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1. Contemporary Management of Severe Symptomatic Aortic Stenosis

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Iung, Bernard, Bax, Jeroen, De Bonis, Michele, Delgado, Victoria, Haude, Michael, Hindricks, Gerhard, Maggioni, Aldo P., Pierard, Luc, Popescu, Bogdan A., Prendergast, Bernard, Price, Susanna, Rosenhek, Raphael, Ruschitzka, Frank, Vahanian, Alec, Wendler, Olaf, Windecker, Stephan, Mekhaldi, Souad, Lemaitre, Katell, Authier, Sébastien, Laroche, Cécile, Abdelhamid, Magdy, Apor, Astrid, Bajraktari, Gani, Beleslin, Branko, Bogachev-Prokophiev, Alexander, Demarco, Daniela Cassar, Pasquet, Agnes, Dogan, Sait Mesut, Erglis, Andrejs, Evangelista, Arturo, Goda, Artan, Ihlemann, Nikolaj, Ince, Huseyin, Katsaros, Andreas, Linhartova, Katerina, Mascherbauer, Julia, Mirrakhimov, Erkin, Mizariene, Vaida, Rahman-Haley, Shelley, Ribeiras, Regina, Samadov, Fuad, Saraste, Antti, Simkova, Iveta, Kostovska, Elizabeta Srbinovska, Tomkiewicz-Pajak, Lidia, Tribouilloy, Christophe, Zera, Eliverta, Metalla, Mimoza, Shirka, Ervina, Dado, Elona, Bica, Loreta, Aleksi, Jorida, Knuti, Gerti, Gjyli, Lidra, Pjeci, Rudina, Shuperka, Eritinka, Lleshi, Erviola, Rustemaj, Joana, Qordja, Marsjon, Gina, Mirald, Husi, Senada, Basic, Daniel, Steringer-Mascherbauer, Regina, Huber, Charlotte, Ebner, Christian, Sigmund, Elisabeth, Ploechl, Andrea, Sturmberger, Thomas, Eder, Veronica, Koppler, Tanja, Heger, Maria, Kammerlander, Andreas, Duca, Franz, Binder, Christina, Koschutnik, Matthias, Perschy, Leonard, Puskas, Lisa, Ho, Chen-Yu, Aliyev, Farid, Guluzada, Vugar, Imanov, Galib, Ibrahimov, Firdovsi, Abbasaliyev, Abbasali, Ahmedov, Tahir, Muslumova, Fargana, Babayev, Jamil, Rustamova, Yasmin, Jahangirov, Tofig, Samadov, Rauf, Museyibov, Muxtar, Isayev, Elnur, Musayev, Oktay, Xalilov, Shahin, Huseynov, Saleh, Yuzbashova, Madina, Zamanov, Vuqar, Mammadov, Vusal, Van Camp, Gery, Penicka, Martin, Batjoens, Hedwig, Debonnaire, Philippe, Dendooven, Daniel, Knecht, Sebastien, Duytschaever, Mattias, Vandekerckhove, Yves, Missault, Luc, Muyldermans, Luc, Tavernier, René, De Grande, Tineke, Coussement, Patrick, DeTroyer, Joyce, Derycker, Katrien, De Jaegher, Kelly, Bondue, Antoine, Beauloye, Christophe, Goffinet, Céline, Mirica, Daniela Corina, Eynden, Frédéric Vanden, Van de Borne, Philippe, Van Frachen, Béatrice, Vancraeynest, David, Vanoverschelde, Jean Louis, Pierard, Sophie, Malanca, Mihaela, Sinnaeve, Florence, Tahon, Séverine, De Clippel, Marie, Gayet, Frederic, Loiseau, Jacques, Van de Veire, Nico, Moerman, Veronique, Willems, Anne-Marie, Cosyns, Bernard, Droogmans, Steven, Motoc, Andreea, Kerkhove, Dirk, Plein, Daniele, Roosens, Bram, Weytjens, Caroline, Lancellotti, Patrizio, Dulgheru, Elena Raluca, Parenicova, Ilona, Bedanova, Helena, Tousek, Frantisek, Sindelarova, Stepanka, Canadyova, Julia, Taborsky, Milos, Ostransky, Jiri, Ivona simkova, Vicha, Marek, Jelinek, Libor, Opavska, Irena, Homza, Miroslav, Kvrayola, Miriam, Brat, Radim, Mrozek, Dan, Lichnerova, Eva, Docekalova, Iveta, Zarybnicka, Marta, Peskova, Marketa, Roucka, Patrik, Stastna, Vlasta, Vondrackova, Dagmar Jungwirtova, Hornig, Alfred, Niznansky, Matus, Branny, Marian, Vodzinska, Alexandra, Dorda, Miloslav, Snkouril, Libor, Kluz, Krystyna, Kypusova, Jana, Nezvalova, Radka, Olsen, Niels Thue, Ali, Hosam Hasan, Taha, Salma, Hassan, Mohamed, Afifi, Ahmed, Kabil, Hamza, Mady, Amr, Ebaid, Hany, Ahmed, Yasser, Nour, Mohammad, Talaat, Islam, Sayed, CairoMaiy El, Mostafa, Ahmad Elsayed, Sadek, CairoYasser, Eltobgi, CairoSherif, Bakhoum, Sameh, Doss, Ramy, Sheashea, Mahmoud, Elasry, Abd Allah, Fouad, Ahmed, Baraka, Mahmoud, Samir, Sameh, Roshdy, Alaa, AbdelRazek, Yasmin, Abd Rabou, Mostafa M., Abobakr, Ahmed, Moaaz, Moemen, Mokhtar, Mohamed, Ashry, Mohamed, Elkhashab, Khaled, Ghareeb, Haytham Soliman, Kamal, Mostafa, AbdelRazek, Gomaa, Farag, GizaNabil, Elbarbary, Giza:Ahmed, Wahib, Evette, Kazamel, Ghada, Kamal, Diaa, Tantawy, Mahmoud, Alansary, Adel, Yahia, Mohammed, Mahmoud, Raouf, El Banna, Tamer, Atef, Mohamed, Nasr, Gamela, Ahmed, Salah, El Hefny, Ehab E., Saifelyazal, Islam, El Ghany, Mostafa Abd, El Rahman El Hadary, Abd, Khairy, Ahmed, Lommi, Jyri, Laine, Mika, Kylmala, Minna, Kankanen, Katja, Turpeinen, Anu, Hartikainen, Juha, Kujanen, Lari, Airaksinen, Juhani, Vasankari, Tuija, Szymanski, Catherine, Bohbot, Yohann, Gun, Mesut, Rousseaux, Justine, Biere, Loic, Mateus, Victor, Audonnet, Martin, Rautureau, Jérémy, Cornet, Charles, Sorbets, Emmanuel, Mear, BourgesKarine, Issa, Adi, Jobic, Yannick, Le Ven, Florent, Pouliquen, Marie-Claire, Gilard, Martine, Ohanessian, Alice, Farhat, Ali, Vlase, Alina, Said, Fkhar, Lasgi, Caroline, Sanchez, Carlos, Breil, Romain, Peignon, Marc, Elkaim, Jean-Philippe, Jan-Blin, Virginie, BertrandM'Ban, Sylvain Ropars, Bardet, Hélène, Sawadogo, Samuel, Muschoot, Aurélie, Tchatchoua, Dieudonné, Elhadad, Simon, Maubert, Aline, Lazizi, Tahar, Ourghi, Kais, Bonnet, Philippe, Menager-Gangloff, Clarisse, Gafsi, Sofiene, Mansouri, Djidjiga, Aboyans, Victor, Magne, Julien, Martins, Elie, Karm, Sarah, Mohty, Dania, Briday, Guillaume, David, Amandine, Marechaux, Sylvestre, Le Goffic, Caroline, Binda, Camille, Menet, Aymeric, Delelis, Francois, Ringlé, Anne, Castel, Anne-Laure, Appert, Ludovic, Tristram, Domitille, Trouillet, Camille, Nacer, Yasmine, Ngoy, Lucas, Habib, MarseilleGilbert, Thuny, Franck, Haentjens, Julie, Cautela, Jennifer, Lavoute, Cécile, Robin, Floriane, Armangau, Pauline, Vergeylen, Ugo, Sanhadji, Khalil, Abdallah, Nessim Hamed, Kerzazi, Hassan, Perianu, Mariana, Plurien, François, Oueslati, Chaker, Debauchez, Mathieu, Monin, Jean-Luc, Konstantinos, Zannis, Berrebi, Alain, Dibie, Alain, Lansac, Emmanuel, Veugeois, Aurélie, Diakov, Christelle, Caussin, Christophe, Czitrom, Daniel, Salvi, Suzanna, Amabile, Nicolas, Dervanian, Patrice, Lejeune, Stéphanie, Bagdadi, Imane, Mokrane, Yemmi, Rouault, Gilles, Abalea, Jerome, Leledy, Marion, Horen, Patrice, Donal, Erwan, Bosseau, Christian, Paven, Elise, Galli, Elena, Collette, Edouard, Urien, Jean-Marie, Bridonneau, Valentin, Gervais, Renaud, Bauer, Fabrice, Chopra, Houzefa, Charbonnier, Arthur, Attias, David, Dahouathi, Nesrine, Khounlaboud, Moukda, Daudin, Magalie, Thebault, Christophe, Hamon, Cécile, Couffon, Philippe, Bellot, Catherine, Vomscheid, Maelle, Bernard, Anne, Dion, Fanny, Naudin, Djedjiga, Mouzouri, Mohammed, Rudelin, Mathilde, Berenfeld, Alain, Vanzwaelmen, Thibault, Alloui, Tarik, Radovikj, Marija