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1. Oral Abstract session: Stress echo in clinical practice: Friday 5 December 2014, 08: 30–10: 00Location: Agora

Author: Teramoto, K, Suzuki, K, Satoh, Y, Minami, K, Mizukoshi, K, Kamijima, R, Kou, S, Takai, M, Izumo, M, and Akashi, YJ
Published: 2014

2. Poster Session Saturday 14 December - AM: 14/12/2013, 08: 30–12: 30Location: Poster area

Author: Machida, T, Izumo, M, Suzuki, K, Kaimijima, R, Mizukoshi, K, Manabe-Uematsu, M, Takai, M, Harada, T, and Akashi, YJ
Published: 2013

3. Poster session Friday 13 December - PM: 13/12/2013, 14: 00–18: 00Location: Poster area

Author: Izumo, M, Takeuchi, M, Seo, Y, Yamashita, E, Suzuki, K, Ishizu, T, Sato, K, Aonuma, K, Otsuji, Y, and Akashi, YJ
Published: 2013

4. Algorithmic versus expert human interpretation of instantaneous wave-Free Ratio (iFR) coronary pressure-wire pullback data

Author: Cook, C, Takayuki, W, Howard, J, Keeble, TR, Iglesias, JF, Schampaert, E, Bhindi, R, Ambrosia, A, Matsuo, H, Nishina, H, Kikuta, Y, Shiono, Y, Nakayama, M, Doi, S, Takai, M, Goto, S, Yakuta, Y, Karube, K, Akashi, YJ, Clesham, GJ, Kelly, PA, Davies, JR, Karamasis, GV, Kawase, Y, Robinson, NM, Sharp, ASP, Escaned, J, Davies, J, and Wellcome Trust
Subjects: RISK, Science & Technology, Cardiac & Cardiovascular Systems, coronary physiology, percutaneous coronary intervention, IFR, artificial intelligence, instantaneous wave-free ratio, DISEASE, surgical procedures, operative, INCREMENTAL PROGNOSTIC VALUE, Cardiovascular System & Hematology, Cardiovascular System & Cardiology, REVASCULARIZATION, cardiovascular diseases, Life Sciences & Biomedicine, 1102 Cardiorespiratory Medicine and Haematology
Abstract: Background Interpretation of instantaneous wave-Free Ratio (iFR) pressure-wire pullback data can be complex and is subjective. Objectives To investigate if algorithmic interpretation (AI) of iFR pressure-wire pullback data would be non-inferior to expert human interpretation. Methods Fifteen human experts interpreted 1008 iFR pullback traces (691 unique, 317 duplicate). For each trace, experts determined the hemodynamic appropriateness for percutaneous coronary intervention (PCI), and in such cases, the optimal physiological strategy for PCI. The Heart Team (HT) interpretation was determined by consensus of the individual expert opinions. The same 1008 pullback traces were also interpreted algorithmically. The co-primary hypotheses of this study were that AI would be non-inferior to that of the median expert human in determining 1) the hemodynamic appropriateness for PCI, and 2) the physiological strategy for PCI. Results Regarding the hemodynamic appropriateness for PCI, the median expert human demonstrated 89.3% agreement with the HT in comparison to 89.4% for AI (p
Published: 2019

5. International Expert Consensus Document on Takotsubo Syndrome (Part II): Diagnostic Workup, Outcome, and Management

Author: Ghadri, Jr, Wittstein, I, Prasad, A, Sharkey, S, Dote, K, Akashi, Yj, Cammann, Vl, Crea, Filippo, Galiuto, Leonarda, Desmet, W, Yoshida, T, Manfredini, R, Eitel, I, Kosuge, M, Nef, Hm, Deshmukh, A, Lerman, A, Bossone, E, Citro, R, Ueyama, T, Corrado, D, Kurisu, S, Ruschitzka, F, Winchester, D, Lyon, Ar, Omerovic, E, Bax, Jj, Meimoun, P, Tarantini, G, Rihal, C, Y-Hassan, S, Migliore, F, Horowitz, Jd, Shimokawa, H, Lüscher, Tf, Templin, C, Crea F (ORCID:0000-0001-9404-8846), Galiuto L (ORCID:0000-0002-6831-479X), Ghadri, Jr, Wittstein, I, Prasad, A, Sharkey, S, Dote, K, Akashi, Yj, Cammann, Vl, Crea, Filippo, Galiuto, Leonarda, Desmet, W, Yoshida, T, Manfredini, R, Eitel, I, Kosuge, M, Nef, Hm, Deshmukh, A, Lerman, A, Bossone, E, Citro, R, Ueyama, T, Corrado, D, Kurisu, S, Ruschitzka, F, Winchester, D, Lyon, Ar, Omerovic, E, Bax, Jj, Meimoun, P, Tarantini, G, Rihal, C, Y-Hassan, S, Migliore, F, Horowitz, Jd, Shimokawa, H, Lüscher, Tf, Templin, C, Crea F (ORCID:0000-0001-9404-8846), and Galiuto L (ORCID:0000-0002-6831-479X)
Abstract: The clinical expert consensus statement on takotsubo syndrome (TTS) part II focuses on the diagnostic workup, outcome, and management. The recommendations are based on interpretation of the limited clinical trial data currently available and experience of international TTS experts. It summarizes the diagnostic approach, which may facilitate correct and timely diagnosis. Furthermore, the document covers areas where controversies still exist in risk stratification and management of TTS. Based on available data the document provides recommendations on optimal care of such patients for practising physicians.
Published: 2018

6. International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical Characteristics, Diagnostic Criteria, and Pathophysiology

Author: Ghadri, Jr, Wittstein, I, Prasad, A, Sharkey, S, Dote, K, Akashi, Yj, Cammann, Vl, Crea, Filippo, Galiuto, Leonarda, Desmet, W, Yoshida, T, Manfredini, R, Eitel, I, Kosuge, M, Nef, Hm, Deshmukh, A, Lerman, A, Bossone, E, Citro, R, Ueyama, T, Corrado, D, Kurisu, S, Ruschitzka, F, Winchester, D, Lyon, Ar, Omerovic, E, Bax, Jj, Meimoun, P, Tarantini, G, Rihal, C, Y-Hassan, S, Migliore, F, Horowitz, Jd, Shimokawa, H, Lüscher, Tf, Templin, C, Crea F (ORCID:0000-0001-9404-8846), Galiuto L (ORCID:0000-0002-6831-479X), Ghadri, Jr, Wittstein, I, Prasad, A, Sharkey, S, Dote, K, Akashi, Yj, Cammann, Vl, Crea, Filippo, Galiuto, Leonarda, Desmet, W, Yoshida, T, Manfredini, R, Eitel, I, Kosuge, M, Nef, Hm, Deshmukh, A, Lerman, A, Bossone, E, Citro, R, Ueyama, T, Corrado, D, Kurisu, S, Ruschitzka, F, Winchester, D, Lyon, Ar, Omerovic, E, Bax, Jj, Meimoun, P, Tarantini, G, Rihal, C, Y-Hassan, S, Migliore, F, Horowitz, Jd, Shimokawa, H, Lüscher, Tf, Templin, C, Crea F (ORCID:0000-0001-9404-8846), and Galiuto L (ORCID:0000-0002-6831-479X)
Abstract: Takotsubo syndrome (TTS) is a poorly recognized heart disease that was initially regarded as a benign condition. Recently, it has been shown that TTS may be associated with severe clinical complications including death and that its prevalence is probably underestimated. Since current guidelines on TTS are lacking, it appears timely and important to provide an expert consensus statement on TTS. The clinical expert consensus document part I summarizes the current state of knowledge on clinical presentation and characteristics of TTS and agrees on controversies surrounding TTS such as nomenclature, different TTS types, role of coronary artery disease, and etiology. This consensus also proposes new diagnostic criteria based on current knowledge to improve diagnostic accuracy.
Published: 2018

7. SAT0369 Heterogeneity in the underlining pathogenesis in patients with connective tissue disease-associated borderline mean pulmonary arterial pressure and its distinctive hemodynamic characteristics from those with normal pulmonary arterial pressure

Author: Yamasaki, Y, primary, Asari, Y, additional, Tsuchida, K, additional, Suzuki, K, additional, Akashi, YJ, additional, Okazaki, T, additional, Ozaki, S, additional, and Yamada, H, additional
Published: 2017
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8. Poster session 1GENERAL PRINCIPLESP194Ultrasound indexes of adipose tissue and lipid goals attainment in high and very high cardiovascular risk patientsTHE IMAGING EXAMINATIONP195Right ventricular global longitudinal strain provides higher prognostic value than right free wall longitudinal strain in patients with left heart diseaseP196Normal values of echocardiographlc left and right cardiac chambers dimensions as multifactorially determined by sex, level of physical activity, age, BMI, systolic blood pressure and heart rateAnatomy and physiology of the heart and great vesselsP197Echocardiographic phenotypes according to levels of oxygen consumption at peak exercise: findings from the EURO(pean) EX(ercise) population-based studyAnatomy and physiology of the heart and great vesselsP198Systemic vascular resistance and central arterial stiffness in relation to left ventricular geometry and diastolic function in essential hypertensionAssessment of diameters, volumes and massP199Left atrial diameter predicts a new diagnosis of paroxysmal atrial fibrillation in a population presenting with palpitationsP200Interventricular septum thickness and acute coronary syndromes: small differences, big prognostic influence?P201Detection of abdominal aortic aneurysm in a population referred for an ultrasonographyAssessments of haemodynamicsP202The ultrasound vector velocity method transverse oscillation validated in a flowrig with constant and pulsatile flow and in-vivo of blood flow in the ascending aortaASSESSMENT OF SYSTOLIC FUNCTIONP203Different types of left ventrical remodeling in children with arterial hypertensionP204Assessment of myocardial performance index in hypertensive patients with or without hyperuricemiaP205Strain echocardiography detects mild impairment of systolic function in patients with frequent premature ventricular contractionsP206Speckle tracking strain correlates better with functional capacity and hemodynamic burden than ejection fraction in patients with severe heart failureP207Prognostic value of 2D and 3D echocardiographic volumes, ejection fraction and strain as markers of abnormal left ventricular performanceP208Long-term prognostic value of left ventricular ejection fraction assessed by echocardiography and magnetic resonance imaging after acute STEMIP209Assessment of left ventricular function after percutaneous coronary intervention of chronic total occluded coronary artery by speckle tracking and cardiac magnetic resonanceP210Physiologic variations of tricuspid annular plane systolic excursion in healthy subjects: clinical and echocardiographic correlatesP211Predictors of incipient ventricular dysfunction with tyrosine kinase inhibitors in metastatic renal cell carcinomaAssessment of diastolic functionP212Disagreement between the American Society of Echocardiography (ASE) and gastroenterology-based guidelines for the diagnosis of diastolic dysfunction among patients with advanced liver diseaseP213Nomograms for mitral inflow doppler and tissue doppler velocities in caucasian childrenP215Diastolic function is impaired in women with angina pectoris and no obstructive coronary artery disease independently of coronary microvascular functionP216Clinical value of myocardial performance index in patients with isolated diastolic dysfunctionIschemic heart diseaseP217Cardiac imaging strategy is clinically more effective and at lower cost than traditional ETT strategy for the diagnosis of stable coronary artery diseaseP218Does the ESC clinical pretest probability score stratify our patients correctly? Validation with stress echocardiographyP219Incremental value of exercise echocardiography over exercise electrocardiography in a chest pain unit: a decision curve analysisP220A bedside echocardiographic score for risk stratification of ST-elevation myocardial infarction patients undergoing primary percutaneous coronary interventionP221Interventricular and intraventricular dyssynchrony in patients with Q-wave acute myocardial infarctionP222Comparison of tagging and tissue tracking for myocardial strain assessment at 1.5T and 3.0T following ST-segment elevation myocardial infarctionP223Left atrial strain rate evaluated by two-dimensional speckle tracking is predictor of left ventricular arrhythmias in STEMI patients treated by primary PCIP224Impact of percutaneous coronary intervention of chronic total oclussion on left ventricular function using speckle tracking and cardiac magnetic resonanceHeart valve DiseasesP225Clinical and echocardiographic characteristics of patients with low flow severe aortic stenosis and preserved ejection fractionP226Ventricular-arterial interplay in patients with severe aortic stenosis: additional role of wave intensity analysisP227Degenerative aortic stenosis: don't forget the vascular componentP228Reclassifying low gradient aortic stenosis with 3D transesophageal echocardiography and global longitudinal strainP229Importance of mitral regurgitation on pre- and postoperative clinical status and echocardiographic findings in patients with severe aortic stenosis admitted for aortic valve replacementsP230Aorto-septal angle and degenerative aortic stenosis: a case-control study stenosisP231Difference of sST2 level in mitral stenosis compare with control subjectsP232Velocity-time integral of aortic regurgitation: a novel echocardiographic marker in the evaluation of aortic regurgitation severityP233Color doppler 3D echocardiography-derived regurgitant volume in primary mitral regurgitation: a comparison of different techniques with magnetic resonanceP234Outcome of surgery for degenerative mitral regurgitationP235Mitral valve repair or replacement for functional regurgitation and left ventricular dysfunction: clinical and echocardiographic outcomeP236Prevalence, characteristics and prognosis of moderate to severe tricuspid regurgitation in patients with precapillary pulmonary hypertensionP237Management of late bioprosthetic mitral valve thrombosisP238Relationship between pulmonary venous flow and prosthetic mitral valve thrombosisP239Transcatheter aortic valve implantation does not reduce acutely valvuloarterial impedance in an elderly population with degenerative calcific aortic valve stenosisP240Influence of type of prosthesis on mitral regurgitation change after transcatheter aortic valve replacement for aortic stenosisP241The prevalence of valve disease in patients undergoing atrial fibrillation ablationCardiomyopathiesP242The prognostic value of lung ultrasound at discharge in heart failureP243Prognostic value of global longitudinal strain in non-ischaemic dilated cardiomyopathyP244Additional effect of high intensity exercise training to cardiac resynchronization in heart failure: the reduction on left venticular massP245Dobutamine-induced changes of longitundinal strain predicts longterm mortality in severe heart failureP246Myocardial fibrosis is not related to two-dimensional longitudinal strain in dilated cardiomyopathyP247Echocardiographic parameters are predictors of positive genetic study in a Portuguese population with hypertrophic cardiomyopathy: a multicentre studyP248Myocardial deformation techniques for the evaluation of the right ventricle in fabry diseaseP249Borderline hypertrophic cardiomyopathy or athlete's heart: what is the role for genetic testing in athletes?P250Isolated papillary muscle hypertrophy. Clinical, electrocardiographic and morphologic characteristicsP251Prognostic value of the assessment of left atrial deformation in hypertrophic cardiomyopathyP252Assessment of subtle echocardiographic changes may improve risk stratification of arrhythmias in early stages of arrhythmogenic right ventricular cardiomyopathy (ARVC)P253Long-term correlation of electrocardiography with structural echocardiography changes in patients with arrhythmogenic right ventricular cardiomyopathyP254Right ventricular strain and dyssynchrony assessment in arrhythmogenic right ventricular cardiomyopathy: a cardiac magnetic resonance feature-tracking studyP255Association of non compaction and hypertrophic cardiomyopathies, Noonan and long QT syndromesP256Predictors of mortality in patients with acute myocarditisP257Clinical characteristics and natural history of acute myocarditisP258One-beat 3dimensional echocardiography for the assessment of right ventricular function in heart transplant recipientsP259Hemodynamically irrelevant, non-surgery related pericardial effusion is a predictor of mortality in heart transplanted patientsSystemic diseases and other conditionsP260Left ventricular function as a cardiac marker of target organ damage in non-diabetic, never treated hypertensive patients: Camparison with microalbuminuriaP261Subclinical myocardial dysfunction in hypertensive patients with hyperuricemiaP262Can deformation indices (strain/strain rate) establish differential diagnosis in infiltrative cardiomyopathies?P263Prevalence and factors associated with inappropriately high left ventricular mass in patients with rheumatoid arthritisP264Echocardiographic evaluation of patients with end-stage liver disease, the importance of follow up after liver transplantationP265Cardiovasclular involvement in asymptomatic juvenile localized scleroderma patientsP267Can the left ventricular mechanics using speckle tracking echocardiography in pregnancy predict the new onset heart failure?P268What causes impaired exercise tolerance in HFpEF? Relative contribution from LV filling pressure and other factorsCongenital heart diseaseP269Pregnancy in patients with Ebsteins anomaly - echocardiographic and clinical studyP270Double aortic arch anomalies in clinical practiceP271Echocardiography as the essential imaging modality in congenital heart disease - first one to begin with and the one who staysMasses, tumors and sources of embolismP272Can the reduction of wall shear stress in diskinetic myocardial wall segments be used to predict trombogenicity?Diseases of the aortaP273The role of modified transoesophageal echocardiography for optimal access decision making for transcatheter aortic valve replacement proceduresStress echocardiographyP274Is aortic valve resistance different in patients with severe aortic stenosis and left ventricular fraction below 40% with low or high gradient?P275Does wall motion score index in dobutamine stress echocardiography predict syntax score in catheterization lab?P276Sex-related differences in peak stress left ventricular global longitudinal strain during dobutamine stress echocardiography in patients with significant coronary artery diseaseP277Exercise stress echocardiography complications: a 4-year single center experienceP278Reduced baseline left ventricular longitudinal systolic function is a marker of inducible myocardial ischemia in patients undergoing exercise echocardiographyP279Estimation of mean pulmonary arterial pressure based on right ventricle systolic pressure observed from exercise echocardiography among non-pulmonary hypertension with systemic sclerosisTransesophageal echocardiographyP280Transoesophageal echocardiography in patients with neuroendocrine tumour and carcinoid symptoms is safe without intravenous octreotideP281The feasibility and the clinical benefit of the cognitive-behavioral intervention for preparing patients for transesophageal echocardiographic studyP282Dynamic changes of mitral annulus shape in different types of mitral valve prolapse. A three-dimensional transoesophageal studyReal-time three-dimensional TEEP283Severe aortic stenosis: evaluation of effective and anatomy valve by 2D transthoracic echocardiography and 3D transesophageal echocardiographyP2843D-transeosphageal echocardiography usefulness for assessment of cardiac output in intensive care unit: an ultrasound versus thermodilution comparative study for patients under mechanical ventilationP285The predictive value of three-dimensional vena-contracta in determining the number of MitraClip devices needed during the procedure in functional mitral regurgitationTissue Doppler and speckle trackingP286Should the septum be included in the assessment of right ventricular longitudinal strain?P287Can machine learning help to identify heart failure with preserved ejection fraction?P288Concordance of atrial function measurement by 3D volumetric echocardiography and speckle tracking deformation imagingP289Heterogonous regional diastolic function revealed by 2D speckle tracking echocardiography identifies patients with ischemic etiology of left ventricular systolic dysfunctionP290The values from Real time 3-dimensional strain is not independent from preload changesP291Risk stratification in hypertrophic cardiomyopathy. a potential role for speckle-tracking parameters by cardiac magnetic resonanceP292Abnormal longitudinal peak systolic strain in asymptomatic patients with type-I diabetes mellitusP294Strain evaluation of subclinical cardiac dysfunction in patients with myotonic dystrophy type 1P295Heart function assessment in perinatal asphyxia; speckle tracking indices from greyscale recordings perform better than from tissue Doppler recordings, fractional shortening and tissue Doppler indicesP297Longitudinal strain assessed by automatic function imaging - a useful tool in significant coronary artery disease detection in patients with low risk anginaP298Global 2-Dimensional strain as a predictor of mortality in heart transplant patients with cardiac allograft vasculopathyP299Two-dimensional longitudinal strain and strain rate in asymptomatic middle-aged patients with type 2 diabetes mellitus - a pilot study resultsP300Limited accuracy of myocardial deformation imaging in diagnosis of left ventricular segmental dysfunction in patients with acute myocardial infarction: is it only a limitation of the strain software?Computed Tomography & Nuclear CardiologyP301Evaluation of the actual prevalence of myocardial ischemia in patients prior to performing a peripheral vascular surgeryP302Prognostic value of myocardial ischemia detected by myocardial perfusion imaging in asymptomatic patients with diabetes type 2P303Economic cost analysis derived by coronary computed tomography angiography inappropriate indications to rule out coronary heart disease

