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3. Myocardial Blood Flow Quantification Using Stress Cardiac Magnetic Resonance Improves Detection of Coronary Artery Disease

Author

Wang, Shuo, Kim, Paul, Wang, Haonan, Ng, Ming-Yen, Arai, Andrew E., Singh, Amita, Mushtaq, Saima, Sin, Tsun Hei, Tada, Yuko, Hillier, Elizabeth, Jin, Ruyun, Mariager, Christian Østergaard, Salerno, Michael, Pontone, Gianluca, Urmeneta Ulloa, Javier, Saeed, Ibrahim M., Patel, Hena, Goh, Victor, Madsen, Simon, Kim, Won Yong, Singram Krishnam, Mayil, Martínez de Vega, Vicente, Maceira, Alicia M., Monmeneu, Jose V., Pazhenkottil, Aju P., Amir-Khalili, Alborz, Benovoy, Mitchel, Friedrich, Silke, Janich, Martin A., Friedrich, Matthias G., and Patel, Amit R.

Published
2024
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9. Left ventricular function and volumes from gated [13N]-ammonia positron emission tomography myocardial perfusion imaging: A prospective head-to-head comparison against CMR using a hybrid PET/MR device

Author

Maurer, Alexander, Sustar, Aleksandra, Giannopoulos, Andreas A., Grünig, Hannes, Bakula, Adam, Patriki, Dimitri, von Felten, Elia, Messerli, Michael, Pazhenkottil, Aju P., Gebhard, Catherine, Kaufmann, Philipp A., Buechel, Ronny R., and Fuchs, Tobias A.

Published
2023
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14. Dimensional structure of the Brief Illness Perception Questionnaire and Association with adverse childhood experiences in patients with an implantable cardioverter-defibrillator.

Author

Dörner, Marc, von Känel, Roland, Pazhenkottil, Aju P., Altwegg, Rahel, König, Noelle, Nager, Ladina, Attanasio, Veronica, Guth, Lisa, Zirngast, Sina, Menzi, Anna, Zuccarella-Hackl, Claudia, and Princip, Mary

Subjects
ADVERSE childhood experiences, IMPLANTABLE cardioverter-defibrillators, PATIENT experience, DIMENSIONAL analysis, PATIENTS' attitudes
Abstract

Illness perceptions (IP), as measured by the Brief Illness Perception Questionnaire (BIPQ), and adverse childhood experiences (ACE) have been shown to affect the physical and psychological well-being in different patient populations. However, little is known about IP and ACE in patients with an implantable cardioverter-defibrillator (ICD). Our objectives were to investigate the dimensional structure and to evaluate correlates of the BIPQ in ICD patients. 423 patients with an ICD were prospectively recruited. We conducted a principal component analysis to determine the dimensional structure of the BIPQ. Associations between ACE, other sociodemographic and clinical variables, and IP were analysed using a multivariable linear regression. We identified a two-factor structure (I = Consequences, II = Control) of the BIPQ. Among others, a higher number of ICD shocks in the past (0.21, 95% CI = 0.01–0.41, p = 0.036), low physical activity (-2.16, 95% CI = -4.37 to -0.37, p = 0.045), more frequent ACE (0.56, 95% CI = 0.08–1.22, p = 0.030), ICD shock-related concerns (0.75, 95% CI 0.62–0.89, p < 0.001), and primary ICD indication (-2.29, 95% CI -4.47 to -0.11, p = 0.039) were significantly associated with more threatening IP. The identification of those variables might lead to more precise interventions targeting maladaptive IP in this vulnerable patient population. [ABSTRACT FROM AUTHOR]

Published
2025
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15. Splenic switch-off as a novel marker for adenosine response in nitrogen-13 ammonia PET myocardial perfusion imaging: Cross-validation against CMR using a hybrid PET/MR device

Author

Bakula, Adam, Patriki, Dimitri, von Felten, Elia, Benetos, Georgios, Sustar, Aleksandra, Benz, Dominik C., Wiedemann-Buser, Muriel, Treyer, Valerie, Pazhenkottil, Aju P., Gräni, Christoph, Gebhard, Catherine, Kaufmann, Philipp A., Buechel, Ronny R., and Fuchs, Tobias A.

