bluuebunny/crossref_metadata_2025_split huggingface dataset:
P312 Early changes of left ventricular myocardial work performance in patients undergoing coronary artery bypass surgery: off-pump vs. on-pump
Authors: Hatam N , Spetsostaki K , Musetti G , Steffen H , Autschbach R , Zayat R 
Published: January 2020

Abstract

Background
Coronary-artery bypass grafting (CABG) without the use of cardio-pulmonary bypass (CPB) was introduced to avoid the potential damaging effects of fpreign surfaces. Nevertheless, the value of off-pump CABG (OPCAB) remains controversial. Regional myocardial work has been shown to reflect regional metabolic demand and provide a more comprehensive assessment of myocardial function. Recently a novel non-invasive method for assessing regional MW by LV pressure–strain loop analysis has been described.

Purpose
To detect changes of MW after CABG comparing off- and on-pump techniques.

Methods
We prospectively evaluated 93 patients undergoing CABG (50 on- vs. 43 off-pump). Patients underwent transthoracic echocardiography exams prior to and one week after surgery as well as concurrently systolic arterial blood pressure measurements at rest. Besides conventional echocardiography parameters, wemeasured global longitudinal strain (GLS), global work index (GWI) and global work efficiency (GWE).

Results
All patients survived surgery. Patients in the OPCAB group had significantly higher EuroSCORE II (3.3% vs. 1.1%, p &lt; 0.001). Preoperatively, OPCABgroup had significantly lower EF (50.1 vs. 55.7%, p = 0.004), lower GWI (1411 vs. 1650mmHg%, p = 0.039) and lower GWE (86.7 vs. 91.6%, p = 0.017). GLS did not differ significantly between off- and on-pump groupspreoperatively. However, postoperatively GLS, MWI, MWE and EF decreased significantly within the on-pump group (p &lt; 0.001, p &lt; 0.001, p &lt; 0.001 and p = 0.002, respectively). In the OPCAB group only GWI and GLSdecreased significantly (p = 0.028 and p = 0.017, respectively). Due to the fact, that mean differences between all pre- and postoperative values were higher in the on-pump group, no significant differences in systolic LV-function (sLVF) could be detected between on- and off-pump patients postoperatively. During the early postoperative phase, no correlation between GWI and GWE and clinical outcomes could be detected, onlylower preoperative-GWI values showed a weak correlation with the incidence of postoperative cardiogenic shock (r= -0.27, p = 0.029).

Conclusion
Despite having worse preoperative sLVF in the off-pump group determined by EF, GLS, GWI and GWE, the decrease in sLVF parameters was significantly higher in the on-pump group, leading to an equal distribution of LV-function parameters between off- and on-pump patients postoperatively. Our results suggest that off-pump CABG provides a better preservation of LV-function.
P314 The functional effects of intramural course of coronary arteries by two-dimensional speckle-tracking dobutamine stress
Authors: Ballo H , Uusitalo V , Luotolahti M , Pietila M , Saarenhovi M W , Hartiala J , Saraste M , Knuuti J , Saraste A 
Published: January 2020

Abstract

Background
Intramural course of a coronary artery is a common anatomic variant, especially in the left anterior descending coronary artery (LAD). However, its effect on the myocardial function during stress remains still unclear.

Purpose
We compared regional myocardial strain measured by speckle tracking during dobutamine stress echocardiography (DSE) in patients with or without intramural course of the LAD.

Methods
Fifty patients (63 ±7 years) were prospectively enrolled and underwent DSE, computed tomography angiography (CTA), quantitative 15-Oxygen water positron emission tomographic perfusion imaging (PET), and invasive angiography. Patients with superficial (&gt;1 mm) or deep (&gt;2 mm) intramural course in the LAD were identified using CTA. Regional longitudinal strain and strain rate (LS, LSr), circumferential strain and strain rate (CS, CSr), as well as radial strain and strain rate (RS, RSr) were measured at rest, at a dobutamine dose of 20 mg/kg/min, at peak stress, and at early recovery (1 min after stress). Obstructive coronary artery disease (CAD) was defined as &gt;75% stenosis or 40% to 75% stenosis combined with either fractional flow reserve &lt; 0.80 or ischemia on PET.