Author: Haberka, M, primary, Garcia Martin, A, primary, Barbier, P, primary, Pellegrino, M, primary, Angelis, A, primary, Howlett, PJ, primary, Madeira, M, primary, Carrero, PJ, primary, Hansen, KL, primary, Trunina, I, primary, Basar, C, primary, Lie, OH, primary, Sade, LE, primary, Gopal, A S, primary, Klug, G, primary, Rodriguez Gonzalez, E, primary, Ferrara, F, primary, Moustafa, S, primary, Naksuk, N, primary, Cantinotti, M, primary, Michelsen, MM, primary, Fernandes, JMG, primary, Demir, OM, primary, Cano Carrizal, R, primary, Bouzas-Mosquera, A, primary, Leao, S, primary, Kuznetsov, VA, primary, Nazir, S A, primary, Trifunovic, D, primary, Spampinato, RA, primary, Antonini-Canterin, F, primary, Ribeiro, JM, primary, Morgado, GJ, primary, Reis, L, primary, Naratrekoon, B, primary, Soto-Ruiz, RM, primary, Penicka, M, primary, Zilberszac, R, primary, De Chiara, B, primary, Rifai, R, primary, Gunduz, S, primary, Cersit, S, primary, Devecchi, C, primary, Ancona, F, primary, Smith, D, primary, Gargani, L, primary, Asmarats Serra, L, primary, Abreu, A, primary, Ikonomidis, I, primary, Biernacka, B, primary, Gomes, AC, primary, Caballero, L, primary, Mansencal, N, primary, Venturini, C, primary, Zaroui, A, primary, Leren, I S, primary, Astrom Aneq, M, primary, Nucifora, G, primary, Rocon, CRLA, primary, Cho, J Y, primary, Stampfli, S F, primary, Cho, EJ, primary, Stevanovic, A, primary, Pena, J L, primary, Ognibeni, F, primary, Colunga, S, primary, Borowiec, A, primary, Hristova, K, primary, Kosmala, W, primary, Lesniak-Sobelga, A M, primary, Kaldararova, M, primary, Stanojevic, D, primary, Carbonell San Roman, A, primary, Hoetink, A, primary, Ferreira, R, primary, Rohani, A, primary, Wierzbowska-Drabik, K, primary, Carvalho, J F, primary, Cherubini, A, primary, Teramoto, K, primary, May, CJH, primary, Wejner-Mik, P, primary, Gurzun, M M, primary, Perea, GO, primary, Laveau, F, primary, Mahmoud, HM, primary, Sanz, M, primary, Sanchez-Martinez, S, primary, Montserrat, S, primary, Kowalczyk, E, primary, Park, CS, primary, Hinojar, R, primary, Van Berendoncks, A M, primary, Guedes, H, primary, Nestaas, E, primary, Onut, R, primary, Moran, L, primary, Kisko, A, primary, Agmon, Y, primary, Corneli, M, primary, Peovska Mitevska, IPM, primary, Barreiro Perez, M, primary, Banska, K, additional, Gasior, Z, additional, Moya-Mur, JL, additional, Carbonell-San Roman, S-A, additional, Rodriguez-Munoz, D, additional, Garcia-Lledo, A, additional, Casas-Rojo, E, additional, Hinojar, R, additional, Jimenez-Nacher, JJ, additional, Fernandez-Golfin, C, additional, Zamorano-Gomez, JL, additional, Ravani, A, additional, Cefalu, C, additional, Maltagliati, A, additional, Frigerio, B, additional, Sansaro, D, additional, Amato, M, additional, Baldassarre, D, additional, Bandera, F, additional, Generati, G, additional, Labate, V, additional, Alfonzetti, E, additional, Guazzi, M, additional, Aggeli, K, additional, Ioakeimidis, N, additional, Abdelrasoul, M, additional, Felekos, I, additional, Gourgouli, I, additional, Aznaouridis, K, additional, Rousakis, G, additional, Vlachopoulos, C, additional, Tousoulis, D, additional, Darasz, K, additional, Mahmoudi, M, additional, Shah, N, additional, Jabr, RI, additional, Hickman, M, additional, Leatham, EW, additional, Fry, CH, additional, Teixeira, R, additional, Almeida, I, additional, Caetano, F, additional, Fernandes, A, additional, Cassandra, M, additional, Reis, L, additional, Costa, M, additional, Goncalves, L, additional, Nielsen, AJ, additional, Carrero, MC, additional, Saubidet, GL, additional, Peralta, SP, additional, Moeller-Soerensen, H, additional, Kjaergaard, J, additional, Jensen, MB, additional, Lund, JT, additional, Pedersen, MM, additional, Olesen, JB, additional, Jensen, JA, additional, Nielsen, MB, additional, Sharykin, AS, additional, Karelina, EV, additional, Telezhnikova, ND, additional, Ozhan, H, additional, Kayapinar, O, additional, Albayrak, ES, additional, Saberniak, J, additional, Dejgaard, L, additional, Nestaas, E, additional, Edvardsen, T, additional, Haugaa, KH, additional, Bal, U, additional, Eroglu, S, additional, Pirat, B, additional, Muderrisoglu, H, additional, Muthukumar, L, additional, Saha, SK, additional, Toole, RS, additional, Reinstadler, S, additional, Feistritzer, HJ, additional, Pernter, B, additional, Mayr, A, additional, Franz, WM, additional, Mueller, S, additional, Metzler, B, additional, Mingo Santos, S, additional, Palomero Monivas, V, additional, Gonzalez Mirelis, J, additional, Goirigolzarri Artaza, J, additional, Zorita Gil, B, additional, Fernandez Diaz, JA, additional, Goicolea Ruigomez, J, additional, Restrepo Cordoba, MA, additional, Alonso Pulpon, L, additional, Gargani, L, additional, D'alto, M, additional, Ghio, S, additional, Acri, E, additional, Carannante, L, additional, Argiento, P, additional, D'andrea, A, additional, Vriz, O, additional, Bossone, E, additional, Ho, TH, additional, Shah, P, additional, Murphy, 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additional, Yingchoncharoen, T, additional, Vathesatogkit, P, additional, Yamwong, S, additional, Sritara, P, additional, Bonaque Gonzalez, J C, additional, Abellan-Huerta, J, additional, Rubio-Paton, R, additional, Soria, F, additional, Ramos, JL, additional, Egea, S, additional, Garcia-Gomez, J, additional, Martinez Diaz, JJ, additional, Castillo, JA, additional, Vecera, J, additional, Mirica, C, additional, Kotrc, M, additional, Kockova, R, additional, Gabriel, H, additional, Maurer, G, additional, Rosenhek, R, additional, Botta, L, additional, Musca, F, additional, Belli, O, additional, Costetti, A, additional, Trolese, I, additional, Spano, F, additional, Russo, C, additional, Giannattasio, C, additional, Moreo, A, additional, Berthelot, E, additional, Le, MT, additional, Hilpert, L, additional, Montani, D, additional, Sitbon, O, additional, Jais, X, additional, Humbert, M, additional, Assayag, P, additional, Yesin, M, additional, Kalcik, M, additional, Gursoy, MO, additional, Cersit, S, additional, Astarcioglu, MA, additional, Karakoyun, S, additional, Aykan, AC, additional, Ozkan, M, additional, Gunduz, S, additional, Tabakci, M, additional, Bayam, E, additional, Degiovanni, A, additional, Di Ruocco, MV, additional, Marino, P, additional, Rosa, I, additional, Stella, S, additional, Barletta, M, additional, Marini, C, additional, Latib, A, additional, Montorfano, M, additional, Colombo, A, additional, Margonato, A, additional, Agricola, E, additional, Ray, R, additional, Gallagher, M, additional, Nazir, M, additional, Perreso, V, additional, Sharma, R, additional, Pang, PS, additional, Miglioranza, M, additional, Landi, P, additional, Dini, FL, additional, Picano, E, additional, Pons Llinares, J, additional, Macaya Ten, F, additional, Pericas Ramis, P, additional, Caldes Llull, O, additional, Grau Sepulveda, A, additional, Frontera, G, additional, Bethencourt, A, additional, Santa Clara, H, additional, Santos, V, additional, Oliveira, M, additional, Cunha, P, additional, Portugal, G, additional, Rio, P, additional, Branco, L, additional, Ferreira, R, additional, Mota Carmo, M, additional, Paraskevaidis, I, additional, Papadopoulos, C, additional, Stasinos, V, additional, Parissis, J, additional, Lekakis, J, additional, Rubis, P, additional, Gackowski, A, additional, Wisniowska-Smialek, S, additional, Lesniak-Sobelga, A, additional, Kostkiewicz, M, additional, Bento, D, additional, Correia, E, additional, Teles, L, additional, Picarra, B, additional, Lourenco, C, additional, Faria, R, additional, Domingues, K, additional, Azevedo, O, additional, Climent Paya, V, additional, Martinez Moreno, M, additional, Gimeno, JR, additional, Oliva, MJ, additional, Saura, D, additional, Sanchez Quinones, J, additional, Garcia Honrubia, A, additional, Valdes, M, additional, De La Morena, G, additional, Richard, P, additional, Guerard, S, additional, Brion, R, additional, Paul, P, additional, Dubourg, O, additional, Komajda, M, additional, Isnard, R, additional, Arslan, M, additional, Charron, P, additional, Avegliano, G, additional, Andres, S, additional, Costabel, JP, additional, Kuschnir, P, additional, Sciancalepore, A, additional, Mendoza, O, additional, Perea, G, additional, Ronderos, R, additional, Ben Said, RYM, additional, EL Chalbia, TEJ, additional, Wali, SANA, additional, Mourali, MS, additional, Mechmeche, RACHID, additional, Haland, TF, additional, Svetlichnaya, J S, additional, Shikha, SS, additional, Scheinmann, MS, additional, Klein, LK, additional, Prati, G, additional, Vitrella, G, additional, Allocca, G, additional, Cukon Buttignoni, S, additional, Muser, D, additional, Morocutti, G, additional, Pinamonti, B, additional, Sinagra, G, additional, Proclemer, A, additional, Melo, MDTM, additional, Bocchi, EAB, additional, Araujo, JABAF, additional, Demarchi, LMMFD, additional, Mady, CM, additional, Biselli, BB, additional, Kalil, RKF, additional, Salemi, VMCS, additional, Tuma, RT, additional, Kim, K H, additional, Yoon, H J, additional, Lee, K J, additional, Park, H, additional, Kim, J H, additional, Ahn, Y, additional, Jeong, M H, additional, Cho, J G, additional, Park, J C, additional, Park, H J, additional, Kozan, H, additional, Sezgin, A, additional, Aydinalp, A, additional, Oezkartal, T, additional, Bernhart, S, additional, Flammer, AJ, additional, Vecchiati, A, additional, Froehlich, GM, additional, Ruschitzka, F, additional, Tanner, FC, additional, Choi, KY, additional, Kim, DB, additional, Jang, SW, additional, Cho, JS, additional, Park, CS, additional, Jung, HO, additional, Jeon, HK, additional, Youn, HJ, additional, Dekleva, M, additional, Fortes, PRL, additional, Passos, BR, additional, Rodrigues, AB, additional, Sampaio, IH, additional, Oliveira, MCN, additional, Silva, MG, additional, Cardoso, RAF, additional, Tofani, FA, additional, Moreira, MCV, additional, Cioffi, G, additional, Viapiana, O, additional, Dalbeni, A, additional, Fracassi, E, additional, Di Nora, C, additional, Cherubini, A, additional, Mazzone, C, additional, Di Lenarda, A, additional, Rossini, M, additional, Corros, C, additional, Garcia-Campos, A, additional, Martin, M, additional, Rodriguez-Suarez, M, additional, Leon, V, additional, Fidalgo, A, additional, Lopez-Iglesias, F, additional, Moris, C, additional, De La Hera, JM, additional, Dabrowski, R, additional, Wozniak, J, additional, Jasek, S, additional, Chwyczko, T, additional, Kowalik, I, additional, Musiej-Nowakowska, E, additional, Szwed, H, additional, Marinov, R, additional, Stamenov, G, additional, Mihova, M, additional, Chacheva, K, additional, Persenska, S, additional, Racheva, A, additional, Przewlocka-Kosmala, M, additional, Rojek, A, additional, Karolko, B, additional, Mysiak, A, additional, Marwick, TH, additional, Biernacka, B, additional, Tittel, P, additional, Kardos, M, additional, Vrsanska, V, additional, Ondriska, M, additional, Hraska, V, additional, Nosal, M, additional, Masura, J, additional, Simkova, I, additional, Apostolovic, S, additional, Salinger-Martinovic, S, additional, Jankovic-Tomasevic, R, additional, Djordjevic-Radojkovic, D, additional, Stanojlovic, T, additional, Atanaskovic, V, additional, Pavlovic, M, additional, Tahirovic, E, additional, Dungen, HD, additional, Moya Mur, JL, additional, Lozano Granero, C, additional, Jimenez Nacher, JJ, additional, Gonzalez Gomez, A, additional, Fraile Sanz, C, additional, Segura De La Cal, T, additional, Zamorano Gomez, JL, additional, Jansen Klomp, WW, additional, Van 'T Hof, AWJ, additional, Brandon Bravo Bruinsma, GJ, additional, Spanjersberg, AJ, additional, Grandjean, J, additional, Nierich, AP, additional, Ferreira, J, additional, Lazaro Mendes, S, additional, Martins, R, additional, Monteiro, S, additional, Pego, M, additional, Khamene Bagheri, R, additional, Peruga, JZ, additional, Sobczak, M, additional, Plewka, M, additional, Wcislo, T, additional, Krecki, R, additional, Kasprzak, JD, additional, Morgado, G, additional, Cruz, I, additional, Almeida, AR, additional, Joao, I, additional, Lopes, L, additional, Cotrim, C, additional, Faganello, G, additional, Pandullo, C, additional, Russo, G, additional, Stefenelli, C, additional, Furlanello, F, additional, Tarantini, L, additional, Suzuki, K, additional, Satoh, Y, additional, Minami, K, additional, Mizukoshi, K, additional, Kamijima, R, additional, Kou, S, additional, Takai, M, additional, Izumo, M, additional, Akashi, YJ, additional, Ayuk, J, additional, Geh, I, additional, Shah, T, additional, Edwards, NC, additional, Steeds, RP, additional, Miskowiec, D, additional, Wdowiak-Okrojek, K, additional, Lipiec, P, additional, Rosca, M, additional, Calin, A, additional, Beladan, C, additional, Serban, M, additional, Ginghina, C, additional, Popescu, BA, additional, Lombardero, M, additional, Henquin, R, additional, Corneli, M, additional, Tinetti, M, additional, Hekimian, G, additional, Achkar, M, additional, Combes, A, additional, Hammoudi, N, additional, Al-Ghamdi, M, additional, Ghabashi, A, additional, Ezzat, M H, additional, Al-Amin, A, additional, Giraldeau, G, additional, Sarvari, SI, additional, Marin, J, additional, Brambila, C, additional, Gabrielli, L, additional, Bijnens, B, additional, Sitges, M, additional, Duchateau, N, additional, Erdei, T, additional, Fraser, A, additional, Bijnens, B H, additional, Piella, G, additional, Sanchis, L, additional, Borras, R, additional, Vidal, B, additional, Prat, S, additional, Azqueta, M, additional, Pare, C, additional, Grazioli, G, additional, Sanz, M, additional, Wejner-Mik, P, additional, Jung, MH, additional, Ahn, HS, additional, Kim, JH, additional, Megias, A, additional, Alonso, GL, additional, Gonzalez-Gomez, A, additional, Rincon, LM, additional, Esteban, A, additional, Fernandez Mendez, MA, additional, Barrios, V, additional, Zamorano, JL, additional, Van Gaal, L, additional, De Block, C, additional, Salgado, R, additional, Vrints, C, additional, Shivalkar, B, additional, Pereira, A, additional, Santos, R, additional, Marques, L, additional, Moreno, N, additional, Carvalho, R, additional, Pires, M, additional, Sousa, R, additional, Andrade, A, additional, Pinto, P, additional, Stoylen, A, additional, Fugelseth, D, additional, Tautu, O, additional, Onciul, S, additional, Marinescu, C, additional, Zamfir, D, additional, Dorobantu, M, additional, Sanchez Sanchez, V, additional, Navas, P, additional, Garcia-Cosio, D, additional, Diaz, B, additional, Carballo-Alzola, L, additional, Lombera, F, additional, Delgado, J, additional, Babcak, M, additional, Kishko, N, additional, Eitan, A, additional, Mutlak, D, additional, Kehat, I, additional, Meretta, AH, additional, Perea, GO, additional, Belcastro, F, additional, Aguirre, E, additional, Rosa, D, additional, Zaefferer, P, additional, Masoli, O, additional, Srbinovska, ES, additional, Bosevski, MB, additional, Antova, EA, additional, Pop Gorceva, DPG, additional, Martin Fernandez, M, additional, Costilla Garcia, SM, additional, Diaz Pelaez, E, additional, and Moris De La Tassa, C, additional
Published: 2015
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9. Takotsubo cardiomyopathy: a new form of acute, reversible heart failure.

Author: Akashi YJ, Goldstein DS, Barbaro G, Ueyama T, Akashi, Yoshihiro J, Goldstein, David S, Barbaro, Giuseppe, and Ueyama, Takashi
Published: 2008
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10. 123I-BMIPP delayed scintigraphic imaging in patients with chronic heart failure.

Author: Kida K, Akashi YJ, Yoneyama K, Shimokawa M, Musha H, Kida, Keisuke, Akashi, Yoshihiro J, Yoneyama, Kihei, Shimokawa, Mitsuhiro, and Musha, Haruki
Abstract: Objective: The objective of the present study was to clarify the ability of 123I-beta-methyl-iodophenylpentadecanoic acid (123I-BMIPP) to evaluate the heart-to-mediastinum (H/M) ratio and myocardial global washout rate (WR) in patients with chronic heart failure (CHF). Methods: The severity of CHF was evaluated on the basis of the New York Heart Association (NYHA) classification. Twenty patients with CHF (13 with idiopathic dilated cardiomyopathy and 7 with ischemic cardiomyopathy) and 11 age-matched controls underwent myocardial radionuclide imaging. Scintigraphic images were obtained from each participant at the early (30 min following radio-isotope injection) and late (4 h) phases using 123I-BMIPP. The H/M ratio and WR were calculated from planar images. Concentrations of plasma brain natriuretic peptide (BNP) were measured prior to the scintigraphic study. Results: The 123I-BMIPP uptake of early H/M and global WR did not significantly differ among groups, but uptake of delayed H/M was significantly lower in patients with NYHA class III than in controls (control 2.47 +/- 0.39; class III 1.78 +/- 0.28, P < 0.05). The uptake of delayed H/M and global WR correlated with plasma log BNP in all participants (r = -0.38, P < 0.05; 0.43, P < 0.05, respectively). Conclusions: These data suggest that 123I-BMIPP uptake of delayed H/M enhances the image of CHF severity. The myocardial WR of 123I-BMIPP also effectively depicted the severity of CHF. [ABSTRACT FROM AUTHOR]
Published: 2008
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11. Prognosis and therapy approaches of cardiac cachexia [corrected] [published erratum appears in CURR OPIN CARDIOL 2006 Sep;21(5):528].

Author: Springer J, Filippatos G, Akashi YJ, and Anker SD
Published: 2006
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12. Left ventricular rupture associated with takotsubo cardiomyopathy.

