bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of rhythm in non-valvular atrial fibrillation on four cardiac chamber deformation imaging
Authors: Philabout P , Soulat-Dufour L , Benhamou-Tarallo I , Lang S , Ederhy S , Ancedy Y , Adavane-Scheuble S , Chauvet-Droit M , Nhan P , Jean M , Ben Said R , Boccara F , Addetia K , Lang R , Cohen A 
Published: November 2020

Abstract

Background
Few studies have assessed the evolution of cardiac chambers deformation imaging in patients with atrial fibrillation (AF) according to cardiac rhythm outcome.

Purpose
To evaluate cardiac chamber deformation imaging in patients admitted for AF and the evolution at 6-month follow-up (M6).

Methods
In forty-one consecutive patients hospitalised for AF two-dimensional transthoracic echocardiography was performed at admission (M0) and after six months (M6) of follow up. In addition to the usual parameters of chamber size and function, chamber deformation imaging was obtained including global left atrium (LA) and right atrium (RA) reservoir strain, global left ventricular (LV) and right ventricular (RV) free wall longitudinal strain. Patients were divided into three groups according to their cardiac rhythm at M0 and M6: AF at M0 and sinus rhythm (SR) at M6 (AF-SR) (n=23), AF at M0 and AF at M6 (AF-AF) (n=11), SR at M0 (spontaneous conversion before the first echocardiography exam) and SR in M6 (SR-SR) (n=7)

Results
In comparison with SR patients (n=7), at M0, AF patients (n=34)) had lower global LA reservoir strain (+5.2 (+0.4 to 12.8) versus +33.2 (+27.0 to +51.5)%; p&lt;0.001), lower global RA reservoir strain (+8.6 (−5.4 to 11.6) versus +24.3 (+12.3 to +44.9)%; p&lt;0.001), lower global LV longitudinal strain (respectively −12.8 (−15.2 to −10.4) versus −19.1 (−21.8 to −18.3)%; p&lt;0.001) and lower global RV longitudinal strain (respectively −14.2 (−17.3 to −10.7) versus −23.8 (−31.1 to −16.2)%; p=0.001). When compared with the AF-SR group at M0 the AF-AF group had no significant differences with regard to global LA and RA reservoir strain, global LV and RV longitudinal strain (Table). Between M0 and M6 there was a significant improvement in global longitudinal strain of the four chambers in the AF-SR group whereas no improvements were noted in the AF-AF and SR-SR group (Figure).

Conclusion
Initial atrial and ventricular deformations were not associated with rhythm outcome at six-month follow up in AF. The improvement in strain in all four chambers strain suggests global reverse remodelling all cardiac cavities with the restoration of sinus rhythm.
Evolution of strain between M0 and M6

Funding Acknowledgement
Type of funding source: None
Early change in left atrial and left ventricular strain predicts sinus rhythm maintenance after cardioversion
Authors: Kupczynska K , Miskowiec D , Michalski B , Szyda L , Wierzbowska-Drabik K , Wejner-Mik P , Lipiec P , Kasprzak J.D 
Published: November 2020

Abstract

Background
Atrial fibrillation (AF) impairs mechanical function of the heart, especially atria and restoration of sinus rhythm (SR) leads to improvement of mechanics. The predicting role of changes in strain parameters for AF recurrence is not established yet.

Purpose
To analyse changes in left atrial (LA) and left ventricular (LV) mechanical function after conversion to SR and their prognostic values for AF recurrence during 24 months follow-up.

Methods
Prospective study involved 59 patients after successful electrical cardioversion (EC) because of nonvalvular AF (mean age 65±4 years, 47% female). Speckle tracking analysis (STE) was applied to calculate longitudinal strain of LV and LA before EC and within 24 hours after restoration of SR and additionally total left heart strain (TS) defined as a sum of absolute peak LV and LA strain. We calculated change in strain between AF and SR analyses expressed as delta (Δ). During follow-up we noticed AF recurrence in 42 (71%) patients, most of them (93%) during 1st year after EC. Median time of AF recurrence was 3 months.

