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2. Outcome of transcatheter atrial septal defect closure in a nationwide cohort.

Author

Muroke, V., Jalanko, M., Haukka, J., Hartikainen, J., Tahvanainen, A., Ukkonen, H., Ylitalo, K., Pihkala, J., and Sinisalo, J.

Subjects
ATRIAL septal defects, CORONARY disease, HEART failure, MYOCARDIAL ischemia, VENTRICULAR fibrillation, ATRIAL fibrillation, ARRHYTHMIA, THERAPEUTIC embolization
Abstract

Transcatheter (TC) atrial septal defect (ASD) closure has been the mainstay of therapy for secundum-type ASDs for over 20 years. This nationwide cohort evaluated the long-term outcome of transcatheter-closed ASDs. The study enrolled every transcatheter ASD closure performed in Finland from 1999 to 2019. Five age, sex, and municipality-matched controls per ASD patient were gathered from the general population. The median follow-up period was 5.9 years (range 0–20.8). We used the hospital discharge register to gather all hospital visits and diagnoses. Closure complications and echocardiographic changes were collected from the electronic health records. Transcatheter ASD closure was performed in 1000 patients (68.5% females) during the study period. The median (range) age at the time of the procedure was 37.9 (1.8–87.5) years. ASD patients had an increased risk for new-onset atrial fibrillation (RR 2.45, 95% CI: 1.84–3.25), migraine (RR 3.61, 95% CI: 2.54–5.14), ischemic heart disease (RR 1.73, 95% CI: 1.23–2.45), ventricular fibrillation/tachycardia (RR 3.54 (95% CI: 1.48–8.43) and AV conduction disorder (RR 3.60, 95% CI: 1.94–6.70) compared to the control cohort. Stroke risk was not increased (RR 1.36, 95% CI: 0.91–2.03). Adverse events occurred in 6.3% (n = 63) of the patients, including four erosions and ten device embolizations. After TC closure of ASD, patients had a higher risk of new-onset atrial fibrillation and migraine than controls without ASD. As novel findings, we found an increased risk for ischemic heart disease, AV conduction disorders, and ventricular fibrillation/tachycardia. Even though patients have an excellent overall prognosis after percutaneous ASD closure, the increased incidence of major comorbidities like atrial fibrillation and heart failure prompts more thorough lifelong follow-up. This study's novel findings revealed the increased risk for ischemic heart disease, AV conduction disorders, or ventricular tachycardia/fibrillation during the follow-up. Major complications after the closure are rare; erosion is seen in 0.4% of the patients and embolization in 1.0% of the patients. [ABSTRACT FROM AUTHOR]

Published
2023
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4. Effect of radiotherapy on expression of transmembrane mucin MUC1 in oral mucosal cells

Author

Ukkonen, H. (Helena), Kashyap, B. (Bina), Sirviö, E. (Ellinoora), Dekker, H. (Hannah), Vähänikkilä, H. (Hannu), Pirhonen, P. (Paula), Mikkonen, J. J. (Jopi J.W.), ten Bruggenkate, C. M. (Chris M), Schulten, E. A. (Engelbert AJM), Koistinen, A. (Arto), Bloemena, E. (Elisabeth), and Kullaa, A. M. (Arja M.)

Subjects
mucosal pellicle, oral epithelium, mucins, oral cancer, radiotherapy
Abstract

Objective: Mucins form a protective surface called mucosal pellicle on oral epithelium. Mucin — 1 (MUC1) is secreted from the oral mucosal squamous epithelium itself on the apical surface of the epithelial cell. The objective of this study was to determine the effect of radiotherapy (RT) on MUC1 expression of the oral epithelium in patients with head and neck cancer (HNC). Methods: Oral mucosal tissue biopsies were obtained from 55 patients; Study group 1 consisted of 33 clinically healthy subjects as controls. The oncology group consisted of two subgroups: Group 2 consisted of 7 oral cancer patients treated with surgery without RT, and Group 3 consisted of 15 HNC patients treated with RT. To visualized MUC1 staining, HMFG1 antibody was used. In addition, microstructures of the specimens were studied under electron microscopies. Results: The superficial layer of the oral epithelium had strong MUC1 staining in control samples compared to oncological groups (p=0.002). Intermediate layer showed the most expression of MUC1 in irradiated mucosa (p=0.02). In both oncological groups, the expression of MUC1 was detected on the basal layer (p=0.005). Morphological analysis with electron microscopies showed destruction in the microstructure of apical cells of the irradiated oral epithelium. Irradiated oral mucosa with strong MUC1 expression showed loose intercellular bonds. Conclusion: Radiotherapy affects the expression of MUC1 in basal and intermediate layers of oral epithelium. Irradiation alters or hinders the intra and intercellular linkages which affects the normal apical transportation of MUC1 and hence, such alteration may play a role in promoting radiation — induced complications.

Published
2020

6. Biochemical changes in irradiated oral mucosa:a FTIR spectroscopic study

Author

Ukkonen, H. (Helena), Vuokila, S. (Simo), Mikkonen, J. J. (Jopi J. W.), Dekker, H. (Hannah), Schulten, E. A. (Engelbert A. J. M.), Bloemena, E. (Elisabeth), Koistinen, A. (Arto), Valdez, T. A. (Tulio A.), Kullaa, A. M. (Arja M.), Singh, S. P. (Surya Pratap), Ukkonen, H. (Helena), Vuokila, S. (Simo), Mikkonen, J. J. (Jopi J. W.), Dekker, H. (Hannah), Schulten, E. A. (Engelbert A. J. M.), Bloemena, E. (Elisabeth), Koistinen, A. (Arto), Valdez, T. A. (Tulio A.), Kullaa, A. M. (Arja M.), and Singh, S. P. (Surya Pratap)

Abstract

Radiation exposure during the course of treatment in head and neck cancer (HNC) patients can induce both structural and biochemical anomalies. The present study is focused on utilizing infrared imaging for the identification of the minor biochemical alterations in the oral mucosa. Chemical maps generated using glycoprotein band indicates its differential distribution along the superficial layer. Spectra extracted from this layer suggests changes in overall nucleic acid and protein content in response to the therapeutic irradiation. Discrimination among control and irradiated groups have been achieved using principal component analysis. Findings of this preliminary study further support prospective utilization of Fourier Transform InfraRed (FTIR) imaging as a non-destructive, label-free tool for objective assessment of the oral mucosa in patient groups with or without radiation therapy.

Published
2019

7. Posters display III clinical outcome and PET

Author

Baliño, N., Masoli, O., Traverso, S., Grynberg, L., Rappallo, C., Redruello, M., Rosa, D., Cragnolino, D., Meretta, A., Vidal, L., Graf, S., Khorsand, A., Gyongyosi, M., Karanikas, G., Eidherr, H., Kletter, K., Porenta, G., Glogar, D., Sochor, H., Beheshti, M., Poetzi, C., Wadsak, W., Maurer, G., Wolfram, J., Winter, O., Velghe, A., Veire, N., Bondt, P., Buyzere, M., Wiele, C., Backer, G., Gillebert, T., Dierckx, R., Sutter, J., Bernard, D., Langlois, M., Duarte, P., Mastrocolla, L., Sampaio, C., Rossi, J., Smanio, P., Lima, E., Oliveira, C., Pereira, J., Beraldo, P., Rodrigues, F., Thom, A., Yoshinaga, K., Ukkonen, H., Burwash, I., DeKemp, R., Dafoe, W., Davies, R., Haddad, H., Ruddy, T., DaSilva, J., Beanlands, R., Chow, B., Williams, K., Garrard, L., Szeto, A., Aung, M., Sondergaard, H., Bottcher, M., Madsen, M., Schmitz, O., Nielsen, T., Botker, H., Høilund-Carlsen, P., Johansen, A., Christensen, H., Vach, W., Møldrup, M., Haghfelt, T., Kristensen, J., Maeng, M., Mortensen, U., Berg, J., Rehling, M., Elsaban, K., El-Kady, T., El-Gabaly, M., Yehia, A., El-Sayed, M., Naum, A., Laaksonen, M., Tuunanen, H., Oikonen, V., Kemppainen, J., Järvisalo, M., Nuutila, P., Knuuti, J., Vanzetto, G., Jacon, P., Fagret, D., Machecourt, J., Lindner, O., Vogt, J., Kammeier, A., Fricke, E., Wielepp, P., Baller, D., Lamp, B., Holzinger, J., Horstkotte, D., Burchert, W., Nekolla, S., Souvatzoglou, M., Hausleiter, J., Henke, N., Kruschke, K., Bengel, F., Schwaiger, M., Sundaram, P., Padma, S., Haridas, K., Kumar, S., Zachariah, M., Livschitz, S., Zornitzki, T., Vered, S., Oettinger, M., Levy, R., Caspi, A., Faraggi, D., Knobler, H., Mats, I., Solodky, A., Ben-Gal, T., Battler, A., Zafrir, N., Varani, E., Balducelli, M., Severi, S., Patroncini, A., Vecchi, G., Gatti, C., Corbelli, C., Casanova, R., Maresta, A., Cittanti, C., Valgimigli, M., Giganti, M., Malagutti, P., Percoco, G., Bagatin, E., Panareo, S., Avigni, N., Ferrari, R., Feggi, L., Filardi, P., Cuocolo, A., Storto, G., Brevetti, G., Dellegrottaglie, S., Corrado, L., Cafiero, M., Polimeno, M., Zarrilli, A., Chiariello, M., Marcassa, C., Campini, R., Calza, P., Giannuzzi, P., Galassi, A., Grasso, C., Azzarelli, S., Leotta, E., Moshiri, S., Tamburino, C., Acampa, W., Ferro, A., Petretta, M., Salvatore, M., Pieri, P., Berta, R., Moscatelli, G., Buccoliero, F., Inglese, E., Medolago, G., Imperiale, A., Rimini, M., Bertagna, F., Sullo, P., Lupo, M., Cappagli, M., Fukuda, H., Kunimasa, T., Furuhashi, T., Moroi, M., Yasuhi, W., Akihiro, S., Akio, Y., Ryou, K., Kimio, T., Yasunori, W., Yasuhiko, T., Nariaki, E., Watabe, H., Teramoto, N., Ohta, Y., Kou, Y., Hayashi, T., Iida, H., Bom, H., Song, H., Min, J., Heo, Y., Seo, J., Lee, J., Bae, J., Jeong, S., Ahn, B., Chae, S., Lee, K., Popiel, M., Grajek, S., Czepczynski, R., Breborowicz, P., Lesiak, M., Czyz, A., Sawinski, K., Komarnicki, M., Cieslinski, A., Sowinski, J., Ferreira, A., Ventosa, A., Gil, V., Calqueiro, J., Lima, S., Aguiar, C., Couto, R., Raposo, L., Seabra-Gomes, R., Vasconcelos, M., Martins, E., Faria, T., Oliveira, A., Garcia, M., Rocha-Gonçalves, F., Lourenço, C., Roque, C., Ferrer-Antunes, A., Ferreira, M., Providência, L., Lima, J., Medrea, C., Bogdan, R., Lazar, A., Mot, S., Capilneanu, R., Kozulin, V., Berkovich, O., Ivashchenko, T., Larionova, V., Esipovich, I., Gordeev, M., Panov, A., Shlyakhto, E., Burova, N., Baranov, D., Timoshin, V., Chuprova, S., Shkolnikova, M., Zaklyazminskaya, E., Poliakov, A., Sazonova, S., Romero-Farina, G., Arenillas, J., Candell-Riera, J., Aguadè-Bruix, S., Leon, G., Molina, C., Chacon, P., Montaner, J., Rovira, A., Alvarez-Sabin, J., Namdar, M., Siegrist, P., Grathwohl, R., Delaloye, R., Koepfli, P., Wyss, C., Kaufmann, P., Bartenstein, N., Hellermann, J., Pollack, C., Schurr, U., Zellweger, M., Burger, P., Mueller-Brand, J., Pfisterer, M., Gordon, L., Epps, A., Chiarameda, S., Navare, S., Ahlberg, A., Cyr, G., Katten, D., Ausef, A., Heller, G., Darrow, B., Thomas, G., Ip, T., Thompson, R., Kramer, D., Rice, D., Thomas, J., Miyamoto, M., Druz, R., Nichols, K., Akinboboye, O., Reichek, N., Podrasky, E., Tuttle, R., Shaw, L., Hanson, M., Borges-Neto, S., Lundbye, J., Werden, S., Kazi, F., Whalen, A., Noble, G., O'Sullivan, D., Boden, W., Danias, P., Papaioannou, G., Leka, I., Beretta, M., Viňas, S., Gonzalez, A., Vidal, I., and Rener, A.

Published
2018

8. P606High intermodality variability in ejection fraction measured by echocardiography, cardiac magnetic resonance and single photon emission computed tomography in chronic coronary artery disease patients

Author

Stokke, T M, primary, Sarvari, S I, additional, Bjerring, A W, additional, Haugaa, K H, additional, Elahi, M T, additional, Hoedemakers, S I, additional, Rademakers, F, additional, Monaghan, M, additional, Sicari, R, additional, Engvall, J, additional, Nagel, E, additional, Zamorano, J L, additional, Ukkonen, H, additional, D'hooge, J, additional, and Edvardsen, T, additional

Published
2019
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12. Long-Term Follow-Up of Outcomes With F-18-Fluorodeoxyglucose Positron Emission Tomography Imaging–Assisted Management of Patients With Severe Left Ventricular Dysfunction Secondary to Coronary Disease

Author

Mc Ardle, Brian, primary, Shukla, Tushar, additional, Nichol, Graham, additional, deKemp, Robert A., additional, Bernick, Jordan, additional, Guo, Ann, additional, Lim, Siok Ping, additional, Davies, Ross A., additional, Haddad, Haissam, additional, Duchesne, Lloyd, additional, Hendry, Paul, additional, Masters, Roy, additional, Ross, Heather, additional, Freeman, Michael, additional, Gulenchyn, Karen, additional, Racine, Normand, additional, Humen, Dennis, additional, Benard, Francois, additional, Ruddy, Terrence D., additional, Chow, Benjamin J., additional, Mielniczuk, Lisa, additional, DaSilva, Jean N., additional, Garrard, Linda, additional, Wells, George A., additional, Beanlands, Rob S.B., additional, Higginson, L., additional, Mesana, T., additional, Ukkonen, H., additional, Yoshinaga, K., additional, Renaud, J., additional, Klein, R., additional, Aung, M., additional, Kostuk, W., additional, Wisenberg, G., additional, White, M., additional, Iwanochko, R.M., additional, Mickleborough, L., additional, Abramson, B., additional, Latter, D., additional, Lamy, A., additional, Fallen, E., additional, and Coates, G., additional

Published
2016
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13. Young Investigator Award Competition : Sunday 3 May 2015, 08

