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187 results on '"Ihlemann N"'

2. Long-term impact of persistent vegetations at 6 month followup after treatment of infective endocarditis: a substudy of the Partial Oral vs Intravenous Antibiotic Treatment of Endocarditis (POET) tria

Author

Hjulmand, J, primary, Pries-Heje, M, additional, Try Lenz, I, additional, Carter-Storch, R, additional, Gill, S, additional, Bruun, N E, additional, Povlsen, J A, additional, Christiansen, U, additional, Helweg-Larsen, J, additional, Fosboel, E, additional, Toender, N, additional, Moser, C, additional, Iversen, K, additional, Ihlemann, N, additional, and Bundgaard, H, additional

Published
2022
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3. Survival after aortic root replacement with a stentless xenograft is determined by patient characteristics

Author

Dagnegård, H.H., Bekke, K., Kolseth, S.M., Glaser, N., Wallén, C., El-Hamamsy, I., Vidisson, K.O., Lie, A.S., Valentin, J.B., Sartipy, U., Haaverstad, R., Vanky, Farkas, Lefebvre, L., Gudbjartsson, T., Johnsen, S.P., Søndergaard, L., Thyregod, G.H., Lund, J.T., Ihlemann, N., Smerup, M.H., Dagnegård, H.H., Bekke, K., Kolseth, S.M., Glaser, N., Wallén, C., El-Hamamsy, I., Vidisson, K.O., Lie, A.S., Valentin, J.B., Sartipy, U., Haaverstad, R., Vanky, Farkas, Lefebvre, L., Gudbjartsson, T., Johnsen, S.P., Søndergaard, L., Thyregod, G.H., Lund, J.T., Ihlemann, N., and Smerup, M.H.

Abstract

Objectives: Our objective was to examine intermediate-term survival and reinterventions in unselected patients, stratified according to indication, who received a Freestyle (Medtronic Inc, Minneapolis, Minn) bioprosthesis as a full aortic root replacement. Methods: Data from medical records were retrospectively collected for patients who had aortic root replacement using Freestyle bioprostheses between 1999 and 2018 at 6 North-Atlantic centers. Survival status was extracted from national registries and results stratified according to indication for surgery. Results: We included 1030 implantations in 1008 patients with elective indications for surgery: aneurysm (39.8%), small root (8.3%), and other (13.8%), and urgent/emergent indications: endocarditis (26.7%) and Stanford type A aortic dissection (11.4%). Across indications, 46.3% were nonelective cases and 34.0% were reoperations. Median age was 66.0 (interquartile range, 58.0-71.8) years and median follow-up was 5.0 (interquartile range, 2.6-7.9) years. Thirty-day mortality varied from 2.9% to 27.4% depending on indication. Intermediate survival for 90-day survivors with elective indications were not different from the general population standardized for age and sex (P = .95, 83, and .16 for aneurysms, small roots, and other, respectively). In contrast, patients with endocarditis and type A dissection had excess mortality (P < .001). Freedom from valve reinterventions was 95.0% and 94.4% at 5 and 8 years, respectively. In all, 52 patients (5.2%) underwent reinterventions, most because of endocarditis. Conclusions: At intermediate term follow-up this retrospective study provides further support for the use of the Freestyle bioprosthesis in the real-world setting of diverse, complex, and often high-risk aortic root replacement and suggests that outcome is determined by patient and disease, rather than by prosthesis, characteristics. © 2021 The Authors

Published
2022
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4. Survival after aortic root replacement with a stentless xenograft is determined by patient characteristics

Author

Dagnegård, H.H., Bekke, K., Kolseth, S.M., Glaser, N., Wallén, C., El-Hamamsy, I., Vidisson, K.O., Lie, A.S., Valentin, J.B., Sartipy, U., Haaverstad, R., Vanky, Farkas, Lefebvre, L., Gudbjartsson, T., Johnsen, S.P., Søndergaard, L., Thyregod, G.H., Lund, J.T., Ihlemann, N., Smerup, M.H., Dagnegård, H.H., Bekke, K., Kolseth, S.M., Glaser, N., Wallén, C., El-Hamamsy, I., Vidisson, K.O., Lie, A.S., Valentin, J.B., Sartipy, U., Haaverstad, R., Vanky, Farkas, Lefebvre, L., Gudbjartsson, T., Johnsen, S.P., Søndergaard, L., Thyregod, G.H., Lund, J.T., Ihlemann, N., and Smerup, M.H.

Abstract

Objectives: Our objective was to examine intermediate-term survival and reinterventions in unselected patients, stratified according to indication, who received a Freestyle (Medtronic Inc, Minneapolis, Minn) bioprosthesis as a full aortic root replacement. Methods: Data from medical records were retrospectively collected for patients who had aortic root replacement using Freestyle bioprostheses between 1999 and 2018 at 6 North-Atlantic centers. Survival status was extracted from national registries and results stratified according to indication for surgery. Results: We included 1030 implantations in 1008 patients with elective indications for surgery: aneurysm (39.8%), small root (8.3%), and other (13.8%), and urgent/emergent indications: endocarditis (26.7%) and Stanford type A aortic dissection (11.4%). Across indications, 46.3% were nonelective cases and 34.0% were reoperations. Median age was 66.0 (interquartile range, 58.0-71.8) years and median follow-up was 5.0 (interquartile range, 2.6-7.9) years. Thirty-day mortality varied from 2.9% to 27.4% depending on indication. Intermediate survival for 90-day survivors with elective indications were not different from the general population standardized for age and sex (P = .95, 83, and .16 for aneurysms, small roots, and other, respectively). In contrast, patients with endocarditis and type A dissection had excess mortality (P < .001). Freedom from valve reinterventions was 95.0% and 94.4% at 5 and 8 years, respectively. In all, 52 patients (5.2%) underwent reinterventions, most because of endocarditis. Conclusions: At intermediate term follow-up this retrospective study provides further support for the use of the Freestyle bioprosthesis in the real-world setting of diverse, complex, and often high-risk aortic root replacement and suggests that outcome is determined by patient and disease, rather than by prosthesis, characteristics. © 2021 The Authors

Published
2021
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7. Infective endocarditis in patients who have undergone transcatheter aortic valve implantation:a review

Author

Østergaard, L., Lauridsen, T. Kiilerich, Iversen, K., Bundgaard, H., Søndergaard, L., Ihlemann, N., Moser, C., Fosbøl, E., Østergaard, L., Lauridsen, T. Kiilerich, Iversen, K., Bundgaard, H., Søndergaard, L., Ihlemann, N., Moser, C., and Fosbøl, E.