Results
We noticed significant immediate post-EC improvement in peak LA longitudinal strain (PALS) and LV global longitudinal strain (LVGLS) (table). Unlike CHA2DS2-VASc score, strain parameters were predictors of AF recurrence. Every 1% increment in ΔLVGLS was related with 13% increase in AF recurrence risk (p=0.02) and every 1% increment in ΔPALS and ΔTS were related with 9% decrease in AF recurrence risk (p=0.007 and p=0.0014, respectively). Multivariate analysis revealed ΔTS as a strongest predictor with 9% decrease in AF risk per every 1% increment. The criterion of ΔTS ≤7.5% allows to predict AF recurrence with 81% sensitivity and 63% specificity.

Conclusions
Speckle tracking measurements are able to detect early mechanical changes in LA even within 24 hours of SR and these absolute changes in LVGLS as well as PALS can predict AF recurrence, with optimal stratification by novel parameter - TS.

Funding Acknowledgement
Type of funding source: None
Differences in valve morphology between patients with bicuspid and tricuspid aortic valve
Authors: Aviv Y , Nassar M , Perlman G , Arow Z , Lessick J , Danenberg H , Vaknin-Assa H , Finkelstein A , Kornowski R , Hamdan A 
Published: November 2020

Abstract

Background
Bicuspid aortic valve (BAV) patients represent a significant minority of severe aortic stenosis (AS) patients undergoing transcutaneous aortic valve implantation (TAVI). These patients demonstrate anatomic differences compared to tricuspid aortic valve (TAV). Ethnicity is associated with different valve morphologies characterized by Siever's classification.

Purpose
We aim to evaluated the prevalence of BAV subtypes and the differences in valve morphology and aortic root dimensions between BAV and TAV in patients undergoing computed tomography (CT) before TAVI.

Methods
In five Israeli medical centers, 131 patients with BAV and 674 patients with TAV underwent CT angiography. BAV morphology was defined according to the number of commissures and raphe, following Siever's classification. Aortic root dimensions were measured at the level of the aortic annulus, sinus of Valsalva (SOV), and sino-tubular junction (STJ). Finally, Agatston score unit (AU) for valve calcification was evaluated.

Results
Type 0 accounted for 27% (36/131), Type IA for 63% (82/131), Type IC for 9% (12/131), and Type 2 for 1% (1/131). Calcium score in BAV patients was significantly higher compared to TAV patients, 4000±1897 vs. 2152±1216 AU; respectively (P&lt;0.001). Distance from the annulus to the left main coronary artery was greater in BAV patients compared to TAV (13.8±3.6 mm vs. 12.8±2.8 mm; respectively, P&lt;0.001), similar distance from annulus to right coronary artery was observed in BAV and TAV patients (16.7±3.7 mm vs. 15±3 mm; respectively, P&lt;0.001). Aortic annulus perimeter was greater in BAV than TAV patients (79.3±11mm vs. 73±8.7mm, respectively, P&lt;0.001), as well as SOV perimeter (35.7±4.5mm vs. 32±3.7mm, respectively, P&lt;0.001), and STJ perimeter (32.3±5mm vs. 27±3.3 mm; respectively, P&lt;0.001).

Conclusion
In Israel, AS patients showed more frequently type 1A BAV. BAV patients have larger aortic root dimensions and higher calcium burden than TAV patients.

Funding Acknowledgement
Type of funding source: None
Resolution of leaflet thrombosis under anticoagulant therapy in patients after transcatheter aortic valve implantation: influence of prosthesis type and size
Authors: Ferstl P , Arnold M , Goeller M , Ammon F , Smolka S , Moshage M , Uehlein S , Achenbach S , Marwan M , Bittner D.O 
Published: November 2020

Abstract

Introduction
Leaflet thrombosis can frequently be identified by computed tomography angiography (CTA) in patients after transcatheter aortic valve implantation (TAVI). Oral anticoagulation is assumed to lead to resolution of thrombosis. We analyzed the resolution of leaflet thrombosis after TAVI by anticoagulant therapy in serial CTA and assessed the influence of prosthesis type.

