19 results on '"Flachskampf, Frank A."'
Search Results
2. Left atrial strain: evaluating left ventricular filling pressure from an upstream vantage point.
- Author
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Flachskampf FA and Baron T
- Subjects
- Humans, Ventricular Pressure, Ventricular Function, Left
- Published
- 2021
- Full Text
- View/download PDF
3. Clinical Value of Stress Transaortic Flow Rate During Dobutamine Echocardiography in Reduced Left Ventricular Ejection Fraction, Low-Gradient Aortic Stenosis: A Multicenter Study.
- Author
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Vamvakidou A, Annabi MS, Pibarot P, Plonska-Gosciniak E, Almeida AG, Guzzetti E, Dahou A, Burwash IG, Koschutnik M, Bartko PE, Bergler-Klein J, Mascherbauer J, Orwat S, Baumgartner H, Cavalcante J, Pinto F, Kukulski T, Kasprzak JD, Clavel MA, Flachskampf FA, and Senior R
- Subjects
- Aged, Aortic Valve physiopathology, Aortic Valve Stenosis diagnosis, Cardiotonic Agents pharmacology, Female, Follow-Up Studies, Humans, Male, Prognosis, Retrospective Studies, Risk Factors, Severity of Illness Index, Aortic Valve diagnostic imaging, Aortic Valve Stenosis physiopathology, Blood Flow Velocity physiology, Dobutamine pharmacology, Echocardiography, Stress methods, Stroke Volume physiology, Ventricular Function, Left physiology
- Abstract
Background: Low rest transaortic flow rate (FR) has been shown previously to predict mortality in low-gradient aortic stenosis. However limited prognostic data exists on stress FR during low-dose dobutamine stress echocardiography. We aimed to assess the value of stress FR for the detection of aortic valve stenosis (AS) severity and the prediction of mortality., Methods: This is a multicenter cohort study of patients with reduced left ventricular ejection fraction and low-gradient aortic stenosis (aortic valve area <1 cm
2 and mean gradient <40 mm Hg) who underwent low-dose dobutamine stress echocardiography to identify the AS severity and presence of flow reserve. The outcome assessed was all-cause mortality., Results: Of the 287 patients (mean age, 75±10 years; males, 71%; left ventricular ejection fraction, 31±10%) over a mean follow-up of 24±30 months there were 127 (44.3%) deaths and 147 (51.2%) patients underwent aortic valve intervention. Higher stress FR was independently associated with reduced risk of mortality (hazard ratio, 0.97 [95% CI, 0.94-0.99]; P =0.01) after adjusting for age, chronic kidney disease, heart failure symptoms, aortic valve intervention, and rest left ventricular ejection fraction. The minimum cutoff for prediction of mortality was stress FR 210 mL/s. Following adjustment to the same important clinical and echocardiographic parameters, among the three criteria of AS severity during stress, ie, the guideline definition of aortic valve area <1cm2 and aortic valve mean gradient ≥40 mm Hg, or aortic valve mean gradient ≥40 mm Hg, or the novel definition of aortic valve area <1 cm2 at stress FR ≥210 mL/s, only the latter was independently associated with mortality (hazard ratio, 1.72 [95% CI, 1.05-2.82]; P =0.03). Furthermore aortic valve area <1cm2 at stress FR ≥210 mL/s was the only severe aortic stenosis criterion that was associated with improved outcome following aortic valve intervention ( P <0.001). Guideline-defined stroke volume flow reserve did not predict mortality., Conclusions: Stress FR during low-dose dobutamine stress echocardiography was useful for the detection of both AS severity and flow reserve and was associated with improved prediction of outcome following aortic valve intervention.- Published