Results
Intramural course of the LAD was detected in 17 patients. Of these, 8 patients had obstructive CAD and were excluded. Thus, 9 patients with intramural course and 11 controls without intramural course or obstructive CAD in the LAD were included. Myocardial strain and strain rate in the myocardial territory distal to intramural segment were similar to those in controls at rest, dobutamine stress and early recovery (Figure). Furthermore, there were no significant differences, at all time points, between the regional strain values of the myocardial segments those distal to the superficial and deep intramural course. In the myocardium distal to an intramural coronary segment, regional myocardial flow measured by PET during adenosine stress correlated with the regional LS (r = 0.80, p = 0.004), LSr (r = 0.66, p = 0.03), and CS (r = 0.69, p = 0.02) and RS (r = 0.53, p = 0.07) at the peak dobutamine stress. However, there was no correlation between flow and strain at rest.

Conclusions
Myocardial strain is not consistently affected in patients with intramural course of the LAD during dobutamine stress as assessed by speckle tracking echocardiography. Larger studies are warranted to evaluate whether certain anatomical variants cause abnormalities in systolic myocardial strain.
Abstract P314 Figure.
P321 Cardiotoxicity related to cancer therapy. is the study of mechanical dispersion an additional value?
Authors: Privitera F , Losi V , Monte I P 
Published: January 2020

Abstract
Myocardial dysfunction are the most concerning cardiovascular complications of cancer therapies with a poor prognosis, so it’s critical to detect subclinical cardiac abnormalities in order to start cardioprotective therapy early or increased surveillance frequency. Global longitudinal strain (GLS) by echocardiography is an excellent tool for assessing regional and global left ventricular (LV) function. Mechanical dispersion (MD) reflects heterogeneous myocardial contraction, evaluated in many cardiopathies.
We evaluated subclinical myocardial dysfunction by GLS and MD using 2D Speckle-tracking Echo, in order to established if MD could be a predictor of ventricular dysfunction in the field of Cardiotoxicity (CTX).
Were enrolled 42 women with breast cancer chemotherapy-treated and underwent to Echo evaluation during 3- and 6-months follow-up, compared to evaluation performed before starting chemotherapy (T0). Depending on chemotherapy type were identified 2 groups: Anthracyclines ± Taxol treated (group 1) and Anti-HER2 treated (group 2). CTX diagnosis was made according ESC criteria: LVEF &lt; 50%, LVEF decrease &gt;10% or GLS decrease &gt;15% compared to previous check.
At three months, 28% patients (p &lt; 0,009) developed CTX and, in this group, MD was significantly increased compared to T0 (64,4ms ± 18,6 vs 43,48ms ± 7.88 p &lt; 0,001). This finding was consistent regardless treatment group: 65,2 ms ± 5,30 (p &lt; 0.0001) in group 1 and 63,14 ms ± 36,40 (p 0.02) in group 2. Also, GLS was significantly changed: in CTX patients decreased of 9% compared to T0 (p 0.02), but this finding was consistent in group 1 in which GLS decreased of 18% (p 0,01), while in group 2 decrease only of 5% and wasn’t statistically significant compared to T0 (p = 0,3). These patients were treated by beta-blockers or ACE-inhibitors. At six months there was a normalization of MD value (47.7 ± 15.97 ms in CTX group) that was not statistically significant compared to T0 (p = 0,2) and we have interpreted as consequence of positive effect induced by cardioprotective therapy.
We believe that MD is a predictor of ventricular dysfunction earlier than GLS during Anti-HER2 treatment, so in this field MD could integrates information obtained from GLS about subclinical dysfunction.
P333 Left ventricular rotational abnormalities in hypereosinophilic syndrome as assessed by three-dimensional speckle-tracking echocardiography
Authors: Nemes A , Kormanyos A , Marton I , Domsik P , Kalapos A , Ambrus N , Modok S , Borbenyi Z , Forster T 
Published: January 2020

