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  • Dona, C  (11)
  • 1
    Online-Ressource
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    Cardiac imaging in tafamidis-treatment patients with transthyretin amyloid cardiomyopathy
    Oxford University Press (OUP) ; 2021
    In:  European Heart Journal Vol. 42, No. Supplement_1 ( 2021-10-12)
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 42, No. Supplement_1 ( 2021-10-12)
    Kurzfassung: Tafamidis kinetically stabilizes the tetrameric form of transthyretin (TTR) and thus may halt disease progression in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). In our explorative analysis, we aimed to investigate the treatment effect on functional capacity and cardiac biomarkers as well as cardiac function and structure using echocardiography and cardiac magnetic resonance imaging (CMR), and to compare patients treated with tafamidis with an untreated control cohort. Methods Consecutive ATTR-CM patients either received tafamidis 61mg (n=64) or tafamidis 20mg (n=23) or were assigned to an untreated control cohort (n=54) reflecting the natural history of the disease. Subsequently, we performed clinical, laboratory, echocardiography and CMR follow-up at a median of 9 to 12.5 months. Results Main results are summarized in Table 1. In brief, we observed evidence of improvement in functional capacity as measured by the 6-minute walk distance (6MWD) in tafamidis 61mg treated patients (baseline: 377.1m vs. follow-up: 383.2m, p=0.678) compared to a significant decline in mean 6MWD in untreated patients (388.1m vs. 336.4m, p=0.002; cohort comparison: p=0.005). Analysis of cardiac biomarkers revealed evidence of therapeutic response by a decrease in median NT-proBNP levels in patients treated with tafamidis 61mg (2633.0pg/mL vs. 2244.0pg/mL, p=0.366), whereas a significant increase was observed in untreated patients (2798.0pg/mL vs. 3422.0pg/mL, p & lt;0.001; cohort comparison: p & lt;0.001). Echocardiographic findings revealed evidence of approximate stabilization in mean left ventricular (LV) strain (−11.75% vs. −11.58%, p=0.534) and mean right ventricular (RV) strain (−14.18% vs. −13.72, p=0.377) in the tafamidis 61mg treatment cohort compared to significant deterioration of mean LV longitudinal function (−11.71% vs. −10.59%, p=0.001) and mean RV longitudinal function (−14.36% vs. −12.99%, p=0.038) in the untreated cohort (cohort comparison: p=0.030 and p=0.269). Furthermore, cardiac structural assessment by CMR showed a significant increase in mean LV mass (199.1g vs. 214.3g, p=0.040) and mean extracellular volume (50.52% vs. 55.96%, p=0.026) in untreated patients, suggesting increased progression of myocardial amyloid deposition. Conclusion Treatment with tafamidis in patients with ATTR-CM results in significant improvements in functional capacity and cardiac biomarkers, and shows marked benefits in functional as well as structural imaging parameters compared with an untreated control cohort. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Pfizer Inc.
    Materialart: Online-Ressource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehab724.1814
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2021
    ZDB Id: 2001908-7
    ZDB Id: 603098-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
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    Monitoring patisiran and inotersen treatment with quantitative SPECT/CT in hereditary transthyretin amyloid cardiomyopathy
    Oxford University Press (OUP) ; 2023
    In:  European Heart Journal Vol. 44, No. Supplement_2 ( 2023-11-09)
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 44, No. Supplement_2 ( 2023-11-09)
