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1. TRI-SCORE and benefit of intervention in patients with severe tricuspid regurgitation

Author

Dreyfus, J, Galloo, X, Taramasso, M, Heitzinger, G, Benfari, G, Kresoja, K, Juarez-Casso, F, Omran, H, Bohbot, Y, Iliadis, C, Russo, G, Topilsky, Y, Weber, M, Nombela-Franco, L, Sala, A, Eixerés-Esteve, A, Iung, B, Obadia, J, Estevez Loureiro, R, Riant, E, Donal, E, Hausleiter, J, Badano, L, Le Tourneau, T, Coisne, A, Modine, T, Latib, A, Praz, F, Windecker, S, Zamorano, J, von Bardeleben, R, Tang, G, Hahn, R, Webb, J, Muraru, D, Nejjari, M, Chan, V, De Bonis, M, Carnero-Alcazar, M, Nickenig, G, Pfister, R, Tribouilloy, C, Rudolph, V, Crestanello, J, Lurz, P, Bartko, P, Maisano, F, Bax, J, Enriquez-Sarano, M, Messika-Zeitoun, D, Dreyfus, Julien, Galloo, Xavier, Taramasso, Maurizio, Heitzinger, Gregor, Benfari, Giovanni, Kresoja, Karl-Patrick, Juarez-Casso, Fernando, Omran, Hazem, Bohbot, Yohann, Iliadis, Christos, Russo, Giulio, Topilsky, Yan, Weber, Marcel, Nombela-Franco, Luis, Sala, Alessandra, Eixerés-Esteve, Andrea, Iung, Bernard, Obadia, Jean-François, Estevez Loureiro, Rodrigo, Riant, Elisabeth, Donal, Erwan, Hausleiter, Jörg, Badano, Luigi, Le Tourneau, Thierry, Coisne, Augustin, Modine, Thomas, Latib, Azeem, Praz, Fabien, Windecker, Stephan, Zamorano, Jose Luis, von Bardeleben, Ralph Stephan, Tang, Gilbert H L, Hahn, Rebecca, Webb, John, Muraru, Denisa, Nejjari, Mohammed, Chan, Vincent, De Bonis, Michele, Carnero-Alcazar, Manuel, Nickenig, Georg, Pfister, Roman, Tribouilloy, Christophe, Rudolph, Volker, Crestanello, Juan, Lurz, Philipp, Bartko, Philipp, Maisano, Francesco, Bax, Jeroen, Enriquez-Sarano, Maurice, Messika-Zeitoun, David, Dreyfus, J, Galloo, X, Taramasso, M, Heitzinger, G, Benfari, G, Kresoja, K, Juarez-Casso, F, Omran, H, Bohbot, Y, Iliadis, C, Russo, G, Topilsky, Y, Weber, M, Nombela-Franco, L, Sala, A, Eixerés-Esteve, A, Iung, B, Obadia, J, Estevez Loureiro, R, Riant, E, Donal, E, Hausleiter, J, Badano, L, Le Tourneau, T, Coisne, A, Modine, T, Latib, A, Praz, F, Windecker, S, Zamorano, J, von Bardeleben, R, Tang, G, Hahn, R, Webb, J, Muraru, D, Nejjari, M, Chan, V, De Bonis, M, Carnero-Alcazar, M, Nickenig, G, Pfister, R, Tribouilloy, C, Rudolph, V, Crestanello, J, Lurz, P, Bartko, P, Maisano, F, Bax, J, Enriquez-Sarano, M, Messika-Zeitoun, D, Dreyfus, Julien, Galloo, Xavier, Taramasso, Maurizio, Heitzinger, Gregor, Benfari, Giovanni, Kresoja, Karl-Patrick, Juarez-Casso, Fernando, Omran, Hazem, Bohbot, Yohann, Iliadis, Christos, Russo, Giulio, Topilsky, Yan, Weber, Marcel, Nombela-Franco, Luis, Sala, Alessandra, Eixerés-Esteve, Andrea, Iung, Bernard, Obadia, Jean-François, Estevez Loureiro, Rodrigo, Riant, Elisabeth, Donal, Erwan, Hausleiter, Jörg, Badano, Luigi, Le Tourneau, Thierry, Coisne, Augustin, Modine, Thomas, Latib, Azeem, Praz, Fabien, Windecker, Stephan, Zamorano, Jose Luis, von Bardeleben, Ralph Stephan, Tang, Gilbert H L, Hahn, Rebecca, Webb, John, Muraru, Denisa, Nejjari, Mohammed, Chan, Vincent, De Bonis, Michele, Carnero-Alcazar, Manuel, Nickenig, Georg, Pfister, Roman, Tribouilloy, Christophe, Rudolph, Volker, Crestanello, Juan, Lurz, Philipp, Bartko, Philipp, Maisano, Francesco, Bax, Jeroen, Enriquez-Sarano, Maurice, and Messika-Zeitoun, David

Abstract

BACKGROUND AND AIMS: Benefit of tricuspid regurgitation (TR) correction and timing of intervention are unclear. This study aimed to compare survival rates after surgical or transcatheter intervention to conservative management according to a TR clinical stage as assessed using the TRI-SCORE. METHODS: A total of 2,413 patients with severe isolated functional TR were enrolled in TRIGISTRY (1217 conservatively managed, 551 isolated tricuspid valve surgery, and 645 transcatheter valve repair). The primary endpoint was survival at 2 years. RESULTS: The TRI-SCORE was low (≤3) in 32%, intermediate (4-5) in 33%, and high (≥6) in 35%. A successful correction was achieved in 97% and 65% of patients in the surgical and transcatheter groups, respectively. Survival rates decreased with the TRI-SCORE in the three treatment groups (all P < .0001). In the low TRI-SCORE category, survival rates were higher in the surgical and transcatheter groups than in the conservative management group (93%, 87%, and 79%, respectively, P = .0002). In the intermediate category, no significant difference between groups was observed overall (80%, 71%, and 71%, respectively, P = .13) but benefit of the intervention became significant when the analysis was restricted to patients with successful correction (80%, 81%, and 71%, respectively, P = .009). In the high TRI-SCORE category, survival was not different to conservative management in the surgical and successful repair group (61% and 68% vs 58%, P = .26 and P = .18 respectively). CONCLUSIONS: Survival progressively decreased with the TRI-SCORE irrespective of treatment modality. Compared to conservative management, an early and successful surgical or transcatheter intervention improved 2-year survival in patients at low and, to a lower extent, intermediate TRI-SCORE, while no benefit was observed in the high TRI-SCORE category.