Author

Bertella, E, Baggiano, A, Petulla', M, Mushtaq, S, Beltrama, V, Gripari, P, Conte, E, Russo, E, Andreini, D, Pontone, G, Soukka, I, Maaniitty, T, Saraste, A, Uusitalo, V, Ukkonen, H, Kajander, S, Maki, M, Bax, J, Knuuti, J, De Graaf, M A, Caselli, C, Lorenzoni, V, Rovai, D, Marinelli, M, Del Ry, S, Giannessi, D, Bax, J J, Scholte, A J, Neglia, D, Thackeray, J T, Korf-Klingebiel, M, Wang, Y, Kustikova, O, Bankstahl, J P, Wollert, K C, Bengel, F M, Harms, H J, Tolbod, L P, Hansson, N H, Kim, W Y, Bouchelouche, K, Wiggers, H, Frokiaer, J, Sörensen, Jens, Stenstrom, I, Bertella, E, Baggiano, A, Petulla', M, Mushtaq, S, Beltrama, V, Gripari, P, Conte, E, Russo, E, Andreini, D, Pontone, G, Soukka, I, Maaniitty, T, Saraste, A, Uusitalo, V, Ukkonen, H, Kajander, S, Maki, M, Bax, J, Knuuti, J, De Graaf, M A, Caselli, C, Lorenzoni, V, Rovai, D, Marinelli, M, Del Ry, S, Giannessi, D, Bax, J J, Scholte, A J, Neglia, D, Thackeray, J T, Korf-Klingebiel, M, Wang, Y, Kustikova, O, Bankstahl, J P, Wollert, K C, Bengel, F M, Harms, H J, Tolbod, L P, Hansson, N H, Kim, W Y, Bouchelouche, K, Wiggers, H, Frokiaer, J, Sörensen, Jens, and Stenstrom, I

Published
2015
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14. Poster Session 1: Sunday 3 May 2015, 08:30-18:00 * Room: Poster Area

Author

Taniguchi, Y., primary, Takahashi, Y., additional, Toba, T., additional, Yamada, S., additional, Yokoi, K., additional, Kobayashi, S., additional, Okajima, S., additional, Shimane, A., additional, Kawai, H., additional, Yasaka, Y., additional, Smanio, P., additional, Oliveira, M. A., additional, Machado, L., additional, Cestari, P., additional, Medeiros, E., additional, Fukuzawa, S., additional, Okino, S., additional, Ikeda, A., additional, Maekawa, J., additional, Ichikawa, S., additional, Kuroiwa, N., additional, Yamanaka, K., additional, Igarashi, A., additional, Inagaki, M., additional, Patel, K., additional, Mahan, M., additional, Ananthasubramaniam, K., additional, Mouden, M., additional, Yokota, S., additional, Ottervanger, J., additional, Knollema, S., additional, Timmer, J., additional, Jager, P., additional, Padron, K., additional, Peix, A., additional, Cabrera, L., additional, Pena Bofill, V., additional, Valera, D., additional, Rodriguez Nande, L., additional, Carrillo Hernandez, R., additional, Mena Esnard, E., additional, Fernandez Columbie, Y., additional, Bertella, E., additional, Baggiano, A., additional, Mushtaq, S., additional, Segurini, C., additional, Loguercio, M., additional, Conte, E., additional, Beltrama, V., additional, Petulla', M., additional, Andreini, D., additional, Pontone, G., additional, Guzic Salobir, B., additional, Dolenc Novak, M., additional, Jug, B., additional, Kacjan, B., additional, Novak, Z., additional, Vrtovec, M., additional, Volpato, V., additional, Formenti, A., additional, Pepi, M., additional, Ajanovic, R., additional, Husic-Selimovic, A., additional, Zujovic-Ajanovic, A., additional, Mlynarski, R., additional, Mlynarska, A., additional, Golba, K., additional, Sosnowski, M., additional, Ameta, D., additional, Goyal, M., additional, Kumar, D., additional, Chandra, S., additional, Sethi, R., additional, Puri, A., additional, Dwivedi, S. K., additional, Narain, V. S., additional, Saran, R. K., additional, Nekolla, S., additional, Rischpler, C., additional, Nicolosi, S., additional, Langwieser, N., additional, Dirschinger, R., additional, Laugwitz, K., additional, Schwaiger, M., additional, Goral, J. L., additional, Napoli, J., additional, Forcada, P., additional, Zucchiatti, N., additional, Damico, A., additional, Olivieri, D., additional, Lavorato, M., additional, Dubesarsky, E., additional, Montana, O., additional, Salgado, C., additional, Jimenez-Heffernan, A., additional, Ramos-Font, C., additional, Lopez-Martin, J., additional, Sanchez De Mora, E., additional, Lopez-Aguilar, R., additional, Manovel, A., additional, Martinez, A., additional, Rivera, F., additional, Soriano, E., additional, Maroz-Vadalazhskaya, N., additional, Trisvetova, E., additional, Vrublevskaya, O., additional, Abazid, R., additional, Kattea, M., additional, Saqqah, H., additional, Sayed, S., additional, Smettei, O., additional, Winther, S., additional, Svensson, M., additional, Birn, H., additional, Jorgensen, H., additional, Botker, H., additional, Ivarsen, P., additional, Bottcher, M., additional, Maaniitty, T., additional, Stenstrom, I., additional, Saraste, A., additional, Pikkarainen, E., additional, Uusitalo, V., additional, Ukkonen, H., additional, Kajander, S., additional, Bax, J., additional, Knuuti, J., additional, Choi, T., additional, Park, H., additional, Lee, C., additional, Lee, J., additional, Seo, Y., additional, Cho, Y., additional, Hwang, E., additional, Cho, D., additional, Sanchez Enrique, C., additional, Ferrera, C., additional, Olmos, C., additional, Jimenez - Ballve, A., additional, Perez - Castejon, M. J., additional, Fernandez, C., additional, Vivas, D., additional, Vilacosta, I., additional, Nagamachi, S., additional, Onizuka, H., additional, Nishii, R., additional, Mizutani, Y., additional, Kitamura, K., additional, Lo Presti, M., additional, Polizzi, V., additional, Pino, P., additional, Luzi, G., additional, Bellavia, D., additional, Fiorilli, R., additional, Madeo, A., additional, Malouf, J., additional, Buffa, V., additional, Musumeci, F., additional, Rosales, S., additional, Puente, A., additional, Zafrir, N., additional, Shochat, T., additional, Mats, A., additional, Solodky, A., additional, Kornowski, R., additional, Lorber, A., additional, Boemio, A., additional, Pellegrino, T., additional, Paolillo, S., additional, Piscopo, V., additional, Carotenuto, R., additional, Russo, B., additional, Pellegrino, S., additional, De Matteis, G., additional, Perrone-Filardi, P., additional, Cuocolo, A., additional, Petretta, M., additional, Amirov, N., additional, Ibatullin, M., additional, Sadykov A, A., additional, Saifullina, G., additional, Ruano, R., additional, Diego Dominguez, M., additional, Rodriguez Gabella, T., additional, Diego Nieto, A., additional, Diaz Gonzalez, L., additional, Garcia-Talavera, J., additional, Sanchez Fernandez, P., additional, Leen, A., additional, Al Younis, I., additional, Zandbergen-Harlaar, S., additional, Verberne, H., additional, Gimelli, A., additional, Veltman, C., additional, Wolterbeek, R., additional, Scholte, A., additional, Mooney, D., additional, Rosenblatt, J., additional, Dunn, T., additional, Vasaiwala, S., additional, Okuda, K., additional, Nakajima, K., additional, Nystrom, K., additional, Edenbrandt, L., additional, Matsuo, S., additional, Wakabayashi, H., additional, Hashimoto, M., additional, Kinuya, S., additional, Iric-Cupic, V., additional, Milanov, S., additional, Davidovic, G., additional, Zdravkovic, V., additional, Ashikaga, K., additional, Yoneyama, K., additional, Akashi, Y., additional, Shugushev, Z., additional, Maximkin, D., additional, Chepurnoy, A., additional, Volkova, O., additional, Baranovich, V., additional, Faibushevich, A., additional, El Tahlawi, M., additional, Elmurr, A., additional, Alzubaidi, S., additional, Sakrana, A., additional, Gouda, M., additional, El Tahlawi, R., additional, Sellem, A., additional, Melki, S., additional, Elajmi, W., additional, Hammami, H., additional, Okano, M., additional, Kato, T., additional, Kimura, M., additional, Funasako, M., additional, Nakane, E., additional, Miyamoto, S., additional, Izumi, T., additional, Haruna, T., additional, Inoko, M., additional, Massardo, T., additional, Swett, E., additional, Fernandez, R., additional, Vera, V., additional, Zhindon, J., additional, Alay, R., additional, Ohshima, S., additional, Nishio, M., additional, Kojima, A., additional, Tamai, S., additional, Kobayashi, T., additional, Murohara, T., additional, Burrell, S., additional, Van Rosendael, A., additional, Van Den Hoogen, I., additional, De Graaf, M., additional, Roelofs, J., additional, Kroft, L., additional, Rjabceva, I., additional, Krumina, G., additional, Kalvelis, A., additional, Chanakhchyan, F., additional, Vakhromeeva, M., additional, Kankiya, E., additional, Koppes, J., additional, Knol, R., additional, Wondergem, M., additional, Van Der Ploeg, T., additional, Van Der Zant, F., additional, Lazarenko, S. V., additional, Bruin, V. S., additional, Pan, X. B., additional, Declerck, J. M., additional, Van Der Zant, F. M., additional, Knol, R. J. J., additional, Juarez-Orozco, L. E., additional, Alexanderson, E., additional, Slart, R., additional, Tio, R., additional, Dierckx, R., additional, Zeebregts, C., additional, Boersma, H., additional, Hillege, H., additional, Martinez-Aguilar, M., additional, Jordan-Rios, A., additional, Christensen, T. E., additional, Ahtarovski, K. A., additional, Bang, L. E., additional, Holmvang, L., additional, Soeholm, H., additional, Ghotbi, A. A., additional, Andersson, H., additional, Ihlemann, N., additional, Kjaer, A., additional, Hasbak, P., additional, Gulya, M., additional, Lishmanov, Y. B., additional, Zavadovskii, K., additional, Lebedev, D., additional, Stahle, M., additional, Hellberg, S., additional, Liljenback, H., additional, Virta, J., additional, Metsala, O., additional, Yla-Herttuala, S., additional, Saukko, P., additional, Roivainen, A., additional, Thackeray, J., additional, Wang, Y., additional, Bankstahl, J., additional, Wollert, K., additional, Bengel, F., additional, Saushkina, Y., additional, Evtushenko, V., additional, Minin, S., additional, Efimova, I., additional, Evtushenko, A., additional, Smishlyaev, K., additional, Lishmanov, Y., additional, Maslov, L., additional, Kirihara, Y., additional, Sugino, S., additional, Taki, J., additional, Ahmadian, A., additional, Berman, J., additional, Govender, P., additional, Ruberg, F., additional, Miller, E., additional, Piriou, N., additional, Pallardy, A., additional, Valette, F., additional, Cahouch, Z., additional, Mathieu, C., additional, Warin-Fresse, K., additional, Gueffet, J., additional, Serfaty, J., additional, Trochu, J., additional, Kraeber-Bodere, F., additional, Van Dijk, J., additional, Van Dalen, J., additional, Ofrk, H., additional, Vaturi, M., additional, Hassid, Y., additional, Belzer, D., additional, Sagie, A., additional, Kaminek, M., additional, Metelkova, I., additional, Budikova, M., additional, Koranda, P., additional, Henzlova, L., additional, Sovova, E., additional, Kincl, V., additional, Drozdova, A., additional, Jordan, M., additional, Shahid, F., additional, Teoh, Y., additional, Thamen, R., additional, Hara, N., additional, Onoguchi, M., additional, Hojyo, O., additional, Kawaguchi, Y., additional, Murai, M., additional, Udaka, F., additional, Matsuzawa, Y., additional, Bulugahapitiya, D. S., additional, Avison, M., additional, Martin, J., additional, Liu, Y.-H., additional, Wu, J., additional, Liu, C., additional, Sinusas, A., additional, Daou, D., additional, Sabbah, R., additional, Bouladhour, H., additional, Coaguila, C., additional, Aguade-Bruix, S., additional, Pizzi, M., additional, Romero-Farina, G., additional, Candell-Riera, J., additional, Castell-Conesa, J., additional, Patchett, N., additional, Sverdlov, A., additional, Boulaamayl El Fatemi, S., additional, Sallam, L., additional, Snipelisky, D., additional, Park, J., additional, Ray, J., additional, Shapiro, B., additional, Kostkiewicz, M., additional, Szot, W., additional, Holcman, K., additional, Lesniak-Sobelga, A., additional, Podolec, P., additional, Clerc, O., additional, Possner, M., additional, Liga, R., additional, Vontobel, J., additional, Mikulicic, F., additional, Graeni, C., additional, Benz, D., additional, Herzog, B., additional, Gaemperli, O., additional, and Kaufmann, P., additional

Published
2015
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15. Moderated Poster Session 5: Tuesday 5 May 2015, 10:00-11:00 * Room: Moderated Poster Area

Author

Nudi, F., primary, Procaccini, E., additional, Neri, G., additional, Vetere, M., additional, Biondi-Zoccai, G., additional, Tomai, F., additional, Solomyanyy, V., additional, Al-Housni, M. B., additional, Hinton-Taylor, S., additional, Ilsley, C., additional, Kelion, A., additional, Palyo, R., additional, Sinusas, A., additional, Liu, Y.-H., additional, Ruano, R., additional, Diego Dominguez, M., additional, Diego Nieto, A., additional, Diaz Gonzalez, L., additional, Garcia Piney, E., additional, Sanchez Fernandez, P., additional, Garcia-Talavera, J., additional, Soukka, I., additional, Maaniitty, T., additional, Saraste, A., additional, Pikkarainen, E., additional, Uusitalo, V., additional, Ukkonen, H., additional, Kajander, S., additional, Maki, M., additional, Bax, J., additional, Knuuti, J., additional, Caobelli, F., additional, Akin, M., additional, Brunkhorst, T., additional, Thackeray, J., additional, Widder, J., additional, Berding, G., additional, Bauersachs, J., additional, Bengel, F., additional, Shrestha, U., additional, Seo, Y., additional, Botvinick, E., additional, and Gullberg, G., additional

Published
2015
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16. Young Investigator Award Competition: Sunday 3 May 2015, 08:30-10:00 * Room: Milan

Author

Bertella, E., primary, Baggiano, A., additional, Petulla', M., additional, Mushtaq, S., additional, Beltrama, V., additional, Gripari, P., additional, Conte, E., additional, Russo, E., additional, Andreini, D., additional, Pontone, G., additional, Soukka, I., additional, Maaniitty, T., additional, Saraste, A., additional, Uusitalo, V., additional, Ukkonen, H., additional, Kajander, S., additional, Maki, M., additional, Bax, J., additional, Knuuti, J., additional, De Graaf, M. A., additional, Caselli, C., additional, Lorenzoni, V., additional, Rovai, D., additional, Marinelli, M., additional, Del Ry, S., additional, Giannessi, D., additional, Scholte, A., additional, Neglia, D., additional, Thackeray, J., additional, Korf-Klingebiel, M., additional, Wang, Y., additional, Kustikova, O., additional, Bankstahl, J., additional, Wollert, K., additional, Bengel, F., additional, Harms, H., additional, Tolbod, L., additional, Hansson, N., additional, Kim, W., additional, Bouchelouche, K., additional, Wiggers, H., additional, Frokiaer, J., additional, Sorensen, J., additional, and Stenstrom, I., additional

Published
2015
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19. Trimetazidine, a metabolic modulator, has cardiac and extracardiac benefits in idiopathic dilated cardiomyopathy

Author

Tuunanen, H., Engblom, E., Naum, A., Nagren, K., Scheinin, M., Hesse, B., Airaksinen, K.E. Juhani, Nuutila, P., Iozzo, P., Ukkonen, H., Opie, L.H., Knuuti, J., Tuunanen, H., Engblom, E., Naum, A., Nagren, K., Scheinin, M., Hesse, B., Airaksinen, K.E. Juhani, Nuutila, P., Iozzo, P., Ukkonen, H., Opie, L.H., and Knuuti, J.

