Database : MEDLINE
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[PMID]: 29524154
[Au] Autor:Yilmaz P; Wallecan K; Kristanto W; Aben JP; Moelker A
[Ad] Address:Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Room Hs-220, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
[Ti] Title:Evaluation of a Semi-automatic Right Ventricle Segmentation Method on Short-Axis MR Images.
[So] Source:J Digit Imaging;, 2018 Mar 09.
[Is] ISSN:1618-727X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The purpose of this study was to evaluate a semi-automatic right ventricle segmentation method on short-axis cardiac cine MR images which segment all right ventricle contours in a cardiac phase using one seed contour. Twenty-eight consecutive short-axis, four-chamber, and tricuspid valve view cardiac cine MRI examinations of healthy volunteers were used. Two independent observers performed the manual and automatic segmentations of the right ventricles. Analyses were based on the ventricular volume and ejection fraction of the right heart chamber. Reproducibility of the manual and semi-automatic segmentations was assessed using intra- and inter-observer variability. Validity of the semi-automatic segmentations was analyzed with reference to the manual segmentations. The inter- and intra-observer variability of manual segmentations were between 0.8 and 3.2%. The semi-automatic segmentations were highly correlated with the manual segmentations (R 0.79-0.98), with median difference of 0.9-4.8% and of 3.3% for volume and ejection fraction parameters, respectively. In comparison to the manual segmentation, the semi-automatic segmentation produced contours with median dice metrics of 0.95 and 0.87 and median Hausdorff distance of 5.05 and 7.35 mm for contours at end-diastolic and end-systolic phases, respectively. The inter- and intra-observer variability of the semi-automatic segmentations were lower than observed in the manual segmentations. Both manual and semi-automatic segmentations performed better at the end-diastolic phase than at the end-systolic phase. The investigated semi-automatic segmentation method managed to produce a valid and reproducible alternative to manual right ventricle segmentation.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher
[do] DOI:10.1007/s10278-018-0061-3

  2 / 17996 MEDLINE  
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[PMID]: 29519359
[Au] Autor:Lauten A; Dreger H; Schofer J; Grube E; Beckhoff F; Jakob P; Sinning JM; Stangl K; Figulla HR; Laule M
[Ti] Title:Caval Valve Implantation for Treatment of Severe Tricuspid Regurgitation.
[So] Source:J Am Coll Cardiol;71(10):1183-1184, 2018 Mar 13.
[Is] ISSN:1558-3597
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review

  3 / 17996 MEDLINE  
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[PMID]: 29442199
[Au] Autor:Laish-Farkash A; Bruoha S; Khalameizer V; Yosefy C; Michowitz Y; Suleiman M; Katz A
[Ad] Address:Department of Cardiology, Assuta University Medical Center, Ashdod, Israel. avishagl@inter.net.il.
[Ti] Title:Multisite cardiac resynchronization therapy for traditional and non-traditional indications.
[So] Source:J Interv Card Electrophysiol;51(2):143-152, 2018 Mar.
[Is] ISSN:1572-8595
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:PURPOSE: Multisite cardiac resynchronization therapy (MSCRT) with dual-vein left ventricular (LV) pacing has theoretical advantages over conventional CRT in faster and more physiological LV activation. We aimed to define indications, feasibility, safety, acute, and long-term results of MSCRT. METHODS: All patients implanted with MSCRT during 2008-2014 in a single center were reviewed and analyzed. RESULTS: Thirty-nine patients (90% CRT-defibrillators, 64 ± 9 years, 85% male, 74% ischemic etiology) were included. Four groups of indications were recognized: (1) significant tricuspid regurgitation (TR) in patients planned for device implantation without right ventricular lead (n = 3). Follow-up (f/u) of 4 ± 3 years showed major symptomatic improvement in all, with stable LV size and function and deferral of valve surgery; (2) severe heart failure with reduced ejection fraction (HFrEF) and refractory ventricular tachycardia (VT) (n = 4). Except for 1 early death for acute renal failure, all others showed no VT episodes and HF improvement (f/u 4.5 ± 0.5 years); (3) severe HFrEF and wide QRS (≥ 150 ms) or failure of biventricular pacing to narrow QRS during implantation (n = 5). One patient had periprocedural mortality. The others had major clinical improvement; (4) severe HF and narrow QRS/RBBB (n = 27). 23/24 patients with available f/u of 3 ± 1.7 years improved clinically and 57% had EF improvement. In 3 patients, LV1 was disabled and one had LV2 dislodgement. CONCLUSIONS: MSCRT is feasible, safe, and valuable in selected patients with a need to avoid RV lead during device implantation, refractory VT with no other solution, severe HFrEF with wide QRS or CRT non-responsiveness, and severe HF without LBBB. Randomized controlled studies are required.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1007/s10840-018-0316-4