Published
2022
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27. Relationship between erectile dysfunction and alexithymia in male patients with implantable cardioverter defibrillators: a cross-sectional study.

Author

Ledermann, Katharina, Zuccarella-Hackl, Claudia, Altwegg, Rahel, Dörner, Marc, Attanasio, Veronica, Guth, Lisa, Zirngast, Sina, Pazhenkottil, Aju P., Menzi, Anna, von Känel, Roland, and Princip, Mary

Subjects
SEXUAL excitement, IMPOTENCE, IMPLANTABLE cardioverter-defibrillators, ADJUSTMENT disorders, SELF-expression
Abstract

Background: Implantable Cardioverter-Defibrillator (ICD) implantation is a life-saving intervention for individuals at risk of life-threatening arrhythmias. However, the psychosocial impact of ICD implantation extends beyond its cardiovascular benefits, potentially influencing emotional well-being and sexual health. This can lead to erectile dysfunction, which, is often associated with alexithymia. Both erectile dysfunction and alexithymia can significantly affect the psychological well-being of both patients and their partners. Aims: This study examines the association of erectile dysfunction with alexithymia in patients after ICD implantation. Additionally, we investigate potential moderators of this association. Method: Patients (N=165) completed self-rating questionnaires: Toronto Alexithymia scale (TAS-20), International Index of Erectile Function (IIEF-5), Adjustment disorder – new module (ADNM-20). Descriptive statistics, correlations, multivariate linear regressions, and moderation analysis were conducted. Results: The determinants of erectile dysfunction in ICD patients were explored in a regression model explaining 22% of the total variance. The ADNM-20 subscale preoccupation was found to significantly moderate the relationship between the alexithymia subscale externally oriented thinking and erectile dysfunction (R2 = 0.02, p=0.03). Conclusion: We did not find evidence for a relationship between externally oriented thinking and erectile dysfunction at low to average levels of preoccupation. However, evidence for such a relationship was found at high levels of preoccupation, where more externally oriented thinking was related to more erectile dysfunction. The intersection of alexithymia and erectile dysfunction represents a promising avenue for future research, offering opportunities to unravel the intricate connections between emotional processing and sexual health. Enhancing insights into this relationship could lead to innovative interventions that address the needs of individuals struggling with both conditions, fostering improved emotional expression, intimate relationships, and sexual satisfaction. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Duration of adenosine-induced myocardial hyperaemia: insights from quantitative 13N-ammonia positron emission tomography myocardial perfusion imaging.

Author

Garefa, Chrysoula, Sager, Dominik F, Heiniger, Pascal S, Markendorf, Susanne, Albertini, Tobia, Jurisic, Stjepan, Gajic, Marko, Gebhard, Catherine, Benz, Dominik C, Pazhenkottil, Aju P, Giannopoulos, Andreas A, Kaufmann, Philipp A, Slomka, Piotr J, and Buechel, Ronny R

Subjects
LEFT heart ventricle, DATA analysis, ADENOSINES, CORONARY circulation, MULTIPLE regression analysis, POSITRON emission tomography, RETROSPECTIVE studies, QUANTITATIVE research, DESCRIPTIVE statistics, HEART physiology, MANN Whitney U Test, CHI-squared test, PERFUSION imaging, HYPEREMIA, MEDICAL records, ACQUISITION of data, STATISTICS, PERFUSION, DATA analysis software
Abstract

