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1. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction: TRANSITION Study

Author

Gniot, Jacek, Mozheiko, Maria, Lelonek, Malgorzata, Dominguez, Antonio Reyes, Horacek, Thomas, Garcia del Rio, Enrique, Kobalava, Zhanna, Mueller, Christian Eugen, Cavusoglu, Yuksel, Straburzynska-Migaj, Ewa, Slanina, Miroslav, vom Dahl, Juergen, Senni, Michele, Ryding, Alisdair, Moriarty, Andrew, Robles, Manuel Beltran, Villota, Julio Nunez, Quintana, Antonio Garcia, Nitschke, Thorsten, Garcia Pinilla, Jose Manuel, Bonet, Luis Almenar, Chaaban, Said, Filali zaatari, Samia, Spinar, Jindrich, Musial, Wlodzimierz, Abdelbaki, Khaled, Belohlavek, Jan, Fehske, Wolfgang, Bott, Michael Carlos, Hoegalmen, Geir, Leiro, Marisa Crespo, Ozcan, Ismail Turkay, Mullens, Wilfried, Kryza, Radim, Al-Ani, Riadh, Loboz-Grudzien, Krystyna, Ermoshkina, Lyudmila, Hojerova, Silvia, Fernandez, Alberto Alfredo, Spinarova, Lenka, Lapp, Harald, Bulut, Efraim, Almeida, Filipa, Vishnevsky, Alexander, Belicova, Margita, Pascual, Domingo, Witte, Klaus, Wong, Kenneth, Droogne, Walter, Delforge, Marc, Peterka, Martin, Olbrich, Hans-Georg, Carugo, Stefano, Nessler, Jadwiga, McGill, Thao Huynh, Huegl, Burkhard, Akin, Ibrahim, Moreira, Ilidio, Baglikov, Andrey, Thambyrajah, Jeetendra, Hayes, Chris, Barrionuevo, Marcelo Raul, Yigit, Zerrin, Kaya, Hakki, Klimsa, Zdenek, Radvan, Martin, Kadel, Christoph, Landmesser, Ulf, Di Tano, Giuseppe, Lisik, Malgorzata Buksinska, Fonseca, Candida, Oliveira, Luis, Marques, Irene, Santos, Luis Miguel, Lenner, Egon, Letavay, Peter, Bueno, Manuel Gomez, Mota, Paula, Wong, Aaron, Bailey, Kristian, Foley, Paul, Hasbani, Eduardo, Virani, Sean, Massih, Tony Abdel, Al-Saif, Shukri, Taborsky, Milos, Kaislerova, Marta, Motovska, Zuzana, Cohen, Aron Ariel, Logeart, Damien, Endemann, Dierk, Ferreira, Daniel, Brito, Dulce, Kycina, Peter, Bollano, Entela, Basilio, Enrique Galve, Rubio, Lorenzo Facila, Aguado, Marcos Garcia, Schiavi, Lilia Beatriz, Zivano, Daniel Francisco, Lonn, Eva, El Sayed, Ali, Pouleur, Anne-Catherine, Heyse, Alex, Schee, Alexandr, Polasek, Rostislav, Houra, Marek, Tribouilloy, Christophe, Seronde, Marie France, Galinier, Michel, Noutsias, Michel, Schwimmbeck, Peter, Voigt, Ingo, Westermann, Dirk, Pulignano, Giovanni, Vegsundvaag, Johnny, Da Silva Antunes, Jose Alexandre, Monteiro, Pedro, Stevlik, Jan, Goncalvesova, Eva, Hulkoova, Beata, Castro Fernandez, Antonio Juan, Davies, Ceri, Squire, Iain, Meyer, Philippe, Sheppard, Richard, Sahin, Tayfun, Sochor, Karel, De Geeter, Guillaume, Wachter, Rolf, Schmeisser, Alexander, Weil, Joachim, Soares, Ana Oliveira, Vasilevna, Olga Bulashova, Oshurkov, Andrey, Sunderland, Shahid Junejo, Glover, Jason, Exequiel, Tomas, Decoulx, Eric, Meyer, Sven, Muenzel, Thomas, Frioes, Fernando, Arbolishvili, Georgy, Tokarcikova, Anna, Karlstrom, Patric, Trullas Vila, Joan Carles, Perez, Gonzalo Pena, Sankaranarayanan, Rajiv, Nageh, Thuraia, Alasia, Diego Cristian, Refaat, Marwan, Demirkan, Burcu, Al-Buraiki, Jehad, Karabsheh, Shadi, Pascual-Figal, Domingo, Bao, Weibin, Noè, Adele, Schwende, Heike, Butylin, Dmytro, and Prescott, Margaret F.