  4 / 17996 MEDLINE  
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[PMID]: 29432360
[Au] Autor:Poffo R; Montanhesi PK; Toschi AP; Pope RB; Mokross CA
[Ad] Address:From the Minimally Invasive and Robotic Cardiac Surgery Center, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
[Ti] Title:Periareolar Access for Minimally Invasive Cardiac Surgery: The Brazilian Technique.
[So] Source:Innovations (Phila);13(1):65-69, 2018 Jan/Feb.
[Is] ISSN:1559-0879
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The periareolar access has been the preferred technique used at our institution for minimally invasive cardiac surgery since 2006. The surgical approach consists of video-assisted minithoracotomy in the 4th right intercostal space, through a periareolar incision. Initially, the technique was restricted to minimally invasive mitral valve surgeries but, due to its feasibility and safety, was soon incorporated as an ideal access for other cardiac pathologies such as tricuspid valve disease, atrial septal defect, atrial fibrillation, and pacemaker leads endocarditis. The technique was performed in 214 patients, and it is associated with excellent aesthetic and functional results, with low morbimortality and no reoperations at long-term follow-up. Here, we describe and support the use of periareolar access as a routine surgical technique for correction of several cardiac pathologies, especially in women.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1097/IMI.0000000000000454

  5 / 17996 MEDLINE  
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[PMID]: 29515048
[Au] Autor:Tatsuishi W; Nakano K
[Ad] Address:Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East.
[Ti] Title:Progression of Functional Tricuspid Regurgitation With Aortic Valve Stenosis After Intervention.
[So] Source:Circ J;, 2018 Mar 08.
[Is] ISSN:1347-4820
[Cp] Country of publication:Japan
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1253/circj.CJ-18-0226

