bluuebunny/crossref_metadata_2025_split huggingface dataset:
Right heart echocardiographic parameters and outcomes of patients with aortic stenosis after transcatheter aortic valve implantation
Authors: Brandao M , Mendes L , Diaz S , Santos-Ferreira D , Barros A , Rodrigues A , Braga P , Sampaio F , Fontes-Carvalho R 
Published: June 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
The impact of right ventricular (RV) function and RV to pulmonary artery (RV-PA) coupling on outcomes of patients with aortic stenosis undergoing transcatheter aortic valve implantation (TAVI), and the early effect of the intervention, remain partly unclear.

Aim
To evaluate the impact of right heart echocardiographic (echo) parameters on the outcome of patients undergoing TAVI.

Methods
Retrospective analysis including consecutive patients submitted to TAVI at our center between 2007–2021.
Pre and postprocedural (≤96h) echo parameters were analyzed: tricuspid annular plane systolic excursion (TAPSE), S-wave tissue Doppler velocity of the tricuspid annulus (S'), pulmonary arterial systolic pressure (PASP). TAPSE/PASP ratio was used as a surrogate of RV-PA coupling; TAPSE/PASP ratio&lt;0.31 defined RV uncoupling.
Primary endpoint (PE) was defined as all-cause death within 1-year after TAVI. Echo parameters were compared between patients according to the PE. Pairwise comparison of pre- and post-TAVI indexes was also performed, for the overall cohort and according to the primary endpoint. Statistical significance was considered if p&lt;0.05.

Results
Of 1040 TAVI patients, 615 patients with complete echo data were included: median age 81 years, 53% female, left ventricular ejection fraction 55(45–60)%. Before TAVI, 60 patients (11%) presented RV dysfunction (TAPSE&lt;17mm), and 30 (15%) RV-PA uncoupling.
A significant reduction in PASP was observed after TAVI (40 vs 36 mmHg, p&lt;0.01).[image] TAPSE decreased post-TAVI (20.0 vs 19.5 mm, p = 0.04); S’ values did not differ between evaluations (11.20 vs 11.50, p = 0.08).
1-year follow up data was available for 467 patients; the primary endpoint occurred in 37 (7.9%) patients. Patients meeting the PE had higher preprocedural PASP (42 vs 39 mmHg, p = 0.036). PASP decreased after TAVI (39 vs 36 mmHg, p&lt;0.001) in patients who survived the 1st year, but not in patients meeting the PE (p = 0.82).
Postprocedural TAPSE/PASP ratio was lower in the deceased group (0.43 vs 0.57, p = .031); persistence of RV-PA uncoupling post-TAVI was more frequent in patients who met the PE (25% vs 8.1%, p = .047).

Conclusions
In this cohort, RV longitudinal function parameters did not improve after TAVI. Contrastingly, RV-PA coupling improved after the procedure. Persistence of RV-PA uncoupling after TAVI was more frequent in patients who died during the 1st year of follow-up.
Association of strain echocardiography with cardiovascular outcomes in patients with heart failure with preserved ejection fraction
Authors: Frye J T , Tao M , Ghosalkar D , Rahman T , Tam E , Dianati-Maleki N 
Published: June 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Speckle Tracking Echocardiography (STE) with measurement of Left Ventricular Global Longitudinal Strain (LVGLS) is an important predictor of morbidity and mortality in Heart Failure with Reduced Ejection Fraction (HFrEF), but its prognostic importance in Heart Failure with Preserved Ejection Fraction (HFpEF) is less clear. The purpose of this meta-analysis is to analyze the association between LVGLS and Major Adverse Cardiac Events (MACE) in HFpEF.

Methods
A literature search was conducted for studies reporting on STE in patients with HFpEF and the association between LVGLS and MACE. The databases queried were Pubmed, Embase, and Web of Science. The search was not restricted to time or publication status.