Published
2020
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2. Management of patients with severe aortic stenosis in the TAVI-era: how recent recommendations are translated into clinical practice

Author

Lauten, Alexander, primary, Rudolph, Tanja K, additional, Messika-Zeitoun, David, additional, Thambyrajah, Jeetendra, additional, Serra, Antonio, additional, Schulz, Eberhard, additional, Frey, Norbert, additional, Maly, Jiri, additional, Aiello, Marco, additional, Lloyd, Guy, additional, Bortone, Alessandro Santo, additional, Clerici, Alberto, additional, Delle-Karth, Georg, additional, Rieber, Johannes, additional, Indolfi, Ciro, additional, Mancone, Massimo, additional, Belle, Loic, additional, Arnold, Martin, additional, Bouma, Berto J, additional, Lutz, Matthias, additional, Deutsch, Cornelia, additional, Kurucova, Jana, additional, Thoenes, Martin, additional, Bramlage, Peter, additional, and Steeds, Richard Paul, additional

Published
2021
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3. IMPULSE: the impact of gender on the presentation and management of aortic stenosis across Europe

Author

Steeds, Richard Paul, primary, Messika-Zeitoun, David, additional, Thambyrajah, Jeetendra, additional, Serra, Antonio, additional, Schulz, Eberhard, additional, Maly, Jiri, additional, Aiello, Marco, additional, Rudolph, Tanja K, additional, Lloyd, Guy, additional, Bortone, Alessandro Santo, additional, Clerici, Alberto, additional, Delle-Karth, Georg, additional, Rieber, Johannes, additional, Indolfi, Ciro, additional, Mancone, Massimo, additional, Belle, Loic, additional, Lauten, Alexander, additional, Arnold, Martin, additional, Bouma, Berto J, additional, Lutz, Matthias, additional, Deutsch, Cornelia, additional, Kurucova, Jana, additional, Thoenes, Martin, additional, Bramlage, Peter, additional, and Frey, Norbert, additional

Published
2021
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4. NT-proBNP Response to Sacubitril/Valsartan in Hospitalized Heart Failure Patients With Reduced Ejection Fraction