Abstract

BACKGROUND: The anti-ischemic agent trimetazidine improves ejection fraction in heart failure that is hypothetically linked to inhibitory effects on cardiac free fatty acid (FFA) oxidation. However, FFA oxidation remains unmeasured in humans. We investigated the effects of trimetazidine on cardiac perfusion, efficiency of work, and FFA oxidation in idiopathic dilated cardiomyopathy. METHODS AND RESULTS: Nineteen nondiabetic patients with idiopathic dilated cardiomyopathy on standard medication were randomized to single-blind trimetazidine (n=12) or placebo (n=7) for 3 months. Myocardial perfusion, FFA, and total oxidative metabolism were measured using positron emission tomography with [(15)O]H(2)O, [(11)C]acetate, and [(11)C]palmitate. Cardiac function was assessed echocardiographically; insulin sensitivity was assessed by the homeostasis model assessment index. Trimetazidine increased ejection fraction from 30.9+/-8.5% to 34.8+/-12% (P=0.027 versus placebo). Myocardial FFA uptake was unchanged, and beta-oxidation rate constant decreased only 10%. Myocardial perfusion, oxidative metabolism, and work efficiency remained unchanged. Trimetazidine decreased insulin resistance (glucose: 5.9+/-0.7 versus 5.5+/-0.6 mmol/L, P=0.047; insulin: 10+/-6.9 versus 7.6+/-3.6 mU/L, P=0.031; homeostasis model assessment index: 2.75+/-2.28 versus 1.89+/-1.06, P=0.027). The degree of beta-blockade and trimetazidine interacted positively on ejection fraction. Plasma high-density lipoprotein concentrations increased 11% (P<0.001). CONCLUSIONS: In idiopathic dilated cardiomyopathy with heart failure, trimetazidine increased cardiac function and had both cardiac and extracardiac metabolic effects. Cardiac FFA oxidation modestly decreased and myocardial oxidative rate was unchanged, implying increased oxidation of glucose. Trimetazidine improved whole-body insulin sensitivity and glucose control in these insulin-resistant idiopathic dilated cardiomyopathy patients, thus hypothetically c

Published
2008

20. Resting coronary flow velocity in the functional evaluation of coronary artery stenosis: study on sequential use of computed tomography angiography and transthoracic Doppler echocardiography

Author

Joutsiniemi, E., primary, Saraste, A., additional, Pietila, M., additional, Ukkonen, H., additional, Kajander, S., additional, Maki, M., additional, Koskenvuo, J., additional, Airaksinen, J., additional, Hartiala, J., additional, Saraste, M., additional, and Knuuti, J., additional

Published
2011
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21. Abstracts