Aims This study aimed to assess the impact of adenosine on quantitative myocardial blood flow (MBF) in a rapid stress–rest protocol compared with a rest–stress protocol using 13N-ammonia positron emission tomography (PET) myocardial perfusion imaging (MPI) and to gain insights into the time dependency of such effects. Methods and results Quantitative MBF at rest (rMBF) and during adenosine-induced stress (sMBF) and myocardial flow reserve (MFR) were obtained from 331 retrospectively identified patients who underwent 13N-ammonia PET MPI for suspected chronic coronary syndrome and who all exhibited no perfusion defects. Of these, 146 (44.1%) underwent a rapid stress–rest protocol with a time interval (Δ t stress–rest) of 20 ± 4 min between adenosine infusion offset and rest imaging, as per clinical routine. The remaining 185 (55.9%) patients underwent a rest–stress protocol and served as the reference. Groups did not differ regarding demographics, risk factors, medication, left ventricular function, and calcium scores. rMBF was significantly higher in the stress–rest vs. the rest–stress group [0.80 (interquartile range 0.66–1.00) vs. 0.70 (0.58–0.83) mL·min−1·g−1, P < 0.001], and, as sMBF was identical between groups [2.52 (2.20–2.96) vs. 2.50 (1.96–3.11), P = 0.347], MFR was significantly lower in the stress–rest group [3.07 (2.43–3.88) vs. 3.50 (2.63–4.10), P = 0.007]. There was a weak correlation between Δ t stress–rest and rMBF (r = −0.259, P = 0.002) and between Δ t stress–rest and MFR (r = 0.163, P = 0.049), and the proportion of patients with abnormally high rMBF was significantly decreasing with increasing Δ t stress–rest. Conclusion Intravenously applied adenosine induces a long-lasting hyperaemic effect on the myocardium. Consequently, rapid stress–rest protocols could lead to an overestimation of rMBF and an underestimation of MFR. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Association between vertebral bone mineral density, myocardial perfusion, and long-term cardiovascular outcomes: A sex-specific analysis

Author

Fiechter, Michael, Bengs, Susan, Roggo, Andrea, Haider, Achi, Marędziak, Monika, Portmann, Angela, Treyer, Valerie, Burger, Irene A., Messerli, Michael, Patriki, Dimitri, von Felten, Elia, Benz, Dominik C., Fuchs, Tobias A., Gräni, Christoph, Pazhenkottil, Aju P., Buechel, Ronny R., Kaufmann, Philipp A., and Gebhard, Catherine

Published
2020
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37. Quantification of intrathoracic fat adds prognostic value in women undergoing myocardial perfusion imaging

Author

Haider, Achi, Possner, Mathias, Messerli, Michael, Bengs, Susan, Osto, Elena, Maredziak, Monika, Portmann, Angela, Fiechter, Michael, Giannopoulos, Andreas A., Treyer, Valerie, Gaisl, Thomas, von Felten, Elia, Patriki, Dimitri, Benz, Dominik C., Fuchs, Tobias A., Gräni, Christoph, Pazhenkottil, Aju P., Buechel, Ronny R., Kaufmann, Philipp A., and Gebhard, Catherine

Published
2019
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39. Splenic switch-off as a predictor for coronary adenosine response: validation against 13N-ammonia during co-injection myocardial perfusion imaging on a hybrid PET/CMR scanner

Author

Patriki, Dimitri, von Felten, Elia, Bakula, Adam, Giannopoulos, Andreas A., Kamani, Christel H., Schwyzer, Moritz, Messerli, Michael, Benz, Dominik C., Gebhard, Catherine, Gräni, Christoph, Pazhenkottil, Aju P., Kaufmann, Philipp A., Fuchs, Tobias A., and Buechel, Ronny R.

Published
2021
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43. Heart rate reserve during pharmacological stress is a significant negative predictor of impaired coronary flow reserve in women

Author

Haider, Achi, Bengs, Susan, Maredziak, Monika, Messerli, Michael, Fiechter, Michael, Giannopoulos, Andreas A., Treyer, Valerie, Schwyzer, Moritz, Kamani, Christel Hermann, Patriki, Dimitri, von Felten, Elia, Benz, Dominik C., Fuchs, Tobias A., Gräni, Christoph, Pazhenkottil, Aju P., Kaufmann, Philipp A., Buechel, Ronny R., and Gebhard, Catherine

Published
2019
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44. Association between beta-adrenoceptor antagonist-induced sympathicolysis and severity of coronary artery disease as assessed by coronary computed tomography angiography (CCTA)

