bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of different software solutions for AVC quantification using contrast enhanced MDCT
Authors: Evertz R , Hub S , Backhaus S , Lange T , Toischer K , Kowallick J , Hasenfuss G , Schuster A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Aims
Estimating aortic valve calcification (AVC) derived from multi detector computed tomography (MDCT) scans in aortic stenosis (AS) patients has gained increasing interest for diagnostic and prognostic reasons. Little is known about the interchangeability of AVC obtained from different software solutions which, was systematically determined in consecutive patients undergoing contrast enhanced MDCT before TAVR.

Methods and results
50 randomly selected patients who underwent contrast enhanced MDCT for TAVR planning were included in the analysis. All MDCT data sets were analysed using three different software vendors (3 Mensio, CVI 42, Snygo.Via). AVC score was expressed as mm³. For analysing intra- and inter-observer variability a subset of 10 patients were analysed twice with at least 2 weeks in between the measurements. Intra- and inter-observer variability was quantified using the ICC reliability method, Bland-Altman analysis and coefficients of variation.
AVC scores were successfully obtained using all software solutions (3 Mensio 941 ± 623, CVI42 941 ± 637, Syngo.Via 948 mm³ ± 655) without significant differences (p = 0.455). There was excellent intra- (3 Mensio: ICC 0.999 [0.995 – 1.000], COV 3.86 %, mean difference -19.28 [± 45.07]; CVI 42: ICC 1.000 [0.999 – 1.000], COV 1.6 %, mean difference -10.28 [± 18.6]; Syngo.Via: ICC 0.998 [0.993 – 1.000], COV 4.13 %, mean difference -24.81 [± 48.52]) and inter-observer variability (3 Mensio: ICC 1.000 [0.999 – 1.000], COV 1.38 %, mean difference -7.14 [± 16.20]; CVI 42: ICC 1.000 [1.000 – 1.000], COV 1.01 %, mean difference -1.74 [± 11.83]; Syngo.Via: ICC 0.996 [0.985 – 0.999], COV 6.68 %, mean difference -0.65 [± 79.43]) for all software types. Best inter-vendor agreement was found between CVI 42 and Syngo.Via (ICC 0.997 [CI 0.995-0.998], COV 7.26 %, mean difference -7 [± 68.60]) followed by 3 Mensio / CVI 42 (ICC 0,996 [CI 0,922-0,998], COV 8.95 %, mean difference -0.06 [± 84.16]) and 3 Mensio / Syngo.Via (ICC 0,992 [CI 0,986-0,995], COV 12.19%, mean difference -7.06 [± 115.07]).

Conclusion
Contrast enhanced MDCT derived AVC scores are interchangeable between and reproducible within different commercially available software solutions. This is important since sufficient reproducibility, inter-changeability and valid results represent prerequisites for accurate TAVR planning and wide spread clinical use.
Cardiac magnetic resonance to asess aortic valve anatomy in doubtful cases. Case series from a cardiology clinic
Authors: Sanz Ortega I , Bravo Martinez I , Oca Penas R , Cacicedo Fernandez De Bobadilla A , Rodriguez Sanchez I , Velasco Del Castillo S , Capelastegi Alber A , Salcedo Arruti A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Bicuspid aortic valve (BAV) is the most common congenital cardiac malformation, affecting 1-2% of the population, and several types have been described, each one with different prevalence. Partial raphae have also been described and much rarer congenital affectations of aortic valve also exist (unicuspid, quadricuspid), with its own classification. Although echocardiogram is usually enough for diagnosis, sometimes other exams are needed to assess the anatomy of the valve. In these cases, due to lack of radiation, Magnetic Resonance (MRI) can be performed.

Methods
We reviewed cases from a single general cardiology clinic in which MRI was needed for asses aortic valve anatomy during a period of 9 non-consecutive (due to Covid-19 pandemic) months, Characteristics of the patients, as well as valvular and aortic characteristics, were reported.