Author

Dunet, V., primary, Dabiri, A., additional, Allenbach, G., additional, Goyeneche Achigar, A., additional, Waeber, B., additional, Feihl, F., additional, Heinzer, R., additional, Prior, J. O., additional, Van Velzen, J. E., additional, Schuijf, J. D., additional, De Graaf, F. R., additional, De Graaf, M. A., additional, Schalij, M. J., additional, Kroft, L. J., additional, De Roos, A., additional, Jukema, J. W., additional, Van Der Wall, E. E., additional, Bax, J. J., additional, Lankinen, E., additional, Saraste, A., additional, Noponen, T., additional, Klen, R., additional, Teras, M., additional, Kokki, T., additional, Kajander, S., additional, Pietila, M., additional, Ukkonen, H., additional, Knuuti, J., additional, Pazhenkottil, A. P., additional, Nkoulou, R. N., additional, Ghadri, J. R., additional, Herzog, B. A., additional, Buechel, R. R., additional, Kuest, S. M., additional, Wolfrum, M., additional, Gaemperli, O., additional, Husmann, L., additional, Kaufmann, P. A., additional, Andreini, D., additional, Pontone, G., additional, Mushtaq, S., additional, Antonioli, L., additional, Bertella, E., additional, Formenti, A., additional, Cortinovis, S., additional, Ballerini, G., additional, Fiorentini, C., additional, Pepi, M., additional, Koh, A. S., additional, Flores, J. S., additional, Keng, F. Y. J., additional, Tan, R. S., additional, Chua, T. S. J., additional, Annoni, A. D., additional, Tamborini, G., additional, Fusari, M., additional, Bartorelli, A. L., additional, Ewe, S. H., additional, Ng, A. C. T., additional, Delgado, V., additional, Schuijf, J., additional, Van Der Kley, F., additional, Colli, A., additional, De Weger, A., additional, Marsan, N. A., additional, Yiu, K. H., additional, Ng, A. C., additional, Timmer, S. A. J., additional, Knaapen, P., additional, Germans, T., additional, Dijkmans, P. A., additional, Lubberink, M., additional, Ten Berg, J. M., additional, Ten Cate, F. J., additional, Russel, I. K., additional, Lammertsma, A. A., additional, Van Rossum, A. C., additional, Wong, Y. Y., additional, Ruiter, G., additional, Raijmakers, P., additional, Van Der Laarse, W. J., additional, Westerhof, N., additional, Vonk-Noordegraaf, A., additional, Youssef, G., additional, Leung, E., additional, Wisenberg, G., additional, Marriot, C., additional, Williams, K., additional, Etele, J., additional, Dekemp, R. A., additional, Dasilva, J., additional, Birnie, D., additional, Beanlands, R. S. B., additional, Thompson, R. C., additional, Allam, A. H., additional, Wann, L. S., additional, Nureldin, A. H., additional, Adelmaksoub, G., additional, Badr, I., additional, Sutherland, M. L., additional, Sutherland, J. D., additional, Miyamoto, M. I., additional, Thomas, G. S., additional, Harms, H. J., additional, De Haan, S., additional, Huisman, M. C., additional, Schuit, R. C., additional, Windhorst, A. D., additional, Allaart, C., additional, Einstein, A. J., additional, Khawaja, T., additional, Greer, C., additional, Chokshi, A., additional, Jones, M., additional, Schaefle, K., additional, Bhatia, K., additional, Shimbo, D., additional, Schulze, P. C., additional, Srivastava, A., additional, Chettiar, R., additional, Moody, J., additional, Weyman, C., additional, Natale, D., additional, Bruni, W., additional, Liu, Y., additional, Ficaro, E., additional, Sinusas, A. J., additional, Peix, A., additional, Batista, E., additional, Cabrera, L. O., additional, Padron, K., additional, Rodriguez, L., additional, Sainz, B., additional, Mendoza, V., additional, Carrillo, R., additional, Fernandez, Y., additional, Mena, E., additional, Naum, A., additional, Bach-Gansmo, T., additional, Kleven-Madsen, N., additional, Biermann, M., additional, Johnsen, B., additional, Aase Husby, J., additional, Rotevatn, S., additional, Nordrehaug, J. E., additional, Schaap, J., additional, Kauling, R. M., additional, Post, M. C., additional, Rensing, B. J. W. M., additional, Verzijlbergen, J. F., additional, Sanchez, J., additional, Giamouzis, G., additional, Tziolas, N., additional, Georgoulias, P., additional, Karayannis, G., additional, Chamaidi, A., additional, Zavos, N., additional, Koutrakis, K., additional, Sitafidis, G., additional, Skoularigis, J., additional, Triposkiadis, F., additional, Radovanovic, S., additional, Djokovic, A., additional, Simic, D. V., additional, Krotin, M., additional, Savic-Radojevic, A., additional, Pljesa-Ercegovac, M., additional, Zdravkovic, M., additional, Saponjski, J., additional, Jelic, S., additional, Simic, T., additional, Eckardt, R., additional, Kjeldsen, B. J., additional, Andersen, L. I., additional, Haghfelt, T., additional, Grupe, P., additional, Johansen, A., additional, Hesse, B., additional, Pena, H., additional, Cantinho, G., additional, Wilk, M., additional, Srour, Y., additional, Godinho, F., additional, Zafrir, N., additional, Gutstein, A., additional, Mats, I., additional, Battler, A., additional, Solodky, A., additional, Sari, E., additional, Singh, N., additional, Vara, A., additional, Peters, A. M., additional, De Belder, A., additional, Nair, S., additional, Ryan, N., additional, James, R., additional, Dizdarevic, S., additional, Depuey, G., additional, Friedman, M., additional, Wray, R., additional, Old, R., additional, Babla, H., additional, Chuanyong, B., additional, Maddahi, J., additional, Tragardh Johansson, E., additional, Sjostrand, K., additional, Edenbrandt, L., additional, Aguade-Bruix, S., additional, Cuberas-Borros, G., additional, Pizzi, M. N., additional, Sabate-Fernandez, M., additional, De Leon, G., additional, Garcia-Dorado, D., additional, Castell-Conesa, J., additional, Candell-Riera, J., additional, Casset-Senon, D., additional, Edjlali-Goujon, M., additional, Alison, D., additional, Delhommais, A., additional, Cosnay, P., additional, Low, C. S., additional, Notghi, A., additional, O'brien, J., additional, Tweddel, A. C., additional, Bingham, N., additional, O Neil, P., additional, Harbinson, M., additional, Lindner, O., additional, Burchert, W., additional, Schaefers, M., additional, Marcassa, C., additional, Campini, R., additional, Calza, P., additional, Zoccarato, O., additional, Kisko, A., additional, Kmec, J., additional, Babcak, M., additional, Vereb, M., additional, Vytykacova, M., additional, Cencarik, J., additional, Gazdic, P., additional, Stasko, J., additional, Abreu, A., additional, Pereira, E., additional, Oliveira, L., additional, Colarinha, P., additional, Veloso, V., additional, Enriksson, I., additional, Proenca, G., additional, Delgado, P., additional, Rosario, L., additional, Sequeira, J., additional, Kosa, I., additional, Vassanyi, I., additional, Egyed, C. S., additional, Kozmann, G. Y., additional, Morita, S., additional, Nanasato, M., additional, Nanbu, I., additional, Yoshida, Y., additional, Hirayama, H., additional, Allam, A., additional, Sharef, A., additional, Shawky, I., additional, Farid, M., additional, Mouden, M., additional, Ottervanger, J. P., additional, Timmer, J. R., additional, De Boer, M. J., additional, Reiffers, S., additional, Jager, P. L., additional, Knollema, S., additional, Nasr, G. M., additional, Mohy Eldin, M., additional, Ragheb, M., additional, Casans-Tormo, I., additional, Diaz-Exposito, R., additional, Hurtado-Mauricio, F. J., additional, Ruano, R., additional, Diego, M., additional, Gomez-Caminero, F., additional, Albarran, C., additional, Martin De Arriba, A., additional, Rosero, A., additional, Lopez, R., additional, Martin Luengo, C., additional, Garcia-Talavera, J. R., additional, Laitinen, I. E. K., additional, Rudelius, M., additional, Weidl, E., additional, Henriksen, G., additional, Wester, H. J., additional, Schwaiger, M., additional, Pan, X. B., additional, Schindler, T., additional, Quercioli, A., additional, Zaidi, H., additional, Ratib, O., additional, Declerck, J. M., additional, Alexanderson Rosas, E., additional, Jacome, R., additional, Jimenez-Santos, M., additional, Romero, E., additional, Pena-Cabral, M. A., additional, Meave, A., additional, Gonzalez, J., additional, Rouzet, F., additional, Bachelet, L., additional, Alsac, J. M., additional, Suzuki, M., additional, Louedec, L., additional, Petiet, A., additional, Chaubet, F., additional, Letourneur, D., additional, Michel, J. B., additional, Le Guludec, D., additional, Aktas, A., additional, Cinar, A., additional, Yaman, G., additional, Bahceci, T., additional, Kavak, K., additional, Gencoglu, A., additional, Jimenez-Heffernan, A., additional, Sanchez De Mora, E., additional, Lopez-Martin, J., additional, Lopez-Aguilar, R., additional, Ramos, C., additional, Salgado, C., additional, Ortega, A., additional, Sanchez-Gonzalez, C., additional, Roa, J., additional, Tobaruela, A., additional, Nesterov, S. V., additional, Turta, O., additional, Maki, M., additional, Han, C., additional, Daou, D., additional, Tawileh, M., additional, Chamouine, S. O., additional, Coaguila, C., additional, Mariscal-Labrador, E., additional, Kisiel-Gonzalez, N., additional, De Araujo Goncalves, P., additional, Sousa, P. J., additional, Marques, H., additional, O'neill, J., additional, Pisco, J., additional, Cale, R., additional, Brito, J., additional, Gaspar, A., additional, Machado, F. P., additional, Roquette, J., additional, Martinez, M., additional, Melendez, G., additional, Kimura, E., additional, Ochoa, J. M., additional, Alessio, A. M., additional, Patel, A., additional, Lautamaki, R., additional, Bengel, F. M., additional, Bassingthwaighte, J. B., additional, Caldwell, J. H., additional, Rahbar, K., additional, Seifarth, H., additional, Schafers, M., additional, Stegger, L., additional, Spieker, T., additional, Hoffmeier, A., additional, Maintz, D., additional, Scheld, H., additional, Schober, O., additional, Weckesser, M., additional, Aoki, H., additional, Matsunari, I., additional, Kajinami, K., additional, Martin Fernandez, M., additional, Barreiro Perez, M., additional, Fernandez Cimadevilla, O. V., additional, Leon Duran, D., additional, Velasco Alonso, E., additional, Florez Munoz, J. P., additional, Luyando, L. H., additional, Templin, C., additional, Veltman, C. E., additional, Reiber, J. H. C., additional, Venuraju, S., additional, Yerramasu, A., additional, Atwal, S., additional, Lahiri, A., additional, Kunimasa, T., additional, Shiba, M., additional, Ishii, K., additional, Aikawa, J., additional, Kroner, E. S. J., additional, Ho, K. T., additional, Yong, Q. W., additional, Chua, K. C., additional, Panknin, C., additional, Roos, C. J., additional, Van Werkhoven, J. M., additional, Witkowska-Grzeslo, A. J., additional, Boogers, M. J., additional, Anand, D. V., additional, Dey, D., additional, Berman, D., additional, Mut, F., additional, Giubbini, R., additional, Lusa, L., additional, Massardo, T., additional, Iskandrian, A., additional, Dondi, M., additional, Sato, A., additional, Kakefuda, Y., additional, Ojima, E., additional, Adachi, T., additional, Atsumi, A., additional, Ishizu, T., additional, Seo, Y., additional, Hiroe, M., additional, Aonuma, K., additional, Kruk, M., additional, Pracon, R., additional, Kepka, C., additional, Pregowski, J., additional, Kowalewska, A., additional, Pilka, M., additional, Opolski, M., additional, Michalowska, I., additional, Dzielinska, Z., additional, Demkow, M., additional, Stoll, V., additional, Sabharwal, N., additional, Chakera, A., additional, Ormerod, O., additional, Fernandes, H., additional, Bernardes, M., additional, Martins, E., additional, Oliveira, P., additional, Vieira, T., additional, Terroso, G., additional, Oliveira, A., additional, Faria, T., additional, Ventura, F., additional, Pereira, J., additional, Fukuzawa, S., additional, Inagaki, M., additional, Sugioka, J., additional, Ikeda, A., additional, Okino, S., additional, Maekawa, J., additional, Uchiyama, T., additional, Kamioka, N., additional, Ichikawa, S., additional, Afshar, M., additional, Alvi, R., additional, Aguilar, N., additional, Ippili, R., additional, Shaqra, H., additional, Bella, J., additional, Bhalodkar, N., additional, Dos Santos, A., additional, Daicz, M., additional, Cendoya, L. O., additional, Marrero, H. G., additional, Casuscelli, J., additional, Embon, M., additional, Vera Janavel, G., additional, Duronto, E., additional, Gurfinkel, E. P., additional, Cortes, C. M., additional, Takeishi, Y., additional, Nakajima, K., additional, Yamasaki, Y., additional, Nishimura, T., additional, Hayes Brown, K., additional, Collado, F., additional, Alhaji, M., additional, Green, J., additional, Alexander, S., additional, Vashistha, R., additional, Jain, S., additional, Aldaas, F., additional, Shanes, J., additional, Doukky, R., additional, Ashikaga, K., additional, Akashi, Y. J., additional, Uemarsu, M., additional, Kamijima, R., additional, Yoneyama, K., additional, Omiya, K., additional, Miyake, Y., additional, Brodov, Y., additional, Raval, U., additional, Berezin, A., additional, Seden, V., additional, Koretskaya, E., additional, Panasenko, T. A., additional, Matsuo, S., additional, Kinuya, S., additional, Chen, J., additional, Van Bommel, R. J., additional, Van Der Hiel, B., additional, Dibbets-Schneider, P., additional, Garcia, E. V., additional, Rutten-Vermeltfoort, I., additional, Gevers, M. M. J., additional, Verhoeven, B., additional, Dijk Van, A. B., additional, Raaijmakers, E., additional, Raijmakers, P. G. H. M., additional, Engvall, J. E., additional, Gjerde, M., additional, De Geer, J., additional, Olsson, E., additional, Quick, P., additional, Persson, A., additional, Mazzanti, M., additional, Marini, M., additional, Pimpini, L., additional, Perna, G. P., additional, Marciano, C., additional, Gargiulo, P., additional, Galderisi, M., additional, D'amore, C., additional, Savarese, G., additional, Casaretti, L., additional, Paolillo, S., additional, Cuocolo, A., additional, Perrone Filardi, P., additional, Al-Amoodi, M., additional, Thompson, E. C., additional, Kennedy, K., additional, Bybee, K. A., additional, Mcghie, A. I., additional, O'keefe, J. H., additional, Bateman, T. M., additional, Van Der Palen, R. L. F., additional, Mavinkurve-Groothuis, A. M., additional, Bulten, B., additional, Bellersen, L., additional, Van Laarhoven, H. W. M., additional, Kapusta, L., additional, De Geus-Oei, L. F., additional, Pollice, P. P., additional, Bonifazi, M. B., additional, Pollice, F. P., additional, Clements, I. P., additional, Hodge, D. O., additional, Scott, C. G., additional, De Ville De Goyet, M., additional, Brichard, B., additional, Pirotte, T., additional, Moniotte, S., additional, Tio, R. A., additional, Elvan, A., additional, Dierckx, R. A. I. O., additional, Slart, R. H. J. A., additional, Furuhashi, T., additional, Moroi, M., additional, Hase, H., additional, Joki, N., additional, Masai, H., additional, Nakazato, R., additional, Fukuda, H., additional, Sugi, K., additional, Kryczka, K., additional, Kaczmarska, E., additional, Petryka, J., additional, Mazurkiewicz, L., additional, Ruzyllo, W., additional, Smanio, P., additional, Vieira Segundo, E., additional, Siqueira, M., additional, Kelendjian, J., additional, Ribeiro, J., additional, Alaca, J., additional, Oliveira, M., additional, Alves, F., additional, Peovska, I., additional, Maksimovic, J., additional, Vavlukis, M., additional, Kostova, N., additional, Pop Gorceva, D., additional, Majstorov, V., additional, Zdraveska, M., additional, Hussain, S., additional, Djearaman, M., additional, Hoey, E., additional, Morus, L., additional, Erinfolami, O., additional, Macnamara, A., additional, Opolski, M. P., additional, Witkowski, A., additional, Berti, V., additional, Ricci, F., additional, Gallicchio, R., additional, Acampa, W., additional, Cerisano, G., additional, Vigorito, C., additional, Sciagra', R., additional, Pupi, A., additional, Sliem, H., additional, Collado, F. M., additional, Schmidt, S., additional, Maheshwari, A., additional, Kiriakos, R., additional, Mwansa, V., additional, Ljubojevic, S., additional, Sedej, S., additional, Holzer, M., additional, Marsche, G., additional, Marijanski, V., additional, Kockskaemper, J., additional, Pieske, B., additional, Ricalde, A., additional, Alexanderson, G., additional, Mohani, A., additional, Khanna, P., additional, Sinusas, A., additional, Lee, F., additional, Pinas, V. A., additional, Van Eck-Smit, B. L. F., additional, Verberne, H. J., additional, De Bruin, C. M., additional, Guilhermina, G., additional, Jimenez-Angeles, L., additional, Ruiz De Jesus, O., additional, Yanez-Suarez, O., additional, Vallejo, E., additional, Reyes, E., additional, Chan, M., additional, Hossen, M. L., additional, Underwood, S. R., additional, Karu, A., additional, Bokhari, S., additional, Pineda, V., additional, Gracia-Sanchez, L. M., additional, Garcia-Burillo, A., additional, Zavadovskiy, K., additional, Lishmanov, Y. U., additional, Saushkin, W., additional, Kovalev, I., additional, Chernishov, A., additional, Annoni, A., additional, Tarkia, M., additional, Saanijoki, T., additional, Oikonen, V., additional, Savunen, T., additional, Green, M. A., additional, Strandberg, M., additional, Roivainen, A., additional, Gaeta, M. C., additional, Artigas, C., additional, Deportos, J., additional, Geraldo, L., additional, Flotats, A., additional, La Delfa, V., additional, Carrio, I., additional, Laarse, W. J., additional, Izquierdo Gomez, M. M., additional, Lacalzada Almeida, J., additional, Barragan Acea, A., additional, De La Rosa Hernandez, A., additional, Juarez Prera, R., additional, Blanco Palacios, G., additional, Bonilla Arjona, J. A., additional, Jimenez Rivera, J. J., additional, Iribarren Sarrias, J. L., additional, Laynez Cerdena, I., additional, Dedic, A., additional, Rossi, A., additional, Ten Kate, G. J. R., additional, Dharampal, A., additional, Moelker, A., additional, Galema, T. W., additional, Mollet, N., additional, De Feyter, P. J., additional, Nieman, K., additional, Trabattoni, D., additional, Broersen, A., additional, Frenay, M., additional, Boogers, M. M., additional, Kitslaar, P. H., additional, Dijkstra, J., additional, Annoni, D. A., additional, Muratori, M., additional, Johki, N., additional, Tokue, M., additional, Dharampal, A. S., additional, Weustink, A. C., additional, Neefjes, L. A. E., additional, Papadopoulou, S. L., additional, Chen, C., additional, Mollet, N. R. A., additional, Boersma, E. H., additional, Krestin, G. P., additional, Purvis, J. A., additional, Sharma, D., additional, Hughes, S. M., additional, Berman, D. S., additional, Taillefer, R., additional, Udelson, J., additional, Devine, M., additional, Lazewatsky, J., additional, Bhat, G., additional, Washburn, D., additional, Patel, D., additional, Mazurek, T., additional, Tandon, S., additional, Bansal, S., additional, Inzucchi, S., additional, Staib, L., additional, Davey, J., additional, Chyun, D., additional, Young, L., additional, Wackers, F., additional, Harbinson, M. T., additional, Wells, G., additional, Dougan, J., additional, Borges-Neto, S., additional, Phillips, H., additional, Farzaneh-Far, A., additional, Starr, Z., additional, Shaw, L. K., additional, Fiuzat, M., additional, O'connor, C., additional, Henzlova, M., additional, Duvall, W. L., additional, Levine, A., additional, Baber, U., additional, Croft, L., additional, Sahni, S., additional, Sethi, S., additional, Hermann, L., additional, Nureldin, A., additional, Gomaa, A., additional, Soliman, M. A. T., additional, Hany, H. A. R., additional, De Graaf, F., additional, Pazhenkottil, A., additional, Siebelink, H. M. J., additional, Reiber, J. H., additional, Ayub, M., additional, Naveed, T., additional, Azhar, M., additional, Van Tosh, A., additional, Faber, T. L., additional, Votaw, J. R., additional, Reichek, N., additional, Pulipati, B., additional, Palestro, C., additional, Nichols, K. J., additional, Okuda, K., additional, Kirihara, Y., additional, Ishikawa, T., additional, Taki, J., additional, Yoshita, M., additional, Yamada, M., additional, Salacata, A., additional, Keavey, S., additional, Chavarri, V., additional, Mills, J., additional, Nagaraj, H., additional, Bhambhani, P., additional, Kliner, D. 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B., additional, Aksoy, T., additional, Slavich, G. A., additional, Piccoli, G., additional, Puppato, M., additional, Grillone, S., additional, Gasparini, D., additional, Dunet, V., additional, Perruchoud, S., additional, Poitry-Yamate, C., additional, Lepore, M., additional, Gruetter, R., additional, Pedrazzini, T., additional, Anselm, D., additional, Anselm, A., additional, Atkins, H., additional, Renaud, J., additional, Dekemp, R., additional, Burwash, I., additional, Guo, A., additional, Beanlands, R., additional, Glover, C., additional, Vilardi, I., additional, Zangheri, B., additional, Calabrese, L., additional, Romano, P., additional, Bruno, A., additional, Fernandez Cimadevilla, O. C., additional, Uusitalo, V. A., additional, Luotolahti, M., additional, Wendelin-Saarenhovi, M., additional, Sundell, J., additional, Raitakari, O., additional, Huidu, S., additional, Gadiraju, R., additional, Ghesani, M., additional, Uddin, Q., additional, Wosnitzer, B., additional, Takahashi, N., additional, Alhaj, E., additional, Legasto, A., additional, Abiri, B., additional, Elsaban, K., additional, El Khouly, T., additional, El Kammash, T., additional, Al Ghamdi, A., additional, Kyung Deok, B., additional, Bon Seung, K., additional, Sang Geun, Y., additional, Chang Min, D., additional, and Gwan Hong, M., additional

Published
2011
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22. Cardiac Positron Emission Tomography/Computed Tomography Imaging Accurately Detects Anatomically and Functionally Significant Coronary Artery Disease

Author

Kajander, S., primary, Joutsiniemi, E., additional, Saraste, M., additional, Pietilä, M., additional, Ukkonen, H., additional, Saraste, A., additional, Sipilä, H.T., additional, Teräs, M., additional, Mäki, M., additional, Airaksinen, J., additional, Hartiala, J., additional, and Knuuti, J., additional

Published
2010
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26. Is ventilatory efficiency (VE/VCO(2) slope) associated with right ventricular oxidative metabolism in patients with congestive heart failure?

Author

Ukkonen H, Burwash IG, Dafoe W, de Kemp RA, Haddad H, Yoshinaga K, Davies RA, Gannon EK, Dasilva JN, Beanlands RS, Ukkonen, Heikki, Burwash, Ian G, Dafoe, William, de Kemp, Robert A, Haddad, Haissam, Yoshinaga, Keiichiro, Davies, Ross A, Gannon, Edward K, Dasilva, Jean N, and Beanlands, Rob S B

Abstract

Background: The relationship between minute ventilation and the rate of CO2 elimination (VE/VCO2 slope) is associated with mortality in patients with congestive heart failure (CHF). The VE/VCO2 slope > or =34 denotes a poor prognosis and has been proposed to reflect abnormalities in pulmonary perfusion. Aims: To study whether increased VE/VCO2 slope is associated with elevated right ventricular (RV) oxidative metabolism relative to the left ventricle (LV). Methods: 21 patients with stable NYHA II-III CHF underwent symptom limited cardiopulmonary exercise testing. Dynamic [(11)C]acetate positron emission tomography (PET) was used to measure oxidative metabolism (k(mono)) of the LV and RV. Corrected RV oxidative metabolism (RVOx) was calculated as RV/LV k(mono) ratio. Results: Peak VO2 was 16.2+/-4.1 ml/min/kg and the VE/VCO2 slope was 33.4+/-6.1. LV and RV k(mono) were 0.046+/-0.009 and 0.037+/-0.007 min(-1), respectively, with a RVOx of 0.83+/-0.17. There was a good correlation between RVOx and the VE/VCO2 slope (r=0.61, p=0.0034). RVOx was 0.77+/-0.16 in patients with a VE/VCO2 slope <34 and 0.93+/-0.16 in patients with VE/VCO2 slope > or =34 (p=0.047). Conclusion: RVOx correlates with VE/VCO2 slope in CHF patients. This supports the hypothesis that pulmonary vascular resistance is a determinant of the VE/VCO2 slope. [ABSTRACT FROM AUTHOR]

Published
2008
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30. Posters display III clinical outcome and PET