Abstract

Background: Transcatheter aortic valve implantation (TAVI) has been approved for the treatment of severe aortic stenosis since 2008 and recent trials have shown that TAVI is at least non-inferior to surgical aortic valve replacement (SAVR) with regards to short-term efficacy and safety in patients across all surgical risk profiles. Prosthetic valve endocarditis of the transcatheter heart valve is a feared complication; data on the risk of infective endocarditis (IE) subsequent to TAVI are now gradually emerging. Objectives: We set forth to conduct a review of the incidence, diagnosis, microbial aetiologies, prevention, outcome and management of TAVI-IE. Sources: From the MEDLINE database we included a total of 12 observational studies and five studies of long-term results from randomized controlled trials. Content: The incidence of TAVI-IE was reported to be between 0.7% and 3.0% per person-year. The most common microbes were reported to be enterococci, Staphylococcus aureus, streptococci and coagulase-negative staphylococci. International guidelines on prevention strategies of IE recommend good sanitary conditions including cutaneous care, good oral hygiene and good care of dialysis catheters. Antibiotic prophylaxis is recommended by guidelines prior to dental procedures in patients with TAVI; however, evidence is sparse. The majority of the patients included in this review with TAVI-IE had an indication for surgical intervention due to IE (50.0% or more); however, only a small subset of the patients underwent surgery (16.4% or less). The in-hospital mortality was around 25%, i.e. of the same order of magnitude as in prosthetic valve IE in general, but varied substantially between studies (from 11% to 64%). Implications: The US Food and Drug Administration's approval of TAVI in patients at low surgical risk may change the characteristics of patients with TAVI, which may influence the incidence, management, and outcome of patients with TAVI-IE.

Published
2020

9. Contemporary Presentation and Management of Valvular Heart Disease The EURObservational Research Programme Valvular Heart Disease II Survey