Author: Akashi YJ, Tejima T, Sakurada H, Matsuda H, Suzuki K, Kawasaki K, Tsuchiya K, Hashimoto N, Musha H, Sakakibara M, Nakazawa K, and Miyake F
Abstract: A 70-year-old woman was admitted to the hospital with chest discomfort after quarreling with her neighbors. Electrocardiography revealed ST-segment elevation in leads I, II, III, aVL, aVF, and V2 through V6. Coronary angiography demonstrated normal arteries, but left ventriculography showed apical akinesis and basal hyperkinesis. Takotsubo cardiomyopathy was diagnosed on the basis of these characteristic findings. The creatine kinase and creatine kinase-MB concentrations were elevated at admission and reached maximum levels 6 hours after admission. The plasma level of brain natriuretic peptide was 10.7 pg/mL (reference range, <18.4 pg/mL) on the first hospital day. ST-segment elevation in leads I, II, III, aVL, aVF, and V2 through V6 persisted at 72 hours after admission. On the third hospital day, sudden rupture of the left ventricle occurred, and despite extensive resuscitation efforts, the patient died. Takotsubo cardiomyopathy presents in a manner similar to that of acute myocardial infarction, but ventricular systolic function usually returns to normal within a few weeks. To our knowledge, this is the first reported case of fatal left ventricular rupture associated with takotsubo cardiomyopathy. We suggest that takotsubo cardiomyopathy may be a newly recognized cause of sudden cardiac death. [ABSTRACT FROM AUTHOR]
Published: 2004

13. Poster session 1

Author: Haberka, M, Banska, K, Gasior, Z, Garcia Martin, A, Moya-Mur, JL, Carbonell-San Roman, S-A, Rodriguez-Munoz, D, Garcia-Lledo, A, Casas-Rojo, E, Hinojar, R, Jimenez-Nacher, JJ, Fernandez-Golfin, C, Zamorano-Gomez, JL, Barbier, P, Ravani, A, Cefalu, C, Maltagliati, A, Frigerio, B, Sansaro, D, Amato, M, Baldassarre, D, Pellegrino, M, Bandera, F, Generati, G, Labate, V, Alfonzetti, E, Guazzi, M, Angelis, A, Aggeli, K, Ioakeimidis, N, Abdelrasoul, M, Felekos, I, Gourgouli, I, Aznaouridis, K, Rousakis, G, Vlachopoulos, C, Tousoulis, D, Howlett, PJ, Darasz, K, Mahmoudi, M, Shah, N, Jabr, RI, Hickman, M, Leatham, EW, Fry, CH, PREDICT-PAF, Madeira, M, Teixeira, R, Almeida, I, Caetano, F, Fernandes, A, Cassandra, M, Reis, L, Costa, M, Goncalves, L, Carrero, PJ, Nielsen, AJ, Carrero, MC, Saubidet, GL, Peralta, SP, Argentina, Aorta Abdominal, Hansen, KL, Moeller-Soerensen, H, Kjaergaard, J, Jensen, MB, Lund, JT, Pedersen, MM, Olesen, JB, Jensen, JA, Nielsen, MB, Trunina, I, Sharykin, AS, Karelina, EV, Telezhnikova, ND, Basar, C, Ozhan, H, Kayapinar, O, Albayrak, ES, Lie, OH, Saberniak, J, Dejgaard, L, Nestaas, E, Edvardsen, T, Haugaa, KH, Sade, LE, Bal, U, Eroglu, S, Pirat, B, Muderrisoglu, H, Gopal, A S, Muthukumar, L, Saha, SK, Toole, RS, Klug, G, Reinstadler, S, Feistritzer, HJ, Pernter, B, Mayr, A, Franz, WM, Mueller, S, Metzler, B, Rodriguez Gonzalez, E, Mingo Santos, S, Palomero Monivas, V, Gonzalez Mirelis, J, Goirigolzarri Artaza, J, Zorita Gil, B, Fernandez Diaz, JA, Goicolea Ruigomez, J, Restrepo Cordoba, MA, Alonso Pulpon, L, Ferrara, F, Gargani, L, D'alto, M, Ghio, S, Acri, E, Carannante, L, Argiento, P, D'andrea, A, Vriz, O, Bossone, E, Moustafa, S, Ho, TH, Shah, P, Murphy, K, Nelluri, BK, Lee, H, Wilansky, S, Mookadam, F, Naksuk, N, Peeraphatdit, T, Chaiteerakij, R, Klarich, KW, Cantinotti, M, Scalese, M, Melo, M, Assanta, N, Marotta, M, Crocetti, M, Spadoni, I, Giordano, R, Kutty, S, Iervasi, I, Michelsen, MM, Mygind, ND, Pena, A, Frestad, D, Hoest, N, Prescott, E, Fernandes, JMG, Romao, BO, Rivera, IR, Mendonca, MA, Carvalho, AC, Campos, O, Amato, A, Moises, VA, Demir, OM, Bashir, A, Marshall, K, Douglas, M, Wasan, B, Plein, S, Alfakih, K, Cano Carrizal, R, Casanova Rodriguez, C, Cadenas Chamorro, R, Iglesias Del Valle, D, Martin-Penato Molina, A, De Juan Baguda, J, Prieto Moriche, E, Garcia Garcia, A, De La Cruz Berlanga, E, Plaza Perez, I, Bouzas-Mosquera, A, Peteiro, J, Broullon, FJ, Alvarez-Garcia, N, Barbeito-Caamano, C, Larranaga-Moreira, JM, Maneiro-Melon, N, Martinez-Ruiz, D, Yanez, JC, Vazquez-Rodriguez, JM, Leao, S, Cordeiro, F, Magalhaes, P, Moz, M, Trigo, J, Mateus, P, Fontes, P, Moreira, I, Kuznetsov, VA, Krinochkin, DV, Plusnin, AV, Soldatova, AM, Nazir, S A, Shetye, A, Khan, JN, Singh, A, Kanagala, P, Swarbrick, DJ, Graham-Brown, M, Mccann, GP, Trifunovic, D, Krljanac, G, Savic, L, Asanin, M, Aleksandric, S, Lasica, R, Srdic, M, Zlatic, N, Petrovic, M, Mrdovic, I, Rodriguez Gonzalez, E, Mingo Santos, S, Monivas Palomero, V, Gonzalez Mirelis, J, Zorita Gil, B, Fernandez Diaz, JA, Restrepo Cordoba, MA, Goirigolzarri Artaza, J, Rivero Arribas, B, Goicolea Ruigomez, J, Spampinato, RA, Dobrovie, M, Da Rocha E Silva, JG, Bonamigo Thome, F, Kluttig, R, Schloma, V, Dmitrieva, Y, Strotdrees, E, Mohr, FW, Antonini-Canterin, F, Luzza, G, Caruso, R, Belfiore, R, Della Mattia, A, Poli, S, Vriz, O, Zito, C, La Carrubba, S, Carerj, S, Ribeiro, JM, Teixeira, R, Goncalves, L, Morgado, GJ, Carvalho, JF, Gomes, AC, Caldeira, D, Cruz, IR, Stuart, B, Maia, R, Fazendas, P, Pereira, H, Trifunovic, D, Rakocevic, I, Tutos, V, Petrovic, O, Petrovic, M, Boricic-Kostic, M, Stepanovic, J, Jovanovic, I, Banovic, M, Vujisic-Tesic, B, Reis, L, Teixeira, R, Leite, L, Fernandes, A, Cassandra, M, Madeira, M, Botelho, A, Santos, M, Nascimento, J, Goncalves, L, Naratrekoon, B, Yingchoncharoen, T, Vathesatogkit, P, Yamwong, S, Sritara, P, Soto-Ruiz, RM, Bonaque Gonzalez, J C, Abellan-Huerta, J, Rubio-Paton, R, Soria, F, Ramos, JL, Egea, S, Garcia-Gomez, J, Martinez Diaz, JJ, Castillo, JA, Penicka, M, Vecera, J, Mirica, C, Kotrc, M, Kockova, R, Zilberszac, R, Gabriel, H, Maurer, G, Rosenhek, R, De Chiara, B, Botta, L, Musca, F, Belli, O, Costetti, A, Trolese, I, Spano, F, Russo, C, Giannattasio, C, Moreo, A, Rifai, R, Berthelot, E, Le, MT, Hilpert, L, Montani, D, Sitbon, O, Jais, X, Humbert, M, Assayag, P, Gunduz, S, Yesin, M, Kalcik, M, Gursoy, MO, Cersit, S, Astarcioglu, MA, Karakoyun, S, Aykan, AC, Ozkan, M, Cersit, S, Gunduz, S, Tabakci, M, Kalcik, M, Yesin, M, Bayam, E, Ozkan, M, Devecchi, C, Degiovanni, A, Di Ruocco, MV, Marino, P, Ancona, F, Rosa, I, Stella, S, Barletta, M, Marini, C, Latib, A, Montorfano, M, Colombo, A, Margonato, A, Agricola, E, Smith, D, Ray, R, Gallagher, M, Nazir, M, Perreso, V, Sharma, R, Gargani, L, Pang, PS, Miglioranza, M, Landi, P, Dini, FL, Picano, E, Asmarats Serra, L, Pons Llinares, J, Macaya Ten, F, Pericas Ramis, P, Caldes Llull, O, Grau Sepulveda, A, Frontera, G, Bethencourt, A, Abreu, A, Santa Clara, H, Santos, V, Oliveira, M, Cunha, P, Portugal, G, Rio, P, Branco, L, Ferreira, R, Mota Carmo, M, Ikonomidis, I, Paraskevaidis, I, Papadopoulos, C, Stasinos, V, Parissis, J, Lekakis, J, Biernacka, B, Rubis, P, Gackowski, A, Wisniowska-Smialek, S, Lesniak-Sobelga, A, Kostkiewicz, M, Gomes, AC, Bento, D, Correia, E, Teles, L, Picarra, B, Lourenco, C, Faria, R, Magalhaes, P, Domingues, K, Azevedo, O, Caballero, L, Climent Paya, V, Martinez Moreno, M, Gimeno, JR, Oliva, MJ, Saura, D, Sanchez Quinones, J, Garcia Honrubia, A, Valdes, M, De La Morena, G, Mansencal, N, Richard, P, Guerard, S, Brion, R, Paul, P, Dubourg, O, Komajda, M, Isnard, R, Arslan, M, Charron, P, Venturini, C, Avegliano, G, Andres, S, Costabel, JP, Kuschnir, P, Sciancalepore, A, Mendoza, O, Perea, G, Ronderos, R, Zaroui, A, Ben Said, RYM, EL Chalbia, TEJ, Wali, SANA, Mourali, MS, Mechmeche, RACHID, Leren, I S, Saberniak, J, Haland, TF, Edvardsen, T, Haugaa, KH, Astrom Aneq, M, Svetlichnaya, J S, Shikha, SS, Scheinmann, MS, Klein, LK, Nucifora, G, Prati, G, Vitrella, G, Allocca, G, Cukon Buttignoni, S, Muser, D, Morocutti, G, Pinamonti, B, Sinagra, G, Proclemer, A, Rocon, CRLA, Melo, MDTM, Bocchi, EAB, Araujo, JABAF, Demarchi, LMMFD, Mady, CM, Biselli, BB, Kalil, RKF, Salemi, VMCS, Tuma, RT, Cho, J Y, Kim, K H, Yoon, H J, Lee, K J, Park, H, Kim, J H, Ahn, Y, Jeong, M H, Cho, J G, Park, J C, Cho, J Y, Kim, K H, Yoon, H J, Park, H J, Kim, J H, Ahn, Y, Jeong, M H, Cho, J G, Park, J C, Sade, LE, Kozan, H, Eroglu, S, Pirat, B, Sezgin, A, Aydinalp, A, Muderrisoglu, H, Stampfli, S F, Oezkartal, T, Bernhart, S, Flammer, AJ, Vecchiati, A, Froehlich, GM, Ruschitzka, F, Tanner, FC, Cho, EJ, Choi, KY, Kim, DB, Jang, SW, Cho, JS, Park, CS, Jung, HO, Jeon, HK, Youn, HJ, Stevanovic, A, Dekleva, M, Pena, J L, Fortes, PRL, Passos, BR, Rodrigues, AB, Sampaio, IH, Oliveira, MCN, Silva, MG, Cardoso, RAF, Tofani, FA, Moreira, MCV, Ognibeni, F, Cioffi, G, Viapiana, O, Dalbeni, A, Fracassi, E, Di Nora, C, Cherubini, A, Mazzone, C, Di Lenarda, A, Rossini, M, Colunga, S, Corros, C, Garcia-Campos, A, Martin, M, Rodriguez-Suarez, M, Leon, V, Fidalgo, A, Lopez-Iglesias, F, Moris, C, De La Hera, JM, Borowiec, A, Dabrowski, R, Wozniak, J, Jasek, S, Chwyczko, T, Kowalik, I, Musiej-Nowakowska, E, Szwed, H, Hristova, K, Marinov, R, Stamenov, G, Mihova, M, Chacheva, K, Persenska, S, Racheva, A, Kosmala, W, Przewlocka-Kosmala, M, Rojek, A, Karolko, B, Mysiak, A, Marwick, TH, Lesniak-Sobelga, A M, Kostkiewicz, M, Wisniowska-Smialek, S, Biernacka, B, Rubis, P, Kaldararova, M, Tittel, P, Kardos, M, Vrsanska, V, Ondriska, M, Hraska, V, Nosal, M, Masura, J, Simkova, I, Stanojevic, D, Apostolovic, S, Salinger-Martinovic, S, Jankovic-Tomasevic, R, Djordjevic-Radojkovic, D, Stanojlovic, T, Atanaskovic, V, Pavlovic, M, Tahirovic, E, Dungen, HD, Carbonell San Roman, A, Moya Mur, JL, Rodriguez-Munoz, D, Lozano Granero, C, Jimenez Nacher, JJ, Gonzalez Gomez, A, Fraile Sanz, C, Segura De La Cal, T, Fernandez-Golfin, C, Zamorano Gomez, JL, Hoetink, A, Jansen Klomp, WW, Van 'T Hof, AWJ, Brandon Bravo Bruinsma, GJ, Spanjersberg, AJ, Grandjean, J, Nierich, AP, Ferreira, R, Ferreira, J, Lazaro Mendes, S, Martins, R, Monteiro, S, Pego, M, Rohani, A, Khamene Bagheri, R, Wierzbowska-Drabik, K, Peruga, JZ, Sobczak, M, Plewka, M, Wcislo, T, Krecki, R, Kasprzak, JD, Carvalho, J F, Morgado, G, Cruz, I, Caldeira, D, Almeida, AR, Joao, I, Lopes, L, Fazendas, P, Cotrim, C, Pereira, H, Cherubini, A, Cioffi, G, Mazzone, C, Faganello, G, Pandullo, C, Russo, G, Stefenelli, C, Furlanello, F, Tarantini, L, Di Lenarda, A, Teramoto, K, Suzuki, K, Satoh, Y, Minami, K, Mizukoshi, K, Kamijima, R, Kou, S, Takai, M, Izumo, M, Akashi, YJ, May, CJH, Ayuk, J, Geh, I, Shah, T, Edwards, NC, Steeds, RP, Wejner-Mik, P, Sobczak, M, Miskowiec, D, Wdowiak-Okrojek, K, Kasprzak, JD, Lipiec, P, Gurzun, M M, Rosca, M, Calin, A, Beladan, C, Serban, M, Ginghina, C, Popescu, BA, Perea, GO, Lombardero, M, Henquin, R, Corneli, M, Tinetti, M, Laveau, F, Hekimian, G, Achkar, M, Isnard, R, Combes, A, Hammoudi, N, Mahmoud, HM, Al-Ghamdi, M, Ghabashi, A, Ezzat, M H, Al-Amin, A, Sanz, M, Giraldeau, G, Sarvari, SI, Marin, J, Brambila, C, Gabrielli, L, Bijnens, B, Sitges, M, Sanchez-Martinez, S, Duchateau, N, Erdei, T, Fraser, A, Bijnens, B H, Piella, G, Montserrat, S, Sanchis, L, Borras, R, Vidal, B, Prat, S, Azqueta, M, Pare, C, Grazioli, G, Sanz, M, Sitges, M, Kowalczyk, E, Kasprzak, JD, Wejner-Mik, P, Wdowiak-Okrojek, K, Lipiec, P, Park, CS, Jung, MH, Ahn, HS, Kim, JH, Cho, JS, Jeon, HK, Youn, HJ, Hinojar, R, Fernandez-Golfin, C, Megias, A, Alonso, GL, Gonzalez-Gomez, A, Rincon, LM, Esteban, A, Fernandez Mendez, MA, Barrios, V, Zamorano, JL, Van Berendoncks, A M, Van Gaal, L, De Block, C, Salgado, R, Vrints, C, Shivalkar, B, Guedes, H, Pereira, A, Santos, R, Marques, L, Moreno, N, Carvalho, R, Pires, M, Sousa, R, Andrade, A, Pinto, P, Nestaas, E, Stoylen, A, Fugelseth, D, Onut, R, Tautu, O, Onciul, S, Marinescu, C, Zamfir, D, Dorobantu, M, Moran, L, Sanchez Sanchez, V, Navas, P, Garcia-Cosio, D, Diaz, B, Carballo-Alzola, L, Lombera, F, Delgado, J, Kisko, A, Babcak, M, Kishko, N, Agmon, Y, Eitan, A, Mutlak, D, Kehat, I, Corneli, M, Meretta, AH, Perea, GO, Belcastro, F, Aguirre, E, Rosa, D, Zaefferer, P, Masoli, O, Peovska Mitevska, IPM, Srbinovska, ES, Bosevski, MB, Antova, EA, Pop Gorceva, DPG, Barreiro Perez, M, Martin Fernandez, M, Costilla Garcia, SM, Diaz Pelaez, E, and Moris De La Tassa, C
Abstract: Background: The attainment of the primary (low density lipoprotein cholesterol; LDL-C) and the secondary (non-high density lipoprotein cholesterol; non-HDL) lipid therapeutic targets may depend on several potential factors. Our aim was assess the associations between ultrasound fat indexes, lipid levels and the lipid goals attainment in high and very high cardiovascular (CV) risk patients. Methods: Four hundred twenty (n=420) patients (F/M=146/274; age=61 ± 7 y.o.) with high (43%) or very high (57%) cardiovascular risk and chronic statin treatment (³12 months) were enrolled into the study. Obesity measures (body-mass index, BMI; bioelectrical impedance body fat; BF, waist circumference, WC, body adiposity index; BAI), serum levels of lipids (total cholesterol–TC, LDL-C, HDL-C and triglycerides–TG) and goal lipid levels (LDL-C and non-HDL-C) according to the CV risk were determined in all patients. The following ultrasound fat parameters were used in the study: intraabdominal fat (IAT), preperitoneal fat thickness (PreFT), epicardial (EFT) and pericardial (PFT) fat thickness and were indexed to BMI. Results: Our study patients had 5.2 ± 1.7 CV risk factors (80% hypertension, 32% diabetes, 59% metabolic syndrome), 49% were obese, 63% had high BF% and 85% had increased waist circumference (F>80 or M>94cm). All the patients were on a long-term statin treatment (rosuvastatin, atorvastatin or simvastatin). The attainment of the target lipid levels in the study group was as follows: LDL-C–34%, non-HDL-C–39%, both LDL-C and non-HDL-C 31%. Mean fat parameters in the study group were as follows: IAT–76.4 ± 26mm, PreFT–23.3 ± 6.5mm, EFT–3.5 ± 1.5mm and PFT–8.6 ± 3.8mm. Patients with LDL-C goal attainment had significantly higher BAI (34.6 ± 33 vs 30.5 ± 7, p=0.04), but significantly lower IAT/BMI (2.35 ± 0.7 vs 2.51 ± 0.7, p<0.05) with no differences in other clinical (BMI, BF%, WC) and ultrasound (PreFT/BMI, EFT/BMI, PFT/BMI) indexes. The LDL-C goal achievement revealed inverse association with IAT/BMI (r=-0.15, p<0.05) and no associations with PreFT/BMI, EFT/BMI or PFT/BMI. Multivariable regression analysis revealed independent association between IAT/BMI and the LDL-C goal achievement. Conclusions: Intraabdominal fat thickness representing visceral adipose tissue is inversely associated with the LDL-C goal attainment independently from general obesity. It may help to identify individuals requiring more aggressive management of dylipidaemia.
Published: 2015
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14. Oral Abstract session: Stress echo in clinical practice: Friday 5 December 2014, 08:30-10:00 * Location: Agora