Author

Pascual-Figal, Domingo, primary, Wachter, Rolf, additional, Senni, Michele, additional, Bao, Weibin, additional, Noè, Adele, additional, Schwende, Heike, additional, Butylin, Dmytro, additional, Prescott, Margaret F., additional, Gniot, Jacek, additional, Mozheiko, Maria, additional, Lelonek, Malgorzata, additional, Dominguez, Antonio Reyes, additional, Horacek, Thomas, additional, Garcia del Rio, Enrique, additional, Kobalava, Zhanna, additional, Mueller, Christian Eugen, additional, Cavusoglu, Yuksel, additional, Straburzynska-Migaj, Ewa, additional, Slanina, Miroslav, additional, vom Dahl, Juergen, additional, Ryding, Alisdair, additional, Moriarty, Andrew, additional, Robles, Manuel Beltran, additional, Villota, Julio Nunez, additional, Quintana, Antonio Garcia, additional, Nitschke, Thorsten, additional, Garcia Pinilla, Jose Manuel, additional, Bonet, Luis Almenar, additional, Chaaban, Said, additional, Filali zaatari, Samia, additional, Spinar, Jindrich, additional, Musial, Wlodzimierz, additional, Abdelbaki, Khaled, additional, Belohlavek, Jan, additional, Fehske, Wolfgang, additional, Bott, Michael Carlos, additional, Hoegalmen, Geir, additional, Leiro, Marisa Crespo, additional, Ozcan, Ismail Turkay, additional, Mullens, Wilfried, additional, Kryza, Radim, additional, Al-Ani, Riadh, additional, Loboz-Grudzien, Krystyna, additional, Ermoshkina, Lyudmila, additional, Hojerova, Silvia, additional, Fernandez, Alberto Alfredo, additional, Spinarova, Lenka, additional, Lapp, Harald, additional, Bulut, Efraim, additional, Almeida, Filipa, additional, Vishnevsky, Alexander, additional, Belicova, Margita, additional, Pascual, Domingo, additional, Witte, Klaus, additional, Wong, Kenneth, additional, Droogne, Walter, additional, Delforge, Marc, additional, Peterka, Martin, additional, Olbrich, Hans-Georg, additional, Carugo, Stefano, additional, Nessler, Jadwiga, additional, McGill, Thao Huynh, additional, Huegl, Burkhard, additional, Akin, Ibrahim, additional, Moreira, Ilidio, additional, Baglikov, Andrey, additional, Thambyrajah, Jeetendra, additional, Hayes, Chris, additional, Barrionuevo, Marcelo Raul, additional, Yigit, Zerrin, additional, Kaya, Hakki, additional, Klimsa, Zdenek, additional, Radvan, Martin, additional, Kadel, Christoph, additional, Landmesser, Ulf, additional, Di Tano, Giuseppe, additional, Lisik, Malgorzata Buksinska, additional, Fonseca, Candida, additional, Oliveira, Luis, additional, Marques, Irene, additional, Santos, Luis Miguel, additional, Lenner, Egon, additional, Letavay, Peter, additional, Bueno, Manuel Gomez, additional, Mota, Paula, additional, Wong, Aaron, additional, Bailey, Kristian, additional, Foley, Paul, additional, Hasbani, Eduardo, additional, Virani, Sean, additional, Massih, Tony Abdel, additional, Al-Saif, Shukri, additional, Taborsky, Milos, additional, Kaislerova, Marta, additional, Motovska, Zuzana, additional, Cohen, Aron Ariel, additional, Logeart, Damien, additional, Endemann, Dierk, additional, Ferreira, Daniel, additional, Brito, Dulce, additional, Kycina, Peter, additional, Bollano, Entela, additional, Basilio, Enrique Galve, additional, Rubio, Lorenzo Facila, additional, Aguado, Marcos Garcia, additional, Schiavi, Lilia Beatriz, additional, Zivano, Daniel Francisco, additional, Lonn, Eva, additional, El Sayed, Ali, additional, Pouleur, Anne-Catherine, additional, Heyse, Alex, additional, Schee, Alexandr, additional, Polasek, Rostislav, additional, Houra, Marek, additional, Tribouilloy, Christophe, additional, Seronde, Marie France, additional, Galinier, Michel, additional, Noutsias, Michel, additional, Schwimmbeck, Peter, additional, Voigt, Ingo, additional, Westermann, Dirk, additional, Pulignano, Giovanni, additional, Vegsundvaag, Johnny, additional, Da Silva Antunes, Jose Alexandre, additional, Monteiro, Pedro, additional, Stevlik, Jan, additional, Goncalvesova, Eva, additional, Hulkoova, Beata, additional, Castro Fernandez, Antonio Juan, additional, Davies, Ceri, additional, Squire, Iain, additional, Meyer, Philippe, additional, Sheppard, Richard, additional, Sahin, Tayfun, additional, Sochor, Karel, additional, De Geeter, Guillaume, additional, Schmeisser, Alexander, additional, Weil, Joachim, additional, Soares, Ana Oliveira, additional, Vasilevna, Olga Bulashova, additional, Oshurkov, Andrey, additional, Sunderland, Shahid Junejo, additional, Glover, Jason, additional, Exequiel, Tomas, additional, Decoulx, Eric, additional, Meyer, Sven, additional, Muenzel, Thomas, additional, Frioes, Fernando, additional, Arbolishvili, Georgy, additional, Tokarcikova, Anna, additional, Karlstrom, Patric, additional, Trullas Vila, Joan Carles, additional, Perez, Gonzalo Pena, additional, Sankaranarayanan, Rajiv, additional, Nageh, Thuraia, additional, Alasia, Diego Cristian, additional, Refaat, Marwan, additional, Demirkan, Burcu, additional, Al-Buraiki, Jehad, additional, and Karabsheh, Shadi, additional