Gjerakaroska, Jordanova, Slavica, Scholtz, Werner, Liberda-Knoke, Eva, Wiemer, Melanie, Mugge, Andreas, Nickenig, Georg, Sinning, Jan-Malte, Sedaghat, Alexander, Heintzen, Matthias, Ballof, Jan, Frenk, Daniel, Hambrecht, Rainer, Wienbergen, Harm, Seidel, Annemarie, Osteresch, Rico, Kramer, Kirsten, Ziemann, Janna, Schulze, Ramona, Fehske, Wolfgang, Eifler, Clarissa, Wafaisade, Bahram, Kuhn, Andreas, Fischer, Sören, Lichtenberg, Lutz, Brunold, Mareike, Simons, Judith, Balling, Doris, Buck, Thomas, Plicht, Bjoern, Schols, Wolfgang, Ebelt, Henning, Chamieh, Marwan, Anacker, Jelena, Rassaf, Tienush, Janosi, Alexander, Lind, Alexander, Lortz, Julia, Lüdike, Peter, Kahlert, Philipp, Rittger, Harald, Eichinger, Gabriele, Kuhls, Britta, Felix, Stephan B., Lehnert, Kristin, Pedersen, Ann-Louise, Dorr, Marcus, Empen, Klaus, Kaczmarek, Sabine, Busch, Mathias, Baly, Mohammed, Er, Fikret, Duman, Erkan, Gabriel, Linda, Weinbrenner, Christof, Bauersachs, Johann, Wider, Julian, Kempf, Tibor, Bohm, Michael, Schulze, Paul-Christian, Poerner, C. Tudor, Möbius-Winkler, Sven, Lenk, Karsten, Heitkamp, Kerstin, Franz, Marcus, Krauspe, Sabine, Schumacher, Burghard, Windmuller, Volker, Kurwitz, Sarah, Thiele, Holger, Kurz, Thomas, Meyer-Saraei, Roza, Akin, Ibrahim, Fastner, Christian, Lossnitzer, Dirk, Hoffmann, Ursula, Borggrefe, Martin, Baumann, Stefan, Kircher, Brigitte, Foellinger, Claudia, Dietz, Heike, Schieffer, Bernhard, Niroomand, Feraydoon, Mudra, Harald, Maier, Lars, Camboni, Daniele, Birner, Christoph, Debl, Kurt, Paulus, Michael, Seither, Benedikt, El Mokhtari, Nour Eddine, Oner, Alper, Caglayan, Evren, Sherif, Mohammed, Yucel, Seyrani, Custodis, Florian, Schwinger, Robert, Vorpahl, Marc, Seyfarth, Melchior, Nover, Ina, Koehler, Till, Christiani, Sarah, Sanchez, David Calvo, Schanze, Barbel, Sigusch, Holger, Salman, Athir, Hancock, Jane, Chambers, John, Demetrescue, Camelia, Prendergast, Claire, Dalby, Miles, Smith, Robert, Rogers, Paula, Riley, Cheryl, Tousoulis, Dimitris, Kanakakis, Ioannis, Spargias, Konstantinos, Lampropoulos, Konstantinos, Panagiotis, Tolis, Koutsoukis, Athanasios, Michalis, Lampros, Goudevenos, Ioannis, Bellos, Vasileios, Papafaklis, Michail, Lakkas, Lampros, Hahalis, George, Makris, Athanasios, Karvounis, Haralampos, Kamperidis, Vasileios, Ninios, Vlasis, Sachpekidis, Vasileios, Rouskas, Pavlos, Poulimenos, Leonidas, Charalampidis, Georgios, Hamodraka, Eftihia, Manolis, Athanasios, Kiss, Robert Gabor, Borsanyi, Tunde, Jarai, Zoltan, Zsary, Andras, Bartha, Elektra, Kosztin, Annamaria, Doronina, Alexandra, Kovacs, Attila, Imre, Barabas Janos, Chao, Chun, Benke, Kalman, Karoczkai, Istvan, Keltai, Kati, Förchécz, Zsolt, Pozsonyi, Zoltán, Jenei, Zsigmond, Patthy, Adam, Sallai, Laszlo, Majoros, Zsuzsanna, Pál, Tamás, Bencze, Jusztina, Sagi, Ildiko, Molnar, Andrea, Kurczina, Anita, Kolodzey, Gabor, Edes, Istvan, Szatmari, Valeria, Zajacz, Zsuzsanna, Cziraki, Attila, Nemeth, Adam, Faludi, Reka, Vegh, Laszlone, Jebelovszki, Eva, Lupkovics, Geza Karoly, Kovacs, Zsofia, Horvath, Andras, Berisha, Gezim, Ibrahimi, Pranvera, Percuku, Luan, Arapova, Rano, Laahunova, Elmira, Neronova, Kseniia, Zhakypova, Zarema, Naizabekova, Gulira, Muratova, Gulnazik, Sime, Iveta, Sorokins, Nikolajs, Kamzola, Ginta, Cgojeva-Sproge, Irina, Rancane, Gita, Valentinaviciene, Ramune, Rudiene, Laima, Raugaliene, Rasa, Bardzilauske, Aiste, Jonkaitiene, Regina, Petrauskaite, Jurate, Bieseviciene, Monika, Verseckaite, Raimonda, Zvirblyte, Ruta, Kalibatiene, Danute, Radauskaite, Greta, Janaviciute-Matuzeviciene, Gabija, Jancauskaite, Dovile, Balkute, Deimile, Maneikyte, Juste, Mileryte, Ingrida, Vaisvilaite, Monika, Gedvilaite, Lina, Biliukas, Mykolas, Karpaviciene, Vaiva, Xuereb, Robert George, Pllaha, Elton, Djaberi, Roxana, Komor, Klaudiusz, Gorgon-Komor, Agnieszka, Loranc, Beata, Myszor, Jaroslaw, Mizia-Stec, Katarzyna, Berger-Kucza, Adrianna, Mizia, Magdalena, Polak, Mateusz, Bogacki, Piotr, Podolec, Piotr, Komar, Monika, Sedziwy, Ewa, Sliwiak, Dorota, Sobien, Bartosz, Rog, Beata, Hlawaty, Marta, Gancarczyk, Urszula, Libiszewska, Natasza, Sorysz, Danuta, Gackowski, Andrzej, Cieply, Malgorzata, Misiuda, Agnieszka, Racibor, Franciszek, Nytko, Anna, Widenka, Kazimierz, Kolowca, Maciej, Bak, Janusz, Curzytek, Andrzej, Regulski, Mateusz, Kamela, Malgorzata, Wisniowski, Mateusz, Hryniewiecki, Tomasz, Szymanski, Piotr, Rozewicz, Monika, Grabowski, Maciej, Duchnowski, Piotr, Budaj, Andrzej, Zaborska, Beata, Pilichowska-Paskiet, Ewa, Sikora-Frac, Malgorzata, Slomski, Tomasz, Joao, Isabel, Cruz, Ines, Pereira, Hélder, Cale, Rita, Marques, Ana, Pereira, Ana Rita, Morais, Carlos, Freitas, Antonio, Roque, David, Antunes, Nuno, Pereira, Antonio Costeira, Vieira, Catarina, Salome, Nuno, Martins, Juliana, Campos, Isabel, Cardoso, Goncalo, Silva, Claudia, Oliveira, Afonso, Goncalves, Mariana, Martins, Rui, Quintal, Nuno, Mendes, Bruno, Silva, Joseline, Ferreira, Joao, Milner, James, Alves, Patricia, Marinho, Vera, Gago, Paula, Amado, Jose, Bispo, Joao, Bento, Dina, Machado, Inocencia, Oliveira, Margarida, Calvo, Lucy, von Hate, Pedro, Faria, Bebiana, Galrinho, Ana, Branco, Luisa, Goncalves, Antonio, Mendonca, Tiago, Selas, Mafalda, Macedo, Filipe, Sousa, Carla, Cabral, Sofia, Oliveira, Filomena, Trepa, Maria, Fontes-Oliveira, Marta, Nunes, Alzira, Araújo, Paulo, Ribeiro, Vasco Gama, Almeida, Joao, Rodrigues, Alberto, Braga, Pedro, Dias, Sonia, Carvalho, Sofia, Ferreira, Catarina, Ferreira, Alberto, Mateus, Pedro, Moz, Miguel, Leao, Silvia, Margato, Renato, Moreira, Ilidio, Guimanaes, Jose, Ribeiro, Joana, Goncalves, Fernando, Cabral, Jose, Almeida, Ines, Goncalves, Luisa, Tarusi, Mariana, Pop, Calin, Matei, Claudia, Tint, Diana, Barbulescu, Sanziana, Micu, Sorin, Pop, Ioana, Baba, Costica, Dimulescu, Doina, Dorobantu, Maria, Ginghina, Carmen, Onut, Roxana, Popescu, Andreea, Zamfirescu, Brandusa, Aflorii, Raluca, Popescu, Mihaela, Ghilencea, Liviu, Rachieru, Andreeea, Stoian, Monica, Oprescu, Nicoleta, Iancovici, Silvia, Petre, Iona, Mateescu, Anca