Author: Ciampi, Q, Bombardini, T, Cortigiani, L, Pratali, L, Rigo, F, Villari, B, Picano, E, Sicari, R, Teramoto, K, Suzuki, K, Satoh, Y, Minami, K, Mizukoshi, K, Kamijima, R, Kou, S, Takai, M, Izumo, M, Akashi, YJ, Cifra, B, Dragulescu, A, Friedberg, MK, Mertens, L, O'driscoll, J, Gargallo-Fernandez, P, Araco, M, Perez-Lopez, M, Sharma, R, Abram, S, Arruda-Olson, MA, Scott, GC, Pellikka, AP, Nkomo, TV, Oh, JK, Milan, A, Mccully, BR, Aguiar Rosa, S, Portugal, G, Moura Branco, L, Galrinho, A, Afonso Nogueira, M, Abreu, J, Cacela, D, Abreu, A, Fragata, J, Cruz Ferreira, R, Mielczarek, A, Kasprzak, JD, Chrzanowski, L, Plewka, M, Lipiec, P, Qawoq, D, Rechcinski, T, Wierzbowska-Drabik, K, Magne, J, Donal, E, Dulgheru, R, Pierard, L, and Lancellotti, P
Abstract: Background: LV contractility plays an important diagnostic and prognostic role in non-ischemic dilated cardiomyopathy (IDC). Systolic pressure/end-systolic volume relationship (SP/ESVi) is a useful method for evaluating LV myocardial contractility during stress echocardiography (SE). Coronary flow reserve (CFR) on left anterior descending (LAD) can be reduced in IDC. Aim: To assess the relationship between SP/ESVi and CFR on LAD in IDC patients Methods: We enrolled 134 IDC patients (98 men; 62 ± 12 years, mean value of ejection fraction: 34 ± 8%) and 38 age-sex matched normal subjects as control's group (29 men; 65 ± 11 years, mean value of ejection fraction: 61 ± 4%). All underwent dipyridamole SE (dip-SE 0.84 mg/kg in 6'). CFR was defined as the ratio between maximal vasodilation and rest peak diastolic flow velocity in LAD. SP/ESVI was defined as systolic cuff pressure/end-systolic volume index difference between rest-peak dip-SE. Results: SP/ESVi was 0.25 ± 0.74 mmHg/ml/m2 in IDC patients and 3.90 ± 2.67 mmHg/ml/m2 in controls. SP/ESVi was not related to ejection fraction at rest, while it was directly related to ejection fraction at peak dip-SE (r=.448, p<.001) and rest-stress difference in ejection fraction (r=.435, p<.001). CFR on LAD was abnormal (<2) in 66 (49%) IDC patients. SP/ESVi was directly related to CFR on LAD (r=.369, p=.001, Figure, red points) in IDC patients: LV contractile reserve affected increase in CFR, while in controls we did not find relationship between SP/ESVi and CFR (Figure, green points). Conclusions: In IDC with impaired LV systolic function CFR was directly related to LV myocardial contractility, while this relationship disappeared in normal subjects. Figure Figure
Published: 2014
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15. Poster session Friday 13 December - PM: 13/12/2013, 14:00-18:00 * Location: Poster area

Author: Caiani, EG, Pellegrini, A, Carminati, MC, Lang, RM, Auricchio, A, Vaida, P, Obase, K, Sakakura, T, Komeda, M, Okura, H, Yoshida, K, Zeppellini, R, Noni, M, Rigo, T, Erente, G, Carasi, M, Costa, A, Ramondo, BA, Thorell, L, Akesson-Lindow, T, Shahgaldi, K, Germanakis, I, Fotaki, A, Peppes, S, Sifakis, S, Parthenakis, F, Makrigiannakis, A, Richter, U, Sveric, K, Forkmann, M, Wunderlich, C, Strasser, RH, Djikic, D, Potpara, T, Polovina, M, Marcetic, Z, Peric, V, Ostenfeld, E, Werther-Evaldsson, A, Engblom, H, Ingvarsson, A, Roijer, A, Meurling, C, Holm, J, Radegran, G, Carlsson, M, Tabuchi, H, Yamanaka, T, Katahira, Y, Tanaka, M, Kurokawa, T, Nakajima, H, Ohtsuki, S, Saijo, Y, Yambe, T, Dalto, M, Romeo, E, Argiento, P, Dandrea, A, Vanderpool, R, Correra, A, Sarubbi, B, Calabro, R, Russo, MG, Naeije, R, Saha, S K, Warsame, T A, Caelian, A G, Malicse, M, Kiotsekoglou, A, Omran, A S, Sharif, D, Sharif-Rasslan, A, Shahla, C, Khalil, A, Rosenschein, U, Erturk, M, Oner, E, Kalkan, AK, Pusuroglu, H, Ozyilmaz, S, Akgul, O, Aksu, HU, Akturk, F, Celik, O, Uslu, N, Bandera, F, Pellegrino, M, Generati, G, Donghi, V, Alfonzetti, E, Guazzi, M, Rangel, I, Goncalves, A, Sousa, C, Correia, AS, Martins, E, Silva-Cardoso, J, Macedo, F, Maciel, MJ, Lee, S, Kim, W, Yun, H, Jung, L, Kim, E, Ko, J, Enescu, OA, Florescu, M, Rimbas, RC, Cinteza, M, Vinereanu, D, Kosmala, W, Rojek, A, Cielecka-Prynda, M, Laczmanski, L, Mysiak, A, Przewlocka-Kosmala, M, Liu, D, Hu, K, Niemann, M, Herrmann, S, Cikes, M, Gaudron, PD, Knop, S, Ertl, G, Bijnens, B, Weidemann, F, Saravi, M, Tamadoni, AHMAD, Jalalian, ROZITA, Hojati, MOSTAF, Ramezani, SAEED, Yildiz, A, Inci, U, Bilik, MZ, Yuksel, M, Oyumlu, M, Kayan, F, Ozaydogdu, N, Aydin, M, Akil, MA, Tekbas, E, Shang, Q, Zhang, Q, Fang, F, Wang, S, Li, R, Lee, A PW, Yu, CM, Mornos, C, Ionac, A, Cozma, D, Popescu, I, Ionescu, G, Dan, R, Petrescu, L, Sawant, AC, Srivatsa, SV, Adhikari, P, Mills, PK, Srivatsa, SS, Boshchenko, A, Vrublevsky, A, Karpov, R, Trifunovic, D, Stankovic, S, Vujisic-Tesic, B, Petrovic, M, Nedeljkovic, I, Banovic, M, Tesic, M, Petrovic, M, Dragovic, M, Ostojic, M, Zencirci, E, Esen Zencirci, A, Degirmencioglu, A, Karakus, G, Ekmekci, A, Erdem, A, Ozden, K, Erer, HB, Akyol, A, Eren, M, Zamfir, D, Tautu, O, Onciul, S, Marinescu, C, Onut, R, Comanescu, I, Oprescu, N, Iancovici, S, Dorobantu, M, Melao, F, Pereira, M, Ribeiro, V, Oliveira, S, Araujo, C, Subirana, I, Marrugat, J, Dias, P, Azevedo, A, study, EURHOBOP, Grillo, M T, Piamonti, B, Abate, E, Porto, A, Dellangela, L, Gatti, G, Poletti, A, Pappalardo, A, Sinagra, G, Pinto-Teixeira, P, Galrinho, A, Branco, L, Fiarresga, A, Sousa, L, Cacela, D, Portugal, G, Rio, P, Abreu, J, Ferreira, R, Fadel, B, Abdullah, N, Al-Admawi, M, Pergola, V, Bech-Hanssen, O, Di Salvo, G, Tigen, M K, Pala, S, Karaahmet, T, Dundar, C, Bulut, M, Izgi, A, Esen, A M, Kirma, C, Boerlage-Van Dijk, K, Yamawaki, M, Wiegerinck, EMA, Meregalli, PG, Bindraban, NR, Vis, MM, Koch, KT, Piek, JJ, Bouma, BJ, Baan, J, Mizia, M, Sikora-Puz, A, Gieszczyk-Strozik, K, Lasota, B, Chmiel, A, Chudek, J, Jasinski, M, Deja, M, Mizia-Stec, K, Silva Fazendas Adame, P R, Caldeira, D, Stuart, B, Almeida, S, Cruz, I, Ferreira, A, Lopes, L, Joao, I, Cotrim, C, Pereira, H, Unger, P, Dedobbeleer, C, Stoupel, E, Preumont, N, Argacha, JF, Berkenboom, G, Van Camp, G, Malev, E, Reeva, S, Vasina, L, Pshepiy, A, Korshunova, A, Timofeev, E, Zemtsovsky, E, Jorgensen, P G, Jensen, JS, Fritz-Hansen, T, Biering-Sorensen, T, Jons, C, Olsen, NT, Henri, C, Magne, J, Dulgheru, R, Laaraibi, S, Voilliot, D, Kou, S, Pierard, L, Lancellotti, P, Tayyareci, Y, Dworakowski, R, Kogoj, P, Reiken, J, Kenny, C, Maccarthy, P, Wendler, O, Monaghan, MJ, Song, JM, Ha, TY, Jung, YJ, Seo, MO, Choi, SA, Kim, YJ, Sun, BJ, Kim, DH, Kang, DH, Song, JK, Le Tourneau, T, Topilsky, Y, Inamo, J, Mahoney, D, Suri, R, Schaff, H, Enriquez-Sarano, M, Bonaque Gonzalez, JC, Sanchez Espino, AD, Merchan Ortega, G, Bolivar Herrera, N, Ikuta, I, Macancela Quinonez, JJ, Munoz Troyano, S, Ferrer Lopez, R, Gomez Recio, M, Dreyfus, J, Cimadevilla, C, Brochet, E, Himbert, D, Iung, B, Vahanian, A, Messika-Zeitoun, D, Izumo, M, Takeuchi, M, Seo, Y, Yamashita, E, Suzuki, K, Ishizu, T, Sato, K, Aonuma, K, Otsuji, Y, Akashi, YJ, Muraru, D, Addetia, K, Veronesi, F, Corsi, C, Mor-Avi, V, Yamat, M, Weinert, L, Lang, RM, Badano, LP, Minamisawa, M, Koyama, J, Kozuka, A, Motoki, H, Izawa, A, Tomita, T, Miyashita, Y, Ikeda, U, Florescu, C, Niemann, M, Liu, D, Hu, K, Herrmann, S, Gaudron, PD, Scholz, F, Stoerk, S, Ertl, G, Weidemann, F, Marchel, M, Serafin, A, Kochanowski, J, Piatkowski, R, Madej-Pilarczyk, A, Filipiak, KJ, Hausmanowa-Petrusewicz, I, Opolski, G, Meimoun, P, Mbarek, D, Clerc, J, Neikova, A, Elmkies, F, Tzvetkov, B, Luycx-Bore, A, Cardoso, C, Zemir, H, Mansencal, N, Arslan, M, El Mahmoud, R, Pilliere, R, Dubourg, O, Ikonomidis, I, Lambadiari, V, Pavlidis, G, Koukoulis, C, Kousathana, F, Varoudi, M, Tritakis, V, Triantafyllidi, H, Dimitriadis, G, Lekakis, I, Kovacs, A, Kosztin, A, Solymossy, K, Celeng, C, Apor, A, Faludi, M, Berta, K, Szeplaki, G, Foldes, G, Merkely, B, Kimura, K, Daimon, M, Nakajima, T, Motoyoshi, Y, Komori, T, Nakao, T, Kawata, T, Uno, K, Takenaka, K, Komuro, I, Gabric, I D, Vazdar, LJ, Pintaric, H, Planinc, D, Vinter, O, Trbusic, M, Bulj, N, Nobre Menezes, M, Silva Marques, J, Magalhaes, R, Carvalho, V, Costa, P, Brito, D, Almeida, AG, Nunes-Diogo, AG, Davidsen, E S, Bergerot, C, Ernande, L, Barthelet, M, Thivolet, S, Decker-Bellaton, A, Altman, M, Thibault, H, Moulin, P, Derumeaux, G, Huttin, O, Voilliot, D, Frikha, Z, Aliot, E, Venner, C, Juilliere, Y, Selton-Suty, C, Yamada, T, Ooshima, M, Hayashi, H, Okabe, S, Johno, H, Murata, H, Charalampopoulos, A, Tzoulaki, I, Howard, LS, Davies, RJ, Gin-Sing, W, Grapsa, J, Wilkins, MR, Gibbs, JSR, Castillo, JMDC, Bandeira, AMPB, Albuquerque, ESA, Silveira, C, Pyankov, V, Chuyasova, Y, Lichodziejewska, B, Goliszek, S, Kurnicka, K, Dzikowska Diduch, O, Kostrubiec, M, Krupa, M, Grudzka, K, Ciurzynski, M, Palczewski, P, Pruszczyk, P, Arana, X, Oria, G, Onaindia, JJ, Rodriguez, I, Velasco, S, Cacicedo, A, Palomar, S, Subinas, A, Zumalde, J, Laraudogoitia, E, Saeed, S, Kokorina, MV, Fromm, A, Oeygarden, H, Waje-Andreassen, U, Gerdts, E, Gomez, ELENA, Vallejo, NURIA, Pedro-Botet, LUISA, Mateu, LOURDE, Nunyez, RAQUEL, Llobera, LAIA, Bayes, ANTONI, Sabria, MIQUEL, Antonini-Canterin, F, Mateescu, AD, La Carrubba, S, Vriz, O, Di Bello, V, Carerj, S, Zito, C, Ginghina, C, Popescu, BA, Nicolosi, GL, Mateescu, AD, La Carrubba, S, Vriz, O, Di Bello, V, Carerj, S, Zito, C, Ginghina, C, Popescu, BA, Nicolosi, GL, Antonini-Canterin, F, Pudil, R, Praus, R, Vasatova, M, Vojacek, J, Palicka, V, Hulek, P, P37/03, Prvouk, Pradel, S, Mohty, D, Damy, T, Echahidi, N, Lavergne, D, Virot, P, Aboyans, V, Jaccard, A, Mateescu, AD, La Carrubba, S, Vriz, O, Di Bello, V, Carerj, S, Zito, C, Ginghina, C, Popescu, BA, Nicolosi, GL, Antonini-Canterin, F, Doulaptsis, C, Symons, R, Matos, A, Florian, A, Masci, PG, Dymarkowski, S, Janssens, S, Bogaert, J, Lestuzzi, C, Moreo, A, Celik, S, Lafaras, C, Dequanter, D, Tomkowski, W, De Biasio, M, Cervesato, E, Massa, L, Imazio, M, Watanabe, N, Kijima, Y, Akagi, T, Toh, N, Oe, H, Nakagawa, K, Tanabe, Y, Ikeda, M, Okada, K, Ito, H, Milanesi, O, Biffanti, R, Varotto, E, Cerutti, A, Reffo, E, Castaldi, B, Maschietto, N, Vida, VL, Padalino, M, Stellin, G, Bejiqi, R, Retkoceri, R, Bejiqi, H, Retkoceri, A, Surdulli, SH, Massoure, PL, Cautela, J, Roche, NC, Chenilleau, MC, Gil, JM, Fourcade, L, Akhundova, A, Cincin, A, Sunbul, M, Sari, I, Tigen, MK, Basaran, Y, Suermeci, G, Butz, T, Schilling, IC, Sasko, B, Liebeton, J, Van Bracht, M, Tzikas, S, Prull, MW, Wennemann, R, Trappe, HJ, Attenhofer Jost, C H, Pfyffer, M, Scharf, C, Seifert, B, Faeh-Gunz, A, Naegeli, B, Candinas, R, Medeiros-Domingo, A, Wierzbowska-Drabik, K, Roszczyk, N, Sobczak, M, Plewka, M, Krecki, R, Kasprzak, JD, Ikonomidis, I, Varoudi, M, Papadavid, E, Theodoropoulos, K, Papadakis, I, Pavlidis, G, Triantafyllidi, H, Anastasiou - Nana, M, Rigopoulos, D, Lekakis, J, Tereshina, O, Surkova, E, Vachev, A, Merchan Ortega, G, Bonaque Gonzalez, JC, Sanchez Espino, AD, Bolivar Herrera, N, Bravo Bustos, D, Ikuta, I, Aguado Martin, MJ, Navarro Garcia, F, Ruiz Lopez, F, Gomez Recio, M, Merchan Ortega, G, Bonaque Gonzalez, JC, Bravo Bustos, D, Sanchez Espino, AD, Bolivar Herrera, N, Bonaque Gonzalez, JJ, Navarro Garcia, F, Aguado Martin, MJ, Ruiz Lopez, MF, Gomez Recio, M, Eguchi, H, Maruo, T, Endo, K, Nakamura, K, Yokota, K, Fuku, Y, Yamamoto, H, Komiya, T, Kadota, K, Mitsudo, K, Nagy, A I, Manouras, AI, Gunyeli, E, Shahgaldi, K, Winter, R, Hoffmann, R, Barletta, G, Von Bardeleben, S, Kasprzak, J, Greis, C, Vanoverschelde, J, Becher, H, Hu, K, Liu, D, Niemann, M, Herrmann, S, Cikes, M, Gaudron, PD, Knop, S, Ertl, G, Bijnens, B, Weidemann, F, Di Salvo, G, Al Bulbul, Z, Issa, Z, Khan, AM, Faiz, AA, Rahmatullah, SH, Fadel, BM, Siblini, G, Al Fayyadh, M, Menting, M E, Van Den Bosch, AE, Mcghie, JS, Cuypers, JAAE, Witsenburg, M, Van Dalen, BM, Geleijnse, ML, Roos-Hesselink, JW, Olsen, FJ, Jorgensen, PG, Mogelvang, R, Jensen, JS, Fritz-Hansen, T, Bech, J, Biering-Sorensen, T, Agoston, G, Pap, R, Saghy, L, Forster, T, Varga, A, Scandura, S, Capodanno, D, Dipasqua, F, Mangiafico, S, Caggegi, A M, Grasso, C, Pistritto, A M, Imme, S, Ministeri, M, Tamburino, C, Cameli, M, Lisi, M, Dascenzi, F, Cameli, P, Losito, M, Sparla, S, Lunghetti, S, Favilli, R, Fineschi, M, Mondillo, S, Ojaghihaghighi, Z, Javani, B, Haghjoo, M, Moladoust, H, Shahrzad, S, Ghadrdoust, B, Altman, M, Aussoleil, A, Bergerot, C, Bonnefoy-Cudraz, E, Derumeaux, G A, Thibault, H, Shkolnik, E, Vasyuk, Y, Nesvetov, V, Shkolnik, L, Varlan, G, Gronkova, N, Kinova, E, Borizanova, A, Goudev, A, Saracoglu, E, Ural, D, Sahin, T, Al, N, Cakmak, H, Akbulut, T, Akay, K, Ural, E, Mushtaq, S, Andreini, D, Pontone, G, Bertella, E, Conte, E, Baggiano, A, Annoni, A, Formenti, A, Fiorentini, C, Pepi, M, Cosgrove, C, Carr, L, Chao, C, Dahiya, A, Prasad, S, Younger, JF, Biering-Sorensen, T, Christensen, LM, Krieger, DW, Mogelvang, R, Jensen, JS, Hojberg, S, Host, N, Karlsen, FM, Christensen, H, Medressova, A, Abikeyeva, L, Dzhetybayeva, S, Andossova, S, Kuatbayev, Y, Bekbossynova, M, Bekbossynov, S, Pya, Y, Farsalinos, K, Tsiapras, D, Kyrzopoulos, S, Spyrou, A, Stefopoulos, C, Romagna, G, Tsimopoulou, K, Tsakalou, M, Voudris, V, Cacicedo, A, Velasco Del Castillo, S, Anton Ladislao, A, Aguirre Larracoechea, U, Onaindia Gandarias, J, Romero Pereiro, A, Arana Achaga, X, Zugazabeitia Irazabal, G, Laraudogoitia Zaldumbide, E, Lekuona Goya, I, Varela, A, Kotsovilis, S, Salagianni, M, Andreakos, V, Davos, CH, Merchan Ortega, G, Bonaque Gonzalez, JC, Sanchez Espino, AD, Bolivar Herrera, N, Macancela Quinones, JJ, Ikuta, I, Ferrer Lopez, R, Munoz Troyano, S, Bravo Bustos, D, and Gomez Recio, M
Abstract: Purpose: Cardiac deconditioning due to immobilization is a risk factor for cardiovascular disease. The physiology of cardiac adaptation to deconditioning has not been fully elucidated. The purpose of the present study was to assess the effects of 21-days of strict head-down (-6 degrees) bed-rest (BR) deconditioning on left ventricular (LV) dimensions and mass measured by MRI. Methods: Ten healthy men (mean age 32±6) were enrolled; the experiment was conducted at DLR (Koln, Germany) as part of the European Space Agency BR studies. Steady-state free precession MRI images (7mm thickness, no gap, no overlap) were obtained (Symphony 1.5T, Siemens) in a stack of short-axis views from LV base to LV apex, before (PRE), at the end of BR (HDT20), and four days after the BR conclusion (POST). Endocardial and epicardial semi-automated contouring was performed using freely available software (Segment). Results: At HDT20, significant reductions in LV mass (16%), end-diastolic (26%) and end-systolic (27%) volumes and stroke volume (27%) were observed, while ejection fraction did not change. These changes were accompanied by a measured decrease (14%) in plasma and blood volume (by gas-rebreathing technique), as well as by a significant reduction (14%) in VO2max aerobic power, measured using a graded cycle ergometer test protocol to volitional fatigue, at one day after the BR conclusion, while expiratory exchange ratio did not change. At POST, LV volumes were restored, while LV mass was still trending towards control values. Conclusions: Cardiac adaptation to deconditioning affected LV mass and dimensions, as a combined result of LV remodeling and fluids loss, accompanied by worsening in aerobic power. This should be taken into account in patients with cardiovascular diseases, when immobilized in bed, to proper adjust the therapy, or to define appropriate physical exercises when possible, in order to avoid further complications. Cardiac MRI parameters PREHDT20POSTLV mass (g)121±6102±11*114±16End-diastolic volume (ml)119±2590±14*118±25End-systolic volume (ml)42±831±8*45±14Stroke volume (ml)76±2259±11*73±15Ejection fraction (%)64±665±762±7 *: p<.01 vs PRE (one-way Anova for paired data and Tukey test)
Published: 2013
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16. Poster Session Saturday 14 December - AM: 14/12/2013, 08:30-12:30 * Location: Poster area

