bluuebunny/crossref_metadata_2025_split huggingface dataset:
P280 Evaluation of right atrium in patients with gestational hypertension
Authors: Stojsic S , Ilic A , Tadic S , Grkovic D , Stojsic-Milosavljevic A 
Published: January 2020

Abstract

Introduction
Some authors have confirmed changes in function of the right hearth in different conditions with endothelial dissfunction, such as systemic hypertension and metabolic syndrome. During gestational hypertension (GH), endothelial disfunction is one of the main pathogenic causes of vasoconstriction and placental insuficiety and following intrauterine growth restriction. Few authors evaluated function of the right ventricle during gestational hypertension, but to our knoledge, there are no studies about right atrial function during gestational hypertension.

Purpose
We hypothesized that there are changes in right atrial function durig gestational hypertension, and wondered if they are reversible.

Methods
Study included 45 pregnant women. 25 with GH (defined as blood pressure ≥140/90mmHg that appeared after 20th week of gestation and disappeared within six weeks postpartum) and 20 normotensivewomen,as control. Function of right atrium and right ventricle was evaluated according to the last guidelines for chamber quantification. Additionally, right atrial function was assessed with p-p cycle speckle tracking. Echo was performed in the third trimester of pregnancy and 6 weeks after delivery.

Results
Parameters showed impairment of RV diastolic function. Women with gestational hypertension had E/e" over the normal value and higher than healthy pregnants, althow difference was not significant. ( 6.46 +- 4.7 vs 5.16 +- 1.9, p =0.66). TDI derived E" from lateral tricuspid annulus was significantly lower in hypertensive group (0.11 +- 0.03 vs 0.14 +- 0.03 p= 0.023). Atv – right ventricle late filling velocity was significantly higher in patients with GH (0.61 +- 0.1 vs 0.51+-0.12, p= 0.08) .
All pregnant women had normal values of RA dimensions, RA endsystolic area, RA endsystolic volume (RAVs). RAVs was significantly larger in GH group (34.64 +-12 vs 27.9+- 9.89, p= 0.041) comparing to the controls, but when we indexed it to the BSA, difference disappeared. Peak longitudinal strain was signfificantly higher in hypertensive group (33.49+- 2.48 vs 28.05+- 4.52, p= 0.001). After Pearson correlation of peak longitudinal strain with parameters of right ventricle diastolic function was done, there was possitive correlation between peak longitudinal strain and Etv (right ventricle early filling velocity) in hypertensive group (r 0.646, p 0.017). Also RAVs positively correlated with LAVsI (r= 0.577, p= 0.019), and RAVsI positively correlated with LAVsI (r= 0.690, p = 0.019).
After delivery all changes disappeared.

Conclusion
Our study indicates that right atrium accommodates to the hemodynamic and functional changes during gestational hypertension. It changes because of modified right ventricle diastolic function and probably in the same mode as left atrium. RA peak longitudinal strain is high, so function of the right atrium is preserved, and we assume that short time of mentioned changes during pregnancy, is the reason why.
P282 Left ventricular diastolic dysfunction in asymptomatic type 2 diabetes mellitus with preserved systolic function
Authors: Mouadili M , Sebani M , Mbauchy C , El Hattaoui M , El Karimi S 
Published: January 2020

Abstract
The involvement of diabetes in the occurrence of an alteration of the diastolic function of LV is well established.
The objective of our study was to evaluate the prevalence of diastolic dysfunction in Type II diabetic patients in light of the latest 2016 recommendations of the American Society of Echocardiography and to identify its associated factors.
It was a cross-sectional observational study with a descriptive and analytic focus spread over a 6-month period from July to December 2017.The study included 66 asymptomatic type II diabetic patients, with a normal ECG and a negative stress test ischemia. All hypertensive subjects with an ejection fraction &lt;50%, or those with myocardial, valvular or rhythm disorder, were excluded.
The mean age of our patients, was 42 years ± 9 years with extremes ranging from 39 to 84 years, we noted a female predominance (68%) with a sex ratio of 2.14. The prevalence of diastolic dysfunction was 27%. Factors associated with this change in diastolic function were advanced age (p &lt;0.0001), age of diabetes&gt; 10 years (p &lt;0.0001), glycemic imbalance with HbA1c&gt; 7% (p &lt;0) , 0001) and elevated fasting glucose levels (p = 0.039), obesity (p &lt;0.0001), dyslipidemia (p &lt;0.0001) and menopause (p = 0.002).
Diastolic dysfunction affects a significant percentage of patients with type II diabetes. Therefore, we propose strict glycemic control in these patients, an early cardiographic echo screening in at-risk subjects, in order to improve their management, and to limit their progression to more serious complications.
P303 Characteristics and prognosis of patients with significant tricuspid regurgitation
Authors: Bohbot Y , Chadha G , Delabre J , Landemaine T , Beyls C , Tribouilloy C 
Published: January 2020