Author

Messerli, Michael, Maredziak, Monika, Bengs, Susan, Haider, Achi, Giannopoulos, Andreas A., Schwyzer, Moritz, Benz, Dominik C., von Felten, Elia, Kudura, Ken, Treyer, Valerie, Fiechter, Michael, Gräni, Christoph, Fuchs, Tobias A., Pazhenkottil, Aju P., Buechel, Ronny R., Kaufmann, Philipp A., and Gebhard, Catherine

Published
2019
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47. Mindfulness Is Associated with Lower Depression, Anxiety, and Post-Traumatic Stress Disorder Symptoms and Higher Quality of Life in Patients with an Implantable Cardioverter–Defibrillator—A Cross-Sectional Study.

Author

Dörner, Marc, von Känel, Roland, König, Noelle, Pazhenkottil, Aju P., Altwegg, Rahel, Nager, Ladina, Attanasio, Veronica, Guth, Lisa, Zirngast, Sina, Menzi, Anna, Zuccarella-Hackl, Claudia, and Princip, Mary

Subjects
ANXIETY treatment, TREATMENT of post-traumatic stress disorder, CROSS-sectional method, T-test (Statistics), STATISTICAL significance, MINDFULNESS, SEX distribution, LOGISTIC regression analysis, QUESTIONNAIRES, AGE distribution, PATH analysis (Statistics), CHI-squared test, DESCRIPTIVE statistics, LONGITUDINAL method, ODDS ratio, QUALITY of life, IMPLANTABLE cardioverter-defibrillators, ONE-way analysis of variance, CONFIDENCE intervals, DATA analysis software, MENTAL depression, EDUCATIONAL attainment, PHYSICAL activity
Abstract

Several studies suggested the efficacy of dispositional mindfulness and mindfulness-based interventions in reducing anxiety and depression in cardiovascular diseases. However, data on the impact of mindfulness on the psychological well-being of patients with an implantable cardioverter–defibrillator (ICD) are scarce. In this study, 422 patients with an ICD were prospectively recruited. Logistic regression was applied to determine associations between dispositional mindfulness (Freiburg Mindfulness Inventory), depression (Patient Health Questionnaire-8), anxiety (Generalized Anxiety Disorder-7 scale), and post-traumatic stress disorder (PTSD) symptoms (Post-Traumatic Stress Diagnostic Scale), adjusting for age, sex, educational status, number of ICD shocks after ICD implantation, and physical activity. The PROCESS regression path analysis modelling tool was used to identify indirect mediating effects of dispositional mindfulness on depression, anxiety, and PTSD symptoms and quality of life (QoL; EuroQol group 5-dimension questionnaire). Participants presented high baseline QoL (mean 1.06 to 1.72) and medium–high mindfulness scores (mean 40.85 points). Higher mindfulness scores were associated with lower levels of anxiety (OR 0.90, 95% CI 0.86 to 0.95, 0.001), depression (OR 0.93, 95% CI 0.88 to 0.98, p = 0.006), and PTSD symptoms (OR 0.94, 95% CI 0.89 to 0.98, p = 0.011). Furthermore, greater mindfulness partially mediated the relationship between anxiety (indirect effect 0.10, 95% CI 0.02 to 0.21), depression (indirect effect 0.08, 95% CI 0.01 to 0.17), or PTSD (indirect effect 0.04, 95% CI 0.01 to 0.17) as independent variables and the QoL as the dependent variable. This study suggests that greater dispositional mindfulness is associated with less anxiety, depression, and PTSD symptoms. Mindfulness might also increase the QoL in ICD patients by mitigating the impact of those with psychological distress. [ABSTRACT FROM AUTHOR]

Published
2024
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48. Imaging of the brain–heart axis: prognostic value in a European setting.