Author: Muraru, D, Addetia, K, Veronesi, F, Corsi, C, Mor-Avi, V, Yamat, M, Weinert, L, Lang, RM, Badano, LP, Faita, F, Di Lascio, N, Bruno, RM, Bianchini, E, Ghiadoni, L, Sicari, R, Gemignani, V, Angelis, A, Ageli, K, Ioakimidis, N, Chrysohoou, C, Agelakas, A, Felekos, I, Vaina, S, Aznaourides, K, Vlachopoulos, C, Stefanadis, C, Nemes, A, Szolnoky, G, Gavaller, H, Gonczy, A, Kemeny, L, Forster, T, Ramalho, A, Placido, R, Marta, L, Menezes, M, Magalhaes, A, Cortez Dias, N, Martins, S, Almeida, A, Pinto, F, Nunes Diogo, A, Botezatu, C-D, Enache, R, Popescu, BA, Nastase, O, Coman, MC, Ghiorghiu, I, Calin, A, Rosca, M, Beladan, C, Ginghina, C, Grapsa, J, Cabrita, IZ, Durighel, G, Oregan, D, Dawson, D, Nihoyannopoulos, P, Pellicori, P, Kallvikbacka-Bennett, A, Zhang, J, Lukaschuk, E, Joseph, A, Bourantas, C, Loh, H, Bragadeesh, T, Clark, A, Cleland, JG, Kallvikbacka-Bennett, A, Pellicori, P, Lomax, S, Putzu, P, Diercx, R, Parsons, S, Dicken, B, Zhang, J, Clark, A, Cleland, JG, Vered, Z, Adirevitz, L, Dragu, R, Blatt, A, Karev, E, Malca, Y, Roytvarf, A, Marek, D, Sovova, E, Berkova, M, Cihalik, C, Taborsky, M, Lindqvist, P, Tossavainen, ERIK, Soderberg, S, Gonzales, M, Gustavsson, S, Henein, MY, Sonne, C, Bott-Fluegel, L, Hauck, S, Lesevic, H, Hadamitzky, M, Wolf, P, Kolb, C, Bandera, F, Pellegrino, M, Generati, G, Donghi, V, Alfonzetti, E, Castelvecchio, S, Menicanti, L, Guazzi, M, Buchyte, S, Rinkuniene, D, Jurkevicius, R, Smarz, K, Zaborska, B, Jaxa-Chamiec, T, Maciejewski, P, Budaj, A, Santoro, A, Federico Alvino, FA, Giovanni Antonelli, GA, Roberta Molle, RM, Matteo Bertini, MB, Stefano Lunghetti, SL, Sergio Mondillo, SM, Henri, C, Magne, J, Dulgheru, R, Laaraibi, S, Voilliot, D, Kou, S, Pierard, L, Lancellotti, P, Szulik, M, Stabryla-Deska, J, Kalinowski, M, Sliwinska, A, Szymala, M, Lenarczyk, R, Kalarus, Z, Kukulski, T, Investigators, TRUST CRT, Yiangou, K, Azina, C, Yiangou, A, Ioannides, M, Chimonides, S, Baysal, S, Pirat, B, Okyay, K, Bal, U, Muderrisoglu, H, Popovic, D, Ostojic, M, Petrovic, M, Vujisic-Tesic, B, Arandjelovic, A, Petrovic, I, Banovic, M, Popovic, B, Vukcevic, V, Damjanovic, S, Velasco Del Castillo, S, Onaindia Gandarias, JJ, Arana Achaga, X, Laraudogoitia Zaldumbide, E, Rodriguez Sanchez, I, Cacicedo De Bobadilla, A, Romero Pereiro, A, Aguirre Larracoechea, U, Salinas, T, Subinas, A, Elzbieciak, M, Wita, K, Grabka, M, Chmurawa, J, Doruchowska, A, Turski, M, Filipecki, A, Wybraniec, M, Mizia-Stec, K, Varho, VV, Karjalainen, PP, Lehtinen, T, Airaksinen, JKE, Ylitalo, A, Kiviniemi, TO, Gargiulo, P, Galderisi, M, D Amore, C, Lo Iudice, F, Savarese, G, Casaretti, L, Pellegrino, AM, Fabiani, I, La Mura, L, Perrone Filardi, P, Kim, J Y, Chung, WB, Yu, JS, Choi, YS, Park, CS, Youn, HJ, Lee, MY, Nagy, AI, Manouras, A, Gunyeli, E, Gustafsson, U, Shahgaldi, K, Winter, R, Johnsson, J, Zagatina, A, Krylova, L, Zhuravskaya, N, Vareldzyan, Y, Tyurina, TV, Clitsenko, O, Khalifa, E A, Ashour, Z, Elnagar, W, Jung, IH, Seo, HS, Lee, SJ, Lim, DS, Mizariene, V, Verseckaite, R, Janenaite, J, Jonkaitiene, R, Jurkevicius, R, Sanchez Espino, AD, Bonaque Gonzalez, JC, Merchan Ortega, G, Bolivar Herrera, N, Ikuta, I, Macancela Quinones, JJ, Gomez Recio, M, Silva Fazendas Adame, P R, Caldeira, D, Stuart, B, Almeida, S, Cruz, I, Ferreira, A, Freire, G, Lopes, L, Cotrim, C, Pereira, H, Mediratta, A, Addetia, K, Moss, JD, Nayak, HM, Yamat, M, Weinert, L, Mor-Avi, V, Lang, RM, Al Amri, I, Debonnaire, P, Van Der Kley, F, Schalij, MJ, Bax, JJ, Ajmone Marsan, N, Delgado, V, Schmidt, F P, Gniewosz, T, Jabs, A, Munzel, T, Jansen, T, Kaempfner, D, Hink, U, Von Bardeleben, RS, Jose, J, George, OK, Joseph, G, Jose, J, Adawi, S, Najjar, R, Ahronson, D, Shiran, A, Van Riel, ACMJ, Boerlage - Van Dijk, K, De Bruin - Bon, HACM, Araki, M, Meregalli, PG, Koch, KT, Vis, MM, Mulder, BJM, Baan, J, Bouma, BJ, Marciniak, A, Elton, D, Glover, K, Campbell, I, Sharma, R, Batalha, S, Lourenco, C, Oliveira Da Silva, C, Manouras, A, Shahgaldi, K, Caballero, L, Garcia-Lara, J, Gonzalez-Carrillo, J, Oliva, MJ, Saura, D, Garcia-Navarro, M, Espinosa, MD, Pinar, E, Valdes, M, De La Morena, G, Barreiro Perez, M, Lopez Perez, M, Roy, D, Brecker, S, Sharma, R, Venkateshvaran, A, Dash, P K, Sola, S, Barooah, B, Govind, S C, Winter, R, Shahgaldi, K, Brodin, L A, Manouras, A, Saura Espin, D, Caballero Jimenez, L, Gonzalez Carrillo, J, Oliva Sandoval, MJ, Lopez Ruiz, M, Garcia Navarro, M, Espinosa Garcia, MD, Valdes Chavarri, M, De La Morena Valenzuela, G, Gatti, G, Dellangela, L, Pinamonti, B, Benussi, B, Sinagra, G, Pappalardo, A, Group, Heart Muscle Disease Study, Hernandez, V, Saavedra, J, Gonzalez, A, Iglesias, P, Civantos, S, Guijarro, G, Monereo, S, Ikeda, M, Toh, N, Oe, H, Tanabe, Y, Watanabe, N, Ito, H, Ciampi, Q, Cortigiani, L, Pratali, L, Rigo, F, Villari, B, Picano, E, Sicari, R, Yoon, JH, Sohn, JW, Kim, YJ, Chang, HJ, Hong, GR, Kim, TH, Ha, JW, Choi, BW, Rim, SJ, Choi, EY, Tibazarwa, K, Sliwa, K, Wonkam, A, Mayosi, BM, Oryshchyn, N, Ivaniv, Y, Pavlyk, S, Lourenco, M R, Azevedo, O, Moutinho, J, Nogueira, I, Fernandes, M, Pereira, V, Quelhas, I, Lourenco, A, Sunbul, M, Tigen, K, Karaahmet, T, Dundar, C, Ozben, B, Guler, A, Cincin, A, Bulut, M, Sari, I, Basaran, Y, Baydar, O, Kadriye Kilickesmez, KK, Ugur Coskun, UC, Polat Canbolat, PC, Veysel Oktay, VO, Umit Yasar Sinan, US, Okay Abaci, OA, Cuneyt Kocas, CK, Sinan Uner, SU, Serdar Kucukoglu, SK, Zaroui, A, Mourali, MS, Ben Said, R, Asmi, M, Aloui, H, Kaabachi, N, Mechmeche, R, Saberniak, J, Hasselberg, NE, Borgquist, R, Platonov, PG, Holst, AG, Edvardsen, T, Haugaa, KH, Lourenco, M R, Azevedo, O, Nogueira, I, Moutinho, J, Fernandes, M, Pereira, V, Quelhas, I, Lourenco, A, Eran, A, Yueksel, D, Er, F, Gassanov, N, Rosenkranz, S, Baldus, S, Guedelhoefer, H, Faust, M, Caglayan, E, Matveeva, N, Nartsissova, G, Chernjavskij, A, Ippolito, R, De Palma, D, Muscariello, R, Santoro, C, Raia, R, Schiano-Lomoriello, V, Gargiulo, F, Galderisi, M, Lipari, P, Bonapace, S, Zenari, L, Valbusa, F, Rossi, A, Lanzoni, L, Canali, G, Molon, G, Campopiano, E, Barbieri, E, Ikonomidis, I, Varoudi, M, Papadavid, E, Theodoropoulos, K, Papadakis, I, Pavlidis, G, Triantafyllidi, H, Anastasiou - Nana, M, Rigopoulos, D, Lekakis, J, Sunbul, M, Tigen, K, Ozen, G, Durmus, E, Kivrak, T, Cincin, A, Ozben, B, Atas, H, Direskeneli, H, Basaran, Y, Stevanovic, A, Dekleva, M, Trajic, S, Paunovic, N, Simic, A, Khan, SG, Mushemi-Blake, S, Jouhra, F, Dennes, W, Monaghan, M, Melikian, N, Shah, AM, Division, Cardiovascular, Excellence, Kings BHF Centre of, Maceira Gonzalez, A M, Lopez-Lereu, MP, Monmeneu, JV, Igual, B, Estornell, J, Boraita, A, Kosmala, W, Rojek, A, Bialy, D, Mysiak, A, Przewlocka-Kosmala, M, Popescu, I, Mancas, S, Mornos, C, Serbescu, I, Ionescu, G, Ionac, A, Gaudron, P, Niemann, M, Herrmann, S, Hu, K, Liu, D, Wojciech, K, Frantz, S, Bijnens, B, Ertl, G, Weidemann, F, Maceira Gonzalez, A M, Cosin-Sales, J, Ruvira, J, Diago, JL, Aguilar, J, Igual, B, Lopez-Lereu, MP, Monmeneu, J, Estornell, J, Cruz, C, Pinho, T, Madureira, AJ, Lebreiro, A, Dias, CC, Ramos, I, Silva Cardoso, J, Julia Maciel, M, De Meester, P, Van De Bruaene, A, Herijgers, P, Voigt, J-U, Budts, W, Franzoso, F, Voser, EM, Wohlmut, C, Kellenberger, CJ, Valsangiacomo Buechel, E, Carrero, C, Benger, J, Parcerisa, MF, Falconi, M, Oberti, PF, Granja, M, Cagide, AM, Del Pasqua, A, Secinaro, A, Antonelli, G, Iacomino, M, Toscano, A, Chinali, M, Esposito, C, Carotti, A, Pongiglione, G, Rinelli, G, Youssef Moustafa, A, Al Murayeh, M, Al Masswary, A, Al Sheikh, K, Moselhy, M, Dardir, MD, Deising, J, Butz, T, Suermeci, G, Liebeton, J, Wennemann, R, Tzikas, S, Van Bracht, M, Prull, MW, Trappe, H-J, Martin Hidalgo, M, Delgado Ortega, M, Ruiz Ortiz, M, Mesa Rubio, D, Carrasco Avalos, F, Seoane Garcia, T, Pan Alvarez-Ossorio, M, Lopez Aguilera, J, Puentes Chiachio, M, Suarez De Lezo Cruz Conde, J, Petrovic, M T, Giga, V, Stepanovic, J, Tesic, M, Jovanovic, I, Djordjevic-Dikic, A, Generati, G, Pellegrino, M, Bandera, F, Donghi, V, Alfonzetti, E, Guazzi, M, Piatkowski, R, Kochanowski, J, Scislo, P, Opolski, G, Zagatina, A, Zhuravskaya, N, Krylova, L, Vareldzhyan, Y, Tyurina, TV, Clitsenko, O, Bombardini, T, Gherardi, S, Leone, O, Picano, E, Michelotto, E, Ciccarone, A, Tarantino, N, Ostuni, V, Rubino, M, Genco, W, Santoro, G, Carretta, D, Romito, R, Colonna, P, foundation, Cassa di Risparmio di Puglia, Cameli, M, Lunghetti, S, Lisi, M, Curci, V, Cameli, P, Focardi, M, Favilli, R, Galderisi, M, Mondillo, S, Hoffmann, R, Barletta, G, Von Bardeleben, S, Kasprzak, J, Greis, C, Vanoverschelde, J, Becher, H, Machida, T, Izumo, M, Suzuki, K, Kaimijima, R, Mizukoshi, K, Manabe-Uematsu, M, Takai, M, Harada, T, Akashi, YJ, Medicine., St. Marianna University School of, Cardiology, Division of, Martin Garcia, A, Arribas-Jimenez, A, Cruz-Gonzalez, I, Nieto, F, Iscar, A, Merchan, S, Martin-Luengo, C, Brecht, A, Theres, L, Spethmann, S, Dreger, H, Baumann, G, Knebel, F, Jasaityte, R, Heyde, B, Rademakers, F, Claus, P, Dhooge, J, Lervik Nilsen, L C, Lund, J, Brekke, B, Stoylen, A, Giraldeau, G, Duchateau, N, Gabrielli, L, Penela, D, Evertz, R, Mont, L, Brugada, J, Berruezo, A, Bijnens, BH, Sitges, M, Kordybach, M, Kowalski, M, Hoffman, P, Pilichowska, E, Zaborska, B, Baran, J, Kulakowski, P, Budaj, A, Wahi, S, Vollbon, W, Leano, R, Thomas, A, Bricknell, K, Holland, D, Napier, S, Stanton, T, Teferici, D, Qirko, S, Petrela, E, Dibra, A, Bajraktari, G, Bara, P, Sanchis Ruiz, L, Gabrielli, L, Andrea, R, Falces, C, Duchateau, N, Perez-Villa, F, Bijnens, B, Sitges, M, Sulemane, S, Panoulas, VF, Bratsas, AH, Tam, FW, Nihoyannopoulos, P, Abduch, MCD, Alencar, AM, Coracin, FL, Barban, A, Saboya, R, Dulley, FL, Mathias, W, Vieira, MLC, Buccheri, S, Mangiafico, S, Arcidiacono, A, Bottari, VE, Leggio, S, Tamburino, C, Monte, I P, Cruz, C, Lebreiro, A, Pinho, T, Dias, CC, Silva Cardoso, J, Julia Maciel, M, Spitzer, E, Beitzke, D, Kaneider, A, Pavo, N, Gottsauner-Wolf, M, Wolf, F, Loewe, C, Mushtaq, S, Andreini, D, Pontone, G, Bertella, E, Conte, E, Baggiano, A, Annoni, A, Cortinovis, S, Fiorentini, C, Pepi, M, Gustafsson, M, Alehagen, U, Dahlstrom, U, Johansson, P, Faden, G, Faggiano, P, Albertini, L, Reverberi, C, Gaibazzi, N, Taylor, R J, Moody, WE, Umar, F, Edwards, NC, Townend, JN, Steeds, RP, Leyva, F, Mihaila, S, Muraru, D, Piasentini, E, Peluso, D, Casablanca, S, Naso, P, Puma, L, Iliceto, S, Vinereanu, D, Badano, LP, Ciciarello, F L, Agati, L, Cimino, S, De Luca, L, Petronilli, V, Fedele, F, and Tsverava, M
Abstract: Purpose: Transthoracic 3D echocardiography (3DE) allows an unparalleled opportunity for quantifying the dynamic changes of the tricuspid annulus (TA). Accordingly, our aims were: (I) to assess the determinants of TA size during cardiac cycle in healthy subjects; (II) to propose an approach and timing for TA sizing using 3DE. Methods: In 50 healthy volunteers (45±14 yrs, range 18-74, 27 males, with no risk factors, symptoms, signs or history of cardiovascular disease and on no medication), a full-volume dataset of the right ventricle (RV) containing the tricuspid valve (TV) was acquired (Vivid E9, GE Healthcare). TA diameters (septo-lateral, SL; antero-posterior, AP) and areas were measured on multiplanar images (Flexi-slice, EchoPac BT12, GE Healthcare) at 5 time points during the cardiac cycle: OS (onset of systole, at TV closure); MS (mid-systole); ES (end-systole); ED (onset of diastole); LD (late diastole, after the P wave). RV volumes and ejection fraction (EF) were analyzed with commercial software (4D RV analysis, TomTec, D). Results: Temporal resolution of the 3D datasets was 32±4 vps (range 24-53). TA areas were more closely correlated with RV volumes and body surface area (BSA) than with either SL or AP diameters. TA areas increased during systole from OS (3.9±0.6 cm2/m2) to ES (4.9±0.8 cm2/m2) and reached its largest area in LD (6.7±1.0 cm2/m2). All 5 TA areas were correlated with BSA (r range 0.57-0.62) and RV volumes (r ranges 0.53-0.60 for end-diastolic volume and 0.43-0.50 for end-systolic volume, p<0.0001 for all). Indexed TA areas were not related to either age or gender. With multivariable analysis, both RV end-diastolic volume and BSA determined TA areas during systole and early diastole, while TA area at LD and at OS were independently related with BSA only. Conclusions: In healthy subjects, the main determinants of TA size are RV volume and BSA. The largest TA area occurs at LD and is independently related with BSA only. Therefore, normative values should be based on TA areas measured at LD and indexed for BSA. However, the rapid change in TA areas occurring from LD to OS underscores the importance of adequate temporal resolution of 3DE data sets for reliable TA measurements.
Published: 2013
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17. International Expert Consensus Document on Takotsubo Syndrome (Part I): Clinical Characteristics, Diagnostic Criteria, and Pathophysiology