- 2021
- Full Text
- View/download PDF
4. Prognostic implications of left ventricular myocardial work indices in cardiac amyloidosis.
- Author
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Clemmensen TS, Eiskjær H, Ladefoged B, Mikkelsen F, Sørensen J, Granstam SO, Rosengren S, Flachskampf FA, and Poulsen SH
- Subjects
- Humans, Myocardium, Predictive Value of Tests, Prognosis, Sweden epidemiology, Amyloidosis diagnostic imaging, Ventricular Function, Left
- Abstract
Aims: Left ventricular (LV) myocardial work index (LVMWI) derived from pressure-strain analysis resembles a novel non-invasive method for LV function evaluation. LV global longitudinal strain (LVGLS) has proven beneficial for risk stratification in cardiac amyloidosis (CA) patients. This study aimed to evaluate the potential additive value of LVMWI for outcome prediction in CA patients., Methods and Results: We enrolled 100 CA patients in the period 2014-19 from Aarhus University Hospital, Denmark and Uppsala University Hospital, Sweden. All patients underwent comprehensive echocardiographic evaluation and were prospectively followed until censuring date on 31 March 2019 or death. During follow-up, we registered major adverse cardiac events (MACE) comprising heart failure requiring hospitalization and all-cause mortality. The median follow-up was 490 (228-895) days. During follow-up, a total of 42% of patients experienced MACE and 29% died. Patients with LVMWI <1043 mmHg% had higher MACE risk than patients with LVMWI >1043 mmHg% [hazard ratio (HR) 2.3, 95% confidence interval (CI) 1.2-4.3; P = 0.01]. Furthermore, patients with LVMWI <1039 mmHg% also had higher all-cause mortality risk than patients with LVMWI >1039 mmHg% (HR 2.6, 95% CI 1.2-5.5; P < 0.05). Moreover, the apical-to-basal segmental work ratio was a significant MACE and all-cause mortality predictor. By combining LVMWI and apical-to-basal segmental work ratio, we obtained an independent model for all-cause mortality prediction (high vs. low risk: HR 6.4, 95% CI 2.4-17.1; P < 0.0001). In contrast, LVGLS did not predict all-cause mortality., Conclusion: LV myocardial work may be of prognostic value in CA patients by predicting both MACE and all-cause mortality., (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
- Full Text
- View/download PDF
5. Development, validation, and implementation of biomarker testing in cardiovascular medicine state-of-the-art: proceedings of the European Society of Cardiology-Cardiovascular Round Table.
- Author
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Elliott P, Cowie MR, Franke J, Ziegler A, Antoniades C, Bax J, Bucciarelli-Ducci C, Flachskampf FA, Hamm C, Jensen MT, Katus H, Maisel A, McDonagh T, Mittmann C, Muntendam P, Nagel E, Rosano G, Twerenbold R, and Zannad F
- Subjects
- Biomarkers blood, Cardiovascular Diseases blood, Cardiovascular Diseases physiopathology, Cardiovascular Diseases therapy, Humans, Predictive Value of Tests, Prognosis, Reproducibility of Results, Biomedical Research, Cardiology, Cardiovascular Diseases diagnosis, Echocardiography, Magnetic Resonance Imaging, Troponin T blood, Ventricular Function, Left
- Abstract
Many biomarkers that could be used to assess ejection fraction, heart failure, or myocardial infarction fail to translate into clinical practice because they lack essential performance characteristics or fail to meet regulatory standards for approval. Despite their potential, new technologies have added to the complexities of successful translation into clinical practice. Biomarker discovery and implementation require a standardized approach that includes: identification of a clinical need; identification of a valid surrogate biomarker; stepwise assay refinement, demonstration of superiority over current standard-of-care; development and understanding of a clinical pathway; and demonstration of real-world performance. Successful biomarkers should improve efficacy or safety of treatment, while being practical at a realistic cost. Everyone involved in cardiovascular healthcare, including researchers, clinicians, and industry partners, are important stakeholders in facilitating the development and implementation of biomarkers. This article provides suggestions for a development pathway for new biomarkers, discusses regulatory issues and challenges, and suggestions for accelerating the pathway to improve patient outcomes. Real-life examples of successful biomarkers-high-sensitivity cardiac troponin, T2* cardiovascular magnetic resonance imaging, and echocardiography-are used to illustrate the value of a standardized development pathway in the translation of concepts into routine clinical practice., (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
- Full Text
- View/download PDF
6. Getting Shorter Predicts Living Longer: The Remarkable Success of Ventricular Strain as a Prognostic Marker.
- Author
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Flachskampf FA and Chandrashekhar Y
- Subjects
- Diastole, Humans, Predictive Value of Tests, Prognosis, Risk Assessment, Risk Factors, Stroke Volume, Systole, Ventricular Dysfunction, Left mortality, Ventricular Dysfunction, Left physiopathology, Ventricular Dysfunction, Left therapy, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Function, Left
- Published
- 2020
- Full Text
- View/download PDF
7. Interobserver Variability in Applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 Guidelines for Estimation of Left Ventricular Filling Pressure.
