bluuebunny/crossref_metadata_2025_split huggingface dataset:
P946 Right atrial volumetric and functional analysis by three-dimensional speckle-tracking echocardiography in acromegaly
Authors: Kormanyos A , Kalapos A , Domsik P , Gyenes N , Ambrus N , Valkusz Z , Lengyel C , Forster T , Nemes A 
Published: January 2020

Abstract

Introduction
Acromegaly is a chronic, rare hormonal disease associated with major cardiovascular comorbidities. The disease, in the majority of the cases, is caused by a benign human growth hormone secreting adenoma. Cardiovascular involvement is especially common in acromegaly patients from the most common hypertension to cardiomyopathy. It was set out to quantify right atrial (RA) morphology and function in a group of acromegaly patients using three-dimensional (3D) speckle-tracking echocardiography (3DSTE).

Methods
The study comprised 30 patients from which 8 patients were excluded due to inadequate image quality. Mean age of the remaining acromegaly patients were 53.7 ± 14.5 years (7 males). Ten patients were in active phase, while 12 subjects had inactive acromegaly. In the control group 40 healthy adults were enrolled (mean age: 52.3 ± 8.2 years, 15 males). In each case, complete two-dimensional Doppler echocardiography was performed followed by 3DSTE.

Results
Maximum (54.5 ± 14.4 ml vs. 47.2 ± 11.6 ml, p &lt;0.05) and minimum (35.5 ± 10.2 ml vs. 29.2 ± 9.1 ml, p &lt;0.05) RA volumes and RA volume before atrial contraction (45.1 ± 11.1 ml vs. 38.2 ± 10.3 ml, p &lt;0.05) were significantly higher in case of acromegaly compared to the healthy controls. Both global and mean segmental peak 3D strain (-11.94 ± 7.52% vs. -8.07 ± 5.03%, p &lt;0.05 and -17.16 ± 6.13% vs. -13.78 ± 5.35%, p &lt;0.05) were higher in the acromegaly group compared to the controls. At atrial contraction, mean segmental radial strain (-13.22 ± 6.45% vs. -9.74 ± 4.58%, p &lt;0.05) was significantly higher and mean segmental 3D strain (-9.78 ± 5.44% vs. -13.78 ± 5.35%, p &lt;0.05) was significantly lower in the acromegaly group compared to the controls. Between the active and inactive group of acromegaly patients, mean segmental longitudinal strain (28.17 ± 4.89% vs. 35.34 ± 9.75%, p &lt;0.05) was significantly different. Numerous independent strain parameters had significant correlations with different hormonal variables in the active acromegaly group. These correlations were not present in the inactive acromegaly subgroup.

Conclusion
Acromegaly is associated with significant RA volumetric and functional abnormalities.
P958 Back to basis? Feasibility of standard and novel echocardiographic measurements after breast cancer surgery
Authors: Orstad E , Steine K , Nerdrum T 
Published: January 2020

Abstract

Background
It is recommended that breast cancer patients should undergo cardiac follow-up during chemotherapy, with clinical assessment and echocardiogram. Standard measurements are robust and reproducible, but novel echocardiography methods as global longitudinal strain (GLS) and three-dimensional (3D) echocardiography are recommended due to their superior sensitivity. These methods require high-quality images. Breast cancer surgery may lead to reduced echocardiographic image quality in this population, in addition to age, obesity and smoking.

Purpose
We wanted to explore the feasibility of standard and novel echo methods in an unselected breast cancer population.

Methods
The present study included consecutive, unselected patients referred to baseline echocardiogram at the cardio oncology outpatient clinic in a large university hospital prior to start of adjuvant chemotherapy. Data on surgery, smoking habits, age and body mass index were collected. Feasibility was defined as the presence or absence to carry out meaningful measurements of left ventricular (LV) systolic function, from standard mitral annular plane systolic excursion (MAPSE) and two-dimensional LV ejection fraction (EF), to novel GLS and 3D LVEF. Multivariable logistic regression was performed to assess the impact of relevant variables on image quality.

Results
116 female patients were included. 21 % of these patients had insufficient images for novel analyses. Left sided breast implant (OR 5,77; P 0,04), age (OR 3,89; P 0,02) and daily smoking (OR 3,57; P 0,03) were found to be independently associated with insufficient image quality. Standard analyses like two-dimensional EF and MAPSE were obtainable in 99 and 97 % of the examinations, respectively.

