Scandinavian Cardiovascular Journal最新文献

{"title":"Reduced left ventricular function and sustained hypertension in women seven years after severe preeclampsia.","authors":"L Gronningsaeter,&nbsp;H Skulstad,&nbsp;A Quattrone,&nbsp;E Langesaeter,&nbsp;M E Estensen","doi":"10.1080/14017431.2022.2099012","DOIUrl":"https://doi.org/10.1080/14017431.2022.2099012","url":null,"abstract":"<p><p><i>Objective</i>. To study left ventricular (LV) function and blood pressure (BP) at a long-term follow-up in women after severe pre-eclampsia. <i>Design</i>. In this single-centre, cross-sectional study, 96 patients were eligible for inclusion. LV function was examined by transthoracic echocardiography including tissue Doppler echocardiography and speckle tracking. BP was measured at rest using repeated non-invasive techniques. <i>Results</i>. We compared 36 patients with early-onset and 33 patients with late-onset pre-eclampsia with 28 healthy controls. Mean age (40 ± 3 years) and median time since delivery (7 ± 2 years) were similar across the study groups. The patients had 18% higher systolic BP (139 ± 15 mmHg) and 24% higher diastolic BP (87 ± 19 mmHg) than controls (<i>p</i> < .01). Hypertension was present in 23 patients (33%), where the estimated LV mass was 16% higher (<i>p</i> = .05) than in controls. The LV ejection fraction was 19% lower in the early-onset group (51 ± 4%; <i>p</i> = .01) and 14% lower in the late-onset group (54 ± 6; <i>p</i> = .04) compared with controls. LV global longitudinal strain was 18% lower in the patient group (-17.7 ± 2.1%) compared with controls (<i>p</i> = .01). Indicative of a more restrictive filling pattern, the diastolic indices showed a lower e' mean (<i>p</i> < .01) and subsequently higher E/e' ratio (<i>p</i> < .01). There were no significant differences in BP, systolic or diastolic function indices between the patient groups. <i>Conclusion</i>. We found sustained hypertension, higher LV mass and reduced LV systolic and diastolic function 7 y after severe pre-eclampsia. Our findings emphasize the importance of early risk stratification and clinical counselling, and follow-up for such cases.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40616472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three decades of heart transplantation: experience and long-term outcome","authors":"L. M. Nelson, K. Rossing, S. Boesgaard, H. Møller-Sørensen, C. Møller, F. Gustafsson, P. Olsen","doi":"10.1080/14017431.2022.2061726","DOIUrl":"https://doi.org/10.1080/14017431.2022.2061726","url":null,"abstract":"Abstract Objectives. Heart transplantation (HTx) has become an established treatment option in patients with end-stage heart failure. The aim of this study was to report on long-term outcome over the past three decades. Design. Consecutive adult patients receiving first-time and isolated HTx from October 3, 1990, to November 2, 2020, at Rigshospitalet, Copenhagen, Denmark, were retrospectively evaluated. Data were obtained from the Scandinavian Transplant Registry and patient medical records. Recipients were grouped by time of transplantation (early era: 1990–1999; mid era: 2000–2009; recent era: 2010–2020). Results. A total of 384 recipients (77% men, median age 50 [IQR: 40–57]) were included. Median number of HTx procedures per year was 12 (10–14). Overall, 22% of patients were bridged to HTx with a mechanical circulatory support device. Median survival for the whole cohort was 13.8 years and improved numerically from the early era (12.6 years) to the mid era (14.9 years). Median survival conditional on survival to 1-year follow-up after HTx was 16.1 years. Survival probability by Kaplan–Meier method improved significantly from the mid to the recent era (log-rank p = .02). Conclusions. Heart transplantation remains an excellent treatment for selected patients with end-stage heart failure and long-term outcome has improved significantly over the past decades.","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42113504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term prognosis after a first myocardial infarction: eight years follow up of the case-control study PAROKRANK.","authors":"Giulia Ferrannini,&nbsp;Mariam Almosawi,&nbsp;Kåre Buhlin,&nbsp;Ulf De Faire,&nbsp;Barbro Kjellström,&nbsp;Björn Klinge,&nbsp;Åke Nygren,&nbsp;Per Näsman,&nbsp;Elisabet Svenungsson,&nbsp;Lars Rydén,&nbsp;Anna Norhammar","doi":"10.1080/14017431.2022.2112072","DOIUrl":"https://doi.org/10.1080/14017431.2022.2112072","url":null,"abstract":"<p><p><i>Objective.