Results
A total of 9 studies with 2,082 total patients met inclusion criteria. Among these, 5 studies with 944 HFpEF patients (300 with future MACE, 644 without future MACE) compared baseline mean LVGLS. Mean follow up duration was 28 months (ranging 12–48 months), mean age was 67 years old, 39.4% were male. LVGLS was significantly reduced in patients who eventually had MACE compared to those without MACE on follow-up (MD −2.09, 95% CI −2.17, −2.01, p &lt; 0.01).
4 studies with 1,138 HFpEF patients (676 with impaired LVGLS below cutoff, 462 with unimpaired LVGLS above cutoff) compared all-cause mortality or heart failure hospitalization. Mean follow up was 35 months, mean age was 71 years old, 38.3% were male, and the average LVGLS cutoff was 14. Impaired LVGLS below cutoff was associated with significantly higher risk of MACE (OR 2.13, 95% CI 1.67, 2.72, p &lt; 0.01). Subgroup analysis demonstrated that impaired LVGLS below cutoff was associated with significantly higher risk of both all-cause mortality (OR 2.11, 95% CI 1.40, 2.97, p &lt; 0.01) and heart failure hospitalization (OR 2.16, 95% CI 1.53, 3.06, p &lt; 0.01).

Conclusions
STE and measurement of LVGLS may represent a useful clinical tool in risk stratification of HFpEF patients at risk for future mortality and adverse cardiac events.
Long term prognostic value of global myocardial work in patients with heart failure with mildly reduced ejection fraction
Authors: Chang W 
Published: June 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Heart failure (HF) with mildly reduced ejection fraction (HFmrEF) is defined as HF with a left ventricular (LV) ejection fraction (LVEF) of 41–49%. However, the change in LV function and the subsequent prognosis in these patients remain unclear. Echocardiographic global longitudinal strain (GLS) is a useful measure for detection of myocardial function but is influenced by blood pressure changes. In contrast, myocardial work (MW), incorporating blood pressure, may overcome the limitation.

Objectives
We aimed to investigate whether LV MW could differentiate the changes of LVEF and predict the clinical outcomes in patients with HFmrEF.

Methods
In this prospective cohort study, 273 outpatients with HFmrEF underwent echocardiograms at diagnosis and one year after HF therapies. GLS, global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency were measured. The observed clinical outcome was hospitalizations for HF. Regression analysis was used to study the combined use of GLS and MW for the diagnostic and prognostic assessment of HFmrEF.

Results
Among patients with HFmrEF, the more impaired the LV GLS at baseline, the higher probability of worsening EF development. An absolute change in GLS and GWI were associated with subsequent worsening EF. Change in GWI and GCW demonstrated incremental value over GLS and clinical factors for the diagnosis of concurrent worsening EF. Regarding the clinical outcome, patients who presented with worsening EF had a higher risk of hospitalization for HF. In Cox regression, patients with more preserved GLS or lesser GLS decline during the follow-up had a lower risk of hospitalization for HF. Notably, the combined use of GLS and MW add incremental value on the prognosis in patients with HFmrEF.

Conclusions
GLS can be used for differentiating the changes of LVEF and subsequent hospitalization for HF in patients with HFmrEF while MW added predictive values.
Changes in echocardiographic parameters over time in paradoxical low-flow low-gradient aortic stenosis
Authors: Galian-Gay L , Teixido-Tura G , Casas G , Fernandez-Galera R , Ferrer-Sistach E , Mitroi C , Saura D , Vidal B , Moral S , Calvo F , Sanchez V , Gonzalez A , Rodriguez Palomares J F , Ferreira-Gonzalez I , Evangelista A 
Published: June 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Although paradoxical low-flow low-gradient (LFLG) aortic stenosis (AS) has been considered a more severe form of AS with a worse prognosis than high-gradient (HG) AS, data on the natural history of this entity are scant.

Objectives
To assess the progression of the disease and evolution of the main echocardiographic variables for quantifying AS in patients with severe LFLG AS compared to HG and normal-flow low-gradient (NFLG) AS.

Methods
A longitudinal, observational, multicenter study including consecutive asymptomatic patients with severe AS (AVA&lt;1.0cm²) and normal LVEF (≥50%) was conducted. Patients were classified according to baseline echocardiography into one of three groups: HG (mean gradient≥40 mmHg), NFLG (mean gradient&lt;40 mmHg, indexed systolic volume (SVi)&gt;35ml/m²), or LFLG (mean gradient&lt;40mmHg, SVi≤35ml/m²). AS progression was analyzed by comparing patients’ baseline measurements and their last follow-up measurements or those taken prior to aortic valve replacement (AVR).