Published
2020
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5. Differences in the presentation and management of patients with severe aortic stenosis in different European centres

Author

Lutz, Matthias, primary, Messika-Zeitoun, David, additional, Rudolph, Tanja K, additional, Schulz, Eberhard, additional, Thambyrajah, Jeetendra, additional, Lloyd, Guy, additional, Lauten, Alexander, additional, Frey, Norbert, additional, Kurucova, Jana, additional, Thoenes, Martin, additional, Deutsch, Cornelia, additional, Bramlage, Peter, additional, and Steeds, Richard Paul, additional

Published
2020
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6. Impact of selected comorbidities on the presentation and management of aortic stenosis

Author

Rudolph, Tanja K., primary, Messika-Zeitoun, David, additional, Frey, Norbert, additional, Thambyrajah, Jeetendra, additional, Serra, Antonio, additional, Schulz, Eberhard, additional, Maly, Jiri, additional, Aiello, Marco, additional, Lloyd, Guy, additional, Bortone, Alessandro Santo, additional, Clerici, Alberto, additional, Delle-Karth, Georg, additional, Rieber, Johannes, additional, Indolfi, Ciro, additional, Mancone, Massimo, additional, Belle, Loic, additional, Lauten, Alexander, additional, Arnold, Martin, additional, Bouma, Berto J, additional, Lutz, Matthias, additional, Deutsch, Cornelia, additional, Kurucova, Jana, additional, Thoenes, Martin, additional, Bramlage, Peter, additional, and Steeds, Richard P., additional

Published
2020
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7. Initiation of sacubitril/valsartan in haemodynamically stabilised heart failure patients in hospital or early after discharge: primary results of the randomised TRANSITION study