Author

Baliño, N., Masoli, O., Traverso, S., Grynberg, L., Rappallo, C., Redruello, M., Rosa, D., Cragnolino, D., Meretta, A., Vidal, L., Graf, S., Khorsand, A., Gyongyosi, M., Karanikas, G., Eidherr, H., Kletter, K., Porenta, G., Glogar, D., Sochor, H., Beheshti, M., Poetzi, C., Wadsak, W., Maurer, G., Wolfram, J., Winter, O., Velghe, A., Veire, N., Bondt, P., Buyzere, M., Wiele, C., Backer, G., Gillebert, T., Dierckx, R., Sutter, J., Bernard, D., Langlois, M., Duarte, P., Mastrocolla, L., Sampaio, C., Rossi, J., Smanio, P., Lima, E., Oliveira, C., Pereira, J., Beraldo, P., Rodrigues, F., Thom, A., Yoshinaga, K., Ukkonen, H., Burwash, I., DeKemp, R., Dafoe, W., Davies, R., Haddad, H., Ruddy, T., DaSilva, J., Beanlands, R., Chow, B., Williams, K., Garrard, L., Szeto, A., Aung, M., Sondergaard, H., Bottcher, M., Madsen, M., Schmitz, O., Nielsen, T., Botker, H., Høilund-Carlsen, P., Johansen, A., Christensen, H., Vach, W., Møldrup, M., Haghfelt, T., Kristensen, J., Maeng, M., Mortensen, U., Berg, J., Rehling, M., Elsaban, K., El-Kady, T., El-Gabaly, M., Yehia, A., El-Sayed, M., Naum, A., Laaksonen, M., Tuunanen, H., Oikonen, V., Kemppainen, J., Järvisalo, M., Nuutila, P., Knuuti, J., Vanzetto, G., Jacon, P., Fagret, D., Machecourt, J., Lindner, O., Vogt, J., Kammeier, A., Fricke, E., Wielepp, P., Baller, D., Lamp, B., Holzinger, J., Horstkotte, D., Burchert, W., Nekolla, S., Souvatzoglou, M., Hausleiter, J., Henke, N., Kruschke, K., Bengel, F., Schwaiger, M., Sundaram, P., Padma, S., Haridas, K., Kumar, S., Zachariah, M., Livschitz, S., Zornitzki, T., Vered, S., Oettinger, M., Levy, R., Caspi, A., Faraggi, D., Knobler, H., Mats, I., Solodky, A., Ben-Gal, T., Battler, A., Zafrir, N., Varani, E., Balducelli, M., Severi, S., Patroncini, A., Vecchi, G., Gatti, C., Corbelli, C., Casanova, R., Maresta, A., Cittanti, C., Valgimigli, M., Giganti, M., Malagutti, P., Percoco, G., Bagatin, E., Panareo, S., Avigni, N., Ferrari, R., Feggi, L., Filardi, P., Cuocolo, A., Storto, G., Brevetti, G., Dellegrottaglie, S., Corrado, L., Cafiero, M., Polimeno, M., Zarrilli, A., Chiariello, M., Marcassa, C., Campini, R., Calza, P., Giannuzzi, P., Galassi, A., Grasso, C., Azzarelli, S., Leotta, E., Moshiri, S., Tamburino, C., Acampa, W., Ferro, A., Petretta, M., Salvatore, M., Pieri, P., Berta, R., Moscatelli, G., Buccoliero, F., Inglese, E., Medolago, G., Imperiale, A., Rimini, M., Bertagna, F., Sullo, P., Lupo, M., Cappagli, M., Fukuda, H., Kunimasa, T., Furuhashi, T., Moroi, M., Yasuhi, W., Akihiro, S., Akio, Y., Ryou, K., Kimio, T., Yasunori, W., Yasuhiko, T., Nariaki, E., Watabe, H., Teramoto, N., Ohta, Y., Kou, Y., Hayashi, T., Iida, H., Bom, H., Song, H., Min, J., Heo, Y., Seo, J., Lee, J., Bae, J., Jeong, S., Ahn, B., Chae, S., Lee, K., Popiel, M., Grajek, S., Czepczynski, R., Breborowicz, P., Lesiak, M., Czyz, A., Sawinski, K., Komarnicki, M., Cieslinski, A., Sowinski, J., Ferreira, A., Ventosa, A., Gil, V., Calqueiro, J., Lima, S., Aguiar, C., Couto, R., Raposo, L., Seabra-Gomes, R., Vasconcelos, M., Martins, E., Faria, T., Oliveira, A., Garcia, M., Rocha-Gonçalves, F., Lourenço, C., Roque, C., Ferrer-Antunes, A., Ferreira, M., Providência, L., Lima, J., Medrea, C., Bogdan, R., Lazar, A., Mot, S., Capilneanu, R., Kozulin, V., Berkovich, O., Ivashchenko, T., Larionova, V., Esipovich, I., Gordeev, M., Panov, A., Shlyakhto, E., Burova, N., Baranov, D., Timoshin, V., Chuprova, S., Shkolnikova, M., Zaklyazminskaya, E., Poliakov, A., Sazonova, S., Romero-Farina, G., Arenillas, J., Candell-Riera, J., Aguadè-Bruix, S., Leon, G., Molina, C., Chacon, P., Montaner, J., Rovira, A., Alvarez-Sabin, J., Namdar, M., Siegrist, P., Grathwohl, R., Delaloye, R., Koepfli, P., Wyss, C., Kaufmann, P., Bartenstein, N., Hellermann, J., Pollack, C., Schurr, U., Zellweger, M., Burger, P., Mueller-Brand, J., Pfisterer, M., Gordon, L., Epps, A., Chiarameda, S., Navare, S., Ahlberg, A., Cyr, G., Katten, D., Ausef, A., Heller, G., Darrow, B., Thomas, G., Ip, T., Thompson, R., Kramer, D., Rice, D., Thomas, J., Miyamoto, M., Druz, R., Nichols, K., Akinboboye, O., Reichek, N., Podrasky, E., Tuttle, R., Shaw, L., Hanson, M., Borges-Neto, S., Lundbye, J., Werden, S., Kazi, F., Whalen, A., Noble, G., O'Sullivan, D., Boden, W., Danias, P., Papaioannou, G., Leka, I., Beretta, M., Viňas, S., Gonzalez, A., Vidal, I., Rener, A., Baliño, N., Masoli, O., Traverso, S., Grynberg, L., Rappallo, C., Redruello, M., Rosa, D., Cragnolino, D., Meretta, A., Vidal, L., Graf, S., Khorsand, A., Gyongyosi, M., Karanikas, G., Eidherr, H., Kletter, K., Porenta, G., Glogar, D., Sochor, H., Beheshti, M., Poetzi, C., Wadsak, W., Maurer, G., Wolfram, J., Winter, O., Velghe, A., Veire, N., Bondt, P., Buyzere, M., Wiele, C., Backer, G., Gillebert, T., Dierckx, R., Sutter, J., Bernard, D., Langlois, M., Duarte, P., Mastrocolla, L., Sampaio, C., Rossi, J., Smanio, P., Lima, E., Oliveira, C., Pereira, J., Beraldo, P., Rodrigues, F., Thom, A., Yoshinaga, K., Ukkonen, H., Burwash, I., DeKemp, R., Dafoe, W., Davies, R., Haddad, H., Ruddy, T., DaSilva, J., Beanlands, R., Chow, B., Williams, K., Garrard, L., Szeto, A., Aung, M., Sondergaard, H., Bottcher, M., Madsen, M., Schmitz, O., Nielsen, T., Botker, H., Høilund-Carlsen, P., Johansen, A., Christensen, H., Vach, W., Møldrup, M., Haghfelt, T., Kristensen, J., Maeng, M., Mortensen, U., Berg, J., Rehling, M., Elsaban, K., El-Kady, T., El-Gabaly, M., Yehia, A., El-Sayed, M., Naum, A., Laaksonen, M., Tuunanen, H., Oikonen, V., Kemppainen, J., Järvisalo, M., Nuutila, P., Knuuti, J., Vanzetto, G., Jacon, P., Fagret, D., Machecourt, J., Lindner, O., Vogt, J., Kammeier, A., Fricke, E., Wielepp, P., Baller, D., Lamp, B., Holzinger, J., Horstkotte, D., Burchert, W., Nekolla, S., Souvatzoglou, M., Hausleiter, J., Henke, N., Kruschke, K., Bengel, F., Schwaiger, M., Sundaram, P., Padma, S., Haridas, K., Kumar, S., Zachariah, M., Livschitz, S., Zornitzki, T., Vered, S., Oettinger, M., Levy, R., Caspi, A., Faraggi, D., Knobler, H., Mats, I., Solodky, A., Ben-Gal, T., Battler, A., Zafrir, N., Varani, E., Balducelli, M., Severi, S., Patroncini, A., Vecchi, G., Gatti, C., Corbelli, C., Casanova, R., Maresta, A., Cittanti, C., Valgimigli, M., Giganti, M., Malagutti, P., Percoco, G., Bagatin, E., Panareo, S., Avigni, N., Ferrari, R., Feggi, L., Filardi, P., Cuocolo, A., Storto, G., Brevetti, G., Dellegrottaglie, S., Corrado, L., Cafiero, M., Polimeno, M., Zarrilli, A., Chiariello, M., Marcassa, C., Campini, R., Calza, P., Giannuzzi, P., Galassi, A., Grasso, C., Azzarelli, S., Leotta, E., Moshiri, S., Tamburino, C., Acampa, W., Ferro, A., Petretta, M., Salvatore, M., Pieri, P., Berta, R., Moscatelli, G., Buccoliero, F., Inglese, E., Medolago, G., Imperiale, A., Rimini, M., Bertagna, F., Sullo, P., Lupo, M., Cappagli, M., Fukuda, H., Kunimasa, T., Furuhashi, T., Moroi, M., Yasuhi, W., Akihiro, S., Akio, Y., Ryou, K., Kimio, T., Yasunori, W., Yasuhiko, T., Nariaki, E., Watabe, H., Teramoto, N., Ohta, Y., Kou, Y., Hayashi, T., Iida, H., Bom, H., Song, H., Min, J., Heo, Y., Seo, J., Lee, J., Bae, J., Jeong, S., Ahn, B., Chae, S., Lee, K., Popiel, M., Grajek, S., Czepczynski, R., Breborowicz, P., Lesiak, M., Czyz, A., Sawinski, K., Komarnicki, M., Cieslinski, A., Sowinski, J., Ferreira, A., Ventosa, A., Gil, V., Calqueiro, J., Lima, S., Aguiar, C., Couto, R., Raposo, L., Seabra-Gomes, R., Vasconcelos, M., Martins, E., Faria, T., Oliveira, A., Garcia, M., Rocha-Gonçalves, F., Lourenço, C., Roque, C., Ferrer-Antunes, A., Ferreira, M., Providência, L., Lima, J., Medrea, C., Bogdan, R., Lazar, A., Mot, S., Capilneanu, R., Kozulin, V., Berkovich, O., Ivashchenko, T., Larionova, V., Esipovich, I., Gordeev, M., Panov, A., Shlyakhto, E., Burova, N., Baranov, D., Timoshin, V., Chuprova, S., Shkolnikova, M., Zaklyazminskaya, E., Poliakov, A., Sazonova, S., Romero-Farina, G., Arenillas, J., Candell-Riera, J., Aguadè-Bruix, S., Leon, G., Molina, C., Chacon, P., Montaner, J., Rovira, A., Alvarez-Sabin, J., Namdar, M., Siegrist, P., Grathwohl, R., Delaloye, R., Koepfli, P., Wyss, C., Kaufmann, P., Bartenstein, N., Hellermann, J., Pollack, C., Schurr, U., Zellweger, M., Burger, P., Mueller-Brand, J., Pfisterer, M., Gordon, L., Epps, A., Chiarameda, S., Navare, S., Ahlberg, A., Cyr, G., Katten, D., Ausef, A., Heller, G., Darrow, B., Thomas, G., Ip, T., Thompson, R., Kramer, D., Rice, D., Thomas, J., Miyamoto, M., Druz, R., Nichols, K., Akinboboye, O., Reichek, N., Podrasky, E., Tuttle, R., Shaw, L., Hanson, M., Borges-Neto, S., Lundbye, J., Werden, S., Kazi, F., Whalen, A., Noble, G., O'Sullivan, D., Boden, W., Danias, P., Papaioannou, G., Leka, I., Beretta, M., Viňas, S., Gonzalez, A., Vidal, I., and Rener, A.

31. Exercise training improves biventricular oxidative metabolism and left ventricular efficiency in patients with dilated cardiomyopathy.

Author

Stolen KQ, Kemppainen J, Ukkonen H, Kalliokoski KK, Luotolahti M, Lehikoinen P, Hämäläinen H, Salo T, Airaksinen KEJ, Nuutila P, Knuuti J, Stolen, Kira Q, Kemppainen, Jukka, Ukkonen, Heikki, Kalliokoski, Kari K, Luotolahti, Matti, Lehikoinen, Pertti, Hämäläinen, Helena, Salo, Tiina, and Airaksinen, K E Juhani

Abstract

Objectives: The aim of this study was to determine the effect of exercise training on myocardial oxidative metabolism and efficiency in patients with idiopathic dilated cardiomyopathy (DCM) and mild heart failure (HF).Background: Exercise training is known to improve exercise tolerance and quality of life in patients with chronic HF. However, little is known about how exercise training may influence myocardial energetics.Methods: Twenty clinically stable patients with DCM (New York Heart Association classes I through III) were prospectively separated into a training group (five-month training program; n = 9) and a non-trained control group (n = 11). Oxidative metabolism in both the right and left ventricles (RV and LV) was measured using [(11)C]acetate and positron emission tomography. Myocardial work power was measured using echocardiography. Myocardial efficiency for forward work was calculated as myocardial work power per mass/LV oxidative metabolism.Results: Significant improvements were noted in exercise capacity (VO(2)) and ejection fraction in the training group, whereas no changes were observed in the non-trained group. Exercise training reduced both RV and LV oxidative metabolism and elicited a significant increase in LV forward work efficiency, although no significant changes were observed in the non-trained group.Conclusions: Exercise training improves exercise tolerance and LV function. This is accompanied by a decrease in biventricular oxidative metabolism and enhanced forward work efficiency. Therefore, exercise training elicits an energetically favorable improvement in myocardial function and exercise tolerance in patients with DCM. [ABSTRACT FROM AUTHOR]

Published
2003
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32. Baseline characteristics of patients with heart failure with mildly reduced or preserved ejection fraction: The FINEARTS-HF trial.