Methods
Consecutive TAVI patients who underwent CTA follow-up were screened and individuals with leaflet thrombosis on CTA (defined by the presence of hypo-attenuated leaflet thickening, HALT) in whom oral anticoagulation was initiated and who underwent follow-up CTA were included. The type of anticoagulation was according to physicians' discretion. We assessed the resolution of HALT and compared patients with and without resolution of HALT regarding prosthesis type, prosthesis diameter and type of anticoagulation.

Results
Out of 395 patients screened for participation, 36 patients (mean age 80±7, 67% men) with leaflet thrombosis underwent follow-up CTA at a medial interval of 3 months (IQR: 3; 5.75 months) after anticoagulation was initiated. 36 patients received either vitamin-K antagonists (n=28, 78%) or Factor-Xa Inhibitors (n=8, 22%). A total of 22 (61%) balloon-expandable and 14 (39%) self-expandable transcatheter aortic valves were implanted. Nominal prosthesis diameter was 23, 25, 26, 27 and 29 mm in 7 (19%), 1 (3%), 10 (28%), 7 (19%) and 11 (31%) patients, respectively. 30 patients (83%) with anticoagulation showed resolution of HALT, whereas persistent HALT was detected in 6 patients (17%), of whom 1 patient with balloon-expandable and 5 patients with self-expandable valve. No difference was seen in duration of anticoagulation between patients with and without resolution of HALT (p=0.984). In univariate analysis, prosthesis type (balloon-expandable vs. self-expandable valves) showed a significant association of self-expandable valves with lack of resolution of leaflet thrombosis (p=0.017). In multivariable logistic regression analysis, this association persisted (p=0.043) and was independent of the type of anticoagulation (p=0.660) and prosthesis diameter (p=0.942).

Conclusion
Persisting leaflet thrombosis despite anticoagulation is not infrequent and seems to be associated with prosthesis-type rather than small valve diameter or type of anticoagulation. Further research is necessary to identify structural aortic valve determinants for this finding.

Funding Acknowledgement
Type of funding source: None
Texture analysis of CINE CMR image in healthy volunteers-preliminary results
Authors: Tie P , Gandy S.J , Ross R.A , Houston J.G 
Published: November 2020

Abstract

Background
Texture analysis (TA) is a technique that measures the MRI signal via pixel greyscale variations (figure 1), and may be useful in cardiac MR (CMR) for detecting features not visible to the human eye.

Purpose
To use TA to examine myocardial CINE MR Images in a cohort of volunteers. Major feature differences were anticipated between images at end diastole (ED) and end systole (ES), whilst minor differences were anticipated between younger and older volunteers.

Methods
Two cohorts (each n=30) were studied - young (44±3 years), and old (68±4 years). A 2D ECG-gated breath-hold segmented steady-state gradient echo sequence was used. Myocardial TA features were derived using MaZda v4.7. Measurements were made by two observers.

Results
A total of 39 TA features were significantly different between ED and ES (p&lt;0.05), and 9 features were significantly different between the young and old cohorts (p&lt;0.05). Finally, 15 of the original 50 TA features were repeatable (root mean squared coefficient of variation under 10%).

Conclusion
Selected TA features in CINE CMR are repeatable and can identify differences between major and minor texture changes.

Funding Acknowledgement
Type of funding source: Other. Main funding source(s): Medical Research Scotland, Guerbet Group
Insight form cardiovascular magnetic resonance on cardiac sarcoidosis: a single centre experience
Authors: Alderighi C , Baritussio A , Ozden Tok O , Perazzolo Marra M , Iliceto S , Bucciarelli-Ducci C 
Published: November 2020

Abstract

Background
Clinically manifest cardiac sarcoidosis (CS) has a prevalence of 5%, but is more frequent in autoptic series (25%). Diagnosis is multiparametric and relies on clinical criteria and imaging findings, although a certain diagnosis, especially in the case of isolated CS (ICS), can only be based on endomyocardial biopsy. Cardiovascular magnetic resonance (CMR) has a comprehensive role in the assessment of CS: left ventricular (LV) dysfunction and extent of late gadolinium enhancement (LGE)are important predictors of prognosis, T2 mapping provides information on disease activity and global longitudinal strain (GLS) analysis can uncover subclinical LV impairment.