Abstract

Introduction
Hypereosinophilic syndrome (HES) is a very heterogeneous group of disorders with varied etiologies characterized by peripheral eosinophilia and eosinophilic tissue/end-organ damage. In the present study, the ability of a novel non-invasive clinical tool, three-dimensional speckle-tracking echocardiography (3DSTE) was investigated to reveal any change in left ventricular (LV) rotational mechanics in clinically asymptomatic HES patients without manifest organ damage as determined by conventional diagnostic methods.

Methods
The present study comprised 13 patients established diagnosis of HES. However, one patient with idiopathic HES has been excluded due to insufficient image quality. The remaining patient population contained 11 cases with idiopathic HES and one patient with acute T-lymphoma associated HES (mean age: 59.7 ± 13.7 years, 8 males). The control group consisted of 36 healthy volunteers (mean age: 52.9 ± 8.3 years, 23 males). All HES patients and controls underwent complete two-dimensional Doppler echocardiography and 3DSTE.

Results
Both LV apical rotation (4.86 ± 1.92 degree vs. 10.07 ± 3.92 degree, p &lt; 0.0001) and LV twist (8.52 ± 2.79 degree vs. 14.41 ± 4.26 degree, p &lt; 0.0001) showed significant deteriotations in most of HES patients. In 2 subjects absence of LV twist called as LV „rigid body rotation’ (RBR) was detected. One patient had 1.77 degree counterclockwise (abnormally directed) LV basal rotation and 14.29 degree counterclockwise (normally directed) LV apical rotation resulting in 12.59 degree LV apico-basal gradient. The other patient had normally directed -2.09 degree LV basal rotation and almost zero (-0.27 degree) LV apical rotation resulting in 1.82 degree LV apico-basal gradient.

Conclusions
Reduced LV apical rotation and twist could be demonstrated in HES. LV-RBR could be detected in some HES patients.
P350 Right atrial remodelling in atrial fibrillation using three dimensional transthoracic echocardiography and strain imaging
Authors: Chalard C , Soulat-Dufour L , Lang S , Ederhy S , Ancedy Y , Adavane-Scheuble S , Chauvet-Droit M , Nhan P , Ben Said R , Boccara F , Cohen A 
Published: January 2020

Abstract

Background
Evaluation of right atrial cavities and right atrial (RA) remodelling in atrial fibrillation (AF) has been poorly studied.

Purpose
The aim of this study was to evaluate in AF, the role of three-dimensional (3D) transthoracic echocardiography (TTE) and strain to refine the evaluation of the RA according to evolution of cardiac rhythm ad mid-term follow-up.

Methods
A complete 2D and 3D TTE was performed in patient hospitalized for AF. In addition to the usual parameters, RA parameters were specifically assessed: 3D RA end-systolic (ES) and end-diastolic (ED) volume, RA ejection fraction (EF) and the global longitudinal strain (GLS) of the RA. A complete clinical evaluation and electrocardiogram were performed at admission (M0) and 6 months after inclusion (M6) to determine the cardiac rhythm at follow-up.

Results
34 consecutive patients hospitalized for AF were analysed. At M0, there was no significant difference between 2D RA ES volume and the 3D RA ES volume. Three groups of patients were individualized according to cardiac rhythm at M0 and M6: AF at M0 and AF at M6 (AF-AF), AF at M0 and sinus rhythm (SR) at M6 (AF-SR), SR at M0 (spontaneous reduction before the admission ECG) and SR at M6 (SR-SR). At M0 echocardiography, in the AF-AF group and AF-SR in comparison with SR-SR group were as follow: the 3D RA ED volume was significantly higher (respectively 21.6 (18.2-26.6) and 26.9 (19.4-36.8) versus 11.3 (6.9-16.6) mL/m2 ; p = 0.0025), the 3D RAEF was significantly lower (42.2 (35.1-44.7) and 34.5 (24.1-38.6) versus 57.6 (53.4-62.2)%; p = 0.0105) and the RA GLS was also significantly lower (7.6 (6.5-10.5) and 9.1 (5.8-11.2) versus 26.6 (22.0-35.0)%; p = 0.0001) (Figure 1).