Doina, Calin, Andreea, Botezatu, Simona, Enache, Roxana, Rosca, Monica, Ciuperca, Daniela, Babalac, Evelyn, Beyer, Ruxandra, Cadis, Laura, Rancea, Raluca, Tomoaia, Raluca, Rosianu, Adela, Kovacs, Emese, Militaru, Constantin, Craciun, Alina, Mirea, Oana, Florescu, Mihaela, Grigorica, Lucica, Dragusin, Daniela, Nechita, Luiza, Marinescu, Mihai, Chiscaneanu, Teodor, Botezatu, Lucia, Corciova, Costela, Petris, Antoniu Octavian, Arsenescu-Georgescu, Catalina, Salaru, Delia, Alexandrescu, Dan Mihai, Plesoianu, Carmjen, Tanasa, Ana, Mitu, Ovidiu, Costache, Irina Iuliana, Tudorancea, Ionut, Usurelu, Catalin, Eminovici, Gabriela, Manitiu, Ioan, Stoia, Oana, Mitre, Adriana, Nistor, Dan-Octavian, Maier, Anca, Lupu, Silvia, Opris, Mihaela, Ionac, Adina, Popescu, Irina, Crisan, Simina, Mornos, Cristian, Goanta, Flavia, Gruescu, Liana, Voinescu, Oana, Petcu, Madalina, Cozlac, Ramona, Damrina, Elena, Khilova, Liliya, Ryazantseva, Irina, Kozmin, Dmitry, Kiseleva, Maria, Goncharova, Marina, Kitalaeva, Kamila, Demetskay, Victoria, Verevetinov, Artem, Fomenko, Mikhail, Skripkina, Elena, Tsoi, Viktor, Antipov, Georgii, Schneider, Yuri, Yazikov, Denis, Makarova, Marina, Cherkes, Aleksei, Ermakova, Natalya, Medvedev, Aleksandr, Sarosek, Anastasia, Isayan, Mikhail, Voronova, Tatyana, Kulumbegov, Oleg, Tuchina, Alina, Stefanov, Sergei, Klimova, Margarita, Smolyaninov, Konstantin, Dandarova, Zhargalma, Magamet, Victoriya, Spiropulos, Natalia, Boldyrev, Sergey, Barbukhatty, Kirill, Buyankov, Dmitrii, Yurin, Vladimir, Gross, Yuriy, Boronin, Maksim, Mikhaleva, Mariya, Shablovskaya, Mariya, Zotov, Alex, Borisov, Daniil, Tereshchenko, Vasily, Zubova, Ekaterina, Kuzmin, A., Tarasenko, Ivan, Gamzaev, Alishir, Borovkova, Natalya, Koroleva, Tatyana, Botova, Svetlana, Pochinka, Ilya, Dunaeva, Vera, Teplitskaya, Victoria, Semenova, Elena I., Korabel'Nikova, Olga V., Simonov, Denis S., Denisenko, Elena, Harina, Natalia, Yarohno, Natalia, Alekseeva, Svetlana, Abydenkova, Julia, Shabalkina, Lyubov, Mayorova, Olga, Tsechanovich, Valeriy, Medvedev, Igor, Lepilin, Michail, Nemchenko, PenzaEvgenii, Karnahin, Vadim, Safina, Vasilya, Slastin, Yaroslav, Gilfanova, Venera, Gorbunov, Roman, Jakubov, Ramis, Fazylova, Aigul, Poteev, Mansur, Vazetdinova, Laysan, Tarasova, Indira, Irgaliyev, Rishat, Moiseeva, Olga, Gordeev, Mikhail, Irtyuga, Olga, Moiseeva, Raisa, Ostanina, Nina, Zverev, Dmitry, Murtazalieva, Patimat, Kuznetsov, Dmitry, Skurativa, Mariya, Polyaeva, Larisa, Mihaiilov, Kirill, Obrenovic-Kircanski, Biljana, Putnik, Svetozar, Simic, Dragan, Petrovic, Milan, Nikolic, Natasa Markovic, Jovovic, Ljiljana, Ostric, Dimitra Kalimanovska, Brajovic, Milan, Manojlovic, Milica Dekleva, Novakovic, Vladimir, Zamaklar-Trifunovic, Danijela, Orbovic, Bojana, Petrovic, Olga, Boricic-Kostic, Marija, Andjelkovic, Kristina, Milanov, Marko, Despotovic-Nikolic, Maja, Budisavljevic, Sreten, Veljkovic, Sanja, Cvetinovic, Nataša, Lepojevic, Daniijela, Todorovic, Aleksandra, Nikolic, Aleksandra, Borzanovic, Branislava, Trkulja, Ljiljana, Tomic, Slobodan, Vukovic, Milan, Milosavljevic, Jelica, Milanovic, Mirjana, Stakic, Vladan, Cvetkovic, Aleksandra, Milutinovic, Suzana, Bozic, Olivera, Miladinovic, Miodrag, Nikolic, Zoran, Despotovic, Dinka, Jovanovic, Dimitrije, Stojsic-Milosavljevic, Anastazija, Ilic, Aleksandra, Sladojevic, Mirjana, Susak, Stamenko, Maletin, Srdjan, Pavlovic, Salvo, Kuzmanovic, Vladimir, Ivanovic, Nikola, Dejanovic, Jovana, Ruzicic, Dusan, Drajic, Dragana, Cvetanovic, Danijel, Mirkovic, Marija, Omoran, Jon, Margoczy, Roman, Sedminova, Katarina, Reptova, Adriana, Baranova, Eva, Valkovicova, Tatiana, Valocik, Gabriel, Kurecko, Marian, Vachalcova, Marianna, Kollarova, Alzbeta, Studencan, Martin, Alusik, Daniel, Kozlej, Marek, Macakova, Jana, Moral, Sergio, Cladellas, Merce, Luiso, Daniele, Calvo, Alicia, Palet, Jordi, Carballo, Juli, Tura, Gisela Teixido, Maldonado, Giuliana, Gutierrez, Laura, Gonzalez-Alujas, Teresa, Jose Fernando, Rodriguez Palomares, Villalva, Nicolas, Molina-Mora, Ma Jose, Paton, Ramon Rubio, Martinez Diaz, Juan Jose, Ruiz, Pablo Ramos, Valle, Alfonso, Rodriguez, Ana, Alania, Edgardo, Galcera, Emilio, Seller, Julia, Valenzuela, Gonzalo de la Morena, Espin, Daniel Saura, Garcia, Dolores Espinosa, Oliva Sandoval, Maria Jose, Gonzalez, Josefa, Navarro, Miguel Garcia, Perez-Martinez, Maria Teresa, Ortega Trujillo, Jose Ramon, Gallego, Irene Menduina, San Roman, Daniel, Perez Nogales, Eliu David, Medina, Olga, Montiel Quintero, Rodolfo Antonio, Bujanda Morun, Pablo Felipe, Perez, Marta Lopez, Huaripata, Jimmy Plasencia, Morales Gonzalez, Juan Jose, Nelson, Veronica Quevedo, Zamorano, Jose Luis, Gomez, Ariana Gonzalez, Fraile, Alfonso, Alberca, Maria Teresa, Martin, Joaquin Alonso, Fernandez-Golfin, Covadonga, Ramos, Javier, Jimenez, Sergio Hernandez, Mitroi, Cristina, Sanchez Fernandez, Pedro L., Diaz-Pelaez, Elena, Garde, Beatriz, Caballero, Luis, Garcia, Fermin Martinez, Cambronero, Francisco, Castro, Noelia, Castro, Antonio, De La Rosa, Alejandro, Gallego, Pastora, Mendez, Irene, Villegas, David Villagomez, Correa, Manuel Gonzalez, Calvo, Roman, Florian, Francisco, Paya, Rafael, Esteban, Esther, Buendia, Francisco, Cubillos, Andrés, Fernandez, Carmen, Cárdenas, Juan Pablo, Pérez-Boscá, José Leandro, Vano, Joan, Belchi, Joaquina, Iglesia-Carreno, Cristina, Iglesias, Francisco Calvo, Escudero-Gonzalez, Aida, Zapateria-Lucea, Sergio, Duarte, Juan Sterling, Perez-Davila, Lara, Cobas-Paz, Rafael, Besada-Montenegro, Rosario, Fontao-Romeo, Maribel, Lopez-Rodriguez, Elena, Paredes-Galan, Emilio, Caneiro-Queija, Berenice, Gonzalez, Alba Guitian, Bozkurt, Abdi, Demir, Serafettin, Unlu, Durmus, Cagliyan, Caglar Emre, Ikikardes, Muslum Firat, Tangalay, Mustafa, Kuloglu, Osman, Ozer, Necla, Canpolat, Ugur, Kemaloglu, Melek Didem, Demirtas, Abdullah Orhan, Akgün, Didar Elif, Avci, Eyup, Taylan, Gokay, Yilmaztepe, Mustafa Adem, Ucar, Fatih Mehmet, Altay, Servet, Gurdogan, Muhammet, Gudul, Naile Eris, Aktas, Mujdat, Buyuklu, Mutlu, Degirmenci, Husnu, Turan, Mehmet Salih, Mert, Kadir Ugur, Mert, Gurbet Ozge, Dural, Muhammet, Arslan, Sukru, Sayar, Nurten, Kanar, Batur, Sadic, Beste Ozben, Sahin, Ahmet Anil, Buyuk, Ahmet, Kilicarslan, Onur, Bostan, Cem, Yildirim, Tarik, Yildirim, Seda Elcim, Cosansu, Kahraman, Varim, Perihan, Ilguz, Ersin, Demirbag, Recep, Yesilay, Asuman, Cirit, Abdullah, Tusun, Eyyup, Erkus, Emre, Sayin, Muhammet Rasit, Kazaz, Zeynep, Kul, Selim, Karabag, Turgut, Kalayci, Belma, Eugène, Marc, and Bax, Jeroen J.