Purpose
To assess the prevalence of CS by CMR in patients with biopsy-proven extracardiacsarcoidosis (ECS); to describe the imaging characteristics of patients with ECS and those with high clinical suspicionof ICS; to investigate the contribution of more recent techniques to the diagnosis of CS alongside traditional LGE assessment.

Methods
We retrospectively enrolled 84 patients (66% males, mean age 59±13 years) referred to our centreforsuspected CS (biopsy-proven ECS, n=61; clinical presentation suggestive of CS,, n=23). CMR was performed on a 1.5T scanner, with a protocol comprehensive of biventricular functional assessment and post-contrast images; T2-STIR images (n=30), native myocardial T1 mapping (n=24) and T2 mapping (n=19) were also performed in selected patients. Tissue tracking analysis was perfomed in all patients using a dedicated software.

Results
Based on CMR findings, 35 patients (42%) with ECS did not show cardiac involvement (SS), 26 (31%) showed both cardiac and systemic involvement (CS-SS) and 23 (27%) had evidence of ICS (ICS). 43% of patients had history of arrhythmias, but life-threatening tachyarrhythmiaswere more frequent in patients with CS (p=0.02).Patients with CS had significantly lower LVEF (p&lt;0,01), larger LV volumes (p&lt;0,01) and greater LV mass (p&lt;0,01). GLS values were impaired in all the groups but significantly more in patients with CS (p&lt;0,01). With regards to LGE distribution, ICS patients showed a higher number of segments involved (p=0,011) as compared to CS patients. T2-STIRimages were positive in 3 out of 30 patients; T2 mapping detected myocardial oedema in 1 patient with negative T2- STIR and was positive in 7 who did not undergo traditional oedema evaluation. T1 mapping mainly confirmed the results provided by LGE, but was altered in 1 patient who could not receive gadolinium.

Conclusions
CMR findings consistent with CS were found in 49 patients referred for suspected CS. Patients with cardiac involvement, particularly if isolated, had significantly lower LVEF, greater LV volumes and more impaired GLS. Patients with SS, despite a normal LV function, showed mildly impaired GLS, subtending subclinical cardiac involvement.

Funding Acknowledgement
Type of funding source: None
Decreased global strains of the left ventricle in asymptomatic female carriers for duchenne muscular dystrophy gene using feature-tracking: a prospective study
Authors: Masarova L , Panovsky R , Pisciotti M , Kincl V , Pesl M , Opatril L , Machal J , Novak J , Holecek T , Feitova V 
Published: November 2020

Abstract

Background
Duchenne muscular dystrophy (DMD) is an X-linked recessive disease manifested in males predominantly by skeletal muscle wasting but also dilated myocardium. Heterozygous female carriers often have normal echocardiographic findings. Nevertheless, untreated could develop in 4th and 5th decade of life to cardiomyopathy, probably due to progressive myocardial fibrosis. CMR feature tracking (FT) is an innovative technique that measures the myocardial wall deformation and could help to detect the contractile dysfunction, even in its early stages, due to its high sensitivity. Thus, it could identify asymptomatic carriers at higher risk of developing cardiomyopathy later in life.

Aim
This prospective study aimed to assess left ventricular systolic function (LV) in DMD carriers using CMR-FT.

Methodology
Global longitudinal strain (GLS), global circumferential strain (GCS) and global radial strain (GRS) were evaluated by CMR-FT. End-systolic (ESV), end-diastolic (EDV) LV volumes and ejection fraction (EF) LV were also measured using CMR-FT.
There were 37 carriers, and 20 healthy controls enrolled in the study. The measured parameters showed a Gaussian distribution and were compared using a t-test, followed by Benjamini-Hochberg correction.