- Author
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Nagueh SF, Abraham TP, Aurigemma GP, Bax JJ, Beladan C, Browning A, Chamsi-Pasha MA, Delgado V, Derumeaux G, Dolci G, Donal E, Edvardsen T, El Tallawi KC, Ernande L, Esposito R, Flachskampf FA, Galderisi M, Gentry J, Goldstein SA, Harb SC, Hubert A, Hung J, Klein AL, Lancellotti P, Mahmood RZ, Marino P, Popescu BA, Previato M, Sanghai SR, Smiseth OA, and Xu J
- Subjects
- Aged, Female, Heart Diseases physiopathology, Heart Ventricles physiopathology, Humans, Male, Middle Aged, Observer Variation, Predictive Value of Tests, Reproducibility of Results, Echocardiography, Doppler standards, Heart Diseases diagnostic imaging, Heart Ventricles diagnostic imaging, Practice Guidelines as Topic standards, Ventricular Function, Left, Ventricular Pressure
- Abstract
Background: Assessment of left ventricular (LV) filling pressure is among the important components of a comprehensive echocardiographic report. Previous studies noted wide limits of agreement using 2009 American Society of Echocardiography/European Association of Echocardiography guidelines, but reproducibility of 2016 guidelines update in estimating LV filling pressure is unknown., Methods: Echocardiographic and hemodynamic data were obtained from 50 patients undergoing cardiac catheterization for clinical indications. Clinical and echocardiographic findings but not invasive hemodynamics were provided to 4 groups of observers, including experienced echocardiographers and cardiology fellows. Invasively acquired LV filling pressure was the gold standard., Results: In group I of 8 experienced echocardiographers from the guidelines writing committee, sensitivity for elevated LV filling pressure was 92% for all observers, and specificity was 93±6%. Fleiss κ-value for the agreement in group I was 0.80. In group II of 4 fellows in training, sensitivity was 91±2%, and specificity was 95±2%. Fleiss κ-value for the agreement in group II was 0.94. In group III of 9 experienced echocardiographers who had not participated in drafting the guidelines, sensitivity was 88±5%, and specificity was 91±7%. Fleiss κ-value for the agreement in group III was 0.76. In group IV of 7 other fellows, sensitivity was 91±3%, and specificity was 92±5%. Fleiss κ-value for the agreement in group IV was 0.89., Conclusions: There is a good level of agreement and accuracy in the estimation of LV filling pressure using the American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 recommendations update, irrespective of the experience level of the observer.
- Published
- 2019
- Full Text
- View/download PDF
8. Global Longitudinal Shortening: A Positive Step Towards Reducing Confusion Surrounding Global Longitudinal Strain.
- Author
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Flachskampf FA, Blankstein R, Grayburn PA, Kramer CM, Kwong RYK, Marwick TH, Nagel E, Sengupta PP, Zoghbi WA, and Chandrashekhar Y
- Subjects
- Consensus, Heart Diseases diagnosis, Humans, Heart Diseases physiopathology, Myocardial Contraction, Terminology as Topic, Ventricular Function, Left