Author

Wachter, Rolf, Senni, Michele, Belohlavek, Jan, Straburzynska‐Migaj, Ewa, Witte, Klaus K., Kobalava, Zhanna, Fonseca, Candida, Goncalvesova, Eva, Cavusoglu, Yuksel, Fernandez, Alberto, Chaaban, Said, Bøhmer, Ellen, Pouleur, Anne‐Catherine, Mueller, Christian, Tribouilloy, Christophe, Lonn, Eva, A.L. Buraiki, Jehad, Gniot, Jacek, Mozheiko, Maria, Lelonek, Malgorzata, Noè, Adele, Schwende, Heike, Bao, Weibin, Butylin, Dmytro, Pascual‐Figal, Domingo, Dominguez, Antonio Reyes, Horacek, Thomas, del Rio, Enrique Garcia, Mueller, Christian Eugen, Straburzynska-Migaj, Ewa, Slanina, Miroslav, vom Dahl, Juergen, Ryding, Alisdair, Moriarty, Andrew, Robles, Manuel Beltran, Villota, Julio Nunez, Quintana, Antonio Garcia, Nitschke, Thorsten, Manuel Garcia Pinilla, Jose, Bonet, Luis Almenar, Filali zaatari, MD, Samia, Spinar, Jindrich, Musial, Wlodzimierz, Abdelbaki, Khaled, Fehske, Wolfgang, Bott, Michael Carlos, Hoegalmen, Geir, Leiro, Marisa Crespo, Ozcan, Ismail Turkay, Mullens, Wilfried, Kryza, Radim, Al-Ani, Riadh, Loboz-Grudzien, Krystyna, Ermoshkina, Lyudmila, Hojerova, Silvia, Fernandez, Alberto Alfredo, Spinarova, Lenka, Lapp, Harald, Bulut, Efraim, Almeida, Filipa, Vishnevsky, Alexander, Belicova, Margita, Pascual, Domingo, Witte, Klaus, Wong, Kenneth, Droogne, Walter, Delforge, Marc, Peterka, Martin, Olbrich, Hans‐Georg, Carugo, Stefano, Nessler, Jadwiga, McGill, Thao Huynh, Huegl, Burkhard, Akin, Ibrahim, Moreira, Ilidio, Baglikov, Andrey, Thambyrajah, Jeetendra, Hayes, Chris, Barrionuevo, Marcelo Raul, Yigit, Zerrin, Kaya, Hakki, Klimsa, Zdenek, Radvan, Martin, Kadel, Christoph, Landmesser, Ulf, Di Tano, Giuseppe, Lisik, Malgorzata Buksinska, Oliveira, Luis, Marques, Irene, Santos, Luis Miguel, Lenner, Egon, Letavay, Peter, Bueno, Manuel Gomez, Mota, Paula, Wong, Aaron, Bailey, Kristian, Foley, Paul, Hasbani, Eduardo, Virani, Sean, Massih, Tony Abdel, Al‐Saif, Shukri, Taborsky, Milos, Kaislerova, Marta, Motovska, Zuzana, Praha, Cohen, Aron Ariel, Logeart, Damien, Endemann, Dierk, Ferreira, Daniel, Brito, Dulce, Kycina, Peter, Bollano, Entela, Basilio, Enrique Galve, Rubio, Lorenzo Facila, Aguado, Marcos Garcia, Schiavi, Lilia Beatriz, Zivano, Daniel Francisco, Sayed, Ali El, Heyse, Alex, Schee, Alexandr, Polasek, Rostislav, Houra, Marek, Seronde, Marie France, Galinier, Michel, Noutsias, Michel, Schwimmbeck, Peter, Voigt, Ingo, Westermann, Dirk, Pulignano, Giovanni, Vegsundvaag, Johnny, Alexandre Da Silva Antunes, Jose, Monteiro, Pedro, Stevlik, Jan, Hulkoova, Beata, Juan Castro Fernandez, Antonio, Davies, Ceri, Squire, Iain, Meyer, Philippe, Sheppard, Richard, Sahin, Tayfun, Sochor, Karel, De Geeter, Guillaume, Schmeisser, Alexander, Weil, Joachim, Soares, Ana Oliveira, Vasilevna, Olga Bulashova, Oshurkov, Andrey, Sunderland, Shahid Junejo, Glover, Jason, Exequiel, Tomas, Decoulx, Eric, Meyer, Sven, Muenzel, Thomas, Frioes, Fernando, Arbolishvili, Georgy, Tokarcikova, Anna, Karlstrom, Patric, Carles Trullas Vila, Joan, Perez, Gonzalo Pena, Sankaranarayanan, Rajiv, Nageh, Thuraia, Alasia, Diego Cristian, Refaat, Marwan, Demirkan, Burcu, Al-Buraiki, Jehad, Karabsheh, Shadi, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire, Wachter, R, Senni, M, Belohlavek, J, Straburzynska-Migaj, E, Witte, K, Kobalava, Z, Fonseca, C, Goncalvesova, E, Cavusoglu, Y, Fernandez, A, Chaaban, S, Bøhmer, E, Pouleur, A, Mueller, C, Tribouilloy, C, Lonn, E, A L Buraiki, J, Gniot, J, Mozheiko, M, Lelonek, M, Noè, A, Schwende, H, Bao, W, Butylin, D, Pascual-Figal, D, and Transition, I

Subjects
Male, medicine.medical_specialty, Acute decompensated heart failure, Tetrazoles, Heart failure, 030204 cardiovascular system & hematology, Sacubitril, 03 medical and health sciences, Angiotensin Receptor Antagonists, 0302 clinical medicine, Internal medicine, medicine, Clinical endpoint, Hospitalisation, Humans, Sacubitril/valsartan, Aged, Angiotensin receptor–neprilysin inhibitor, Heart Failure, Ejection fraction, Dose-Response Relationship, Drug, business.industry, Aminobutyrates, Biphenyl Compounds, Hemodynamics, medicine.disease, Angiotensin receptor-neprilysin inhibitor, Patient Discharge, 3. Good health, Discontinuation, Drug Combinations, Treatment Outcome, Valsartan, Tolerability, Female, Neprilysin, business, Cardiology and Cardiovascular Medicine, Sacubitril, Valsartan, medicine.drug, Follow-Up Studies
Abstract