Conclusion
One of five in a postoperative breast cancer population cannot undergo follow-up using novel, sensitive echocardiographic measurements. Standard measurements, however, are obtainable in almost all patients. It is therefore important that these measurements are included in cardiac follow-up during chemotherapy.
P961 Diagnostic use of proportion between ascending aorta and left atrium in patients referred for coronary artery calcium scoring
Authors: Sosnowski M , Czekaj A , Mlynarski R , Chromik K , Tendera M , Wojakowski W 
Published: January 2020

Abstract

Background
Non-contrast-enhanced cardiac computed tomography (NCE-CCT) is currently used for coronary artery calcium (CAC) scoring. Meanwhile, other cardiac, vascular and extra-cardiac structures can be evaluated. Data about ascending aorta (AA) and left atrium (LA) has been quantified separately in a few studies. Their mutual proportion has not been examined, as yet.
Aim. We hypothesize that mutual proportion between AA and LA size might help for diagnosing their enlargement before absolute cut-off values are reached.

Method
Among 7950 patients who had NCE-CCT with a 64 raw scanner (Aquillion, Toshiba) within the last decade in our center, in 797 persons the AA diameter (at the level of pulmonary artery bifurcation) and LA diameter and area (highest value) were measured. Raw AAD values were qualified as abnormal if exceeded upper normal limit UNL) for age and height. Weight, BMI and BSA has not been used in order to avoid falsified results in obese patients. The ratio AAD:LAD was quantified as low (&lt;0.8), normal (0.8-1.2) and high (&gt;1.2).

Results
There were 45 patients (5.6%) who had AAD higher than age-height predicted UNL, including 24 patients with a raw AAD &gt;43mm (3.0%). The other 752 has their AAD within limits. The means of AAD were 42.9 ± 3.2mm and 33.6 ± 3.6mm (p &lt; 0.001). LA size differed significantly, both in diameters 38.5 ± 7.4 vs 34.2 ± 5.6mm (p &lt; 0.001) and areas 2138 ± 593 vs 1837 ± 481 mm2 (p &lt; 0.001). Data regarding mutual relationship are shown in the fig.1. It is seen that normal mutual proportion (AOLARel =1) in patients with high AAD means that LAD was also increased (left graph, red open square). In 603 patients with normal AAD corresponded with normal LAD. The AAD:LAD &gt;1.2 in 845 subjects might suggest increased AAD in spite to normal raw diameter. Similar rules were found in respect to the LA area.

Conclusions
Ascending aorta and left atrium enlargement are infrequently recognized in patients referred to CAC scoring. Mutual proportion between AA and LA size might complement diagnostic approach of their abnormalities.
P969 Functional classification of extrasystolic arrhythmia
Authors: Germanova O , Germanov A 
Published: January 2020

Abstract

Introduction
Exstrasystoles" classifications mostly are based on ectopic centers localization and frequency per time. These classifications are not focus on the functional importance of extrasystolic and first post-extrasystolic reductions.
Aim. To make functional classification of extrasystoles based on hemodynamics and kinetics of main arteries.

Methods
233 patients were observed with supraventricular and ventricular extrasystoles, which appeared in the phase of isovolumic decrease of intraventricular pressure before the mitral valve opening and in fast or slow ventricules filling phase in cardiocycle. We performed doppler - ultrasound of carotid, radial, ulnaris, posterior tibia, arch of foot arteries and sphygmograms of these arteries. The volume of cardiac output and transmitral blood flow were measured by echocardiography. To know the moment of extrasystoles appearance in cardio cycle and ectopic center localization we used apex-cardiography and electrocardiography. We determined the parameters of heart biomechanics and main arteries kinetics: speed, acceleration, capacity and work in each phase of heart cycle in systole and diastole, and also the periods of dominance of outflow over inflow. We analyzed the peak speed direct blood flow, blood flow volume.

Results
The increasing of main parameters (speed, acceleration, capacity and work) was observed in first-extrasystolic contraction with the tendency: if earlier extrasystole appeared in cardiocycle than more changes were observed. We can quantitatively characterize different types of extrasystoles which are principally different in the degree of participation of resulting blood flow. We measured the contribution of extrasystolic and first post-extrasystolic reduction. So we classified extrasystoles due to its functional importance:
1. Exstrasystoles before the mitral valve opening.
2. Exstrasystoles in phase of fast ventricules filling before the peak of transmitral blood flow.
3. Exstrasystoles in phase of fast ventricules filling after the peak of transmitral blood flow.
4. Exstrasystoles in slow ventricules filling phase.
5. Coupled and group extrasystoles.