Published
2024

2. Tricuspid Valve Academic Research Consortium Definitions for Tricuspid Regurgitation and Trial Endpoints

Author

Hahn, R, Lawlor, M, Davidson, C, Badhwar, V, Sannino, A, Spitzer, E, Lurz, P, Lindman, B, Topilsky, Y, Baron, S, Chadderdon, S, Khalique, O, Tang, G, Taramasso, M, Grayburn, P, Badano, L, Leipsic, J, Lindenfeld, J, Windecker, S, Vemulapalli, S, Redfors, B, Alu, M, Cohen, D, Rodes-Cabau, J, Ailawadi, G, Mack, M, Ben-Yehuda, O, Leon, M, Hausleiter, J, Arnold, S, Bapat, V, Berry, N, Blanke, P, Burkhoff, D, Coylewright, M, Duggal, N, Galper, B, George, I, Guerrero, M, Hamid, N, Jagadeesan, V, Kodali, S, Krucoff, M, Lang, R, Madhavan, M, Mclaughin, V, Mehran, R, Philippon, F, Sethi, S, Simonato, M, Smith, R, Sodhi, N, Spertus, J, Stocker, T, Stone, G, Hahn R. T., Lawlor M. K., Davidson C. J., Badhwar V., Sannino A., Spitzer E., Lurz P., Lindman B. R., Topilsky Y., Baron S. J., Chadderdon S., Khalique O. K., Tang G. H. L., Taramasso M., Grayburn P. A., Badano L., Leipsic J., Lindenfeld J., Windecker S., Vemulapalli S., Redfors B., Alu M. C., Cohen D. J., Rodes-Cabau J., Ailawadi G., Mack M., Ben-Yehuda O., Leon M. B., Hausleiter J., Arnold S., Bapat V., Berry N., Blanke P., Burkhoff D., Coylewright M., Duggal N., Galper B., George I., Guerrero M., Hamid N., Jagadeesan V., Kodali S., Krucoff M., Lang R., Madhavan M., McLaughin V., Mehran R., Philippon F., Sethi S. S., Simonato M., Smith R., Sodhi N., Spertus J., Stocker T. J., Stone G., Hahn, R, Lawlor, M, Davidson, C, Badhwar, V, Sannino, A, Spitzer, E, Lurz, P, Lindman, B, Topilsky, Y, Baron, S, Chadderdon, S, Khalique, O, Tang, G, Taramasso, M, Grayburn, P, Badano, L, Leipsic, J, Lindenfeld, J, Windecker, S, Vemulapalli, S, Redfors, B, Alu, M, Cohen, D, Rodes-Cabau, J, Ailawadi, G, Mack, M, Ben-Yehuda, O, Leon, M, Hausleiter, J, Arnold, S, Bapat, V, Berry, N, Blanke, P, Burkhoff, D, Coylewright, M, Duggal, N, Galper, B, George, I, Guerrero, M, Hamid, N, Jagadeesan, V, Kodali, S, Krucoff, M, Lang, R, Madhavan, M, Mclaughin, V, Mehran, R, Philippon, F, Sethi, S, Simonato, M, Smith, R, Sodhi, N, Spertus, J, Stocker, T, Stone, G, Hahn R. T., Lawlor M. K., Davidson C. J., Badhwar V., Sannino A., Spitzer E., Lurz P., Lindman B. R., Topilsky Y., Baron S. J., Chadderdon S., Khalique O. K., Tang G. H. L., Taramasso M., Grayburn P. A., Badano L., Leipsic J., Lindenfeld J., Windecker S., Vemulapalli S., Redfors B., Alu M. C., Cohen D. J., Rodes-Cabau J., Ailawadi G., Mack M., Ben-Yehuda O., Leon M. B., Hausleiter J., Arnold S., Bapat V., Berry N., Blanke P., Burkhoff D., Coylewright M., Duggal N., Galper B., George I., Guerrero M., Hamid N., Jagadeesan V., Kodali S., Krucoff M., Lang R., Madhavan M., McLaughin V., Mehran R., Philippon F., Sethi S. S., Simonato M., Smith R., Sodhi N., Spertus J., Stocker T. J., and Stone G.

Abstract

Interest in the pathophysiology, etiology, management, and outcomes of patients with tricuspid regurgitation (TR) has grown in the wake of multiple natural history studies showing progressively worse outcomes associated with increasing TR severity, even after adjusting for multiple comorbidities. Historically, isolated tricuspid valve surgery has been associated with high in-hospital mortality rates, leading to the development of transcatheter treatment options. The aim of this first Tricuspid Valve Academic Research Consortium document is to standardize definitions of disease etiology and severity, as well as endpoints for trials that aim to address the gaps in our knowledge related to identification and management of patients with TR. Standardizing endpoints for trials should provide consistency and enable meaningful comparisons between clinical trials. A second Tricuspid Valve Academic Research Consortium document will focus on further defining trial endpoints and will discuss trial design options.

Published
2023

3. Current trends in patients with chronic total occlusions undergoing coronary CT angiography

Author

Opolski, MP, Hartaigh, BO, Berman, DS, Budoff, MJ, Achenbach, S, Al-Mallah, M, Andreini, D, Cademartiri, F, Chang, HJ, Chinnaiyan, K, Chow, BJW, Hadamitzky, M, Hausleiter, J, Feuchtner, G, Kim, YJ, Kaufmann, PA, Leipsic, J, Maffei, E, Pontone, G, Raff, G, Shaw, LJ, Villines, TC, and Min, JK

Subjects
Cardiovascular System & Hematology, Cardiorespiratory Medicine and Haematology
Abstract

Objective: Data describing the prevalence, characteristics and management of coronary chronic total occlusions (CTOs) in patients undergoing coronary CT angiography (CCTA) have not been reported. The purpose of this study was to determine the prevalence, characteristics and treatment strategies of CTO identified by CCTA. Methods: We identified 23 745 patients who underwent CCTA for suspected coronary artery disease (CAD) from the prospective international CCTA registry. Baseline clinical data were collected, and allocation to early coronary revascularisation performed within 90 days of CCTA was determined. Multivariable hierarchical mixed-effects logistic regression reporting OR with 95% CI was performed. Results: The prevalence of CTO was 1.4% (342/23 745) in all patients and 6.2% in patients with obstructive CAD (≥50% stenosis). The presence of CTO was independently associated with male sex (OR 3.12, 95% CI 2.39 to 4.08, p

Published
2015

4. A Clinical model to identify patients with high-risk coronary artery disease

Author

Yang, Y, Chen, L, Yam, Y, Achenbach, S, Al-Mallah, M, Berman, DS, Budoff, MJ, Cademartiri, F, Callister, TQ, Chang, HJ, Cheng, VY, Chinnaiyan, K, Cury, R, Delago, A, Dunning, A, Feuchtner, G, Hadamitzky, M, Hausleiter, J, Karlsberg, RP, Kaufmann, PA, Kim, YJ, Leipsic, J, Labounty, T, Lin, F, Maffei, E, Raff, GL, Shaw, LJ, Villines, TC, Min, JK, and Chow, BJW

Subjects
Cardiorespiratory Medicine and Haematology, Clinical Sciences, Cardiovascular System & Hematology
Abstract

Objectives This study sought to develop a clinical model that identifies patients with and without high-risk coronary artery disease (CAD). Background Although current clinical models help to estimate a patient's pre-test probability of obstructive CAD, they do not accurately identify those patients with and without high-risk coronary anatomy. Methods Retrospective analysis of a prospectively collected multinational coronary computed tomographic angiography (CTA) cohort was conducted. High-risk anatomy was defined as left main diameter stenosis ≥50%, 3-vessel disease with diameter stenosis ≥70%, or 2-vessel disease involving the proximal left anterior descending artery. Using a cohort of 27,125, patients with a history of CAD, cardiac transplantation, and congenital heart disease were excluded. The model was derived from 24,251 consecutive patients in the derivation cohort and an additional 7,333 nonoverlapping patients in the validation cohort. Results The risk score consisted of 9 variables: age, sex, diabetes, hypertension, current smoking, hyperlipidemia, family history of CAD, history of peripheral vascular disease, and chest pain symptoms. Patients were divided into 3 risk categories: low (≤7 points), intermediate (8 to 17 points) and high (≥18 points). The model was statistically robust with area under the curve of 0.76 (95% confidence interval [CI]: 0.75 to 0.78) in the derivation cohort and 0.71 (95% CI: 0.69 to 0.74) in the validation cohort. Patients who scored ≤7 points had a low negative likelihood ratio (

Published
2015

5. NYHA class IV in patients with degenerative mitral regurgitation undergoing transcatheter edge-to-edge repair: Results of the worldwide, multicenter PRIME-MR registry

Author

Koell, B, primary, Ludwig, S, additional, Weimann, J, additional, Scotti, A, additional, Weber, M, additional, Iliadis, C, additional, Xhepa, E, additional, Dreyfus, J, additional, Paradis, J M, additional, Praz, F, additional, Modine, T, additional, Hausleiter, J, additional, Donal, E, additional, Coisne, A, additional, and Kalbacher, D, additional

Published
2023
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6. Reduction of cardiac allograft vasculopathy by PCI: Quantification and correlation with outcome after heart transplantation