AIMS: To assess tolerability and optimal time point for initiation of sacubitril/valsartan in patients stabilised after acute heart failure (AHF). METHODS AND RESULTS: TRANSITION was a randomised, multicentre, open-label study comparing two treatment initiation modalities of sacubitril/valsartan. Patients aged ≥ 18 years, hospitalised for AHF were stratified according to pre-admission use of renin-angiotensin-aldosterone system inhibitors and randomised (n = 1002) after stabilisation to initiate sacubitril/valsartan either ≥ 12-h pre-discharge or between Days 1-14 post-discharge. Starting dose (as per label) was 24/26 mg or 49/51 mg bid with up- or down-titration based on tolerability. The primary endpoint was the proportion of patients attaining 97/103 mg bid target dose after 10 weeks. Median time of first dose of sacubitril/valsartan from the day of discharge was Day -1 and Day +1 in the pre-discharge group and the post-discharge group, respectively. Comparable proportions of patients in the pre- and post-discharge initiation groups met the primary endpoint [45.4% vs. 50.7%; risk ratio (RR) 0.90; 95% confidence interval (CI) 0.79-1.02]. The proportion of patients who achieved and maintained for ≥ 2 weeks leading to Week 10, either 49/51 or 97/103 mg bid was 62.1% vs. 68.5% (RR 0.91; 95% CI 0.83-0.99); or any dose was 86.0% vs. 89.6% (RR 0.96; 95% CI 0.92-1.01). Discontinuation due to adverse events occurred in 7.3% vs. 4.9% of patients (RR 1.49; 95% CI 0.90-2.46). CONCLUSIONS: Initiation of sacubitril/valsartan in a wide range of heart failure with reduced ejection fraction patients stabilised after an AHF event, either in hospital or shortly after discharge, is feasible with about half of the patients achieving target dose within 10 weeks. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02661217. © 2019 The Authors. European Journal of Heart Failure published by John Wiley & Sons peerReviewed

Published
2019

8. Symptoms, disease severity and treatment of adults with a new diagnosis of severe aortic stenosis

Author

Frey, Norbert, Steeds, Richard Paul, Rudolph, Tanja K., Thambyrajah, Jeetendra, Serra, Antonio, Schulz, Eberhard, Maly, Jiri, Aiello, Marco, Lloyd, Guy, Bortone, Alessandro Santo, Hauptmann, Karl Eugen, Clerici, Alberto, Delle Karth, Georg, Rieber, Johannes, Indorfi, Ciro, Mancone, Massimo, Belle, Loic, Lauten, Alexander, Arnold, Martin, Bouma, Berto J., Lutz, Matthias, Pohlmann, Christiane, Kurucova, Jana, Thoenes, Martin, Bramlage, Peter, Messika-Zeitoun, David, Cardiology, ACS - Heart failure & arrhythmias, and ACS - Pulmonary hypertension & thrombosis

Subjects
Male, Comorbidity, Risk Assessment, Severity of Illness Index, Ventricular Function, Left, aortic stenosis, surgical aortic valve replacement, symptoms, transcatheter aortic valve replacement, age factors, aged, aged, 80 and over, aortic valve, aortic valve stenosis, asymptomatic diseases, comorbidity, cross-sectional studies, europe, female, hemodynamics, humans, male, predictive value of tests, prognosis, prospective studies, registries, risk assessment, risk factors, severity of illness index, ventricular function, left, echocardiography, left, Predictive Value of Tests, Risk Factors, 80 and over, Humans, Prospective Studies, Registries, Aged, Aged, 80 and over, Age Factors, Hemodynamics, Aortic Valve Stenosis, Prognosis, Europe, Cross-Sectional Studies, Echocardiography, Aortic Valve, Asymptomatic Diseases, ventricular function, Female
Abstract

Objective Contemporary data on patients with previously undiagnosed severe aortic stenosis (AS) are scarce. We aimed to address this gap by gathering data from consecutive patients diagnosed with severe AS on echocardiography. Methods This was a prospective, multicentre, multinational, registry in 23 tertiary care hospitals across 9 European countries. Patients with a diagnosis of severe AS were included using echocardiography (aortic valve area (AVA) 4 m/s and/or mean transvalvular gradient >40 mm Hg). Results The 2171 participants had a mean age of 77.9 years and 48.0% were female. The mean AVA was 0.73 cm 2, V max 4.3 m/s and mean gradient 47.1 mm Hg; 62.1% had left ventricular hypertrophy and 27.3% an ejection fraction (EF)