Author

Solomon SD, Ostrominski JW, Vaduganathan M, Claggett B, Jhund PS, Desai AS, Lam CSP, Pitt B, Senni M, Shah SJ, Voors AA, Zannad F, Abidin IZ, Alcocer-Gamba MA, Atherton JJ, Bauersachs J, Ma CS, Chiang CE, Chioncel O, Chopra V, Comin-Colet J, Filippatos G, Fonseca C, Gajos G, Goland S, Goncalvesová E, Kang SM, Katova T, Kosiborod MN, Latkovskis G, Lee AP, Linssen GCM, Llamas-Esperón G, Mareev V, Martinez FA, Melenovský V, Merkely B, Nodari S, Petrie MC, Saldarriaga CI, Saraiva JFK, Sato N, Schou M, Sharma K, Troughton R, Udell JA, Ukkonen H, Vardeny O, Verma S, von Lewinski D, Voronkov LG, Yilmaz MB, Zieroth S, Lay-Flurrie J, van Gameren I, Amarante F, Viswanathan P, and McMurray JJV

Subjects
Humans, Female, Male, Aged, Double-Blind Method, Ventricular Function, Left physiology, Ventricular Function, Left drug effects, Middle Aged, Treatment Outcome, Glomerular Filtration Rate physiology, Natriuretic Peptide, Brain blood, Heart Failure physiopathology, Heart Failure drug therapy, Stroke Volume physiology, Mineralocorticoid Receptor Antagonists therapeutic use, Naphthyridines therapeutic use
Abstract

Aims: To describe the baseline characteristics of participants in the FINEARTS-HF trial, contextualized with prior trials including patients with heart failure (HF) with mildly reduced and preserved ejection fraction (HFmrEF/HFpEF). The FINEARTS-HF trial is comparing the effects of the non-steroidal mineralocorticoid receptor antagonist finerenone with placebo in reducing cardiovascular death and total worsening HF events in patients with HFmrEF/HFpEF., Methods and Results: Patients with symptomatic HF, left ventricular ejection fraction (LVEF) ≥40%, estimated glomerular filtration rate ≥ 25 ml/min/1.73 m 2 , elevated natriuretic peptide levels and evidence of structural heart disease were enrolled and randomized to finerenone titrated to a maximum of 40 mg once daily or matching placebo. We validly randomized 6001 patients to finerenone or placebo (mean age 72 ± 10 years, 46% women). The majority were New York Heart Association functional class II (69%). The baseline mean LVEF was 53 ± 8% (range 34-84%); 36% of participants had a LVEF <50% and 64% had a LVEF ≥50%. The median N-terminal pro-B-type natriuretic peptide (NT-proBNP) was 1041 (interquartile range 449-1946) pg/ml. A total of 1219 (20%) patients were enrolled during or within 7 days of a worsening HF event, and 3247 (54%) patients were enrolled within 3 months of a worsening HF event. Compared with prior large-scale HFmrEF/HFpEF trials, FINEARTS-HF participants were more likely to have recent (within 6 months) HF hospitalization and greater symptoms and functional limitations. Further, concomitant medications included a larger percentage of sodium-glucose cotransporter 2 inhibitors and angiotensin receptor-neprilysin inhibitors than previous trials., Conclusions: FINEARTS-HF has enrolled a broad range of high-risk patients with HFmrEF and HFpEF. The trial will determine the safety and efficacy of finerenone in this population., (© 2024 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Published
2024
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33. Atrial septal defect patients have an elevated risk for infective endocarditis.

Author

Muroke V, Jalanko M, Haukka J, Pätilä T, Hartikainen J, Tahvanainen A, Ukkonen H, Ylitalo K, Anttila V, Pihkala J, and Sinisalo J

Subjects
Humans, Male, Risk Factors, Endocarditis, Bacterial, Endocarditis diagnosis, Endocarditis epidemiology, Heart Septal Defects, Atrial diagnosis, Heart Septal Defects, Atrial epidemiology, Heart Septal Defects, Atrial complications, Heart Defects, Congenital epidemiology
Abstract

Background . It has been unclear whether simple atrial septal defect (ASD) is an independent risk factor for infective endocarditis (IE). This study aimed to untangle the risk of endocarditis in a large nationwide cohort. Methods . We acquired data from the Finnish hospital discharge register on all individuals with ASD diagnosis from 1969 to 2019. Patients with complex congenital cardiac abnormalities were ruled out. Five individualized controls from the general population were matched to the ASD patient's birth year, sex, and residence at the index date. All the patients with ICD-8, -9, or -10 diagnosis codes for IE were gathered from the hospital discharge registry. Results . Altogether, 8322 patients with ASD and 39,237 individualized controls were enrolled in the study. Median follow-up was 21.6 years (IQR 11.8-36.9) from the first hospital contact. In total, 24 (16 male) cases of infective endocarditis among ASD patients and 10 (8 male) cases among controls were diagnosed during the follow-up. The incidence of endocarditis was 0.11 per 1000 person-years in the patients with ASD and 0.011 per 1000 person-years in the controls. The adjusted risk ratio for endocarditis was 13.51 (95% CI: 6.20-29.46) in patients with ASD compared to the control cohort. Patients with ASD and endocarditis had higher long-term mortality than individualized control patients (MRR 2.25, 95% CI: 1.23-4.11). Conclusions . The incidence of IE in patients with ASD was higher than in the general population. Mortality associated with IE was higher in patients with ASD compared to controls.

Published
2023
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34. Computed tomography coronary angiography for patients with heart failure (CTA-HF): a randomized controlled trial (IMAGE-HF 1C).

Author

Chow BJW, Coyle D, Hossain A, Laine M, Hanninen H, Ukkonen H, Rajda M, Larose E, Hartikainen J, Mielniczuk L, Kass M, Connelly KA, O'Meara E, Garrard L, Bishop H, Small G, Hedman M, Coyle K, Yla-Herttuala S, Knuuti J, Wells GA, and Beanlands RS

Subjects
Aged, Computed Tomography Angiography, Coronary Angiography, Humans, Middle Aged, Quality of Life, Coronary Artery Disease diagnostic imaging, Heart Failure diagnostic imaging
Abstract

Aims: This randomized controlled trial sought to determine the financial impact of an initial diagnostic strategy of coronary computed tomography angiography (CCTA) in patients with heart failure (HF) of unknown aetiology. Invasive coronary angiography (ICA) is used to investigate HF patients. CCTA may be a non-invasive cost-effective alternative to ICA. This randomized controlled trial sought to determine the financial impact of an initial diagnostic strategy of coronary computed tomography angiography (CCTA) in patients with heart failure (HF) of unknown aetiology., Methods and Results: This multicentre, international trial enrolled patients with HF of unknown aetiology. The primary outcome was the cost of CCTA vs. ICA strategies at 12 months. Clinical outcomes were also collected. An 'intention-to-diagnose' analysis was performed and a secondary 'as-tested' analysis was based on the modality received. Two hundred and forty-six patients were randomized (age = 57.8 ± 11.0 years, ejection fraction = 30.1 ± 10.1%). The severity of coronary artery disease was similar in both groups. In the 121 CCTA patients, 93 avoided ICA. Rates of downstream ischaemia and viability testing were similar for both arms. There were no significant differences in the composite clinical outcomes or quality of life measures. The cost of CCTA trended lower than ICA [CDN -$871 (confidence interval, CI -$4116 to $3028)]. Using an 'as-tested' analysis, CCTA was associated with a decrease in healthcare costs (CDN -$2932, 95% CI -$6248 to $746)., Conclusion: In patients with HF of unknown aetiology, costs were not statistically different between the CCTA and ICA strategies., Clinical Trials.gov: NCT01283659., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)

Published
2021
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35. Recurrent hospitalizations are associated with increased mortality across the ejection fraction range in heart failure.

Author

Huusko J, Tuominen S, Studer R, Corda S, Proudfoot C, Lassenius M, and Ukkonen H

Subjects
Female, Finland, Hospitalization, Humans, Prognosis, Retrospective Studies, Stroke Volume, Ventricular Function, Left, Heart Failure epidemiology
Abstract

Aims: The proportion of patients hospitalized for heart failure (HF) with preserved left ventricular ejection fraction (LVEF) is rising, but no approved treatment exists, in part owing to incomplete characterization of this particular HF phenotype. In order to better define the characteristics of HF phenotypes in Finland, a large cohort with 12 years' follow-up time was analysed., Methods and Results: Patients diagnosed between 2005 and 2017 at the Hospital District of Southwest Finland were stratified according to LVEF measure and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. For this retrospective registry study, previously diagnosed HF patients were defined as follows: patients with reduced ejection fraction (HFrEF; LVEF ≤ 40%; n = 4042), mid-range ejection fraction (HFmrEF; LVEF > 40-50% and NT-proBNP ≥ 125 pg/mL; n = 1468), and preserved ejection fraction (HFpEF; LVEF > 50% and NT-proBNP ≥ 125 pg/mL; n = 3122) and followed up for 15 022, 4962, and 10 097 patient-years, respectively. Cardiovascular (CV) hospitalization and mortality, influence of pre-selected covariates on hospitalization and mortality, and the proportion of HFpEF and HFmrEF patients with a drop in LVEF to HFrEF phenotype were analysed. All data were extracted from the electronic patient register. HFrEF patients were rehospitalized slightly earlier than HFpEF/HFmrEF patients, but the second, third, and fourth rehospitalization rates did not differ between the subgroups. Female gender and better kidney function were associated with reduced rehospitalizations in HFmrEF and HFrEF, with a non-significant trend in HFpEF. Each additional hospitalization was associated with a two-fold increased risk of death and 2.2- to 2.3-fold increased risk of CV death. All-cause mortality was higher in patients with HFpEF. Although CV mortality was less frequent in HFpEF patients, it was associated with increased NT-proBNP concentrations at index in all patient groups. During the 10 years following the index date, 26% of HFmrEF patients and 10% of HFpEF patients progressed to an HFrEF phenotype., Conclusions: These findings suggest that disease progression, in terms of increased frequency of hospitalizations, and the relationship between increased number of hospitalizations and mortality are similar by LVEF phenotypes. These data highlight the importance of effective treatments that can reduce hospitalizations and suggest a role for monitoring NT-proBNP levels in the management of HFpEF patients in particular., (© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)

Published
2020
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36. Real-world clinical diagnostics of heart failure patients with reduced or preserved ejection fraction.

Author

Huusko J, Purmonen T, Toppila I, Lassenius M, and Ukkonen H

Subjects
Cohort Studies, Finland epidemiology, Humans, Stroke Volume, Heart Failure diagnosis, Heart Failure epidemiology
Abstract

Aims: The study aimed at investigating the use of guideline-recommended diagnostic tools and medication in patients with heart failure (HF) in specialty care in Southwest Finland. We also compared the characteristics of the diagnosed and undiagnosed patients as well as laboratory tests, procedures, and treatments in everyday clinical practice., Methods and Results: Patients diagnosed with HF, cardiomyopathy, or hypertension-induced heart disease (n = 20 878, primary cohort) or not diagnosed with HF but having a record of elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) (>125 ng/L, n = 24 321, secondary cohort) were included in the study from the specialty care patient register of the Hospital District of Southwest Finland during the years 2005-2017. Among patients with an International Classification of Diseases, Tenth Revision (ICD-10) code for HF, only 50% had ejection fraction (EF) data to be found by data mining from the electronic health records. Of these patients, 39% (n = 4042) had EF ≤ 40% [HF with reduced EF (HFrEF)] and 61% (n = 6347) had EF > 40%. Elevated NT-proBNP together with EF > 40% narrowed down the number to 4590 patients, a population defined as HF with preserved EF (HFpEF) patients. HFpEF patients were further stratified into HF with mildly reduced EF (HFmrEF; EF 41-50%, n = 1468) and EF > 50% patients (n = 3122) to compare clinical characteristics. NT-proBNP was higher within the HFrEF patients vs. HFpEF {4580 [inter-quartile range (IQR): 2065-9765] vs. 2900 [2065-9765] ng/L, P < 0.001}. Baseline co-morbidities differed between HFpEF and HFrEF groups. Further, HFpEF patients had more procedures and lab tests taken prior to diagnosis than had HFrEF patients. HFmrEF patients were found to resemble more HFrEF than EF > 50% patients. In 70% (n = 17 156) of patients in the secondary cohort, the NT-proBNP concentrations were >300 ng/L, median was 1090 (IQR 551-2558) ng/L and EF 58.4 ± 12.1% (n with EF available = 6845). Reduced EF was present in 6.8% of patients lacking HF diagnosis., Conclusions: Half of the patients with ICD-10 code for HF did not have EF data available after a visit at specialty care. In particular, the diagnosis of HFpEF seems challenging, reflected as an increase in procedures and laboratory test preceding diagnosis compared with those in HFrEF patients. Also, a large proportion of patients did not have HF diagnosis, yet they presented elevated NT-proBNP concentrations and clinical characteristics resembling those of HFpEF patients., (© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)

Published
2020
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37. Absolute Stress Myocardial Blood Flow After Coronary CT Angiography Guides Referral to Invasive Angiography.

Author

Stenström I, Maaniitty T, Uusitalo V, Ukkonen H, Kajander S, Mäki M, Nammas W, Bax JJ, Knuuti J, and Saraste A

Subjects
Aged, Angina Pectoris mortality, Angina Pectoris physiopathology, Angina Pectoris therapy, Blood Flow Velocity, Clinical Decision-Making, Coronary Artery Disease mortality, Coronary Artery Disease physiopathology, Coronary Artery Disease therapy, Disease Progression, Female, Humans, Male, Middle Aged, Myocardial Revascularization, Predictive Value of Tests, Prognosis, Retrospective Studies, Risk Factors, Time Factors, Angina Pectoris diagnostic imaging, Computed Tomography Angiography, Coronary Angiography methods, Coronary Artery Disease diagnostic imaging, Coronary Circulation, Myocardial Perfusion Imaging methods, Positron-Emission Tomography, Referral and Consultation
Published
2019
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38. Heart failure in Finland: clinical characteristics, mortality, and healthcare resource use.

Author

Huusko J, Kurki S, Toppila I, Purmonen T, Lassenius M, Gullberg E, Wirta SB, and Ukkonen H

Subjects
Aged, Aged, 80 and over, Chronic Disease, Female, Finland epidemiology, Humans, Male, Middle Aged, Patient Acceptance of Health Care statistics & numerical data, Retrospective Studies, Stroke Volume, Heart Failure diagnosis, Heart Failure mortality, Heart Failure physiopathology, Heart Failure therapy
Abstract

Aims: The aims of this study were to describe patient characteristics of the adult chronic heart failure (HF) population and to estimate the prevalence, incidence, healthcare resource utilization (HCRU), and mortality associated with HF in Southwest Finland., Methods and Results: This was a retrospective biobank and clinical registry study. Adult patients with an HF diagnosis (International Statistical Classification of Diseases and Related Health Problems (ICD) code I50) during 2004-2013 in secondary care were included in the study and compared with age-matched and gender-matched control patients without an I50 diagnosis. HF patients were stratified in groups by left ventricular ejection fraction (LVEF) as follows: LVEF < 40% [HF with reduced ejection fraction (HFrEF)]; LVEF ≥ 40% [HF with preserved ejection fraction (HFpEF)]; or unknown (LVEF unknown). HCRU was stratified by inpatient, outpatient, and emergency room visits. In 2013, the incidence of HF was 3.2/1000, and the prevalence was 13.9/1000 inhabitants (n = 15 594). In the stratified analysis of HF patients (n = 8833, average ± SD age 77.1 ± 11.2), 1115 (12.6%) patients had HFrEF (female 31.3%), 1449 (16.4%) had HFpEF (female 50.9%), and 6269 (71%) had unknown LVEF (female 52.1%). The most common co-morbidities were essential hypertension (58%), chronic elevated serum creatinine (57.3%), atrial fibrillation and flutter (55.1%), and chronic ischaemic heart disease (46.4%). Patients with HF diagnosis had higher HCRU compared with that of age-matched and gender-matched controls (3.7 more days per year at the hospital for HF patients compared with the controls). The total 5 year mortality was 62.6% for HF patients and 28.3% for controls, with higher age being the strongest predictor of mortality. Moreover, multivariable Cox regression analysis showed that patients with HFrEF had a 13% (95% confidence interval 2.7-25%) increased risk of mortality compared with HFpEF patients., Conclusions: The high mortality rate and HCRU among the studied HF patients highlight the severity of the disease and the economic and social burden on both patients and society. This calls for improved methods of care for this large patient population., (© 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)

Published
2019
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39. Biochemical Changes in Irradiated Oral Mucosa: A FTIR Spectroscopic Study.