Author: Ilan S. Wittstein, Abhishek Deshmukh, Takashi Ueyama, Keigo Dote, G. Tarantini, Patrick Meimoun, David E. Winchester, Jelena-Rima Ghadri, Elmir Omerovic, Leonarda Galiuto, Roberto Manfredini, Scott W. Sharkey, Thomas F. Lüscher, Federico Migliore, Abhiram Prasad, Charanjit S. Rihal, Tetsuro Yoshida, Masami Kosuge, Eduardo Bossone, Filippo Crea, Holger Nef, Hiroaki Shimokawa, Yoshihiro J. Akashi, Christian Templin, Domenico Corrado, John D. Horowitz, Satoshi Kurisu, Walter Desmet, Jeroen J. Bax, Amir Lerman, Shams Y. Hassan, Frank Ruschitzka, Rodolfo Citro, Victoria L. Cammann, Ingo Eitel, Alexander R. Lyon, Ghadri, Jr, Wittstein, I, Prasad, A, Sharkey, S, Dote, K, Akashi, Yj, Cammann, Vl, Crea, F, Galiuto, L, Desmet, W, Yoshida, T, Manfredini, R, Eitel, I, Kosuge, M, Nef, Hm, Deshmukh, A, Lerman, A, Bossone, E, Citro, R, Ueyama, T, Corrado, D, Kurisu, S, Ruschitzka, F, Winchester, D, Lyon, Ar, Omerovic, E, Bax, Jj, Meimoun, P, Tarantini, G, Rihal, C, Y-Hassan, S, Migliore, F, Horowitz, Jd, Shimokawa, H, Luescher, Tf, and Templin, C
Subjects: Benign condition, Cardiac & Cardiovascular Systems, TAKO-TSUBO CARDIOMYOPATHY, Heart disease, 030204 cardiovascular system & hematology, EMOTIONAL-STRESS, Coronary artery disease, Takotsubo definition, 0302 clinical medicine, ST-SEGMENT ELEVATION, APICAL BALLOONING SYNDROME, Broken heart syndrome, F-18 FDG PET, InterTAK Diagnostic Criteria, Takotsubo syndrome, Broken heart syndrome, Takotsubo definition, Acute heart failure, Consensus statement, InterTAK Diagnostic Criteria, WALL-MOTION, OF-THE-LITERATURE, DESCENDING CORONARY-ARTERY, Consensus statement, Acute heart failure, Takotsubo syndrome, Cardiology and Cardiovascular Medicine, CORONARY-ARTERY-DISEASE, MENTAL STRESS, Life Sciences & Biomedicine, ACUTE MYOCARDIAL-INFARCTION, medicine.medical_specialty, MEDLINE, Socio-culturale, 1102 Cardiovascular Medicine And Haematology, ADRENERGIC-RECEPTOR POLYMORPHISMS, 03 medical and health sciences, LEFT-VENTRICULAR DYSFUNCTION, Consensus Paper, STRESS-INDUCED CARDIOMYOPATHY, medicine, Intensive care medicine, Science & Technology, STRESS CARDIOMYOPATHY, business.industry, TERTIARY CARDIOVASCULAR CENTERS, Expert consensus, medicine.disease, Editor's Choice, Cardiovascular System & Hematology, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Cardiovascular System & Cardiology, Etiology, business, 030217 neurology & neurosurgery
Abstract: Takotsubo syndrome (TTS) is a poorly recognized heart disease that was initially regarded as a benign condition. Recently, it has been shown that TTS may be associated with severe clinical complications including death and that its prevalence is probably underestimated. Since current guidelines on TTS are lacking, it appears timely and important to provide an expert consensus statement on TTS. The clinical expert consensus document part I summarizes the current state of knowledge on clinical presentation and characteristics of TTS and agrees on controversies surrounding TTS such as nomenclature, different TTS types, role of coronary artery disease, and etiology. This consensus also proposes new diagnostic criteria based on current knowledge to improve diagnostic accuracy. ispartof: EUROPEAN HEART JOURNAL vol:39 issue:22 pages:2032-2046 ispartof: location:England status: published
Published: 2018
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18. International Expert Consensus Document on Takotsubo Syndrome (Part II): Diagnostic Workup, Outcome, and Management

Author: Domenico Corrado, Ilan S. Wittstein, Charanjit S. Rihal, Victoria L. Cammann, Satoshi Kurisu, John D. Horowitz, Abhiram Prasad, Alexander R. Lyon, Patrick Meimoun, Federico Migliore, Tetsuro Yoshida, Rodolfo Citro, Walter Desmet, Filippo Crea, Masami Kosuge, David E. Winchester, Holger Nef, Eduardo Bossone, Jeroen J. Bax, Amir Lerman, Shams Y. Hassan, Hiroaki Shimokawa, Thomas F. Lüscher, Yoshihiro J. Akashi, Abhishek Deshmukh, Jelena-Rima Ghadri, Leonarda Galiuto, Ingo Eitel, Christian Templin, Scott W. Sharkey, Elmir Omerovic, Roberto Manfredini, Takashi Ueyama, Keigo Dote, G. Tarantini, Frank Ruschitzka, Ghadri, Jr, Wittstein, I, Prasad, A, Sharkey, S, Dote, K, Akashi, Yj, Cammann, Vl, Crea, F, Galiuto, L, Desmet, W, Yoshida, T, Manfredini, R, Eitel, I, Kosuge, M, Nef, Hm, Deshmukh, A, Lerman, A, Bossone, E, Citro, R, Ueyama, T, Corrado, D, Kurisu, S, Ruschitzka, F, Winchester, D, Lyon, Ar, Omerovic, E, Bax, Jj, Meimoun, P, Tarantini, G, Rihal, C, Hassan, Sy, Migliore, F, Horowitz, Jd, Shimokawa, H, Luscher, Tf, and Templin, C
Subjects: Cardiac & Cardiovascular Systems, TAKO-TSUBO CARDIOMYOPATHY, Computed Tomography Angiography, RIGHT-VENTRICULAR INVOLVEMENT, Diagnostic algorithm, 030204 cardiovascular system & hematology, Coronary Angiography, ACUTE CORONARY SYNDROME, Outcome (game theory), Electrocardiography, 0302 clinical medicine, Recurrence, IN-HOSPITAL MORTALITY, APICAL BALLOONING SYNDROME, ST-SEGMENT ELEVATION, 030212 general & internal medicine, Disease management (health), Broken heart syndrome, Acute heart failure, Consensus statement, Takotsubo syndrome, Cardiology and Cardiovascular Medicine, LATE GADOLINIUM ENHANCEMENT, Myocardial Perfusion Imaging, Disease Management, Magnetic Resonance Imaging, Treatment Outcome, Echocardiography, CARDIOVASCULAR MAGNETIC-RESONANCE, Risk stratification, LIFE-THREATENING ARRHYTHMIAS, Medical emergency, Life Sciences & Biomedicine, Algorithms, ACUTE MYOCARDIAL-INFARCTION, OUTFLOW TRACT OBSTRUCTION, MEDLINE, Socio-culturale, takotsubo syndrome, broken heart syndrome, acute heart failure, consensus statement, diagnostic algorithm, 1102 Cardiovascular Medicine And Haematology, Timely diagnosis, 03 medical and health sciences, LEFT-VENTRICULAR DYSFUNCTION, Takotsubo Cardiomyopathy, Consensus Paper, medicine, Humans, ANTERIOR MYOCARDIAL-INFARCTION, Science & Technology, business.industry, Expert consensus, Arrhythmias, Cardiac, medicine.disease, Clinical trial, Editor's Choice, Cardiovascular System & Hematology, Takotsubo syndrome, Broken heart syndrome, Acute heart failure, Consensus statement, Diagnostic algorithm, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Cardiovascular System & Cardiology, business
Abstract: The clinical expert consensus statement on takotsubo syndrome (TTS) part II focuses on the diagnostic workup, outcome, and management. The recommendations are based on interpretation of the limited clinical trial data currently available and experience of international TTS experts. It summarizes the diagnostic approach, which may facilitate correct and timely diagnosis. Furthermore, the document covers areas where controversies still exist in risk stratification and management of TTS. Based on available data the document provides recommendations on optimal care of such patients for practising physicians. ispartof: EUROPEAN HEART JOURNAL vol:39 issue:22 pages:2047-2062 ispartof: location:England status: published
Published: 2018

19. Clinical findings of Takotsubo cardiomyopathy: results from a multicenter international study

Author: Gabriele Di Gesaro, Giovanni Fazio, Loredana Sutera, Tomáš Paleček, Salvatore Azzarelli, Yoshiro J Akashi, D Guttilla, Salvatore Novo, Caterina Pizzuto, Raffaele Lombardi, Giuseppe Barbaro, FAZIO, G, BARBARO, G, SUTERA, L, GUTTILLA, D, PIZZUTO, C, AZZARELLI, S, PALECEK, T, DI GESARO, G, LOMBARDI, R, AKASHI, YJ, and NOVO, S
Subjects: Male, medicine.medical_specialty, Time Factors, Cardiomyopathy, Chest pain, Coronary Angiography, Severity of Illness Index, Takotsubo cardiomiopathy, Diagnosis, Differential, Electrocardiography, Takotsubo Cardiomyopathy, Internal medicine, Severity of illness, medicine, Humans, cardiovascular diseases, Myocardial infarction, Aged, medicine.diagnostic_test, business.industry, clinical and instrumental pattern, Gated Blood-Pool Imaging, Stroke Volume, General Medicine, Stroke volume, medicine.disease, Prognosis, Myocardial Contraction, Settore MED/11 - Malattie Dell'Apparato Cardiovascolare, Echocardiography, natural history, diagnostic criteria, cardiovascular system, Cardiology, Exercise Test, Female, Differential diagnosis, medicine.symptom, Cardiology and Cardiovascular Medicine, business, management, Follow-Up Studies
Abstract: BACKGROUND: Takotsubo cardiomyopathy consists of reversible systolic left ventricular apical ballooning associated with chest pain. Electrocardiographic abnormalities and the minimal rise of serum cardiac markers are similar to those in acute myocardial infarction, but without evidence of myocardial ischemia or injury. To date, many reports concerning this kind of acute reversible heart failure have been published, but the information available about the management of affected patients is scarce and the clinical data are incomplete. AIMS: In the present study, we report a collection of 40 patients who were affected by Takotsubo cardiomyopathy obtained in a multicentric international study, aiming to investigate the origins, and the clinical and instrumental patterns, and to establish the best diagnostic criteria for this syndrome. METHODS AND RESULTS: In the analysed group, the mean age was 68 years, of whom 85% were women. On admission to hospital, 68% of patients reported chest pain. An electrocardiogram (ECG) showed anterolateral (34%) or anterior (36%) ST segment elevation. The ECG demonstrated hyperkinesis of the basal segments with a severe hypokinesis of the other segments. Mean ejection fraction was 42.53%. Three patients died within the first 24 h from acute heart failure. The remaining 37 patients showed a complete resolution of symptoms and a complete normalization of the kinesis deficiency. Sixteen patients underwent myocardial scintigraphy, nine cases underwent myocardial biopsy and two patients received an ergonovine test. CONCLUSION: Our results demonstrate a good course of Takotsubo cardiomioathy, after the initial phase. An echocardiogram is an important tool for improving the diagnosis.
Published: 2008

20. Transient mid-ventricular dyskinesia: a variant of Takotsubo syndrome

Author: Salvatore Azzarelli, Loredana Sutera, Giuseppe Barbaro, Giovanni Fazio, Yoshihiro J. Akashi, Salvatore Evola, Salvatore Novo, Gabriele Di Gesaro, Giuseppina Novo, Fazio, G, Novo, G, Azzarelli, S, Evola, S, Barbaro, G, Sutera, L, Di Gesaro, G, Akashi, YJ, and Novo, S
Subjects: medicine.medical_specialty, Takotsubo syndrome, Takotsubo Cardiomyopathy, Mid-ventricular dyskinesia, Echocardiograms, Ventriculographies, Heart disease, business.industry, Cardiomyopathy, Neurological disorder, medicine.disease, Ventricular dyskinesia, Surgery, Central nervous system disease, Basal (phylogenetics), Dyskinesia, Internal medicine, cardiovascular system, Cardiology, Medicine, cardiovascular diseases, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Takotsubo Cardiomyopathy is characterized by a reversible systolic left ventricular apical ballooning. A new pattern of dyskinesia in the absence of angiographic evidence of coronary artery stenosis has been indicated like a variant of takotsubo cardiomiopathy: mid-ventricular akinesis with preservation of apical and basal contractilities revealed at echocardiograms and ventriculographies. We report the case of a 65 years old patient with this pattern, reverted in 4 weeks.
Published: 2008

21. Chronic pharmacological treatment in takotsubo cardiomyopathy

Author: Giuseppe Barbaro, Giuseppina Novo, Giovanni Fazio, Salvatore Azzarelli, Egle Incalcaterra, Tomáš Paleček, Salvatore Novo, Yoshihiro J. Akashi, Loredana Sutera, Caterina Cascio, Gabriele Di Gesaro, Evola G, Caterina Pizzuto, Fazio, G, Pizzuto, C, Barbaro, G, Sutera, L, Incalcaterra, E, Evola, G, Azzarelli, S, Palecek, T, Di Gesaro, G, Cascio, C, Novo, G, Akashi, YJ, and Novo, S
Subjects: Male, medicine.medical_specialty, Heart disease, Adrenergic beta-Antagonists, Cardiomyopathy, Angiotensin-Converting Enzyme Inhibitors, Takotsubo Cardiomyopathy, Internal medicine, Medicine, Humans, Myocardial infarction, Aged, Retrospective Studies, Aspirin, Ejection fraction, business.industry, Retrospective cohort study, medicine.disease, Calcium Channel Blockers, Surgery, Treatment Outcome, ACE inhibitor, Cardiology, Female, Differential diagnosis, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract: Background Takotsubo cardiomyopathy is a disorder that has been appreciated only recently. In most of reported cases, this syndrome mimes an acute myocardial infarction. Till this moment no data are available from literature about the treatment in the acute phase of this disease. Aim of the study In our multicentric experience we have retrospectively looked at the benefits of a treatment with ACE-inhibitors, beta-blockers, Aspirin and calcium channels blockers, started until the early phases of the disease and continued for 30 days, in 36 patients affected by Takotsubo cardiomyopathy. We chose as endpoint of the study the efficacy of the used drug in improving left ventricular myocardial function and the rapidity of the effects of the same drug.bethods: from an international registry about the Takotsubo cardiomiopathy, co-ordinate by our research group, we evaluated the long term efficacy of some drugs, administrated like single treatment in some patients. Results Obtained data did not show any statistically significant difference in the percentages of improvement in the left ventricle ejection fraction evaluated at the admission to the hospital, before the discharge and after 30 days of treatment between each treated group and the control group of non-treated patients. No significant differences were found in hospitalization times between treated patients and controls. None of our patients experienced during the observation period a relapse of the disease. Conclusions The results of our survey suggest that a chronic treatment with beta-blockers, ACE-inhibitors, calcium channels blockers and aspirin does not provide any benefit in patients with Takotsubo cardiomyopathy. Thus, it seem to be important an early correct differential diagnosis to avoid any chronic treatment in these patients.
Published: 2007

22. Current state of knowledge on Takotsubo syndrome: a Position Statement from the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology

Author: Ar, Lyon, Bossone E, Schneider B, Sechtem U, Citro R, Sr, Underwood, Mn, Sheppard, Ga, Figtree, Parodi G, Yoshihiro Akashi, Ruschitzka F, Filippatos G, Mebazaa A, Omerovic E, University of Zurich, Lyon, Alexander R, Lyon, Ar, Bossone, E, Schneider, B, Sechtem, U, Citro, R, Underwood, Sr, Sheppard, Mn, Figtree, Ga, Parodi, G, Akashi, Yj, Ruschitzka, F, Filippatos, G, Mebazaa, A, and Omerovic, E
Subjects: stress, Cardiovascular System & Hematology, 10209 Clinic for Cardiology, heart failure, 610 Medicine & health, risk stratification, Takotsubo syndrome, 1102 Cardiovascular Medicine And Haematology, 2705 Cardiology and Cardiovascular Medicine

23. Uptitration of Sacubitril/Valsartan and Outcomes in Patients With Heart Failure　- Insight From the REVIEW-HF Registry.

Author: Doi S, Kida K, Nasu T, Ishii S, Kagiyama N, Fujimoto W, Kikuchi A, Ijichi T, Shibata T, Kanaoka K, Matsumoto S, and Akashi YJ
Subjects: Humans, Aged, Male, Female, Retrospective Studies, Middle Aged, Aged, 80 and over, Angiotensin Receptor Antagonists administration & dosage, Angiotensin Receptor Antagonists adverse effects, Angiotensin Receptor Antagonists therapeutic use, Tetrazoles administration & dosage, Tetrazoles adverse effects, Tetrazoles therapeutic use, Treatment Outcome, Hospitalization, Heart Failure drug therapy, Heart Failure mortality, Heart Failure physiopathology, Valsartan administration & dosage, Biphenyl Compounds administration & dosage, Aminobutyrates adverse effects, Aminobutyrates administration & dosage, Aminobutyrates therapeutic use, Drug Combinations, Registries
Abstract: Background: Guideline-directed medical therapy has become an important component of heart failure (HF) therapy, with sacubitril/valsartan as one of the recommended drugs; however, the real-world prognostic implications of sacubitril/valsartan uptitration are unclear., Methods and Results: Patients with HF newly initiated on sacubitril/valsartan were registered in a retrospective multicenter study (REVIEW-HF). In all, 995 patients were divided into 3 groups according to the maximum dose achieved: high dose, sacubitril/valsartan 400 mg; intermediate dose, sacubitril/valsartan 200-<400 mg; and low dose, sacubitril/valsartan <200 mg. A total of 397 (39.9%) patients received high-dose sacubitril/valsartan; they had a significantly lower risk of mortality or HF hospitalization than patients in the low-dose (hazard ratio [HR] 0.39; 95% confidence interval [CI] 0.29-0.53; P<0.001) and intermediate-dose (HR 0.64; 95% CI 0.45-0.94; P=0.03) groups. In the multivariable Cox regression model, higher systolic blood pressure and maintained geriatric nutritional risk index were significantly associated with a higher incidence of achieving a high dose of sacubitril/valsartan. Patients who did not receive high-dose sacubitril/valsartan experienced more hypotension during the follow-up period, whereas hyperkalemia, severe renal events, and angioedema did not differ across the achieved dose classifications., Conclusions: Patients who achieved sacubitril/valsartan uptitration had a better prognosis than those who did not. Before sacubitril/valsartan uptitration, patients need to monitor blood pressure closely to prevent worsening events.
Published: 2024
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24. Imaging characteristics and clinical outcomes of hemodialysis vs. non-hemodialysis patients undergoing transcatheter aortic valve replacement: a Japanese single-center experience.

Author: Yoshida T, Okuno T, Kuwata S, Kobayashi Y, Kai T, Sato Y, Koga M, Kida K, Ishibashi Y, Tanabe Y, Izumo M, and Akashi YJ
Abstract: In 2021, Japan approved transcatheter aortic valve replacement (TAVR) for end-stage renal disease patients on hemodialysis (ESRD-HD). Yet, clinical/anatomical differences and outcomes between patients with and without ESRD-HD remain underexplored. This single-center study enrolled consecutive patients who underwent TAVR with the SAPIEN 3 between 2021 and 2023. Baseline characteristics and outcomes up to 1 year were compared. Inverse probability treatment weighting (IPTW) approach and Cox regression were used. Among 287 eligible patients, 59 had ESRD-HD. Patients with ESRD-HD were predominantly male (59.2% vs. 40.7%; p = 0.01), younger (78.0 [73.5-83.5] vs. 84.0 [79.8-88.0]; < 0.001), with lower body mass index (21.4 [19.6-23.3] vs. 22.9 [20.3-25.3]; p = 0.02], higher surgical risk (Society of Thoracic Surgeons Predicted Risk of Mortality ≧8%: 28 [47.5%] vs. 34 [14.9%]; p < 0.001), and more peripheral artery disease (25.4% vs. 4.8%; p < 0.001). Patients with ESRD-HD had a significantly higher prevalence of severely calcified femoral arteries (12.5% vs. 2.6%; p < 0.001). However, there were no differences in the computed-tomographic (CT) anatomical characteristics of the aortic valve complex (AVC), including the aortic valve calcium score (1995 [1372-3374] vs. 2195 [1380-3172]; p = 0.65) or the presence of moderate or severe left ventricular outflow tract calcification (4.3% vs. 5.2%; p > 0.99). Major vascular complications were rare, and technical (98.3% vs. 98.7%; p > 0.99) and device success (75.9% vs. 82.4%; p = 0.26) rates were high in both. At 1 year, there were no significant differences in a composite endpoint of death, stroke, major bleeding, or myocardial infarction (32.4% vs. 33.2%; HR 1.12; 95% CI 0.45-2.80; p = 0.81), nor its components after baseline adjustment., (© 2024. Springer Nature Japan KK, part of Springer Nature.)
Published: 2024
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25. Predictors and clinical outcomes of true mitral stenosis in patients undergoing transcatheter aortic valve implantation.