Conclusion
The main important thing for hemodynamic measuring is the moment of extrasystoles’ appearance in cardiocycle and the ability of the first post-exstrasystolic reduction to reestablish an adequate resulting blood flow. The treatment and cupping of extrasystoles is determined by the degree of hemodinamic disturbance in each variant of arrhythmia. The most changes of blood flow are with extrasystoles before the mitral valve opening. The first poist-extrasystolic reduction causes the significant increase of cardiac output, arteries diameter and non-stability of atheromas.
P980 RV longitudinal dysfunction predicts outcomes in anterior ST elevation myocardial infarction treated by primary PCI
Authors: Zamfir D , Onciul S , Scarlatescu A , Guzu C , Pascal A , Cojocaru I , Stoian M , Petre I , Iancovici S , Bataila V , Dorobantu M 
Published: January 2020

Abstract

Funding Acknowledgements
This work was supported by CREDO Project - ID: 49182, financed through the SOP IEC -A2-0.2.2.1-2013-1 cofinanced by the ERDF

Background
The prognostic value of LV function in the setting of an acute ST elevation myocardial infarction (STEMI) is well established, but data regarding the association between RV function and adverse events in this population of patients are still scarce, especially for the cases with anterior wall localization of necrosis. Two-dimensional speckle tracking echocardiography (STE) is able to detect subclinical changes in local or regional RV function.

AIMS
To evaluate the relation between STE parameters of RV global and regional function recorded 24 hours after admission and the occurrence of major non-fatal cardiovascular adverse events (MACE) in anterior STEMI patients treated by primary percutaneous intervention (PCI)

Methods
We have prospectively analyzed a cohort of 80 consecutive patients (mean age 61.17 years, 68.8% males) presenting with a first STEMI treated successfully by PCI. Patients with history of cardiac or pulmonary disease were excluded. All patients underwent conventional echocardiography and STE, 24 hours after the index event. RV strain was assessed as RV free wall strain (RVFWS) representing the average of peak strain values encountered in three segments of the RV free wall and RV global longitudinal strain (RVGLS) obtained by averaging peak strain values in six segments including RV free wall and interventricular septum . The mean follow-up duration was 8.2 ± 0.69 months.The combined endpoint of non fatal MACE was defined as recurrent myocardial infarction, need for repeat revascularization, hospitalization for heart failure or stroke.

Results
In the study population 45 patients (56%) had the culprit lesion on the anterior descendent artery. In this group we observed that RVGLS was predictive for non fatal MACE independent of LVEF or extension of necrosis expressed by wall motion score index with OR 0.89 95 % CI 0.7-0.9, p = 0.042, with a ROC curve with a sensitivity 73% and specificity 53%, AUC =0.7. In addition, in anterior STEMI complicated by LVEF &lt;40 % , a RVFWS absolute value lower than -14.3 % has proved to be an additional parameter of negative prognosis with a sensitivity of 91 %, and a specificity of 40% (AUC 0.68, CI 95%: 0.3-0.7)

Conclusions
In anterior STEMI patients treated by primary PCI, global RV longitudinal dysfunction assessed by STE early after the index event is predictive for non fatal MACE independently of LV function or the infarct size. In addition, RV regional longitudinal dysfunction provides incremental prognostic information in patients with anterior STEMI with moderate or severe LV systolic dysfunction. These data highlight the importance of the assessment of subclinical RV dysfunction in this setting.
1032 Evaluation viability in patients with ventricular dysfunction by 2D speckle tracking echocardiography: the impact of low dose dobutamine. A meta-analysis of prospective trials
Authors: Ballo H , Doghman F , Saraste A , Knuuti J 
Published: January 2020

Abstract

Background
2D-Speckle tracking echocardiography (2DSTE) has been used for the assessment of myocardial viability in patients with artery disease and left ventricular (LV) dysfunction.

Aim
The purpose of this analysis was to evaluate the diagnostic accuracy of 2DSTE using longitudinal (LS) and rest circumferential strain (CS) in this setting with or without low dose dobutamine (LDD) infusion.

Methods
A systematic review of MEDLINE, Cochrane, and Embase for all the prospective trials using 2DSTE to assess myocardial viability until January 2019 was done. Studies that utilized 2DSTE before coronary revascularisation and used the wall motion evaluation in the long term after the revascularisation as a reference were included. A standard approach of meta-analysis for diagnostic tests and a bivariate analysis of sensitivity, specificity, positive likelihood ratio(+LR), and negative likelihood (-LR) were performed. In addition, direct comparison analysis was done to only studies that compared the tests in the same patients.