Author

Orban, M, primary, Kuehl, A, additional, Pechmajou, L, additional, Mueller, C, additional, Hausleiter, J, additional, Sfeir, M, additional, Bories, M C, additional, Martin, A C, additional, Ulrich, S M, additional, Dalla Pozza, R, additional, Mehilli, J, additional, Jouven, X, additional, Hagl, C, additional, Karam, N, additional, and Massberg, S, additional

Published
2023
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7. Right-ventricular/pulmonary artery coupling predicts long-term mortality in aortic stenosis patients with different flow types

Author

Steffen, J, primary, Lux, M, additional, Kneidinger, N, additional, Stocker, T, additional, Low, K, additional, Doldi, P, additional, Haum, M, additional, Fischer, J, additional, Stolz, L, additional, Theiss, H, additional, Rizas, K, additional, Peterss, S, additional, Hausleiter, J, additional, Massberg, S, additional, and Deseive, S, additional

Published
2023
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9. Early outcomes of the PASCAL P10 and the MitraClip XT transcatheter mitral leaflet approximation devices - A propensity score matched multicentre comparison

Author

Von Stein, P, primary, Wienemann, H, additional, Horn, P, additional, Sugiura, A, additional, Spieker, M, additional, Tanaka, T, additional, Lurz, P, additional, Ruf, T, additional, Grothusen, C, additional, Hausleiter, J, additional, Nef, H, additional, Luedike, P, additional, Gercek, M, additional, Pfister, R, additional, and Mauri, V, additional

Published
2023
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11. Characteristics and outcomes of patients with atrial versus ventricular secondary tricuspid regurgitation undergoing tricuspid transcatheter edge-to-edge repair - Results from the TriValve registry

Author

Russo, G, Badano, L, Adamo, M, Alessandrini, H, Andreas, M, Braun, D, Connelly, K, Denti, P, Estevez-Loureiro, R, Fam, N, Gavazzoni, M, Hahn, R, Harr, C, Hausleiter, J, Himbert, D, Kalbacher, D, Ho, E, Latib, A, Lubos, E, Ludwig, S, Lurz, P, Monivas, V, Nickenig, G, Pedicino, D, Pedrazzini, G, Pozzoli, A, Marafon, D, Pastorino, R, Praz, F, Rodes-Cabau, J, Besler, C, Schofer, J, Scotti, A, Piayda, K, Sievert, H, Tang, G, Thiele, H, Schlotter, F, von Bardeleben, R, Webb, J, Windecker, S, Leon, M, Maisano, F, Metra, M, Taramasso, M, Connelly, KA, Hahn, RT, Marafon, DP, Tang, GHL, von Bardeleben, RS, Russo, G, Badano, L, Adamo, M, Alessandrini, H, Andreas, M, Braun, D, Connelly, K, Denti, P, Estevez-Loureiro, R, Fam, N, Gavazzoni, M, Hahn, R, Harr, C, Hausleiter, J, Himbert, D, Kalbacher, D, Ho, E, Latib, A, Lubos, E, Ludwig, S, Lurz, P, Monivas, V, Nickenig, G, Pedicino, D, Pedrazzini, G, Pozzoli, A, Marafon, D, Pastorino, R, Praz, F, Rodes-Cabau, J, Besler, C, Schofer, J, Scotti, A, Piayda, K, Sievert, H, Tang, G, Thiele, H, Schlotter, F, von Bardeleben, R, Webb, J, Windecker, S, Leon, M, Maisano, F, Metra, M, Taramasso, M, Connelly, KA, Hahn, RT, Marafon, DP, Tang, GHL, and von Bardeleben, RS

Abstract

Aim Functional or secondary tricuspid regurgitation (STR) is the most common phenotype of tricuspid regurgitation (TR) with atrial STR (ASTR) and ventricular STR (VSTR) being recently identified as two distinct entities. Data on tricuspid transcatheter edge-to-edge repair (T-TEER) in patients with STR according to phenotype (i.e. ASTR vs. VSTR) are lacking. The aim of this study was to assess characteristics and outcomes of patients with ASTR versus VSTR undergoing T-TEER. Methods and results Patients with STR undergoing T-TEER were selected from the Transcatheter Tricuspid Valve Therapies (TriValve) registry. ASTR was defined by (i) left ventricular ejection fraction >= 50%, (ii) atrial fibrillation, and (iii) systolic pulmonary artery pressure <50 mmHg. Patients not matching these criteria were classified as VSTR. Patients with primary TR and cardiac implantable electronic device were excluded. Key endpoints included procedural success and survival at follow-up. A total of 298 patients were enrolled in the study: 65 (22%) with ASTR and 233 (78%) with VSTR. Procedural success was similar in the two groups (80% vs. 83% for ASTR vs. VSTR, p = 0.56) and TEER was effective in reducing TR in both groups (from 97% of patients with baseline TR >= 3+ to 23% in ASTR and to 15% in VSTR, all p = 0.001). At 12-month follow-up, survival was significantly higher in the ASTR versus VSTR cohort (91% vs. 72%, log-rank p = 0.02), with VSTR being an independent predictor of mortality at multivariable analysis (hazard ratio 4.75). Conclusions In a real-world, multicentre registry, T-TEER was effective in reducing TR grade in both ASTR and VSTR. At 12-month follow-up, ASTR showed better survival than VSTR.

Published
2023

16. Staging heart failure patients with secondary mitral regurgitation undergoing transcatheter edge-to-edge repair

Author

Stolz, L, primary, Karam, N, additional, Von Bardeleben, R S, additional, Pfister, R, additional, Petronio, A, additional, Butter, C, additional, Melica, B, additional, Praz, F, additional, Massberg, S, additional, Kalbacher, D, additional, Lurz, P, additional, Adamo, M, additional, Metra, M, additional, Bax, J J, additional, and Hausleiter, J, additional

Published
2022
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17. Propofol versus midazolam sedation in patients with cardiogenic shock – an observational propensity-matched study

Author

Scherer, C, primary, Kleeberger, J, additional, Kellnar, A, additional, Binzenhoefer, L, additional, Luesebrink, E, additional, Stocker, T J, additional, Thienel, M, additional, Deseive, S, additional, Braun, D, additional, Petzold, T, additional, Brunner, S, additional, Hagl, C, additional, Hausleiter, J, additional, Massberg, S, additional, and Orban, M, additional

Published
2022
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18. Characteristics and outcomes of normal-flow low-gradient aortic stenosis patients compared to high-gradient aortic stenosis patients undergoing TAVI

Author

Steffen, J, primary, Andreae, D, additional, Haum, M, additional, Fischer, J, additional, Doldi, P, additional, Peterss, S, additional, Hausleiter, J, additional, Rizas, K, additional, Braun, D, additional, Orban, M, additional, Nabauer, M, additional, Massberg, S, additional, and Deseive, S, additional

Published
2022
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19. Transcatheter treatment for tricuspid valve disease

Author

Praz, F, Muraru, D, Kreidel, F, Lurz, P, Hahn, R, Delgado, V, Senni, M, Von Bardeleben, R, Nickenig, G, Hausleiter, J, Mangieri, A, Zamorano, J, Prendergast, B, Maisano, F, Praz F., Muraru D., Kreidel F., Lurz P., Hahn R. T., Delgado V., Senni M., Von Bardeleben R. S., Nickenig G., Hausleiter J., Mangieri A., Zamorano J. L., Prendergast B., Maisano F., Praz, F, Muraru, D, Kreidel, F, Lurz, P, Hahn, R, Delgado, V, Senni, M, Von Bardeleben, R, Nickenig, G, Hausleiter, J, Mangieri, A, Zamorano, J, Prendergast, B, Maisano, F, Praz F., Muraru D., Kreidel F., Lurz P., Hahn R. T., Delgado V., Senni M., Von Bardeleben R. S., Nickenig G., Hausleiter J., Mangieri A., Zamorano J. L., Prendergast B., and Maisano F.

