lamin A/C.\u0000 Abstract Figure.\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81896366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of idiopathic tricuspid regurgitation","authors":"Lw Li, Huang, WH Lee, W. Tsai","doi":"10.1093/EHJCI/JEAA356.058","DOIUrl":"https://doi.org/10.1093/EHJCI/JEAA356.058","url":null,"abstract":"\u0000 \u0000 \u0000 Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Science and Technology, Executive Yuan, Taiwan\u0000 \u0000 \u0000 \u0000 Tricuspid regurgitation (TR) were traditionally classified as primary and secondary TR. Recently a new category of TR was developed and named as idiopathic TR. However, diagnosis and characteristics of idiopathic TR were not consisted. We tried to identify idiopathic TR by a new systemic approach and studied its characteristics.\u0000 \u0000 \u0000 \u0000 207 consecutive patients (mean age 71.2 ± 14.7 years, 40.6% male) identified as significant TR (moderate and severe) by echocardiography were recruited. We classified TR by a new systemic approach. The classification process started from identified primary TR, then pacemaker related TR, left heart disease related TR, congenital heart related TR, right ventricular (RV) myopathy, pulmonary hypertension and, finally idiopathic TR step by step.\u0000 \u0000 \u0000 \u0000 There were 29 (14%) primary TR, 18 (8.7%) pacemaker related, 81 (39.1 %) left heart diseases, 6 (2.9%) congenital heart diseases, 3 (1.4%) RV myopathy, 27 (13%) pulmonary hypertension, and 43 (20.8%) idiopathic TR. Mean age of idiopathic TR was 72.9 ± 11.4 years and 39.5% was male which were not different from other groups. Atrial fibrillation was presented highest in patients with pacemaker related TR (77.8%) and left heart disease (55.6%), lowest in primary TR (24.1%) and pulmonary HT (25.9%), and modest in idiopathic TR (44.2%). Among the echocardiographic characteristics of right heart measurements, idiopathic TR had lowest TR maximal velocity (3.0 ± 0.3 m/s), pulmonary (41.2 ± 8.7 mmHg) and right atrium pressure (5.3 ± 0.3 mmHg; all p <0.001). Idiopathic TR had smallest RV wall thickness (4.5 ± 1.4 mm; p = 0.008), tricuspid annulus diameter (3.2 ± 0.7 cm; p = 0.001), and right atrial area (18.9 ± 8.4 cm2; p <0.001). RV function represented as tricuspid annulus velocity S’ (12.8 ± 3.3 cm/s; p = 0.011) and RV fractional area change FAC (42.6 ± 16.0 %; p <0.001) were best in idiopathic TR. RV dysfunction (FAC < 35%) was lowest (14%) in idiopathic TR.\u0000 \u0000 \u0000 \u0000 Idiopathic TR had better RV function then other types of TR. Idiopathic TR can be regarded as a unique disease category in studying TR.\u0000","PeriodicalId":11963,"journal":{"name":"European Journal of Echocardiography","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78287345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}