Published
2019

9. Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe

Author

Steeds, Richard P., Lutz, Matthias, Thambyrajah, Jeetendra, Serra, Antonio, Schulz, Eberhard, Maly, Jiri, Aiello, Marco, Rudolph, Tanja K., Lloyd, Guy, Santo Bortone, Alessandro, Hauptmann, Karl Eugen, Clerici, Alberto, Delle-Karth, Georg, Rieber, Johannes, Indolfi, Ciro, Mancone, Massimo, Belle, Loic, Lauten, Alexander, Arnold, Martin, Bouma, Berto J., Deutsch, Cornelia, Kurucova, Jana, Thoenes, Martin, Bramlage, Peter, Frey, Norbert, Messika-Zeitoun, David, Steeds, Richard P., Lutz, Matthias, Thambyrajah, Jeetendra, Serra, Antonio, Schulz, Eberhard, Maly, Jiri, Aiello, Marco, Rudolph, Tanja K., Lloyd, Guy, Santo Bortone, Alessandro, Hauptmann, Karl Eugen, Clerici, Alberto, Delle-Karth, Georg, Rieber, Johannes, Indolfi, Ciro, Mancone, Massimo, Belle, Loic, Lauten, Alexander, Arnold, Martin, Bouma, Berto J., Deutsch, Cornelia, Kurucova, Jana, Thoenes, Martin, Bramlage, Peter, Frey, Norbert, and Messika-Zeitoun, David

Abstract

Background-Many patients with severe aortic stenosis are referred late with advanced symptoms or inappropriately denied intervention. The objective was to investigate whether a structured communication to referring physicians (facilitated data relay) might improve the rate and timeliness of intervention. Methods and Results-A prospective registry of consecutive patients with severe aortic stenosis at 23 centers in 9 European countries with transcatheter as well as surgical aortic valve replacement being available was performed. The study included a 3-month documentation of the status quo (phase A), a 6-month intervention phase (implementing facilitated data relay), and a 3-month documentation of a legacy effect (phase-B). Two thousand one hundred seventy-one patients with severe aortic stenoses were enrolled (phase A: 759; intervention: 905; phase-B: 507). Mean age was 77.9 +/- 10.0 years, and 80% were symptomatic, including 52% with severe symptoms. During phase A, intervention was planned in 464/696 (67%), 138 (20%) were assigned to watchful waiting, 8 (1%) to balloon aortic valvuloplasty, 60 (9%) were listed as not for active treatment, and in 26 (4%), no decision was made. Three hundred sixty-three of 464 (78%) patients received the planned intervention within 3 months. Timeliness of the intervention improved as shown by the higher number of aortic valve replacements performed within 3 months (59% versus 51%, P=0.002) and a significant decrease in the time to intervention (36 +/- 38 versus 30 +/- 33 days, P=0.002). Conclusions-A simple, low-cost, facilitated data relay improves timeliness of treatment for patients diagnosed with severe aortic stenosis, resulting in a shorter time to transcatheter aortic valve replacement. This effect was mainly driven by a significant improvement in timeliness of intervention in transcatheter aortic valve replacement but not surgical aortic valve replacement. Clinical Trial Registration-URL: https://www.clinicaltrials.gov/. Uniq

Published
2019

10. Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe

Author

Steeds, Richard P., primary, Lutz, Matthias, additional, Thambyrajah, Jeetendra, additional, Serra, Antonio, additional, Schulz, Eberhard, additional, Maly, Jiri, additional, Aiello, Marco, additional, Rudolph, Tanja K., additional, Lloyd, Guy, additional, Bortone, Alessandro Santo, additional, Hauptmann, Karl Eugen, additional, Clerici, Alberto, additional, Delle‐Karth, Georg, additional, Rieber, Johannes, additional, Indolfi, Ciro, additional, Mancone, Massimo, additional, Belle, Loic, additional, Lauten, Alexander, additional, Arnold, Martin, additional, Bouma, Berto J., additional, Deutsch, Cornelia, additional, Kurucova, Jana, additional, Thoenes, Martin, additional, Bramlage, Peter, additional, Frey, Norbert, additional, and Messika‐Zeitoun, David, additional