    Kurzfassung: Novel ribonucleic acid interference (RNAi) therapeutics such as patisiran and inotersen have been shown to benefit neurologic disease course and quality of life in patients with hereditary transthyretin amyloidosis (ATTRv). Purpose We aimed to determine treatment effects on myocardial amyloid load determined by quantitative single photon emission computed tomography/computed tomography (SPECT/CT) in patients with ATTRv-related cardiomyopathy (ATTRv-CM) and to identify nuclear imaging biomarkers to quantify and monitor response to therapy. Methods ATTRv-CM patients underwent [99mTc]-radiolabeled diphosphono-1,2-propanodicarboxylic acid ([99mTc] -DPD) scintigraphy and SPECT/CT imaging before and after 12 months of treatment with patisiran (n=5) or inotersen (n=4). Results Patisiran-treated patients had a significant reduction in cardiac uptake as measured by standardized uptake values (SUVpeak: 7.98 g/mL ±0.87 vs. 6.50 g/mL ±1.59, p=0.025, Figure 1A; SUVmax: 8.80 g/mL ±0.94 vs. 6.96 g/mL ±1.59, p=0.009, Figure 1B; SUVmean: 5.64 g/mL ±1.01 vs. 4.42 g/mL ±1.26, p=0.016, Figure 1C). Patients treated with inotersen showed evidence of stabilization in cardiac SUV uptake (SUVpeak: 8.56 g/mL ±2.25 vs. 7.99 g/mL ±1.90, p=0.665; SUVmax: 9.29 g/mL ±2.39 vs. 8.79 g/mL ±2.03, p=0.719; SUVmean: 5.07 g/mL ±1.46 vs. 4.86 g/mL ±0.95, p=0.834) but had significant deterioration in left ventricular (LV) function (LV cardiac index: 3.39 L/min/m2 ±0.04 vs. 2.94 L/min/m2 ±0.01, p=0.028, Figure 1D). Comparison of cardiac SUV uptake and longitudinal cardiac function revealed significant correlations between longitudinal changes in cardiac SUVpeak and LV global longitudinal strain (r=-0.658, p=0.027, Figure 1E) and right ventricular free wall longitudinal strain (r=-0.771, p=0.008, Figure 1F). Conclusions In conclusion, using serial quantitative SPECT/CT imaging, we demonstrated that patisiran treatment significantly reduces cardiac SUV uptake in ATTRv-CM patients, indicating regression of cardiac TTR amyloid. Our data suggest that quantitative SPECT/CT imaging may be a valid tool to quantify and monitor response to disease-specific RNAi therapeutic agents in ATTRv-CM patients.Figure 1Graphical Abstract
    Materialart: Online-Ressource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehad655.1887
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2023
    ZDB Id: 2001908-7
    ZDB Id: 603098-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
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    P139Feature tracking by cardiovascular magnetic resonance: left ventricular dysfunction predicts outcome in heart failure with preserved ejection fraction
    Oxford University Press (OUP) ; 2019
    In:  European Heart Journal - Cardiovascular Imaging Vol. 20, No. Supplement_2 ( 2019-06-01)
    Details
    In: European Heart Journal - Cardiovascular Imaging, Oxford University Press (OUP), Vol. 20, No. Supplement_2 ( 2019-06-01)
    Materialart: Online-Ressource
    ISSN: 2047-2404 , 2047-2412
    URL: Article
    DOI: 10.1093/ehjci/jez117.002
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2019
    ZDB Id: 2638345-7
    ZDB Id: 2647943-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
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    Right ventricular longitudinal strain on cardiovascular magnetic resonance imaging predicts outcome in patients undergoing transcatheter mitral valve repair
    Oxford University Press (OUP) ; 2021
    In:  European Heart Journal Vol. 42, No. Supplement_1 ( 2021-10-12)
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 42, No. Supplement_1 ( 2021-10-12)
    Kurzfassung: The prognostic value of left and right ventricular global longitudinal strain (LV and RV GLS) derived from cardiovascular magnetic resonance (CMR) feature tracking in patients with severe mitral regurgitation (MR) undergoing transcatheter mitral valve repair (TMVR) is unknown. Methods Consecutive patients scheduled for TMVR underwent pre-procedural and follow-up CMR imaging including feature tracking strain analysis. Kaplan-Meier estimates and multivariate Cox-regression analyses were used to identify the prognostic impact of LV and RV GLS on CMR using a composite of heart failure hospitalization and death. Results A total of 62 patients (78.3±7.0y/o, 45% female, EuroSCORE II: 9.7±7.2%) with severe MR underwent CMR prior to TMVR. 23 (37%) patients presented with right ventricular dysfunction (RVD) defined by RV GLS & gt;−20% on CMR. At baseline, RVD was associated with NT-proBNP levels (9510 vs. 4064pg/mL, p=0.030). On CMR, RVD was associated with reduced left and RV ejection fraction (LVEF: 39.2 vs. 48.7%, p=0.011, RVEF: 35.1 vs. 46.7%, p & lt;0.001), as well as increased LV GLS (−14.0 vs. −19.5%, p=0.003). A total of 18 events (12 deaths, 6 hospitalizations for heart failure) occurred during follow-up (mean 11.4±9.1months). While LV GLS was not significantly associated with outcome (HR 0.95, 95% CI: 0.90–1.01, p=0.082), RV GLS showed a strong and independent association with event-free survival by multivariate Cox-regression analysis (adj.HR 0.91, 95% CI: 0.83–0.99, p=0.033) after adjustment for relevant baseline and procedural data (EuroSCORE II, post-procedural residual MR), imaging parameters (TAPSE, LV and RVEF on CMR), and cardiac biomarkers (NT-proBNP). When compared with the “gold standard” RVEF on CMR (RVEF & lt;45%: adj.HR 0.86, 95% CI: 0.23–3.20, p=0.825) and TAPSE on echo (TAPSE & lt;17mm: adj.HR: 2.77, 95% CI: 0.72–10.70, p=0.140), only RVD (RV GLS & gt;−20%: adj.HR 5.05, 95% CI: 1.23–20.63, p=0.024) was significantly associated with the composite endpoint (Figure 1). Follow-up CMR was performed in 21 (34%) patients. RV GLS significantly improved after TMVR (−20.6 to −25.2%, p=0.016, Figure 2). Conclusions RV rather than LV GLS, as determined on CMR, is an important predictor of outcome in patients undergoing TMVR. At 1 year follow-up, RV function significantly improved, and thus might add useful prognostic information on top of established risk factors. Funding Acknowledgement Type of funding sources: None. Figure 1Figure 2
    Materialart: Online-Ressource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehab724.2220
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2021
    ZDB Id: 2001908-7
    ZDB Id: 603098-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
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    Hepatic T2-times on cardiovascular magnetic resonance imaging reflect liver fibrosis and predict outcome in an all-comer cohort
    Oxford University Press (OUP) ; 2021
    In:  European Heart Journal Vol. 42, No. Supplement_1 ( 2021-10-12)
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 42, No. Supplement_1 ( 2021-10-12)
    Kurzfassung: Non-alcoholic fatty liver disease (NAFLD) is associated with dismal outcomes in patients with cardiac disorders but infrequently assessed by cardiologists. Cardiovascular magnetic resonance (CMR) is evolving as one-stop-shop imaging modality in cardiology, allowing for non-invasive myocardial tissue characterization by T1-mapping. On standard CMR exams, hepatic tissue is also assessable on T1-maps. However, it is unknown whether hepatic T1-times are associated with 1) myocardial T1-times, 2) established NAFLD scores, and 3) outcomes in patients referred for CMR. Methods In consecutive patients undergoing CMR we assessed hepatic and myocardial T1-times, and the NAFLD Fibrosis Score (NFS). Correlation analyses were used to test the association between hepatic and myocardial T1-times as well as the NFS. We used Kaplan-Meier estimates and Cox-regression models to investigate the association between hepatic T1-times and a composite endpoint of heart failure hospitalization and cardiovascular death. Results 513 patients were included (57±18 y/o, 49% female). Hepatic T1-times were 588±98ms on average and were correlated with myocardial T1-times (r=0.42, p & lt;0.001) and – weakly – with the NFS (r=0.11, p=0.04). Patients with severe liver fibrosis or cirrhosis (n=47) had significantly higher hepatic T1-times as compared to patients with no or mild fibrosis based on the NFS (635±197ms versus 588±80ms, p=0.02). During follow-up (100±40 months), a total of 137 (27%) events occurred. When stratified by quartiles, patients in the highest hepatic T1-time quartile ( & gt;700ms) were at higher risk for events compared to all other quartiles (log-rank, p=0.01), which was consistent across different NAFLD risk groups based on the NFS (no/mild fibrosis, indeterminant score, severe fibrosis/cirrhosis). On Cox regression analyses, higher hepatic T1-times yielded significantly higher risk estimates for events (adj. HR 1.20 [95% CI: 1.04–1.38] per 1-SD inc rease, p=0.01) even when adjusted for age, sex, left and right ventricular ejection fractions, and myocardial T1-times. Conclusion Hepatic T1-times assessed on standard CMR reflect severity of NAFLD and predict outcome on top of established risk factors, including myocardial T1-times, in an all-comer CMR cohort. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Medical University of Vienna
