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  • 1.
    Almeida, Joao G.
    et al.
    Ctr Hosp Gaia Espinho, Dept Cardiol, R Conceicao Fernandes 1079, Vila Nova De Gaia, Portugal.
    Fontes-Carvalho, Ricardo
    Ctr Hosp Gaia Espinho, Dept Cardiol, R Conceicao Fernandes 1079, Vila Nova De Gaia, Portugal; Univ Porto, Dept Surg & Physiol, Fac Med, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal.
    Sampaio, Francisco
    Ctr Hosp Gaia Espinho, Dept Cardiol, R Conceicao Fernandes 1079, Vila Nova De Gaia, Portugal.
    Ribeiro, Jose
    Ctr Hosp Gaia Espinho, Dept Cardiol, R Conceicao Fernandes 1079, Vila Nova De Gaia, Portugal.
    Bettencourt, Paulo
    Univ Porto, Dept Med, Fac Med, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal.
    Flachskampf, Frank
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Leite-Moreira, Adelino
    Univ Porto, Dept Surg & Physiol, Fac Med, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal; Sao Joao Hosp Ctr, Dept Cardiothorac Surg, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal.
    Azevedo, Ana
    Univ Porto, Dept Clin Epidemiol, Predict Med & Publ Hlth, Fac Med, Alameda Prof Hernani Monteiro, P-4200319 Porto, Portugal; Univ Porto ISPUP, Inst Publ Hlth, Epidemiol Res Unit, EPIUnit, Rua Taipas 135, P-4050600 Porto, Portugal.
    Impact of the 2016 ASE/EACVI recommendations on the prevalence of diastolic dysfunction in the general population2018In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 19, no 4, p. 380-386Article in journal (Refereed)
    Abstract [en]

    Aims: Diastolic dysfunction (DD) is frequent in the general population; however, the assessment of diastolic function remains challenging. We aimed to evaluate the impact of the recent 2016 American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) recommendations in the prevalence and grades of DD compared with the 2009 guidelines and the Canberra Study Criteria (CSC).

    Methods and results: Within a population-based cohort, a total of 1000 individuals, aged ≥45 years, were evaluated retrospectively. Patients with previously known cardiac disease or ejection fraction <50% were excluded. Diastolic function was assessed by transthoracic echocardiography. DD prevalence and grades were determined according to the three classifications. The mean age was 62.0 ± 10.5 years and 37% were men. The prevalence of DD was 1.4% (n = 14) with the 2016 recommendations, 38.1% (n = 381) with the 2009 recommendations, and 30.4% (n = 304) using the CSC. The concordance between the updated recommendations and the other two was poor (from k = 0.13 to k = 0.18, P < 0.001). Regarding the categorization in DD grades, none of the 14 individuals with DD by the 2016 guidelines were assigned to Grade 1 DD, 64% were classified as Grade 2, 7% had Grade 3, and 29% had indeterminate grade.

    Conclusion: The application of the new 2016 ASE/EACVI recommendations resulted in a much lower prevalence of DD. The concordance between the classifications was poor. The updated algorithm seems to be able to diagnose only the most advanced cases.

  • 2.
    Almeida, Nuno
    et al.
    Katholieke University of Leuven, Belgium; GE Vingmed Ultrasound AS, Norway.
    Papachristidis, Alexandros
    Kings Coll Hospital London, England.
    Pearson, Peter
    Kings Coll Hospital London, England.
    Imre Sarvari, Sebastian
    University of Oslo, Norway.
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Edvardsen, Thor
    University of Oslo, Norway.
    Monaghan, Mark
    Kings Coll Hospital London, England.
    Gerard, Olivier
    GE Vingmed Ultrasound AS, Norway.
    Samset, Eigil
    GE Vingmed Ultrasound AS, Norway; University of Oslo, Norway.
    Dhooge, Jan
    Katholieke University of Leuven, Belgium.
    Left atrial volumetric assessment using a novel automated framework for 3D echocardiography: a multi-centre analysis2017In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 18, no 9, p. 1008-1015Article in journal (Refereed)
    Abstract [en]

