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1. Characterizing a Clinical Trial – Representative, Real-World Population with Heart Failure with Reduced Ejection Fraction

Author

Wells QS, Farber-Eger E, Lipworth L, Dluzniewski P, Dent R, Umeijiego J, and Cohen SS

Subjects
heart failure, reduced ejection fraction, real world evidence, electronic health record, Infectious and parasitic diseases, RC109-216
Abstract

Quinn S Wells,1,2 Eric Farber-Eger,1,2 Loren Lipworth,2,3 Paul Dluzniewski,4 Ricardo Dent,4 John Umeijiego,4 Sarah S Cohen3,5 1Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; 2Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University Medical Center, Nashville, TN, USA; 3Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; 4Center for Observational Research, Amgen, Inc., Thousand Oaks, CA, USA; 5Epidstrategies, A Division of Toxstrategies, Inc., Cary, NC, USACorrespondence: Sarah S Cohen Tel +1 919-885-0548Email scohen@epidstrategies.comPurpose: Given known differences between real-world and clinical trial populations, we characterized demographics, clinical characteristics, and outcomes using real-world (RW) data for patients with heart failure with reduced ejection fraction (HFrEF), including those similar to subjects enrolled in an HFrEF clinical trial to better understand patient populations that could benefit from novel therapies.Patients and Methods: Using Vanderbilt University Medical Center electronic health records (2006– 2019), two RW cohorts of HFrEF patients were identified. The “Clinical Cohort” was based on a validated HFrEF algorithm and left ventricular ejection fraction (LVEF) ≤ 40%. The “GALACTIC-HF-like Cohort” mirrored enrollment requirements of the GALACTIC-HF clinical trial including hospitalizations, medications, laboratory values, and LVEF ≤ 35%.Results: Median age at index for the Clinical Cohort (N = 3954) and GALACTIC-HF-like Cohort (N = 1541) were 65 and 61 years, respectively; both were 67% male and 80% white. Over half had coronary artery disease (55% Clinical vs 64% GALACTIC-HF-like); hypercholesterolemia was common (69% Clinical vs 74% GALACTIC-HF-like). Chronic kidney disease (31 vs 21%), atrial fibrillation (32 vs 29%), and cardiac resynchronization or implantable cardioverter defibrillator (26 vs 23%) were higher in the GALACTIC-HF-like Cohort. ACE inhibitor use was high in both groups but more common in the GALACTIC-HF-like Cohort (71% and 82%, respectively). Beta-blockers or loop diuretics were used by > 90% of both cohorts. HF hospitalization rates were 261 (95% CI 224, 297) per 1000 person-years in Clinical versus 523 (484, 562) in GALACTIC-HF-like Cohort (median follow-up of 2.9 and 4.2 years, respectively).Conclusion: Approximately 40% of RW HFrEF patients met criteria for the GALACTIC-HF trial. While findings of ongoing clinical trials may be directly generalizable to this sizable proportion of patients, future trials should examine whether the majority of patients with lower prevalence of comorbidities and rate of HF hospitalization could benefit from emerging HF treatments.Keywords: heart failure, reduced ejection fraction, real-world evidence, electronic health record

Published
2022

2. Longitudinal Invariance Testing Of The Knee Injury Osteoarthritis Outcome Score For Joint Replacement Scale (KOOS-JR).

Author

Dluzniewski, Alexandra, Allred, Caleb, Casanova, Madeline P., Moore, Jonathan D., Cady, Adam C., and Baker, Russell T.

Subjects
KNEE osteoarthritis, STATISTICS, TOTAL knee replacement, RESEARCH methodology evaluation, RESEARCH methodology, EFFECT sizes (Statistics), MULTIVARIATE analysis, AGE distribution, HEALTH outcome assessment, SPORTS injuries, SURGERY, PATIENTS, PSYCHOMETRICS, TREATMENT effectiveness, PRE-tests & post-tests, CRONBACH'S alpha, COMPARATIVE studies, SEX distribution, FACTOR analysis, DESCRIPTIVE statistics, CHI-squared test, RESEARCH funding, DATA analysis software, KNEE injuries, LONGITUDINAL method, EVALUATION
Abstract

Background The Knee Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) is a seven-item patient reported outcome measure used to assess perceived knee health. Though commonly used, the longitudinal psychometric properties of the KOOS-JR have not been established and further characterization of its structural validity and multi-group invariance properties is warranted. Purpose The purpose of this study was to evaluate psychometric properties of the KOOS-JR in a large sample of patients who received care for knee pathology. Study Design Original research. Methods Longitudinal data extracted from the Surgical Outcome System (SOS) database of 13,470 knee pathology patients who completed the KOOS-JR at baseline, three-months, six-months, and one-year. Scale structure was assessed with confirmatory factor analysis (CFA), while multi-group and longitudinal invariance properties were assessed with CFA-based procedures. Latent group means were compared with statistical significance set at α ≤ .05 and Cohen's d effect size as d = 0.2 (small), d = 0.5 (medium), and d = 0.8 (large). Results CFA results exceeded goodness-of-fit indices at all timepoints. Multi-group invariance properties passed test requirements. Longitudinal analysis identified a biased item resulting in removal of item #1; the retained six-item model (KOOS-JR-6) passed longitudinal invariance requirements. KOOS-JR-6 scores significantly changed over time (p ≤ .001, Mdiff = 1.08, Cohen's d = 0.57): the highest scores were at baseline examination and the lowest at 12-month assessment. Conclusions The KOOS-JR can be used to assess baseline differences between males and females, middle and older aged adults, and patients receiving total knee arthroplasty or non-operative care. Caution is warranted if the KOOS-JR is used longitudinally due to potential measurement error associated with item #1. The KOOS-JR-6 may be a more viable option to assess change over time; however, more research is warranted. [ABSTRACT FROM AUTHOR]

Published
2023
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6. Trends in Recurrent Coronary Heart Disease after Myocardial Infarction among US Women and Men between 2008 and 2017

Author

Peters, SAE ; https://orcid.org/0000-0003-0346-5412, Colantonio, LD, Dai, Y, Zhao, H, Bittner, V, Farkouh, ME, Dluzniewski, P, Poudel, B, Muntner, P, Woodward, M ; https://orcid.org/0000-0001-9800-5296, Peters, SAE ; https://orcid.org/0000-0003-0346-5412, Colantonio, LD, Dai, Y, Zhao, H, Bittner, V, Farkouh, ME, Dluzniewski, P, Poudel, B, Muntner, P, and Woodward, M ; https://orcid.org/0000-0001-9800-5296

Abstract

Background: Rates for recurrent coronary heart disease (CHD) events have declined in the United States. However, few studies have assessed whether this decline has been similar among women and men. Methods: Data were used from 770 408 US women and 700 477 US men <65 years of age with commercial health insurance through MarketScan and ≥66 years of age with government health insurance through Medicare who had a myocardial infarction (MI) hospitalization between 2008 and 2017. Women and men were followed up for recurrent MI, recurrent CHD events (ie, recurrent MI or coronary revascularization), heart failure hospitalization, and all-cause mortality (Medicare only) in the 365 days after MI. Results: From 2008 to 2017, age-standardized recurrent MI rates per 1000 person-years decreased from 89.2 to 72.3 in women and from 94.2 to 81.3 in men (multivariable-adjusted P interaction by sex <0.001). Recurrent CHD event rates decreased from 166.3 to 133.3 in women and from 198.1 to 176.8 in men (P interaction <0.001). Heart failure hospitalization rates decreased from 177.4 to 158.1 in women and from 162.9 to 156.1 in men (P interaction=0.001). All-cause mortality rates decreased from 403.2 to 389.5 in women and from 436.1 to 417.9 in men (P interaction=0.82). In 2017, the multivariable-adjusted rate ratios comparing women with men were 0.90 (95% CI, 0.86-0.93) for recurrent MI, 0.80 (95% CI, 0.78-0.82) for recurrent CHD events, 0.99 (95% CI, 0.96-1.01) for heart failure hospitalization, and 0.82 (95% CI, 0.80-0.83) for all-cause mortality. Conclusions: Rates of recurrent MI, recurrent CHD events, heart failure hospitalization, and mortality in the first year after an MI declined considerably between 2008 and 2017 in both men and women, with proportionally greater reductions for women than men. However, rates remain very high, and rates of recurrent MI, recurrent CHD events, and death continue to be higher among men than women.

Published
2021

10. Estimating the Effect of Preventable Treatment Discontinuation on Health Outcomes.

Author

Brookhart, M. A., Reams, D., Dluzniewski, P. J., Kshirsagar, A., Walsh, L., and Bradbury, B. D.

Abstract

Background: There is increased interest in studying the effects of medication adherence on health outcomes. However, if patients appropriately stop treatment because of side effects and treatment failure, it is neither possible nor clinically meaningful to estimate the effect of full medication adherence.Methods: We present an analysis designed to estimate the effect of nonmedical (preventable) discontinuation of cinacalcet, an oral medication approved to treat secondary hyperparathyroidism in patients with end-stage renal disease on dialysis on mortality and heart failure. The approach involves artificially censoring patients who discontinue treatment for a reason that does not appear to be related to an adverse effect of treatment. We address potential bias from informative censoring through inverse-probability of censoring weighted estimation.Results: Although the analysis is subject to possible residual confounding by the healthy adherer effect and other limitations, we find that potentially preventable discontinuation associates with 2.9 excess deaths at 1 year per 100 patients treated (95% confidence interval, 2.4, 3.5), and 4.6 excess deaths at 2 years (95% confidence interval, 3.5, 5.5). The association between cinacalcet persistence and heart failure hospitalization risk was sensitive to the outcome definition.Conclusions: Inverse-probability of censoring weighted estimation can be used to estimate the effect of potentially preventable treatment discontinuation in populations where treatment can be stopped for both medical and nonmedical reasons. Estimates from such approaches may represent an upper bound of what would be achievable by an adherence improvement intervention. [ABSTRACT FROM AUTHOR]

Published
2018
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11. Lipid Testing Trends in the US Before and After the Release of the 2013 Cholesterol Treatment Guidelines

Author

Levintow SN, Reading SR, Saul BC, Yu Y, Reams D, McGrath LJ, Philip K, Dluzniewski PJ, and Brookhart MA

Subjects
low-density lipoprotein cholesterol, statin, ezetimibe, cardiovascular disease, guideline adherence, database, epidemiology, Infectious and parasitic diseases, RC109-216
Abstract

Sara N Levintow,1,2 Stephanie R Reading,3 Bradley C Saul,1 Ying Yu,1 Diane Reams,1 Leah J McGrath,1 Kiran Philip,3 Paul J Dluzniewski,3 M Alan Brookhart1,4 1NoviSci, Inc, Durham, NC, USA; 2Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA; 3Center for Observational Research, Amgen, Thousand Oaks, CA, USA; 4Department of Population Health Sciences, Duke University, Durham, NC, USACorrespondence: Sara N LevintowNoviSci, Inc, PMB 218, 201 W Main St, Ste 200, Durham, NC 27701 Email slevintow@novisci.comBackground: The 2013 ACC/AHA cholesterol treatment guidelines removed the recommendation to treat adults at risk of cardiovascular disease to goal levels of low-density lipoprotein cholesterol (LDL-C). We anticipated that the frequency of LDL-C testing in clinical practice would decline as a result. To test this hypothesis, we evaluated the frequency of LDL-C testing before and after the guideline release.Methods: We used the MarketScan® Commercial and Medicare Supplemental claims data (1/1/2007– 12/31/2016) to identify four cohorts: 1) statin initiators (any intensity), 2) high-intensity statin initiators, 3) ezetimibe initiators, and 4) patients at very high cardiovascular risk (≥ 2 hospitalizations for myocardial infarction or ischemic stroke, with prevalent statin use). Rates of LDL-C testing by calendar year quarter were estimated for each cohort. To estimate rates in the absence of a guideline change, we fit a time-series model to the pre-guideline rates and extrapolated to the post-guideline period, adjusting for covariates, seasonality, and time trend.Results: Pre- and post-guideline rates (LDL-C tests per 1,000 persons per quarter) were 248 and 235, respectively, for 3.9 million statin initiators; 263 and 246 for 1.3 million high-intensity statin initiators; 277 and 261 for 323,544 ezetimibe initiators; and 180 and 158 for 42,108 very high-risk patients. For all cohorts, observed post-guideline rates were similar to model-predicted rates. On average, the difference between observed and predicted rates was 8.5 for patients initiating any statin; 2.6 for patients initiating a high-intensity statin; 11.4 for patients initiating ezetimibe, and − 0.5 for high-risk patients.Conclusion: We observed no discernible impact of the release of the 2013 ACC/AHA guidelines on LDL-C testing rates. Rather, there was a gradual decline in testing rates starting prior to the guideline change and continuing throughout the study period. Our findings suggest that the guidelines had little to no impact on use of LDL-C testing.Keywords: low-density lipoprotein cholesterol, statin, ezetimibe, cardiovascular disease, guideline adherence, database, epidemiology

Published
2020

13. Echocardiographic assessment of right ventricle adaptation to endurance training in young rowers -- speckle tracking echocardiography.

Author

Konopka, M., Krol, W., Burkhard-Jagodzinska, K., Jakubiak, A., Klusiewicz, A., Chwalbinska, J., Pokrywka, A., Sitkowski, D., Dluzniewski, M., and Braksator, W.