    Materialart: Online-Ressource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehab724.0224
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2021
    ZDB Id: 2001908-7
    ZDB Id: 603098-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
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    Hepatic T1-time predicts cardiovascular risk in all-comers referred for cardiovascular magnetic resonance
    Oxford University Press (OUP) ; 2022
    In:  European Heart Journal Vol. 43, No. Supplement_2 ( 2022-10-03)
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 43, No. Supplement_2 ( 2022-10-03)
    Kurzfassung: Liver damage is frequently observed in patients with cardiovascular disease (CVD) but infrequently quantified. We hypothesized that in patients with CVD undergoing cardiac magnetic resonance (CMR), liver T1-times indicate liver damage and are associated with cardiovascular outcome. Methods We measured hepatic T1-times, displayed on standard cardiac T1-maps, in an all-comer CMR-cohort. At the time of CMR, we assessed validated general liver fibrosis scores. Kaplan-Meier estimates and Cox-regression models were used to investigate the association between hepatic T1-times and a composite endpoint of non-fatal myocardial infarction, heart failure hospitalization, and death. Results 1022 participants (58±18 y/o, 47% female) were included (972 patients, 50 controls). Hepatic T1-times were 590±89ms in patients and 574±45ms in controls (p=0.052). They were significantly correlated with cardiac size and function, presence of atrial fibrillation, NT-pro-BNP levels, and gamma-glutamyl-transferase levels (p & lt;0.001 for all). During follow-up (58±31 months), a total of 280 (29%) events occurred. On Cox-regression, high hepatic T1-times yielded a significantly higher risk for events (adj.HR 1.66 [95% CI: 1.45–1.89] per 100ms increase, p & lt;0.001), even when adjusted for age, sex, left and right ventricular ejection fraction, NT-proBNP, and myocardial T1-time. On restricted cubic splines, we found that a hepatic T1-time exceeding 610ms was associated with excessive risk. Conclusion Hepatic T1-times on standard CMR scans were significantly associated with cardiac size and function, comorbidities, natriuretic peptides, and independently predicted cardiovascular mortality and morbidity. A hepatic T1-time & gt;610ms seems to indicate excessive risk. Funding Acknowledgement Type of funding sources: None.
    Materialart: Online-Ressource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehac544.294
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2022
    ZDB Id: 2001908-7
    ZDB Id: 603098-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
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    Right ventricular global longitudinal strain on cardiovascular magnetic resonance imaging predicts outcome in patients undergoing transcatheter edge-to-edge mitral valve repair
    Oxford University Press (OUP) ; 2023
    In:  European Heart Journal Vol. 44, No. Supplement_2 ( 2023-11-09)
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 44, No. Supplement_2 ( 2023-11-09)
    Kurzfassung: Right ventricular dysfunction (RVD) on echocardiography was shown to predict outcomes in patients undergoing transcatheter edge-to-edge mitral valve repair (M-TEER). However, the prognostic value of left and RV global longitudinal strain (LV- and RV-GLS) on cardiovascular magnetic resonance feature tracking (CMR-FT) is unknown. Methods Consecutive M-TEER patients underwent pre-procedural and follow-up CMR-FT analysis. Kaplan-Meier estimates and multivariable Cox-regression analyses were performed, using a composite endpoint of heart failure hospitalization (HFH) and death. Results 62 patients (78.3±7.0y/o, 45% female, EuroSCORE-II: 9.6±7.1%) underwent CMR-FT prior to M-TEER, 24% had concomitant tricuspid edge-to-edge repair (T-TEER). On presentation, 23 (37%) patients suffered RVD, defined as RV-GLS & gt;-20% on CMR-FT. RVD was associated with reduced LV and RV ejection fraction (LVEF: 39 vs. 49%, p=0.01, RVEF: 35 vs. 47%, p & lt;0.01), as well as impaired LV-GLS (-14.0 vs. -19.5%, p=0.01). Eighteen