Published
2019
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11. Long-Term Outcomes Comparing Minimally Invasive Mitral Valve Repair versus Conventional Mitral Valve Surgery

Author

Jackson, Matthew, primary, Sandhu, Manraj S., additional, Dong, Chao, additional, Bawamia, Bilal, additional, Qureshi, Muhammad, additional, Khan, Khalid, additional, Goodwin, Andrew, additional, Kendall, Simon, additional, Hunter, Steven, additional, Graham, Richard, additional, Thambyrajah, Jeetendra, additional, and Akowuah, Enoch F., additional

Published
2018
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16. Symptoms, disease severity and treatment of adults with a new diagnosis of severe aortic stenosis.

Author

Frey N, Steeds RP, Rudolph TK, Thambyrajah J, Serra A, Schulz E, Maly J, Aiello M, Lloyd G, Bortone AS, Hauptmann KE, Clerici A, Delle Karth G, Rieber J, Indorfi C, Mancone M, Belle L, Lauten A, Arnold M, Bouma BJ, Lutz M, Pohlmann C, Kurucova J, Thoenes M, Bramlage P, and Messika-Zeitoun D

Subjects
Age Factors, Aged, Aged, 80 and over, Aortic Valve physiopathology, Aortic Valve Stenosis physiopathology, Asymptomatic Diseases, Comorbidity, Cross-Sectional Studies, Europe, Female, Hemodynamics, Humans, Male, Predictive Value of Tests, Prognosis, Prospective Studies, Registries, Risk Assessment, Risk Factors, Severity of Illness Index, Ventricular Function, Left, Aortic Valve diagnostic imaging, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis therapy, Echocardiography
Abstract

Objective: Contemporary data on patients with previously undiagnosed severe aortic stenosis (AS) are scarce. We aimed to address this gap by gathering data from consecutive patients diagnosed with severe AS on echocardiography., Methods: This was a prospective, multicentre, multinational, registry in 23 tertiary care hospitals across 9 European countries. Patients with a diagnosis of severe AS were included using echocardiography (aortic valve area (AVA) <1 cm 2 , indexed AVA <0.6 cm 2 /m 2 , maximum jet-velocity (V max ) >4 m/s and/or mean transvalvular gradient >40 mm Hg)., Results: The 2171 participants had a mean age of 77.9 years and 48.0% were female. The mean AVA was 0.73 cm 2 , V max 4.3 m/s and mean gradient 47.1 mm Hg; 62.1% had left ventricular hypertrophy and 27.3% an ejection fraction (EF) <50%. 1743 patients (80.3%) were symptomatic (shortness-of-breath 91.0%; dizziness 30.2%, chest pain 28.9%). Patients had a EuroSCORE II of 4.0; 25.3% had a creatinine clearance <50 mL/min, and 3.2% had an EF <30%. Symptomatic patients were older and had more comorbidities than asymptomatic patients. Despite European Society of Cardiology 2017 valvular heart disease guideline class I recommendation, in only 76.2% a decision was made for an intervention (transcatheter 50.4%, surgical aortic valve replacement 25.8%). In asymptomatic patients, 57.7% with a class I/IIa indication were scheduled for a procedure, while 36.3% patients without an indication had their valve replaced., Conclusions: The majority of patients with severe AS presented at an advanced disease stage. Management of severe AS remained suboptimal in a significant proportion of contemporary patients with severe AS., Trial Registration Number: NCT02241447;Results., Competing Interests: Competing interests: PB is the representative of the IPPMed. NF, RPS, TKR and DM-Z have received speakers’ honoraria from Edwards Lifesciences. The institutions of these three and those of the remaining authors representing study centers have received funding from the sponsor for employing a study nurse for the duration of the study. IPPMed designed and executed the study, collected and analysed the data and drafted/revised the manuscript in collaboration with the other authors., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2019
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