Published
2021
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6. Long-Term Implications of Atrial Fibrillation in Patients With Degenerative Mitral Regurgitation

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Suri, R., Clavel, M.A, Maalouf, J., Michelena, H., Nkomo, Vuyisile T., Enriquez-Sarano, M., Tribouilloy, C., Trojette, F., Szymanski, C., Rusinaru, D., Touati, G., Remadi, J.P., Guerra, F., Capucci, A., Grigioni, F., Russo, A., Biagini, E., Pasquale, F., Ferlito, M., Rapezzi, C., Savini, C., Marinelli, G., Pacini, D., Gargiulo, G.D., Di Bartolomeo, R., Boulif, J., de Meester, C., El Khoury, G., Gerber, B., Lazam, S., Pasquet, A., Noirhomme, P., Vancraeynest, D., Vanoverschelde, J-L., Avierinos, J.F., Collard, F., Théron, A., Habib, G., Barbieri, A., Bursi, F., Mantovani, F., Lugli, R., Modena, M.G., Boriani, G., Bacchi-Reggiani, L., Grigioni, Francesco, Benfari, Giovanni, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Avierinos, Jean-Francois, Bursi, Francesca, Suri, Rakesh M., Guerra, Federico, Pasquet, Agnés, Rusinaru, Dan, Marcelli, Emanuela, Théron, Alexis, Barbieri, Andrea, Michelena, Hector, Lazam, Siham, Szymanski, Catherine, Capucci, Alessandro, Thapa, Prabin, and Enriquez-Sarano, Maurice

Published
2019
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13. Twenty-Year Outcome After Mitral Repair Versus Replacement for Severe Degenerative Mitral Regurgitation: Analysis of a Large, Prospective, Multicenter, International Registry

Author

Lazam, Siham, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Grigioni, Francesco, Suri, Rakesh M., Avierinos, Jean-Francois, Meester, Christophe de, Barbieri, Andrea, Rusinaru, Dan, Russo, Antonio, Pasquet, Agnès, Michelena, Hector I., Huebner, Marianne, Maalouf, Joseph, Clavel, Marie-Annick, Szymanski, Catherine, and Enriquez-Sarano, Maurice

Published
2017
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18. Impact of two COVID-19 national lockdowns on acute coronary syndrome admissions

Author

Hauguel-Moreau, Marie, primary, Prati, Giulio, additional, Pillière, Rémy, additional, Beaune, Sébastien, additional, Loeb, Thomas, additional, Sawczynski, Bruno, additional, Aïdan, Vincent, additional, Hergault, Hélène, additional, Ouadahi, Mounir, additional, Szymanski, Catherine, additional, Dubourg, Olivier, additional, and Mansencal, Nicolas, additional

Published
2021
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24. Long-term implications of atrial fibrillation in patients with degenerative mitral regurgitation

Author

Grigioni, Francesco, Pasquet, Agnès, Benfari, Giovanni, Clavel, Marie-Annick, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Avierinos, Jean-Francois, Bursi, Francesca, Suri, Rakesh M., Guerra, Federico, Rusinaru, Dan, Marcelli, Emanuela, Théron, Alexis, Barbieri, Andrea, Michelena, Hector I., Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T., Capucci, Alessandro, Thapa, Prabin, Enriquez-Sarano, Maurice, Suri, Ranjit, Maalouf, Joseph F., Trojette, Faouzi, Touati, Gilles, Remadi, Jean-Paul, Russo, Antonio, Biagini, Elena, Pasquale, Ferdinando, Ferlito, Marinella, Rapezzi, Claudio, Savini, Carlo, Marinelli, Giuseppe, Pacini, Davide, Gargiulo, Gaetano, Di Bartolomeo, Roberto, Boulif, Jamila, De Meester, Christophe, El-Khoury, Gébrine, Gerber, Bernhard, Noirhomme, Philippe, Vancraeynest, David, Collard, Frédéric, Habib, Gilbert, Mantovani, Francesca, Lugli, Roberta, Modena, Maria Grazia, Boriani, Giuseppe, Bacchi Reggiani, Maria Letizia, Grigioni, Francesco, Pasquet, Agnès, Benfari, Giovanni, Clavel, Marie-Annick, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Avierinos, Jean-Francois, Bursi, Francesca, Suri, Rakesh M., Guerra, Federico, Rusinaru, Dan, Marcelli, Emanuela, Théron, Alexis, Barbieri, Andrea, Michelena, Hector I., Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T., Capucci, Alessandro, Thapa, Prabin, Enriquez-Sarano, Maurice, Suri, Ranjit, Maalouf, Joseph F., Trojette, Faouzi, Touati, Gilles, Remadi, Jean-Paul, Russo, Antonio, Biagini, Elena, Pasquale, Ferdinando, Ferlito, Marinella, Rapezzi, Claudio, Savini, Carlo, Marinelli, Giuseppe, Pacini, Davide, Gargiulo, Gaetano, Di Bartolomeo, Roberto, Boulif, Jamila, De Meester, Christophe, El-Khoury, Gébrine, Gerber, Bernhard, Noirhomme, Philippe, Vancraeynest, David, Collard, Frédéric, Habib, Gilbert, Mantovani, Francesca, Lugli, Roberta, Modena, Maria Grazia, Boriani, Giuseppe, and Bacchi Reggiani, Maria Letizia