Abstract

The aim of this study was to determine the relationship between the degree of cardiorespiratory fitness and the function of the right ventricle (RV). 117 rowers, age 17.5±1.5 years. All subjects underwent cardiopulmonary exercise. Standard echocardiography and 2D speckle tracking echocardiography with evaluation of longitudinal strain in each segment of the RV (basal - RVLS-B; mid - RVLS-M, apical - RVLS-A) and global RV free-wall strain (RVLS-G) were performed. RVLS-B values were lower compared to the RVLS-M (-25.8±4.4 vs -29.3±3.5; p<0.001) and RVLS-A values (-25.8±4.4 vs -26.2±3.4; p=0.85). Correlations between VO2max and RVLS were observed in men: RVLS-G strain (r = 0.43; p <0.001); RVLS-B (r = 0.30; p = 0.02); RVLS-M (r = 0.38; p = 0.02). A similar relationship was not observed in the group of women. The strongest predictors corresponding to a change in global and basal strain were VO2max and training time: RVLS-G (VO2max: β = 0.18, p = 0.003; training time: β = -0.39; p = 0.02) and RVLS-B (VO2max: β = 0.23; p = 0.0001 training time: β = -1.16; p = 0.0001). The global and regional reduction of RV systolic function positively correlates with the level of fitness, and this relationship is observed already in young athletes. The character of the relationship between RV deformation parameters and the variables that determine the physical performance depend on gender. The dependencies apply to the proximal fragment of the RV inflow tract, which may be a response to the type of flow during exercise in endurance athletes. [ABSTRACT FROM AUTHOR]

Published
2016
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14. Polymorphisms Influencing Prostate-Specific Antigen Concentration May Bias Genome-Wide Association Studies on Prostate Cancer.

Author

Dluzniewski, Paul J., Jianfeng Xu, Ruczinski, Ingo, Isaacs, William B., and Platz, Elizabeth A.

Abstract

The article discusses genome-wide association studies (GWAS) that reveals association between single nucleotide polymorphisms (SNPs) and prostate cancer. It mentions the simulation study conducted to quantify the influence of SNP on the Prostate-Specific Antigen (PSA) concentration. It adds the calculation of mean betas from the replicate cohorts and prevalence of carrying minor allele.

Published
2015
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16. Variation in IL10 and Other Genes Involved in the Immune Response and in Oxidation and Prostate Cancer Recurrence.

Author

Dluzniewski, Paul J., Ming-Hsi Wang, Siqun Lilly Zheng, De Marzo, Angelo M., Drake, Charles G., Fedor, Helen L., Partin, Alan W., Misop Han, Fallin, M. Daniele, Jianfeng Xu, Isaacs, William B., and Platz, Elizabeth A.

Abstract

The article presents a study which examines the connection of variation in genes involved in immune response with the risk of recurrence after surgery for localized prostate cancer. It also studied whether risk of recurrence is influenced by production and detoxification of reactive oxygen species and repair of oxidative DNA damage. Men who underwent radical prostatectomy in 1993 to 2001 were the subjects of the research study.

Published
2012
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17. Electron emission from nitrogen-doped polycrystalline diamond/Si heterostructures

Author

Staryga, E., Fabisiak, K., Dluzniewski, M., and Bak, G.

Abstract

The field electron emission from polycrystalline diamond/silicon and nitrogen-doped polycrystalline diamond/silicon structures obtained by HF CVD deposition method has been investigated. Electron emission currents from the samples were measured in a chamber at the pressure equal to 2·10-6Pa in sphere-to-plane diode configuration with the 5 µm distance between electrodes. As expected, the results confirm the relation between the structure of diamond films and their emission properties. The type of silicon substrate also influences the value of emission currents and the diamond/n-Si heterostructures exhibit better electron emission than diamond/p-Si ones. The nitrogen doping significantly enhances the electron emission from the heterostructures and their emission parameters. The values of the threshold field between 2 V/µm and 3 V/µm were registered, the values of emission current close to 1 mA/cm2at 5 V/µm for the nitrogen-doped films were obtained. The shape of current-voltage characteristics for nitrogen-doped polycrystalline films may be interpreted in terms of stochastic distribution of diameters of conducting channels which form the emission centers.The field electron emission from polycrystalline diamond/silicon and nitrogen-doped polycrystalline diamond/silicon structures obtained by HF CVD deposition method has been investigated. Electron emission currents from the samples were measured in a chamber at the pressure equal to 2·10-6Pa in sphere-to-plane diode configuration with the 5 µm distance between electrodes. As expected, the results confirm the relation between the structure of diamond films and their emission properties. The type of silicon substrate also influences the value of emission currents and the diamond/n-Si heterostructures exhibit better electron emission than diamond/p-Si ones. The nitrogen doping significantly enhances the electron emission from the heterostructures and their emission parameters. The values of the threshold field between 2 V/µm and 3 V/µm were registered, the values of emission current close to 1 mA/cm2at 5 V/µm for the nitrogen-doped films were obtained. The shape of current-voltage characteristics for nitrogen-doped polycrystalline films may be interpreted in terms of stochastic distribution of diameters of conducting channels which form the emission centers.

Published
2012
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18. Characteristics and Outcomes of a Real-world Population with Heart Failure with Reduced Ejection Fraction Representative of Clinical Trial Patients.

Author

Cohen, Sarah S., Farber-Eger, Eric, Lipworth, Loren, Umejiego, John, Dent, Ricardo, Dluzniewski, Paul, and Wells, Quinn S.

Abstract

Heart failure with reduced ejection fraction (HFrEF) incurs significant mortality, morbidity and cost. Despite recent advances, opportunities for therapeutic improvement remains. Omecamtiv mecarbil (OM) is a first-in-class cardiac myotrope currently in a phase-3 clinical trial (GALACTIC-HF) for HFrEF treatment. Given known differences between real world (RW) and clinical trial populations, we sought to characterize RW patients who might benefit from OM. In the Vanderbilt University Medical Center de-identified electronic health record of in- and outpatients (Synthetic Derivative) from 2006-2019, we created two RW cohorts of HFrEF patients: 1) Based on the validated eMERGE Network phenotype of HFrEF (left ventricular ejection fraction (LVEF) ≤ 40%; 'clinical cohort') and 2) Mirroring eligibility criteria of the GALACTIC-HF trial (LVEF ≤ 35%; 'GALACTIC-HF-like cohort') including hospitalizations, medications and laboratory values. Diagnosis and procedure codes, structured and unstructured problem lists, laboratory values, and medications were used to characterize demographics, clinical characteristics and outcomes. HF hospitalization rates were calculated from 5 days post HF index date to last encounter or death. The clinical cohort included 3,955 HFrEF patients and the GALACTIC-HF-like cohort included 1,541 (median age at index date 65 and 61 years, respectively), both approximately 67% male and 80% white. Aside from higher median BNP level in the GALACTIC-HF-like cohort, clinical characteristics such as blood pressure and heart rate of the two cohorts were similar. (Table). Comorbidities and utilization of cardiac devices were somewhat higher in the GALACTIC-HF-like cohort including chronic kidney disease (39 v 30%), atrial fibrillation (52 v 48%), and cardiac resynchronization or implantable cardioverter defibrillator (52 v 40%). HF hospitalization rate (per 1000py) was 242 (95% CI 203, 280) in the clinical and 396 (95% CI 350, 442) in the GALACTIC-HF like cohorts during median follow up of 2.7 and 4.1 years, respectively. Approximately 40% of RW HFrEF patients met GALACTIC-HF trial criteria, suggesting that RW HFrEF populations may benefit from new therapies such as OM. The higher prevalence of comorbidities and higher rate of HF hospitalization in the GALACTIC-HF-like cohort may indicate a high-need, high-risk population that may achieve better clinical outcomes with OM. [ABSTRACT FROM AUTHOR]

Published
2020
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21. Abstract 13025: Lipid Testing Trends in the US Before and After the Release of the 2013 ACC / AHA Cholesterol Guidelines

Author

Levintow, Sara, Reading, Stephanie, Saul, Bradley, Yu, Ying, Reams, Diane, McGrath, Leah, Philip, Kiran, Dluzniewski, Paul, and Brookhart, M. A

Abstract

Introduction:The 2013 ACC/AHA cholesterol treatment guidelines removed the recommendation to treat to blood cholesterol goals for adults with risk of ASCVD. We anticipated that the frequency of lipid testing would decline as a result. To test this hypothesis, we evaluated the frequency of LDL-C testing before and after the release of the 2013 guidelines.Methods:We used the MarketScan Commercial and Medicare Supplemental claims data to identify adults initiating any statin, a high-intensity statin, ezetimibe, and those at high cardiovascular risk (i.e., two MI or IS hospitalizations and statin use). Patients were identified between 1/1/2008 and 12/31/2015 with 12 months of continuous enrollment in a healthcare plan. Rates of LDL-C testing by calendar year quarter were estimated until the first of medication discontinuation, insurance disenrollment, or 12/31/2016. To compare the observed post-guideline rates to those expected, we fit a time-series model to the pre-guideline rates and extrapolated to the post-guideline period, adjusting for covariates, seasonality, and time trend.Results:All rates are given as number of LDL-C tests per 1,000 persons per quarter. The overall pre- and post-guideline unadjusted rates were 248 and 235, respectively, for 3.9 million patients initiating statins; 263 and 246 for 1.3 million patients initiating high-intensity statins; 277 and 261 for 323,544 patients initiating ezetimibe; and 180 and 158 for 42,108 high cardiovascular risk patients. For all patients, the observed post-guideline rates were similar to or slightly higher than the model-predicted rates had no guideline change occurred (Figure).Conclusions:We observed no discernible impact of the release of the 2013 guidelines on LDL-C testing rates. Rather, there was a gradual decline in testing rates from 2008 to 2016. These findings suggest that the 2013 guidelines may have had limited impact on behavioral changes in LDL testing, compared to the ongoing decline.

Published
2019
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22. Abstract P146: Trends in Recurrent Coronary Heart Disease Following Myocardial Infarction Among US Men and Women Between 2008 and 2016

Author

Peters, Sanne A, Colantonio, Lisandro D, Zhao, Hong, Bittner, Vera, Farkouh, Michael, Dluzniewski, Paul, Poudel, Bharat, Muntner, Paul, and Woodward, Mark

Abstract

Background:In the US, morbidity and mortality from coronary heart disease (CHD) has declined considerably from the 1970’s through the 2000’s. We examined whether rates of recurrent MI, recurrent CHD, heart failure hospitalization, and all-cause mortality among US men and women with a MI hospitalization have continued to decline between 2008 and 2016, and whether this differs between the sexes.Methods:Data were used from 1,369,617 (53% women) US adults <65 years of age with commercial health insurance in the MarketScan database and US adults ≥66 years of age with government health insurance through Medicare who had a MI hospitalization between January 1, 2008 and September 30, 2016. For each year, sex-specific rates of recurrent MI, recurrent CHD, heart failure hospitalization, and all-cause mortality (Medicare only) per 1,000 person-years were calculated at 30 days from the MI discharge date.Results:Between 2008 and 2016, rates of recurrent MI declined by 15%, from 190 to 162/1000 person-years, in men and by 27%, from 220 to 160/1000 person-years, in women. CHD recurrence rates decreased by 22%, from 311 to 244/1000 person-years, in men and by 32%, from 318 to 216/1000 person-years, in women (Figure). Heart failure hospitalization decreased by 4%, from 367 to 352/1000 person-years, in men and by 18%, from 517 to 425/1000 person-years, in women. Rates of 30-day mortality reduced by 5%, from 1,208 to 1,142/1000 person-years, in men and by 4%, from 1,416 to 1,358/1000 person-years, in women.Conclusion:Rates of recurrent MI, recurrent CHD, heart failure hospitalization, and all-cause mortality within 30 days after hospitalization for MI continue to decline in US adults, with greater reductions in the recurrence of CHD among women than men. Factors underpinning these trends warrant further investigation.