Author: Yamaga M, Izumo M, Sato Y, Shoji T, Miyahara D, Kobayashi Y, Kai T, Okuno T, Kuwata S, Koga M, Tanabe Y, and Akashi YJ
Abstract: Aims: Predictors of true degenerative mitral stenosis (MS) in patients with aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) remain unknown. This study aimed to investigate the predictors and prognostic value of true degenerative MS in this population., Methods and Results: We retrospectively reviewed the records of 760 consecutive patients who underwent TAVI. The mitral valve area (MVA) was assessed using transthoracic echocardiography, and mitral valve calcification was assessed using multi-detector computed tomography. MS was defined as an MVA of ≤2.0 cm², and true MS was defined as moderate or severe MS following TAVI. In our TAVI cohort, we identified 72 (9.5%) patients with degenerative MS. Among these, true MS was observed in 38 (52.7%) patients. Echocardiographic data showed that the true MS group had a significantly lower MVA and higher trans-mitral gradient. The severity of mitral annular calcification was not significantly different between the two groups; however, the true MS group had significantly more posterior mitral leaflet and anterior mitral leaflet (AML) calcification. Multivariable logistic regression analysis showed that AML calcification was the independent predictor of true MS [adjusted odds ratio, 9.23; 95% confidence interval (CI) 2.84-29.9]. True MS was independently associated with poor prognosis (adjusted hazard ratio, 2.76; 95% CI 1.09-6.98)., Conclusion: Approximately half of the patients with concomitant degenerative MS who underwent TAVI had true MS, which was associated with a poor prognosis. Computed tomographic analysis of AML calcification was useful for predicting true MS., Competing Interests: Conflict of interest: M.I. is a consultant for Edwards Lifesciences and Abbott Medical Japan, and S.K. is a consultant for Abbott Medical Japan. The other authors declare no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Published: 2024
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26. The value of the dynamic changes in cardiac power output in aortic stenosis patients following transcatheter aortic valve implantation: an exercise stress echocardiography study.

Author: Miyahara D, Izumo M, Sato Y, Shoji T, Murata R, Oda R, Okuno T, Kuwata S, and Akashi YJ
Abstract: Aims: Evidence for risk stratification using exercise stress echocardiography (ESE) in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) is currently lacking. Cardiac power output (CPO) has demonstrated prognostic value in patients undergoing TAVI for severe AS. This study investigated prognoses in patients undergoing TAVI for severe AS and to explore the additional information that ESE can provide for risk stratification., Methods: In this retrospective observational study, we included 96 consecutive patients who underwent TAVI for severe AS and patients with preserved left ventricular (LV) ejection fraction (≥ 50%) who underwent ESE at 3-6 months after TAVI. CPO was calculated as 0.222 × cardiac output × mean blood pressure/LV mass, where 0.222 was the conversion constant to W/100 g of the LV myocardium. All patients were followed up for all-cause mortality and hospitalization for heart failure., Results: Of the 96 patients, 3 were excluded and 93 patients (82.0 years; 45.2% male) were included in this study. During a median follow-up period of 1446 (1271-1825) days, the composite end point was reached in 17 patients. Multivariable Cox regression analysis revealed that CPO at rest and the change in CPO from rest to exercise (ΔCPO) were independently associated with the composite end point (hazard ratio = 0.278, p = 0.023). The addition of ΔCPO resulted in an incremental value of the model containing clinical and resting echocardiography variables (p = 0.030)., Conclusions: This study suggests that resting CPO and exercise-induced changes in CPO are useful for risk stratification of patients undergoing TAVI for severe AS., (© 2024. Japanese Society of Echocardiography.)
Published: 2024
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27. Impact of Long-Term Exercise-Based Cardiac Rehabilitation in Patients With Chronic Heart Failure　- A Systematic Review and Meta-Analysis.

Author: Yamamoto S, Okamura M, Akashi YJ, Tanaka S, Shimizu M, Tsuchikawa Y, Ashikaga K, Kamiya K, Kato Y, Nakayama A, Makita S, and Isobe M
Subjects: Humans, Chronic Disease, Male, Female, Aged, Patient Readmission statistics & numerical data, Time Factors, Treatment Outcome, Middle Aged, Randomized Controlled Trials as Topic, Oxygen Consumption, Heart Failure rehabilitation, Heart Failure mortality, Heart Failure physiopathology, Cardiac Rehabilitation methods, Quality of Life, Exercise Therapy, Exercise Tolerance
Abstract: Background: This study aimed to clarify the effects of exercise-based cardiac rehabilitation (CR) on patients with heart failure., Methods and Results: Patients were divided into groups according to intervention duration (<6 and ≥6 months). We searched for studies published up to July 2023 in Embase, MEDLINE, PubMed, and the Cochrane Library, without limitations on data, language, or publication status. We included randomized controlled trials comparing the efficacy of CR and usual care on mortality, prehospitalization, peak oxygen uptake (V̇O 2 ), and quality of life. Seventy-two studies involving 8,495 patients were included in this review. It was found that CR reduced the risk of rehospitalization for any cause (risk ratio [RR] 0.80; 95% confidence interval [CI] 0.70-0.92) and for heart failure (RR 0.88; 95% CI 0.78-1.00). Furthermore, CR was found to improve exercise tolerance (measured by peak V̇O 2 and the 6-min walk test) and quality of life. A subanalysis performed based on intervention duration (<6 and ≥6 months) revealed a similar trend., Conclusions: Our meta-analysis showed that although CR does not reduce mortality, it is effective in reducing rehospitalization rates and improving exercise tolerance and quality of life, regardless of the intervention duration.
Published: 2024
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28. Prognostic value of extraaortic-valvular cardiac damage in patients with moderate aortic stenosis and reduced left ventricular ejection fraction.

Author: Onishi H, Izumo M, Watanabe Y, Okutsu M, Hozawa K, Shoji T, Sato Y, Kuwata S, and Akashi YJ
Subjects: Humans, Male, Female, Aged, Prognosis, Echocardiography methods, Risk Assessment methods, Retrospective Studies, Severity of Illness Index, Ventricular Function, Left physiology, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Ventricular Dysfunction, Left physiopathology, Ventricular Dysfunction, Left etiology, Ventricular Dysfunction, Left diagnostic imaging, Heart Ventricles diagnostic imaging, Heart Ventricles physiopathology, Aortic Valve Stenosis physiopathology, Aortic Valve Stenosis complications, Stroke Volume physiology
Abstract: Purpose: The extraaortic-valvular cardiac damage (EVCD) Stage has shown potential for risk stratification for patients with aortic stenosis (AS). This study aimed to examine the usefulness of the EVCD Stage in risk stratification of patients with moderate AS and reduced left ventricular ejection fraction (LVEF)., Methods: Clinical data from patients with moderate AS (aortic valve area, .60-.85 cm 2 /m 2 ; peak aortic valve velocity, 2.0-4.0 m/s) and reduced LVEF (LVEF 20%-50%) were analyzed during 2010-2019. Patients were categorized into three groups: EVCD Stages 1 (LV damage), 2 (left atrium and/or mitral valve damage), and 3/4 (pulmonary artery vasculature and/or tricuspid valve damage or right ventricular damage). The primary endpoint included a composite of cardiac death and heart failure hospitalization, with non-cardiac death as a competing risk., Results: The study included 130 patients (mean age 76.4 ± 6.8 years; 62.3% men). They were categorized into three groups: 26 (20.0%) in EVCD Stage 1, 66 (50.8%) in Stage 2, and 48 (29.2%) in Stage 3/4. The endpoint occurred in 54 (41.5%) patients during a median follow-up of 3.2 years (interquartile range, 1.4-5.1). Multivariate analysis indicated EVCD Stage 3/4 was significantly associated with the endpoint (hazard ratio 2.784; 95% confidence interval 1.197-6.476; P = .017) compared to Stage 1, while Stage 2 did not (hazard ratio 1.340; 95% confidence interval .577-3.115; P = .500)., Conclusion: The EVCD staging system may aid in the risk stratification of patients with moderate AS and reduced LVEF., (© 2024 Wiley Periodicals LLC.)
Published: 2024
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29. Physiological Assessment with iFR prior to FFR Measurement in Left Main Disease.

Author: Warisawa T, Cook CM, Ahmad Y, Howard JP, Seligman H, Rajkumar C, Toya T, Doi S, Nakajima A, Nakayama M, Vera-Urquiza R, Yuasa S, Sato T, Kikuta Y, Kawase Y, Nishina H, Al-Lamee R, Sen S, Lerman A, Matsuo H, Akashi YJ, Escaned J, and Davies JE
Subjects: Humans, Male, Female, Aged, Middle Aged, Coronary Angiography, Registries, Myocardial Revascularization methods, ROC Curve, Cardiac Catheterization methods, Retrospective Studies, Fractional Flow Reserve, Myocardial physiology, Coronary Artery Disease physiopathology, Coronary Artery Disease surgery, Coronary Artery Disease diagnosis
Abstract: Despite guideline-based recommendation of the interchangeable use of instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) to guide revascularization decision-making, iFR/FFR could demonstrate different physiological or clinical outcomes in some specific patient or lesion subsets. Therefore, we sought to investigate the impact of difference between iFR and FFR-guided revascularization decision-making on clinical outcomes in patients with left main disease (LMD). In this international multicenter registry of LMD with physiological interrogation, we identified 275 patients in whom physiological assessment was performed with both iFR/FFR. Major adverse cardiovascular event (MACE) was defined as a composite of death, non-fatal myocardial infarction, and ischemia-driven target lesion revascularization. The receiver-operating characteristic analysis was performed for both iFR/FFR to predict MACE in respective patients in whom revascularization was deferred and performed. In 153 patients of revascularization deferral, MACE occurred in 17.0% patients. The optimal cut-off values of iFR and FFR to predict MACE were 0.88 (specificity:0.74; sensitivity:0.65) and 0.76 (specificity:0.81; sensitivity:0.46), respectively. The area under the curve (AUC) was significantly higher for iFR than FFR (0.74; 95%CI 0.62-0.85 vs. 0.62; 95%CI 0.48-0.75; p = 0.012). In 122 patients of coronary revascularization, MACE occurred in 13.1% patients. The optimal cut-off values of iFR and FFR were 0.92 (specificity:0.93; sensitivity:0.25) and 0.81 (specificity:0.047; sensitivity:1.00), respectively. The AUCs were not significantly different between iFR and FFR (0.57; 95%CI 0.40-0.73 vs. 0.46; 95%CI 0.31-0.61; p = 0.43). While neither baseline iFR nor FFR was predictive of MACE in patients in whom revascularization was performed, iFR-guided deferral seemed to be safer than FFR-guided deferral., (© 2024. The Author(s).)
Published: 2024
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30. Helix-fixation leadless pacemaker as a potential alternative to conventional transvenous pacemaker in post-Mustard baffle stenosis.

Author: Sasaki K, Nakajima I, Kasagawa A, Harada T, and Akashi YJ
Abstract: Obstruction of a systemic venous pathway is relatively common after the Mustard operation. A helix-fixation leadless pacemaker was successfully implanted in the subpulmonic but morphologic LV in a d-TGA patient with post-Mustard baffle stenosis and failure of a previously implanted epicardial lead., Competing Interests: Authors declare no conflict of interests for this article., (© 2024 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)
Published: 2024
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31. Preoperative Prediction of Shock Impedance for Subcutaneous Implantable Cardioverter Defibrillator Using Chest Computed Tomography.

Author: Kasagawa A, Nakajima I, Nakayama Y, Togashi D, Sasaki K, Matsuda H, Harada T, and Akashi YJ
Subjects: Humans, Middle Aged, Male, Female, Aged, Adult, Adipose Tissue diagnostic imaging, Ventricular Fibrillation therapy, Ventricular Fibrillation diagnostic imaging, Ventricular Fibrillation physiopathology, Predictive Value of Tests, Defibrillators, Implantable, Tomography, X-Ray Computed, Electric Impedance
Abstract: Background: High shock impedance is associated with conversion failure among patients with subcutaneous implantable cardioverter defibrillators (S-ICD). Currently, there is no preoperative assessment method for predicting high shock impedance. This study examined the efficacy of chest computed tomography (CT) as a preoperative evaluation tool to assess the shock impedance of S-ICDs., Methods and results: The amount of adipose tissue adjacent to the device and anteroposterior diameter at the basal heart region were measured preoperatively using chest CT. We examined the correlation between these measurements and shock impedance at the conversion test. We enrolled 43 patients with S-ICDs (mean [±SD] age 54±15 years; body mass index 23±4 kg/m 2 ; PRAETORIAN score 30-270 points; amount of adipose tissue 1,250±716 cm 3 ), who underwent intraoperative conversion tests by inducing ventricular fibrillation, which was terminated with a 65-J shock. A sufficient concordance correlation coefficient was observed between the shock impedance and the amount of adipose tissue (r=0.616, P<0.01) and anteroposterior diameter (r=0.645, P<0.01). In multiple regression analysis, the amount of adipose tissue (β=0.439, P=0.009) and anteroposterior diameter (β=0.344, P=0.038) were identified as independent predictive factors of shock impedance., Conclusions: The preoperative CT-measured amount of adipose tissue and basal heart anteroposterior diameter are independent predictors of shock impedance. These parameters may be more accurate in identifying higher shock impedance in patients with S-ICDs.
Published: 2024
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32. Residual Coronary Risk Factors Associated With Long-Term Clinical Outcomes in Patients With Coronary Artery Disease Treated With High- vs. Low-Dose Statin Therapy　- REAL-CAD Substudy.

Author: Higuma T, Akashi YJ, Fukumoto Y, Obara H, Kakuma T, Asaumi Y, Yasuda S, Sakuma I, Daida H, Shimokawa H, Kimura T, Iimuro S, and Nagai R
Subjects: Humans, Aged, Male, Female, Middle Aged, Risk Factors, Blood Pressure drug effects, Glycated Hemoglobin analysis, Glycated Hemoglobin metabolism, Treatment Outcome, Blood Glucose analysis, Blood Glucose metabolism, Coronary Artery Disease mortality, Coronary Artery Disease drug therapy, Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage, Glomerular Filtration Rate
Abstract: Background: It remains unclear which comorbidities, other than lipid parameters, or combination of comorbidities, best predicts cardiovascular events in patients with known coronary artery disease (CAD) treated with statins. Therefore, we aimed to identify the nonlipid-related prognostic factors and risk stratification of patients with stable CAD enrolled in the REAL-CAD study., Methods and results: Blood pressure, glucose level, and renal function were considered as risk factors in the 11,141 enrolled patients. The primary endpoint was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic stroke, and unstable angina. The secondary composite endpoint was the primary endpoint and/or coronary revascularization. A significantly worse prognosis at the primary endpoint was observed in the estimated glomerular filtration rate (eGFR) ≤60 group, and the combination of eGFR ≤60 and HbA1c ≥6.0 was the worst (hazard ratio (HR) 1.66; P<0.001). However, even in the eGFR >60 group, systolic blood pressure (SBP) ≥140 mmHg met the secondary endpoint (HR 1.33; P=0.006), and the combination of eGFR ≤60 and HbA1c ≥6.0 was also the worst at the secondary endpoint (HR 1.35; P=0.002)., Conclusions: Regarding nonlipid prognostic factors contributing to the incidence of cardiovascular events in statin-treated CAD patients, renal dysfunction was the most significant, followed by poor glucose control and high SBP.
Published: 2024
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33. Cardiac power output is associated with adverse outcomes in patients with preserved ejection fraction after transcatheter aortic valve implantation.

Author: Miyahara D, Izumo M, Sato Y, Shoji T, Yamaga M, Kobayashi Y, Kai T, Okuno T, Kuwata S, Koga M, Tanabe Y, and Akashi YJ
Abstract: Aims: Cardiac power output (CPO) measures cardiac performance, and its prognostic significance in heart failure with preserved ejection fraction (EF) has been previously reported. However, the effectiveness of CPO in risk stratification of patients with valvular heart disease and post-operative valvular disease has not been reported. We aimed to determine the association between CPO and clinical outcomes in patients with preserved left ventricular (LV) EF after transcatheter aortic valve implantation (TAVI)., Methods and Results: This retrospective observational study included 1047 consecutive patients with severe aortic stenosis after TAVI. All patients were followed up for all-cause mortality and hospitalization for HF. CPO was calculated as 0.222 × cardiac output × mean blood pressure (BP)/LV mass, where 0.222 was the conversion constant to W/100 g of the LV myocardium. CPO was assessed using transthoracic echocardiography at discharge after TAVI. Of the 1047 patients, 253 were excluded following the exclusion criteria, including those with low LVEF, and 794 patients (84.0 [80.0-88.0] years; 35.8% male) were included in this study. During a median follow-up period of 684 (237-1114) days, the composite endpoint occurred in 196 patients. A dose-dependent association was observed between the CPO levels and all-cause mortality. Patients in the lowest CPO tertile had significantly lower event-free survival rates (log-rank test, P = 0.043). Multivariate Cox regression analysis showed that CPO was independently associated with adverse outcomes (hazard ratio = 0.561, P = 0.020). CPO provided an incremental prognostic effect in the model based on clinical and echocardiographic markers ( P = 0.034)., Conclusion: CPO is independently and incrementally associated with adverse outcomes in patients with preserved LVEF following TAVI., Competing Interests: Conflict of interest: M.I. is a consultant of Edwards Lifesciences and Abbott Medical Japan, and S.K. is a consultant of Abbott Medical Japan. All other authors declare no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Published: 2024
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34. Three-dimensional echocardiography-fluoroscopy fusion imaging-guided zero-contrast transcatheter aortic valve implantation.

Author: Koga M, Izumo M, and Akashi YJ
Abstract: Competing Interests: Conflict of interest: M.I. is a consultant of Edwards Lifesciences and Abbott Medical Japan. All other authors declare no conflicts of interest.
Published: 2024
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35. Impact of Renal Congestion in Patients With Secondary Mitral Regurgitation After Mitral Transcatheter Edge-to-Edge Repair.

Author: Kuwata S, Izumo M, Okuno T, Shiokawa N, Sato Y, Koga M, Okuyama K, Tanabe Y, Harada T, Ishibashi Y, and Akashi YJ
Subjects: Humans, Angiography, Kaplan-Meier Estimate, Kidney diagnostic imaging, Treatment Outcome, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery, Heart Failure diagnostic imaging
Abstract: Background: Renal congestion is a potential prognostic factor in patients with heart failure and recently, assessment has become possible with intrarenal Doppler ultrasonography (IRD). The association between renal congestion assessed by IRD and outcomes after mitral transcatheter edge-to-edge repair (TEER) is unknown, so we aimed to clarify renal congestion and its prognostic implications in patients with mitral regurgitation (MR) who underwent TEER using MitraClip system., Methods and results: Patients with secondary MR who underwent TEER and were assessed for intrarenal venous flow (IRVF) by IRD were classified according to their IRVF pattern as continuous or discontinuous. Of the 105 patients included, 78 patients (74%) formed the continuous group and 27 (26%) were the discontinuous group. Kaplan-Meier analysis revealed significant prognostic power of the IRVF pattern for predicting the composite outcome of all-cause death and heart failure rehospitalization (log-rank P=0.0257). On multivariate Cox regression analysis, the composite endpoint was independently associated with the discontinuous IRVF pattern (hazard ratio, 3.240; 95% confidence interval, 1.300-8.076; P=0.012) adjusted using inverse probability of treatment weighting., Conclusions: IRVF patterns strongly correlated with clinical outcomes without changes in renal function. Thus, they may be useful for risk stratification after mitral TEER for patients with secondary MR.
Published: 2024
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36. Impact of the MitraClip G4 System on Routine Practice and Outcomes in Patients With Secondary Mitral Regurgitation.

Author: Okuno T, Izumo M, Shiokawa N, Kuwata S, Ishibashi Y, Sato Y, Koga M, Okuyama K, Suzuki N, Kida K, Tanabe Y, and Akashi YJ
Subjects: Humans, Mitral Valve diagnostic imaging, Mitral Valve surgery, Treatment Outcome, Proportional Hazards Models, Cardiac Catheterization, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery, Heart Valve Prosthesis Implantation
Abstract: Background: The MitraClip G4 system is a new iteration of the transcatheter edge-to-edge repair system. We assessed the impact of the G4 system on routine practice and outcomes in secondary mitral regurgitation (2°MR)., Methods and results: Consecutive patients with 2°MR treated with either the MitraClip G2 (n=89) or G4 (n=63) system between 2018 and 2021 were included. Baseline characteristics, procedures, and outcomes were compared. Inverse probability of treatment weighting and Cox regression were used to adjust for baseline differences. Baseline characteristics were similar, except for a lower surgical risk in the G4 group (Society of Thoracic Surgeons Predicted Risk of Mortality ≥8: 38.1% vs. 56.2%; P=0.03). In the G4 group, more patients had short (≤2 mm) coaptation length (83.7% vs. 54.0%; P<0.001) and fewer clips were used (17.5% vs. 36.0%; P=0.02). Acceptable MR reduction was observed in nearly all patients, with no difference between the G4 and G2 groups (100% vs. 97.8%, respectively; P=0.51). The G4 group had fewer patients with high transmitral gradients (>5mmHg; 3.3% vs. 13.6%; P=0.03). At 1 year, there was no significant difference between groups in the composite endpoint (death or heart failure rehospitalization) after baseline adjustment (10.5% vs. 20.2%; hazard ratio 0.39; 95% confidence interval 0.11-1.32; P=0.13)., Conclusions: The G4 system achieved comparable device outcomes to the early-generation G2, despite treating more challenging 2°MR with fewer clips.
Published: 2024
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37. Accuracy and Efficacy of Artificial Intelligence-Derived Automatic Measurements of Transthoracic Echocardiography in Routine Clinical Practice.