Author

Iung, B., Delgado, V., Rosenhek, R., Price, S., Prendergast, B., Wendler, O., Bonis, M. de, Tribouilloy, C., Evangelista, A., Bogachev-Prokophiev, A., Apor, A., Ince, H., Laroche, C., Popescu, B.A., Pierard, L., Haude, M., Hindricks, G., Ruschitzka, F., Windecker, S., Bax, J.J., Maggioni, A., Vahanian, A., Mekhaldi, S., Lemaitre, K., Authier, S., Druais, H., Goda, A., Mascherbauer, J., Samadov, F., Pasquet, A., Linhartova, K., Ihlemann, N., Abdelhamid, M., Saraste, A., Kostovska, E.S., Bajraktari, G., Mirrakhimov, E., Erglis, A., Mizariene, V., Cassar, D., Tomkiewicz-Pajak, L., Ribeiras, R., Popescu, B., Beleslin, B., Simkova, I., Dogan, S.M., Rahman-Haley, S., Shirka, E., Dado, E., Zera, E., Bica, L., Heger, M., Muslumova, F., Jahangirov, T., Ahmedov, T., Husseynov, S., Cosyns, B., Camp, G. van, Sindelarova, S., Branny, M., Parenicova, I., Vondrackova, D.J., Homza, M., Ostransky, J., Hasan-Ali, H., Abdelhady, Y., Hassan, M., Soliman, H., Mostafa, A.E., Moaaz, M., Kazamel, G., Sadek, Y., Eltobgi, S., Kamal, D., Kylmala, M., Turpeinen, A., Monin, J.L., Jobic, Y., Attias, D., Magne, J., Marechaux, S., Donal, E., Biere, L., Bernard, A., Daudin, M., Khounlaboud, M., Habib, G., Bardet, H., Audonnet, M., Thuny, F., Plurien, F., Berenfeld, A., Gervais, R., Sorbets, E., Charbonnier, A., Bauer, F., Menager-Gangloff, C., Gjerakorska-Radovikj, M., Jordanova, S., Caglayan, E., Hambrecht, R., Akin, I., Maier, L., Nickenig, G., Scholtz, W., Schulze, P.C., Heintzen, M., Er, F., Sigusch, H., Spargias, K., Kamperidis, V., Sachpekidis, V., Bellos, V., Kanakakis, I., Papafaklis, M., Makris, A., Poulimenos, L., Katsaros, A., Lampropoulos, K., Bartha, E., Zsary, A., Jebelovszki, E., Cziraki, A., Borsanyi, T., Lupkovics, G., Jarai, Z., Ibrahimi, P., Arapova, R., Laahunova, E., Sime, I., Rancane, G., Radauskaite, G., Raugaliene, R., Xuereb, R.G., Djaberi, R., Komar, M., Szymanski, P., Zaborska, B., Mizia-Stec, K., Regulski, M., Bogacki, P., Sedziwy, E., Komor, K., Myszor, J., Joao, I., Martins, R., Cabral, S., Gago, P., Cardoso, G., Almeida, I., Antunes, N., Carvalho, S., Galrinho, A., Freitas, A., Grigorica, L., Mitre, A., Ionac, A., Tint, D., Popescu, A., Petris, A.O., Onut, R., Pop, C., Usurelu, C., Beyer, R., Militaru, C., Eminovici, G., Arsenescu-Georgescu, C., Irtyuga, O., Semenova, E., Boldyrev, S., Kozmin, D., Gross, Y., Zotov, A., Kuznetsov, D., Nemchenko, E., Kulumbegov, O., Jakubov, R., Stefanov, S., Schneider, Y., Tsechanovich, V., Gamzaev, A., Fomenko, M., Mayorova, O., Skripkina, E., Safina, V., Slastin, Y., Koroleva, T., Polyaeva, L., Tarasenko, I., Alekseeva, S., Magamet, V., Medvedev, I., Khilova, L., Verevetinov, A., Stojsic-Milosavljevic, A., Nikolic, N.M., Ostric, D.K., Ruzicic, D., Pavlovic, S., Milosavljevic, J., Jovovic, L., Margoczy, R., Valocik, G., Studencan, M., Iglesias, F.C., Mendez, I., Gomez, A.G., Sanchez Fernandez, P.L., Valenzuela, G.M., Cladellas, M., Villegas, D.V., Moral, S., Gallego, I.M., Paya, R., Caballero, L., Paton, R.R., Esteban, E., Iglesia-Carreno, C., Alberca, M.T., Valle, A., Molina-Mora, M.J., Castro, N., Sayar, N., Demirtas, A.O., Yesilay, A., Demir, S., Bozkurt, A., Kanar, B., Gudul, N.E., Yildirim, T., Taylan, G., Mert, K.U., Yilmaztepe, M.A., Mert, G.O., Cosansu, K., Sayin, M.R., Karabag, T., EORP VHD II Investigators, Instituto Universitario de Investigacion de Nanocienca de Aragon, University of Zaragoza - Universidad de Zaragoza [Zaragoza], Instituto de Física de Cantabria (IFCA), Universidad de Cantabria [Santander]-Consejo Superior de Investigaciones Científicas [Madrid] (CSIC), Leibniz Institute for Astrophysics Potsdam (AIP), St. Josef Hospital, Ruhr-University Bochum, Université Paris Diderot - Paris 7 (UPD7), Institut National de la Santé et de la Recherche Médicale (INSERM), Leiden University Medical Center (LUMC), Universiteit Leiden, Medizinische Universität Wien = Medical University of Vienna, Department of Imaging Royal Brompton Hospital, Royal Brompton Hospital, Guy's and St Thomas' Hospital [London], CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Vall d'Hebron University Hospital [Barcelona], Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Liège (CHU-Liège), Lukaskrankenhaus, Universität Leipzig, University Heart Centre Freiburg - Bad Krozingen, Research Center [Associazione Nazionale Medici Cardiologi Ospedalieri] (ANMCO Research Center), Associazione Nazionale Medici Cardiologi Ospedalieri [Firenze] (ANMCO), Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Uppsala University, SAFRAN Group, Laboratory of In Vivo Cellular and Molecular Imaging, Vrije Universiteit Brussel (VUB), Université de Lille, Sciences et Technologies, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes - Faculté de Médecine (UR Médecine), Université de Rennes (UR), CHU Pontchaillou [Rennes], Laboratoire de Protection et Remodelage du Myocarde (PMRM), Université d'Angers (UA)-Université d'Angers (UA), Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer (LabEx LipSTIC), Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Gustave Roussy (IGR)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Université de Montpellier (UM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU de Saint-Brieuc, Hôpital Lapeyronie [Montpellier] (CHU), Assistance Publique - Hôpitaux de Marseille (APHM), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Institut de la Vision, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, University of Latvia (LU), Dipartimento di Scienza dei Materiali = Department of Materials Science [Milano-Bicocca], Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), MDM Laboratory, IMM-CNR, Consejo Superior de Investigaciones Científicas [Madrid] (CSIC), Réseaux épuration et qualité des eaux (UR REBX), Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA), King Abdullah University of Science and Technology (KAUST), INSTITUTO NACIONAL DE INVESTIGACAO AGRARIA E VETERINARIA VILA DO CONDE PRT, Partenaires IRSTEA, Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA), Université de Médecine Carol Davila, Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C.C. Iliescu' [Bucharest, Romania], Département Intelligence Ambiante et Systèmes Interactifs (DIASI), Laboratoire d'Intégration des Systèmes et des Technologies (LIST (CEA)), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Department of photonics engineering, Danmarks Tekniske Universitet = Technical University of Denmark (DTU), Clinical sciences, Cardio-vascular diseases, Cardiology, Universität Leipzig [Leipzig], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 - Faculté de Médecine (UR1 Médecine), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Institut National de la Recherche Agronomique (INRA)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université Paris-Sud - Paris 11 (UP11)-École pratique des hautes études (EPHE), UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Fédération Francophone de la Cancérologie Digestive, FFCD-Université de Montpellier (UM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), Technical University of Denmark [Lyngby] (DTU), Université d'Angers (UA), Iung, Bernard, Delgado, Victoria, Rosenhek, Raphael, Price, Susanna, Prendergast, Bernard, Wendler, Olaf, De Bonis, Michele, Tribouilloy, Christophe, Evangelista, Arturo, Bogachev-Prokophiev, Alexander, Apor, Astrid, Ince, Hüseyin, Laroche, Cécile, Popescu, Bogdan A, Piérard, Luc, Haude, Michael, Hindricks, Gerhard, Ruschitzka, Frank, Windecker, Stephan, Bax, Jeroen J, Maggioni, Aldo, and Vahanian, Alec

Subjects
Male, Time Factors, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, heart valve diseases, valvular surgery, Cardiologists, 0302 clinical medicine, Time-to-Treatment/trends, Referral and Consultation/trends, Heart Valve Diseases/diagnosis, Medicine, echocardiography, 03.02. Klinikai orvostan, 030212 general & internal medicine, Prospective Studies, Practice Patterns, Physicians', 610 Medicine & health, Referral and Consultation, valvular heart disease, Middle Aged, Europe, Practice Guidelines as Topic, cardiovascular system, Healthcare Disparities/trends, transcatheter aortic valve replacement, Female, Guideline Adherence, Presentation (obstetrics), Cardiology and Cardiovascular Medicine, guideline, Cardiologists/trends, medicine.medical_specialty, transcatheter intervention, Clinical Decision-Making, Time-to-Treatment, Europe/epidemiology, 03 medical and health sciences, Physiology (medical), Guideline Adherence/trends, Humans, Healthcare Disparities, Intensive care medicine, Aged, business.industry, medicine.disease, Practice Patterns, Physicians'/trends, Health Care Surveys, business, aged, 80 and over, guidelines as topic
Abstract