Published
2019
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25. Moderated Posters session: pulmonary hypertension and other conditions

Author

Baggen, VJM, Driessen, MMP, Post, MC, Van Dijk, AP, Roos-Hesselink, JW, Van Den Bosch, AE, Takkenberg, JJM, Sieswerda, GT, Spinelli, L, Giudice, C A, Castaldo, D, Pisani, A, Trimarco, B, Venner, C, Huttin, O, Mandry, D, Voilliot, D, Chabot, JF, Marie, PY, Juilliere, Y, Chaouat, A, Selton-Suty, C, Tuohinen, S, Skytta, T, Virtanen, V, Kellokumpu-Lehtinen, PL, Raatikainen, P, Konopka, M, Burkhard-Jagodzinska, K, Krol, W, Zdanowicz, R, Starczewski, M, Aniol-Strzyzewska, K, Jakubiak, A, Sitkowski, D, Dluzniewski, M, Braksator, W, Santoro, C, Buonauro, A, Bocchino, ML, Esposito, R, Canora, A, Vaccaro, A, Castaldo, S, Sanduzzi Zamparelli, A, Trimarco, B, Galderisi, M, Wahi, S, Chong, A, Krstic, I, Deljanin Ilic, M, Vrbic, S, Marinkovic, D, Ilic, S, Duchateau, N, Sermesant, M, Gibelin, P, Ferrari, E, Moceri, P, Handoko, M L, Di Pasqua, MC, Spruijt, OA, Oosterveer, FPT, Marcus, JT, Bogaard, HJ, and Vonk Noordegraaf, A

Abstract

Purpose: Accurate prognostication is essential to guide clinical management in patients with pulmonary arterial hypertension (PAH). The goal of this study is to provide a comprehensive overview of the most thoroughly evaluated echocardiographic findings aiming to predict adverse outcome in PAH. Methods: MEDLINE and EMBASE electronic databases were systematically searched for longitudinal studies published by April 2015 that reported associations between echocardiographic findings and adverse clinical outcome in PAH. Studies were appraised using previously developed criteria for prognostic studies. Meta-analysis of echocardiographic findings investigated by ≥4 studies was performed using random effect models. In case of significant heterogeneity (I²>50% or Cochran’s Q p-value <0.10) additional sensitivity analyses were performed by excluding specific patient subgroups. Results: Thirty-seven papers investigating 6669 patients were included. Pooled hazard ratios and heterogeneity statistics are shown in the table. For TR severity and RV free wall LPSS no statistical heterogeneity was found, however the reported standard errors were generally larger. Sensitivity analyses did not change the overall results and conclusions for pericardial effusion, right atrial area and TAPSE. These results can be therefore regarded with a higher degree of certainty. Conclusions: This meta-analysis substantiates the clinical yield of specific echocardiographic findings in the prognostication of PAH patients in day-to-day practice. Especially, pericardial effusion, right atrial area and TAPSE are of prognostic value. Systematic review registration number: CRD42014009231. Prognostic value of echo findings in PAH No. of studiesHazard ratio95% CIp-valueI², %Cochran's Q (p-value)Presence of pericardial effusion161.701.44-1.99<0.0014225.7 (0.041)Right atrial area, per 5 cm² increase51.711.38-2.13<0.001558.9 (0.063)RV systolic pressure, per 10 mmHg increase71.181.01-1.380.0437625.1 (<0.001)Tricuspid regurgitation severity72.201.64-2.95<0.001399.8 (0.133)Right atrial pressure, >15 mmHg62.451.56-3.85<0.0017620.7 (<0.001)TAPSE, per 5 mm increase70.580.46-0.75<0.0017726.1 (<0.001)RV fractional area change, per 5% increase50.810.69-0.960.0396010.1 (0.039)Tei index, per 0.1 unit increase71.231.09-1.400.0017322.3 (0.001)RV free wall longitudinal peak systolic strain, per 5% increase41.721.53-1.93<0.00103.0 (0.392)

Published
2015
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26. Poster session 4

Author

Parisi, V, Ferro, G, Bevilacqua, A, Caruso, A, Grimaldi, G, Rengo, G, Leosco, D, Ferrara, N, Yan, B P Y, Lai, KH, Chan, MYT, Lam, DYY, Fong, KNY, Chau, C, Fok, MHL, Kam, K, Tam, GM, Lee, PW, Takeuchi, H, Angelis, A, Aggeli, K, Ioakeimidis, N, Felekos, I, Abdelrasoul, M, Aznaouridis, K, Rokas, K, Vlachopoulos, C, Tousoulis, D, Cano Carrizal, R, Casanova Rodriguez, C, Prieto Moriche, E, Iglesias Del Valle, D, Cadenas Chamorro, R, De Juan Baguda, J, Martin-Penato Molina, A, Paredes Gonzalez, B, Garcia Garcia, A, Plaza Perez, I, Caiani, EG, Arbeille, P, Massabuau, P, Colombo, F, Ferri, G, Kasswat, C, Medvedofsky, D, Lang, RM, Vaida, P, Kuznetsov, VA, Yaroslavskaya, EI, Krinochkin, DV, Pushkarev, GS, Gorbatenko, EA, Bruno, RM, Bianchini, E, Di Lascio, N, Stea, F, Ujka, K, Marabotti, A, D’angelo, GS, Ghiadoni, L, Pratali, L, Zemedkun, M, Wang, Z, Asch, FM, Niki, K, Sugawara, M, Yauchi, S, Inoue, K, Yagawa, M, Takamisawa, I, Umemura, J, Yoshikawa, T, Sumiyoshi, T, Tomoike, H, Christov, G, Saundankar, J, Perdreau, E, Mukasa, T, Shah, V, Klein, N, Brogan, P, Marek, J, Batalli, A, Ibrahimi, P, Ahmeti, A, Haliti, E, Bytyci, I, Poniku, A, Henein, MY, Bajraktari, G, Luo, XX, Fang, F, Gan, SF, Ma, Z, Yu, CM, Gonella, A, Conte, E, Morena, L, Riva, L, Civelli, D, Losardo, L, Canepari, ME, Castellino, C, Grasso, M, Margaria, F, Massoure, P L, Camus, O, Gabaudan, C, Desmots, F, Fourcade, L, Jacquier, A, Divchev, D, Weippert, M, Schmidt, P, Gettel, H, Neugebauer, A, Behrens, K, Braumann, K-M, Wolfarth, B, Nienaber, CA, Rodriguez Gonzalez, E, Monivas Palomero, V, Mingo Santos, S, Restrepo Cordoba, MA, Goirigolzarri Artaza, J, Gomez Bueno, M, Garcia Izquierdo, E, Serrano Fiz, S, Gonzalez Roman, A, Segovia Cubero, J, Pila-On, SASTRA, Atmadikoesoemah, C, Soesanto, A, Andriantoro, H, Kowallick, J T, Morton, G, Lamata, P, Jogiya, R, Kutty, S, Lotz, J, Hasenfuss, G, Nagel, E, Chiribiri, A, Schuster, A, Jung, IH, Moon, JG, Byun, YS, Kim, TH, Park, SH, Seo, HS, Wellnhofer, E, Kriatselis, C, Gerds-Li, JH, Kropf, M, Pieske, B, Graefe, M, Eldeep, M, Marghany, K, Mokarrab, M, Albaz, M, Marcos-Alberca Moreno, P, Perez-Isla, L, Palacios, J, Gomez De Diego, JJ, De Agustin, JA, Luaces, M, Mahia, P, Arrazola, J, Garcia-Fernandez, MA, Macaya, C, Attenhofer Jost, C H, Mueller, P, Naegeli, B, Levis, P, Amann, FW, Seifert, B, Maurer, D, Bertel, O, Caspar, T, Samet, H, Jesel, L, Petit-Eisenmann, H, Trinh, A, Talha, S, Morel, O, Ohlmann, P, Leao, S, Cordeiro, F, Magalhaes, P, Moz, M, Trigo, J, Mateus, P, Fontes, P, Moreira, I, Sharif, D, Matanis, W, Sharif-Rasslan, A, Sharif, Y, Rosenschein, U, Faustino, M, Bravo Baptista, S, Freitas, A, Bicho Augusto, J, Leal, P, Nedio, M, Antunes, C, Farto E Abreu, P, Gil, V, Morais, C, Nguyen, VT, Cimadevilla, C, Arangalage, D, Dehoux, M, Dreyfus, J, Codogno, I, Duval, X, Huart, V, Vahanian, A, Messika-Zeitoun, D, Cakmak, HA, Aslan, S, Erturk, M, Ornek, V, Tosu, AR, Kalkan, AK, Ozturk, D, Tasbulak, O, Avci, Y, Gul, M, Cioffi, G, Mazzone, C, Di Nora, C, Barbati, G, Ognibene, F, Nistri, S, Tarantini, L, Pulignano, G, Di Lenarda, A, Faggiano, P, Nishimura, S, Izumi, C, Amano, M, Miyake, M, Tamura, T, Kondo, H, Kaitani, K, Nakagawa, Y, Rosa, I, Ancona, F, Stella, S, Marini, C, Spartera, M, Barletta, M, Pavon, AG, Margonato, A, Agricola, E, Arangalage, D, Nguyen, V, Robert, T, Melissopoulou, M, Mathieu, T, Codogno, I, Cimadevilla, C, Dehoux, M, Vahanian, A, Messika-Zeitoun, D, Rahman, MT, Zito, C, Longobardo, L, Cusma Piccione, M, Zucco, M, D'angelo, M, Rivetti, L, Carerj, ML, Boretti, I, Calabro, MP, Carerj, S, Lozano Granero, VC, Rodriguez Munoz, D, Carbonell San Roman, A, Moya Mur, JL, Hinojar, R, Gonzalez, A, Casas, E, Jimenez Nacher, JJ, Fernandez-Golfin, C, Zamorano Gomez, JL, Gripari, P, Tamborini, G, Muratori, M, Ghulam Ali, S, Fusini, L, Alamanni, F, Pepi, M, Keramida, K, Bellamy, M, Dawson, D, Nihoyannopoulos, P, Solowjowa, N, Musayeva, L, Hrytsyna, Y, Knosalla, CH, Falk, V, Muraru, D, Maddalozzo, A, Jenei, C, Dequal, D, Veronesi, F, Aruta, P, Romeo, G, Iliceto, S, Badano, L, Gursoy, MO, Kalcik, M, Ozkan, M, Astarcioglu, MA, Gokdeniz, T, Yesin, M, Karakoyun, S, Gunduz, S, Tuncer, MA, Koksal, C, Cresti, A, Chiavarelli, M, Guerrini, F, D'aiello, N, Albano, A, De Sensi, F, Picchi, A, Cesareo, F, Severi, S, Braga, M, Nascimento, H, Flores, L, Ribeiro, V, Melao, F, Dias, P, Maciel, MJ, Bettencourt, P, Ferreiro Quero, C, Delgado Ortega, M, Puentes Chiachio, M, Mesa Rubio, M D, Ruiz Ortiz, M, Duran Jimenez, E, Sanchez Fernandez, J, Morenate Navio, C, Pan, M, Suarez De Lezo, J, Jansen, R, Agostoni, P, Stella, PR, Nijhoff, F, Ramjankhan, FZ, Suyker, WJ, Chamuleau, SAJ, Scislo, P, Huczek, Z, Kochman, J, Rymuza, B, Kochanowski, J, Scisbisz, A, Piatkowski, R, Opolski, G, Ray, R, Knott, K, Smith, D, Rodriguez, A, Finocchiaro, G, Sharma, R, Veiga, C, Calvo Iglesias, F, Paredes-Galan, E, Pazos, Pablo, Romo, Andres Iniguez, Ageing, Disease, Cardiovascular, Krejci, J, Hude, P, Ozabalova, E, Zampachova, V, Mlejnek, D, Sochorova, D, Spinarova, L, Wess, G, Klueser, L, Holler, PJ, Simak, J, Kuechenhoff, H, Vago, H, Czimbalmos, CS, Toth, A, Csecs, I, Kecskes, K, Suhai, F, Kiss, O, Simor, T, Becker, D, Merkely, B, Hinojar, R, Fernandez-Golfin, C, Portugal, JC, Esteban, A, Megias, A, Ruiz Leria, S, Rincon, LM, Jimenez-Nacher, JJ, Zamorano, JL, Dejgaard, LA, Haland, T, Lie, OH, Massey, R, Edvardsen, T, Haugaa, KH, Pavlyukova, EN, Evtushenko, VA, Smushlyaev, KA, Karpov, RS, Zaroui, A, Asmi, MONIA, Ben Said, RYM, Zidi, WIEM, Wali, SANA, Feki, M, Mourali, MS, Kaabachi, NEZIHZ, Mechmeche, RACHID, Labarre, Q, Garcia, R, Degand, B, Christiaens, L, Coisne, D, Csecs, I, Czimbalmos, CS, Toth, A, Suhai, F I, Pozsonyi, Z, Becker, D, Simor, T, Merkely, B, Vago, H, Maceira Gonzalez, A M, Tuset, L, Ripoll, C, Cosin-Sales, J, Igual, B, Salazar, J, Belloch, V, Coisne, D, Viera, F, Labarre, Q, Garcia, R, Degand, B, Christiaens, L, Rodriguez Gonzalez, E, Monivas Palomero, V, Mingo Santos, S, Restrepo Cordoba, MA, Goirigolzarri Artaza, J, Gomez Bueno, M, Serrano Fiz, S, Gonzalez Roman, A, Garcia Izquierdo Jaen, E, Segovia Cubero, J, Rojek, A, Chrostowska, M, Dudziak, M, Narkiewicz, K, Grapsa, J, Tan, TC, Dawson, D, Nihoyannopoulos, P, Methia, N, Cioffi, G, Viapiana, O, Ognibeni, F, Dalbeni, A, Gatti, D, Di Nora, C, Mazzone, C, Faganello, G, Di Lenarda, A, Rossini, M, Styczynski, G, Milewska, A, Marczewska, M, Sobieraj, P, Sobczynska, M, Dabrowski, M, Kuch-Wocial, A, Szmigielski, C A, Czimbalmos, C, Vago, H, Csecs, I, Toth, A, Suhai, F I, Kiss, O, Sydo, N, Becker, D, Simor, T, Merkely, B, Konopka, M, Burkhard-Jagodzinska, K, Krol, W, Jakubiak, A, Aniol-Strzyzewska, K, Sitkowski, D, Dluzniewski, M, Braksator, W, Sturmberger, T, Eder, V, Ebner, C, Winter, S, Martinek, M, Puererfellner, H, Aichinger, J, Sormani, P, Rusconi, C, Zancanella, M, Peritore, A, De Chiara, B, Spano’, F, Vallerio, P, Cairoli, R, Giannattasio, C, Moreo, A, Siliste, RN, Chitroceanu, A, Ianula, R, Spataru, D, Isacoff, D, Rodrigues, AC, Monaco, C, Guimaraes, L, Cordovil, R, Piveta, R, Franca, L, Fischer, CH, Vieira, M, Lira, E, Morhy, S, Antonielli, E, Pizzuti, A, Dogliani, S, Mabritto, B, Bassignana, A, Pancaldo, D, Doronzo, B, Evdoridis, C, Papasaikas, D, Sergi, E, Papadimitriou, D, Tolios, P, Papagiannis, G, Tzamou, V, Trikas, A, Scali, MC, Bombardini, T, Picano, E, Scali, MC, Bombardini, T, Salvadori, S, Costantino, MF, Picano, E, Scali, MC, Bombardini, T, Salvadori, S, Picano, E, Generati, G, Bandera, F, Pellegrino, M, Labate, V, Carbone, F, Alfonzetti, E, Guazzi, M, Rivetti, L, Cusma Piccione, M, Zito, C, D'angelo, M, Manganaro, R, Pizzino, F, Terrizzi, A, Quattrocchi, S, Ioppolo, A, Carerj, S, Giga, V, Boskovic, N, Stepanovic, J, Beleslin, B, Nedeljkovic, I, Dobric, M, Djordjevic-Dikic, A, Popovic, D, Petrovic, I, Banovic, M, Lasica, R, Pesic, V, Plecas - Solarovic, B, Vidojevic, D, Djordjevic, T, Orovic, M, Vujisic - Tesic, B, Bordonaro, V, Buccheri, S, Bottari, VE, Romano, C, Atanasio, FA, Tamburino, C, Monte, I P, Korchi, F, Kassongo, A, Meimoun, P, De Zuttere, D, Lardoux, HERVE, Zoppellaro, G, Venneri, L, Khattar, RS, Li, W, Senior, R, Casanova Rodriguez, C, Cano Carrizal, R, Cadenas Chamorro, R, Iglesias Del Valle, D, Prieto Moriche, E, Garcia Garcia, A, Martin Penato Molina, A, De Juan Baguda, J, Paredes Gonzalez, B, Plaza Perez, I, Sreekumar, P, Manjunath, CN, Ravindranath, KS, Dhanalakshmi, CD, Ranjbar, S, Karvandi, M, Ranjbar, F, Ghaffaripour Jahromi, M, Hassantash, SA, Foroughi, M, Maurea, N, Coppola, C, Piscopo, G, Galletta, F, Maurea, C, Esposito, E, Barbieri, A, Riccio, G, De Laurentiis, M, De Lorenzo, C, Strachinaru, M, De Jong, N, Geleijnse, ML, Van Dalen, BM, Vos, HJ, Keramida, K, Kouris, N, Dawson, D, Olympios, CD, Nihoyannopoulos, P, Rodriguez Munoz, D, Carbonell San Roman, A, Lozano Granero, C, Moya Mur, JL, Fernandez-Golfin, C, Moreno Planas, J, Casas Rojo, E, Fernandez Santos, S, Hernandez-Madrid, A, Zamorano Gomez, JL, D'auria, F, Leone, R, Itri, F, Del Negro, G, Colombino, M, Masiello, P, Longobardi, A, Rosapepe, F, Iesu, S, Di Benedetto, G, Capotosto, L, D'orazio, S, Ashurov, R, Continanza, G, Mangieri, E, Terzano, C, Vitarelli, A, Seo, J, Cho, IJ, Chang, HJ, Hong, GR, Ha, JW, Chung, NS, Shim, CY, Bianco, F, Cicchitti, V, Radico, F, Conti, M, Bucciarelli, V, Marchetti, M, Tonti, G, De Caterina, R, Di Girolamo, E, Gallina, S, Plokhova, EV, Akasheva, D, Tkacheva, O, Strazhesko, I, Dudinskaya, E, Pokshubina, I, Pykhtina, V, Kruglikova, A, Brailova, N, Boytsov, S, Weng, K-P, Lin, CC, Wahba Hassanein, M, Ashour, Z A, Bakhoum, S W G, Abdel Wahab, A M A, Hussein, EKHLAS, Saad, ZIZI, Malik, RAUOOF, Almasswary, ADEL, Elrawy, M, Lo Iudice, F, Lembo, M, Muscariello, R, Carlomagno, F, Pivonello, R, Colao, A, Trimarco, B, Galderisi, M, Purwowiyoto, S L, Santoso, A, Soesanto, A M, Indonesia), PERKI (Perhimpunan Dokter Spesialis Kardiovaskular, Segura De La Cal, T, Moya Mur, JL, Garcia Martin, A, Carbonell, S, Fraile Sanz, C, Rincon, LM, Rodriguez Munoz, DA, Jimenez Nacher, JJ, Fernandez-Golfin, C, Zamorano, JL, Ongun, A, Habibova, U, Gerede, DM, Dincer, I, Kilickap, M, Erol, C, Nouhravesh, N, Andersen, HU, Jensen, JS, Rossing, P, Jensen, MT, Gasior, Z, Dabek, J, Balys, M, Glogowska-Rygus, J, and Pysz, P