Results
Groups carriers and controls did not differ in basic demographic data (age: 39.5±9.1 vs. 39.1±10.7 years). In contrast, there were found statistically significant differences in EF LV (56±5 vs. 60±3%), and all strain parameters (GLS (−19.4±2.4 vs. −22.3±2.2%), GCS (26.8±3.3 vs. 29.5±2.0%) and GRS (59.8±12.9 vs. 70.9±14.8%, all p&lt;0.05)).

Conclusion
Carriers had significantly lower values of all strains compared to controls using CMR-FT, although they had preserved EF LV. CMR-FT could be beneficial for early diagnosis of the developing heart disease in asymptomatic patients with a genetic predisposition.

Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The work was supported by project no. LQ1605 from the National Program of Sustainability II (MEYS CR).This publication was written at Masaryk University as part of the project “Evaluation of left ventricular function using the feature tracking technique of Duchenne muscular dystrophy genes carriers” MUNI/A/1493/2018 with the support of the Specific University Research Grant, as provided by the Ministry of Education, Youth and Sports of the Czech Republic in the year 2018.
Prognostic value of cardiac 123I-metaiodobenzylguanidine imaging for predicting cardiac events after transcatheter aortic valve replacement
Authors: Kadoya Y , Zen K , Tamaki N , Yashige M , Takamatsu K , Ito N , Kuwabara K , Yamano M , Yamano T , Nakamura T , Matsushima S , Yaku H , Matoba S 
Published: November 2020

Abstract

Background
In patients with aortic valve stenosis (AS), cardiac sympathetic nervous (CSN) dysfunction and its improvement after TAVR have been reported; however, the prognostic impact of CSN function remains unclear. This study investigated the prognostic value of cardiac 123I-metaiodobenzylguanidine (MIBG) imaging for the prediction of cardiac events after transcatheter aortic valve replacement (TAVR).

Methods
This study was a single-center prospective observational study that enrolled patients with AS or failed surgical bioprostheses between July 2017 and May 2019. MIBG scintigraphy was performed before and after TAVR to evaluate the delayed heart–mediastinum ratio (d-H/M). Patients were classified into three pairs of groups based on the baseline and post-TAVR d-H/M (≥2.0 or &lt;2.0) and on the presence of TAVR-related improvement of d-H/M. The study endpoints were major adverse cardiac events (MACE), including all-cause death, myocardial infarction, and hospitalization due to heart failure. The association of d-H/M with MACE following TAVR was based on a Cox proportional hazards ratio model adjusted for multiple prognostic variables.

Results
Of 187 consecutive patients who underwent TAVR, 111 (31 men; median age: 86 years) were evaluated. Over a median follow-up of 366 days, 16 (14.4%) patients had MACE. The incidence of MACE was significantly lower in patients with d-H/M improvement and/or the high post-TAVR d-H/M (≥2.0). Post-TAVR d-H/M had significant impacts on MACE, with an adjusted hazard ratio of 1.326 (95% confidence interval, 0.139–2.515; p=0.027).

Conclusions
Both d-H/M improvement and high post-TAVR d-H/M were associated with better prognosis in patients who underwent TAVR. Cardiac MIBG imaging was useful for predicting cardiac events after TAVR.

Funding Acknowledgement
Type of funding source: None
Perfusion-metabolic mismatch in myocardial scintigraphy in patients with vasospastic angina: what does it mean clinically?
Authors: Teragawa H , Oshita C , Orita Y 
Published: November 2020

Abstract

Background
It has been reported that perfusion-metabolic mismatch (PMM) in thallium-201 (Tl) and 123I-βmethyl-p-iodophenyl-pentadecanoic acid (BMIPP) shows important information regarding myocardial ischemia in the clinical setting. Such findings have been frequently obtained, even in patients with vasospastic angina (VSA). However, it has not been fully clarified what such findings mean clinically in patients with VSA. There, we investigated the frequency of PMM in patients with VSA as well as clinical characteristics of patients with VSA who have PMM.