Abstract

Funding Acknowledgements
none

Background
Severe tricuspid regurgitation (TR) usually remains asymptomatic for a long period, and the diagnosis is often delayed, at an advanced stage of right heart failure (RHF). Only a minority of patients are referred to surgery.

Purpose
To describe the characteristics and prognosis according to aetiologies of patients with significant TR.

Methods
Two hundred and eight consecutive patients with moderate-to-severe (grade III) or severe (grade IV) TR were included from echocardiography reports between 2013 and 2017. Median follow-up was 18(6-38) months.

Results
Patients (mean age 75 years, 46.6% males) were divided into 4 groups according to TR aetiology, group 1: primary TR (15%), group 2: TR secondary to left heart or pulmonary disease with a history of left heart valve surgery (24.5%), group 3: TR secondary to left heart disease with no history of left valvular surgery (26.4%) and group 4: idiopathic TR (34.1%). During follow-up, 61 patients (29%) experienced at least one decompensation of RHF requiring hospitalization. Only 11 patients (5.3%) underwent tricuspid valve surgery during follow-up. The 4 years survival was much lower than the expected survival of age- and sex-matched individuals of the general population (56 ± 4%vs74%). After adjustment for outcome predictors, patients with idiopathic TR had a higher risk of mortality (adjusted HR = 1.83[1.05-3.21]; p = 0.034) compared to other groups.

Conclusions
Moderate-to-severe and severe TR is associated with a high risk of hospitalization for RHF and death at 4 years and a low rate of surgery. Idiopathic TR is associated with worse outcome than other etiologies
Abstract P303 Figure. SURVIVAL CURVES
P315 Prevalence of left ventricular systolic and diastolic dysfunction in patients with chronic kidney disease and preserved left ventricular ejection fraction
Authors: Tereshina O V , Germanova O A , Rogozina L A , Davydkin I L 
Published: January 2020

Abstract

BACKGROUND
Presence of heart failure (HF) is associated with poor outcome in patients with chronic kidney disease (CKD), although Left ventricular (LV) systolic function is often preserved in them. However, CKD patients may have HF symptoms with preserved LVEF. Myocardial Deformation Imaging is more accurate for detecting LV systolic dysfunction. The aim of this study was to evaluate global longitudinal (GLS) and circumferential strain (GCS) in patients with renal function impairment.

METHODS
Overall, 67 patients (40% men, mean age 45 ± 12 years) with CKD stage 3-4 were studied. All patients had an LV ejection fraction ≥50%. We performed echocardiography including speckle-tracking (STE) measurement of LV GLS and LV GCS and as well as assessment of diastolic function.

RESULTS
Despite preserved LVEF, impaired LV GLS (&lt;18%) was observed in all patients. The mean value of GLS was 14,1 ± 1,5. This finding indicates that systolic dysfunction in CKD started from compromise LV longitudinal function. However, the GCS parameter was in the normal range – 22,7 ± 1,8. Thereby preserved LVEF was compensated by normal or slightly increase circumferential strain. Impaired diastolic function was observed in 18% of patients including 8% patients with increased left ventricle filling pressure (stage II-III).