Author

Mikail, Nidaa, Sager, Dominik F, Gebert, Pimrapat, Haider, Ahmed, Todorov, Atanas, Bengs, Susan, Sablonier, Noemi, Glarner, Isabelle, Vinzens, Adriana, Bastian, Nastaran Sang, Epprecht, Gioia, Sütsch, Claudia, Delcò, Alessia, Fiechter, Michael, Portmann, Angela, Treyer, Valerie, Wegener, Susanne, Gräni, Christoph, Pazhenkottil, Aju, and Gebhard, Caroline E

Subjects
PROGNOSIS, MAJOR adverse cardiovascular events, POSITRON emission tomography, COMPUTED tomography, CARDIOVASCULAR disease related mortality
Abstract

Background and Aims Increasing data suggest that stress-related neural activity (SNA) is associated with subsequent major adverse cardiovascular events (MACE) and may represent a therapeutic target. Current evidence is exclusively based on populations from the U.S. and Asia where limited information about cardiovascular disease risk was available. This study sought to investigate whether SNA imaging has clinical value in a well-characterized cohort of cardiovascular patients in Europe. Methods In this single-centre study, a total of 963 patients (mean age 58.4 ± 16.1 years, 40.7% female) with known cardiovascular status, ranging from 'at-risk' to manifest disease, and without active cancer underwent 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography between 1 January 2005 and 31 August 2019. Stress-related neural activity was assessed with validated methods and relations between SNA and MACE (non-fatal stroke, non-fatal myocardial infarction, coronary revascularization, and cardiovascular death) or all-cause mortality by time-to-event analysis. Results Over a maximum follow-up of 17 years, 118 individuals (12.3%) experienced MACE, and 270 (28.0%) died. In univariate analyses, SNA significantly correlated with an increased risk of MACE (sub-distribution hazard ratio 1.52, 95% CI 1.05–2.19; P =.026) or death (hazard ratio 2.49, 95% CI 1.96–3.17; P <.001). In multivariable analyses, the association between SNA imaging and MACE was lost when details of the cardiovascular status were added to the models. Conversely, the relationship between SNA imaging and all-cause mortality persisted after multivariable adjustments. Conclusions In a European patient cohort where cardiovascular status is known, SNA imaging is a robust and independent predictor of all-cause mortality, but its prognostic value for MACE is less evident. Further studies should define specific patient populations that might profit from SNA imaging. [ABSTRACT FROM AUTHOR]

Published
2024
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50. Non-Invasive Assessment of Endothelial Shear Stress in Myocardial Bridges Using Coronary Computed Tomography Angiography.

Author

Giannopoulos, Andreas A., Bolt, Basil, Benz, Dominik C., Messerli, Michael, Von Felten, Elia, Patriki, Dimitri, Gebhard, Catherine, Pazhenkottil, Aju P., Gräni, Christoph, Kaufmann, Philipp A., Buechel, Ronny R., and Gaemperli, Oliver

Subjects
BLOOD vessels, ENDOTHELIUM, PHYSIOLOGIC strain, COMPUTED tomography
Abstract

Myocardial bridging (MB) is a segment of coronary arteries with an intramural course, typically spared from atherosclerosis, while the adjacent proximal segment is reported to be atherosclerosis-prone, a phenomenon contributed to local endothelial shear stress (ESS). We aimed to describe the ESS milieu in coronaries with MBs combining coronary computed tomography angiography with computational fluid dynamics and to investigate the association of atherosclerosis presence proximal to MBs with hemorheological characteristics. Patients (n = 36) were identified and 36 arteries with MBs (11 deep and 25 superficial) were analyzed. ESS did not fluctuate 5 mm proximally to MBs vs 5 mm within MBs (0.94 vs 1.06 Pa, p =.56). There was no difference when comparing ESS in the proximal versus mid versus distal MB segments (1.48 vs 1.37 vs 1.9 Pa, p = ns). In arteries with plaques (n = 12), no significant ESS variances were observed around the MB entrance, when analyzing all arteries (p =.81) and irrespective of morphological features of the bridged segment (deep MBs; p =.65, superficial MBs; p =.84). MBs are characterized by homogeneous, atheroprotective ESS, possibly explaining the absence of atherosclerosis within bridged segments. The interplay between ESS and atherosclerosis is potentially not different in arteries with MB compared with arteries without bridges. [ABSTRACT FROM AUTHOR]

Published
2024
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