Author

Ukkonen H, Vuokila S, Mikkonen JJW, Dekker H, Schulten EAJM, Bloemena E, Koistinen A, Valdez TA, Kullaa AM, and Singh SP

Subjects
Adult, Aged, Aged, 80 and over, Case-Control Studies, Female, Head and Neck Neoplasms radiotherapy, Humans, Male, Microscopy, Middle Aged, Mouth Mucosa metabolism, Mouth Mucosa pathology, Mouth Mucosa radiation effects, Principal Component Analysis, Radiation, Ionizing, Mouth Mucosa chemistry, Spectroscopy, Fourier Transform Infrared
Abstract

Radiation exposure during the course of treatment in head and neck cancer (HNC) patients can induce both structural and biochemical anomalies. The present study is focused on utilizing infrared imaging for the identification of the minor biochemical alterations in the oral mucosa. Chemical maps generated using glycoprotein band indicates its differential distribution along the superficial layer. Spectra extracted from this layer suggests changes in overall nucleic acid and protein content in response to the therapeutic irradiation. Discrimination among control and irradiated groups have been achieved using principal component analysis. Findings of this preliminary study further support prospective utilization of Fourier Transform InfraRed (FTIR) imaging as a non-destructive, label-free tool for objective assessment of the oral mucosa in patient groups with or without radiation therapy.

Published
2019
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40. Cardiac Troponin T Concentrations, Reversible Myocardial Ischemia, and Indices of Left Ventricular Remodeling in Patients with Suspected Stable Angina Pectoris: a DOPPLER-CIP Substudy.

Author

Myhre PL, Omland T, Sarvari SI, Ukkonen H, Rademakers F, Engvall JE, Hagve TA, Nagel E, Sicari R, Zamorano JL, Monaghan M, D'hooge J, Edvardsen T, and Røsjø H

Subjects
Aged, Echocardiography, Female, Humans, Male, Middle Aged, Myocardial Ischemia diagnostic imaging, Angina Pectoris physiopathology, Myocardial Ischemia prevention & control, Troponin T blood, Ventricular Remodeling
Abstract

Background: Cardiac troponin T concentrations measured with high-sensitivity assays (hs-cTnT) provide important prognostic information for patients with stable coronary artery disease (CAD). However, whether hs-cTnT concentrations mainly reflect left ventricular (LV) remodeling or recurrent myocardial ischemia in this population is not known., Methods: We measured hs-cTnT concentrations in 619 subjects with suspected stable CAD in a prospectively designed multicenter study. We identified associations with indices of LV remodeling, as assessed by cardiac MRI and echocardiography, and evidence of myocardial ischemia diagnosed by single positron emission computed tomography., Results: Median hs-cTnT concentration was 7.8 ng/L (interquartile range, 4.8-11.6 ng/L), and 111 patients (18%) had hs-cTnT concentrations above the upper reference limit (>14 ng/L). Patients with hs-cTnT >14 ng/L had increased LV mass (144 ± 40 g vs 116 ± 34 g; P < 0.001) and volume (179 ± 80 mL vs 158 ± 44 mL; P = 0.006), lower LV ejection fraction (LVEF) (59 ± 14 vs 62 ± 11; P = 0.006) and global longitudinal strain (14.1 ± 3.4% vs 16.9 ± 3.2%; P < 0.001), and more reversible perfusion defects ( P = 0.001) and reversible wall motion abnormalities ( P = 0.008). Age ( P = 0.009), estimated glomerular filtration rate ( P = 0.01), LV mass ( P = 0.003), LVEF ( P = 0.03), and evidence of reversible myocardial ischemia ( P = 0.004 for perfusion defects and P = 0.02 for LV wall motion) were all associated with increasing hs-cTnT concentrations in multivariate analysis. We found analogous results when using the revised US upper reference limit of 19 ng/L., Conclusions: hs-cTnT concentrations reflect both LV mass and reversible myocardial ischemia in patients with suspected stable CAD., (© 2018 American Association for Clinical Chemistry.)

Published
2018
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41. Prognostic Value of Coronary CT Angiography With Selective PET Perfusion Imaging in Coronary Artery Disease.

Author

Maaniitty T, Stenström I, Bax JJ, Uusitalo V, Ukkonen H, Kajander S, Mäki M, Saraste A, and Knuuti J

Subjects
Adenosine administration & dosage, Aged, Angina, Unstable etiology, Coronary Artery Disease complications, Coronary Artery Disease mortality, Coronary Artery Disease physiopathology, Coronary Stenosis complications, Coronary Stenosis mortality, Coronary Stenosis physiopathology, Coronary Vessels physiopathology, Disease Progression, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multimodal Imaging, Myocardial Infarction etiology, Predictive Value of Tests, Retrospective Studies, Risk Factors, Severity of Illness Index, Time Factors, Vasodilator Agents administration & dosage, Computed Tomography Angiography, Coronary Angiography methods, Coronary Artery Disease diagnostic imaging, Coronary Circulation, Coronary Stenosis diagnostic imaging, Coronary Vessels diagnostic imaging, Myocardial Perfusion Imaging methods, Positron Emission Tomography Computed Tomography
Abstract

Objectives: The purpose of this study was to evaluate the prognostic value of sequential hybrid imaging strategy in which positron emission tomography (PET) perfusion imaging is performed selectively in patients with suspected obstructive coronary artery disease (CAD) on coronary computed tomography angiography (CTA)., Background: Coronary CTA is an accurate diagnostic test for excluding obstructive CAD. However, the positive predictive value is suboptimal., Methods: We investigated 864 consecutive symptomatic patients with intermediate probability of CAD who adhered to the sequential imaging approach. PET myocardial perfusion imaging using 15 O-labeled water during adenosine stress was performed when suspected obstructive stenosis was present on coronary CTA. The major adverse events (AEs) including all-cause mortality, myocardial infarction (MI), and unstable angina pectoris (UAP) were recorded., Results: During a median follow-up of 3.6 years, 16 deaths, 10 MIs, and 5 UAPs occurred. Obstructive CAD was excluded by coronary CTA in 462 (53%) patients who had significantly lower annual AE rate than did patients with suspected obstructive stenosis on coronary CTA (0.4% vs. 1.5%; p = 0.003). The latter underwent PET study, on which 195 (49%) had normal and 207 had abnormal perfusion. The annual rate of AEs was 5 times higher in those with abnormal perfusion than with normal perfusion (2.5% vs. 0.5%; p = 0.004). Patients with normal perfusion had AE rate comparable to patients without obstructive CAD on coronary CTA (p = 0.77)., Conclusions: In patients with suspected CAD obstructive disease can be excluded in 53% of patients by coronary CTA, and these patients have good outcome. About one-half (49%) of the remaining patients have normal perfusion and event rate comparable to patients without obstructive CAD on coronary CTA while patients with ischemia have clearly worse outcome. Sequential approach utilizing anatomical imaging by coronary CTA followed by selective functional perfusion imaging is a feasible strategy to diagnose and risk-stratify patients with suspected CAD., (Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Published
2017
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42. Frequency and angiographic characteristics of coronary microvascular dysfunction in stable angina: a hybrid imaging study.

Author

Stenström I, Maaniitty T, Uusitalo V, Pietilä M, Ukkonen H, Kajander S, Mäki M, Bax JJ, Knuuti J, and Saraste A

Subjects
Aged, Aged, 80 and over, Female, Humans, Male, Microcirculation, Middle Aged, Prospective Studies, Angina, Stable diagnostic imaging, Computed Tomography Angiography methods, Coronary Angiography methods, Coronary Artery Disease diagnostic imaging, Multimodal Imaging, Positron-Emission Tomography methods
Abstract

Aims: Coronary microvascular dysfunction (CMD) can cause angina in the absence of obstructive coronary artery disease (CAD). We studied the frequency and angiographic characteristics of CMD in symptomatic patients with suspected stable CAD and identified CMD as diffusely abnormal coronary vasodilator capacity by positron emission tomography (PET) perfusion imaging., Methods and Results: We recruited prospectively 189 patients with intermediate pre-test probability of CAD who underwent coronary computed tomography angiography and quantitative 15O-water PET perfusion imaging followed by invasive coronary angiography, and assessment of fractional flow reserve when feasible. Prevalence of obstructive epicardial CAD was 37%. Absolute myocardial blood flow was diffusely reduced (<2.4 mL/g/min) within the left ventricle during adenosine stress in 32 (17%) patients. In 15 (8%) patients, this was explained by three-vessel obstructive CAD, whereas the remaining 17 (9%) were diagnosed with CMD. Of these, 2 (1% of all patients) had no coronary atherosclerosis, 5 (3% of all patients) had non-obstructive atherosclerosis, and in 10 (5% of all patients) CMD co-existed with obstructive CAD. Atypical angina or non-anginal chest pain (53%) was the most common presentation. Older age and male sex were associated with CMD, but other risk factors of CAD were equally common in patients with or without CMD., Conclusion: Coronary microvascular dysfunction exists in 9% of symptomatic stable patients with suspected CAD. However, the prevalence of microvascular dysfunction without any coronary atherosclerosis is low (1%) in this population., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.)

Published
2017
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43. Coronary heart disease risk factors, coronary artery calcification and epicardial fat volume in the Young Finns Study.

Author

Hartiala O, Magnussen CG, Bucci M, Kajander S, Knuuti J, Ukkonen H, Saraste A, Rinta-Kiikka I, Kainulainen S, Kähönen M, Hutri-Kähönen N, Laitinen T, Lehtimäki T, Viikari JS, Hartiala J, Juonala M, and Raitakari OT

Subjects
Adolescent, Anthropometry, Biomarkers blood, Blood Flow Velocity physiology, Brachial Artery diagnostic imaging, Carotid Intima-Media Thickness, Child, Child, Preschool, Coronary Disease epidemiology, Female, Finland epidemiology, Humans, Male, Risk Factors, Tomography, X-Ray Computed, Vascular Calcification epidemiology, Adipose Tissue diagnostic imaging, Coronary Disease diagnostic imaging, Pericardium diagnostic imaging, Vascular Calcification diagnostic imaging
Abstract

Aims: We investigated associations of pre-clinical coronary heart disease (CHD), adolescence and adulthood CHD risk factors, and epicardial fat volume (EFV), which is thought to influence CHD pathology., Methods and Results: EFV and coronary calcium scores were quantified using computed tomography imaging for 557 subjects from the Cardiovascular Risk in Young Finns Study in 2007. CHD risk marker levels were assessed repeatedly from 1980 to 2007. Carotid intima-media thickness (cIMT), carotid distensibility, and brachial flow-mediated dilatation were measured by vascular ultrasound in 2007. Increased EFV was cross-sectionally associated with male sex, increased waist circumference, body-mass index (BMI), cIMT, metabolic syndrome prevalence, levels of apolipoprotein B, total cholesterol, low-density lipoprotein cholesterol, triglycerides, C-reactive protein, blood pressure, insulin, and fasting glucose, as well as ever smoking, alcoholic intake, and lower high-density lipoprotein cholesterol (HDL-C), carotid distensibility and physical activity in adulthood. In BMI-adjusted analyses, only apolipoprotein B, ever smoking, alcohol intake and metabolic syndrome prevalence were independently associated with EFV. In adolescence, skinfold thickness, BMI, and insulin levels were higher and HDL-C lower with increasing EFV. Subjects in the lowest vs. highest quarter of EFV had consistently lower BMI across the early life-course., Conclusion: Associations of CHD risk markers with EFV were attenuated after multivariable adjustment. We found no evidence of increased EFV being independently associated with pre-clinical atherosclerosis. EFV was most strongly associated with BMI and waist circumference. Subjects with higher EFV had consistently higher BMI from age 12 suggesting that life-long exposure to higher BMI influences the development of EFV., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)

Published
2015
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44. Effect of spinal cord stimulation on myocardial perfusion reserve in patients with refractory angina pectoris.

Author

Saraste A, Ukkonen H, Varis A, Vasankari T, Tunturi S, Taittonen M, Rautakorpi P, Luotolahti M, Airaksinen KE, and Knuuti J

Subjects
Aged, Angina, Stable physiopathology, Body Mass Index, Coronary Artery Bypass methods, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Quality of Life, Sensitivity and Specificity, Treatment Outcome, Angina, Stable diagnosis, Angina, Stable therapy, Echocardiography, Stress methods, Fractional Flow Reserve, Myocardial, Hemodynamics, Positron-Emission Tomography methods, Spinal Cord Stimulation
Abstract

Aims: Epidural spinal cord stimulation (SCS) provides symptom relief in refractory angina pectoris, but its mechanism of action remains incompletely understood. We studied effects of short-term SCS therapy on myocardial ischaemia tolerance, myocardial perfusion reserve (MPR), and endothelium-mediated vasodilatation induced by cold pressor test (CPT) in patients with refractory angina pectoris., Methods and Results: We prospectively recruited 18 patients with refractory angina pectoris and studied them after implantation of SCS device at baseline before starting the therapy and after 3 weeks of continuous SCS therapy. Myocardial ischaemia was evaluated by dobutamine stress echocardiography. Global and regional myocardial blood flow (MBF) were measured using positron emission tomography and (15)O-water at rest, during adenosine stress, and in response to CPT. Systemic haemodynamics were comparable before and after 3 weeks of SCS at rest, during adenosine stress and during CPT. Appearance of angina pectoris induced by dobutamine stress was delayed after SCS therapy. Global MPR increased (P = 0.02) from 1.7 ± 0.6 at baseline to 2.0 ± 0.6 after 3-week SCS therapy. This was associated with a significant reduction in global MBF at rest and increase in MBF induced by adenosine in the ischaemic regions. Global MBF response to CPT was improved after SCS (0.27 ± 0.20 vs. 0.40 ± 0.15, P = 0.03)., Conclusion: Short-term SCS therapy improved myocardial ischaemia tolerance, absolute MPR, and endothelium-mediated vasomotor function in refractory angina pectoris, indicating that this therapy can alleviate myocardial perfusion abnormalities in advanced CAD., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)

Published
2015
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45. Absolute flow or myocardial flow reserve for the detection of significant coronary artery disease?