Conclusion
3D ultrasound and strain could be useful tools for evaluating the anatomical and functional RA remodelling in AF, to be further validated in a larger ongoing study.
Abstract P350 Figure 1
P354 Right heart catheterization parameters, echocardiography parameters and B-Type natriuretic peptide prediction of acute cellular rejection in the first year after heart transplant
Authors: Valentim Goncalves A A , Pereira-Da-Silva T , Soares R , Ilhao Moreira R , De Sousa L , Rio P , Feliciano J , Reis J , Mendonca T , Cruz Coutinho M , Mano T , Cruz Ferreira R 
Published: January 2020

Abstract

Introduction
Since the mid-1970s, the diagnosis of acute cellular rejection (ACR) has been made by endomyocardial biopsy (EMB). Whether B-Type Natriuretic Peptide (BNP), transthoracic echocardiography (TTE) parameters and right heart catheterization (RHC) parameters can detect rejection in heart transplant (HT) patients have yielded conflicting results and did not overcome the use of EMB in the first year after HT.

Purpose
The aim of this study was to evaluate whether BNP, TTE and RHC parameters can be used to detect ACR in the first year after HT.

Methods
Prospective study of consecutive EMB performed in the first year after HT. Plasma BNP levels, TTE and RHC were performed at the same day.
Clinical significant ACR was defined as ≥ 2R, according to the ISHLT 2004 grading. The area under the curve (AUC) was analysed for statistically significant associations to detect ACR.

Results
From 2017 to 2018, 50 EMB were performed with the following results: 2R - 5 (10.0%); 1R- 29 (58.0%); 0 – 16 (32%). Mean age was 48.7 ± 8.3 years, with mean BNP value of 964.4 ± 1114.7pg/ml.
AUC results of BNP and several TTE and RHC parameters for the prediction of ACR are represented in the table. Right atrial pressure (RAP) value (p = 0.027) was the only significantly predictor of ACR, while isovolumic relaxation time measured by TTE revealed a borderline significant trend (p = 0.076).
RAP &gt; 10mmHg had a sensitivity of 60.0% and a specificity of 84.4% for detecting ACR.

Conclusion
Detecting ACR without EMB remains a clinical challenge, but RAP measured by RHC was a significant predictor of ACR in the first year after HT, while BNP values did not correlate with ACR.
AUC values PARAMETERS AUC p 95% CI BNP 0.658 0.251 0.405-0.911 Troponin I 0.591 0.507 0.260-0.923 Left ventricular ejection fraction 0.416 0.541 0.218-0.614 E/A 0.480 0.895 0.282-0.678 Deceleration time 0.463 0.463 0.161-0.765 Isovolumic relaxion time 0.745 0.076 0.427-1.000 Cardiac index 0.595 0.488 0.346-0.845 Pulmonary capillary wedge pressure 0.628 0.401 0.329-0.926 Mean pulmonary artery pressure 0.684 0.181 0.511-0.857 Right atrial pressure 0.804 0.027 0.631-0.978 AUC values
P358 Prevalence of suicide in a cohort of subjects submitted to exercise echocardiography: clinical characteristics and exercise echocardiography results
Authors: Peteiro Vazquez J C , Bouzas-Mosquera A , Varela-Cancelo A , Barbeiro-Caamano C , Broullon J , Vazquez-Rodriguez J M 
Published: January 2020

Abstract

Patients with clinical symptoms and morbidities might be more prone to commit suicide. Suicidal rate reaches up to 25-30/100.000 subjects in the countries most affected by this problem. We aimed to establish the rate of suicides among a large cohort of patients submitted to Exercise echocardiography (ExE), and also to study their clinical and ExE results, to better understand possible explanations.