Abstract

Purpose: Epicardial adipose tissue (EAT) thickness, measured by echocardiography, is associated to the presence of coronary artery disease (CAD) and severe aortic stenosis (AS). EAT thickness is commonly referred as the diameter of the echo-free space between the right ventricular wall and the visceral layer of the pericardium in parasternal long axis view, using the aortic annulus as an anatomic landmark (EAT-1). We aimed to demonstrate that the direct measurement of the adipose tissue thickness visualized in the space between the ascending aorta and the right ventricle (EAT-2) might be considered an alternative method. Methods: We measured EAT-1 and EAT-2 in 130 pts with severe cardiac disease referred for cardiac surgery: 53 pts with isolated AS, 49 pts with severe CAD, and 28 pts with both severe AS and CAD (AS+CAD); and in 50 control subjects matched for age, sex and BMI. The two measurements were obtained at end-systole in 3 cardiac cycles (figure). Results. Both EAT-1 and EAT-2 measurements had an excellent reproducibility. With respect to controls pts had significantly increased EAT-1 (2,4 ± 0,5mm vs 6 ± 2mm; p<0,05) and EAT-2 (3 ± 1,2mm vs 12 ± 3mm; p<0,05). EAT-1 and EAT-2 were not statistically different in controls. EAT-2 was significantly higher than EAT-1 in CAD, AS, and AS+CAD pts (p<0,05). Interestingly, EAT-2, but not EAT-1, was significantly increased in AS+CAD pts with respect to EAT-2 of pts with isolated AS and isolated CAD. Conclusions: Our data demonstrate that EAT-2, as well as EAT-1, is a valuable method to measure EAT thickness. Further, EAT-2 seems to better recognize EAT increase, in pts with AS+CAD. Comprehensively, EAT-2 is greater than EAT-1. The larger space between ascending aorta and right ventricle, allowing EAT expansion, could justify our observation.

Published
2015
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28. Poster session 2: Thursday 4 December 2014, 08:30-12:30 * Location: Poster area

