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    Abstract 2260: Asymptomatic Patients with Severe Mitral Regurgitation and either Atrial Fibrillation or Pulmonary Hypertension Benefit from an Early Surgical Strategy
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Circulation Vol. 116, No. suppl_16 ( 2007-10-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 116, No. suppl_16 ( 2007-10-16)
    Abstract: Background. Degenerative mitral regurgitation (MR) is the second most frequent valvular heart disease in industrialized countries. Although there is consensus that valvular surgery should be advised in symptomatic patients (pts) with severe MR and in those with reduced LV function, there is persisting controversy regarding the optimal timing of intervention in asymptomatic pts with only atrial fibrillation or pulmonary hypertension, as shown by the corresponding class IIa recommendation in the recent guidelines. Methods. To test if asymptomatic pts with severe degenerative MR and either atrial fibrillation, pulmonary hypertension or both benefit from early surgery, the outcomes of 69 such pts (70 ± 12 years; 64% males) diagnosed by 2D-echo between 1990 and 2001 were analyzed. Pts with a LV ejection fraction below 60% or telesystolic diameter above 45 mm were not included. Group I comprised 46 pts undergoing mitral repair (within 3 months after diagnosis). Group II comprised 23 pts initially treated conservatively. Results. During follow-up, 3 Group II pts needed mitral surgery. Indications for surgery were according to class I current guidelines. Adjusted 10-year overall survival was better in Group I than in Group II pts (74 ± 8%, 11 ± 7%, p 〈 0.0001). Similarly, adjusted 10-year cardiac event free survival, including the need for (redo) surgery was better in Group I than in Group II pts (72 ± 7%, 10 ± 10%, p 〈 0.0001). Conclusion. Asymptomatic pts with severe MR complicated by either atrial fibrillation, pulmonary hypertension or both, clearly benefit from an early interventional strategy and should probably be operated on as soon as possible.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.116.suppl_16.II_493
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
    detail.hit.zdb_id: 1466401-X
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  • 2
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    Abstract 6115:Assessment of Circumferential and Longitudinal Strain using Speckle Tracking Echocardiography. Comparison With Tagged Cardiac Magnetic Resonance
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Circulation Vol. 118, No. suppl_18 ( 2008-10-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. suppl_18 ( 2008-10-28)
    Abstract: Background. Speckle tracking echocardiography (STE) is a new method that allows to quantitalively measure myocardial deformation in an angle-independent manner. The aim of this study was to evaluate the accuracy of STE-derived estimates of circumferential and longitudinal strains, in patients with variable degrees of LV dysfunction, using tagged cardiac magnetic resonance (cMR) as the reference standard. Methods. A total of 80 patients (66 men, mean age 54 ± 16 years) with a variety of cardiac diseases underwent STE and cMR on the same day. For circumferential strain, data were analyzed on matched short-axis cross-sections (at basal and apical levels) using either the QLab software (for STE) or HARP (for tagged cMR). For longitudinal strain, data were analyzed on similar 4-, 3- and 2-chamber views using either QLab (for STE) or a custom-made program that allows for tracking of cMR tags in long-axis projections (for tagged cMR). Results. 87% of myocardial segments could be analyzed. Correlation and limits of agreement between STE and cMR were good for both global (r = 0.95, p 〈 0.001 and 1.2 ± 5.1%, respectively) and segmental circumferential strain (r=0.84, p 〈 0.001 and 1.1 ± 9.9%, respectively, figure1 ). Correlation and limits of agreement between STE and cMR were similarly good for global (r =0.96, p 〈 0.001 and −0.1 ± 3.0%, respectively) and segmental longitudinal strain (r = 0.77, p 〈 0.001 and 0.2 ± 9.6%, respectively, figure1 ). Conclusions. STE provides accurate measurements of segmental circumferential and longitudinal strains and thus offers the opportunity to routinely assess these parameters in daily clinical practice.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.118.suppl_18.S_1064-a
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
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