Abstract

Background: Scientific guidelines consider atrial fibrillation (AF) complicating degenerative mitral regurgitation (DMR) a debated indication for surgery. Objectives: This study analyzed the prognostic/therapeutic implications of AF at DMR diagnosis and long-term. Methods: Patients were enrolled in the MIDA (Mitral Regurgitation International Database) registry, which reported the consecutive, multicenter, international experience with DMR due to flail leaflets echocardiographically diagnosed. Results: Among 2,425 patients (age 67 ± 13 years; 71% male, 67% asymptomatic, ejection fraction 64 ± 10%), 1,646 presented at diagnosis with sinus rhythm (SR), 317 with paroxysmal AD, and 462 with persistent AF. Underlying clinical/instrumental characteristics progressively worsened from SR to paroxysmal to persistent AF. During follow-up, paroxysmal and persistent AF were associated with excess mortality (10-year survival in SR and in paroxysmal and persistent AF was 74 ± 1%, 59 ± 3%, and 46 ± 2%, respectively; p < 0.0001), that persisted 20 years post-diagnosis and independently of all baseline characteristics (p values <0.0001). Surgery (n = 1,889, repair 88%) was associated with better survival versus medical management, regardless of all baseline characteristics and rhythm (adjusted hazard ratio: 0.26; 95% confidence interval: 0.23 to 0.30; p < 0.0001) but post-surgical outcome remained affected by AF (10-year post-surgical survival in SR and in paroxysmal and persistent AF was 82 ± 1%, 70 ± 4%, and 57 ± 3%, respectively; p < 0.0001). Conclusions: AF is a frequent occurrence at DMR diagnosis. Although AF is associated with older age and more severe presentation of DMR, it is independently associated with excess mortality long-term after diagnosis. Surgery is followed by improved survival in each cardiac rhythm subset, but persistence of excess risk is observed for each type of AF. Our study indicates that detection of AF, even paroxysmal, should trigger prompt considerati

Published
2020

25. The MIDA mortality risk score : development and external validation of a prognostic model for early and late death in degenerative mitral regurgitation

Author

Grigioni, Francesco, Pasquet, Agnès, Clavel, Marie-Annick, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Pizarro, Rodolfo, Huebner, Marianne, Avierinos, Jean-Francois, Barbieri, Andrea, Suri, Rakesh M., Rusinaru, Dan, Gargiulo, Gaetano, Oberti, Pablo, Théron, Alexis, Bursi, Francesca, Michelena, Hector I., Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T., Schumacher, Martin, Bacchi Reggiani, Maria Letizia, Enriquez-Sarano, Maurice, Grigioni, Francesco, Pasquet, Agnès, Clavel, Marie-Annick, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Pizarro, Rodolfo, Huebner, Marianne, Avierinos, Jean-Francois, Barbieri, Andrea, Suri, Rakesh M., Rusinaru, Dan, Gargiulo, Gaetano, Oberti, Pablo, Théron, Alexis, Bursi, Francesca, Michelena, Hector I., Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T., Schumacher, Martin, Bacchi Reggiani, Maria Letizia, and Enriquez-Sarano, Maurice

Abstract

Aims: In degenerative mitral regurgitation (DMR), lack of mortality scores predicting death favours misperception of individual patients’ risk and inappropriate decision-making. Methods and results: The Mitral Regurgitation International Database (MIDA) registries include 3666 patients (age 66 ± 14 years; 70% males; follow-up 7.8 ± 5.0 years) with pure, isolated, DMR consecutively diagnosed by echocardiography at tertiary (European/North/South-American) centres. The MIDA Score was derived from the MIDA-Flail-Registry (2472 patients with DMR and flail leaflet-Derivation Cohort) by weighting all guideline-provided prognostic markers, and externally validated in the MIDA-BNP-Registry (1194 patients with DMR and flail leaflet/prolapse-Validation Cohort). The MIDA Score ranged from 0 to 12 depending on accumulating risk factors. In predicting total mortality post-diagnosis, the MIDA Score showed excellent concordance both in Derivation Cohort (c = 0.78) and Validation Cohort (c = 0.81). In the whole MIDA population (n = 3666 patients), 1-year mortality with Scores 0, 7–8, and 11–12 was 0.4, 17, and 48% under medical management and 1, 7, and 14% after surgery, respectively (P < 0.001). Five-year survival with Scores 0, 7–8, and 11–12 was 98 ± 1, 57 ± 4, and 21 ± 10% under medical management and 99 ± 1, 82 ± 2, and 57 ± 9% after surgery (P < 0.001). In models including all guideline-provided prognostic markers and the EuroScoreII, the MIDA Score provided incremental prognostic information (P ≤ 0.002). Conclusion: The MIDA Score may represent an innovative tool for DMR management, being able to position a given patient within a continuous spectrum of short- and long-term mortality risk, either under medical or surgical management. This innovative prognostic indicator may provide a specific framework for future clinical trials aiming to compare new technologies for DMR treatment in homogeneous risk categories of patients.

Published
2020

34. Long-term implications of atrial fibrillation in patients with degenerative mitral regurgitation

Author

Grigioni, Francesco, Benfari, Giovanni, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Avierinos, Jean-Francois, Bursi, Francesca, Suri, Rakesh M., Guerra, Federico, Pasquet, Agnès, Rusinaru, Dan, Marcelli, Emanuela, Théron, Alexis, Barbieri, Andrea, Michelena, Hector I., Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T., Capucci, Alessandro, Thapa, Prabin, Enriquez-Sarano, Maurice, Suri, Ranjit, Clavel, Marie-Annick, Maalouf, Joseph F., Trojette, Faouzi, Touati, Gilles, Remadi, Jean-Paul, Russo, Antonio, Biagini, Elena, Pasquale, Ferdinando, Ferlito, Marinella, Rapezzi, Claudio, Savini, Carlo, Marinelli, Giuseppe, Pacini, Davide, Gargiulo, Gaetano, Di Bartolomeo, Roberto, Boulif, Jamila, De Meester, Christophe, El-Khoury, Gébrine, Gerber, Bernhard, Noirhomme, Philippe, Vancraeynest, David, Collard, Frédéric, Habib, Gilbert, Mantovani, Francesca, Lugli, Roberta, Modena, Maria Grazia, Boriani, Giuseppe, Bacchi Reggiani, Maria Letizia, Grigioni, Francesco, Benfari, Giovanni, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Avierinos, Jean-Francois, Bursi, Francesca, Suri, Rakesh M., Guerra, Federico, Pasquet, Agnès, Rusinaru, Dan, Marcelli, Emanuela, Théron, Alexis, Barbieri, Andrea, Michelena, Hector I., Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T., Capucci, Alessandro, Thapa, Prabin, Enriquez-Sarano, Maurice, Suri, Ranjit, Clavel, Marie-Annick, Maalouf, Joseph F., Trojette, Faouzi, Touati, Gilles, Remadi, Jean-Paul, Russo, Antonio, Biagini, Elena, Pasquale, Ferdinando, Ferlito, Marinella, Rapezzi, Claudio, Savini, Carlo, Marinelli, Giuseppe, Pacini, Davide, Gargiulo, Gaetano, Di Bartolomeo, Roberto, Boulif, Jamila, De Meester, Christophe, El-Khoury, Gébrine, Gerber, Bernhard, Noirhomme, Philippe, Vancraeynest, David, Collard, Frédéric, Habib, Gilbert, Mantovani, Francesca, Lugli, Roberta, Modena, Maria Grazia, Boriani, Giuseppe, and Bacchi Reggiani, Maria Letizia