Author

Domingos, JS, Augustine, DX, Leeson, P, Noble, JA, Doan, H-L, Boubrit, L, Cheikh-Khalifa, R, Laveau, F, Djebbar, M, Pousset, F, Isnard, R, Hammoudi, N, Lisi, M, Cameli, M, Di Tommaso, C, Curci, V, Reccia, R, Maccherini, M, Henein, M Y, Mondillo, S, Leitman, M, Vered, Z, Rashid, H, Yalcin, M U, Gurses, K M, Kocyigit, D, Evranos, B, Yorgun, H, Sahiner, L, Kaya, B, Aytemir, K, Ozer, N, Bertella, E, Petulla', M, Baggiano, A, Mushtaq, S, Russo, E, Gripari, P, Innocenti, E, Andreini, D, Tondo, C, Pontone, G, Necas, J, Kovalova, S, Hristova, K, Shiue, I, Bogdanva, V, Teixido Tura, G, Sanchez, V, Rodriguez-Palomares, J, Gutierrez, L, Gonzalez-Alujas, T, Garcia-Dorado, D, Forteza, A, Evangelista, A, Timoteo, A T, Aguiar Rosa, S, Cruz Ferreira, R, Campbell, R, Carrick, D, Mccombe, C, Tzemos, N, Berry, C, Sonecki, P, Noda, M, Setoguchi, M, Ikenouchi, T, Nakamura, T, Yamamoto, Y, Murakami, T, Katou, Y, Usui, M, Ichikawa, K, Isobe, M, Kwon, BJ, Roh, JW, Kim, HY, Ihm, SH, Barron, A J, Francis, DP, Mayet, J, Wensel, R, Kosiuk, J, Dinov, B, Bollmann, A, Hindricks, G, Breithardt, OA, Rio, P, Moura Branco, L, Galrinho, A, Cacela, D, Pinto Teixeira, P, Afonso Nogueira, M, Pereira-Da-Silva, T, Abreu, J, Teresa Timoteo, A, Cruz Ferreira, R, Pavlyukova, EN, Tereshenkova, EK, Karpov, RS, Piatkowski, R, Kochanowski, J, Opolski, G, Barbier, P, Mirea, O, Guglielmo, M, Savioli, G, Cefalu, C, Pudil, R, Horakova, L, Rozloznik, M, Balestra, C, P37/03, PRVOUK, Rimbas, RC, Enescu, OA, Calin, S, Vinereanu, D, POSDRU/159/1.5/S/141531, Grant, Karsenty, C, Hascoet, S, Hadeed, K, Semet, F, Dulac, Y, Alacoque, X, Leobon, B, Acar, P, Dharma, S, Sukmawan, R, Soesanto, AM, Vebiona, KPP, Firdaus, I, Danny, SS, Driessen, M M P, Sieswerda, GTJ, Post, MC, Snijder, RJ, Van Dijk, APJ, Leiner, T, Meijboom, FJ, Chrysohoou, C, Tsitsinakis, G, Tsiachris, D, Aggelis, A, Herouvim, E, Vogiatzis, I, Pitsavos, C, Koulouris, G, Stefanadis, C, Erdei, T, Edwards, J, Braim, D, Yousef, Z, Fraser, AG, Cardiff, Investigators, MEDIA, Avenatti, E, Magnino, C, Omede', P, Presutti, D, Moretti, C, Iannaccone, A, Ravera, A, Gaita, F, Milan, A, Veglio, F, Barbier, P, Scali, MC, Simioniuc, A, Guglielmo, M, Savioli, G, Cefalu, C, Mirea, O, Fusini, L, Dini, F, Okura, H, Murata, E, Kataoka, T, Mikaelpoor, A, Ojaghi Haghighi, SH, Ojaghi Haghighi, SZ, Alizadeasl, A, Sharifi-Zarchi, A, Zaroui, A, Ben Halima, M, Mourali, MS, Mechmeche, R, Rodriguez Palomares, J F, Gutierrez, LG, Maldonado, GM, Garcia, GG, Otaegui, IO, Garcia Del Blanco, BGB, Teixido, GT, Gonzalez Alujas, MTGA, Evangelista, AE, Garcia Dorado, DGD, Godinho, A R, Correia, AS, Rangel, I, Rocha, A, Rodrigues, J, Araujo, V, Almeida, PB, Macedo, F, Maciel, MJ, Rekik, B, Mghaieth, F, Aloui, H, Boudiche, S, Jomaa, M, Ayari, J, Tabebi, N, Farhati, A, Mourali, S, Dekleva, M, Markovic-Nikolic, N, Zivkovic, M, Stankovic, A, Boljevic, D, Korac, N, Beleslin, B, Arandjelovic, A, Ostojic, M, Galli, E, Guirette, Y, Auffret, V, Daudin, M, Fournet, M, Mabo, P, Donal, E, Chin, C W L, Luo, E, Hwan, J, White, A, Newby, D, Dweck, M, Carstensen, H G, Larsen, L H, Hassager, C, Kofoed, K F, Jensen, J S, Mogelvang, R, Kowalczyk, M, Debska, M, Kolesnik, A, Dangel, J, Kawalec, W, Migliore, RA, Adaniya, ME, Barranco, MA, Miramont, G, Gonzalez, S, Tamagusuku, H, Davidsen, E S, Kuiper, K K J, Matre, K, Gerdts, E, Igual Munoz, B, Maceira Gonzalez, AMG, Erdociain Perales, MEP, Estornell Erill, JEE, Valera Martinez, FVM, Miro Palau, VMP, Piquer Gil, MPG, Sepulveda Sanchez, PSS, Cervera Zamora, ACZ, Montero Argudo, AMA, Placido, R, Silva Marques, J, Magalhaes, A, Guimaraes, T, Nobre E Menezes, M, Goncalves, S, Ramalho, A, Robalo Martins, S, Almeida, AG, Nunes Diogo, A, Abid, L, Ben Kahla, S, Charfeddine, S, Abid, D, Kammoun, S, Tounsi, A, Abid, LEILA, Abid, DORRA, Charfeddine, SALMA, Hammami, RANIA, Triki, FETEN, Akrout, MALEK, Mallek, SOUAD, Hentati, MOURAD, Kammoun, SAMIR, Sirbu, C F, Berrebi, A, Huber, A, Folliguet, T, Yang, L-T, Shih, JY, Liu, YW, Li, YH, Tsai, LM, Luo, CY, Tsai, WC, Babukov, R, Bartosh, F, Bazilev, V, Muraru, D, Cavalli, G, Addetia, K, Miglioranza, MH, Veronesi, F, Mihaila, S, Tadic, M, Cucchini, U, Badano, L, Lang, RM, Miyazaki, S, Slavich, M, Miyazaki, T, Figini, F, Lativ, A, Chieffo, A, Montrfano, M, Alfieri, O, Colombo, A, Agricola, E, Liu, D, Hu, K, Herrmann, S, Stoerk, S, Kramer, B, Ertl, G, Bijnens, B, Weidemann, F, Brand, M, Butz, T, Tzikas, S, Van Bracht, M, Roeing, J, Wennemann, R, Christ, M, Grett, M, Trappe, H-J, Scherzer, S, Geroldinger, AG, Krenn, L, Roth, C, Gangl, C, Maurer, G, Rosenhek, R, Neunteufl, T, Binder, T, Bergler-Klein, J, Martins, E, Pinho, T, Leite, S, Azevedo, O, Belo, A, Campelo, M, Amorim, S, Rocha-Goncalves, F, Goncalves, L, Silva-Cardoso, J, Ahn, HS, Kim, KT, Jeon, HK, Youn, HJ, Haland, T, Saberniak, J, Leren, IS, Edvardsen, T, Haugaa, KH, Ziolkowska, L, Boruc, A, Kowalczyk, M, Turska-Kmiec, A, Zubrzycka, M, Kawalec, W, Monivas Palomero, V, Mingo Santos, S, Goirigolzarri Artaza, J, Rodriguez Gonzalez, E, Rivero Arribas, B, Castro Urda, V, Dominguez Rodriguez, F, Mitroi, C, Gracia Lunar, I, Fernadez Lozano, I, Palecek, T, Masek, M, Kuchynka, P, Fikrle, M, Spicka, I, Rysava, R, Linhart, A, Saberniak, J, Hasselberg, NE, Leren, IS, Haland, T, Borgquist, R, Platonov, PG, Edvardsen, T, Haugaa, KH, Ancona, R, Comenale Pinto, S, Caso, P, Coopola, MG, Arenga, F, Rapisarda, O, D'onofrio, A, Sellitto, V, Calabro, R, Rosca, M, Popescu, BA, Calin, A, Mateescu, A, Beladan, CC, Jalba, M, Rusu, E, Zilisteanu, D, Ginghina, C, Pressman, G, Cepeda-Valery, B, Romero-Corral, A, Moldovan, R, Saenz, A, Orban, M, Samuel, SP, Fijalkowski, M, Fijalkowska, M, Gilis-Siek, N, Blaut, K, Galaska, R, Sworczak, K, Gruchala, M, Fijalkowski, M, Nowak, R, Gilis-Siek, N, Fijalkowska, M, Galaska, R, Gruchala, M, Ikonomidis, I, Triantafyllidi, H, Trivilou, P, Tzortzis, S, Papadopoulos, C, Pavlidis, G, Paraskevaidis, I, Lekakis, J, Padiyath, A, Li, L, Xiao, Y, Danford, DA, Kutty, S, Kaymaz, C, Aktemur, T, Poci, N, Ozturk, S, Akbal, O, Yilmaz, F, Tokgoz Demircan, HC, Kirca, N, Tanboga, IH, Ozdemir, N, Investigators, EUPHRATES, Greiner, S, Jud, A, Aurich, M, Hess, A, Hilbel, T, Hardt, S, Katus, HA, D'ascenzi, F, Cameli, M, Alvino, F, Lisi, M, Focardi, M, Solari, M, Bonifazi, M, Mondillo, S, Konopka, M, Krol, W, Klusiewicz, A, Burkhard, K, Chwalbinska, J, Pokrywka, A, Dluzniewski, M, Braksator, W, King, G J, Coen, K, Gannon, S, Fahy, N, Kindler, H, Clarke, J, Iliuta, L, Rac-Albu, M, Placido, R, Robalo Martins, S, Guimaraes, T, Nobre E Menezes, M, Cortez-Dias, N, Francisco, A, Silva, G, Goncalves, S, Almeida, AG, Nunes Diogo, A, Kyu, K, Kong, WKF, Songco, GG, Galupo, MJ, Castro, MD, Shin Hnin, W, Ronald Lee, CH, Poh, KK, Milazzo, V, Di Stefano, C, Tosello, F, Leone, D, Ravera, A, Sabia, L, Sobrero, G, Maule, S, Veglio, F, Milan, A, Jamiel, A M, Ahmed, A M, Farah, I, Al-Mallah, M H, Petroni, R, Magnano, R, Bencivenga, S, Di Mauro, M, Petroni, S, Altorio, SF, Romano, S, Penco, M, Kumor, M, Lipczynska, M, Klisiewicz, A, Wojcik, A, Konka, M, Kozuch, K, Szymanski, P, Hoffman, P, Rimbas, RC, Rimbas, M, Enescu, OA, Mihaila, S, Calin, S, Vinereanu, D, 112/2011, Grant CNCSIS, 159/1.5/S/141531, Grant POSDRU, Donal, E, Reynaud, A, Lund, LH, Persson, H, Hage, C, Oger, E, Linde, C, Daubert, JC, investigators, KaRen, Maria Oliveira Lima, M, Costa, H, Gomes Da Silva, M, Noman Alencar, MC, Carmo Pereira Nunes, M, Costa Rocha, MO, Abid, L, Charfeddine, S, Ben Kahla, S, Abid, D, Siala, A, Hentati, M, Kammoun, S, Kovalova, S, Necas, J, Ozawa, K, Funabashi, N, Takaoka, H, Kobayashi, Y, Matsumura, Y, Wada, M, Hirakawa, D, Yasuoka, Y, Morimoto, N, Takeuchi, H, Kitaoka, H, Sugiura, T, Lakkas, L, Naka, KK, Ntounousi, E, Gkirdis, I, Koutlas, V, Bechlioulis, A, Pappas, K, Katsouras, CS, Siamopoulos, K, Michalis, LK, Naka, KK, Evangelou, D, Kalaitzidis, R, Bechlioulis, A, Lakkas, L, Gkirdis, I, Tzeltzes, G, Nakas, G, Katsouras, CS, Michalis, LK, Generati, G, Bandera, F, Pellegrino, M, Labate, V, Alfonzetti, E, Guazzi, M, Zagatina, A, Zhuravskaya, N, Al-Mallah, M, Alsaileek, A, Qureshi, W, Karsenty, C, Hascoet, S, Peyre, M, Hadeed, K, Alacoque, X, Amadieu, R, Leobon, B, Dulac, Y, Acar, P, Yamanaka, Y, Sotomi, Y, Iwakura, K, Inoue, K, Toyoshima, Y, Tanaka, K, Oka, T, Tanaka, N, Orihara, Y, Fujii, K, Soulat-Dufour, L, Lang, S, Boyer-Chatenet, L, Van Der Vynckt, C, Ederhy, S, Adavane, S, Haddour, N, Boccara, F, Cohen, A, Huitema, MP, Boerman, S, Vorselaars, VMM, Grutters, JC, Post, MC, Gopal, A S, Saha, SK, Toole, RS, Kiotsekoglou, A, Cao, JJ, Reichek, N, Meyer, C G, Altiok, E, Al Ateah, G, Lehrke, M, Becker, M, Lotfi, S, Autschbach, R, Marx, N, Hoffmann, R, Frick, M, Nemes, A, Sepp, R, Kalapos, A, Domsik, P, Forster, T, Caro Codon, J, Blazquez Bermejo, Z, Lopez Fernandez, T, Valbuena Lopez, S C, Iniesta Manjavacas, A M, De Torres Alba, F, Dominguez Melcon, F, Pena Conde, L, Moreno Yanguela, M, Lopez-Sendon, J L, Nemes, A, Lengyel, C, Domsik, P, Kalapos, A, Orosz, A, Varkonyi, TT, Forster, T, Rendon, J, Saldarriaga, C I, Duarte, N, Nemes, A, Domsik, P, Kalapos, A, Forster, T, Nemes, A, Domsik, P, Kalapos, A, Sepp, R, Foldeak, D, Borbenyi, Z, Forster, T, Hamdy, AM, Fereig, HM, Nabih, MA, Abdel-Aziz, A, Ali, AA, Broyd, CJ, Wielandts, J-Y, De Buck, S, Michielsen, K, Louw, R, Garweg, C, Nuyts, J, Ector, J, Maes, F, Heidbuchel, H, Gillis, K, Bala, G, Tierens, S, Cosyns, B, Maurovich-Horvat, P, Horvath, T, Jermendy, A, Celeng, C, Panajotu, A, Bartykowszki, A, Karolyi, M, Tarnoki, AD, Jermendy, G, and Merkely, B

Abstract

Purpose: 3D echocardiography (3DE) enables fast 3D acquisition but subsequent manual navigation to find 2D diagnostic planes can be time consuming. We have developed and validated an automated machine learning-based technique to find apical 2-, 3- and 4-chamber (A2C, A3C, A4C) views that enables fast volume navigation and analysis. Methods: 3DE volumes were acquired (Philips iE33: X3-1 and X5-1 probes) from 30 healthy volunteers and 36 clinical patients with suspected valve disease and coronary heart disease. 66 end diastolic volumes were used to assess the accuracy of apical standard view finding by our method against manual plane finding. To do this, dedicated software was developed with a machine learning approach and a 3-fold cross validation of results was performed. Results: Automatic A4C view detection was possible in 60/66 (91%) of volumes; detection failures were due to suboptimal myocardium wall integrity or lack of right ventricle in the scan. A2C and A3C views were extracted from the A4C view using the known geometrical relationships between apical standard views (A2C to A3C: 30°~40° and A2C to A4C: 90° of rotation over the left ventricle long axis, as shown in the Figure). In average, our method accurately found the heart apex and mitral valve centre with a 7.1 ± 5.7 mm and 7.2 ± 5.3 mm error, respectively. Conclusions: In order to automate clinical workflow, we have developed a new and fully automatic machine learning strategy for apical standard view finding which performed well (91% detection accuracy) on volunteer and clinical 3D echocardiograms. Figure

Published
2014
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29. Club 35 Poster session 2: Thursday 4 December 2014, 08:30-18:00 * Location: Poster area

Author

Santos, M, Rivero, J, Mccullough, SD, Opotowsky, AR, Waxman, AB, Systrom, D, Shah, AM, Olsen, F J, Jorgensen, PG, Mogelvang, R, Jensen, JS, Fritz-Hansen, T, Bech, J, Sivertsen, J, Biering-Sorensen, T, Santoro, C, Esposito, R, Schiano Lomoriello, V, Raia, R, De Palma, D, Ippolito, R, Ierano, P, Arpino, G, De Simone, G, Galderisi, M, Cameli, M, Lisi, M, Di Tommaso, C, Solari, M, Focardi, M, Maccherini, M, Henein, M, Galderisi, M, Mondillo, S, Simova, I, Katova, T, Galderisi, M, Pauncheva, B, Vrettos, A, Dawson, D, Grigoratos, C, Papapolychroniou, C, Nihoyannopoulos, P, Danylenko, O, Kovalenko, V, Nesukay, E, Polenova, N, Titov, I, Voilliot, D, Huttin, OH, Vaugrenard, TV, Venner, CV, Sadoul, NS, Aliot, EA, Juilliere, YJ, Selton-Suty, CSS, Hamdi, I, Mahfoudhi, H, Ben Mansour, N, Dahmani, R, Lahidheb, D, Fehri, W, Haouala, H, Erken Pamukcu, H, Gerede, DM, Sorgun, M, Akbostanci, C, Turhan, S, Erol, û, Voilliot, D, Magne, JM, Dulgheru, RD, Kou, SK, Henri, CH, Caballero, LC, De Sousa, CDS, Sprynger, MS, Pierard, LP, Lancellotti, PL, Panelo, M L, Rodriguez-Fernandez, A, Escriba-Bori, S, Krol, W, Konopka, M, Burkhard, K, Jedrzejewska, I, Pokrywka, A, Klusiewicz, A, Chwalbinska, J, Dluzniewski, M, Braksator, W, Elmissiri, AM, Eid, M, Sayed, I, Awadalla, H, Schiano-Lomoriello, V, Esposito, R, Santoro, C, Lo Iudice, F, De Simone, G, Galderisi, M, Ibrahimi, P, Jashari, F, Johansson, E, Gronlund, C, Bajraktari, G, Wester, P, Henein, MY, Potluri, R, Aziz, A, Hooper, J, Mummadi, SM, Uppal, H, Asghar, O, Chandran, S, Surkova, E A, Tereshina, O V, Shchukin, U V, Rubanenko, A O, Medvedeva, E A, Hamdi, I, Mahfoudhi, H, Ben Mansour, N, Dahmani, R, Lahidheb, D, Fehri, W, Haouala, H, Krapf, L, Nguyen, V, Cimadevilla, C, Himbert, D, Brochet, E, Iung, B, Vahanian, A, Messika-Zeitoun, D, Danylenko, O, Kovalenko, V, Nesukay, E, Titov, I, Polenova, N, Van De Heyning, C M, Magne, J, Pierard, LA, Bruyere, PJ, Davin, L, De Maeyer, C, Paelinck, BP, Vrints, CJ, Lancellotti, P, Bertrand, PB, Groenendaels, Y, Vertessen, VJ, Mullens, W, Pettinari, M, Gutermann, H, Dion, RA, Verhaert, D, Vandervoort, PM, Guven, S, Sen, T, Tufekcioglu, O, Gucuk, E, Uygur, B, Kahraman, E, Valuckiene, Z, Jurkevicius, R, Pranevicius, R, Marcinkeviciene, J, Zaliaduonyte-Peksiene, D, Stoskute, N, and Zaliunas, R