- Published
- 2019
- Full Text
- View/download PDF
9. Test-retest reliability of new and conventional echocardiographic parameters of left ventricular systolic function.
- Author
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Baron T, Berglund L, Hedin EM, and Flachskampf FA
- Subjects
- Female, Heart Ventricles physiopathology, Humans, Male, Middle Aged, Prospective Studies, ROC Curve, Reproducibility of Results, Systole, Ventricular Dysfunction, Left physiopathology, Echocardiography methods, Heart Ventricles diagnostic imaging, Stroke Volume physiology, Ventricular Dysfunction, Left diagnosis, Ventricular Function, Left physiology
- Abstract
Background: Reliability of left ventricular function measurements depends on actual biological conditions, repeated registrations and their analyses., Objective: To investigate test-retest reliability of speckle-tracking-derived strain measurements and its determinants compared to the conventional parameters, such as ejection fraction (EF), LV volumes and mitral annular plane systolic excursion (MAPSE)., Methods: In 30 patients with a wide range of left ventricular function (mean EF 46.4 ± 16.4%, range 14-73%), standard echo views were acquired independently in a blinded fashion by two different echocardiographers in immediate sequence and analyzed off-line by two independent readers, creating 4 data sets per patient. Test-retest reliability of studied parameters was calculated using the smallest detectable change (SDC) and a total, inter-acquisition and inter-reader intra-class correlation coefficient (ICC)., Results: The smallest detectable change normalized to the mean absolute value of the measured parameter (SDCrel) was lowest for MAPSE (10.7%). SDCrel for EF was similar to GLS (14.2 and 14.7%, respectively), while SDCrel for CS was much higher (35.6%). The intra-class correlation coefficient was excellent (> 0.9) for all measures of the left ventricular function. Intra-patient inter-acquisition reliability (ICCacq) was significantly better than inter-reader reliability (ICCread) (0.984 vs. 0.950, p = 0.03) only for EF, while no significant difference was observed for any other LV function parameter. Mean intra-subject standard deviations were significantly correlated to the mean values for CS and LV volumes, but not for the other studied parameters., Conclusions: In a test-retest setting, both with normal and impaired left ventricular function, the smallest relative detectable change of EF, GLS and MAPSE was similar (11-15%), but was much higher for CS (35%). Surprisingly, reliability of GLS was not superior to that of EF. Acquisition and reader to a similar extent influenced the reliability of measurements of all left ventricular function measures except for ejection fraction, where the reliability was more dependent on the reader than on the acquisition.
- Published
- 2019
- Full Text
- View/download PDF
10. Clinical outcome and functional characteristics of patients with asymptomatic low-flow low-gradient severe aortic stenosis with preserved ejection fraction are closer to high-gradient severe than to moderate aortic stenosis.
- Author
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Kavianipour M, Farkhooy A, and Flachskampf FA
- Subjects
- Aged, Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve surgery, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis mortality, Aortic Valve Stenosis surgery, Disease Progression, Echocardiography, Doppler, Female, Heart Valve Prosthesis Implantation, Humans, Male, Middle Aged, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Aortic Valve physiopathology, Aortic Valve Stenosis physiopathology, Hemodynamics, Stroke Volume, Ventricular Function, Left
- Abstract
Asymptomatic "paradoxic" severe low-flow low-gradient aortic stenosis with preserved ejection fraction (PAS) constitutes a challenging condition where the optimal management and follow-up remain elusive. We evaluated the clinical outcome in patients with PAS as compared to asymptomatic patients with moderate (MAS) or classical severe aortic stenosis (CAS). Consecutive asymptomatic moderate or severe aortic stenosis patients without concomitant other heart or lung disease (n = 121) were invited. Participants (n = 74) were assigned to three subgroups with regard to degree of aortic stenosis: MAS (n = 25), CAS (n = 22) and PAS (n = 27). Echocardiographic parameters at baseline and clinical outcome data after > 3 years of follow-up time were obtained. Patients with PAS had the smallest stroke volumes and the highest relative wall thickness (p < 0.05). Left ventricular mass index was highest in subjects with CAS, followed closely by PAS and eventually MAS subjects. Whereas ejection fraction was similar amongst the subgroups, a stepwise decrease in global longitudinal left ventricular strain with increasing degree of aortic stenosis was observed, with CAS patients displaying the lowest mean global longitudinal strain, followed by PAS and MAS. A trend towards increasing mortality rate by increasing degree of stenosis was observed. Patients with CAS underwent aortic valve replacement surgery more frequently than both PAS and MAS (p < 0.001). These data suggest that echocardiographic parameters and clinical outcome in patients with PAS bear closer resemblance to CAS than to MAS, but management of PAS is more conservative than in CAS.
- Published
- 2018
- Full Text
- View/download PDF
11. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.