  6 / 17996 MEDLINE  
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[PMID]: 29514226
[Au] Autor:Petersen J; Voigtländer L; Schofer N; Neumann N; von Kodolitsch Y; Reichenspurner H; Girdauskas E
[Ad] Address:Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
[Ti] Title:Geometric changes in the aortic valve annulus during the cardiac cycle: impact on aortic valve repair.
[So] Source:Eur J Cardiothorac Surg;, 2018 Mar 05.
[Is] ISSN:1873-734X
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVES: The growing experience in aortic valve (AV) repair showed that annular stabilization is a crucial component to achieve stable long-term results after AV repair. Dynamic changes in the AV annulus during the cardiac cycle may have an impact on annuloplasty design. METHODS: We retrospectively analysed full cardiac cycle multislice computed tomography data from 58 consecutive patients (mean age 75.9 ± 6.5 years, 36% men) with normally functioning tricuspid AVs (normal AV subgroup). The following computed tomography parameters were measured during systole and diastole: maximum, minimum and mean AV annulus diameter, AV annular area and AV annular perimeter. The AV annular eccentricity index was calculated (%) [(max AV annulus × 100/min AV annulus) - 100] in systole and diastole. Subsequently, multislice computed tomography data from 20 patients with severe aortic regurgitation were analysed [aortic valve regurgitation (AR) subgroup]. RESULTS: In the normal AV subgroup, there was a significant decrease in the mean AV annulus diameter from systole to diastole (i.e. 24.6 ± 2.5 mm vs 23.9 ± 2.4 mm, respectively; P < 0.001), which occurred predominantly in the short annular axis (i.e. 21.2 ± 2.4 mm in systole vs 19.9 ± 2.3 mm in diastole; P < 0.001). The mean AV annular area decreased significantly in diastole (i.e. 467.5 ± 94.5 mm2 in systole vs 444.8 ± 86.1 mm2 in diastole; P = 0.012). The annular eccentricity index increased significantly in diastole (33.0 ± 12.2% in systole vs 41.4 ± 13.5% in diastole; P < 0.001). Furthermore, we found an inverse linear correlation between the mean AV annulus diameter and the annular eccentricity index (r = -0.40, P = 0.034). The diastolic annular eccentricity index was significantly reduced in the AR subgroup (i.e. 41.4 ± 13.5% in the normal AV subgroup vs 33.7 ± 14.8% in the AR cohort; P = 0.035). CONCLUSIONS: The normal AV annulus undergoes important geometric deformation during the cardiac cycle that is significantly reduced in diastole in the AR scenario. A novel AV annuloplasty system should ideally adapt for this marked diastolic annular eccentricity and thereby allow for dynamic aortic root changes during the cardiac cycle.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher
[do] DOI:10.1093/ejcts/ezy099

  7 / 17996 MEDLINE  
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[PMID]: 29355062
[Au] Autor:Dervisoglu P; Kosecik M; Kumbasar S
[Ad] Address:a Department of Pediatric Cardiology , Sakarya University School of Medicine, Sakarya Research and Education Hospital , Sakarya , Turkey.
[Ti] Title:Effects of gestational and pregestational diabetes mellitus on the foetal heart: a cross-sectional study.
[So] Source:J Obstet Gynaecol;38(3):408-412, 2018 Apr.
[Is] ISSN:1364-6893
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:We examined the foetal cardiac structural and functional characteristics in diabetic pregnancies versus non-diabetic, healthy pregnancies. Between August 2015 and April 2016, 32 pregnant women with pregestational diabetes, 36 pregnant women with gestational diabetes, and 42 healthy pregnant women were scheduled to have foetal echocardiograms to assess cardiac structure and function. In the diabetic groups, the foetal interventricular septum (IVS) thickness was significantly greater than in non-diabetics (p < .05) but none had an IVS >2 SD from normal. The peak velocity of tricuspid E, and the E/A ratio were significantly lower in the diabetic groups (p < .05). Tricuspid valve E values and the E /A ratio were lower in the diabetic group than in the control group (p < .05) but there was no significant difference between the pre-GDM and GDM groups (p > .05). Interventricular septal hypertrophy is the most common structural abnormality in diabetic pregnancies. These changes do not pose a risk to the foetal unless they cause functional impairment. Thus, we believe that it is important for diabetic pregnant women to be monitored for foetal cardiac diastolic dysfunction. Impact statement What is already known on this subject? Pregestational insulin-dependent diabetes mellitus is a relatively common condition in pregnancy, affecting up to 0.5% of the pregnant population. Foetuses of diabetic mothers are at an increased risk of perinatal morbidity and death. Gestational diabetes mellitus is under-recognised and affects up to 4% of pregnancies. Although diabetes mellitus is known to increase the risk of cardiovascular defects and structural changes (myocardial hypertrophy and diastolic dysfunction) due to foetal hyperglycaemia and hyperinsulinism, similar data in women with gestational diabetes is scarce. Moreover, the effect of maternal hyperglycaemia on foetal cardiac structure and function is unclear because of discordant results from previous studies. What do the results of this study add? In this study, we have used foetal echocardiography, two-dimensional US, pulsed wave Doppler and TDI to characterise the foetal cardiac structure and function in normal pregnancies as well as in the pregnancies complicated by GDM, and pregestational DM. Interventricular septum thickness is increased in women with pregestational diabetes mellitus and impaired diastolic function. The dominant right ventricle of the foetal circulation was affected earlier than the left ventricle. What are the implications of these findings for clinical practice and/or further research? Large population-based studies are required to establish the absolute risk of congenital heart defects in patients with pregestational diabetes and pregestational diabetes in the utility of routine screening.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.1080/01443615.2017.1410536