Abstract

Introduction: Among patients with unexplained dyspnea, left ventricular (LV) filling pressures (LVFP) is commonly estimated non-invasively by the E/e' ratio using Doppler echocardiography. However the accuracy of E/e' is controversial. We evaluated the correlation of E/e' ratio with invasively measured LVFP and of change in E/e' (ΔE/e') with change in LVFP. Methods: Supine and upright transthoracic echocardiography was performed in patients with unexplained dyspnea undergoing right heart catheterization. Patients with significant valvular disease and reduced LV ejection fraction (LVEF < 50%) were excluded. Pulmonary artery wedge pressure (PAWP) was used as the invasive indicator of LVFP. The mean of septal and lateral e' velocities was used for the calculation of E/e' ratio. Results: We studied 98 subjects with a mean age of 52 ± 20 years (69% of female gender). The supine E/e' and PAWP were 9.2 ± 3.2 and 12.1 ± 4.9 mmHg (range: 4-27 mmHg) respectively and were modestly correlated (r=0.38; p<0.001). With position change (supine to upright), ΔPAWP was -5.1 ± 4.3 mmHg and ΔE/e' was 0.17 ± 2.6, with no significant association between these two measures (r=0.003; p=0.98). Both E-wave (80 ± 22 to 65 ± 22 cm/s) and mean average e' (10.2 ± 3.6 to 7.3 ± 2.0 cm/s) decreased with the upright position. The ΔPAWP was correlated with ΔE-wave velocity (r=0.33; p=0.01), but not with Δe' (r=0.14; p=0.26). Conclusions: In patients with unexplained dyspnea and a preserved LVEF, E/e' is modestly, though significantly, correlated with PAWP. ΔE/e' is not correlated with ΔPAWP, partially related to the preload sensitivity of e'. Figure Figure 1 - Supine and delta E/e' plotted

Published
2014
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30. Poster session 3: Thursday 4 December 2014, 14:00-18:00 * Location: Poster area

Author

Shahgaldi, K, Hegner, T, Da Silva, C, Fukuyama, A, Takeuchi, M, Uema, A, Kado, Y, Nagata, Y, Hayashi, A, Otani, K, Fukuda, S, Yoshitani, H, Otsuji, Y, Morhy, S, Lianza, AC, Afonso, TR, Oliveira, WA, Tavares, GP, Rodrigues, AC, Vieira, MC, Warth, AN, Deutsch, AD, Fischer, CH, Tezynska-Oniszk, I, Turska-Kmiec, A, Kawalec, W, Dangel, J, Maruszewski, B, Bokiniec, R, Burczynski, P, Borszewska-Kornacka, K, Ziolkowska, L, Zuk, M, Mazowsza, eSUM Dzieciaki, Troshina, A, Dzhalilova, DA, Poteshkina, NG, Hamitov, FF, Warita, S, Kawasaki, M, Tanaka, R, Yagasaki, H, Minatoguchi, S, Wanatabe, T, Ono, K, Noda, T, Wanatabe, S, Minatoguchi, S, Angelis, A, Ageli, K, Vlachopoulos, C, Felekos, I, Ioakimidis, N, Aznaouridis, K, Vaina, S, Abdelrasoul, M, Tsiamis, E, Stefanadis, C, Cameli, M, Sparla, S, D'ascenzi, F, Fineschi, M, Favilli, R, Pierli, C, Henein, M, Mondillo, S, Lindqvist, P, Tossavainen, E, Gonzalez, M, Soderberg, S, Henein, M, Holmgren, A, Strachinaru, M, Catez, E, Jousten, I, Pavel, O, Janssen, C, Morissens, M, Chatzistamatiou, E, Moustakas, G, Memo, G, Konstantinidis, D, Mpampatzeva Vagena, I, Manakos, K, Traxanas, K, Vergi, N, Feretou, A, Kallikazaros, I, Tsai, W-C, Sun, Y-T, Lee, W-H, Yang, L-T, Liu, Y-W, Lee, C-H, Li, W-T, Mizariene, V, Bieseviciene, M, Karaliute, R, Verseckaite, R, Vaskelyte, J, Lesauskaite, V, Chatzistamatiou, E, Mpampatseva Vagena, I, Manakos, K, Moustakas, G, Konstantinidis, D, Memo, G, Mitsakis, O, Kasakogias, A, Syros, P, Kallikazaros, I, Hristova, K, Cornelissen, G, Singh, RB, Shiue, I, Coisne, D, Madjalian, A-M, Tchepkou, C, Raud Raynier, P, Degand, B, Christiaens, L, Baldenhofer, G, Spethmann, S, Dreger, H, Sanad, W, Baumann, G, Stangl, K, Stangl, V, Knebel, F, Azzaz, S, Kacem, S, Ouali, S, Risos, L, Dedobbeleer, C, Unger, P, Sinem Cakal, SC, Elif Eroglu, EE, Baydar, O, Beytullah Cakal, BC, Mehmet Vefik Yazicioglu, MVY, Mustafa Bulut, MB, Cihan Dundar, CD, Kursat Tigen, KT, Birol Ozkan, BO, Ali Metin Esen, AME, Tournoux, F, Chequer, R, Sroussi, M, Hyafil, F, Rouzet, F, Leguludec, D, Baum, P, Stoebe, S, Pfeiffer, D, Hagendorff, A, Fang, F, Lau, M, Zhang, Q, Luo, XX, Wang, XY, Chen, L, Yu, CM, -CRT, Predict, Zaborska, B, Smarz, K, Makowska, E, Kulakowski, P, Budaj, A, Bengrid, T M, Zhao, Y, Henein, M Y, Caminiti, G, D'antoni, V, Cardaci, V, Conti, V, Volterrani, M, Warita, S, Kawasaki, M, Yagasaki, H, Minatoguchi, S, Nagaya, M, Ono, K, Noda, T, Watanabe, S, Houle, H, Minatoguchi, S, Gillebert, T C, Chirinos, J A, Claessens, T C, Raja, M W, De Buyzere, M L, Segers, P, Rietzschel, E R, Investigators, The Asklepios, Kim, KH, Cha, JJ, Chung, HM, Kim, JY, Yoon, YW, Lee, BK, Hong, BK, Rim, SJ, Kwon, HM, Choi, EY, Pyankov, V, Aljaroudi, W, Matta, S, Al-Shaar, L, Habib, R, Gharzuddin, W, Arnaout, S, Skouri, H, Jaber, W, Abchee, A, Bouzas Mosquera, A, Peteiro, J, Broullon, FJ, Constanso Conde, IP, Bescos Galego, H, Martinez Ruiz, D, Yanez Wonenburger, JC, Vazquez Rodriguez, JM, Alvarez Garcia, N, Castro Beiras, A, Gunyeli, E, Oliveira Da Silva, C, Shahgaldi, K, Manouras, A, Winter, R, Meimoun, P, Abouth, S, Martis, S, Boulanger, J, Elmkies, F, Zemir, H, Detienne, JP, Luycx-Bore, A, Clerc, J, Rodriguez Palomares, J F, Gutierrez, LG, Maldonado, GM, Garcia, GG, Galuppo, VG, Gruosso, DG, Teixido, GT, Gonzalez Alujas, MTGA, Evangelista, AE, Garcia Dorado, DGD, Rechcinski, T, Wierzbowska-Drabik, K, Wejner-Mik, P, Szymanska, B, Jerczynska, H, Lipiec, P, Kasprzak, JD, El-Touny, K, El-Fawal, S, Loutfi, M, El-Sharkawy, E, Ashour, S, Boniotti, C, Carminati, MC, Fusini, L, Andreini, D, Pontone, G, Pepi, M, Caiani, EG, Oryshchyn, N, Kramer, B, Hermann, S, Liu, D, Hu, K, Ertl, G, Weidemann, F, Ancona, F, Miyazaki, S, Slavich, M, Figini, F, Latib, A, Chieffo, A, Montorfano, M, Alfieri, O, Colombo, A, Agricola, E, Nogueira, MA, Branco, LM, Rosa, SA, Portugal, G, Galrinho, A, Abreu, J, Cacela, D, Patricio, L, Fragata, J, Cruz Ferreira, R, Igual Munoz, B, Erdociain Perales, MEP, Maceira Gonzalez, AMG, Estornell Erill Jordi, JEE, Donate Bertolin, LDB, Vazquez Sanchez Alejandro, AVS, Miro Palau Vicente, VMP, Cervera Zamora, ACZ, Piquer Gil, MPG, Montero Argudo, AMA, Girgis, H Y A, Illatopa, V, Cordova, F, Espinoza, D, Ortega, J, Khan, US, Islam, AKMM, Majumder, AAS, Girgis, H Y A, Bayat, F, Naghshbandi, E, Naghshbandi, E, Samiei, N, Samiei, N, Malev, E, Omelchenko, M, Vasina, L, Zemtsovsky, E, Piatkowski, R, Kochanowski, J, Budnik, M, Scislo, P, Opolski, G, Kochanowski, J, Piatkowski, R, Scislo, P, Budnik, M, Marchel, M, Opolski, G, Abid, L, Ben Kahla, S, Abid, D, Charfeddine, S, Maaloul, I, Ben Jmaa, M, Kammoun, S, Hashimoto, G, Suzuki, M, Yoshikawa, H, Otsuka, T, Isekame, Y, Yamashita, H, Kawase, I, Ozaki, S, Nakamura, M, Sugi, K, Benvenuto, E, Leggio, S, Buccheri, S, Bonura, S, Deste, W, Tamburino, C, Monte, I P, Gripari, P, Fusini, L, Muratori, M, Tamborini, G, Ghulam Ali, S, Bottari, V, Cefalu', C, Bartorelli, A, Agrifoglio, M, Pepi, M, Zambon, E, Iorio, A, Di Nora, C, Abate, E, Lo Giudice, F, Di 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Shin, S, Shim, CY, Hong, GR, and Chung, N

Abstract

Objective:  We aimed to investigate the reproducibility of vena contracta (VC) in mitral regurgitation (MR) of different etiology between an inexperienced and an experienced echocardiographer. Background: MR is the second most common valvular heart disease in Europe that requires surgery.  Echocardiography is the principal modality of investigation when MR is suspected. In European and American guidelines VC is described as one of the most feasible echocardiographic measurements in the assessment of MR. There is a lack of publications regarding intra-observer variability and studies comparing inexperienced and experienced echocardiographers for the assessment of VC. Method/Material: VC of 55 recorded 2D echocardiograms with known MR of different degree and etiology were analyzed from parasternal long axis view, 4- and 3 chamber view. The mean value of the different plane measurements of each exam was used for statistical analysis. Analyses were made by an inexperienced (A) fellow echocardiographer (<100 studies) and a level 3 experienced (B) echocardiographer. Measurements of VC by the 2 echocardiographers were performed blinded to clinical data. Measurements were performed with at least 2 weeks apart, blinded to the first measurement. Results: Three exams were excluded (feasibility 95%) from statistical analysis because adequate color Doppler images from all tree planes was not available. The inter class correlation (ICC) between the first and second analysis was (r=0.75; 95% CI -1.1 to 1.7mm) for A and (r=0.94; 95% CI -0.76 to 0.84mm) for B. There was good ICC between the 2 echocardiographers (r=0.78; 95% CI -1.5 to 1.3mm). The intra observer variability was 11.1% for A and 6.1% for B. The inter observer variability was 11.7% (p>0.05 for all). Conclusion: Measurement of vena contracta in mitral regurgitation is a feasible semi-quantitative parameter. Good correlation and narrow limits of agreement between a novice and an experienced echocardiographer was demonstrated in our study.