CONCLUSION
The prevalence of impaired LV GLS despite preserved LVEF in patients with CKD stage 3-4 is high, which proved that renal disease is associated with early and subclinical impairment of LV systolic function. Impaired diastolic function was not so common among them. Assessment of it is not always so easy and reliable using current recommendation. Thus, STE can be recommended for early detection impairment of LV function.
P334 Heart model method: could it be a new echocardiographic gold-standard for the assessment of the left ventricular systolic function in a population under chemotherapy treatment?
Authors: Molinero D , Cabeza P , Hernandez N , Silva E , Delgado W 
Published: January 2020

Abstract

Background
Echocardiographic assessment of the left ventricular systolic function is essential in diagnosis and during the follow up of cardiovascular diseases. Although subjective visual approach method is easily applied, quantitative systems give more objective information about systolic function analyses. The purpose of this study is to evaluate the different quantitative methods of estimating systolic function basal in non-invasive techniques

Methods
We used a group of 40 patients, prospectively collected, under chemotherapy treatment with preserved systolic function. Same echocardiography device (Philips EPIQ-7) has been used in all studies (acquiring apical 4 and 2 chambers and 3 D of apical volume by an experimented operator). We compare three standard methods with impact in the literature (Speckle tracking and 3D Heartmodel system) to the echocardiographic gold-standard (Simpson’s biplane method). The Bland-Altman method has been used for the graphic comparison of the values of the resulting measures while the statistical comparison was made by a T-student method.

Results
Three quantitative methods were used to compare left ventricular systolic function assessment (Heart Model 3D (60.4% ± 5.2%), Strain (60.50% ± 7.1%), global longitudinal strain (-19.7 ± 3.15%) to Simpson’s biplane (mean 62.10% ± 5.75%). Values of differential means (2.73 with Heart model 3D and 2.08 with Strain) compared to Simpson’s biplane were translated to a Bland-Altman plot and means were compared with a T-student method. A statistically significant difference was found in case of the Heartmodel method compared with Simpson’s biplane (p &lt; 0.05), though it does not imply any clinical difference. Less time consuming and better segmentation of the cardiac cavities in just one beat with the 3D-Heart Model technique was a magnificent point compared to the Strain method that needed a postprocessing modification

Conclusions
Heartmodel method is probably the most time-saving and with a good accuracy of left ventricular systolic function assesment and it is not inferior compared to the echocardiographic gold-standard Simpson’s biplane method.
Abstract P334 Figure 1. Bland-Altman analysis
P337 Edge-to-edge mitral valve repair in patients with secondary mitral regurgitation: impact of tethering pattern on clinical, echocardiographic and procedure-related characteristics
Authors: Oneto Fernandez M J , Ruiz Ortiz M , Delgado Ortega M , Rodriguez Almodovar A M , Gonzalez Manzanares R , Pericet Rodriguez C , Fernandez Ruiz A , Luque Moreno A , Paredes Hurtado N I , Romero Moreno M A , Ojeda Pineda S , Suarez De Lezo Herreros De Tejada J , Lopez Granados A J , Pan Alvarez-Ossorio M , Mesa Rubio D 
Published: January 2020

Abstract
Edge-to-edge mitral valve repair (E2E-MVR) has emerged as a therapeutical option in patients with secondary mitral regurgitation (SMR). Two tethering patterns (TP) have been described in SMR: symmetric and asymmetric. However, information on the implications of these TP on E2E-MVR is limited.
Our aim was to assess the impact of mitral valve TP on clinical, echocardiographic and procedure-related characteristics in patients undergoing E2E-MVR.
We consecutively recruited 62 patients with at least moderate SMR who underwent E2E-MVR in our center between 2011 and 2019 and analysed clinical, echocardiographic and procedure-related characteristics according to TP, which we classified into symmetric and asymmetric considering jet direction and mitral valve leaflet position during systole by means of two-dimensional transesophageal echocardiography (Figure 1).
In our series, 43 patients (69.3%) had symmetric TP and 19 (30.7%) had asymmetric TP. Asymmetric TP was associated with ischemic aetiology (52.6% vs 23.3%, p = 0.02) and a non-significant trend to higher frequency of male sex (89.5% vs 67.4%, p = 0.07), diabetes mellitus (52.6% vs 27.9%, p = 0.06), massive regurgitation (78.9% vs 58.1%, p = 0.11) and higher values of left ventricular ejection fraction (LVEF) (34 ± 9% vs 28 ± 11%, p = 0.06).
There were no differences in procedure-related characteristic between groups, in particular in number of devices (1.63 [IQR 1-2] vs 1.52 [IQR 1-2], p = 0.27), number of graspings (3.21 [IQR 2-4] vs 2.78 [IQR 2-3], p = 0.16) and time of procedure (95 ± 38min vs 107 ± 43min, p = 0.29). Procedural success (defined as SMR severity reduction≥2) was high in both groups (89.5% vs 74.4%, p = 0.18).
At discharge, there was a significant reduction in effective regurgitant orifice area (EROA) in (0.36 ± 0.16cm² vs 0.15 ± 0.10cm², p &lt; 0.001) and pulmonary artery systolic pressure (PASP) (46 ± 12mmHg vs 40 ± 12mmHg, p = 0.004). LVEF was impaired in patients with asymmetric TP but not in patients with symmetric TP (difference in LVEF after procedure: -5 ± 9% vs -0 ± 8%, p = 0.03).
In our study, asymmetric TP was related to the ischemic aetiology of left ventricular dysfunction. Procedural characteristics, and EROA and PASP reductions at discharge were similar regardless of TP. However, patients with asymmetric TP had a significantly impairment in LVEF, probably because of afterload mismatch phenomenon.
Abstract P337 Figure 1: example of tethering patterns
P341 Prognostic value of pulmonary congestion assessed by lung ultrasound to predict decompensation in heart failure patients
Authors: Bidaut A , Hubert A , Donal E 
Published: January 2020