Results
Of the 903 included patients, 401 (44.4%) were HG, 405 (44.9%) NFLG, and 97 (10.7%) LFLG. The median total follow-up time was 60.2 months (IQR 44.7–83.4). Progression of the mean gradient in a linear mixed regression model was greater in low-gradient groups: LFLG vs. HG (regression coefficient 0.124, p = 0.005) and NFLG vs. HG (regression coefficient 0.068, p = 0.018). No differences were observed between the LFLG and NFLG groups (regression coefficient 0.056, p = 0.195). However, aortic valve area (AVA) reduction was slower in the LFLG group compared to the NFLG (p&lt;0.001). During follow-up, 19.1% (n=9) of LFLG patients evolved to having NFLG AS and 44.7% (n=21) to having HG AS. 58.0% of patients underwent AVR with HG AS (n=29).

Conclusions
LFLG AS shows an intermediate AVA and gradient progression compared to NFLG and HG AS. The majority of patients initially classified as having LFLG AS changed over time to having other severe forms of AS, and most of them received AVR with HG AS.
Asymptomatic left ventricular systolic dysfunction in hypertensive patients with disturbed ventriculo arterial coupling
Authors: Georgieva N , Kinova E , Goudev A 
Published: June 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Left ventricular (LV) ejection fraction (LVEF) is most commonly used validated echocardiographic parameter of systolic function estimation, but left ventricular (LV) global longitudinal strain (GLS) is an early indicator of subclinical cardiac dysfunction, even when LVEF is normal.

Purpose
To investigate ventriculo – arterial coupling (VAC) and LV function in asymptomatic hypertensive patients without target organ damage to compare different echocardiographic parameters for systolic function.

Methods
A total 110 patients (56 ± 14 years) with hypertension, were separated in two groups: 32(men, ( 59 %)) patients with normal AE/Ees ratio (Arterial elastance (AE) and ventricular elastance (Ees)) and 78 (men, ( 64%)) hypertensive patients with decrease AE/Ees ratio, marker for ventriculo – arterial coupling. All patients underwent standard two – dimentional echocardiography with Speckle tracking analysis for LV - GLS. End – systolic pressure was determined from the brachial pulse wave. Arterial elastance (AE) and ventricular elastance (Ees) were calculated as and – systolic pressure/stroke volume and end – systolic pressure/end – systolic volume.

Results
Patients with disturbed VAC had concentric hypertrophy whereas patients with normal VAC had concentric remodeling. There were no significant differences in EF, but GLS in all patients was reduced. There were no statistically significant differences in LV diastolic function parameters. Statistically significant differences in echocardiographic parameters were found in patients with normal VAC in comparison with disturbed VAC (TABL. 1), There are negative correlation between LV - GLS and AE/Ees (r = -0.327, p = 0.001) and positive with Ees (r=0.250, p = 0.015).

Conclusion
LV - GLS is a more sensitive parameter of LV systolic function than LVEF, when LV concentric hypertrophy is present in hypertensive patients. Further investigation are needed to confirm the superiority of GLS over LVEF in LV systolic function estimation and its implementation in clinical practice.
Cardiopulmonary exercise test with bicycle stress echocardiography for prediction of cardiac events in patients with stage A or B heart failure
Authors: Ahn H , Cho G Y , Yoon Y E , Hwang I C , Choi H M , Choi H J , Park J S , Kang S E 
Published: June 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Given the high prevalence of stage A or B heart failure (HF), screening for all these patients to development of new HF can be cost prohibitive, hence, further risk stratification may be needed to identify higher risk patients.

Purpose
This study aims to assess the prediction of adverse cardiac events using by cardiopulmonary exercise test (CPET) with bicycle stress echocardiography (BSE) in patients with stage A or B HF.

Methods
Of 688 patients who underwent CPET and BSE at the same time, 423 patients with stage A or B HF were analyzed.

Results
After median of 8 years of follow-up, 59 (13.9%) of the 423 patients had events. Cardiac events were defined as hospitalization for new HF and cardiac death. In univariate analysis, age, LV mass index, LA volume index, LA strain, baseline or exercise E/e’, TR velocity, peak oxygen consumption (VmaxO2), ventilatory sufficiency (VE/VCO2), diastolic flow reserve, and diabetes mellitus were associated with events. However, LV volume, LVEF and systolic flow reserve were not associated. In multivariate analysis, baseline E/e’ (HR 1.07, 95% CI 1.03–1.11) and VE/VCO2 (HR 1.100, 95% CI 1.04–1.16) were only independent predictors for events.