Background: Valvular heart disease (VHD) is an important cause of mortality and morbidity and has been subject to important changes in management. The VHD II survey was designed by the EURObservational Research Programme of the European Society of Cardiology to analyze actual management of VHD and to compare practice with guidelines. Methods: Patients with severe native VHD or previous valvular intervention were enrolled prospectively across 28 countries over a 3-month period in 2017. Indications for intervention were considered concordant if the intervention was performed or scheduled in symptomatic patients, corresponding to Class I recommendations specified in the 2012 European Society of Cardiology and in the 2014 American Heart Association/American College of Cardiology VHD guidelines. Results: A total of 7247 patients (4483 hospitalized, 2764 outpatients) were included in 222 centers. Median age was 71 years (interquartile range, 62–80 years); 1917 patients (26.5%) were ≥80 years; and 3416 were female (47.1%). Severe native VHD was present in 5219 patients (72.0%): aortic stenosis in 2152 (41.2% of native VHD), aortic regurgitation in 279 (5.3%), mitral stenosis in 234 (4.5%), mitral regurgitation in 1114 (21.3%; primary in 746 and secondary in 368), multiple left-sided VHD in 1297 (24.9%), and right-sided VHD in 143 (2.7%). Two thousand twenty-eight patients (28.0%) had undergone previous valvular intervention. Intervention was performed in 37.0% and scheduled in 26.8% of patients with native VHD. The decision for intervention was concordant with Class I recommendations in symptomatic patients with severe single left-sided native VHD in 79.4% (95% CI, 77.1–81.6) for aortic stenosis, 77.6% (95% CI, 69.9–84.0) for aortic regurgitation, 68.5% (95% CI, 60.8–75.4) for mitral stenosis, and 71.0% (95% CI, 66.4–75.3) for primary mitral regurgitation. Valvular interventions were performed in 2150 patients during the survey; of them, 47.8% of patients with single left-sided native VHD were in New York Heart Association class III or IV. Transcatheter procedures were performed in 38.7% of patients with aortic stenosis and 16.7% of those with mitral regurgitation. Conclusions: Despite good concordance between Class I recommendations and practice in patients with aortic VHD, the suboptimal number in mitral VHD and late referral for valvular interventions suggest the need to improve further guideline implementation.

Published
2019
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12. The feasibility of tricuspid annular plane systolic excursion performed by transesophageal echocardiography throughout heart surgery and its interchangeability with transthoracic echocardiography

Author

Korshin, A, Grønlykke, L, Nilsson, J C, Møller-Sørensen, Hasse, Ihlemann, N, Kjøller, M, Damgaard, S, Lehnert, P, Hassager, C, Kjaergaard, J, Ravn, H B, Korshin, A, Grønlykke, L, Nilsson, J C, Møller-Sørensen, Hasse, Ihlemann, N, Kjøller, M, Damgaard, S, Lehnert, P, Hassager, C, Kjaergaard, J, and Ravn, H B

Abstract

Tricuspid annular plane systolic excursion (TAPSE) is a robust measure of RV function, but the performance of transesophageal echocardiography (TEE) measured TAPSE during surgery is not well established. We aim to evaluate feasibility of various TEE views before, during and after surgery. Furthermore, we compare performance of individual TEE measurements depending on view and method (AMM- and M-mode as well as 2D) as well as TAPSE measured using TEE with transthoracic echocardiography (TTE) TAPSE. The study was conducted from January 2015 through September 2016. In 47 patients with normal left ventricular ejection fraction, TEE was prospectively performed during coronary artery bypass grafting surgery. TAPSE and tricuspid annulus tissue Doppler imaging (TDI) were recorded in five different views at pre-specified time points during surgery. Data were analyzed for availability (obtainable/readable images) and reliability (intra-/inter-observer bias and precision). Finally, TEE TAPSE was compared to TTE TAPSE immediately before and after surgery. TAPSE and TDI with TEE was achievable in > 90% of patients in the transgastric view during surgery. The AM- and M-mode had the best reliability and the best correlation with TAPSE measured with TTE. The deep transgastric view was achievable in less than 50% after sternotomy, and TAPSE measured from 2D had a poorer performance compared to the AM- and M-mode. TDI demonstrated a high reliability throughout surgery. RV function can be evaluated by TAPSE and TDI using TEE during surgery. TEE values from the transgastric view demonstrated high performance throughout surgery and a good agreement with TTE TAPSE measurements.

Published
2018

15. The feasibility of tricuspid annular plane systolic excursion performed by transesophageal echocardiography throughout heart surgery and its interchangeability with transthoracic echocardiography

Author

Korshin, A., primary, Grønlykke, L., additional, Nilsson, J. C., additional, Møller-Sørensen, H., additional, Ihlemann, N., additional, Kjøller, M., additional, Damgaard, S., additional, Lehnert, P., additional, Hassager, C., additional, Kjaergaard, J., additional, and Ravn, H. B., additional

Published
2018
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20. The main reduction in tricuspid annular plane systolic excursion (TAPSE) after heart surgery doesn’t happen at the moment of pericardiotomy

Author

Korshin, Andre, primary, Grønlykke, L., additional, Nilsson, J.C., additional, Kjaergaard, J., additional, Ihlemann, N., additional, Hassager, C., additional, Damgaard, S., additional, Lehnert, P., additional, Kjøller, S.M., additional, Møller-Sørensen, H., additional, and Berg Ravn, H., additional