Results
A total of 24 studies of 2DSTE evaluating myocardial viability with 1173 patients (mean age 66 years, 72% male, and mean left ventricular ejection fraction was 45%) fulfilled the inclusion criteria. Eight studies used LS, 8 studies used CS, 4 studies used LS with LDD, and 4 studies used CS with LDD. LS and CS with LDD provided higher +LR ( 4.2 and 4, respectively) as well as a best specificity when compared with LS and CS (81% CI: 65- 92% vs 68% CI: 60- 75%, p = 0.04, and 81% CI: 64-91% vs 66% CI: 59-72%, p= 0.02, respectively) for predicting improved segmental LV contractile function after revascularization. The sensitivities of different 2DSTE tests for detection the viability were not statistically different. The direct comparison of the studies with the same patients yielded similar results.

Conclusions
Using LDD with LS and CS analysis significantly improve specificity of the tests. Therefore, the use of a low dose of the dobutamine can be recommended to improve the accuracy of the 2DSTE for detection of viable myocardium following myocardial infarction.
Abstract 1032 Figure. Summary ROC Curves
1041 Early detection of biventricular mechanical dysfunction in PLN R14del mutation carriers
Authors: Taha K , Te Rijdt W P , De Bruin-Bon H A C M , Cramer M J M , Asselbergs F W , Bouma B J , Van Den Berg M P , Teske A J 
Published: January 2020

Abstract

Funding Acknowledgements
PLN Genetic Heart Disease Foundation

Background
Carriers of the phospholamban (PLN) R14del founder mutation may develop an arrhythmogenic and/or dilated cardiomyopathy. Overt disease is preceded by a pre-symptomatic phase of variable length in which structural abnormalities seem to be absent.

Purpose
We aimed to explore echocardiographic characteristics of PLN R14del mutation carriers, particularly in early disease stages.

Methods
We included 120 PLN R14del mutation carriers and classified them to the pre-symptomatic stage (no symptoms and no structural disease, n = 60), the arrhythmic stage (arrhythmic symptoms and left ventricular ejection fraction (LVEF) ≥50%, n = 30) or the structural stage (LVEF &lt;50%, n = 30). We included 60 healthy control subjects who were age- and gender matched with pre-symptomatic mutation carriers. All subjects underwent comprehensive echocardiographic analysis, including deformation imaging.

Results
Values are provided in the abstract table. Patients in the structural stage had significantly impaired left/right ventricular (LV/RV) function and increased LV/RV size when compared to the other mutation carriers (p &lt; 0.001). In the pre-symptomatic and arrhythmic stage, LV function and volumes did not differ significantly from controls by conventional measurements. However, LV global longitudinal strain (GLS) and LV mechanical dispersion (MD) were already significantly impaired in the pre-symptomatic and arrhythmic stage when compared to controls (p &lt; 0.001). RV function by conventional measurements was lower in arrhythmic subjects than in controls (p = 0.016). A strong linear correlation was found between LV GLS and RV GLS (r = 0.8, p &lt; 0.001).

Conclusion
Echocardiographic deformation imaging reveals biventricular mechanical alterations in PLN R14del mutation carriers before arrhythmic symptoms and overt structural disease. Longitudinal studies are needed to determine the incremental prognostic value of these findings.
Control subjects (n = 60) Pre-symptomatic (n = 60) Arrhythmic (n = 30) Strucutral (n = 30) LVEF(%) 60.3 ± 4.2 58.6 ± 4.2 57.1 ± 5.3 38.8 ± 10.6* LVEDV (ml/m2) 54.6 ± 10.0 53.7 ± 9.5 56.1 ± 11.6 70.1 ± 25.8* LV GLS (%) 21.5 ± 1.8 19.5 ± 1.5* 19.1 ± 1.7* 12.7 ± 3.8* LV MD (msec) 24.4 ± 5.9 33.1 ± 9.5* 48.2 ± 13.3* 60.8 ± 17.1* RV FAC (%) 46.4 ± 4.9 44.7 ± 5.0 42.6 ± 7.4* 33.2 ± 8.0* RV GLS (%) 26.5 ± 3.7 24.2 ± 2.9* 22.5 ± 4.2* 15.1 ± 5.7* FAC = Fractional area change; GLS = Global longitudinal strain; LV/RV = Left/right ventricular; LVEDV = Left ventricular end-diastolic volume; LVEF = Left ventricular ejection fraction; MD = Mechanical dispersion. *p &lt; 0.05 when compared to control subjects.
Abstract 1041 Figure. Clinical stages in PLN mutation carriers
1158 Autograft degeneration, clinical outcomes and predictors after 21 years follow up in Ross procedure. A single center experience
Authors: Pericet Rodriguez C , Pardo Gonzalez L , Fernandez Ruiz A , Gonzalez Manzanares R , Ruiz Ortiz M , Delgado Ortega M , Rodriguez Almodovar A , Carnero Montoro L , Luque Moreno A , Oneto Fernandez M J , Paredes Hurtado N , Villalba Montoro R , Casares Mediavilla J , Pan Alvarez-Ossorio M , Mesa Rubio D 
Published: January 2020

Abstract

Background
Autograft regurgitation and the need of autograft reintervention are possible complications of Ross procedure.