Abstract

Approximately 4% of subjects aged 75 years or more have clinically relevant tricuspid regurgitation (TR). Primary TR results from anatomical abnormality of the tricuspid valve apparatus and is observed in only 8-10% of the patients with tricuspid valve disease. Secondary TR is more common and arises as a result of annular dilation caused by right ventricular enlargement and dysfunction as a consequence of pulmonary hypertension, often caused by left-sided heart disease or atrial fibrillation. Irrespective of its aetiology, TR leads to volume overload and increased wall stress, both of which negatively contribute to detrimental remodelling and worsening TR. This vicious circle translates into impaired survival and increased heart failure symptoms in patients with and without reduced left ventricular ejection fraction. Interventions to correct TR are underutilised in daily clinical practice owing to increased surgical risk and late patient presentation. The recently introduced transcatheter tricuspid valve interventions aim to address this unmet need. Dedicated expertise and an interdisciplinary Heart Team evaluation are essential to integrate these new techniques successfully and select patients. The present article proposes a standardised approach to evaluate patients with TR who may be candidates for transcatheter interventions. In addition, a state-of-the-art review of the available transcatheter therapies, the main criteria for patient and device selection, and information concerning the remaining uncertainties are provided.

Published
2021

20. Addendum to the position paper of the German Cardiac Society Interventional treatment of AV valvular diseases-Criteria for certification of mitral valve centers

Author

Baldus, S., Bardeleben, R. S., V, Eggebrecht, H., Elsasser, A., Hausleiter, J., Ince, H., Kelm, M., Kuck, K. H., Lubos, E., Nef, H., Raake, P., Rillig, A., Rudolph, V, Schulze, P. C., Schlitt, A., Stellbrink, C., Moellmann, H., Baldus, S., Bardeleben, R. S., V, Eggebrecht, H., Elsasser, A., Hausleiter, J., Ince, H., Kelm, M., Kuck, K. H., Lubos, E., Nef, H., Raake, P., Rillig, A., Rudolph, V, Schulze, P. C., Schlitt, A., Stellbrink, C., and Moellmann, H.

Published
2022

21. Combined Tricuspid and Mitral Versus Isolated Mitral Valve Repair for Severe MR and TR: An Analysis From the TriValve and TRAMI Registries

Author

Mehr M, Karam N, Taramasso M, Ouarrak T, Schneider S, Lurz P, von Bardeleben RS, Fam N, Pozzoli A, Lubos E, Boekstegers P, Schillinger W, Plicht B, Eggebrecht H, Baldus S, Senges J, Maisano F, Hausleiter J, TriValve, Investigators T, Mehr, M, Karam, N, Taramasso, M, Ouarrak, T, Schneider, S, Lurz, P, von Bardeleben, R, Fam, N, Pozzoli, A, Lubos, E, Boekstegers, P, Schillinger, W, Plicht, B, Eggebrecht, H, Baldus, S, Senges, J, Maisano, F, Hausleiter, J, Trivalve, and Investigators, T

Published
2020

22. Transcatheter Edge-to-Edge Tricuspid Repair for Severe Tricuspid Regurgitation Reduces Hospitalizations for Heart Failure

Author

Orban M, Rommel KP, Ho EC, Unterhuber M, Pozzoli A, Connelly KA, Deseive S, Besler C, Ong G, Braun D, Edwards J, Miura M, Gulmez G, Stolz L, Gavazzoni M, Zuber M, Nabauer M, Maisano F, Thiele H, Massberg S, Taramasso M, Fam NP, Lurz P, Hausleiter J, Orban, M, Rommel, Kp, Ho, Ec, Unterhuber, M, Pozzoli, A, Connelly, Ka, Deseive, S, Besler, C, Ong, G, Braun, D, Edwards, J, Miura, M, Gulmez, G, Stolz, L, Gavazzoni, M, Zuber, M, Nabauer, M, Maisano, F, Thiele, H, Massberg, S, Taramasso, M, Fam, Np, Lurz, P, and Hausleiter, J

Published
2020

23. ADP-receptor antagonists in patients with acute myocardial infarction complicated by cardiogenic shock: a pooled IABP-SHOCK II and CULPRIT-SHOCK trial sub-analysis

Author

Kleeberger, J A, primary, Ouarrak, T, additional, Freund, A, additional, Fuernau, G, additional, Geissler, T, additional, Huber, K, additional, Noc, M, additional, Montalescot, G, additional, Clemmensen, P, additional, Zeymer, U, additional, Desch, S, additional, Schneider, S, additional, Hausleiter, J, additional, Thiele, H, additional, and Orban, M, additional

Published
2021
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25. Impact of the cardio-hepatic syndrome on outcomes after transcatheter mitral valve edge-to-edge repair

Author

Stolz, L, primary, Orban, M, additional, Karam, N, additional, Lubos, E, additional, Wild, M, additional, Praz, F, additional, Braun, D, additional, Doldi, P, additional, Tence, N, additional, Hagl, C, additional, Mayerle, J, additional, Naebauer, M, additional, Kalbacher, D, additional, Massberg, S, additional, and Hausleiter, J, additional

Published
2021
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32. The management of secondary mitral regurgitation in patients with heart failure: a joint position statement from the Heart Failure Association (HFA), European Association of Cardiovascular Imaging (EACVI), European Heart Rhythm Association (EHRA), and European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC

Author

Coats, A.J.S. Anker, S.D. Baumbach, A. Alfieri, O. von Bardeleben, R.S. Bauersachs, J. Bax, J.J. Boveda, S. Čelutkienė, J. Cleland, J.G. Dagres, N. Deneke, T. Farmakis, D. Filippatos, G. Hausleiter, J. Hindricks, G. Jankowska, E.A. Lainscak, M. Leclercq, C. Lund, L.H. McDonagh, T. Mehra, M.R. Metra, M. Mewton, N. Mueller, C. Mullens, W. Muneretto, C. Obadia, J.-F. Ponikowski, P. Praz, F. Rudolph, V. Ruschitzka, F. Vahanian, A. Windecker, S. Zamorano, J.L. Edvardsen, T. Heidbuchel, H. Seferovic, P.M. Prendergast, B.

Abstract

Secondary (or functional) mitral regurgitation (SMR) occurs frequently in chronic heart failure (HF) with reduced left ventricular (LV) ejection fraction, resulting from LV remodelling that prevents coaptation of the valve leaflets. Secondary mitral regurgitation contributes to progression of the symptoms and signs of HF and confers worse prognosis. The management of HF patients with SMR is complex and requires timely referral to a multidisciplinary Heart Team. Optimization of pharmacological and device therapy according to guideline recommendations is crucial. Further management requires careful clinical and imaging assessment, addressing the anatomical and functional features of the mitral valve and left ventricle, overall HF status, and relevant comorbidities. Evidence concerning surgical correction of SMR is sparse and it is doubtful whether this approach improves prognosis. Transcatheter repair has emerged as a promising alternative, but the conflicting results of current randomized trials require careful interpretation. This collaborative position statement, developed by four key associations of the European Society of Cardiology—the Heart Failure Association (HFA), European Association of Percutaneous Cardiovascular Interventions (EAPCI), European Association of Cardiovascular Imaging (EACVI), and European Heart Rhythm Association (EHRA)—presents an updated practical approach to the evaluation and management of patients with HF and SMR based upon a Heart Team approach. © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