</i> To explore long-term cardiovascular outcomes and mortality in patients after a first myocardial infarction (MI) compared with matched controls in a contemporary setting. <i>Methods</i>. During 2010-2014 the Swedish study PAROKRANK recruited 805 patients <75 years with a first MI and 805 age-, gender-, and area-matched controls. All study participants were followed until 31 December 2018, through linkage with the National Patient Registry and the Cause of Death Registry. The primary endpoint was the first of a composite of all-cause death, non-fatal MI, non-fatal stroke, and heart failure hospitalization. Event rates in cases and controls were calculated using a Cox regression model, subsequently adjusted for baseline smoking, education level, and marital status. Kaplan-Meier curves were computed and compared by log-rank test. <i>Results</i>. A total of 804 patients and 800 controls (mean age 62 years; women 19%) were followed for a mean of 6.2 (0.2-8.5) years. The total number of primary events was 211. Patients had a higher event rate than controls (log-rank test <i>p</i> < .0001). Adjusted hazard ratio (HR) for the primary outcome was 2.04 (95% CI 1.52-2.73). Mortality did not differ between patients (<i>n</i> = 38; 4.7%) and controls (<i>n</i> = 35; 4.4%). A total of 82.5% patients and 91.3% controls were event-free during the follow up. <i>Conclusions</i>. In this long-term follow up of a contemporary, case-control study, the risk for cardiovascular events was higher in patients with a previous first MI compared with their matched controls, while mortality did not differ. The access to high quality of care and cardiac rehabilitation might partly explain the low rates of adverse outcomes.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40419858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of chronic kidney disease severity on clinical outcomes after current generation drug-eluting stent implantation for left main distal bifurcation lesions: the Milan and New-Tokyo registry.","authors":"Yusuke Watanabe,&nbsp;Satoru Mitomo,&nbsp;Toru Naganuma,&nbsp;Kensuke Takagi,&nbsp;Hiroyoshi Kawamoto,&nbsp;Satoshi Matsuoka,&nbsp;Alaide Chieffo,&nbsp;Matteo Montorfano,&nbsp;Sunao Nakamura,&nbsp;Antonio Colombo","doi":"10.1080/14017431.2022.2084561","DOIUrl":"https://doi.org/10.1080/14017431.2022.2084561","url":null,"abstract":"<p><p><i>Objectives</i>. The impact of chronic kidney disease (CKD) on clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main distal bifurcation lesions (ULMD) is not fully understood in current generation drug eluting stent (cDES) era. We assessed clinical outcomes after PCI using cDES for ULMD according to CKD severity based on estimated glomerular filtration rate (eGFR). <i>Design</i>. We identified 720 consecutive patients who underwent PCI using cDES for ULMD at three high volume centers between January 2005 and December 2015. We divided those patients to the following five groups according to eGFR. Each group was defined as follows: no CKD (60 mL/min/1.73 m² ≤ eGFR), mild CKD (45 ≤ eGFR < 60 mL/min/1.73 m²), moderate CKD (30 ≤ eGFR < 45 mL/min/1.73 m²), severe CKD (15 ≤ eGFR < 30 mL/min/1.73 m²) and hemodialysis (HD). The primary endpoint was target lesion failure (TLF) at 3 years. TLF was defined as a composite of cardiac death, target lesion revascularization (TLR) and myocardial infarction (MI). <i>Results</i>. TLF occurred more frequently in severe CKD and HD group compared with other three groups. <i>Conclusions</i>. The patients who have severe CKD or are on HD, were extremely associated with worse clinical outcomes after PCI for ULMD even with cDES.