events (12 deaths, 6 HFH) occurred during follow-up (11.4±9.1months). On multivariable Cox-regression adjusted for baseline, procedural, imaging, and biomarker data, RV but not LV-GLS was significantly associated with outcome (adj.HR 2.50, 95% CI: 1.29-4.86, p=0.01 and 1.46, 95% CI: 0.50-4.28, p=0.49, respectively). Among various definitions of RVD on echocardiography and CMR, only RV-GLS on CMR-FT was significantly associated with outcome (RV-GLS & gt;-20%: adj.HR 7.53, 95% CI: 2.07-27.42, p & lt;0.01), but not RVEF on CMR or echo-indices of RV function. Follow-up CMR-FT was performed in 21 (34%) patients and RV-GLS significantly improved after TMVR (-20.6 to -25.2%, p=0.02), irrespective of additional T-TEER. Conclusions RV-GLS, as determined on CMR-FT, rather than LV-GLS or RVEF, is an independent predictor of outcome in patients undergoing M-TEER.Central Illustration
    Materialart: Online-Ressource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehad655.198
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2023
    ZDB Id: 2001908-7
    ZDB Id: 603098-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    Epicardial adipose tissue is associated with an increased risk of mortality and hospitalizations in patients with heart failure with preserved ejection fraction
    Oxford University Press (OUP) ; 2023
    In:  European Heart Journal Vol. 44, No. Supplement_2 ( 2023-11-09)
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 44, No. Supplement_2 ( 2023-11-09)
    Kurzfassung: Accumulating evidence suggests that epicardial adipose tissue (EAT) plays a critical role in heart failure (HF). Previous studies raised the possibility of an association with mortality and hospitalizations, but data in preserved ejection fraction (HFpEF) is sparse. Purpose To investigate the association of epicardial fat measured by cardiac magnetic resonance imaging (CMR) with the combined end point of heart failure hospitalizations and cardiovascular death in patients with heart failure with preserved ejection fraction Methods In this secondary analysis of a prospective cohort study recruiting participants with HFpEF between July 2012 and March 2018 at a tertiary care centre. Patients with cardiac amyloidosis were excluded. The combined primary endpoint of this analysis consists of heart failure hospitalizations and cardiovascular mortality. The statistical analysis plan consisted of a Cox proportional hazard regression adjusted for multiple potential confounders. Adjustments were predefined and selected by their clinical relevance. EAT volume was measured using a modified Simpson rule, EAT area was measured in the four-chamber view. EAT was defined from visceral (immediately adhering the myocardium) to the parietal layer of the pericardium. Epi-pericardial tissue was excluded. We used dark blood steady-state free precision (SSFP) at end-diastole. If unavailable we used bright blood SSFP or true fast imaging with steady-state free precession. Results We studied 206 patients (69% women, mean age 71±9 years, median N-terminal prohormone of brain natriuretic peptide [NT-proBNP]: 1090 IQR 420 – 1997pg/mL). During mean follow-up of 78±35 months, 78 patients (37%) died of a cardiovascular cause. In multivariate analysis adjusting for age, gender, atrial fibrillation, left-ventricular ejection fraction (EF), right ventricular (RV) end-diastolic volume index, RVEF and NT-proBNP, EAT was significantly associated with a higher risk of the composite outcome (HR 1.07 [95% CI 1.02-1.12] , P = 0.007). Additional adjustments for hepatic-, renal- and pulmonary function as well as metabolic biomarkers did not materially change the results. There was no statistically significant association with pulmonary pressures on right heart catheterization. Conclusions EAT accumulation is associated with increased risk for mortality and hospitalizations in patients with HF with preserved ejection fraction. This finding supports the rational for future interventional studies of EAT in HFpEF. Conclusions EAT accumulation is associated with increased risk for mortality and hospitalizations in patients with HF with preserved ejection fraction. This finding supports the rational for future interventional studies of EAT in HFpEF.