Abstract

BACKGROUND Scientific guidelines consider atrial fibrillation (AF) complicating degenerative mitral regurgitation (DMR) a debated indication for surgery. OBJECTIVES This study analyzed the prognostic/therapeutic implications of AF at DMR diagnosis and long-term. METHODS Patients were enrolled in the MIDA (Mitral Regurgitation International Database) registry, which reported the consecutive, multicenter, international experience with DMR due to flail leaflets echocardiographically diagnosed. RESULTS Among 2,425 patients (age 67 13 years; 71% male, 67% asymptomatic, ejection fraction 64 10%), 1,646 presented at diagnosis with sinus rhythm (SR), 317 with paroxysmal AD, and 462 with persistent AF. Underlying clinical/instrumental characteristics progressively worsened from SR to paroxysmal to persistent AF. During follow-up, paroxysmal and persistent AF were associated with excess mortality (10-year survival in SR and in paroxysmal and persistent AF was 74 1%, 59 3%, and 46 2%, respectively; p < 0.0001), that persisted 20 years post-diagnosis and independently of all baseline characteristics (p values <0.0001). Surgery (n ¼ 1,889, repair 88%) was associated with better survival versus medical management, regardless of all baseline characteristics and rhythm (adjusted hazard ratio: 0.26; 95% confidence interval: 0.23 to 0.30; p < 0.0001) but post-surgical outcome remained affected by AF (10-year post-surgical survival in SR and in paroxysmal and persistent AF was 82 1%, 70 4%, and 57 3%, respectively; p < 0.0001). CONCLUSIONS AF is a frequent occurrence at DMR diagnosis. Although AF is associated with older age and more severe presentation of DMR, it is independently associated with excess mortality long-term after diagnosis. Surgery is followed by improved survival in each cardiac rhythm subset, but persistence of excess risk is observed for each type of AF. Our study indicates that detection of AF, even paroxysmal, should trigger prompt consideration for surgery.

Published
2019

35. Long-Term Implications of Atrial Fibrillation in Patients With Degenerative Mitral Regurgitation.

Author

UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Grigioni, Francesco, Benfari, Giovanni, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Avierinos, Jean-Francois, Bursi, Francesca, Suri, Rakesh M, Guerra, Federico, Pasquet, Agnes, Rusinaru, Dan, Marcelli, Emanuela, Théron, Alexis, Barbieri, Andrea, Michelena, Hector, Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T, Capucci, Alessandro, Thapa, Prabin, Enriquez-Sarano, Maurice, MIDA Investigators, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Grigioni, Francesco, Benfari, Giovanni, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Avierinos, Jean-Francois, Bursi, Francesca, Suri, Rakesh M, Guerra, Federico, Pasquet, Agnes, Rusinaru, Dan, Marcelli, Emanuela, Théron, Alexis, Barbieri, Andrea, Michelena, Hector, Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T, Capucci, Alessandro, Thapa, Prabin, Enriquez-Sarano, Maurice, and MIDA Investigators

Abstract

BACKGROUND: Scientific guidelines consider atrial fibrillation (AF) complicating degenerative mitral regurgitation (DMR) a debated indication for surgery. OBJECTIVES: This study analyzed the prognostic/therapeutic implications of AF at DMR diagnosis and long-term. METHODS: Patients were enrolled in the MIDA (Mitral Regurgitation International Database) registry, which reported the consecutive, multicenter, international experience with DMR due to flail leaflets echocardiographically diagnosed. RESULTS: Among 2,425 patients (age 67 ± 13 years; 71% male, 67% asymptomatic, ejection fraction 64 ± 10%), 1,646 presented at diagnosis with sinus rhythm (SR), 317 with paroxysmal AD, and 462 with persistent AF. Underlying clinical/instrumental characteristics progressively worsened from SR to paroxysmal to persistent AF. During follow-up, paroxysmal and persistent AF were associated with excess mortality (10-year survival in SR and in paroxysmal and persistent AF was 74 ± 1%, 59 ± 3%, and 46 ± 2%, respectively; p < 0.0001), that persisted 20 years post-diagnosis and independently of all baseline characteristics (p values <0.0001). Surgery (n = 1,889, repair 88%) was associated with better survival versus medical management, regardless of all baseline characteristics and rhythm (adjusted hazard ratio: 0.26; 95% confidence interval: 0.23 to 0.30; p < 0.0001) but post-surgical outcome remained affected by AF (10-year post-surgical survival in SR and in paroxysmal and persistent AF was 82 ± 1%, 70 ± 4%, and 57 ± 3%, respectively; p < 0.0001). CONCLUSIONS: AF is a frequent occurrence at DMR diagnosis. Although AF is associated with older age and more severe presentation of DMR, it is independently associated with excess mortality long-term after diagnosis. Surgery is followed by improved survival in each cardiac rhythm subset, but persistence of excess risk is observed for each type of AF. Our study indicates that detection of AF, even paroxysmal, should trigger prompt considerati

Published
2019

37. Long-Term Implications of Atrial Fibrillation in Patients With Degenerative Mitral Regurgitation

Author

Grigioni, Francesco, primary, Benfari, Giovanni, additional, Vanoverschelde, Jean-Louis, additional, Tribouilloy, Christophe, additional, Avierinos, Jean-Francois, additional, Bursi, Francesca, additional, Suri, Rakesh M., additional, Guerra, Federico, additional, Pasquet, Agnés, additional, Rusinaru, Dan, additional, Marcelli, Emanuela, additional, Théron, Alexis, additional, Barbieri, Andrea, additional, Michelena, Hector, additional, Lazam, Siham, additional, Szymanski, Catherine, additional, Nkomo, Vuyisile T., additional, Capucci, Alessandro, additional, Thapa, Prabin, additional, Enriquez-Sarano, Maurice, additional, Suri, R., additional, Clavel, M.A, additional, Maalouf, J., additional, Michelena, H., additional, Enriquez-Sarano, M., additional, Tribouilloy, C., additional, Trojette, F., additional, Szymanski, C., additional, Rusinaru, D., additional, Touati, G., additional, Remadi, J.P., additional, Guerra, F., additional, Capucci, A., additional, Grigioni, F., additional, Russo, A., additional, Biagini, E., additional, Pasquale, F., additional, Ferlito, M., additional, Rapezzi, C., additional, Savini, C., additional, Marinelli, G., additional, Pacini, D., additional, Gargiulo, G.D., additional, Di Bartolomeo, R., additional, Boulif, J., additional, de Meester, C., additional, El Khoury, G., additional, Gerber, B., additional, Lazam, S., additional, Pasquet, A., additional, Noirhomme, P., additional, Vancraeynest, D., additional, Vanoverschelde, J-L., additional, Avierinos, J.F., additional, Collard, F., additional, Théron, A., additional, Habib, G., additional, Barbieri, A., additional, Bursi, F., additional, Mantovani, F., additional, Lugli, R., additional, Modena, M.G., additional, Boriani, G., additional, and Bacchi-Reggiani, L., additional

Published
2019
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38. Assessment of atrial function by myocardial deformation techniques in hypertrophic cardiomyopathy.

Author

Siam‐Tsieu, Valerie, Urtado, Sophie, Charron, Philippe, Hergault, Hélène, Szymanski, Catherine, Mallet, Sophie, Dubourg, Olivier, and Mansencal, Nicolas

Subjects
ECHOCARDIOGRAPHY, CARDIAC hypertrophy, CARDIAC contraction, ATHLETES, COMPARATIVE studies, DESCRIPTIVE statistics, LEFT heart atrium, MEDICAL needs assessment
Abstract

Background: Diastolic dysfunction in hypertrophic cardiomyopathy (HCM) is common, but its assessment is difficult using conventional echocardiography. Aims: To assess left atrial (LA) function in HCM by longitudinal strain and determine its role in understanding of symptoms. Methods: We studied 144 patients divided into 3 age‐ and sex‐matched groups: 48 consecutive patients with HCM, 48 control subjects, and 48 athlete subjects. We assessed LA function by conventional echocardiographic parameters and by longitudinal atrial strain (early‐diastolic left atrial strain during reservoir phase [LASr]; end‐diastolic left atrial strain during conduit phase; end‐systolic peak of the left atrial strain during contraction phase). Results: NYHA classification was as follows in HCM group: I in 46%, II in 31%, III in 19%, and IV in 4%. Conventional echocardiographic parameters of diastolic function were depressed in the HCM group as compared to the control and athlete groups, but not related to symptoms. All longitudinal atrial strain parameters were significantly reduced in HCM group as compared to two groups (P <.0001). LASr was significantly correlated to peak VO2 (r = 0.44, P =.01) and was the best parameter for detecting symptomatic patients presenting with HCM, with a cutoff value of 15%: Sensitivity was 71%, specificity was 79%, PPV was 77%, and NPV was 73%. Conclusion: Assessment of LA function in HCM is feasible using longitudinal strain, and this technique is more reliable than conventional echocardiographic parameters for the understanding of determinants of symptoms. [ABSTRACT FROM AUTHOR]