Published
2021

33. Prasugrel plus bivalirudin vs. clopidogrel plus heparin in patients with ST-segment elevation myocardial infarction

Author

Schulz, Stefanie, Richardt, Gert, Laugwitz, Karl-Ludwig, Morath, Tanja, Neudecker, Julia, Hoppmann, Petra, Mehran, Roxana, Gershlick, Anthony H., Tölg, Ralph, Anette Fiedler, K., Abdel-Wahab, Mohamed, Kufner, Sebastian, Schneider, Simon, Schunkert, Heribert, Ibrahim, Tareq, Mehilli, Julinda, Kastrati, Adnan, Kastrati, A., Mehilli, J., Richardt, G., Mehran, R., Gershlick, A., Mehilli, J., Burgdorf, C., Byrne, R.A., Cassese, S., Fusaro, M., Hausleiter, J., Hengstenberg, C., Joner, M., Kasel, M., Kastrati, A., Massberg, S., Ott, I., Pache, J., Schunkert, H., Seyfarth, M., Sibbing, D., Tiroch, K., Laugwitz, K.-L., Ibrahim, T., Hoppmann, P., Schneider, S., Bradaric, C., Richardt, G., Abdel-Wahab, M., Geist, V., Schwarz, B., Sulimov, D., Tölg, R., Schulz, S., Schömig, G., von Merzljak, B., Luckmann, J., Ruf, J., Morath, T., Holle, H., Paul, H., Vogel, J., Hoesl, K., Rifatov, N., Pastor, I., Maimer-Rodrigues, F., Schulz, M., Neudecker, J., Mayer, K., Hofmann, F., Mann, J., Hauschke, D., Schmitt, C., Poci, D., Barthel, P., Ndrepepa, G., Keta, D., Byrne, R.A., Kufner, S., Piniek, S., Hurt, S., Kastrati, S., and Anette Fiedler, K.

Published
2014
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34. Outcomes of TTVI in Patients With Pacemaker or Defibrillator Leads: Data From the TriValve Registry

Author

Taramasso M, Gavazzoni M, Pozzoli A, Alessandrini H, Latib A, Attinger-Toller A, Biasco L, Braun D, Brochet E, Connelly KA, de Bruijn S, Denti P, Deuschl F, Estevez-Louriero R, Fam N, Frerker C, Ho E, Juliard JM, Kaple R, Kodali S, Kreidel F, Kuck KH, Lauten A, Lurz J, Monivas V, Mehr M, Nazif T, Nickening G, Pedrazzini G, Praz F, Puri R, Rodes-Cabau J, Schafer U, Schofer J, Sievert H, Tang GHL, Khattab AA, Thiele H, Unterhuber M, Vahanian A, Von Bardeleben RS, Webb JG, Weber M, Windecker S, Winkel M, Zuber M, Hausleiter J, Lurz P, Maisano F, Leon MB, Hahn RT, Taramasso, M, Gavazzoni, M, Pozzoli, A, Alessandrini, H, Latib, A, Attinger-Toller, A, Biasco, L, Braun, D, Brochet, E, Connelly, Ka, de Bruijn, S, Denti, P, Deuschl, F, Estevez-Louriero, R, Fam, N, Frerker, C, Ho, E, Juliard, Jm, Kaple, R, Kodali, S, Kreidel, F, Kuck, Kh, Lauten, A, Lurz, J, Monivas, V, Mehr, M, Nazif, T, Nickening, G, Pedrazzini, G, Praz, F, Puri, R, Rodes-Cabau, J, Schafer, U, Schofer, J, Sievert, H, Tang, Ghl, Khattab, Aa, Thiele, H, Unterhuber, M, Vahanian, A, Von Bardeleben, R, Webb, Jg, Weber, M, Windecker, S, Winkel, M, Zuber, M, Hausleiter, J, Lurz, P, Maisano, F, Leon, Mb, and Hahn, Rt

Subjects
Male, Cardiac Catheterization, Pacemaker, Artificial, Time Factors, Clinical Decision-Making, Electric Countershock, Prosthesis Design, Postoperative Complications, Risk Factors, Humans, Hospital Mortality, Registries, 610 Medicine & health, Retrospective Studies, Aged, 80 and over, Heart Valve Prosthesis Implantation, Cardiac Pacing, Artificial, Hemodynamics, Mitral Valve Insufficiency, Recovery of Function, Defibrillators, Implantable, Europe, Treatment Outcome, Heart Valve Prosthesis, North America, Feasibility Studies, Mitral Valve, Female
Abstract

OBJECTIVES The interference of a transtricuspid cardiac implantable electronic device (CIED) lead with tricuspid valve function may contribute to the mechanism of tricuspid regurgitation (TR) and poses specific therapeutic challenges during transcatheter tricuspid valve intervention (TTVI). Feasibility and efficacy of TTVI in presence of a CIED is unclear. BACKGROUND Feasibility of TTVI in presence of a CIED lead has never been proven on a large basis. METHODS The study population consisted of 470 patients with severe symptomatic TR from the TriValve (Transcatheter Tricuspid Valve Therapies) registry who underwent TTVI at 21 centers between 2015 and 2018. The association of CIED and outcomes were assessed. RESULTS Pre-procedural CIED was present in 121 of 470 (25.7%) patients. The most frequent location of the CIED lead was the posteroseptal commissure (44.0%). As compared with patients without a transvalvular lead (no-CIED group), patients having a tricuspid lead (CIED group) were more symptomatic (New York Heart Association functional class III to IV in 95.9% vs. 92.3%; p = 0.02) and more frequently had previous episodes of right heart failure (87.8% vs. 69.0%; p = 0.002). No-CIED patients had more severe TR (effective regurgitant orifice area 0.7 ± 0.6 cm2 vs. 0.6 ± 0.3 cm2; p = 0.02), but significantly better right ventricular function (tricuspid annular plane systolic excursion = 16.7 ± 5.0 mm vs. 15.9 ± 4.0 mm; p = 0.04). Overall, 373 patients (79%) were treated with the MitraClip (Abbott Vascular, Santa Clara, California) (106 [87.0%] in the CIED group). Among them, 154 (33%) patients had concomitant transcatheter mitral repair (55 [46.0%] in the CIED group, all MitraClip). Procedural success was achieved in 80.0% of no-CIED patients and in 78.6% of CIED patients (p = 0.74), with an in-hospital mortality of 2.9% and 3.7%, respectively (p = 0.70). At 30 days, residual TR ≤2+ was observed in 70.8% of no-CIED and in 73.7% of CIED patients (p = 0.6). Symptomatic improvement was observed in both groups (NYHA functional class I to II at 30 days: 66.0% vs. 65.0%; p = 0.30). Survival at 12 months was 80.7 ± 3.0% in the no-CIED patients and 73.6 ± 5.0% in the CIED patients (p = 0.30). CONCLUSIONS TTVI is feasible in selected patients with CIED leads and acute procedural success and short-term clinical outcomes are comparable to those observed in patients without a transtricuspid lead.

Published
2019

37. Coronary atherosclerosis scoring with semiquantitative CCTA risk scores for prediction of major adverse cardiac events: Propensity score-based analysis of diabetic and non-diabetic patients

Author

Hoogen, I.J. van den, Rosendael, A.R. van, Lin, F.Y., Lu, Y., Dimitriu-Leen, A.C., Smit, J.M., Scholte, A., Achenbach, S., Al-Mallah, M.H., Andreini, D., Berman, D.S., Budoff, M.J., Cademartiri, F., Callister, T.Q., Chang, H.J., Chinnaiyan, K., Chow, B.J., Cury, R.C., DeLago, A., Feuchtner, G., Hadamitzky, M., Hausleiter, J., Kaufmann, P.A., Kim, Y. J., Leipsic, J.A., Maffei, E., Marques, H., Gonçalves, P. de Araújo, Pontone, G., Raff, G.L., Rubinshtein, R., Villines, T.C., Gransar, H., Jones, E.C., Peña, J.M., Shaw, L.J., Min, J.K., Bax, J.J., Hoogen, I.J. van den, Rosendael, A.R. van, Lin, F.Y., Lu, Y., Dimitriu-Leen, A.C., Smit, J.M., Scholte, A., Achenbach, S., Al-Mallah, M.H., Andreini, D., Berman, D.S., Budoff, M.J., Cademartiri, F., Callister, T.Q., Chang, H.J., Chinnaiyan, K., Chow, B.J., Cury, R.C., DeLago, A., Feuchtner, G., Hadamitzky, M., Hausleiter, J., Kaufmann, P.A., Kim, Y. J., Leipsic, J.A., Maffei, E., Marques, H., Gonçalves, P. de Araújo, Pontone, G., Raff, G.L., Rubinshtein, R., Villines, T.C., Gransar, H., Jones, E.C., Peña, J.M., Shaw, L.J., Min, J.K., and Bax, J.J.