Methods
Retrospective analysis of prospectively collected data on 12,615 patients (age 62 ± 12 years, 63% men) with a first treadmill ExE performed in our center for known/suspected coronary artery disease. Exclusion criteria were significant valve disease, cardiomyopathy, congenital heart disease, and age &lt;18 year-old. Ischemia was defined as the development of new wall motion abnormalities (WMAs) with exercise; abnormal ExE as ischemia or resting WMAs.

Results
During a follow-up of 4.7± 4.8 years (interquartil range 0.1-8.0 years) there were 2,578 deaths, including 21 due to suicide (rate 166/100.000 subjects). We compare clinical characteristics and ExE results between patients that committed suicide (S), patients that died of other causes (OC), and patients that survived (Surv). The worst clinical and ExE characteristics were found in patients that died of non-suicidal causes, whereas patients that committed suicide were in an intermediate risk position (Table).
In conclusion, suicidal rate seems to be very high among patients with a clinically indicated ExE. Clinical characteristics and ExE results of suicidal subjects are worse than in survivor patients and could in part explain this event.
Surv S OC P value Age, y 61 ± 12 65 ± 11 69 ± 9 &lt;0.001 Male 60% 86% 72% &lt;0.001 Diabetes Mellitus 17.5% 24% 31% &lt;0.001 Achieved METS 9.7 ± 3.2 8.3 ± 3.6 7.6 ± 2.9 &lt;0.001 Good functional capacity (≥10 METs) 55% 52% 29% &lt;0.001 Symptoms during ExE 16% 14% 19% 0.01 Maximal double product 25.0 ± 5.9 22.5 ± 6.4 22.9 ± 6.0 &lt;0.001 Submaximal test 20% 31% 32% &lt;0.001 Ischemia 27% 38% 44% &lt;0.001 ExE abnormal 37% 50% 63% &lt;0.001 LVEF at rest 59 ± 7 53 ± 13 54 ± 11 &lt;0.001 LVEF at peak 64 ± 11 60 ± 16 55 ± 15 &lt;0.001
P364 The first prospective study of non-compaction cardiomyopathy patients with preserved ejection fraction using cardiac magnetic resonance feature tracking
Authors: Kiss A , Szucs A , Furak A , Gregor Z S , Horvath M , Toth A , Czimbalmos C S , Dohy Z S , Szabo L , Suhai F I , Merkely B , Vago H 
Published: January 2020

Abstract
Feature tracking (FT) is a new cardiac magnetic resonance (CMR) technique for strain measurement to reveal changes e.g. in noncompaction cardiomyopathy (NCMP) patients with good ejection fraction (EF).
Our aim was to describe, first in the literature, the functional and CMR-FT strain values of NCMP patients with good EF and to compare them with their previous scans taken 4 years ago.
At the Heart and Vascular Center of Semmelweis University 6743 CMR examinations were done between 2009-2015 and 232 NCMP patients were diagnosed. We followed up 27 patients, who had a previous examination at least 4 years ago, had no co-morbidities and whoes EF were above 50% (mean age: 37 ± 14.4 years, 18 males, mean follow up: 5.7 ± 1.5 years). Their parameters were compared to a matched control (C) group.
The Medis Suite software was used for analysis, the MedCalc software for statistics, (p &lt; 0.05).
We compared the patient’s previous (PREV) and recent (REC) functional parameters but did not find significant changes. Comparing the global longitudinal and global circumferential strains (GLS, GCS) and rotation (R) no difference was found between the PREV and the REC values. The GCS showed significant difference between NCMP and C groups (-30.2 ± 5.0 vs -35.9 ± 4.5; p &lt; 0.0001). We compared the segmental longitudinal and circumferential strain values of PREV vs. REC groups and NCMP vs C groups and found significant differences just in a few segments. The left ventricular (LV) apical part’s mean longitudinal strain value showed significant decrease on the REC scans compared to the PREV (PREV vs REC: -24.4 ± 7.7 vs -20.6 ± 5.1%; p &lt; 0.05) and a non-significant decrease compared to the C (C vs REC: -22.8 ± 7.5 vs -20.6 ± 5.1%; p= n.s.).
The ratio of the average longitudinal strain value of the apical and basal part of the left ventricle was significantly smaller in the REC group compared to the PREV but did not differ from the C subjects ( PREV vs. REC: 1.5 ± 0.8 vs 1.0 ±0.3; C vs REC: 1.5 ± 0.3 vs 1.2 ± 0.5; p &lt; 0.05)
We did not find worsening in the functional parameters of NCMP patients with good EF by the end of the follow up period. However, subclinical changes can be detected in the affected apical part of LV when using FT suggesting the need for follow up.
418 Ultrasound molecular imaging of the role of von willebrand factor-mediated platelet adhesion in atherogenesis
Authors: Ozawa K , Muller M , Varlamov O , Packwood W , Xie A , Lopez J A , Lindner J R 
Published: January 2020