- Author
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Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, Flachskampf FA, Gillebert TC, Klein AL, Lancellotti P, Marino P, Oh JK, Popescu BA, and Waggoner AD
- Subjects
- Diastole, Europe, Humans, United States, Echocardiography standards, Heart Ventricles diagnostic imaging, Societies, Medical, Ventricular Function, Left physiology
- Published
- 2016
- Full Text
- View/download PDF
12. Simultaneous 4-Chamber Strain: More and Faster Analysis, But Is It Good Enough?
- Author
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Baron T and Flachskampf FA
- Subjects
- Female, Humans, Male, Atrial Function, Left, Atrial Function, Right, Echocardiography, Doppler, Color, Ventricular Function, Left, Ventricular Function, Right
- Published
- 2016
- Full Text
- View/download PDF
13. Cardiac Imaging to Evaluate Left Ventricular Diastolic Function.
- Author
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Flachskampf FA, Biering-Sørensen T, Solomon SD, Duvernoy O, Bjerner T, and Smiseth OA
- Subjects
- Echocardiography, Humans, Magnetic Resonance Imaging, Predictive Value of Tests, Prognosis, Radionuclide Ventriculography, Severity of Illness Index, Tomography, X-Ray Computed, Ventricular Dysfunction, Left physiopathology, Diagnostic Imaging methods, Diastole, Ventricular Dysfunction, Left diagnosis, Ventricular Function, Left
- Abstract
Left ventricular diastolic dysfunction in clinical practice is generally diagnosed by imaging. Recognition of heart failure with preserved ejection fraction has increased interest in the detection and evaluation of this condition and prompted an improved understanding of the strengths and weaknesses of different imaging modalities for evaluating diastolic dysfunction. This review briefly provides the pathophysiological background for current clinical and experimental imaging parameters of diastolic dysfunction, discusses the merits of echocardiography relative to other imaging modalities in diagnosing and grading diastolic dysfunction, summarizes lessons from clinical trials that used parameters of diastolic function as an inclusion criterion or endpoint, and indicates current areas of research., (Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
14. Recommendations for the evaluation of left ventricular diastolic function by echocardiography.
- Author
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Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, Waggoner AD, Flachskampf FA, Pellikka PA, and Evangelisa A
- Subjects
- Diastole, Echocardiography, Doppler, Color, Exercise Test, Hemodynamics, Humans, Hypertrophy, Left Ventricular diagnostic imaging, Prognosis, Pulmonary Artery diagnostic imaging, Stroke Volume, Ventricular Dysfunction, Left diagnostic imaging, Ventricular Function, Left
- Published
- 2009
- Full Text
- View/download PDF
15. Severe aortic stenosis with low gradient and apparently preserved left ventricular systolic function--under-recognized or overdiagnosed?
- Author
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Flachskampf FA
- Subjects
- Acute Disease, Echocardiography standards, Humans, Stroke Volume physiology, Systole physiology, Aortic Valve Stenosis diagnostic imaging, Ventricular Function, Left physiology
- Published
- 2008
- Full Text
- View/download PDF
16. Strain rate imaging for the assessment of preload-dependent changes in regional left ventricular diastolic longitudinal function.
- Author
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Voigt JU, Lindenmeier G, Werner D, Flachskampf FA, Nixdorff U, Hatle L, Sutherland GR, and Daniel WG
- Subjects
- Adult, Blood Flow Velocity physiology, Echocardiography, Female, Heart Rate physiology, Heart Ventricles diagnostic imaging, Humans, Leg blood supply, Male, Mitral Valve diagnostic imaging, Mitral Valve physiology, Reference Values, Ventricular Function, Diastole physiology, Ultrasonography, Doppler, Color, Ventricular Function, Left physiology
- Abstract
Background: Strain rate imaging is a new and intriguing way of displaying myocardial deformation properties by means of echocardiography. With high frame rate strain rate imaging we observed a spatial inhomogeneity in diastolic longitudinal strain rates in healthy persons. A base-to-apex time delay in diastolic lengthening could be seen both in early diastole and at atrial contraction., Methods and Results: We investigated this consistent finding and its dependence on loading conditions in 20 healthy volunteers. Propagation velocities of lengthening of 91 +/- 31 cm/s (E-wave) and 203 +/- 11 cm/s (A-wave) at rest (equal to time delays of 104 +/- 29 ms and 56 +/- 24 ms, respectively) increased significantly to 101 +/- 27 cm/s (E) and 283 +/- 17 cm/s (A) with lifting the volunteers' legs. Applying nitroglycerin sublingually and sitting upright significantly decreased propagation velocities (E-wave 76 +/- 20 cm/s, A-wave 172 +/- 93 cm/s and E-wave 66 +/- 17 cm/s, A-wave 150 +/- 64 cm/s, respectively). Free lateral walls showed a lower propagation velocity than septal walls., Conclusion: We conclude that the propagation velocities of left ventricular lengthening waves are dependent on preload changes and increase with increasing preload.