Abstract

Contains fulltext : 220894.pdf (Publisher’s version ) (Closed access), AIMS: We aimed to compare semiquantitative coronary computed tomography angiography (CCTA) risk scores - which score presence, extent, composition, stenosis and/or location of coronary artery disease (CAD) - and their prognostic value between patients with and without diabetes mellitus (DM). Risk scores derived from general chest-pain populations are often challenging to apply in DM patients, because of numerous confounders. METHODS: Out of a combined cohort from the Leiden University Medical Center and the CONFIRM registry with 5-year follow-up data, we performed a secondary analysis in diabetic patients with suspected CAD who were clinically referred for CCTA. A total of 732 DM patients was 1:1 propensity-matched with 732 non-DM patients by age, sex and cardiovascular risk factors. A subset of 7 semiquantitative CCTA risk scores was compared between groups: 1) any stenosis ≥50%, 2) any stenosis ≥70%, 3) stenosis-severity component of the coronary artery disease-reporting and data system (CAD-RADS), 4) segment involvement score (SIS), 5) segment stenosis score (SSS), 6) CT-adapted Leaman score (CT-LeSc), and 7) Leiden CCTA risk score. Cox-regression analysis was performed to assess the association between the scores and the primary endpoint of all-cause death and non-fatal myocardial infarction. Also, area under the receiver-operating characteristics curves were compared to evaluate discriminatory ability. RESULTS: A total of 1,464 DM and non-DM patients (mean age 58 ± 12 years, 40% women) underwent CCTA and 155 (11%) events were documented after median follow-up of 5.1 years. In DM patients, the 7 semiquantitative CCTA risk scores were significantly more prevalent or higher as compared to non-DM patients (p ≤ 0.022). All scores were independently associated with the primary endpoint in both patients with and without DM (p ≤ 0.020), with non-significant interaction between the scores and diabetes (interaction p ≥ 0.109). Discriminatory ability of the Leiden CCTA ri

Published
2020

38. Interventional treatment of AV valvular diseases-Criteria for certification of mitral valve centers Position paper of the German Cardiac Society

Author

Baldus, S., Bardeleben, R. S., V, Eggebrecht, H., Elsaesser, A., Hausleiter, J., Ince, H., Kelm, M., Kuck, K. H., Lubos, E., Nef, H., Raake, P., Rillig, A., Rudolph, V, Schulze, P. C., Schlitt, A., Stellbrink, C., Moellmann, H., Baldus, S., Bardeleben, R. S., V, Eggebrecht, H., Elsaesser, A., Hausleiter, J., Ince, H., Kelm, M., Kuck, K. H., Lubos, E., Nef, H., Raake, P., Rillig, A., Rudolph, V, Schulze, P. C., Schlitt, A., Stellbrink, C., and Moellmann, H.

Abstract

Mitral and tricuspid regurgitation are highly prevalent types of valvular heart disease, important drivers of a poor prognosis and subject to catheter-based treatment. The transcatheter reconstruction of the valves has meanwhile evolved as an important alternative to pure medicinal treatment and surgical interventions. Whereas transcatheter treatment of tricuspid valve insufficiency has recently shown effectiveness and safety in the first registries, transcatheter treatment of mitral valve insufficiency has meanwhile been tested in several randomized trials. This paper comments on the results of these trials and presents recommendations regarding the indications for the interventional treatment modalities available for mitral and tricuspid valve regurgitation. As part of this manuscript and in an effort to further improve the quality of care, the German Cardiac Society has updated the criteria for the certification of centers for transcatheter treatment of mitral valve insufficiency.

Published
2020

39. Interventional treatment of AV valvular diseases-Criteria for certification of mitral valve centers. Position paper of the German Cardiac Society (vol 14, pg 339, 2020)

Author

Baldus, S., V. Bardeleben, R. S., Eggebrecht, H., Elsaesser, A., Hausleiter, J., Ince, H., Kelm, M., Kuck, K. H., Lubos, E., Nef, H., Raake, P., Rillig, A., Rudolph, V., Schulze, P. C., Schlitt, A., Stellbrink, C., Moellmann, H., Baldus, S., V. Bardeleben, R. S., Eggebrecht, H., Elsaesser, A., Hausleiter, J., Ince, H., Kelm, M., Kuck, K. H., Lubos, E., Nef, H., Raake, P., Rillig, A., Rudolph, V., Schulze, P. C., Schlitt, A., Stellbrink, C., and Moellmann, H.

Published
2020

40. The Diagnosis and Treatment of Tricuspid Regurgitation.

Author

Stocker, T J, Besler, C, Treede, H, and Hausleiter, J

Abstract

Background: It is estimated that 6% of persons over age 75 have clinically relevant tricuspid regurgitation (TR). This condition carries a high mortality and is of particular interest because of the recent development of new interventional treatments. Methods: This review is based on publications that were retrieved by a selective search in the PubMed database for randomized controlled trials (RCTs), observational studies, registry studies, expert recommendations, and current international guidelines. Results: The evidence reveals that TR is an independent cause of mortality. Mortality is correlated with the severity of TR: approximately 35% of patients with severe TR and right heart failure die within 1 year, and about 60% within 3 years. The clinical course varies depending on the etiology (primary TR, atrial/ventricular secondary TR, association with pacemaker systems). In the outpatient setting, timely diagnosis by transthoracic echocardiography is crucial. The options for pharmacotherapy are essentially limited to diuretic treatment (grade 2a recommendation). Early referral to a specialized heart valve center is essential for the prevention of irreversible damage of the right heart and secondary end-organ damage, including cardiohepatic and cardiorenal syndromes. In the heart valve center, an extended diagnostic evaluation with multimodal imaging is followed by a case discussion by the interdisciplinary cardiac team, with individual evaluation of the treatment options. The first randomized controlled trial of treatment for TR yielded a win ratio of 1.48 (95% confidence interval, [1.06; 2.13]) for interventional treatment (edge-to-edge repair) compared to optimal medical therapy. Conclusion: As the understanding of tricuspid regurgitation improves, strategies for its interventional treatment are undergoing steady development, with the aim of lowering the mortality of this condition. [ABSTRACT FROM AUTHOR]

Published
2024
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41. Isoflurane sedation in patients undergoing VA-ECMO treatment for cardiogenic shock – an observational propensity-matched study

Author

Scherer, C, primary, Kupka, D, additional, Stocker, T, additional, Joskowiak, D, additional, Scheuplein, H, additional, Schoenegger, C, additional, Stremmel, C, additional, Luesebrink, E, additional, Stark, K, additional, Orban, M, additional, Peterss, S, additional, Hausleiter, J, additional, Hagl, C, additional, and Massberg, S, additional

Published
2020
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45. Impact of an interatrial shunt device on survival and heart failure hospitalization in patients with preserved ejection fraction

Author

Kaye, DM, Petrie, MC, McKenzie, S, Hasenfuss, G, Malek, F, Post, M, Doughty, RN, Trochu, J-N, Gustafsson, F, Lang, I, Kolodziej, A, Westenfeld, R, Penicka, M, Rosenberg, M, Hausleiter, J, Raake, P, Jondeau, G, Bergmann, MW, Spelman, T, Aytug, H, Ponikowski, P, Hayward, C, Kaye, DM, Petrie, MC, McKenzie, S, Hasenfuss, G, Malek, F, Post, M, Doughty, RN, Trochu, J-N, Gustafsson, F, Lang, I, Kolodziej, A, Westenfeld, R, Penicka, M, Rosenberg, M, Hausleiter, J, Raake, P, Jondeau, G, Bergmann, MW, Spelman, T, Aytug, H, Ponikowski, P, and Hayward, C