Author

Joutsiniemi E, Saraste A, Pietilä M, Mäki M, Kajander S, Ukkonen H, Airaksinen J, and Knuuti J

Subjects
Aged, Aged, 80 and over, Cohort Studies, Coronary Angiography methods, Coronary Artery Disease drug therapy, Female, Humans, Male, Middle Aged, Positron-Emission Tomography methods, Prospective Studies, ROC Curve, Sensitivity and Specificity, Severity of Illness Index, Tomography, X-Ray Computed methods, Adrenergic beta-Antagonists administration & dosage, Coronary Artery Disease diagnosis, Fractional Flow Reserve, Myocardial physiology, Multimodal Imaging methods, Myocardial Perfusion Imaging methods
Abstract

Objectives: We compared the accuracy of quantified myocardial flow reserve and absolute stress myocardial blood flow (MBF) alone in the detection of coronary artery disease (CAD)., Background: Myocardial flow reserve, i.e. ratio of stress and rest flow, has been commonly used to detect CAD with many imaging modalities. However, it is not known whether absolute stress flow alone is sufficient for detection of significant CAD., Methods: We enrolled 104 patients with moderate (30-70%) pre-test likelihood of CAD without previous myocardial infarction. MBF was measured by positron emission tomography and O-15-water at rest and during the adenosine stress in the regions of the left anterior descending, left circumflex, and right coronary artery. All the patients underwent invasive coronary angiography including the measurement of fractional flow reserve when appropriate., Results: Quantified myocardial flow reserve (optimal cut-off value 2.5) detected significant coronary stenosis with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 81, 87, 66 and 94%, respectively. When compared with flow reserve, absolute MBF at stress (optimal cut-off value of 2.4 mL/min/g) was more accurate in detecting significant coronary stenosis [area under the curve (AUC) 0.94 vs. 0.90, P = 0.02] with sensitivity, specificity, PPV, and NPV of 95% (P = 0.03 vs. flow reserve), 90, 73, and 98%, respectively. An absolute increase of MBF from rest to stress by <1.5 mL/g/min had also similar accuracy in detecting CAD (AUC: 0.95). The results were comparable in patients who did and did not receive i.v. beta-blockers prior imaging., Conclusions: Absolute stress perfusion alone was superior to perfusion reserve in the detection of haemodynamically significant CAD and allows shorter imaging protocols with smaller radiation dose., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)

Published
2014
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46. Alternative Imaging Modalities in Ischemic Heart Failure (AIMI-HF) IMAGE HF Project I-A: study protocol for a randomized controlled trial.

Author

O'Meara E, Mielniczuk LM, Wells GA, deKemp RA, Klein R, Coyle D, Mc Ardle B, Paterson I, White JA, Arnold M, Friedrich MG, Larose E, Dick A, Chow B, Dennie C, Haddad H, Ruddy T, Ukkonen H, Wisenberg G, Cantin B, Pibarot P, Freeman M, Turcotte E, Connelly K, Clarke J, Williams K, Racine N, Garrard L, Tardif JC, DaSilva J, Knuuti J, and Beanlands R

Subjects
Algorithms, Canada, Clinical Protocols, Heart Arrest etiology, Heart Failure etiology, Heart Failure mortality, Heart Failure therapy, Humans, Myocardial Infarction etiology, Myocardial Ischemia complications, Myocardial Ischemia mortality, Myocardial Ischemia therapy, Patient Readmission, Patient Selection, Predictive Value of Tests, Prognosis, Registries, Time Factors, Diagnostic Imaging methods, Heart Failure diagnosis, Magnetic Resonance Imaging, Myocardial Ischemia diagnosis, Positron-Emission Tomography, Research Design, Tomography, Emission-Computed, Single-Photon
Abstract

Background: Ischemic heart disease (IHD) is the most common cause of heart failure (HF); however, the role of revascularization in these patients is still unclear. Consensus on proper use of cardiac imaging to help determine which candidates should be considered for revascularization has been hindered by the absence of clinical studies that objectively and prospectively compare the prognostic information of each test obtained using both standard and advanced imaging., Methods/design: This paper describes the design and methods to be used in the Alternative Imaging Modalities in Ischemic Heart Failure (AIMI-HF) multi-center trial. The primary objective is to compare the effect of HF imaging strategies on the composite clinical endpoint of cardiac death, myocardial infarction (MI), cardiac arrest and re-hospitalization for cardiac causes.In AIMI-HF, patients with HF of ischemic etiology (n = 1,261) will follow HF imaging strategy algorithms according to the question(s) asked by the physicians (for example, Is there ischemia and/or viability?), in agreement with local practices. Patients will be randomized to either standard (SPECT, Single photon emission computed tomography) imaging modalities for ischemia and/or viability or advanced imaging modalities: cardiac magnetic resonance imaging (CMR) or positron emission tomography (PET). In addition, eligible and consenting patients who could not be randomized, but were allocated to standard or advanced imaging based on clinical decisions, will be included in a registry., Discussion: AIMI-HF will be the largest randomized trial evaluating the role of standard and advanced imaging modalities in the management of ischemic cardiomyopathy and heart failure. This trial will complement the results of the Surgical Treatment for Ischemic Heart Failure (STICH) viability substudy and the PET and Recovery Following Revascularization (PARR-2) trial. The results will provide policy makers with data to support (or not) further investment in and wider dissemination of alternative 'advanced' imaging technologies., Trial Registration: NCT01288560.

Published
2013
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47. Adolescence risk factors are predictive of coronary artery calcification at middle age: the cardiovascular risk in young Finns study.

Author

Hartiala O, Magnussen CG, Kajander S, Knuuti J, Ukkonen H, Saraste A, Rinta-Kiikka I, Kainulainen S, Kähönen M, Hutri-Kähönen N, Laitinen T, Lehtimäki T, Viikari JS, Hartiala J, Juonala M, and Raitakari OT

Subjects
Adolescent, Adult, Age Factors, Calcinosis complications, Calcinosis epidemiology, Child, Child, Preschool, Coronary Artery Disease etiology, Coronary Artery Disease pathology, Cross-Sectional Studies, Female, Finland epidemiology, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Prognosis, Retrospective Studies, Time Factors, Young Adult, Calcinosis diagnosis, Coronary Artery Disease epidemiology, Coronary Vessels pathology, Risk Assessment methods
Abstract

Objectives: The purpose of this study was to examine the roles of adolescence risk factors in predicting coronary artery calcium (CAC)., Background: Elevated coronary heart disease risk factor levels in adolescence may predict subsequent CAC independently of change in risk factor levels from adolescence to adulthood., Methods: CAC was assessed in 589 subjects 40 to 46 years of age from the Cardiovascular Risk in Young Finns Study. Risk factor levels were measured in 1980 (12 to 18 years) and in 2007., Results: The prevalence of any CAC was 19.2% (27.9% in men and 12.2% in women). Age, levels of systolic blood pressure (BP), total cholesterol, and low-density lipoprotein cholesterol (LDL-C) in adolescence, as well as systolic BP, total cholesterol, diastolic BP, and pack-years of smoking in adulthood were higher among subjects with CAC than those without CAC. Adolescence LDL-C and systolic BP levels predicted CAC in adulthood independently of 27-year changes in these risk factors. The multivariable odds ratios were 1.34 (95% confidence interval: 1.05 to 1.70; p=0.02) and 1.38 (95% confidence interval: 1.08 to 1.77; p=0.01), for 1-SD increase in adolescence LDL-C and systolic BP, respectively. Exposure to both of these risk factors in adolescence (defined as values at or above the age- and sex-specific 75th percentile) substantially increased the risk of CAC (multivariable odds ratio: 3.5 [95% confidence interval: 1.7 to 7.2; p=0.007]) between groups with no versus both risk factors., Conclusions: Elevated adolescence LDL-C and systolic BP levels are independent predictors of adulthood CAC, indicating that adolescence risk factor levels play an important role in the pathogenesis of coronary heart disease., (Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Published
2012
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48. Cardiac Function, Perfusion, Metabolism, and Innervation following Autologous Stem Cell Therapy for Acute ST-Elevation Myocardial Infarction. A FINCELL-INSIGHT Sub-Study with PET and MRI.

Author

Mäki MT, Koskenvuo JW, Ukkonen H, Saraste A, Tuunanen H, Pietilä M, Nesterov SV, Aalto V, Airaksinen KE, Pärkkä JP, Lautamäki R, Kervinen K, Miettinen JA, Mäkikallio TH, Niemelä M, Säily M, Koistinen P, Savolainen ER, Ylitalo K, Huikuri HV, and Knuuti J

Abstract

Purpose: Beneficial mechanisms of bone marrow cell (BMC) therapy for acute ST-segment elevation myocardial infarct (STEMI) are largely unknown in humans. Therefore, we evaluated the feasibility of serial positron emission tomography (PET) and MRI studies to provide insight into the effects of BMCs on the healing process of ischemic myocardial damage., Methods: Nineteen patients with successful primary reteplase thrombolysis (mean 2.4 h after symptoms) for STEMI were randomized for BMC therapy (2.9 × 10(6) CD34+ cells) or placebo after bone marrow aspiration in a double-blind, multi-center study. Three days post-MI, coronary angioplasty, and paclitaxel eluting stent implantation preceded either BMC or placebo therapy. Cardiac PET and MRI studies were performed 7-12 days after therapies and repeated after 6 months, and images were analyzed at a central core laboratory., Results: In BMC-treated patients, there was a decrease in [(11)C]-HED defect size (-4.9 ± 4.0 vs. -1.6 ± 2.2%, p = 0.08) and an increase in [(18)F]-FDG uptake in the infarct area at risk (0.06 ± 0.09 vs. -0.05 ± 0.16, p = 0.07) compared to controls, as well as less left ventricular dilatation (-4.4 ± 13.3 vs. 8.0 ± 16.7 mL/m(2), p = 0.12) at 6 months follow-up. However, BMC treatment was inferior to placebo in terms of changes in rest perfusion in the area at risk (-0.09 ± 0.17 vs. 0.10 ± 0.17, p = 0.03) and infarct size (0.4 ± 4.2 vs. -5.1 ± 5.9 g, p = 0.047), and no effect was observed on ejection fraction (p = 0.37)., Conclusion: After the acute phase of STEMI, BMC therapy showed only minor trends of long-term benefit in patients with rapid successful thrombolysis. There was a trend of more decrease in innervation defect size and enhanced glucose metabolism in the infarct-related myocardium and also a trend of less ventricular dilatation in the BMC-treated group compared to placebo. However, no consistently better outcome was observed in the BMC-treated group compared to placebo.

Published
2012
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49. Resting coronary flow velocity in the functional evaluation of coronary artery stenosis: study on sequential use of computed tomography angiography and transthoracic Doppler echocardiography.

Author

Joutsiniemi E, Saraste A, Pietilä M, Ukkonen H, Kajander S, Mäki M, Koskenvuo J, Airaksinen J, Hartiala J, Saraste M, and Knuuti J

Subjects
Aged, Aged, 80 and over, Coronary Angiography, Coronary Artery Disease diagnosis, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease pathology, Coronary Stenosis diagnostic imaging, Coronary Stenosis pathology, Coronary Vessels diagnostic imaging, Coronary Vessels pathology, Echocardiography, Feasibility Studies, Female, Health Status Indicators, Hemodynamics, Humans, Male, Middle Aged, ROC Curve, Statistics as Topic, Tomography, X-Ray Computed, Coronary Stenosis diagnosis, Rest
Abstract

Aims: Accelerated flow at the site of flow-limiting stenosis can be detected by transthoracic Doppler echocardiography (TTDE). We studied feasibility and accuracy of sequential coronary computed tomography angiography (CTA) and TTDE in detection of haemodynamically significant coronary artery disease (CAD)., Methods and Results: We prospectively enrolled 107 patients with intermediate (30-70%) pre-test likelihood of CAD. All patients underwent CTA using a 64-slice scanner. Using TTDE, the ratio of maximal diastolic flow velocity to pre-stenotic flow velocity (M/P ratio) was measured in the coronary segments with stenosis in CTA. In all patients, the results were compared with invasive coronary angiography, including measurement of fractional flow reserve when appropriate. All analyses were done blinded. TTDE was feasible in 276 of 285 evaluated coronary segments. Significant coronary stenoses were associated with a higher M/P ratio than non-significant stenoses (3.59 ± 1.82 vs. 1.28 ± 0.60, P < 0.001). The optimal M/P ratio for detection of significant stenosis was 2.2 (area under receiver operating characteristic curve 0.92, P < 0.001). Compared with the strategy of CTA alone, sequential CTA and focused TTDE had a better positive predictive value (PPV; 61 vs. 78%) and diagnostic accuracy (93 vs. 96%, P = 0.006) without impairment of the negative predictive value (97 vs. 97%)., Conclusion: Sequential use of CTA and TTDE is feasible for combined anatomic and functional evaluation of coronary stenoses. Compared with coronary CTA alone, addition of TTDE improved PPV for detection of significant CAD.

Published
2012
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50. Clinical value of absolute quantification of myocardial perfusion with (15)O-water in coronary artery disease.

Author

Kajander SA, Joutsiniemi E, Saraste M, Pietilä M, Ukkonen H, Saraste A, Sipilä HT, Teräs M, Mäki M, Airaksinen J, Hartiala J, and Knuuti J

Subjects
Blood Flow Velocity, Cohort Studies, Contrast Media, Coronary Angiography methods, Coronary Artery Disease diagnosis, Coronary Artery Disease physiopathology, Female, Humans, Image Enhancement methods, Magnetic Resonance Angiography methods, Male, Reproducibility of Results, Sensitivity and Specificity, Severity of Illness Index, Coronary Artery Disease diagnostic imaging, Coronary Circulation physiology, Echocardiography, Stress methods, Perfusion methods, Positron-Emission Tomography methods
Abstract

Background: The standard interpretation of perfusion imaging is based on the assessment of relative perfusion distribution. The limitations of that approach have been recognized in patients with multivessel disease and endothelial dysfunction. To date, however, no large clinical studies have investigated the value of measuring quantitative blood flow and compared that with relative uptake., Methods and Results: One hundred four patients with moderate (30%-70%) pretest likelihood of coronary artery disease (CAD) underwent PET imaging during adenosine stress using (15)O-water and dynamic imaging. Absolute myocardial blood flow was calculated from which both standard relative myocardial perfusion images and images scaled to a known absolute scale were produced. The patients and the regions then were classified as normal or abnormal and compared against the reference of conventional angiography with fractional flow reserve. In patient-based analysis, the positive predictive value, negative predictive value, and accuracy of absolute perfusion in the detection of any obstructive CAD were 86%, 97%, and 92%, respectively, with absolute quantification. The corresponding values with relative analysis were 61%, 83%, and 73%, respectively. In region-based analysis, the receiver operating characteristic curves confirmed that the absolute quantification was superior to relative assessment. In particular, the specificity and positive predictive value were low using just relative differences in flow. Only 9 of 24 patients with 3-vessel disease were correctly assessed using relative analysis., Conclusions: The measurement of myocardial blood flow in absolute terms has a significant impact on the interpretation of myocardial perfusion. As expected, multivessel disease is more accurately detected.

Published
2011
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