Conclusions
In patients with stage A or B HF, baseline E/e’ and ventilatory sufficiency obtained from an CPET were good predictors of future development of HF and cardiac death.
Impact of the new classification of tricuspid regurgitation on the baseline characteristics and prognosis of a wide series of "real life" patients
Authors: Fernandez Ruiz A , Ruiz Ortiz M , Resua Collazo A , Fernandez Aviles Irache C , Campos Heredia G , Rodriguez Almodovar A , Esteban Martinez F , Delgado Ortega M , Piserra Lopez De Heredia A , Cortes N , Moran Salinas A , Nistor A , Gonzalez Manzanares R , Mesa Rubio D , Pan Alvarez-Ossorio M 
Published: June 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Andalusian Society of Cardiology

Introduction
A new classification of severe tricuspid regurgitation (TR) has recently been described that distinguishes three subgroups: severe, massive and torrential. Our objective was to analyse the prevalence of the new categories, describe their baseline characteristics according to severity group and assess their impact on the prognosis in a large series of patients with severe TR of a tertiary care hospital in our area.

Methods
All consecutive patients ≥18 years with severe TR studied with echocardiography in a tertiary care hospital in our area from 01.01.2008 to 12.31.2017 were retrospectively included. Images were analysed off-line to measure the maximum vena contracta (VC) in any echocardiographic plane and severe TR was classified into three groups: severe (VC≥7mm), massive (VC 14–20mm) and torrential (VC≥21mm). Baseline characteristics were analysed in the different subgroups and follow-up events by univariate and multivariate techniques. The combined event of death and heart failure (HF) admission on follow-up was investigated.

Results
A total of 661 patients (69±13 years, 72% women) with severe TR were included. 81.5% (539) presented severe TR, 15.6% (103) massive TR and 2.9% (19) torrential TR. The baseline characteristics were different according to the different subgroups of severity (Table). The 5-year HF-free survival was 42%, 44% and 11% (p&lt;0.0005), for the different subgroups, respectively (Figure). After adjusting for baseline characteristics, the severity of TR assessed by VC was independent predictor of HF-free survival, HR 0.89 [95%CI 0.70–1.15] p = 0.39, for massive TR; and HR 2.48 [95% CI 1.52–4.05] p&lt;0.0005, for torrential TR considering severe TR as reference.

Conclusions
In this large monocentric study, severe TR measured by VC was the most frequent subgroup, followed by massive and torrential. The prognosis was significantly worse in patients with torrential TR.
Effective echocardiographic parameters for predicting cardiac tamponade in patients with large amount of pericardial effusion
Authors: Park S , Son B J , Kim H J , Choi K U , Nam J H , Lee C H , Son J W , Park J S , Shin D G 
Published: June 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Cardiac tamponade is life-threatening medical condition that needs rapid diagnosis and pericardiocentesis. For diagnosing cardiac tamponade, comprehensive and complex doppler echocardiographic evaluation is necessary. The aim of this study was to evaluate the echocardiographic parameters for differentiating cardiac tamponade in patients with large amount of pericardial effusion.

Methods
From March 2003 to January 2020, 392 patients with large amount of PE with TTE evaluation were enrolled. We divided the patients into two groups; group A: patients performed subsequent drainage (n=197), group B: patients who are not performed drainage (n=195). Quantitative echocardiographic parameters were compared between two groups and analyzed which parameters were related with cardiac tamponade.

Results
The patients in group A showed low left ventricular end-diastolic diameter/body surface area (LVEDD/BSA) (25.44 ± 7.75 vs. 28.86 ± 6.10 mm/m2, p&lt;0.001), left atrium volume index (LAVI) (24.08 ± 13.53 vs. 42.69 ± 28.69 ml/m2, p&lt;0.001), early diastolic mitral inflow velocity (E velocity) (0.63 ± 0.18 vs. 0.88 ± 0.31 m/s, p&lt;0.001), right ventricular systolic pressure (RVSP) (31.23 ± 9.47 vs. 39.16 ± 16.49 mmHg, p&lt;0.001), early diastolic mitral inflow velocity/early diastolic mitral annular tissue velocity (E/e’) (11.62 ± 5.07 vs. 16.56 ± 7.75, p&lt;0.001) compared with group B. In the multivariable analysis, E velocity was the most statistically significant parameter (Odds ratio=0.034, 95% CI=0.003–0.470, p = 0.012) and LAVI was the second one (Odds ratio=0.952, 95% CI=0.913–0.993, p = 0.022) related with cardiac tamponade. The ROC curve showed the cutoff value of E velocity was 0.678 m/s (sensitivity=0.675, specificity=0.673) and that of LAVI was 26.62 ml/m2 (sensitivity=0.681, specificity=0.679) for no need of pericardial drainage.