Published
2014
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31. Poster session Thursday 12 December - AM: 12/12/2013, 08:30-12:30 * Location: Poster area

Author

Abdovic, E, Abdovic, S, Hristova, K, Hristova, K, Katova, TZ, Katova, TZ, Gocheva, N, Gocheva, N, Pavlova, M, Pavlova, M, Gurzun, M M, Ionescu, A, Canpolat, U, Yorgun, H, Sunman, H, Sahiner, L, Kaya, EB, Ozer, N, Tokgozoglu, L, Kabakci, G, Aytemir, K, Oto, A, Gonella, A, Dascenzo, F, Casasso, F, Conte, E, Margaria, F, Grosso Marra, W, Frea, S, Morello, M, Bobbio, M, Gaita, F, Seo, HY, Lee, SP, Lee, JM, Yoon, YE, Park, E, Kim, HK, Park, SJ, Lee, H, Kim, YJ, Sohn, DW, Nemes, A, Domsik, P, Kalapos, A, Orosz, A, Lengyel, C, Forster, T, Enache, R, Muraru, D, Popescu, BA, Calin, A, Nastase, O, Botezatu, D, Purcarea, F, Rosca, M, Beladan, CC, Ginghina, C, Canpolat, U, Aytemir, K, Ozer, N, Yorgun, H, Sahiner, L, Kaya, EB, Oto, A, Trial, Turkish Atrial Fibrosis, Muraru, D, Piasentini, E, Mihaila, S, Padayattil Jose, S, Peluso, D, Ucci, L, Naso, P, Puma, L, Iliceto, S, Badano, LP, Cikes, M, Jakus, N, Sutherland, GR, Haemers, P, Dhooge, J, Claus, P, Yurdakul, S, Oner, FATMA, Direskeneli, HANER, 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Munoz, DA, Moya Mur, JL, Becker Filho, D, Gonzalez, A, Casas Rojo, E, Garcia Martin, A, Recio Vazquez, M, Rincon, LM, Fernandez Golfin, C, Zamorano Gomez, JL, Ledakowicz-Polak, A, Polak, L, Zielinska, M, Kamiyama, T, Nakade, T, Nakamura, Y, Ando, T, Kirimura, M, Inoue, Y, Sasaki, O, Nishioka, T, Farouk, H, Sakr, B, Elchilali, K, Said, K, Sorour, K, Salah, H, Mahmoud, G, Casanova Rodriguez, C, Cano Carrizal, R, Iglesias Del Valle, D, Martin Penato Molina, A, Garcia Garcia, A, Prieto Moriche, E, Alvarez Rubio, J, De Juan Bagua, J, Tejero Romero, C, Plaza Perez, I, Korlou, P, Stefanidis, A, Mpikakis, N, Ikonomidis, I, Anastasiadis, S, Komninos, K, Nikoloudi, P, Margos, P, and Pentzeridis, P

Abstract

Purpose: Atrial fibrillation (AF) is the most prevalent sustained arrhythmia. It is a disease of the elderly and it is common in patients (pts) with structural heart disease. Hypertension (HA), hypertensive heart disease (HHD), diabetes mellitus (DM), coronary artery disease (CAD), heart failure (HF), and valvular heart disease (VHD) are recognized predisposing factors to AF. Objectives: To echocardiographicly disclose the most common predisposing morbidities to AF in our population sample. Methods: From June 2000 to February 2013, 3755 consecutive pts with AF were studied during echocardiographic check-up. According to transthoracic echo, pts were divided in groups based on dominative underlying heart diseases. Electrocardiographically documented AF was subdivided in two groups: transitory and chronic. Transitory AF fulfilled criteria for paroxysmal or persistent AF. Chronic AF were cases of long-standing persistent or permanent AF. Results: The median age was 72 years, age range between 16 and 96 years. There were 51.4% of females. Chronic AF was observed in 68.3% pts. Distribution of underlying heart diseases is shown in figure. Lone AF was diagnosed in only 25 pts, mostly in younger males (median age 48 years, range 29–59, men 80%). Chronic AF was predominant in groups with advanced cardiac remodeling such as dilatative cardiomyopaty (DCM) and VHD, mostly in elderly. HA and DM were found in 75.4% and 18.8%, respectively. Almost 1/2 of pts with AF had HF and 59.2% had diastolic HF. Conclusion: Up to now, echocardiographic categorization of the predisposing factors to AF was not reported. Echocardiographic evaluation of patients with AF could facilitate in identification and well-timed treatment of predisposing comorbidites. Figure Etiological distribution of AF

Published
2013
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32. Poster session Wednesday 11 December all day display: 11/12/2013, 09:30-16:00 * Location: Poster area

Author

Bertrand, PB, Grieten, L, Smeets, C, Verbrugge, FH, Mullens, W, Vrolix, M, Rivero-Ayerza, M, Verhaert, D, Vandervoort, P, Tong, L, Ramalli, A, Tortoli, P, Dhoge, J, Bajraktari, G, Lindqvist, P, Henein, MY, Obremska, M, Boratynska, MB, Kurcz, JK, Zysko, DZ, Baran, TB, Klinger, MK, Darahim, K, Mueller, H, Carballo, D, Popova, N, Vallee, J-P, Floria, M, Chistol, R, Tinica, G, Grecu, M, Rodriguez Serrano, M, Osa-Saez, A, Rueda-Soriano, J, Buendia-Fuentes, F, Domingo-Valero, D, Igual-Munoz, B, Alonso-Fernandez, P, Quesada-Carmona, A, Miro-Palau, V, Palencia-Perez, M, Bech-Hanssen, O, Polte, CL, Lagerstrand, K, Janulewicz, M, Gao, S, Erdogan, E, Akkaya, M, Bacaksiz, A, Tasal, A, Sonmez, O, Turfan, M, Kul, S, Vatankulu, MA, Uyarel, H, Goktekin, O, Mincu, RI, Magda, LS, Mihaila, S, Florescu, M, Mihalcea, D, Enescu, OE, Chiru, A, Popescu, B, Tiu, C, Vinereanu, D, 112/2011, Research grant, Broch, K, Kunszt, G, Massey, R, De Marchi, SF, Aakhus, S, Gullestad, L, Urheim, S, Yuan, L, Feng, JL, Jin, XY, Bombardini, T, Casartelli, M, Simon, D, Gaspari, MG, Procaccio, F, Hasselberg, NE, Haugaa, KH, Brunet, A, Kongsgaard, E, Donal, E, Edvardsen, T, Sahin, TAYLAN, Yurdakul, S, Cengiz, BETUL, Bozkurt, AYSEN, Aytekin, SAIDE, Cesana, F, Spano, F, Santambrogio, G, Alloni, M, Vallerio, P, Salvetti, M, Carerj, S, Gaibazzi, N, Rigo, F, Moreo, A, Group, APRES Collaborative, Wdowiak-Okrojek, K, Michalski, B, Kasprzak, JD, Shim, A, Lipiec, P, Generati, G, Pellegrino, M, Bandera, F, Donghi, V, Alfonzetti, E, Guazzi, M, Marcun, R, Stankovic, I, Farkas, J, Vlahovic-Stipac, A, Putnikovic, B, Kadivec, S, Kosnik, M, Neskovic, AN, Lainscak, M, Iliuta, L, Szymanski, P, Lipczynska, M, Klisiewicz, A, Sobieszczanska-Malek, M, Zielinski, T, Hoffman, P, Gjerdalen, G F, Hisdal, J, Solberg, EE, Andersen, TE, Radunovic, Z, Steine, K, Svanadze, A, Poteshkina, N, Krylova, N, Mogutova, P, Shim, A, Kasprzak, JD, Szymczyk, E, Wdowiak-Okrojek, K, Michalski, B, Stefanczyk, L, Lipiec, P, Benedek, T, Matei, C, Jako, B, Suciu, ZS, Benedek, I, Yaroshchuk, N A, Kochmasheva, V V, Dityatev, V P, Kerbikov, O B, Przewlocka-Kosmala, M, Orda, A, Karolko, B, Mysiak, A, Kosmala, W, Rechcinski, T, Wierzbowska-Drabik, K, Lipiec, P, Chmiela, M, Kasprzak, JD, Aziz, A, Hooper, J, Rayasamudra, S, Uppal, H, Asghar, O, Potluri, R, Zaroui, A, Mourali, MS, Rezine, Z, Mbarki, S, Jemaa, M, Aloui, H, Mechmeche, R, Farhati, A, Gripari, P, Maffessanti, F, Tamborini, G, Muratori, M, Fusini, L, Vignati, C, Bartorelli, AL, Alamanni, F, Agostoni, PG, Pepi, M, Ruiz Ortiz, M, Mesa, D, Delgado, M, Seoane, T, Carrasco, F, Martin, M, Mazuelos, F, Suarez De Lezo Herreros De Tejada, J, Romero, M, Suarez De Lezo, J, Brili, S, Stamatopoulos, I, Misailidou, M, Chrisochoou, C, Christoforatou, E, Stefanadis, C, Ruiz Ortiz, M, Mesa, D, Delgado, M, Martin, M, Seoane, T, Carrasco, F, Ojeda, S, Segura, J, Pan, M, Suarez De Lezo, J, Cammalleri, V, Ussia, GP, Muscoli, S, Marchei, M, Sergi, D, Mazzotta, E, Romeo, F, Igual Munoz, B, Bel Minguez, ABM, Perez Guillen, MPG, Maceira Gonzalez, AMG, Monmeneu Menadas, JVMM, Hernandez Acuna, CHA, Estornell Erill, JEE, Lopez Lereu, PLL, Francisco Jose Valera Martinez, FJVM, Montero Argudo, AMA, Sunbul, M, Akhundova, A, Sari, I, Erdogan, O, Mutlu, B, Cacicedo, A, Velasco Del Castillo, S, Anton Ladislao, A, Aguirre Larracoechea, U, Rodriguez Sanchez, I, Subinas Elorriaga, A, Oria Gonzalez, G, Onaindia Gandarias, J, Laraudogoitia Zaldumbide, E, Lekuona Goya, I, Ding, W, Zhao, Y, Lindqvist, P, Nilson, J, Winter, R, Holmgren, A, Ruck, A, Henein, MY, Attenhofer Jost, C H, Soyka, R, Oxenius, A, Kretschmar, O, Valsangiacomo Buechel, ER, Greutmann, M, Weber, R, Keramida, K, Kouris, N, Kostopoulos, V, Karidas, V, Damaskos, D, Makavos, G, Paraskevopoulos, K, Olympios, CD, Eskesen, K, Olsen, NT, Fritz-Hansen, T, Sogaard, P, Cameli, M, Lisi, M, Righini, FM, Curci, V, Massoni, A, Natali, B, Maccherini, M, Chiavarelli, M, Massetti, M, Mondillo, S, Mabrouk Salem Omar, A, Ahmed Abdel-Rahman, M, 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Pinamonti, B, Gigli, M, Poli, S, Porto, A, Di Nora, C, Barbati, G, Di Lenarda, A, Sinagra, G, Coppola, C, Piscopo, G, Cipresso, C, Rea, D, Maurea, C, Esposito, E, Arra, C, Maurea, N, Nemes, A, Kalapos, A, Domsik, P, Forster, T, Voilliot, D, Huttin, O, Vaugrenard, T, Schwartz, J, Sellal, J-M, Aliot, E, Juilliere, Y, Selton-Suty, C, Sanchez Millan, P J, Cabeza Lainez, P, Castillo Ortiz, J, Chueca Gonzalez, EM, Gheorghe, L, Fernandez Garcia, P, Herruzo Rojas, MS, Del Pozo Contreras, R, Fernandez Garcia, M, Vazquez Garcia, R, Rosca, M, Popescu, BA, Botezatu, D, Calin, A, Beladan, CC, Gurzun, M, Enache, R, Ginghina, C, Farouk, H, Al-Maimoony, T, Alhadad, A, El Serafi, M, Abdel Ghany, M, Poorzand, H, Mirfeizi, SZ, Javanbakht, A, center, Preventive Cardiovascular care research, center, Lupus Research, sciences, Mashhad university of medical, Tellatin, S, Famoso, G, Dassie, F, Martini, C, Osto, E, Maffei, P, Iliceto, S, Tona, F, Radunovic, Z, Steine, KS, Jedrzejewska, I, Braksator, W, Krol, W, Swiatowiec, A, Sawicki, J, Kostarska-Srokosz, E, Dluzniewski, M, Maceira Gonzalez, A M, Cosin-Sales, J, Diago, JL, Aguilar, J, Ruvira, J, Monmeneu, J, Igual, B, Lopez-Lereu, MP, Estornell, J, Olszanecka, A, Dragan, A, Kawecka-Jaszcz, K, Czarnecka, D, Scholz, F, Gaudron, PD, Hu, K, Liu, D, Florescu, C, Herrmann, S, Bijnens, B, Ertl, G, Stoerk, S, Weidemann, F, Krestjyaninov, M, Razin, VA, Gimaev, RH, Bogdanovic, Z, Burazor, I, Deljanin Ilic, M, Peluso, D, Muraru, D, Cucchini, U, Mihaila, S, Casablanca, S, Pigatto, E, Cozzi, F, Punzi, L, Badano, LP, Iliceto, S, Zhdanova, E, Rameev, VV, Safarova, AF, Moisseyev, SV, Kobalava, ZD, Magnino, C, Omede, P, Avenatti, E, Presutti, D, Losano, I, Moretti, C, Bucca, C, Gaita, F, Veglio, F, Milan, A, Bellsham-Revell, H, Bell, AJ, Miller, OI, Simpson, JM, Hwang, YM, Kim, GH, Jung, MH, Woo, GH, Medicine, Department of Internal, Hospital, St.Vincents, Korea, The Catholic University of, Suwon, Division of Cardiology, Repu, Driessen, MMP, Leiner, T, Schoof, PH, Breur, JMPJ, Sieswerda, GT, Meijboom, FJ, Bellsham-Revell, H, Hayes, N, Anderson, D, Austin, BC, Razavi, R, Greil, GF, Simpson, JM, Bell, AJ, Zhao, XX, Xu, XD, Qin, YW, Szmigielski, C A, Styczynski, G, Sobczynska, M, Placha, G, Kuch-Wocial, A, Ikonomidis, I, Voumbourakis, A, Triantafyllidi, H, Pavlidis, G, Varoudi, M, Papadakis, I, Trivilou, P, Paraskevaidis, I, Anastasiou-Nana, M, Lekakis, I, Kong, WILL, Yip, JAMES, Ling, LH, Milan, A, Tosello, F, Leone, D, Bruno, G, Losano, I, Avenatti, E, Sabia, L, Veglio, F, Zaborska, B, Baran, J, Pilichowska-Paszkiet, E, Sikora-Frac, M, Michalowska, I, Kulakowski, P, Budaj, A, Mega, S, Bono, MC, De Francesco, V, Castiglione, I, Ranocchi, F, Casacalenda, A, Goffredo, C, Patti, G, Di Sciascio, G, Musumeci, F, Kennedy, M, Waterhouse, DF, Sheahan, R, Foley, DF, Mcadam, BF, Ancona, R, Comenale Pinto, S, Caso, P, Arenga, F, Coppola, MG, Calabro, R, Remme, E W, Smedsrud, M K, Hasselberg, N E, Smiseth, O A, Edvardsen, T, Halmai, L, Nemes, A, Kardos, A, Neubauer, S, Degiovanni, A, Baduena, L, Dellera, G, Occhetta, E, Marino, P, Hotchi, J, Yamada, H, Nishio, S, Bando, M, Hayashi, S, Hirata, Y, Amano, R, Soeki, T, Wakatsuki, T, Sata, M, Lamia, B, Molano, LC, Viacroze, C, Cuvelier, A, Muir, JF, Lipczynska, M, Piotr Szymanski, PS, Anna Klisiewicz, AK, Lukasz Mazurkiewicz, LM, Piotr Hoffman, PH, Van T Sant, J, Wijers, SC, Ter Horst, IAH, Leenders, GE, Cramer, MJ, Doevendans, PA, Meine, M, Hatam, N, Goetzenich, A, Aljalloud, A, Mischke, K, Hoffmann, R, Autschbach, R, Sikora-Frac, M, Zaborska, B, Maciejewski, P, Bednarz, B, Budaj, A, Evangelista, A, Torromeo, C, Pandian, NG, Nardinocchi, P, Varano, V, Schiariti, M, Teresi, L, Puddu, PE, Storve, S, Dalen, H, Snare, SR, Haugen, BO, Torp, H, Fehri, W, Mahfoudhi, H, Mezni, F, Annabi, MS, Taamallah, K, Dahmani, R, Haggui, A, Hajlaoui, N, Lahidheb, D, Haouala, H, Colombo, A, Carminati, MC, Maffessanti, F, Gripari, P, Pepi, M, Lang, RM, Caiani, EG, Walker, JR, Abadi, S, Agmon, Y, Carasso, S, Aronson, D, Mutlak, D, Lessick, J, Saxena, A, Ramakrishnan, S, Juneja, R, Ljubas, J, Reskovic Luksic, V, Matasic, R, Pezo Nikolic, B, Lovric, D, Separovic Hanzevacki, J, Quattrone, A, Zito, C, Alongi, G, Vizzari, G, Bitto, A, De Caridi, G, Greco, M, Tripodi, R, Pizzino, G, Carerj, S, Ibrahimi, P, Jashari, F, Johansson, E, Gronlund, C, Bajraktari, G, Wester, P, Henein, MY, Kosmala, W, Marwick, TH, Souza, J R M, Zacharias, L G T, Geloneze, B, Pareja, J C, Chaim, A, Nadruz, W JR, Coelho, O R, Apostolovic, S, Stanojevic, D, Jankovic-Tomasevic, R, Salinger-Martinovic, S, Djordjevic-Radojkovic, D, Pavlovic, M, Tahirovic, E, Musial-Bright, L, Lainscak, M, Duengen, HD, group, CIBIS ELD study, Filipiak, D, Kasprzak, JD, and Lipiec, P