Results
There 8 doubtful cases. 5 men. Mean Age 60 years old (range 21-77, 6 patients 58 or more). 6 cases were non-tricuspid aortic valve: 5 bicuspid, 1 quadricuspid. Except in rare anatomies (bicuspid with 2 cusps type lateral and quadricuspid), with age 21 and 38 respectively (both men), the mean age was 70, ranging from 58 to 77, with 3 cases (50%) women. Except 2 cases, MRI was performed after the first visit, without follow-up time. Taking into account all patients, mean time from first visit to perform MRI was 1,12 years (maximum 6 years in the quadricuspid case). 6 cases had valvular functional anomalies greater than mild (3 women). 5 cases presented aortic dilatation (3 men), 1 man without valvular functional anomalies, 1 woman with tricuspid aortic valve. BAV with 2 cusps type lateral and quadricuspid cases had no aortic dilatation. There were no extracardiac findings in the exams. Figure shows characteristics of patients. Figure 2 shows images from exams (in the superior left and inferior right part of the image are shown BAV with 2 cusps and quadricuspid valve repectively, in diastole and systole).

Conclusions
Clinicians usually think BAV is a problem of young people, but can be even diagnosed in the eighth decade of life. In these cases, senile changes with valvular degeneration make diagnosis more challenging with doubtful cases. Rare anatomies may be also challenging. MRI seems useful to assess doubtful cases. Although usually performed in the first visit, in some cases it can take years before MRI is performed. In older cases, there may be no sex predominance for BAV. Abstract Table: Characteristics of patients Abstract Figure. Images from exams
Myocardial work evaluation in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation
Authors: Sperlongano S , Renon F , Del Giudice C , Iannuzzi A , Bocchetti M , Liccardo B , Malvezzi Caracciolo D"aquino M , Scognamiglio G , Salerno G , Ciccarelli G , Bianchi R , Tartaglione D , Cappelli Bigazzi M , D"andrea A , Golino P 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
myocardial work (MW) is a novel echocardiographic technique which assesses left ventricular (LV) performance through LV pressure-strain loops. MW corrects speckle tracking echocardiography (STE)-derived parameters for afterload using non-invasive systolic blood pressure (SBP) as a surrogate for LV systolic pressure. In patients with severe aortic stenosis (AS), the corrected MW (cMW) has been proposed, consisting in adding the mean aortic gradient in SBP. This method revealed to be feasible and reliable, demonstrating good correlation with invasively measured LV systolic pressure.

Purpose
to evaluate myocardial performance of patients with severe AS, before and after transcatheter aortic valve implantation (TAVI), by MW indices.

Methods
patients with severe AS undergoing TAVI were included. Transthoracic, standard echocardiography and STE were performed the day before the procedure and within 2 days after. MW was calculated by combining STE-derived indices with non-invasively estimated LV systolic pressure.

Results
30 patients (79 ± 5 years old, 56% females) with severe AS (mean gradient 47 ± 14 mmHg, aortic valve area 0.6 ± 0.1 cm2), and eligible for TAVI were enrolled. Baseline global longitudinal strain was impaired (GLS -15 ± 4%), in presence of normal LV ejection fraction (LVEF 57 ± 10%). Corrected global work index and global constructive work were preserved at baseline and markedly decreased after TAVI (cGWI 2322 ± 791 vs 1710 ± 505 mmHg%, p = 0.001; cGCW 2774 ± 803 vs 2083 ± 536 mmHg%, p = 0.0007). Corrected global wasted work and global work efficiency were higher than reference values existing in literature, and no significant changes were observed after TAVI (cGWW 276 ± 174 vs 277 ± 165 mmHg%, p = 0.974; cGWE 89 ± 5 vs 87 ± 5%, p = 0.177). A significant inverse correlation was found between baseline cGWI and left atrial volume index (r=-0.5, p = 0.03).

Conclusions
patients with severe aortic stenosis and preserved LVEF show a good LV performance before and after TAVI, with a significant decrease in MW indices after TAVI, because of the reduced afterload due to AS treatment. The negative correlation between left atrial volume and cGWI may reflect the extent of myocardial damage in AS. However, further studies with larger sample size and appropriate follow-up are needed to evaluate the role of MW in prognosis and risk stratification of this subset of patients.
Impact of proportionality of tricuspid regurgitation on outcome after tricuspid annuloplasty
Authors: Stephanie YK , Li HL , Wu MZ , Ren QW , Yiu KH 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Sanming Project of Medicine in Shenzhen, China [No. SZSM201911020]; HKU-SZH Fund for Shenzhen Key Medical Discipline [No. SZXK2020081]

Background
Patients with secondary tricuspid regurgitation (TR) benefit differentially from tricuspid annuloplasty. We hypothesized that TR severity may be proportional or disproportional to right ventricular (RV) remodeling and investigated the prognostic implication of this novel framework.