- Published
- 2002
- Full Text
- View/download PDF
17. Multimodality imaging in patients with heart failure and preserved ejection fraction: an expert consensus document of the European Association of Cardiovascular Imaging
- Author
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Smiseth, Otto A, Morris, Daniel A, Cardim, Nuno, Cikes, Maja, Delgado, Victoria, Donal, Erwan, Flachskampf, Frank A, Galderisi, Maurizio, Gerber, Bernhard, Gimelli, Alessia, Klein, Allan L, Knuuti, Juhani, Lancellotti, Patrizio, Mascherbauer, Julia, Milicic, Davor, Seferovic, Petar, Solomon, Scott, Edvardsen, Thor, Popescu, Bogdan A, Reviewers: This document was reviewed by members of the 2018–2020 EACVI Scientific Documents Committee, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Oslo University Hospital [Oslo], Charité Campus Virchow-Klinikum (CVK), University of Zagreb, Leiden University Medical Center (LUMC), Universiteit Leiden, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Uppsala University Hospital, 'Federico II' University of Naples Medical School, Cliniques universitaires St Luc [Bruxelles], Université Catholique de Louvain = Catholic University of Louvain (UCL), Fondazione Toscana Gabriele Monasterio, Cleveland Clinic, University of Turku, Université de Liège, Clinical Center of Serbia (KCS), Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinical sciences, Cardio-vascular diseases, and Cardiology
- Subjects
medicine.medical_specialty ,Consensus ,Diastole ,heart failure ,echocardiography ,diastole ,filling pressure ,multimodality imaging ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,MECHANISMS ,Ventricular Dysfunction, Left ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,diabetic cardiomyopathy ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,030212 general & internal medicine ,Heart Failure ,Ejection fraction ,diabetes ,business.industry ,Expert consensus ,Stroke Volume ,General Medicine ,Prognosis ,medicine.disease ,3. Good health ,Heart failure ,Screening ,Cardiology ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Cardiology and Cardiovascular Medicine ,business ,Heart failure with preserved ejection fraction - Abstract
Nearly half of all patients with heart failure (HF) have a normal left ventricular (LV) ejection fraction (EF) and the condition is termed heart failure with preserved ejection fraction (HFpEF). It is assumed that in these patients HF is due primarily to LV diastolic dysfunction. The prognosis in HFpEF is almost as severe as in HF with reduced EF (HFrEF). In contrast to HFrEF where drugs and devices are proven to reduce mortality, in HFpEF there has been limited therapy available with documented effects on prognosis. This may reflect that HFpEF encompasses a wide range of different pathological processes, which multimodality imaging is well placed to differentiate. Progress in developing therapies for HFpEF has been hampered by a lack of uniform diagnostic criteria. The present expert consensus document from the European Association of Cardiovascular Imaging (EACVI) provides recommendations regarding how to determine elevated LV filling pressure in the setting of suspected HFpEF and how to use multimodality imaging to determine specific aetiologies in patients with HFpEF.
- Published
- 2021
18. Global Longitudinal Shortening: A Positive Step Towards Reducing Confusion Surrounding Global Longitudinal Strain
- Author
-
Flachskampf, Frank A., Blankstein, Ron, Grayburn, Paul A., Kramer, Christopher M., Kwong, Raymond Y.K., Marwick, Thomas H., Nagel, Eike, Sengupta, Partho P., Zoghbi, William A., and Chandrashekhar, Y.