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40479629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of screening for atrial fibrillation in a domiciliary setting: opportunistic one-time screening at preventive home visits in municipalities.","authors":"Peter Bo Poulsen,&nbsp;Ulla Hemmingsen,&nbsp;Tine Anette Melgaard,&nbsp;Heidi Buch Elleby,&nbsp;Dorte Wedell-Wedellsborg,&nbsp;Lars Dybro,&nbsp;Ida Marie Lund,&nbsp;Ulrik Dixen,&nbsp;Lars Frost","doi":"10.1080/14017431.2022.2095016","DOIUrl":"https://doi.org/10.1080/14017431.2022.2095016","url":null,"abstract":"<p><p>Current evidence base for atrial fibrillation (AF) screening is insufficient. An important finding in the STROKESTOP study was that non-participants had significantly worse outcomes. In a group of potentially non-participants feasibility of opportunistic screening in a domiciliary setting with municipality preventive home visits to citizens ≥75 years was investigated. Handheld ECG device was used by trained municipality caregivers followed by cardiologist assessment. Eighty-five percent consented to being screened, and seven of 477 screened were found with AF. Opportunistic screening in preventive home visits had a high participation rate and was feasible. Randomized trials are needed before making any firm conclusions.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and prognostic value of the electrocardiogram in stable outpatients with type 2 diabetes.","authors":"Mads C T Gregers,&nbsp;Morten Schou,&nbsp;Magnus T Jensen,&nbsp;Jesper Jensen,&nbsp;Mark C Petrie,&nbsp;Tina Vilsbøll,&nbsp;Jens Peter Goetze,&nbsp;Peter Rossing,&nbsp;Peter G Jørgensen","doi":"10.1080/14017431.2022.2095435","DOIUrl":"https://doi.org/10.1080/14017431.2022.2095435","url":null,"abstract":"<p><p><b><i>Aims</i></b>. The European Society of Cardiology guidelines on diabetes and cardiovascular disease (CVD) recommend an electrocardiogram (ECG) in patients with diabetes and hypertension or with suspected CVD. We investigated whether ECG abnormalities can be used as a diagnostic and prognostic marker of heart failure (HF) in patients with type-2 diabetes (T2D) in secondary care diabetes-clinics. <b><i>Methods</i></b>. We included 722 patients with T2D in sinus rhythm. HF with preserved ejection fraction (HFpEF) was defined according to the European Society of Cardiology guidelines. Heart failure with mid-range ejection fraction (HFmrEF) was patients with dyspnoea and an LVEF 41-49%. Heart failure with reduced ejection fraction (HFrEF) or asymptomatic left ventricular systolic dysfunction (ALVSD) was defined as a LVEF ≤40%. <b><i>Results</i></b>. Overall, 24% patients had ECG abnormalities. A total of 15% had HF whereof 48% had ECG abnormalities. A normal ECG had a 99.3% negative predictive value (NPV) of ruling out HFrEF/ALVSD. In a sub-group with 0-1 simple clinical risk markers, the ECG ruled out both HFrEF/ALVSD, HFmrEF, and HFpEF with an NPV of 96.6%. The hazard-ratio (HR) of incident CVD or death in patients with HF and a normal ECG compared with patients without HF was 1.85 [95%CI 1.01-3.39], <i>p</i> = .05, while an abnormal ECG increased the HR to 3.84 [2.33-6.33], <i>p</i> < .001. <b><i>Conclusion</i></b>. HFrEF/ALVSD and HFmrEF were rare and HFpEF was frequent in this T2D population. A normal ECG ruled out HFrEF/ALVSD and in a sub-population with 0-1 simple clinical risk markers also both HFrEF/ALVSD, HFmrEF, and HFpEF.Key messages<b>What is already known about this subject?</b>In early studies of unselected patients from primary care with suspected chronic heart failure, the presence of a normal ECG was found be useful to rule out heart failure with reduced ejection fraction.<b>What does this study add?</b>This study confirms that a standard electrocardiogram when normal in 722 stable outpatients with type 2 diabetes can be used to rule out HFrEF/ALVSD. Further, it adds knowledge about the risk of incident cardiovascular disease or death as a pathologic electrocardiogram increases the hazard ratio.<b>How might this implicate clinical practice?</b>With this study clinicians in secondary diabetes care clinics can use an electrocardiogram to select patients to undergo echocardiography when suspecting heart failure with reduced ejection fraction, as a normal electrocardiogram will rule out this diagnosis with a negative predictive value of >99%.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40603214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the national Danish ablation database: a retrospective, registry-based validation study.","authors":"Filip Lyng Lindgren,&nbsp;Sofie Brix Christensen,&nbsp;Søren Lundbye-Christensen,&nbsp;Kristian Kragholm,&nbsp;Arne Johannessen,&nbsp;Peter Karl Jacobsen,&nbsp;Steen Buus Kristiansen,&nbsp;Peter Steen Hansen,&nbsp;Mogens Stig Djurhuus,&nbsp;Uffe Jakob Ortved Gang,&nbsp;Ole Dan Jørgensen,&nbsp;Sam Riahi","doi":"10.1080/14017431.2022.2099009","DOIUrl":"https://doi.org/10.1080/14017431.2022.2099009","url":null,"abstract":"<p><p><i>Aim</i>.To validate the National Danish Ablation Database (NDAD) by investigating to what extent data in NDAD correspond to medical records.