  8 / 17996 MEDLINE  
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[PMID]: 29351635
[Au] Autor:Dobrovie M; Spampinato RA; Efimova E; da Rocha E Silva JG; Fischer J; Kuehl M; Voigt JU; Belmans A; Ciarka A; Bonamigo Thome F; Schloma V; Dmitrieva Y; Lehmann S; Hahn J; Strotdrees E; Mohr FW; Garbade J; Meyer AL
[Ad] Address:Department of Cardiac Surgery, University of Leipzig, Leipzig Heart Center, Leipzig, Germany.
[Ti] Title:Reversibility of severe mitral valve regurgitation after left ventricular assist device implantation: single-centre observations from a real-life population of patients.
[So] Source:Eur J Cardiothorac Surg;, 2018 Jan 16.
[Is] ISSN:1873-734X
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:OBJECTIVES: This study evaluates the impact of untreated preoperative severe mitral valve regurgitation (MR) on outcomes after left ventricular assist device (LVAD) implantation. METHODS: Of the 234 patients who received LVAD therapy in our centre during a 6-year period, we selected those who had echocardiographic images of good quality and excluded those who underwent mitral valve replacement prior to or mitral valve repair during LVAD placement. The 128 patients selected were divided into 2 groups: Group A with severe MR (n = 65) and Group B with none to moderate MR (n = 63, 28 with moderate MR). We evaluated transthoracic echocardiography preoperatively [15 (7-28) days before LVAD implantation; median (interquartile range)] and postoperatively up to the last available follow-up [501 (283-848) days after LVAD]. We collected mortality, complications and clinical status indicators of the patient cohort. RESULTS: We observed a significant decrease in the severity of MR after LVAD implantation (severe MR 51% pre- vs 6% post-LVAD implantation, P < 0.001). There was no difference between groups in terms of right heart failure, rate of urgent heart transplantation, pump thrombosis or ventricular arrhythmias. There was no difference in 1-year survival and 3-year survival (87.7% vs 88.4% and 71.8% vs 66.6% for Groups A and B, respectively, P = 0.97). CONCLUSIONS: Preoperative severe MR resolves in the majority of patients early on after LVAD implantation and is not associated with worse clinical outcomes or intermediate-term survival.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/ejcts/ezx476