    Materialart: Online-Ressource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehad655.757
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2023
    ZDB Id: 2001908-7
    ZDB Id: 603098-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
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    Right ventricular function and outcome in patients undergoing transcatheter mitral valve repair
    Oxford University Press (OUP) ; 2022
    In:  European Heart Journal Vol. 43, No. Supplement_2 ( 2022-10-03)
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 43, No. Supplement_2 ( 2022-10-03)
    Kurzfassung: This study sought to assess the impact of right ventricular dysfunction (RVD) on event-free survival after transcatheter mitral valve repair (TMVR) for severe mitral regurgitation. Background The prognostic value of left and RV global longitudinal strain (LV- and RV-GLS) on cardiovascular magnetic resonance feature tracking (CMR-FT) in patients undergoing TMVR is unknown. Methods Consecutive TMVR patients underwent pre-procedural and follow-up CMR-FT analysis. Kaplan-Meier estimates and multivariable Cox-regression analyses were performed, using a composite endpoint of heart failure hospitalization (HFH) and death. Results 62 patients (78.3±7.0y/o, 45% female, EuroSCORE-II: 9.6±7.1%) underwent CMR-FT prior to TMVR, 24% had concomitant tricuspid edge-to-edge repair (TTVR). On presentation, 23 (37%) patients suffered RVD, defined as RV-GLS & gt;−20% on CMR-FT. RVD was associated with reduced LV and RV ejection fraction (LVEF: 39.2 vs. 48.7%, p=0.008, RVEF: 35.1 vs. 46.7%, p & lt;0.001), as well as impaired LV-GLS (−14.0 vs. −19.5%, p=0.012). Eighteen events (12 deaths, 6 HFH) occurred during follow-up (11.4±9.1 months). On multivariable Cox-regression adjusted for baseline, procedural, imaging, and biomarker data, RV but not LV-GLS was significantly associated with outcome (adj.HR 2.50, 95% CI: 1.29–4.86, p=0.007 and 1.46, 95% CI: 0.50–4.28, p=0.491, respectively). Among various definitions of RVD on echocardiography and CMR, only RV-GLS on CMR-FT was significantly associated with outcome (RV-GLS & gt;−20%: adj.HR 7.53, 95% CI: 2.07–27.42, p=0.002), but not RVEF on CMR or echo-indices of RV function (Central Illustration). Follow-up CMR-FT was performed in 21 (34%) patients and RV-GLS significantly improved after TMVR (−20.6 to −25.2%, p=0.016), irrespective of additional TTVR. Conclusions RV-GLS, as determined on CMR-FT, rather than LV-GLS or RVEF, is an independent predictor of outcome in patients undergoing TMVR. Funding Acknowledgement Type of funding sources: None.
    Materialart: Online-Ressource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehac544.234
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2022
    ZDB Id: 2001908-7
    ZDB Id: 603098-1
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
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    Right atrial function in HFpEF in sinus rhythm vs. atrial fibrillation
    Oxford University Press (OUP) ; 2022
    In:  European Heart Journal Vol. 43, No. Supplement_2 ( 2022-10-03)
    Details
    In: European Heart Journal, Oxford University Press (OUP), Vol. 43, No. Supplement_2 ( 2022-10-03)
    Kurzfassung: We sought to study the prognostic impact of right atrial (RA) size and function in patients with heart failure with preserved ejection fraction (HFpEF) in sinus rhythm (SR) vs. atrial fibrillation (AF). Methods and results Consecutive HFpEF patients were enrolled and indexed RA volumes and emptying fractions (RA-EF) were assessed by cardiac magnetic resonance imaging (CMR). For patients in SR during CMR feature tracking of the RA wall was performed (Figure 1). In addition, all patients underwent right and left heart catheterization, 6 min walk test, and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) evaluation. We prospectively followed patients and used Cox regression models to determine the association of RA size and function with a composite endpoint of heart failure hospitalization and cardiovascular death. A total of 188 patients (71% female patients, 70±8 years old) were included of whom 96 (51%) were in SR. Eighty-five patients reached the combined endpoint during a follow-up of 72 (33–101) months. After multivariate cox regression analysis adjusted for age, NT-proBNP level, right ventricular ejection fraction and HF functional class, impaired RA strain (Figure 1A) (HR 0.959; 95% CI [0.924–0.996] , P=0.024), RA conduit strain (Figure 1A) (HR 0.944; 95% CI [0.898–0.993], P=0.027) and RA conduit strain rate (Figure 1B) (HR 0.990; 95% CI [0.883–0.998] , P=0.013) were significantly associated with adverse outcome for patients in SR (Table 1). In persistent AF, no RA imaging parameter was related to outcome after multivariate regression analysis. Conclusions In HFpEF patients in SR, CMR parameters of impaired RA conduit function show the best association with adverse cardiovascular outcome. In persistent AF, RA parameters lose their prognostic ability. Funding Acknowledgement Type of funding sources: None.
    Materialart: Online-Ressource
    ISSN: 0195-668X , 1522-9645
    URL: Article
    DOI: 10.1093/eurheartj/ehac544.784
    Sprache: Englisch
    Verlag: Oxford University Press (OUP)
    Publikationsdatum: 2022
    ZDB Id: 2001908-7
    ZDB Id: 603098-1
    Standort Signatur Einschränkungen Verfügbarkeit
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