- Subjects
Consensus ,Heart Diseases ,Terminology as Topic ,Humans ,Myocardial Contraction ,Article ,Ventricular Function, Left - Published
- 2019
19. Interobserver Variability in Applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 Guidelines for Estimation of Left Ventricular Filling Pressure
- Author
-
Jeroen J. Bax, Serge C. Harb, Kinan Carlos El Tallawi, Mohammed A. Chamsi-Pasha, Carmen C. Beladan, Saket Sanghai, Sherif F. Nagueh, Roberta Esposito, Steven A. Goldstein, Erwan Donal, Victoria Delgado, Giulia Dolci, Theodore P. Abraham, Frank A. Flachskampf, Patrizio Lancellotti, Arnaud Hubert, Allan L. Klein, Geneviève Derumeaux, Paolo Marino, Otto A. Smiseth, Gerard P. Aurigemma, Laura Ernande, Judy Hung, Thor Edvardsen, Redah Z. Mahmood, James L. Gentry, Alyssa Browning, Maurizio Galderisi, Jiaqiong Xu, Martina Previato, Bogdan A. Popescu, Nagueh, Sherif F., Abraham, Theodore P., Aurigemma, Gerard P., Bax, Jeroen J., Beladan, Carmen, Browning, Alyssa, Chamsi-Pasha, Mohammed A., Delgado, Victoria, Derumeaux, Genevieve, Dolci, Giulia, Donal, Erwan, Edvardsen, Thor, El Tallawi, Kinan Carlo, Ernande, Laura, Esposito, Roberta, Flachskampf, Frank A., Galderisi, Maurizio, Gentry, Jame, Goldstein, Steven A., Harb, Serge C., Hubert, Arnaud, Hung, Judy, Klein, Allan L., Lancellotti, Patrizio, Mahmood, Redah Z., Marino, Paolo, Popescu, Bogdan A., Previato, Martina, Sanghai, Saket R., Smiseth, Otto A., Xu, Jiaqiong, University of Massachusetts Medical School [Worcester] (UMASS), University of Massachusetts System (UMASS), Leiden University Medical Center (LUMC), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], University of Oslo (UiO), Uppsala University, Cleveland Clinic, Università degli Studi del Piemonte Orientale - Amedeo Avogadro (UPO), Universiteit Leiden, and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Male ,medicine.medical_specialty ,Radiology, Nuclear Medicine and Imaging ,Heart Diseases ,Heart Ventricles ,echocardiography, Doppler ,Diastole ,030204 cardiovascular system & hematology ,Doppler echocardiography ,Ventricular Function, Left ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,diastole ,Predictive Value of Tests ,Internal medicine ,medicine ,Ventricular Pressure ,echocardiography ,human ,humans ,ComputingMilieux_MISCELLANEOUS ,Aged ,Estimation ,Observer Variation ,medicine.diagnostic_test ,business.industry ,Limits of agreement ,Doppler ,Reproducibility of Results ,Guideline ,Middle Aged ,Practice Guidelines as Topic ,Cardiology ,Female ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,business ,Ventricular filling ,Cardiology and Cardiovascular Medicine ,[SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing ,guideline - Abstract
Background: Assessment of left ventricular (LV) filling pressure is among the important components of a comprehensive echocardiographic report. Previous studies noted wide limits of agreement using 2009 American Society of Echocardiography/European Association of Echocardiography guidelines, but reproducibility of 2016 guidelines update in estimating LV filling pressure is unknown. Methods: Echocardiographic and hemodynamic data were obtained from 50 patients undergoing cardiac catheterization for clinical indications. Clinical and echocardiographic findings but not invasive hemodynamics were provided to 4 groups of observers, including experienced echocardiographers and cardiology fellows. Invasively acquired LV filling pressure was the gold standard. Results: In group I of 8 experienced echocardiographers from the guidelines writing committee, sensitivity for elevated LV filling pressure was 92% for all observers, and specificity was 93±6%. Fleiss κ-value for the agreement in group I was 0.80. In group II of 4 fellows in training, sensitivity was 91±2%, and specificity was 95±2%. Fleiss κ-value for the agreement in group II was 0.94. In group III of 9 experienced echocardiographers who had not participated in drafting the guidelines, sensitivity was 88±5%, and specificity was 91±7%. Fleiss κ-value for the agreement in group III was 0.76. In group IV of 7 other fellows, sensitivity was 91±3%, and specificity was 92±5%. Fleiss κ-value for the agreement in group IV was 0.89. Conclusions: There is a good level of agreement and accuracy in the estimation of LV filling pressure using the American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 recommendations update, irrespective of the experience level of the observer.
- Published
- 2019
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