  9 / 17996 MEDLINE  
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[PMID]: 29346529
[Au] Autor:Ewen S; Karliova I; Weber P; Schirmer SH; Abdul-Khaliq H; Schöpe J; Mahfoud F; Schäfers HJ
[Ad] Address:Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Str., Geb. 40, 66421 Homburg/Saar, Germany.
[Ti] Title:Echocardiographic criteria to detect unicuspid aortic valve morphology.
[So] Source:Eur Heart J Cardiovasc Imaging;, 2018 Jan 15.
[Is] ISSN:2047-2412
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Aims: Unicuspid aortic valve (UAV) is a rare congenital malformation associated with severe aortic stenosis or regurgitation. This study aimed to systematically determine echocardiographic criteria to identify UAV. Methods and results: All patients underwent a preoperative baseline examination, including echocardiography. A total of 69 patients with intraoperatively confirmed UAV underwent an aortic valve repair procedure between August 2001 and May 2011. To compare the findings of UAV cases with those of other valve morphologies, we examined 99 consecutive patients with a bicuspid aortic valve (BAV) and 103 consecutive patients with a tricuspid aortic valve (TAV) undergoing isolated aortic valve surgery before May 2016. The mean age of the 271 patients was 44.2 ± 12.8 years; 85% were male, with a mean body mass index of 26.2 ± 4.0 kg/m2. Patients with UAV were younger and had fewer co-morbidities than patients with BAV or TAV, respectively. The major criteria for the echocardiographic diagnosis of UAV were defined based on our preoperative examination as follows: (i) single commissural attachment zone, (ii) rounded, leaflet-free edge on the opposite side of the commissural attachment zone, (iii) eccentric valvular orifice during systole, and (iv) patient age <20 years and mean transvalvular gradient >15 mmHg. The minor criteria were defined as an associated thoracic aortopathy and age <40 years. Three out of the four major criteria or two out of the four major criteria and one minor criterion were met in all patients with UAV and in none of the patients with BAV or TAV. Associated 95% confidence intervals were calculated for each estimate of sensitivity (94.7-100%) and specificity (98.1-100%), indicating that an adequate number of patients were included in each of the three groups. Conclusion: The proposed echocardiographic score appears to be a specific and sensitive method to distinguish UAV from BAV and TAV.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/ehjci/jex344

  10 / 17996 MEDLINE  
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[PMID]: 29325064
[Au] Autor:Dalén M; Oliveira Da Silva C; Sartipy U; Winter R; Franco-Cereceda A; Barimani J; Bäck M; Svenarud P
[Ad] Address:Department of Cardiac Surgery, Karolinska University Hospital, Stockholm, Sweden.
[Ti] Title:Comparison of right ventricular function after ministernotomy and full sternotomy aortic valve replacement: a randomized study.
[So] Source:Interact Cardiovasc Thorac Surg;, 2018 Jan 08.
[Is] ISSN:1569-9285
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Right ventricular (RV) function is impaired after cardiac surgery, possibly because of the opening of the pericardium. In minimally invasive aortic valve replacement, the pericardium is only partially incised. METHODS: A randomized trial compared RV function after ministernotomy versus full sternotomy in 40 adults undergoing aortic valve replacement at the Karolinska University Hospital. Primary outcomes were tricuspid annular plane systolic excursion, RV pulsed-wave tissue Doppler velocity, RV fractional area change and basal and mid-RV transversal diameters on postoperative Days 4 and 40. RESULTS: On postoperative Day 4, the tricuspid annular plane systolic excursion had decreased in both groups [ministernotomy: median (Q1-Q3) 25 (21-28) vs 16 (11-18), P < 0.001; sternotomy: 22.5 (22-22.5) vs 8 (7-12) mm, P < 0.001] but was higher in the ministernotomy group (P < 0.001). Pulsed-wave tissue Doppler RV velocity decreased significantly in patients who underwent sternotomy [10.5 (10-12) vs 6.5 (5-8) cm/s, P < 0.001] but did not decrease significantly in patients who underwent ministernotomy [11.5 (11-12) vs 10 (9-11) cm/s, P = 0.054]. Fractional area change was equally decreased in both groups [ministernotomy: 46 (39-51) vs 38 (34-44)%, P < 0.001; sternotomy: 45 (40-49) vs 37 (25-39.5)%, P = 0.003]. RV dimensions did not change on postoperative Day 4 in both groups. The differences between the 2 groups were similar 40 days postoperatively. CONCLUSIONS: RV long-axis function was reduced after both ministernotomy and full sternotomy aortic valve replacement, but the reduction was more pronounced in the full sternotomy group. Global RV function was equally impaired in both groups postoperatively. Clinical trial registration: http://www.clinicaltrials.gov. Unique identifier: NCT01972555.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Cl] Clinical Trial:ClinicalTrial
[St] Status:Publisher
[do] DOI:10.1093/icvts/ivx422


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