<i>Type of study</i>. Non-blinded, registry-based, retrospective, validation study. <i>Material and methods</i>. A sample of patients who underwent ablation for atrial fibrillation in Denmark between 1 January 2016 and 31 December 2016 were included. By utilizing medical records as gold standard, positive predictive (PPV) and negative predictive values (NPV) for NDAD were assessed and presented as five main categories: arrhythmia characteristics, demographics, cardiac history, complications, and medication. PPV's and NPV's exceeding 90% were considered as high agreement. <i>Results</i>. 597 patients (71.0% males) were included in the study. Median age was 63.1 (IQR: 54.9-68.4) years. The median PPV and NPV estimates across all variables were respectively 90.4% (95% CI: 68%-95.2%) (PPV) and 99.4% (95% CI: 98.4%-99.8%) (NPV) at baseline, and 91.7% (95% CI: 67.4%-95.4%) (PPV) and 99.3% (98.2%-99.3%) (NPV) at follow-up. <i>Conclusion</i>. The data registered in NDAD agrees to a great extent with the patients' medical records, suggesting NDAD is a database with high validity. As a result of low complication rate, the PPV- and NPV-estimates among complication variables were prone to somewhat greater uncertainty compared to the rest.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40637930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epicardial transplantation of autologous atrial appendage micrografts: evaluation of safety and feasibility in pigs after coronary artery occlusion.","authors":"Annu Nummi,&nbsp;Tommi Pätilä,&nbsp;Severi Mulari,&nbsp;Milla Lampinen,&nbsp;Tuomo Nieminen,&nbsp;Mikko I Mäyränpää,&nbsp;Antti Vento,&nbsp;Ari Harjula,&nbsp;Esko Kankuri","doi":"10.1080/14017431.2022.2111462","DOIUrl":"https://doi.org/10.1080/14017431.2022.2111462","url":null,"abstract":"<p><p><i>Objectives.</i> Several approaches devised for clinical utilization of cell-based therapies for heart failure often suffer from complex and lengthy preparation stages. Epicardial delivery of autologous atrial appendage micrografts (AAMs) with a clinically used extracellular matrix (ECM) patch provides a straightforward therapy alternative. We evaluated the operative feasibility and the effect of micrografts on the patch-induced epicardial foreign body inflammatory response in a porcine model of myocardial infarction. <i>Design.</i> Right atrial appendages were harvested and mechanically processed into AAMs. The left anterior descending coronary artery was ligated to generate acute infarction. Patches of ECM matrix with or without AAMs were transplanted epicardially onto the infarcted area. Four pigs received the ECM and four received the AAMs patch. Cardiac function was studied by echocardiography both preoperatively and at 3-week follow-up. The primary outcome measures were safety and feasibility of the therapy administration, and the secondary outcome was the inflammatory response to ECM. <i>Results.</i> Neither AAMs nor ECM patch-related complications were detected during the follow-up time. AAMs patch preparation was feasible according to time and safety. Inflammation was greatly reduced in AAMs when compared with ECM patches as measured by the amount of infiltrated inflammatory cells and area of inflammation. Immunohistochemistry demonstrated an increased CD3+ cell density in the AAMs patch infiltrate. <i>Conclusions.</i> Epicardial AAMs transplantation demonstrated safety and clinical feasibility. The use of micrografts significantly inhibited ECM-induced foreign body inflammatory reactivity. Transplantation of AAMs shows good clinical applicability as adjuvant therapy to cardiac surgery and can suppress acute inflammatory reactivity.