Abstract

Funding Acknowledgements
JSPS Overseas Research Fellowship

Background
Platelets are known to be both pro-inflammatory and pro-mitogenic. However, the role of platelet-endothelial interactions in the initiation and growth of atherosclerotic lesions is not well understood.

Purpose
We used contrast-enhanced ultrasound (CEU) molecular imaging of the arterial endothelium to test the hypothesis that platelet attachment to endothelial Von Willebrand Factor (VWF) promotes atherogenesis.

Methods
We studied wild-type mice (WT), low-density lipoprotein deficient mice fed western diet to produce atherosclerosis (LDLR-/-), and LDLR-/- mice also deficient for ADAMTS-13 (LDLR-/-ADAMTS13-/-) which is the enzyme responsible for proteolytic cleavage of endothelial-associated VWF. Mice were studied at 20 weeks and 30 weeks of age. A subset of LDLR-/- mice were treated with recombinant ADAMTS13 1 hr prior to study. Proximal aortic CEU molecular imaging of P-selectin, vascular cell adhesion molecule (VCAM)-1, von Willebrand factor (VWF), and platelet GPIbα was performed. Aortic distensibility was assessed using high-frequency (30 MHz) transthoracic echocardiography and tail cuff blood pressure systems. NF-κB of aorta was assessed by ELISA kit. Plaque size and composition were assessed by histology. Platelets and macrophage immunohistochemistry were also performed on confocal microscopy.

Results
Aortic molecular imaging signal for P-selectin, VCAM-1, VWF, and platelet adhesion was significantly higher in LDLR-/- than WT mice, and increased by 2-fold between 20 and 30 wks of age. Signal for VWF and platelet adhesion was abolished 1 h after administration of ADAMTS13, confirming that platelet adhesion was VWF-mediated. At 20 and 30 wks of age, molecular imaging signal for all targets was 2-fold higher (p &lt; 0.01) in LDLR-/-ADAMTS13-/- versus LDLR-/- mice. The LDLR-/-ADAMTS13-/- mice also had lower aortic distensibility (p &lt; 0.05), had a 2-fold higher NF-κB signal (p &lt; 0.05), and had a 2-fold greater total plaque area (p &lt; 0.01). Fluorescent immunohistochemistry confirmed that the LDLR-/-ADAMTS13-/- mice also had greater platelets (p &lt; 0.05) and increased macrophage content (p &lt; 0.05) than LDLR-/- mice in aortic plaque.

Conclusion
In early to mid-stage atherosclerosis, abnormal regulation of endothelial-associated VWF results in platelet adhesion and secondary up-regulation of endothelial inﬂammatory adhesion molecules, thereby promoting atherosclerotic plaque progression. These results indicate an important role of platelet-endothelial interactions in early atherogenesis.
Abstract 418 Figure