Methods
Seventy-eight patients (mean age: 70 yrs, 29 men and 49 women) were diagnosed with VSA by coronary angiography and spasm-provocation test (SPT). We defined VSA as the presence of more than 90% narrowing of the epicardial coronary artery on angiograms, accompanied by the usual chest symptoms and/or ischemic ST-T changes on electrocardiogram. On SPT, multi-vessel spasm was defined as the presence of spasm on ≥ two major coronary arteries. Dual myocardial scintigraphy with Tl and BMIPP was performed, and the presence of PMM was defined as the summed rest score (SRS) in BMIPP scintigraphy ≥4 and difference in SRS in BMIPP and Tl-201 ≥4. Patients were divided into two groups according to the presence of PMM: Group I (+PMM, n=30) and Group II (−PMM, n=48). Each patient with VSA was assessed for conventional coronary risk factors, numbers of angina attacks per month, and taking vasodilators.

Results
Age, gender distribution, and conventional risk factors were not different between the groups. The median number of angina attacks was higher in the Group I than in the Group II (Group I: 4.5 vs. Group II: 0.1, p&lt;0.01), and fewer patients were taking vasodilators in Group I (Group I: 1.1±1.0 vs. Group II: 1.5±1.1, p&lt;0.05). On SPT, the presence of multi-vessels spasm was significantly higher in Group I (76%) than Group II (44%, p&lt;0.05). Logistic regression analysis showed that the presence of multi-vessels spasm (p&lt;0.05) and taking a smaller amount of vasodilators (p&lt;0.05) were associated with PMM.

Conclusions
These findings suggest that PMM in Tl and BMIPP scintigraphy are associated with multi-vessels spasm and a smaller amount of vasodilator medication. This imaging data may provide important information regarding activity of VSA and sufficient medication.

Funding Acknowledgement
Type of funding source: None
Predicting the change in the coronary calcium score in patients with diabetes
Authors: Bellinge J , Lee S.C , Francis R , Phillips M , Schultz C 
Published: November 2020

Abstract

Background
The rate of increase of coronary arterial calcification score (CCS) on serial CT-scans years apart is a potent marker of cardiovascular risk but identifies risk only after irreversible damage has occurred. Molecular imaging may assist in identifying patients who are at risk of developing severe arterial calcification.

Purpose
To determine if 18F-Sodium Fluoride Positron Emission Tomography (18F-NaF PET) can predict and anatomically locate the progression of CCS over 2 years.

Methods
Subjects with diabetes mellitus underwent a baseline 18F-NaF PET scan and a CT CCS. The CT CCS was repeated after 2 years. 18F-NaF PET tracer uptake was measured as the maximum tissue to background ratio (TBRmax) and using a pre-defined cut-off for positivity, arteries were dichotomised into 18F-NaF positive and negative. We compared the change in the CCS between coronary arteries that were positive and negative for 18F-NaF uptake.

Results
In forty-one participants (mean age 65.0±7.1, male: 63.4%) a total of 163 coronary arteries were included in the analysis. Fifty-two (31.9%) coronary arteries were 18F-NaF positive at baseline and 111 (68.1%) were negative. After 2.8 [2.4–3.2] years follow-up, the TBRmax at baseline correlated with the time-standardised change in the CCS (Spearmans' rho 0.33, p&lt;0.001). The time-standardised change in the CCS was higher in coronary arteries that were 18F-NaF positive compared to negative (48.9 [13.6–119.7] v 3.3 [0–27.9], p&lt;0.001). The time-standardised change in coronary calcium score increased across patients with increasing number of 18F-NaF positive arteries at baseline (p=0.006) (Figure 1).

Conclusions
18F-NaF PET activity at baseline is associated with new co-localised calcifications 2.8 years later
Figure 1

Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): Royal Perth Hospital Research Foundation