Author: Shiokawa N, Izumo M, Shimamura T, Kurosaka Y, Sato Y, Okamura T, and Akashi YJ
Abstract: Background : Transthoracic echocardiography (TTE) is the gold standard modality for evaluating cardiac morphology, function, and hemodynamics in clinical practice. While artificial intelligence (AI) is expected to contribute to improved accuracy and is being applied clinically, its impact on daily clinical practice has not been fully evaluated. Methods : We retrospectively examined 30 consecutive patients who underwent AI-equipped TTE at a single institution. All patients underwent manual and automatic measurements of TTE parameters using the AI-equipped TTE. Measurements were performed by three sonographers with varying experience levels: beginner, intermediate, and expert. Results: A comparison between the manual and automatic measurements assessed by the experts showed extremely high agreement in the left ventricular (LV) filling velocities (E wave: r = 0.998, A wave: r = 0.996; both p < 0.001). The automated measurements of LV end-diastolic and end-systolic diameters were slightly smaller (-2.41 mm and -1.19 mm) than the manual measurements, although without significant differences, and both methods showing high agreement (r = 0.942 and 0.977, both p < 0.001). However, LV wall thickness showed low agreement between the automated and manual measurements (septum: r = 0.670, posterior: r = 0.561; both p < 0.01), with automated measurements tending to be larger. Regarding interobserver variabilities, statistically significant agreement was observed among the measurements of expert, intermediate, and beginner sonographers for all the measurements. In terms of measurement time, automatic measurement significantly reduced measurement time compared to manual measurement ( p < 0.001). Conclusions: This preliminary study confirms the accuracy and efficacy of AI-equipped TTE in routine clinical practice. A multicenter study with a larger sample size is warranted.
Published: 2024
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38. Behavior of the OptiVol2 fluid index and intrathoracic impedance on remote monitoring As a detector of subclinical device infection early after implantation.

Author: Togashi D, Sasaki K, Harada T, and Akashi YJ
Abstract: We report the behavior of OptiVol2 fluid index (OVFI2) and intrathoracic impedance on remote monitoring before the appearance of signs of infection. A sustained rise in OVFI2 early after implantation reflects peri-device fluid retention., Competing Interests: The authors declare no conflict of interest for this article., (© 2024 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)
Published: 2024
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39. CORRIGENDUM: Preprocedural Controlling Nutritional Status Score as a Predictor of Mortality in Patients Undergoing Transcatheter Mitral Valve Repair　- A Single Center Experience in Japan.

Author: Noda A, Doi S, Kuwata S, Shiokawa N, Suzuki N, Kanamitsu Y, Sato Y, Shoji T, Okuno T, Kai T, Koga M, Tanabe Y, Izumo M, Ishibashi Y, and Akashi YJ
Published: 2024
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40. Prediction of symptom development and aortic valve replacement in patients with low-gradient severe aortic stenosis.

Author: Miyahara D, Izumo M, Sato Y, Shoji T, Murata R, Oda R, Okuno T, Kuwata S, and Akashi YJ
Abstract: Aims: Current evidence on the prognostic value of exercise stress echocardiography (ESE) in asymptomatic patients with low-gradient severe aortic stenosis (AS) is limited. Therefore, this study aimed to elucidate its prognostic implications for patients with low-gradient severe AS and determine the added value of ESE in risk stratification for this population., Methods and Results: This retrospective observational study included 122 consecutive asymptomatic patients with either moderate [mean pressure gradient (MPG) < 40 mmHg and aortic valve area (AVA) 1.0-1.5 cm 2 ] or low-gradient severe (MPG < 40 mmHg and AVA < 1.0 cm 2 ) AS and preserved left ventricular ejection fraction (≥50%) who underwent ESE. All patients were followed up for AS-related events. Of 143 patients, 21 who met any exclusion criteria, including early interventions, were excluded, and 122 conservatively managed patients [76.5 (71.0-80.3) years; 48.3% male] were included in this study. During a median follow-up period of 989 (578-1571) days, 64 patients experienced AS-related events. Patients with low-gradient severe AS had significantly lower event-free survival rates than those with moderate AS (log-rank test, P < 0.001). Multivariable Cox regression analysis showed that the mitral E / e ' ratio during exercise was independently associated with AS-related events (hazard ratio = 1.075, P < 0.001) in patients with low-gradient severe AS., Conclusion: This study suggests that asymptomatic patients with low-gradient severe AS have worse prognoses than those with moderate AS. Additionally, the mitral E / e ' ratio during exercise is a useful parameter for risk stratification in patients with low-gradient severe AS., Competing Interests: Conflict of interest: M.I. is a consultant of Edwards Lifesciences and Abbott Medical Japan, and S.K. is a consultant of Abbott Medical Japan. All other authors declare no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Published: 2024
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41. Enhanced Hemodynamic Performance of a New-Generation 23-mm Balloon-Expandable Transcatheter Heart Valve.

Author: Okuno T, Terauchi K, Kai T, Sato Y, Kuwata S, Koga M, Izumo M, and Akashi YJ
Subjects: Humans, Treatment Outcome, Aortic Valve diagnostic imaging, Aortic Valve surgery, Hemodynamics, Prosthesis Design, Transcatheter Aortic Valve Replacement adverse effects, Heart Valve Prosthesis, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery
Published: 2024
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42. ST-Segment Elevation During Percutaneous Left Atrial Appendage Closure.

Author: Shoji T, Sato Y, Togashi D, Kuwata S, Izumo M, Harada T, and Akashi YJ
Abstract: A 70-year-old patient with paroxysmal atrial fibrillation underwent left atrial appendage closure. The patient experienced transient hypotension during device implantation. The procedure was abandoned because of ST-T-wave changes on electrocardiography and elevated coronary flow velocity on transesophageal echocardiography, which indicated that the device caused coronary artery compression., Competing Interests: Dr Harada is a clinical proctor as Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2024 The Authors.)
Published: 2024
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43. Safety and feasibility of zero-contrast transcatheter aortic valve implantation using balloon-expandable valves in patients with aortic stenosis and severe renal impairment: A single-center study.

Author: Koga M, Izumo M, Kobayashi Y, Kai T, Okuno T, Sato Y, Kuwata S, Okuyama K, Ishibashi Y, Tanabe Y, and Akashi YJ
Subjects: Humans, Feasibility Studies, Contrast Media adverse effects, Aortic Valve diagnostic imaging, Aortic Valve surgery, Treatment Outcome, Transcatheter Aortic Valve Replacement, Heart Valve Prosthesis, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Aortic Valve Stenosis complications, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic therapy
Abstract: Background: Aortic stenosis (AS) and chronic kidney disease (CKD) can coexist. Repeat exposure to contrast media in patients undergoing transcatheter aortic valve implantation (TAVI) has latent mortality risks and increased risk for acute kidney injury. We aimed to assess our "zero-contrast TAVI" protocol for patients with advanced CKD., Methods: Consecutive patients with severe AS who underwent TAVI at a single center registry were enrolled. Zero-contrast TAVI group included patients who underwent TAVI without contrast and who had an estimated glomerular filtration rate <30 mL/min/1.73 m 2 . Conventional TAVI group included patients who underwent the regular TAVI procedure. Patients using balloon-expandable valves via transfemoral approach were analyzed. Baseline clinical and procedural characteristics and clinical outcomes were compared between two groups. The primary outcome was early safety as defined by Valve Academic Research Consortium Criteria. Secondary outcomes included the presence of severe prosthesis-patient mismatch, moderate or greater perivalvular leakage, and requirement for new dialysis (within 3 months)., Results: A total of 520 patients were analyzed. Among these, 32 (6 %) underwent zero-contrast TAVI and 488 (94 %) conventional TAVI. In the zero-contrast TAVI group, 12 patients (37.5 %) had to use 20.7 (11.0-31.2) mL of contrast media. There were no significant differences in the primary and secondary outcomes between zero-contrast TAVI and conventional TAVI groups (78.1 % vs. 86.8 %, P = 0.184 and 9.4 % vs. 8.1 %, P = 0.738 for the primary and secondary outcomes, respectively)., Conclusions: Zero-contrast TAVI is feasible, safe, and effective in patients with AS and stage 4 CKD., Competing Interests: Declaration of competing interest Dr. Izumo is a screening proctor at Edwards Lifesciences., (Copyright © 2023 Elsevier Inc. All rights reserved.)
Published: 2024
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44. Prevalence and Clinical Outcomes of Noncardiac Surgery After Transcatheter Aortic Valve Replacement.

Author: Kai T, Izumo M, Okuno T, Kobayashi Y, Sato Y, Kuwata S, Koga M, Tanabe Y, Sakamoto M, and Akashi YJ
Subjects: Humans, Aged, Retrospective Studies, Prevalence, Risk Factors, Treatment Outcome, Aortic Valve surgery, Transcatheter Aortic Valve Replacement adverse effects, Aortic Valve Stenosis epidemiology, Aortic Valve Stenosis surgery, Aortic Valve Stenosis complications, Heart Valve Prosthesis Implantation adverse effects
Abstract: Aortic stenosis is a prevalent valvular heart disease, especially in the older people. They often coexist with other co-morbidities, and noncardiac surgery carries a higher risk because of the underlying valve condition. Despite the growing concern about the safety and optimal management of noncardiac surgery post-transcatheter aortic valve replacement (TAVR), there is limited evidence on this matter. This study aims to assess the clinical outcomes of noncardiac surgeries after TAVR. This retrospective study included 718 patients who underwent TAVR. Of these, 36 patients underwent noncardiac surgery after TAVR. The primary end point was the incidence of cardiovascular adverse events post-TAVR and the secondary end point was the incidence of structural valve deterioration. Composite end points included disabling stroke, heart failure requiring hospitalization, and cardiac death as defined by Valve Academic Research Consortium 3. Most of these surgeries were orthopedic and classified as intermediate risk. All noncardiac surgeries were performed without perioperative adverse events. There was no observed structural valve deterioration, and the incidence of composite end points did not significantly differ between the surgical and nonsurgical groups during the follow-up period. Noncardiac surgery after TAVR can be performed safely and does not have a negative impact on prognosis. Further studies are warranted to determine the optimal strategy for noncardiac surgery after TAVR., Competing Interests: Declaration of Competing Interest Dr. Okuno reports speaker fees from Abbott Medical Japan and Medtronic, Dr. Izumo is a consultant of Edwards Lifesciences and Abbott Medical Japan, and Dr Kuwata is a consultant of Abbott Medical Japan. The remaining authors have no competing interests to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)
Published: 2024
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45. Changes in exercise stress echocardiographic parameters before and after transcatheter mitral valve edge-to-edge repair.

Author: Murata R, Kuwata S, Izumo M, Shiokawa N, Sato Y, Okuno T, Koga M, Okuyama K, Tanabe Y, Harada T, Ishibashi Y, and Akashi YJ
Subjects: Humans, Mitral Valve diagnostic imaging, Mitral Valve surgery, Echocardiography, Stress, Treatment Outcome, Echocardiography, Cardiac Catheterization, Mitral Valve Insufficiency diagnosis, Mitral Valve Insufficiency surgery, Heart Valve Prosthesis Implantation adverse effects
Abstract: The safety and feasibility are still not well known for exercise-induced mitral regurgitation (MR). This study is aimed to assess and compare the hemodynamic and symptomatic changes in patients with significant secondary MR during exercise stress echocardiography (ESE) before and after transcatheter edge-to-edge repair (TEER). The study included a total of 15 patients with secondary MR who underwent ESE before and after TEER using the MitraClip system (Abbott, Abbott Park, IL, USA). Echocardiographic data of ESE were collected both before the procedure and during the follow-up visit at 3 months. During the one-year postoperative observation period, the rate of readmission due to heart failure was 13% (n = 2), with no recorded fatalities. Although no significant differences of ESE data were observed in exercise-induced pulmonary hypertension or cardiac output before and after the repair, the severity of MR was significantly improved after the procedure, both at rest (2 [2-3] vs. 1 [1-2], p = 0.0125) and during ESE (3 [3-3] vs. 1 [1-1], p < 0.0001). Furthermore, the New York Heart Association Functional Classification was improved (3 [3-3] vs. 1 [1-1], p < 0.0001) after treatment. For a supplemental analysis, MR during ESE was significantly improved not only in cases with atrial secondary MR but also in ventricular secondary MR. Transcatheter edge-to-edge repair for exercise-induced MR resulted in a significant improvement in postoperative MR severity and subjective symptoms. These results are novel, as they have not been extensively reported previously, particularly among Japanese patients., (© 2023. The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics.)
Published: 2024
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46. Prognostic value of transvalvular flow rate in patients with low-gradient severe aortic stenosis: A dobutamine stress echocardiography study.

Author: Onishi H, Izumo M, Nishikawa H, Suzuki T, Sato Y, Watanabe M, Kuwata S, Kamijima R, Naganuma T, Nakamura S, and Akashi YJ
Subjects: Male, Humans, Aged, Aged, 80 and over, Stroke Volume, Prognosis, Echocardiography, Stress, Retrospective Studies, Aortic Valve diagnostic imaging, Severity of Illness Index, Ventricular Function, Left, Aortic Valve Stenosis diagnostic imaging
Abstract: Backgrounds: There are limited data on the clinical relevance of transvalvular flow rate (Q mean ) at rest (Q rest) and at peak stress (Q stress ) during dobutamine stress echocardiography (DSE) in patients with low-gradient severe aortic stenosis (LG-SAS)., Methods: We retrospectively analyzed the clinical data of patients with LG-SAS who underwent DSE. LG-SAS was defined as an aortic valve (AV) area index of < .6 cm 2 /m 2 and a mean AV pressure gradient (AVPG) of < 40 mm Hg. The primary endpoint included all-cause death and heart failure hospitalization., Results: Of 100 patients (mean age 79.5 ± 7.3 years; men, 45.0%; resting left ventricular ejection fraction [LVEF] 52.1% ± 15.9%; resting stroke volume index 35.8 ± 7.7 mL/m 2 ; Q rest 171.8 ± 34.9 mL/s), the primary endpoint occurred in 51 patients during a median follow-up of 2.84 (interquartile range 1.01-5.21) years. When the study patients were divided into three subgroups based on Q rest and Q stress , the multivariate analysis showed that Qrest < 200 mL/s and Qstress ≥200 mL/s (hazard ratio 3.844; 95% confidence interval 1.143-12.930; p = .030), as well as Q rest and Qstress < 200 mL/s (hazard ratio 9.444; 95% confidence interval 2.420-36.850; p = .001), were significantly associated with unfavorable outcomes with Q rest and Qstress ≥200 mL/s as a reference after adjusting for resting LVEF, resting mean AVPG, chronic kidney disease, New York Heart Association functional class III/IV, and AV replacement., Conclusions: Flow conditions based on the combination of Q rest and Q stress are helpful for risk stratification in LG-SAS patients., (© 2023 Wiley Periodicals LLC.)
Published: 2024
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47. Response to Letter to the Editor: "Detailed Mechanism of Speech-induced Tachyarrhythmia".

Author: Doi S, Furukawa T, Kameshima H, Tanaka O, Harada T, and Akashi YJ
Subjects: Humans, Electrocardiography, Speech, Tachycardia etiology
Published: 2023
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48. Stress echocardiography in valvular heart disease.

Author: Hirasawa K, Izumo M, and Akashi YJ
Abstract: Valvular heart disease (VHD) has been a significant health problem, particularly in developed countries, in relation to the aging population. Recent developments in the management of VHD require a more accurate assessment of disease severity to determine the need for transcatheter interventions or open heart surgery. Stress echocardiography is a crucial imaging modality for identifying the underlying pathology of VHD. Optimal administration of exercise or intravenous drugs may reveal hemodynamic abnormalities under stress without posing an invasive risk. Therefore, the implementation of stress echocardiography is recommended for determining interventional indications and risk stratification in mitral regurgitation and aortic stenosis. In addition, recent evidence has accumulated regarding the usefulness of stress echocardiography in various conditions including mitral stenosis, aortic regurgitation, and post-interventional VHD. Here, we summarize the current evidence and future perspectives on stress echocardiography in VHD., Competing Interests: MI is a screening proctor of Edwards Lifesciences and a clinical proctor of Abbott Medical Japan. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Hirasawa, Izumo and Akashi.)
Published: 2023
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49. Preprocedural Controlling Nutritional Status Score as a Predictor of Mortality in Patients Undergoing Transcatheter Mitral Valve Repair　- A Single Center Experience in Japan.

Author: Noda A, Doi S, Kuwata S, Shiokawa N, Suzuki N, Kanamitsu Y, Sato Y, Tatsuro S, Okuno T, Kai T, Koga M, Tanabe Y, Izumo M, Ishibashi Y, and Akashi YJ
Abstract: Background: A high score for controlling nutritional status (CONUT) due to poor nutritional status has been associated with adverse outcomes in patients with chronic heart failure. However, because little is known about the effect of CONUT score on mortality rates after transcatheter mitral valve repair, we evaluated nutrition screening tools for prognosis prediction in patients undergoing transcatheter mitral valve repair using the MitraClip TM system. Methods and Results: We retrospectively analyzed 148 patients with severe mitral regurgitation (MR) who underwent MitraClip TM implantation between April 2018 and April 2021. The preprocedural CONUT scores were assessed at the time of hospitalization, the primary outcome was all-cause death, and the analysis was of the mortality and incidence rates of cardiac events 1 year post-operation. Functional MR was of ischemic origin in the majority of patients (69.6%), with a mean left ventricular ejection fraction of 48.9±15.8%. Kaplan-Meier curves indicated that all-cause death was significantly worse in the high-CONUT score group than in the low-CONUT score group. Cox hazard analysis showed a significant association between all-cause death and CONUT score, as well as MitraScore. Conclusions: Preprocedural CONUT score, as well as MitraScore, in patients undergoing transcatheter edge-to-edge mitral valve repair may predict an increased risk of all-cause death. This knowledge should allow the heart team to accurately assess the clinical implications and prognostic benefits of the procedure in individual patients., Competing Interests: S.K. and M.I. are consultants at Abbott Medical in Japan. Y.J.A. is a member of Circulation Reports’ Editorial Team. The other authors have no conflicts of interest to declare., (Copyright © 2023, THE JAPANESE CIRCULATION SOCIETY.)
Published: 2023
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50. Revisiting predictors of worse atrioventricular valve and left ventricular systolic function following pacemaker therapy.

Author: Sasaki K, Togashi D, Nakajima I, Nakayama Y, Harada T, and Akashi YJ
Subjects: Humans, Cardiac Pacing, Artificial, Retrospective Studies, Ventricular Function, Left, Pacemaker, Artificial, Mitral Valve Insufficiency therapy, Tricuspid Valve Insufficiency
Abstract: Background: Predictors of worsening atrioventricular valve regurgitation and left ventricular (LV) systolic function after implantation of a leadless pacemaker (LPM) remain unclear compared with those of a transvenous pacemaker (TPM)., Methods: We retrospectively analyzed 205 patients who were newly implanted with a permanent pacemaker (119 LPMs and 86 TPMs) and underwent transthoracic echocardiography before and 8 ± 5 months after implantation. We evaluated the worsening of tricuspid and mitral regurgitation (TR and MR), defined as at least one-grade aggravation in severity, and changes in LV ejection fraction (LVEF)., Results: Worsening TR occurred more frequently in the LPM group compared to the TPM group (33% vs. 20%, p = .04); however, there was no significant difference between the two groups regarding worsening MR (26% vs. 18%, p = .18) and LVEF change (-2 ± 10% vs. -3 ± 8%, p = .40). In multivariable analysis, independent predictors for worsening TR, MR, and LVEF after implantation were found to be (1) the change from sinus rhythm at baseline to atrioventricular asynchronous right ventricular (RV) pacing (odds ratio [OR]: 5.68, 95% confidence interval [CI]: 1.94-16.70, p < .01); (2) the change from non-pacing ventricular contraction at baseline to RV pacing (OR: 2.42, 95% CI: 1.12-5.24, p = .02); and (3) a higher RV pacing burden (β: -0.05, 95% CI: -0.08--0.02, p < .01), respectively., Conclusion: Worsening TR, MR, and LVEF after pacemaker implantation were not associated with the type of pacing device but loss of atrioventricular synchrony or dependency on RV pacing., (© 2023 Wiley Periodicals LLC.)
Published: 2023
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