Abstract

AIMS: Impaired left ventricular diastolic function leading to elevated left atrial pressures, particularly during exertion, is a key driver of symptoms and outcomes in heart failure with preserved ejection fraction (HFpEF). Insertion of an interatrial shunt device (IASD) to reduce left atrial pressure in HFpEF has been shown to be associated with short-term haemodynamic and symptomatic benefit. We aimed to investigate the potential effects of IASD placement on HFpEF survival and heart failure hospitalization (HFH). METHODS AND RESULTS: Heart failure with preserved ejection fraction patients participating in the Reduce Elevated Left Atrial Pressure in Patients with Heart Failure study (Corvia Medical) of an IASD were followed for a median duration of 739 days. The theoretical impact of IASD implantation on HFpEF mortality was investigated by comparing the observed survival of the study cohort with the survival predicted from baseline data using the Meta-analysis Global Group in Chronic Heart Failure heart failure risk survival score. Baseline and post-IASD implant parameters associated with HFH were also investigated. Based upon the individual baseline demographic and cardiovascular profile of the study cohort, the Meta-analysis Global Group in Chronic Heart Failure score-predicted mortality was 10.2/100 pt years. The observed mortality rate of the IASD-treated cohort was 3.4/100 pt years, representing a 33% lower rate (P = 0.02). By Kaplan-Meier analysis, the observed survival in IASD patients was greater than predicted (P = 0.014). Baseline parameters were not predictive of future HFH events; however, poorer exercise tolerance and a higher workload-corrected exercise pulmonary capillary wedge pressure at the 6 months post-IASD study were associated with HFH. CONCLUSIONS: The current study suggests IASD implantation may be associated with a reduction in mortality in HFpEF. Large-scale ongoing randomized studies are required to confirm the potential benefit of this t

Published
2019

46. Superior Risk Stratification With Coronary Computed Tomography Angiography Using a Comprehensive Atherosclerotic Risk Score

Author

Rosendael, A.R. van, Shaw, L.J., Xie, J.X., Dimitriu-Leen, A.C., Smit, J.M., Scholte, A.J., Werkhoven, J.M. van, Callister, T.Q., DeLago, A., Berman, D.S., Hadamitzky, M., Hausleiter, J., Al-Mallah, M.H., Budoff, M.J., Kaufmann, P.A., Raff, G., Chinnaiyan, K., Cademartiri, F., Maffei, E., Villines, T.C., Kim, Y. J., Feuchtner, G., Lin, F.Y., Jones, E.C., Pontone, G., Andreini, D., Marques, H., Rubinshtein, R., Achenbach, S., Dunning, A., Gomez, M., Hindoyan, N., Gransar, H., Leipsic, J., Narula, J., Min, J.K., Bax, J.J., Rosendael, A.R. van, Shaw, L.J., Xie, J.X., Dimitriu-Leen, A.C., Smit, J.M., Scholte, A.J., Werkhoven, J.M. van, Callister, T.Q., DeLago, A., Berman, D.S., Hadamitzky, M., Hausleiter, J., Al-Mallah, M.H., Budoff, M.J., Kaufmann, P.A., Raff, G., Chinnaiyan, K., Cademartiri, F., Maffei, E., Villines, T.C., Kim, Y. J., Feuchtner, G., Lin, F.Y., Jones, E.C., Pontone, G., Andreini, D., Marques, H., Rubinshtein, R., Achenbach, S., Dunning, A., Gomez, M., Hindoyan, N., Gransar, H., Leipsic, J., Narula, J., Min, J.K., and Bax, J.J.

Abstract

Item does not contain fulltext, OBJECTIVES: This study was designed to assess the prognostic value of a new comprehensive coronary computed tomography angiography (CTA) score compared with the stenosis severity component of the Coronary Artery Disease-Reporting and Data System (CAD-RADS). BACKGROUND: Current risk assessment with coronary CTA is mainly focused on maximal stenosis severity. Integration of plaque extent, location, and composition in a comprehensive model may improve risk stratification. METHODS: A total of 2,134 patients with suspected but without known CAD were included. The predictive value of the comprehensive CTA score (ranging from 0 to 42 and divided into 3 groups: 0 to 5, 6 to 20, and >20) was compared with the CAD-RADS combined into 3 groups (0% to 30%, 30% to 70% and >/=70% stenosis). Its predictive performance was internally and externally validated (using the 5-year follow-up dataset of the CONFIRM [Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry], n = 1,971). RESULTS: The mean age of patients was 55 +/- 13 years, mean follow-up 3.6 +/- 2.8 years, and 130 events (myocardial infarction or death) occurred. The new, comprehensive CTA score showed strong and independent predictive value using the Cox proportional hazard analysis. A model including clinical variables plus comprehensive CTA score showed better discrimination of events compared with a model consisting of clinical variables plus CAD-RADS (0.768 vs. 0.742, p = 0.001). Also, the comprehensive CTA score correctly reclassified a significant proportion of patients compared with the CAD-RADS (net reclassification improvement 12.4%, p < 0.001). Good predictive accuracy was reproduced in the external validation cohort. CONCLUSIONS: The new comprehensive CTA score provides better discrimination and reclassification of events compared with the CAD-RADS score based on stenosis severity only. The score retained similar prognostic accuracy when externally validated. Anatomic risk

Published
2019

47. Diagnosis of obstructive coronary artery disease using computed tomography angiography in patients with stable chest pain depending on clinical probability and in clinically important subgroups: Meta-analysis of individual patient data