Abstract
INTRODUCTION : Lung ultrasound (LUS) evaluation of B lines is a valid tool for the assessment of pulmonary congestion in heart failure (HF) patients. The aim of this study was to evaluate the prognosis of HF patients presenting with B lines, with a primary endpoint of rehospitalization for heart failure and/or death at one year.
METHOD : 93 patients presenting with significant dyspnea (NYHA ≥ 2) underwent an initial analysis of LUS for B-lines, complete TTE, and were propectively followed up for one year.
RESULTS : Data on follow up was obtained for 88 patients. 8 patients presented with HF, and 5 patients died. ROC analysis showed an optimal cutoff of B-lines at 6. Kaplan Meier curves showed a significant difference in rehospitalization for heart failure at 1 year (p = 0,047 for B-lines ≥ 6). There was no significant difference for death. Patients with ≥ 6 B-lines had an OR at 13,7 for HF rehospitalization at 1 year (IC95% , p = 0,017).
CONCLUSION : B-lines assessment by LUS identifies patients more likely to be admitted for decompensated HF in the following year. This tool should be considered in a multi-parametric approach in patients with heart failure to optimize treatment and follow up.
Baseline characteristics Rehospitalization for HF n = 8 No rehospitalization for HF n = 80 p value Age 75,5 +/-8 71,9 +/-9,7 0,325 BMI 23,6 +/- 2,1 26,8 +/- 5,4 0,005 HF history 8 (100%) 35 (43,8%) &lt;0,001 Significant valvulopathy 8 (100%) 45 (56,3%) &lt;0,001 Renal insufficiency 5 (62,5%) 19 (23,8%) 0,019 NYHA ≥3 7 (87,5%) 17 (21,3%) &lt;0,001 Total B-lines 16,1 +/- 9,5 6,8 +/- 9,7 0,012 B-lines ≥ 6 7 (87,5%) 27 (33,8%) 0,003 LVEF 39,3 +/- 11,7 48,5 +/- 15,5 0,109 GLS -9,4 +/- 3,2 -13,3 +/- 5,5 0,018 Mitral S average 4,5 +/- 1,1 6,1 +/- 1,8 0,017 E/A ratio 3 +/- 1,8 1,2 +/- 0,84 0,05 Peak TR velocity (m/s) 3 +/- 0,47 2,5 +/- 0,5 0,018 PASP (mmhg) 52,6 +/- 16 35,8 +/- 14 0,002 HF : heart failure, BMI : body mass index, NYHA : new york heart association, LVEF : left ventricule ejection fraction, GLS : global longitudinal strain, TR : tricuspid regurgitation, PASP : pulmonary artery systolic pressure
Abstract P341 Figure. Kaplan Meier survival curve
P349 Utility and prognostic value of aortic valve area by magnetic resonance imaging in patients with aortic stenosis
Authors: Igual Munoz B , Oscar Blanco Herrera O B H , Francisco Jose Valera Martinez F J V M , Diana Domingo Valero D D V , Pilar Sepulveda Sanchez P S S , Anastasio Montero Argudo A M A , Laura Higueras Ortega L H O , Jose Leandro Perez Bosca J L P B , Alberto Berenguer Jofesa A B J , Rafael Paya Serrano R P S 
Published: January 2020

Abstract

Classically clinical evaluation of patients with aortic stenosis (AS) is made using clinical and echocardiographic parameters but recently new imaging techniques as cardiovascular magnetic resonance (CMR ) are being used increasingly in this clinical setting. We aim to assess utility and prognostic value of aortic valve area (AVA) by CMR in patients with AS regarding echocardiographic data.