Published
2021
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39. The MIDA mortality risk score : development and external validation of a prognostic model for early and late death in degenerative mitral regurgitation

Author

Grigioni, Francesco, Clavel, Marie-Annick, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Pizarro, Rodolfo, Huebner, Marianne, Avierinos, Jean-Francois, Barbieri, Andrea, Suri, Rakesh M., Pasquet, Agnès, Rusinaru, Dan, Gargiulo, Gaetano, Oberti, Pablo, Théron, Alexis, Bursi, Francesca, Michelena, Hector I., Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T., Schumacher, Martin, Bacchi Reggiani, Maria Letizia, Enriquez-Sarano, Maurice, Grigioni, Francesco, Clavel, Marie-Annick, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Pizarro, Rodolfo, Huebner, Marianne, Avierinos, Jean-Francois, Barbieri, Andrea, Suri, Rakesh M., Pasquet, Agnès, Rusinaru, Dan, Gargiulo, Gaetano, Oberti, Pablo, Théron, Alexis, Bursi, Francesca, Michelena, Hector I., Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T., Schumacher, Martin, Bacchi Reggiani, Maria Letizia, and Enriquez-Sarano, Maurice

Abstract

Aims: In degenerative mitral regurgitation (DMR), lack of mortality scores predicting death favours misperception of individual patients’ risk and inappropriate decision-making. Methods and results: The Mitral Regurgitation International Database (MIDA) registries include 3666 patients (age 66 ± 14 years; 70% males; follow-up 7.8 ± 5.0 years) with pure, isolated, DMR consecutively diagnosed by echocardiography at tertiary (European/North/South-American) centres. The MIDA Score was derived from the MIDA-Flail-Registry (2472 patients with DMR and flail leaflet-Derivation Cohort) by weighting all guideline-provided prognostic markers, and externally validated in the MIDA-BNP-Registry (1194 patients with DMR and flail leaflet/prolapse-Validation Cohort). The MIDA Score ranged from 0 to 12 depending on accumulating risk factors. In predicting total mortality post-diagnosis, the MIDA Score showed excellent concordance both in Derivation Cohort (c = 0.78) and Validation Cohort (c = 0.81). In the whole MIDA population (n = 3666 patients), 1-year mortality with Scores 0, 7–8, and 11–12 was 0.4, 17, and 48% under medical management and 1, 7, and 14% after surgery, respectively (P < 0.001). Five-year survival with Scores 0, 7–8, and 11–12 was 98 ± 1, 57 ± 4, and 21 ± 10% under medical management and 99 ± 1, 82 ± 2, and 57 ± 9% after surgery (P < 0.001). In models including all guideline-provided prognostic markers and the EuroScoreII, the MIDA Score provided incremental prognostic information (P ≤ 0.002). Conclusion: The MIDA Score may represent an innovative tool for DMR management, being able to position a given patient within a continuous spectrum of short- and long-term mortality risk, either under medical or surgical management. This innovative prognostic indicator may provide a specific framework for future clinical trials aiming to compare new technologies for DMR treatment in homogeneous risk categories of patients.

Published
2018

40. Twenty-Year Outcome after Mitral Repair Versus Replacement for Severe Degenerative Mitral Regurgitation. Analysis of a Large, Prospective, Multicenter International Registry.

Author

UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Lazam, Siham, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Grigioni, Francesco, Suri, Rakesh M., Avierinos, Jean-Francois, de Meester de Ravenstein, Christophe, Barbieri, Andrea, Rusinaru, Dan, Russo, Antonio, Pasquet, Agnes, Michelena, Hector I., Huebner, Marianne, Maalouf, Joseph, Clavel, Marie-Annick, Szymanski, Catherine, Enriquez-Sarano, Maurice E., UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Lazam, Siham, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Grigioni, Francesco, Suri, Rakesh M., Avierinos, Jean-Francois, de Meester de Ravenstein, Christophe, Barbieri, Andrea, Rusinaru, Dan, Russo, Antonio, Pasquet, Agnes, Michelena, Hector I., Huebner, Marianne, Maalouf, Joseph, Clavel, Marie-Annick, Szymanski, Catherine, and Enriquez-Sarano, Maurice E.

Abstract

BACKGROUND: Mitral valve (MV) repair is preferred over replacement in clinical guidelines and is an important determinant of the indication for surgery in degenerative mitral regurgitation. However, the level of evidence supporting current recommendations is low, and recent data cast doubts on its validity in the current era. Accordingly, the aim of the present study was to analyze very long-term outcome after MV repair and replacement for degenerative mitral regurgitation with a flail leaflet. METHODS: MIDA (Mitral Regurgitation International Database) is a multicenter registry enrolling patients with degenerative mitral regurgitation with a flail leaflet in 6 tertiary European and US centers. We analyzed the outcome after MV repair (n=1709) and replacement (n=213) overall, by propensity score matching, and by inverse probability-of-treatment weighting. RESULTS: At baseline, patients undergoing MV repair were younger, had more comorbidities, and were more likely to present with a posterior leaflet prolapse than those undergoing MV replacement. After propensity score matching and inverse probability-of-treatment weighting, the 2 treatments groups were balanced, and absolute standardized differences were usually <10%, indicating adequate match. Operative mortality (defined as a death occurring within 30 days from surgery or during the same hospitalization) was lower after MV repair than after replacement in both the entire population (1.3% versus 4.7%; P<0.001) and the propensity-matched population (0.2% versus 4.4%; P<0.001). During a mean follow-up of 9.2 years, 552 deaths were observed, of which 207 were of cardiovascular origin. Twenty-year survival was better after MV repair than after MV replacement in both the entire population (46% versus 23%; P<0.001) and the matched population (41% versus 24%; P<0.001). Similar superiority of MV repair was obtained in patient subsets on the basis of age, sex, or any stratification criteria (all P<0.001). MV repair was also

Published
2017

42. Myocardial Infarction Alters Adaptation of the Tethered Mitral Valve

Author

Dal-Bianco, Jacob P, Aikawa, Elena, Bischoff, Joyce, Guerrero, J Luis, Hjortnaes, Jesper, Beaudoin, Jonathan, Szymanski, Catherine, Bartko, Philipp E, Seybolt, Margo M, Handschumacher, Mark D, Sullivan, Suzanne, Garcia, Michael L, Mauskapf, Adam, Titus, James S, Wylie-Sears, Jill, Irvin, Whitney S, Chaput, Miguel, Messas, Emmanuel, Hagège, Albert A, Carpentier, Alain, Levine, Robert A, and Leducq Transatlantic Mitral Network

Subjects
Research Support, N.I.H., Extramural, inflammation, Research Support, Non-U.S. Gov't, Journal Article, echocardiography, mitral regurgitation, papillary muscle, endothelial-to-mesenchymal transition
Abstract

BACKGROUND: In patients with myocardial infarction (MI), leaflet tethering by displaced papillary muscles induces mitral regurgitation (MR), which doubles mortality. Mitral valves (MVs) are larger in such patients but fibrosis sets in counterproductively. The investigators previously reported that experimental tethering alone increases mitral valve area in association with endothelial-to-mesenchymal transition. OBJECTIVES: The aim of this study was to explore the clinically relevant situation of tethering and MI, testing the hypothesis that ischemic milieu modifies mitral valve adaptation. METHODS: Twenty-three adult sheep were examined. Under cardiopulmonary bypass, the papillary muscle tips in 6 sheep were retracted apically to replicate tethering, short of producing MR (tethered alone). Papillary muscle retraction was combined with apical MI created by coronary ligation in another 6 sheep (tethered plus MI), and left ventricular remodeling was limited by external constraint in 5 additional sheep (left ventricular constraint). Six sham-operated sheep were control subjects. Diastolic mitral valve surface area was quantified by 3-dimensional echocardiography at baseline and after 58 ± 5 days, followed by histopathology and flow cytometry of excised leaflets. RESULTS: Tethered plus MI leaflets were markedly thicker than tethered-alone valves and sham control subjects. Leaflet area also increased significantly. Endothelial-to-mesenchymal transition, detected as α-smooth muscle actin-positive endothelial cells, significantly exceeded that in tethered-alone and control valves. Transforming growth factor-β, matrix metalloproteinase expression, and cellular proliferation were markedly increased. Uniquely, tethering plus MI showed endothelial activation with vascular adhesion molecule expression, neovascularization, and cells positive for CD45, considered a hematopoietic cell marker. Tethered plus MI findings were comparable with external ventricular constraint. CONCLUSIONS: MI altered leaflet adaptation, including a profibrotic increase in valvular cell activation, CD45-positive cells, and matrix turnover. Understanding cellular and molecular mechanisms underlying leaflet adaptation and fibrosis could yield new therapeutic opportunities for reducing ischemic MR.