Abstract

Purpose: With the advent of percutaneous transcatheter device closures in congenital heart defects and the emergence of percutaneous left atrial appendage closure, there is an increasingly important role for echocardiographic guidance and control of device position and function. Disc occluder devices frequently present as an unexplained ‘figure-of-8’ on echocardiography. The aim of this study was to clarify this ‘figure-of-8’ display and to relate its morphology to transducer position and device type. Methods: A mathematical model was developed to resemble disc occluder geometry and to allow a numerical simulation of the echocardiographic appearance. In addition, we developed an in vitro set-up for echocardiographic analysis of various disc occluders and various transducer positions. Results: In the mathematical model of an epitrochoid curve (closely resembling disc occluder geometry) a ‘figure-of-8’ display is obtained when emphasizing points with tangent vector perpendicular to the direction of ultrasound waves. Decreasing imaging depth results in a more asymmetric ‘figure-of-8’, with small upper part and wide lower part. Clinical and in vitro data are in close agreement with these results (Figure 1). Furthermore a ‘figure-of-8’ display is only obtained in a coronal imaging position, and is similar for different commercially available disc occluder types. Conclusions: The ‘figure-of-8’ display in the ultrasound image of a disc occluder is an imaging artifact due to the specific ‘epitrochoidal’ geometry of a deployed device and its interaction with ultrasound waves. The morphology of the ‘figure-of-8’ depends on transducer position, i.e. imaging depth, and is similar for different device types. Figure 1 Impact of imaging depth

Published
2013
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35. Use of negative control outcomes to assess the comparability of patients initiating lipid-lowering therapies.

Author

Levintow SN, Orroth KK, Breskin A, Park AS, Flores-Arredondo JH, Dluzniewski P, Navar AM, Sørensen HT, and Brookhart MA

Subjects
Adult, Ezetimibe therapeutic use, Humans, Lipids, PCSK9 Inhibitors, Anticholesteremic Agents, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects
Abstract

Purpose: Clinical trials have demonstrated efficacy of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) in reducing risk of cardiovascular disease events, but effectiveness in routine clinical care has not been well-studied. We used negative control outcomes to assess potential confounding in an observational study of PCSK9i versus ezetimibe or high-intensity statin., Methods: Using commercial claims, we identified U.S. adults initiating PCSK9i, ezetimibe, or high-intensity statin in 2015-2018, with other lipid-lowering therapy (LLT) use in the year prior (LLT cohort) or atherosclerotic cardiovascular disease (ASCVD) in the past 90 days (ASCVD cohort). We compared initiators of PCSK9i to ezetimibe and high-intensity statin by estimating one-year risks of negative control outcomes influenced by frailty or health-seeking behaviors. Inverse probability of treatment and censoring weighted estimators of risk differences (RDs) were used to evaluate residual confounding after controlling for covariates., Results: PCSK9i initiators had lower one-year risks of negative control outcomes associated with frailty, such as decubitus ulcer in the ASCVD cohort (PCSK9i vs. high-intensity statin RD = -3.5%, 95% confidence interval (CI): -4.6%, -2.5%; PCSK9i vs. ezetimibe RD = -1.3%, 95% CI: -2.1%, -0.6%), with similar but attenuated associations in the LLT cohort. Lower risks of accidents and fractures were also observed for PCSK9i, varying by cohort. Risks were similar for outcomes associated with health-seeking behaviors, although trended higher for PCSK9i in the ASCVD cohort., Conclusions: Observed associations suggest lower frailty and potentially greater health-seeking behaviors among PCSK9i initiators, particularly those with a recent ASCVD diagnosis, with the potential to bias real-world analyses of treatment effectiveness., (© 2021 John Wiley & Sons Ltd.)

Published
2022
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36. Trends in Recurrent Coronary Heart Disease After Myocardial Infarction Among US Women and Men Between 2008 and 2017.

Author

Peters SAE, Colantonio LD, Dai Y, Zhao H, Bittner V, Farkouh ME, Dluzniewski P, Poudel B, Muntner P, and Woodward M

Subjects
Adult, Aged, Aged, 80 and over, Coronary Disease physiopathology, Female, History, 21st Century, Humans, Male, Middle Aged, Myocardial Infarction mortality, Recurrence, Time Factors, Young Adult, Coronary Disease etiology, Myocardial Infarction complications
Abstract

Background: Rates for recurrent coronary heart disease (CHD) events have declined in the United States. However, few studies have assessed whether this decline has been similar among women and men., Methods: Data were used from 770 408 US women and 700 477 US men <65 years of age with commercial health insurance through MarketScan and ≥66 years of age with government health insurance through Medicare who had a myocardial infarction (MI) hospitalization between 2008 and 2017. Women and men were followed up for recurrent MI, recurrent CHD events (ie, recurrent MI or coronary revascularization), heart failure hospitalization, and all-cause mortality (Medicare only) in the 365 days after MI., Results: From 2008 to 2017, age-standardized recurrent MI rates per 1000 person-years decreased from 89.2 to 72.3 in women and from 94.2 to 81.3 in men (multivariable-adjusted P interaction by sex <0.001). Recurrent CHD event rates decreased from 166.3 to 133.3 in women and from 198.1 to 176.8 in men ( P interaction <0.001). Heart failure hospitalization rates decreased from 177.4 to 158.1 in women and from 162.9 to 156.1 in men ( P interaction=0.001). All-cause mortality rates decreased from 403.2 to 389.5 in women and from 436.1 to 417.9 in men ( P interaction=0.82). In 2017, the multivariable-adjusted rate ratios comparing women with men were 0.90 (95% CI, 0.86-0.93) for recurrent MI, 0.80 (95% CI, 0.78-0.82) for recurrent CHD events, 0.99 (95% CI, 0.96-1.01) for heart failure hospitalization, and 0.82 (95% CI, 0.80-0.83) for all-cause mortality., Conclusions: Rates of recurrent MI, recurrent CHD events, heart failure hospitalization, and mortality in the first year after an MI declined considerably between 2008 and 2017 in both men and women, with proportionally greater reductions for women than men. However, rates remain very high, and rates of recurrent MI, recurrent CHD events, and death continue to be higher among men than women.

Published
2021
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37. Sex Differences in Incident and Recurrent Coronary Events and All-Cause Mortality.

Author

Peters SAE, Colantonio LD, Chen L, Bittner V, Farkouh ME, Rosenson RS, Jackson EA, Dluzniewski P, Poudel B, Muntner P, and Woodward M

Subjects
Adult, Aged, Aged, 80 and over, Cause of Death trends, Female, Humans, Incidence, Male, Middle Aged, Recurrence, Sex Distribution, Sex Factors, Survival Rate trends, United States epidemiology, Young Adult, Coronary Disease epidemiology, Hospitalization statistics & numerical data, Universal Health Insurance statistics & numerical data
Abstract

Background: Women have lower age-specific rates of incident coronary heart disease (CHD) than men. It is unclear whether women remain at lower risk for CHD events versus men following a myocardial infarction (MI)., Objectives: This study assessed sex differences in recurrent MI, recurrent CHD events, and mortality among patients with MI and compared these associations with sex differences in a control group without a history of CHD., Methods: This study analyzed data for 171,897 women and 167,993 men age 21 years or older with health insurance in the United States who had a MI hospitalization in 2015 or 2016. Patients with a MI were frequency matched by age and calendar year to 687,588 women and 671,972 men without CHD. Beneficiaries were followed until December 2017 for MI, CHD (i.e., MI or coronary revascularization), and in Medicare for all-cause mortality., Results: Age-standardized rates of MI per 1,000 person-years were 4.5 in women and 5.7 in men without CHD (hazard ratio [HR]: 0.64; 95% confidence interval [CI]: 0.62 to 0.67) and 60.2 in women and 59.8 in men with MI (HR: 0.94; 95% CI: 0.92 to 0.96). CHD rates in women versus men were 6.3 versus 10.7 among those without CHD (HR: 0.53; 95% CI: 0.51 to 0.54) and 84.5 versus 99.3 among those with MI (HR: 0.87; 95% CI: 0.85 to 0.89). All-cause mortality rates in women versus men were 63.7 versus 59.0 among those without CHD (HR: 0.72; 95% CI: 0.71 to 0.73) and 311.6 versus 284.5 among those with MI (HR: 0.90; 95% CI: 0.89 to 0.92)., Conclusions: The lower risk for MI, CHD, and all-cause mortality in women versus men is considerably attenuated following a MI., (Copyright © 2020. Published by Elsevier Inc.)

Published
2020
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38. Prediction of mortality after radical prostatectomy by Charlson comorbidity index.

Author

Guzzo TJ, Dluzniewski P, Orosco R, Platz EA, Partin AW, and Han M

Subjects
Cohort Studies, Comorbidity, Humans, Male, Middle Aged, Prognosis, Prostatic Neoplasms epidemiology, Retrospective Studies, Prostatectomy, Prostatic Neoplasms mortality, Prostatic Neoplasms surgery
Abstract

Objectives: Prostate cancer treatment should depend on the characteristics of a patient's prostate cancer as well as overall health status. A possible adverse consequence of poor patient selection is a lack of benefit because of premature death from another cause. We evaluated the association between perioperative comorbidity and risk of death from causes other than prostate cancer in men who underwent radical prostatectomy (RP)., Methods: We conducted a retrospective cohort study of 14,052 men who underwent RP from 1983 to 2006. The Charlson Comorbidity Index (CCI) score was calculated using the discharge records for the prostatectomy hospitalization. Mortality status and cause of death were obtained via chart review and searches of national databases. Cox proportional hazards regression was used to estimate the hazard ratio (HR) of death from causes other than prostate cancer after RP by CCI score (0, 1, 2+)., Results: The median age at RP was 58.1 years. The median follow-up was 7.6 years (interquartile range 4.3-11.5). Of 849 deaths, 599 (70.6%) resulted from causes other than prostate cancer. On multivariable analysis, men with a CCI ≥2 had a statistically significantly higher risk of death from causes other than prostate cancer compared with those with lower CCI scores (HR 2.18, 95% CI 1.30-3.64, P = .0003)., Conclusions: Greater perioperative comorbidity was associated with a higher risk of death from causes other than prostate cancer in men who underwent RP. Physicians should consider using a standardized tool to assess perioperative comorbidities to enhance appropriate recommendation for surgical treatment., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Published
2010
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