Methods
The ratios of pre-procedural effective regurgitant orifice area (EROA) with right ventricular end-diastolic area (RVDA) and tricuspid annular plane systolic excursion (TAPSE) were retrospectively assessed in 307 patients undergoing tricuspid annuloplasty. Based on optimal thresholds derived from cubic splines and maximally selected rank statistics, patients were stratified into 3 groups: proportionate TR (Group 1: EROA/RVDA ≤1.70 and EROA/TAPSE ≤3.42), disproportionate TR to RV size (Group 2: EROA/RVDA &gt;1.70 and EROA/TAPSE ≤3.42), and disproportionate TR to RV size and function (Group 3: EROA/RVDA &gt;1.70 and EROA/TAPSE &gt;3.42).

Results
Overall, 77 (25%), 126 (41%), and 104 (34%) patients were classified into Group 1, 2, and 3, respectively. Compared with those with proportionate TR (Group 1), patients with disproportionate TR (Group 2 and 3) had a higher prevalence of atrial fibrillation and smaller left ventricular end-diastolic and end-systolic volumes. During a median (interquartile range) follow-up of 4.1 (2.5-6.2) years, 81 adverse events (49 HF hospitalizations and 32 deaths) occurred. Patients with disproportionate TR (Group 2 and 3) had higher rates of adverse events than those with proportionate TR (22% and 44% versus 9%; P = 0.018 and P &lt; 0.001, respectively) and were independently associated with poor outcomes on multivariate analysis. TR proportionality outperformed guideline-based prediction algorithm comprising EROA and RV assessment in outcome prediction (C-statistic 0.70 versus 0.62, p = 0.015; likelihood ratio test &lt;0.001).

Conclusion
Disproportionate TR is independently associated with poor prognosis in patients undergoing tricuspid annuloplasty. Characterization of TR severity to RV size and function may aid patient selection and risk stratification for tricuspid annuloplasty. Abstract Figure.
Lead dependent tricuspid dysfunction- diagnosis and management
Authors: Polewczyk A , Nowosielecka DN , Tomaszewski AT , Brzozowski WB , Szczesniak-Stanczyk DS , Kutarski AK 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Lead-dependent tricuspid dysfunction (LDTD) is one of complications related to cardiac implantable electronic devices.

Purpose
The aim of the study was to analyze transthoracic and transesophageal echocardiographic examinations with the assessment of tricuspid valve dysfunction before and after the procedure of transvenous lead extraction (TLE).

Methods
We analyzed data of 3343 patients undergoing TLE in years 2006-2021 in single center and separated 112 (3,35%) patients with LDTD. The mechanism of LDTD and the effect of TLE on tricuspid valve function were assessed
Results are presented in the table

Conclusions
The most common mechanism of LDTD is to pull the leaflet down and propping the leaflet through the lead. In about 40% of patients, an effective method of therapy is removal of the lead, with reimplantation under the control of TEE or bypassing the tricuspid valve (implantation into the coronary sinus). 65% of patients, despite the lack of improvement after TLE, do not require cardiac surgery (mean follow up- 5 years). Abstract Table Abstract Figure. LDTD
The association between epicardial adipose tissue and prognosis in heart failure with preserved and reduced ejection fraction
Authors: Pugliese NR , De Biase N , Mazzola M , Paneni F , Del Punta L , Gargani L , Mengozzi A , Virdis A , Nesti L , Taddei S , Flammer A , Borlaug BA , Ruschitzka F , Masi S 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Recent evidence shows that increased epicardial adipose tissue (EAT) thickness is associated with metabolic syndrome, microvascular dysfunction and enhanced pericardial restraint.
Purpose. We measured echocardiography-derived EAT thickness in a population of heart failure (HF) patients with reduced (HFrEF) and preserved (HFpEF) ejection fraction to examine the relationship between EAT and prognosis at clinical follow-up.
Methods. We prospectively enrolled 393 consecutive HF outpatients  (205 HFrEF, 188 HFpEF) who had been referred to our hospital due to dyspnoea and/or effort intolerance. We performed a resting clinical and biohumoral evaluation, followed by combined cardiopulmonary-echocardiography exercise stress. We considered a composite endpoint of cardiovascular death and HF-related hospitalization during follow-up.
Results. Patients with HFpEF displayed greater EAT thickness (median 8 mm, interquartile range [IQR] 4–12 mm) than HFrEF (median 3 mm, IQR 2–6 mm; p &lt; 0.0001).  During a median follow-up of 20.9 months (IQR 15-25 months), 34 cardiovascular deaths and 146 HF hospitalizations were reported, with no significant differences between the two HF phenotypes. EAT was shown to predict adverse events independently from body mass index, waist circumference and other well-established prognostic markers in HF (such as NT-proBNP and peak oxygen consumption). The risk of adverse events increased with increasing EAT thickness in HFpEF and with EAT thinning in HFrEF. Kaplan-Meier analyses for the composite endpoint showed that in HFpEF, the survival probability was significantly lower in patients with thicker EAT than those with thinner EAT. In HFrEF, conversely, patients with increased EAT thickness had a higher survival probability than those with reduced EAT thickness (Figure 1).
Conclusion. EAT accumulation is increased in HFpEF compared to HFrEF and carries different prognostic meanings in the two subsets. In HFpEF, EAT thickening portends adverse outcomes, which may be due to the secretion of pro-inflammatory and pro-atherogenic adipokines and increased mechanical restraint. In HFrEF, EAT thinning is associated with a worse prognosis, probably reflecting a more advanced catabolic state (e.g., cardiac cachexia). Larger studies are needed to determine whether or not EAT has a causal role in influencing progression and survival in the different HF phenotypes. Abstract Figure 1
Impact of cardiovascular therapy on left ventricular function in her2 positive breast cancer patients who were treated with trastuzumab
Authors: Krstic I , Deljanin Ilic M , Pejcic I , Vrbic S , Marinkovic D 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Trastuzumab prolongs survival in women with HER2-positive breast cancer, but caries the risk of cardiotoxicity. Cardiac function should be closely monitored, as well as identification of the patients (pts) with risk of cardiotoxicity.