METHODS
a retrospective cohort of patients with AS referred to CMR and cardiac echocardiography study for evaluation were included. Patients with known coronary artery disease or another significant valve disease were excluded. Clinical Follow up was performed to asses cardiovascular death, hospital admission or aortic valve replacement at the first year after imaging evaluation. Furthermore symptomatic status was assessed. Echocardiographic severity was estimated used peak and mean gradients . Additionally a CMR study including b-SSFPS for left ventricle ejection fraction (LVEF) quantification and phase-contrast sequences acquired at aortic valve plane to analyze aortic valve area (AVA) by planimetry was performed.

RESULTS
ninety eight patients, mean age 67+ 15 years, 52(58%) males, 23 (25%) with decreased left ventricular ejection fraction. A significant negative correlation was observed between AVA by CMR and echocardiographic gradients ( -0.49 for mean gradient and -0.58 for peak gradient). AVA was strongly associated to symptomatic status (AUROC curve 0.66, p &lt; 0.001). A multivariate logistic regression model including echocardiographic gradients,CMR, LVEF and AVA was performed and mean gradient
( OR:1.02 p = 0.01) and AVA (OR: 0.002 p = 0.001) were shown to be independent predictors of events.

Conclusion
1.AVA by planimetry in phase-contrast CMR sequences is a valid tool to asses severity of aortic valve stenosis . 2 AVA was strongly associated to symptomatic status.3. AVA has proven to have additional prognostic value beyond echocardiographic gradients.
Abstract P349 Figure. Aortic valve area by planimetry by MR
P368 Ross procedure: homograft deterioration, clinical outcomes and predictors after 21 years follow up. A single center experience
Authors: Fernandez Ruiz A , Pardo Gonzalez L , Pericet Rodriguez C , Gonzalez Manzanares R , Ruiz Ortiz M , Delgado Ortega M , Rodriguez Amodovar A , Carnero Montoro L , Luque Moreno A , Oneto Fernandez M J , Paredes Hurtado N , Villalba Montoro R , Merino Cejas C , Pan Alvarez-Ossorio M , Mesa Rubio D 
Published: January 2020

Abstract

Background and purpose
Pulmonary homograft stenosis can appear in long-term follow-up after Ross
intervention. Our aim was to describe the incidence, clinical impact and predictors of homograft stenosis and reintervention after the Ross procedure in a prospective series in a tertiary referral hospital after 21 years followup.

Methods
From 1997 to 2009, 107 patients underwent the Ross procedure (mean age: 30 ± 11 years; 69% men; 21 aged &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. We analyzed echocardiographic homograft stenosis (peak gradient &gt; 36 mmHg) and surgical or percutaneous homograft reintervention.

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: 28/95 (29%) patients developed homograft stenosis and 13/105 (12%) patients underwent diferent homograft reintervention procedures (five patients underwent surgical replacement, four received a percutaneous pulmonary valve and one needed stent implantation). The other three patients underwent two or even three consecutive procedures in follow-up; two died because of complications after percutaneous pulmonary valve implantation and other one after surgical replacement. Rates of survival free from homograft stenosis and reintervention at the end of the follow-up were 71% and 88%, respectively. Younger age, and especially being part of paediatric group (&lt;18 years) at surgical
time predicted worse survival free from homograft stenosis (hazard ratio [HR] 3.88, 95% confidence interval [CI]: 1.78-8,43; p = 0.001), although there were no significant differences regarding reintervention (HR 1.54, [CI] 95% 0.42-5.58, p = 0.52). We found no significant association of this outcome with previous cardiac surgery, donor age, donor or recipient sex, homograft size, time of freezing or congenital aetiology.

Conclusions
After 21 years follow-up, incidence of homograft stenosis and reintervention after the Ross procedure were 29% and 12%, respectively; three patients had a reintervention-related death. Younger recipient age at Ross procedure was associated with a higher rate of stenosis.