Purpose
Our Aim was to identify rates of autograft degeneration, reintervention and predictive
factors valvular disease in a prospective series of a reference cardiovascular surgery hospital.

Methods
Since November 1997 to July 2009, a total of 107 patients diagnosed of aortic valvular disease requiring surgical treatment underwent Ross surgery (mean age 30 ± 11 years, 69% male, 21 patients &lt;18 years). In all of them, a comprehensive clinical and echocardiographic evaluation was performed before the intervention and at discharge, at 6, 12 months and annually after surgery.

Results
At the end of follow-up (21 years, median: 17 years, interquartile rank 12-19 years), echocardiographic and clinical data were available in 95 (89%) and 105 (98%) patients, respectively. 30 patients (32%) developed at least moderate aortic regurgitation and 18 of them (17%) required autograft reintervention. Probability of survival free from at least moderate autograft regurgitation and reintervention at the end of follow up was 71% and 83% respectively. Two patients died because of reintervention related complications. A larger native pulmonary annulus size was the only factor, associated to autograft reintervention (HR 1.24 95% [CI] 1.04-1.48, p = 0.01) and at least moderate autograft regurgitation (HR 1.19 95% [CI] 1.03-1.37, p = 0.02). Autograft reintervention was also associated to intervention in the learning curve period (first 12 cases, HR 3.78, [CI] 95% 1.42-10.08, p = 0.008). We found no significant association of these outcomes with previous cardiac surgery, age, sex, aetiology of aortic lesion or native aortic annulus diameter.

Conclusion
At long term follow-up after Ross procedure, 32% of patients developed at least moderate autograft regurgitation and 17% required autograft reintervention. A larger size of the native pulmonary annulus and intervention in the learning curve period were associated with the need of autograft surgery in the long term follow up.
1175 Comparison of fractional myocardial mass, a vessel-specific myocardial mass-at-risk, with coronary angiographic scoring systems for predicting myocardial ischemia
Authors: Kim H Y , Choi J H , Kim K H , Kim S M 
Published: January 2020

Abstract
Aims The burden of coronary artery disease has been assessed by various semi-quantitative angiographic scores, which are frequently different each other. A non-invasive and quantitative modality may substitute angiographic sores for prognostic implication and decision of revascularization strategy. We compared fractional myocardial mass (FMM) with angiographic scores for predicting myocardial ischemia.
Methods In this multicenter registry, 411 patients who underwent coronary computed tomography angiography (CCTA) were followed by invasive coronary angiography and FFR measurement. CCTA–derived %FMM with diameter stenosis ≥70% (%FMM-70) or ≥50% (%FMM-50) were compared with 9 angiographic scores (APPROACH, Duke Jeopardy, BARI, CASS, SYNTAX, Jenkins, BCIS-1, Leaman, Modified Duke) and were tested regarding their performance for predicting FFR ≤ 0.80. Predictive performance of %FMM or angiographic scores for FFR ≤ 0.80 established in derivation cohort (N = 250) and tested in validation cohort (N = 161).
Results The performance of %FMM-70 and %FMM-50 were similar to most angiographic scores (%FMM-70, c-statistics = 0.76; %FMM-50, 0.71; angiographic scores, 0.68 – 0.79). The frequency of FFR ≤ 0.80 increased consistently according to %FMM-70, %FMM-50, and all angiographic scores (p &lt; 0.001, all). The optimal cutoff of %FMM-50 and %FMM-70 for FFR ≤ 0.80 were ≥34.5% and ≥9.8%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of %FMM-50 were 83%, 56%, 73%, 70%, 72%, and of %FMM-70 were 72%, 78%, 75%, 75%, and 75% using these cutoffs. Validation cohort showed consistent results.
Conclusion %FMM correlated well with angiographic scores and had a potential to be used as a non-invasive alternative to the angiographic scores. The integration of the severity of stenosis and the amount of subtended myocardium may improve the detection of clinically significant coronary artery stenosis.
Abstract 1175 Figure. FMM vs angiographic score