Purose
To assess the impact of cardiovascular therapy on the echocardiografic parameters of left ventricular function in patients with HER2 positiv breast cancer during trastuzumab therapy.

Methods
96 pts with HER2 positive breast cancer (mean age, 59.57 ± 9.6 years) were studied. All pts were on sequential therapy with anthracyclines (IV to VI cycles) within the FAC regimen (fluorouracil 500 mg/m2, doxorubicin 50 mg/m2, cyclophosphamide 500 mg/m2) on day 21, and after that trastuzumab therapy (6 mg/kg of body weight on day 21, for the period of one year). The echocardiographic parameters: left ventricular ejection fraction (LVEF%), fractional shortening (FS%), end-diastolic diameter (EDD, mm); left ventricular mass (LVM, g) were assesed at the beginning and after the therapy with trastuzumab in all pts.
Out of 96 studied pts, 44 pts (45.85%) were treated with beta-blockers, 35 pts with ACE inhibitors (36.45%), 12 pts (12.5%) with calcium antagonists and 5 pts (5.2%) with sartans.

Results
At the end of trastuzumab therapy patients who were on beta-blockers therapy, showed the reduction of LVEF by 3.28% (p = 0.005), while patients on ACE inhibitors (by 2.80%; p = 0.016) and calcium antagonists (by 2.80%; p = 0.012) had the lowest decrease in LVEF. Patients on sartans therapy showed decreased of LVEF by 4,76% (p = 0.461) compared to baseline values.
Patients on beta-blockers had the lowest decrease of FS (0.68%; p = 0.448) while the highest decrease of FS had patients on calcium antagonist therapy (3.05%, p = 0.022). The highest increase in EDD (by 3.28 mm; p = 0.194) was detected in pts on sartans therapy. In patients on beta-blockers therapy, there was an increase in LVM by 16.36 g (p = 0.012). The highest increase in LVM (by 17.56 g, p = 0.141) was observed in patients on sartans therapy.

Conclusion
The results of our study showed that after trastuzumab treatment in patients with HER2 positive breast cancer, the least reduction of LVEF was in pts who were on therapy with ACE inhibitors or calcium antagonists, while the least decrease in FS was in pts on beta-blockers therapy. The highest increase in EDD and LVM was in patients who were on sartans therapy.
Myocardial work and left atrial function, by speckle tracking echocardiography, are the only independent predictors of mid-term mortality in HFpEF
Authors: Rimbas RC , Visoiu SI , Chitroceanu A , Mihaila-Baldea S , Magda LS , Velcea AA , Luchian ML , Memis H , Nicula A , Vinereanu D 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by 2 National grants of Romanian Ministry of Research and Innovation - UEFISCDI (PN-III-P1-1-TE-2016-0669, acronym Heart-Preserved and PN-III-P1-1.2-PCCDI2017-0527, acronym BIOVEA).