Published
2016
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21. PP.22.21

Author

Málek, F., primary, Neuzil, P., additional, Gustafsson, F., additional, Walton, A., additional, Mates, M., additional, Sondergaard, L., additional, Ihlemann, N., additional, and Kaye, D., additional

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

Author

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

Published
2015
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24. Oral Abstract session: Pericardial diseases, masses and sources of embolism: Thursday 4 December 2014, 11:00-12:30 * Location: Agora

Author

Ihlemann, N., primary, Landex, N., additional, Soeholm, H., additional, Hassager, C., additional, Gustafsson, F., additional, Matshela, M. R., additional, Butz, T., additional, Faber, L., additional, Brand, M., additional, Wiemer, M., additional, Piper, C., additional, Noelke, J., additional, Sasko, B., additional, Horstkotte, D., additional, Trappe, H., additional, Cruz, I., additional, Dymarkowski, S., additional, Bogaert, J., additional, Kudaiberdiev, T., additional, Strachinaru, M., additional, Catez, E., additional, Jousten, I., additional, Pavel, O., additional, Janssen, C., additional, Morissens, M., additional, Gazagnes, M.-D., additional, Rodriguez Diego, S., additional, Delgado, M., additional, Ruiz, M., additional, Pardo, L., additional, Hidalgo, F. J., additional, Romo, E., additional, Ortega, R., additional, Mesa, D., additional, and Suarez De Lezo Cruz Conde, J., additional

Published
2014
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25. Case-based session: unusual and multitrouble cases: Saturday 6 December 2014, 08:30-10:0 * Location: Agora

Author

Eissmann, M., primary, Kahlert, P., additional, Erbel, R., additional, Janosi, R., additional, Soeholm, H., additional, Hassager, C., additional, Vejlstrup, N., additional, Arendrup, H., additional, Jensen, M., additional, Lund, J., additional, Ihlemann, N., additional, Neykova, A., additional, Molcard, D., additional, Moulla, M., additional, Valizadeh, R., additional, Alghandour, M., additional, Mahmoud, M., additional, Shimbo, M., additional, Watanabe, H., additional, Iino, K., additional, Ito, H., additional, Piriou, N., additional, Sassier, J., additional, Pallardy, A., additional, Valette, F., additional, Serfaty, J., additional, Trochu, J., additional, Cordovil, A., additional, Tude Rodrigues, A., additional, Piveta, R., additional, De Oliveira, W., additional, Ponchirolli, A., additional, Monaco, C., additional, De Lira Filho, E., additional, Vieira, M., additional, Fischer, C., additional, and Morhy, S., additional

Published
2014
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30. Effects of acute and chronic attenuation of postprandial hyperglycemia on postglucose-load endothelial function in insulin resistant individuals: is stimulation of first phase insulin secretion beneficial for the endothelial function?

Author

Major-Pedersen, A, Ihlemann, N, Hermann, T S, Christiansen, B, Kveiborg, B., Dominguez, H, Nielsen, D, Rask-Madsen, C, Svendsen, O L, Køber, L, Torp-Pedersen, C, Major-Pedersen, A, Ihlemann, N, Hermann, T S, Christiansen, B, Kveiborg, B., Dominguez, H, Nielsen, D, Rask-Madsen, C, Svendsen, O L, Køber, L, and Torp-Pedersen, C

Abstract

Udgivelsesdato: 2008-Sep, The aim of the study is to determine if attenuation of postprandial hyperglycemia, by acutely and chronically enhancing postprandial insulin secretion in insulin-resistant individuals, improves the endothelial dysfunction. We assessed postoral glucose-load endothelial function in 56 insulin-resistant subjects with the Flow-Mediated-Dilation (FMD) technique. We randomized subjects to intervention/control group, and examined the acute and chronic effect of nateglinide, an oral antidiabetic drug of rapid action. In the intervention group, postoral glucose-load (post-OGL) FMD delta values deteriorated when compared to pre-OGL values, most significantly at 3 h post-OGL, on the following days: on the first study day termed "Baseline day" (p=0.04); on both days after 3 months of nateglinide treatment [with nateglinide administered on study-day "acute+chronic" (p=0.01); and without nateglinide on study-day "Closing day", p=0.001]. Post-OGL changes in the control group were nonsignificant both at Baseline and on Closing day. After a single dose of nateglinide "Acute day", post-OGL FMD deterioration was abolished. There was an increment in post-OGL FMD delta values most significant at 2 h post-OGL (p=0.02). Insulin concentrations increased while glucose concentrations decreased on study-days with nateglinide when compared to study-days without (p=<0.001 for both insulin and glucose). Comparisons for insulin and glucose concentrations between days with nateglinide, and likewise between days without, showed no significant difference. Postglucose load endothelial dysfunction can be prevented by administration of nateglinide, however, after 3 months of nateglinide treatment, this effect is abolished. Chronically increased insulin secretion could counteract the initial beneficial effect of reduced glucose excursions. We found no relationship between postprandial hyperglycemia and post-OGL FMD.

Published
2008

31. Effects of oral glucose load on endothelial function and on insulin and glucose fluctuations in healthy individuals

Author

Major-Pedersen, A, Ihlemann, N, Hermann, T S, Christiansen, B, Dominguez, H, Kveiborg, B., Nielsen, D B, Svendsen, O L, Køber, L, Torp-Pedersen, C, Major-Pedersen, A, Ihlemann, N, Hermann, T S, Christiansen, B, Dominguez, H, Kveiborg, B., Nielsen, D B, Svendsen, O L, Køber, L, and Torp-Pedersen, C

Abstract

Udgivelsesdato: 2008, BACKGROUND/AIMS: Postprandial hyperglycemia, an independent risk factor for cardiovascular disease, is accompanied by endothelial dysfunction. We studied the effect of oral glucose load on insulin and glucose fluctuations, and on postprandial endothelial function in healthy individuals in order to better understand and cope with the postprandial state in insulin resistant individuals. METHODS: We assessed post-oral glucose load endothelial function (flow mediated dilation), plasma insulin, and blood glucose in 9 healthy subjects. RESULTS: The largest increases in delta FMD values (fasting FMD value subtracted from postprandial FMD value) occurred at 3 hours after both glucose or placebo load, respectively: 4.80 +/- 1.41 (P = .009) and 2.34 +/- 1.47 (P = .15). Glucose and insulin concentrations achieved maximum peaks at one hour post-glucose load. CONCLUSION: Oral glucose load does not induce endothelial dysfunction in healthy individuals with mean insulin and glucose values of 5.6 mmol/L and 27.2 mmol/L, respectively, 2 hours after glucose load.