Author

Haase, R. (Robert), Schlattmann, P. (Peter), Gueret, P. (Pascal), Andreini, D. (Daniele), Pontone, G. (Gianluca), Alkadhi, H. (Hatem), Hausleiter, J. (Jörg), Garcia, M. (Mario), Leschka, S. (Sebastian), Meijboom, W.B. (Willem Bob), Zimmermann, E. (Elke), Gerber, B. (Bernhard), Schoepf, U.J. (Joseph), Shabestari, A.A. (Abbas A), Nørgaard, B. (Bjarne), Meijs, M.F.L. (Matthijs), Sato, A. (Akira), Altern Ovrehus, K. (Kristian), Diederichsen, A.C.P. (Axel C P), Jenkins, S.M.M. (Shona), Knuuti, J. (Juhani), Hamdan, A. (Ashraf), Halvorsen, B.A. (Bjørn Arild), Mendoza-Rodriguez, V. (Vladimir), Rochitte, C. (Carlos), Rixe, J. (Johannes), Wan, Y.L. (Yung Liang), Langer, C. (Christoph), Bettencourt, N. (Nuno), Martuscelli, E. (Eugenio), Ghostine, S. (Said), Buechel, R.R. (Ronny Ralf), Nikolaou, K. (Konstantin), Mickley, H. (Hans), Yang, L. (Lin), Zhang, Z. (Zhaqoi), Chen, M.Y. (Marcus Y), Halon, D.A. (David), Rief, M. (Matthias), Sun, K. (Kai), Hirt-Moch, B. (Beatrice), Niinuma, H. (Hiroyuki), Marcus, R.P. (Roy P), Muraglia, S. (Simone), Jakamy, R. (Reda), Chow, B.J.W. (Benjamin), Kaufmann, P.A. (Philipp), Tardif, J.-C. (Jean-Claude), Nomura, C.H. (Cesar), Kofoed, K.F. (Klaus F), Laissy, J.-P. (Jean-Pierre), Arbab-Zadeh, A. (Armin), Kitagawa, K. (Kakuya), Laham, R. (Roger), Jinzaki, M. (Masahiro), Hoe, J. (John), Rybicki, F.J. (Frank J), Scholte, A. (Arthur), Paul, N. (Narinder), Tan, S.Y. (Swee Y), Yoshioka, K. (Kunihiro), Röhle, R. (Robert), Schuetz, G.M. (Georg), Schueler, S. (Sabine), Coenen, M.H. (Maria H), Wieske, V. (Viktoria), Achenbach, S. (Stephan), Budoff, M.J. (Matthew), Laule, M. (Michael), Newby, D.E. (David E.), Dewey, T.M. (Todd M.), Haase, R. (Robert), Schlattmann, P. (Peter), Gueret, P. (Pascal), Andreini, D. (Daniele), Pontone, G. (Gianluca), Alkadhi, H. (Hatem), Hausleiter, J. (Jörg), Garcia, M. (Mario), Leschka, S. (Sebastian), Meijboom, W.B. (Willem Bob), Zimmermann, E. (Elke), Gerber, B. (Bernhard), Schoepf, U.J. (Joseph), Shabestari, A.A. (Abbas A), Nørgaard, B. (Bjarne), Meijs, M.F.L. (Matthijs), Sato, A. (Akira), Altern Ovrehus, K. (Kristian), Diederichsen, A.C.P. (Axel C P), Jenkins, S.M.M. (Shona), Knuuti, J. (Juhani), Hamdan, A. (Ashraf), Halvorsen, B.A. (Bjørn Arild), Mendoza-Rodriguez, V. (Vladimir), Rochitte, C. (Carlos), Rixe, J. (Johannes), Wan, Y.L. (Yung Liang), Langer, C. (Christoph), Bettencourt, N. (Nuno), Martuscelli, E. (Eugenio), Ghostine, S. (Said), Buechel, R.R. (Ronny Ralf), Nikolaou, K. (Konstantin), Mickley, H. (Hans), Yang, L. (Lin), Zhang, Z. (Zhaqoi), Chen, M.Y. (Marcus Y), Halon, D.A. (David), Rief, M. (Matthias), Sun, K. (Kai), Hirt-Moch, B. (Beatrice), Niinuma, H. (Hiroyuki), Marcus, R.P. (Roy P), Muraglia, S. (Simone), Jakamy, R. (Reda), Chow, B.J.W. (Benjamin), Kaufmann, P.A. (Philipp), Tardif, J.-C. (Jean-Claude), Nomura, C.H. (Cesar), Kofoed, K.F. (Klaus F), Laissy, J.-P. (Jean-Pierre), Arbab-Zadeh, A. (Armin), Kitagawa, K. (Kakuya), Laham, R. (Roger), Jinzaki, M. (Masahiro), Hoe, J. (John), Rybicki, F.J. (Frank J), Scholte, A. (Arthur), Paul, N. (Narinder), Tan, S.Y. (Swee Y), Yoshioka, K. (Kunihiro), Röhle, R. (Robert), Schuetz, G.M. (Georg), Schueler, S. (Sabine), Coenen, M.H. (Maria H), Wieske, V. (Viktoria), Achenbach, S. (Stephan), Budoff, M.J. (Matthew), Laule, M. (Michael), Newby, D.E. (David E.), and Dewey, T.M. (Todd M.)

Abstract

Objective To determine whether coronary computed tomography angiography (CTA) should be performed in patients with any clinical probability of coronary artery disease (CAD), and whether the diagnostic performance differs between subgroups of patients. Design Prospectively designed meta-analysis of individual patient data from prospective diagnostic accuracy studies. Data sources Medline, Embase, and Web of Science for published studies. Unpublished studies were identified via direct contact with participating investigators. Eligibility criteria for selecting studies Prospective diagnostic accuracy studies that compared coronary CTA with coronary angiography as the reference standard, using at least a 50% diameter reduction as a cutoff value for obstructive CAD. All patients needed to have a clinical indication for coronary angiography due to suspected CAD, and both tests had to be performed in all patients. Results had to be provided using 2×2 or 3×2 cross tabulations for the comparison of CTA with coronary angiography. Primary outcomes were the positive and negative predictive values of CTA as a function of clinical pretest probability of obstructive CAD, analysed by a generalised linear mixed model; calculations were performed including and excluding non-diagnostic CTA results. The no-treat/treat threshold model was used to determine the range of appropriate pretest probabilities for CTA. The threshold model was based on obtained post-test probabilities of less than 15% in case of negative CTA and above 50% in case of positive CTA. Sex, angina pectoris type, age, and number of computed tomography detector rows were used as clinical variables to analyse the diagnostic performance in relevant subgroups. Results Individual patient data from 5332 patients from 65 prospective diagnostic accuracy studies were retrieved. For a pretest probability range of 7-67%, the treat threshold of more than 50% and the no-treat threshold of less than 15% post-test probability were ob

Published
2019
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49. The International Multicenter TriValve Registry: Which Patients Are Undergoing Transcatheter Tricuspid Repair?

Author

Taramasso M, Hahn RT, Alessandrini H, Latib A, Attinger-Toller A, Braun D, Brochet E, Connelly KA, Denti P, Deuschl F, Englmaier A, Fam N, Frerker C, Hausleiter J, Juliard JM, Kaple R, Kreidel F, Kuck KH, Kuwata S, Ancona M, Malasa M, Nazif T, Nickenig G, Nietlispach F, Pozzoli A, Schafer U, Schofer J, Schueler R, Tang G, Vahanian A, Webb JG, Yzeiraj E, Maisano F, Leon MB, Taramasso, M, Hahn, Rt, Alessandrini, H, Latib, A, Attinger-Toller, A, Braun, D, Brochet, E, Connelly, Ka, Denti, P, Deuschl, F, Englmaier, A, Fam, N, Frerker, C, Hausleiter, J, Juliard, Jm, Kaple, R, Kreidel, F, Kuck, Kh, Kuwata, S, Ancona, M, Malasa, M, Nazif, T, Nickenig, G, Nietlispach, F, Pozzoli, A, Schafer, U, Schofer, J, Schueler, R, Tang, G, Vahanian, A, Webb, Jg, Yzeiraj, E, Maisano, F, and Leon, Mb

Published
2017

50. Reduction in Radiation Exposure in Cardiovascular CT Imaging

Author

Stocker, T., Deseive, S. D. C., Leipsic, J., Hadamitzky, M., Chen, M, Rubinshtein, Ronen, Heckner, Mathias, Bax, Jeroen J, Fang, Xiangming, Grove, Erik Lerkevang, Lesser, J., Maurovich-Horvat, Pál, Otton, H. J., Shin, Sanghoon, Pontone, Gianluca, Marques, H., Chow, Benjamin, Nomura, Cesar H, Tabbalat, Ramzi, Schmermund, Axel, Kang, Joon-Wan, Naoum, Christopher, ATKINSON, M, Martuscelli, E., Massberg, Steffen, Hausleiter, J., and van Beek, Edwin

Abstract

Aims Advances of cardiac computed tomography angiography (CTA) have been developed for dose reduction, but their efficacy in clinical practice is largely unknown. This study was designed to evaluate radiation dose exposure and utilization of dose-saving strategies for contrast-enhanced cardiac CTA in daily practice. Methods and results Sixty one hospitals from 32 countries prospectively enrolled 4502 patients undergoing cardiac CTA during one calendar month in 2017. Computed tomography angiography scan data and images were analysed in a central core lab and compared with a similar dose survey performed in 2007. Linear regression analysis was performed to identify independent predictors associated with dose. The most frequent indication for cardiac CTA was the evaluation of coronary artery disease in 89% of patients. The median dose-length product (DLP) of coronary CTA was 195 mGy*cm (interquartile range 110–338 mGy*cm). When compared with 2007, the DLP was reduced by 78% (P

Published
2018
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