Published
2016

43. Effect of Losartan on Mitral Valve Changes After Myocardial Infarction

Author

Bartko, Philipp E., primary, Dal-Bianco, Jacob P., additional, Guerrero, J. Luis, additional, Beaudoin, Jonathan, additional, Szymanski, Catherine, additional, Kim, Dae-Hee, additional, Seybolt, Margo M., additional, Handschumacher, Mark D., additional, Sullivan, Suzanne, additional, Garcia, Michael L., additional, Titus, James S., additional, Wylie-Sears, Jill, additional, Irvin, Whitney S., additional, Messas, Emmanuel, additional, Hagège, Albert A., additional, Carpentier, Alain, additional, Aikawa, Elena, additional, Bischoff, Joyce, additional, and Levine, Robert A., additional

Published
2017
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44. Apical four-chamber longitudinal left ventricular strain in patients with aortic stenosis and preserved left ventricular ejection fraction: analysis related with flow/gradient pattern and association with outcome

Author

Salaun, Erwan, primary, Casalta, Anne-Claire, additional, Donal, Erwan, additional, Bohbot, Yohann, additional, Galli, Elena, additional, Tribouilloy, Christophe, additional, Hubert, Sandrine, additional, Magne, Julien, additional, Mancini, Julien, additional, Renard, Sebastien, additional, Avierinos, Jean-Francois, additional, Maysou, Laurie-Anne, additional, Lavoute, Cécile, additional, Szymanski, Catherine, additional, Haentjens, Julie, additional, and Habib, Gilbert, additional

Published
2017
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46. Evaluation of NT-proBNP in Inflammatory Bowel Disease

Author

Wacrenier, A., Bourgeois, A. -M., Ausseil, J., Szymanski, Catherine, Thiebault, H., Brazier, Franck, Galmiche, A., Nguyen-Khac, Eric, Dupas, Jean-Louis, Colombel, J. -F., Fumery, Mathurin, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Immunologie moléculaire et biothérapies innovantes (IMBI), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université d'Évry-Val-d'Essonne (UEVE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Généthon, CHU Amiens-Picardie, Laboratoire de neurophysiologie cellulaire (LNPC), Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique (CNRS), Groupe de Recherche sur l'alcool et les pharmacodépendances - UMR INSERM_S 1247 (GRAP), Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hépato Gastroenterologie [CHU Amiens-Picardie], Périnatalité et Risques Toxiques - UMR INERIS_I 1 (PERITOX), Institut National de l'Environnement Industriel et des Risques (INERIS)-Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, and DESSAIVRE, Louise

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2015

49. Association of B-Type natriuretic peptide with survival in patients with degenerative mitral

Author

Clavel, Marie-Annick, Tribouilloy, Christophe, Vanoverschelde, Jean-Louis, Pizarro, Rodolfo, Suri, Rakesh M., Szymanski, Catherine, Lazam, Siham, Oberti, Pablo, Michelena, Hector I., Jaffe, Allan, Enriquez-Sarano, Maurice, Clavel, Marie-Annick, Tribouilloy, Christophe, Vanoverschelde, Jean-Louis, Pizarro, Rodolfo, Suri, Rakesh M., Szymanski, Catherine, Lazam, Siham, Oberti, Pablo, Michelena, Hector I., Jaffe, Allan, and Enriquez-Sarano, Maurice

Abstract

Background: Studies suggesting that B-type natriuretic peptide (BNP) may predict outcomes of mitral regurgitation (MR) are plagued by small size, inconsistent etiologies, and lack of accounting for shifting normal BNP ranges with age and sex. Objectives: This study assessed the effect of BNP activation on mortality in a large, multicenter cohort of patients with degenerative MR. Methods: In 1,331 patients with degenerative MR, BNP was prospectively measured at diagnosis and expressed as BNPratio (ratio to upper limit of normal for age, sex, and assay). Initial surgical management was performed within 3 months of diagnosis in 561 patents. Results: The cohort had a mean age of 64 ± 15 years, was 66% male, and had a mean ejection fraction 64 ± 9%, mean regurgitant volume 67 ± 31 ml, and low mean Charlson comorbidity index of 1.09 ± 1.76. Median BNPratio was 1.01 (25th and 75th percentiles: 0.42 to 2.36). Overall, BNPratio was a powerful, independent predictor of mortality (hazard ratio: 1.33 [95% confidence interval: 1.15 to 1.54]; p < 0.0001), whereas absolute BNP was not (p = 0.43). In patients who were initially treated medically (n = 770; 58%), BNPratio was a powerful, independent, and incremental predictor of mortality after diagnosis (hazard ratio: 1.61 [95% confidence interval: 1.34 to 1.93]; p < 0.0001). Higher BNP activation was associated with higher mortality (p < 0.0001). All subgroups, particularly severe MR, incurred similar excess mortality with BNP activation. After initial surgical treatment (n = 561, 42%) BNP activation did not impose excess long-term mortality (p = 0.23). Conclusions: In patients with degenerative MR, BNPratio is a powerful, independent, and incremental predictor of long-term mortality under medical management. BNPratio should be incorporated into the routine clinical assessment of patients with degenerative MR.

Published
2016

50. Twenty-year outcome after mitral repair versus replacement for severe degenerative mitral regurgitation. analysis of a large, prospective, multicenter international registry

Author

Lazam, Siham, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Grigioni, Francesco, Suri, Rakesh M., Avierinos, Jean-Francois, De Meester, Christophe, Barbieri, Andrea, Rusinaru, Dan, Russo, Antonio, Pasquet, Agnès, Michelena, Hector I., Huebner, Marianne, Maalouf, Joseph, Clavel, Marie-Annick, Szymanski, Catherine, Enriquez-Sarano, Maurice, Lazam, Siham, Vanoverschelde, Jean-Louis, Tribouilloy, Christophe, Grigioni, Francesco, Suri, Rakesh M., Avierinos, Jean-Francois, De Meester, Christophe, Barbieri, Andrea, Rusinaru, Dan, Russo, Antonio, Pasquet, Agnès, Michelena, Hector I., Huebner, Marianne, Maalouf, Joseph, Clavel, Marie-Annick, Szymanski, Catherine, and Enriquez-Sarano, Maurice

Abstract

Background—Mitral valve (MV) repair is preferred over replacement in clinical guidelines and is an important determinant of the indication for surgery in degenerative mitral regurgitation (MR). Yet, the level of evidence supporting current recommendations is low, and recent data cast doubts on its validity in the current era. Accordingly, the aim of the present study was to analyze very long-term outcome after MV repair and replacement for degenerative MR with a flail leaflet. Methods—MIDA is a multicenter registry enrolling patients with degenerative MR with a flail leaflet in 6 tertiary European and US centers. We analyzed the outcome after MV repair (n=1,709) and replacement (n= 213), overall, by propensity score matching and by inverse probability-of-treatment weighting. Results—At baseline, patients undergoing MV repair were younger, had more comorbidities and were more likely to present with a posterior leaflet prolapse than those undergoing MV replacement. After propensity score matching as well as after inverse probability-of-treatment weighting, the 2 treatments groups were balanced and absolute standardized differences were usually below 10%, indicating adequate match. Operative mortality (defined as a death occurring within 30 days from surgery or during the same hospitalization) was lower after MV repair than after replacement, both in the entire (1.3 vs 4.7%; p<0.001) and in propensity-matched population (0.2% vs 4.4%; p<0.001). During a mean follow-up of 9.2 years, 552 deaths were observed, of which 207 were of cardiovascular origin. Twenty-year survival was better after MV repair than after MV replacement, both in the entire (46% vs 23%, p<0.001) and in matched population (41% vs 24%, p<0.001). Similar superiority of MV repair were obtained in patients' subsets based on age, sex or any stratification criteria (all p<0.001). MV repair was also associated with reduced incidence of reoperations and valve-related complications. Conclusions—Among patients

Published
2016

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