Published
2008

37. Normal insulin-stimulated endothelial function and impaired insulin-stimulated muscle glucose uptake in young adults with low birth weight

Author

Hermann, T S, Rask-Madsen, C, Ihlemann, N, Domínguez, H, Jensen, C B, Storgaard, H, Vaag, A A, Kober, L, Torp-Pedersen, C, Hermann, T S, Rask-Madsen, C, Ihlemann, N, Domínguez, H, Jensen, C B, Storgaard, H, Vaag, A A, Kober, L, and Torp-Pedersen, C

Abstract

Udgivelsesdato: 2003-Mar, Low birth weight has been linked to insulin resistance and cardiovascular disease. We hypothesized that insulin sensitivity of both muscle and vascular tissues were impaired in young men with low birth weight. Blood flow was measured by venous occlusion plethysmography during dose-response studies of acetylcholine and sodium nitroprusside in the forearm of fourteen 21-yr-old men with low birth weight and 16 controls of normal birth weight. Glucose uptake was measured during intraarterial insulin infusion. Dose-response studies were repeated during insulin infusion. The maximal blood flow during acetylcholine infusion was 14.1 +/- 2.7 and 14.4 +/- 2.1 [ml x (100 ml forearm)(-1) x min(-1)] in low and normal birth weight subjects, respectively. Insulin coinfusion increased acetylcholine-stimulated flow in both groups: 18.0 +/- 3.1 vs. 17.9 +/- 3.1 [ml x (100 ml forearm)(-1) x min(-1)], NS. Insulin infusion increased glucose uptake significantly in the normal birth weight group, compared with the low birth weight group: 0.40 +/- 0.09 to 1.00 +/- 0.16 vs. 0.44 +/- 0.09 to 0.59 +/- 0.1 [ micro mol glucose x (100 ml forearm)(-1) x min(-1)], P = 0.04. Young men with low birth weight have normal insulin-stimulated endothelial function and impaired insulin-stimulated forearm glucose uptake. Thus, endothelial dysfunction does not necessarily coexist with metabolic alterations in subjects with low birth weight.

Published
2003

38. Effects of Acute and Chronic Attenuation of Postprandial Hyperglycemia on Postglucose-load Endothelial Function in Insulin Resistant Individuals: Is Stimulation of First Phase Insulin Secretion Beneficial for the Endothelial Function?

Author

Major-Pedersen, A., primary, Ihlemann, N., additional, Hermann, T., additional, Christiansen, B., additional, Kveiborg, B., additional, Dominguez, H., additional, Nielsen, D., additional, Rask-Madsen, C., additional, Svendsen, O., additional, Køber, L., additional, and Torp-Pedersen, C., additional

Published
2008
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42. Effects of Oral Glucose Load on Endothelial Function and on Insulin and Glucose Fluctuations in Healthy Individuals.

Author

Major-Pedersen, A., Ihlemann, N., Hermann, T. S., Christiansen, B., Dominguez, H., Kveiborg, B., Nielsen, D. B., Svendsen, O. L., Kø, L., and Torp-Pedersen, C.

Subjects
*DIABETES, *HYPERGLYCEMIA, *CARDIOVASCULAR diseases, *BLOOD sugar, *INSULIN resistance
Abstract

Background/aims. Postprandial hyperglycemia, an independent risk factor for cardiovascular disease, is accompanied by endothelial dysfunction. We studied the effect of oral glucose load on insulin and glucose fluctuations, and on postprandial endothelial function in healthy individuals in order to better understand and cope with the postprandial state in insulin resistant individuals. Methods. We assessed post-oral glucose load endothelial function (flow mediated dilation), plasma insulin, and blood glucose in 9 healthy subjects. Results. The largest increases in delta FMD values (fasting FMD value subtracted from postprandial FMD value) occurred at 3 hours after both glucose or placebo load, respectively: 4.80±1.41 (P = .009) and 2.34±1.47 (P = .15). Glucose and insulin concentrations achieved maximum peaks at one hour post-glucose load. Conclusion. Oral glucose load does not induce endothelial dysfunction in healthy individuals with mean insulin and glucose values of 5.6 mmol/L and 27.2 mmol/L, respectively, 2 hours after glucose load. [ABSTRACT FROM AUTHOR]

Published
2009
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44. Insulin therapy improves insulin-stimulated endothelial function in patients with type 2 diabetes and ischemic heart disease.