Conclusion
In patients with large amount of PE, E velocity and LAVI can be simple and useful echocardiographic parameters to differentiate the patients with cardiac tamponade who need pericardial drainage.
Prognostic role of feature tracking strain in stress cardiac magnetic eesonance (the PROGRESS study)
Authors: Guglielmo M , Fusini L , Baessato F , Baggiano A , Mushtaq S , Annoni A , Carerj M L , Fazzari F , Penso M , Volpe A , Tassetti L , Guaricci A I , Van Der Bilt I , Van Der Harst P , Pontone G 
Published: June 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objectives
This study aims to assess the role of feature-tracking (FT) strain in the long-term risk stratification of a large population of patients with known or suspected coronary artery disease (CAD) undergoing stress cardiac magnetic resonance (S-CMR) with dipyridamole.

Background
Recently, FT strain has been applied to S-CMR to improve risk stratification of patients with known or suspected CAD. However, no data are available on the prognostication role of FT strain in patients undergoing a S-CMR with dipyridamole.

Methods
729 consecutive patients (age: 63±10 y, male 84%) with stable symptoms suggesting possible cardiac ischemia underwent dipyridamole S-CMR and followed up for 5.8±1.2 years. CMR-FT analysis was performed in each patient to obtain 2D global peak systolic rest and stress longitudinal (GLS), circumferential (GCS), and radial strain (GRS). Major adverse cardiac events (MACE) were defined as non-fatal myocardial infarction and cardiac death.

Results
MACE occurred in 70 (9.6%) patients. At multivariate analysis, the presence of late gadolinium enhancement (LGE) (HR 2.737 [95% CI 1.534–4.884]), p &lt;0.001, and stress GCS (HR 1.064 [95% CI 1.011–1.119]), p = 0.0164 were independently associated with MACE. By Kaplan-Meier analysis, patients with stress GCS &gt;-15% had significantly reduced event-free survival compared with those with stress GCS ≤-15 (log-rank p = 0.007). The best predictive model of MACE included left ventricular ejection fraction (LVEF) + positive S-CMR for inducible ischemia (positive S-CMR) + LGE. A model based on LVEF + stress GCS (contrast free) showed higher performance in predicting MACE compared to LVEF alone and a similar performance compared to LVEF + positive S-CMR (p =0.05).

Conclusions
In patients with known or suspected CAD undergoing S-CMR with dipyridamole, stress GCS and LGE presence are independent predictors of MACE. Adding strain analysis of stress GCS can help define patients' risk after S-CMR on top of LVEF without needing contrast agents.
Comparison of functional tricuspid regurgitation after transcatheter closure of atrial septal defect in patients with sinus rhythm and atrial fibrillation
Authors: Noda S , Hashimoto K , Miyamoto J , Tanaka H , Kamioka N , Murakami T , Tanaka S , Ohno Y , Nagai T , Ikari Y 
Published: June 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Significant tricuspid regurgitation (TR) often improves during the long-term follow-up period after transcatheter atrial septal defect (ASD) closure. However, It is unknown whether ASD closure improves TR in patients with atrial fibrillation (AF).

Methods
Between 2016 and 2021, 66 consecutive patients (66% males, mean age 58 +/- 16 years, 30% with AF, 68% with severe/moderate TR) underwent transcatheter ASD closure and were evaluated with transthoracic echocardiography at baseline, 1day, 1 month and 1 year.

Results
Sinus rhythm(SR) group showed an improvement in TR one month after ASD closure, which persisted at 12 months, whereas AF group demonstrated no improvement in TR after one month and 1 year.(figure1)
Right atrial volume index improved in both groups, but tricuspid annular diameter showed no improvement in AF group.(figure2)(figure3)

Conclusion
Decrease in tricuspid annular diameter was significantly associated with TR improvement after ASD closure. Our findings suggest that TR is less likely to improve in patients with AF since ASD closure had less impact in tricuspid annular diameter.