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40636235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"13-year single-center experience with the treatment of acute type B aortic dissection.","authors":"Johanna Herajärvi,&nbsp;Mikko Jormalainen,&nbsp;Caius Mustonen,&nbsp;Risto Kesävuori,&nbsp;Peter Raivio,&nbsp;Fausto Biancari,&nbsp;Tatu Juvonen","doi":"10.1080/14017431.2022.2127873","DOIUrl":"https://doi.org/10.1080/14017431.2022.2127873","url":null,"abstract":"<p><p><i>Background</i>. Acute type B aortic dissection (TBAD) is catastrophic event associated with significant mortality and lifelong morbidity. The optimal treatment strategy of TBAD is still controversial. <i>Methods</i>. This analysis includes patients treated for TBAD at the Helsinki University Hospital, Finland in 2007-2019. The endpoints were early and late mortality, and intervention of the aorta. <i>Results</i>. There were 205 consecutive TBAD patients, 59 complicated and 146 uncomplicated patients (mean age of 66 ± 14, females 27.8%). In-hospital and 30-day mortality rates were higher in complicated patients compared with uncomplicated patients with a statistically significant difference (<i>p</i> = 0.035 and <i>p</i> = 0.015, respectively). After a mean follow-up of 4.9 ± 3.8 years, 36 (25.0%) and 22 (37.9%) TBAD -related adverse events occurred in the uncomplicated and complicated groups, respectively (<i>p</i> = 0.066). Freedom from composite outcome was 83 ± 3% and 69 ± 6% at 1 year, 75 ± 4% and 63 ± 7% at 5 years, 70 ± 5% and 59 ± 7% at 10 years in the uncomplicated group and in the complicated group, respectively (<i>p</i> = 0.052). There were 25 (39.1%) TBAD-related deaths in the overall series and prior aortic aneurysm was the only risk factor for adverse aortic-related events in multivariate analysis (HR 3.46, 95% CI 1.72-6.96, <i>p</i> < 0.001). <i>Conclusion</i>. TBAD is associated with a significant risk of early and late adverse events. Such a risk tends to be lower among patients with uncomplicated dissection, still one fourth of them experience TBAD-related event. Recognition of risk factors in the uncomplicated group who may benefit from early aortic repair would be beneficial.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10471257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The a' velocity by tissue-Doppler echocardiography correlates to invasive mean left atrial pressure in patients with normal ejection fraction.","authors":"Benny Johansson,&nbsp;Espen Fengsrud,&nbsp;Fredrik Lundin,&nbsp;Leif Bojö,&nbsp;Dritan Poci","doi":"10.1080/14017431.2022.2032317","DOIUrl":"https://doi.org/10.1080/14017431.2022.2032317","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the correlation of a' velocity by tissue-Doppler measurements with invasively measured mean left atrial pressure in patients with normal ejection fraction.</p><p><strong>Design: </strong>In this retrospective study, we evaluated the septal a', lateral a' and average a' velocity by tissue-Doppler echocardiography, in 125 in-hospital patients, 1-12 h before an elective pulmonary vein isolation due to intermittent atrial fibrillation, and compared to invasively measured mean left atrial pressure (LAP) during the invasive procedure. The patients, aged 35-81 years, had to be in sinus rhythm at both examinations, no atrial fibrillation during two procedures, no or mild valve disease and normal ejection fraction (>50%).</p><p><strong>Results: </strong>Invasively measured mean LAP correlated well to septal a' (<i>r</i> = -0.435), lateral a' (<i>r</i> = -0.473) and average a' velocity (<i>r</i> = -0.491). Normal mean LAP (≤12 mmHg) was found in 95 patients and elevated mean LAP (>12 mmHg) in 30 patients. The patients with elevated mean LAP had a lower septal a' velocity (6.5 ± 2.7 vs 8.6 ± 2.3 cm/s; <i>p</i> < .01), lateral a' velocity (5.9 ± 2.3 vs 8.6 ± 2.1 cm/s; <i>p</i> < .01) and average a' velocity (6.2 ± 2.4 vs 8.8 ± 2.1 cm/s; <i>p</i> < .01) compared to patients with normal mean LAP. Septal a', lateral a' and average a' velocity were good predictors of elevated mean LAP with AUC of 0.78, 0.83 and 0.82. Average a' velocity with cut-off < 7.25 cm/s had a sensitivity of 83% and a specificity of 77% to predict elevated mean LAP.</p><p><strong>Conclusion: </strong>The a' velocity is a good indicator of mean LAP and might be considered in the evaluation of left ventricle filling pressure in patients with normal ejection fraction.</p>","PeriodicalId":21383,"journal":{"name":"Scandinavian Cardiovascular Journal","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39606449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}