Author

Rask-Madsen, Christian, Ihlemann, Nikolaj, Krarup,, Thure, Christiansen, Erik, Kober, Lars, Torp-Pedersen, Christian, Rask-Madsen, C, Ihlemann, N, Krarup, T, Christiansen, E, Kober, L, Nervil Kistorp, C, and Torp-Pedersen, C

Subjects
DIABETES, CORONARY disease, INSULIN, GLUCOSE, METABOLISM, BLOOD sugar analysis, CORONARY heart disease complications, INSULIN therapy, TYPE 2 diabetes complications, ACETYLCHOLINE, COMPARATIVE studies, DOSE-effect relationship in pharmacology, ENDOTHELIUM, RESEARCH methodology, MEDICAL cooperation, TYPE 2 diabetes, REFERENCE values, RESEARCH, SODIUM nitroferricyanide, VASODILATORS, EVALUATION research, PHARMACODYNAMICS
Abstract

Blunted insulin-stimulated endothelial function may be a mechanism for the development of atherothrombotic disease in type 2 diabetes, but it is unknown whether hypoglycemic drug therapy can modulate this abnormality. We studied patients with type 2 diabetes and stable ischemic heart disease (n = 28) and lean, healthy control subjects (n = 31). Forearm blood flow was measured by venous occlusion plethysmography during dose-response studies of acetylcholine (ACh) and sodium nitroprusside (SNP) infused into the brachial artery. In the patients and 10 healthy control subjects, ACh was repeated after intrabrachial infusion of insulin. Patients were restudied after 2 months of insulin therapy with four daily subcutaneous injections (treatment group, n = 19) or without hypoglycemic drug therapy (time control group, n = 9). Insulin infusion raised venous serum insulin in the forearm to high physiological levels (133 +/- 14.6 mU/l in patients) with a minor increase in systemic venous serum insulin. This increased the ACh response by 149 +/- 47, 110 +/- 33, 100 +/- 45, and 106 +/- 44% during the four ACh doses in healthy control subjects (P < 0.0001) but had no effect in patients (P = 0.3). After 2 months, HbA(1c) in the treatment group had decreased from 10.0 +/- 0.4 to 7.5 +/- 0.2%. Although neither the ACh response (P = 0.09) nor the SNP response (P = 0.4) had changed significantly, insulin stimulation had a significant effect, as the ACh response increased by 58 +/- 25, 84 +/- 66, 120 +/- 93, and 69 +/- 36% (P = 0.0002). In the time control group, insulin stimulation remained without effect after 8 weeks (P = 0.7). In conclusion, insulin therapy partly restores insulin-stimulated endothelial function in patients with type 2 diabetes and ischemic heart disease. [ABSTRACT FROM AUTHOR]

Published
2001
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46. Promising results after percutaneous mitral valve repair

Author

Ihlemann, N., Franzen, O., Jørgensen, E., Hansen, P. B., Hassager, C., Jacob Eifer Møller, and Søndergaard, L.

Subjects
Aged, 80 and over, Male, Myocardial Ischemia, Mitral Valve Insufficiency, Ultrasonography, Doppler, Middle Aged, Prognosis, Treatment Outcome, Exercise Test, Humans, Female, Angioplasty, Balloon, Coronary, Cardiomyopathies, Aged
Abstract

Mitral valve regurgitation (MR) is the secondmost frequent valve disease in Europe. Untreated MR causes considerable morbidity and mortality. In the elderly, as many as half of these patients are denied surgery because of an estimated high surgical risk. Percutaneous mitral valve repair with the MitraClip system resembles the Alfieristitch where a clip is used to connect the tip of the mitral valve leaflets.Sixteen patients with MR of various origins (functional/degenerative) were treated with the MitraClip system. All patients were highly symptomatic with dyspnoea (New York Heart Association (NYHA) grade three) and MR grade three or more, and had been turned down for surgery due to an excessively high risk.MR was reduced in all but one patient, generally from grade 3.5±0.5 to grade 1.4±0.9. A total of four patients (25%) received two clips. Thirty-day complications were as follows: one patient died, one had a stroke (speech sequelae), one patient had a new chord rupture that was treated surgically. During 90 days of follow-up, symptoms of dyspnoea diminished (reduction of 1 NYHA grade) and the 6-minute walk test results improved from 171±99 to 339±134 metres (p0.001).Percutaneous mitral valve repair with the MitraClip system is now available in Denmark. The treatment is a reasonable alternative in patients with MR and a high estimated surgery risk.Not relevant.Not relevant.

47. The Nordic Aortic Valve Intervention (NOTION) trial comparing transcatheter versus surgical valve implantation: study protocol for a randomised controlled trial

Author

Thyregod Hans Gustav, Søndergaard Lars, Ihlemann Nikolaj, Franzen Olaf, Andersen Lars Willy, Hansen Peter Bo, Olsen Peter Skov, Nissen Henrik, Winkel Per, Gluud Christian, and Steinbrüchel Daniel Andreas

Subjects
Aortic valve stenosis, Aortic valve prosthesis, Transcatheter aortic valve implantation, Surgical aortic valve replacement, Randomised clinical trial design, Medicine (General), R5-920
Abstract

Abstract Background Degenerative aortic valve (AV) stenosis is the most prevalent heart valve disease in the western world. Surgical aortic valve replacement (SAVR) has until recently been the standard of treatment for patients with severe AV stenosis. Whether transcatheter aortic valve implantation (TAVI) can be offered with improved safety and similar effectiveness in a population including low-risk patients has yet to be examined in a randomised setting. Methods/Design This randomised clinical trial will evaluate the benefits and risks of TAVI using the transarterial CoreValve System (Medtronic Inc., Minneapolis, MN, USA) (intervention group) compared with SAVR (control group) in patients with severe degenerative AV stenosis. Randomisation ratio is 1:1, enrolling a total of 280 patients aged 70 years or older without significant coronary artery disease and with a low, moderate, or high surgical risk profile. Trial outcomes include a primary composite outcome of myocardial infarction, stroke, or all-cause mortality within the first year after intervention (expected rates 5% for TAVI, 15% for SAVR). Exploratory safety outcomes include procedure complications, valve re-intervention, and cardiovascular death, as well as cardiac, cerebral, pulmonary, renal, and vascular complications. Exploratory efficacy outcomes include New York Heart Association functional status, quality of life, and valve prosthesis and cardiac performance. Enrolment began in December 2009, and 269 patients have been enrolled up to December 2012. Discussion The trial is designed to evaluate the performance of TAVI in comparison with SAVR. The trial results may influence the choice of treatment modality for patients with severe degenerative AV stenosis. Trial registration ClinicalTrials.gov: NCT01057173