OnBehalf
HEART-PRESERVED
Background. Heart failure with preserved ejection fraction (HFpEF), defined by the 2021 ESC guidelines and the new universal definition, is one of the most challenging diagnosis in cardiology. Parameters for predicting mortality in HFpEF are still debatable. Left atrial (LA) function and myocardial work (MW) by speckle-tracking echocardiography (STE) might be promising tools for predicting mortality in HFpEF.
Methods. We assessed 88 patients (67 ± 9 years, 33 men) with HFpEF (mean NTproBNP of 357 ± 350 pg/ml) by 2D echo, STE, and CMR. By echo we measured LV ejection fraction (LVEF), E/E’, sPAP, left atrial volume indexed (LAVi), and global longitudinal strain (GLS). We assessed LA function by 2DSTE: reservoir function by strain from MVC to MVO (LASr) and positive strain rate (LASRr), conduit function by strain from MVO to onset of atrial contraction (LAScd) and early negative strain rate during conduit phase (LASRcd), and LA pump function by negative strain at MVC (LASct) and late negative strain rate during atrial contraction phase (LASRct) (Figure 1); and MW by 2DSTE: global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), as GCW/(GCW + GWW) in %. By CMR we evaluated LVEFcmr, LV mass, T1 mapping with mean extracellular volume (ECVm), and pre-gadolinium times quantification (preGDT1m) as markers of myocardial fibrosis. A follow-up visit for cardiovascular mortality was performed by phone at 18 months from the baseline visit.
Results. 12 patients died during follow-up (14%). Comparing non-survivors vs. survivors (see tables from Figure 2), NTproBNP level and LV mass were significantly higher in non-survivors (P &lt; 0.001); meanwhile, GWE was lower, whereas GWW was higher in non-survivors vs. survivors. Moreover, LASRct was lower in non-survivors vs. survivors. All the other echo or CMR parameters, including markers of myocardial fibrosis were not different between non-survivors and survivors (Figure 2). By multiple regression analysis, GWE &lt; 92% (AUC = 0.72, p = 0.018) and LASRct &lt;-1 (AUC = 0.70, p = 0.014) were the only independent predictors of mortality, from all conventional echo, STE, and CMR parameters.

Conclusions
LV assessment by myocardial work and LA assessment by STE are the only independent predictors of mid-term mortality in HFpEF. Abstract Figure. LA deformation analysis Abstract Figure. Survivors vs non-survivors
Bandwidth, perfusion standard deviation and entropy derived from single photon emission computed tomography are useful markers of systolic synchrony index evaluated thought echocardiography
Authors: Espinola-Zavaleta NG , Gonzalez-Hernandez MGH , Antonio-Villa NAV , Guerra ECG , Garcia-Cardenas MGC , Caballero-Guadarrama YCG , Lopez-Mendez ALM , Alexanderson-Rosas EAR 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

BACKGROUND
Systolic synchrony (SS) is a fundamental predictor of adverse clinical outcomes in patients who develop myocardial ischemia or infarction. Although the evaluation could be assessed with myocardial perfusion image methods, the correlation with automatized methods such as the systolic synchrony index is still unclear.

AIMS
To evaluate the correlation of the bandwidth, perfusion standard deviation and entropy as makers of systolic synchrony derived from single photon emission computed tomography (SPECT) at basal and stress phase with the echocardiography systolic synchrony index.

METHODS
A cross-sectional cohort of patients with suspected ischemia or infarction were tested using SPECT in a center of reference in our city. An additional transthoracic echocardiography was performed. Pearson correlation test were used to extract the correlation coefficient of each variable after arithmetical normalization. An interaction analysis was performed to evaluate an interaction effect in patients either with ischemia or infarction.

RESULTS
We recruited 229 subjects, of which 49.3% (n = 83) had myocardial ischemia, 9.6% (n = 22) infarction and 4.8% (n = 11) both conditions. We observed a positive and significant correlation of bandwidth, perfusion standard deviation and entropy from SPECT with echocardiographic systolic synchrony index, which further increased at stress phase (Figure 1). We observe a positive interaction with subjects classified with only myocardial ischemia with all three SPECT parameters at stress phase (Figure 2).

CONCLUSION
We found a that SPECT bandwidth; perfusion standard deviation and entropy could adequately identify higher systolic dyssynchrony in stress phase and within patients with myocardial ischemia only. Abstract Figure. Dispersion plot Abstract Figure. Interaction analysis