Published
2013
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49. Oral Abstract session: Pericardial diseases, masses and sources of embolism: Thursday 4 December 2014, 11:00-12:30 * Location: Agora

Author

Ihlemann, N, Landex, N, Soeholm, H, Hassager, C, Gustafsson, F, Matshela, M R, Butz, T, Faber, L, Brand, M, Wiemer, M, Piper, C, Noelke, J, Sasko, B, Horstkotte, D, Trappe, HJ, Cruz, I, Dymarkowski, S, Bogaert, J, Kudaiberdiev, T, Strachinaru, M, Catez, E, Jousten, I, Pavel, O, Janssen, C, Morissens, M, Gazagnes, M-D, Kim, MN, Kim, SA, Kim, YH, Shim, JM, Park, SM, Park, SW, Kim, YH, Shim, WJ, Rodriguez Diego, S, Delgado, M, Ruiz, M, Pardo, L, Hidalgo, F J, Romo, E, Ortega, R, Mesa, D, and Suarez De Lezo Cruz Conde, J

Abstract

Background: Constrictive pericarditis (CP) is challenging in diagnosis and treatment. Echocardiographic characteristics of consctrictio has been studied, however little is known about the reversibility of the characteristics during short and long term follow-up after surgical pericardiectomy. Method and Results: A retrospective review found 46 patients (56.5 ± 14.9 yrs) with the diagnosis of CP confirmed by echocardiography and right-sided heart catherization. Echocardiographic exams were available at time of diagnosis and in 22 patients at short and long term follow-up. Most prevalent etiology was rheumatic/inflammatory disease. At time of diagnosis the most significant features were: dilated inferior vena cava (IVC) in 100% (mean 25 ± 4mm), diastolic retrograde liver vein flow (rLVF) in 90%, abnormal presenting pericardium in 98%, septal bounce (SB) in 98%, high for age diastolic septal tissue doppler velocity (septal e') of 13.2 ± 3.9cm/s with a ratio of septal to medial e' of 1.01 ± 0.33. Mitral inflow deceleration time MvDT was general low with a mean of 135 ± 31 msec (range 90-230), but in 29% of patients the MvDT was normal (>140msec) and abnormal respiratory mitral inflow variation (resp. Mvvar) (>25%) was only present in 53%. Early after pericardiectomy (mean 8.8 ± 8 days) the only echocardiographic parameters that was significantly changed was: increased MvDT (22.1 ± 30.7msec, p=0.003), decreased septal e' (3.9 ± 2.8 cm/sec, p=0.006), reduced proportion of patients with abnormal resp. Mvvar (53% vs. 6%,p=0.003). All other of the above mentioned characteristics of CP remained unchanged. At late follow-up (mean 32 ± 27 months) many of the echocardiographic CP characteristics was changed towards normal: decreased IVC diameter (-4.3 ± 4.9mm, p=0.016) but still dilated in 82%, increased MvDT (35.9 ± 47.3 ms, p=0.007), decreased septal e' (-7.0 ± 3.6cm/s, p=0.0004) and decreased lateral e' (-4.5 ± 4.1, p=0.004) with a concomitant normalization of the ratio of septal to lateral e' to 1.44 ± 0.21. The proportion of patients with abnormal resp. Mvvar was reduced to zero and the presence of SB was significantly reduced from 98% to 70% (p=0.009), the rLVF was unchanged present in 44% (NS) as well as the presence of abnormal pericardium in 95%(NS). Conclusions. Specific echocardiographic parameters can be pointed out as characteristic at the time of CP diagnosis like: dilated IVC, SB, rLVF, high septal e' with an abnormal ratio of septal to lateral e'. Many parameters return towards normal at late follow-up but SB and dilated IVC, rLVF as well as an abnormal presenting pericardium remains abnormal in a high proportion of patients.

Published
2014
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50. Case-based session: unusual and multitrouble cases: Saturday 6 December 2014, 08:30-10:0 * Location: Agora

Author

Eissmann, M, Kahlert, P, Erbel, R, Janosi, RA, Soeholm, H, Hassager, C, Vejlstrup, N, Arendrup, H, Jensen, M, Lund, J, Ihlemann, N, Neykova, A, Molcard, D, Moulla, M, Valizadeh, R, Alghandour, M, Mahmoud, M, Shimbo, M, Watanabe, H, Iino, K, Ito, H, Piriou, N, Sassier, J, Pallardy, A, Valette, F, Serfaty, JM, Trochu, JN, Cordovil, A, Tude Rodrigues, AC, Piveta, R, De Oliveira, W, Ponchirolli, AP, Monaco, C, De Lira Filho, E, Vieira, M, Fischer, CH, and Morhy, S

Abstract

An 83-year-old morbid woman presented with progredient dyspnoea (New York Heart Association [NYHA] stage IV) and a history of recurrent pulmonary oedema. Owing to type A aortic disection, she underwent aortic surgery 3 years prior (January 2009), which included supracoronary ascending aortic replacement and a proximal aorta-to-prosthesis anastomosis. Transthoracic echocardiography revealed major pulmonary hypertension with an estimated systolic pulmonary pressure of 70-75 mm Hg and severe tricuspid regurgitation. Further investigation, including computed tomography and 3-D transoesophageal echocardiography, revealed rupture of the aortic prothesis with a fistula of the paraprosthetic lumen to the right pulmonary artery. Because of multiple concomitant diseases and severe right-sided heart failure, an interventional approach was initiated. With a complex 3-D-echo-guided intervention, the fistula was successfully closed using a 12-mm Amplatzer ASD Occluder which resulted in a reduction in shunt volume. Postinterventional imaging showed the correct position of the occluder with only a minor residual flow. At 18 months' follow-up, the patient presented with improvement of the preexisting dyspnoea, from NYHA stage IV to NYHA stage II or III. The cardiac ultrasound result indicated a reduction in estimated systolic pulmonary pressure to 45-50 mm Hg. Figure

Published
2014
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