    Aims This study aims at validating a software tool for automated segmentation and quantification of the left atrium (LA) from 3D echocardiography. Methods and results The LA segmentation tool uses a dual-chamber model of the left side of the heart to automatically detect and track the atrio-ventricular plane and the LA endocardium in transthoracic 3D echocardiography. The tool was tested in a dataset of 121 ultrasound images from patients with several cardiovascular pathologies (in a multi-centre setting), and the resulting volumes were compared with those assessed manually by experts in a blinded analysis using conventional contouring. Bland-Altman analysis showed good agreement between the automated method and the manual references, with differences (mean +/- 1.96 SD) of 0.5 +/- 5.7 mL for LA minimum volume and -1.6 +/- 9.7 mL for LA maximum volume (comparable to the inter-observer variability of manual tracings). The automated tool required no user interaction in 93% of the recordings, while 4% required a single click and only 2% required contour adjustments, reducing considerably the amount of time and effort required for LA volumetric analysis. Conclusion The automated tool was validated in a multi-centre setting, providing quantification of the LA volume over the cardiac cycle with minimal user interaction. The results of the automated analysis were in agreement with those estimated manually by experts. This study shows that such approach has clinical utility for the assessment of the LA morphology and function, automating and facilitating the time-consuming task of analysing 3D echocardiographic recordings.

  • 3.
    Baron, Tomasz
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Christersson, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Hjorthén, Gustav
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Hedin, Eva-Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Flachskampf, Frank
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Changes in global longitudinal strain and left ventricular ejection fraction during the first year after myocardial infarction: results from a large consecutive cohort2018In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 19, no 10, p. 1165-1173Article in journal (Refereed)
    Abstract [en]

    Aims: To determine changes of global longitudinal strain (GLS) and their predictors in relation to classical echocardiographic parameters of left ventricular (LV) function, over 1 year, in consecutive patients with myocardial infarction (MI) and initially normal or impaired LV ejection fraction (EF).

    Methods and results: A total of 285 patients with MI prospectively included in the REBUS (RElevance of Biomarkers for future risk of thromb-oembolic events in UnSelected post-myocardial infarction patients) study underwent echocardiography within 72 h from admission and after 1 year. At baseline, 213 (74.7%) of MI patients had a normal EF (≥52% in men or ≥54% in women), but in 70.4% of them, an impaired GLS ( ≥ -18.0%) was observed. During 1-year follow-up, in patients with normal EF at baseline, GLS improved from -15.8% to - 17.4% (10.1% relative change); EF decreased from 62.5% to 59.9% (4.0% relative change); indexed end-diastolic volume, indexed end-systolic volume, and indexed stroke volume increased with 15.6%, 24.8%, and 10.0% of relative change, respectively (P < 0.001 for all the comparisons). In the whole cohort, initial impairment of LV function [by EF, wall motion score index (WMSI), or GLS], male gender, non-smoking, and treatment with beta-blockers were the independent predictors of GLS improvement. In the group with initially impaired EF, over 1 year GLS improved from -11.9% to - 14.8% (24.4% relative change) and EF from 44.6% to 52.6% (18.2% relative change) (P < 0.001 for both). Improvement in GLS significantly correlated with EF increase in the group with impaired EF (r = -0.41, P = 0.001) but not in the patients with normal EF (r = -0.14, P = ns).

    Conclusions: Despite diveregent evolution of GLS compared with EF and ventricular volumes, one year after MI GLS significantly improved in patients with initially both normal and impaired EF. Initial impairment of LV function (by EF, WMSI, or GLS), male gender, non-smoking, and treatment with beta-blockers were independent predictors of GLS improvement. LV remodelling was present even in patients with normal EF at baseline and during follow-up, confirming limited functional assessment by EF alone.

  • 4.
    Baron, Tomasz
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Flachskampf, Frank A
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Johansson, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Hedin, Eva-Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology-Arrhythmia.
    Christersson, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Usefulness of traditional echocardiographic parameters in assessment of left ventricular function in patients with normal ejection fraction early after acute myocardial infarction: results from a large consecutive cohort2016In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 17, no 4, p. 413-420Article in journal (Refereed)
    Abstract [en]

    AIMS: The aim of this study was to assess the frequency of left ventricular (LV) systolic function impairment using classical echocardiographic parameters and their relation to myocardial damage in patients hospitalized for acute myocardial infarction (MI) with normal LV ejection fraction (LVEF ≥52% in males or ≥54% in females).

    METHODS AND RESULTS: All 421 consecutive patients with MI included in the REBUS (RElevance of Biomarkers for future risk of thromboembolic events in UnSelected post-myocardial infarction patients) study underwent two-dimensional and Doppler echocardiography within 72 h after admission. A normal LVEF was present in 262 (73.8%) of the 355 patients ultimately enrolled in the study. Patients with normal LVEF more often presented with non-ST-elevation myocardial infarction and had less comorbidities when compared with those with impaired LVEF. No differences in demographic factors or relevant medications were observed. Higher value of mean annular plane systolic excursion (MAPSE), lower wall motion score index (WMSI), lower LV as well as left atrial volumes characterized patients with normal LVEF. Impaired MAPSE was present in 64.4%, WMSI >1 in 72.1%, and dilated left atrium in 33.6% of those patients. Maximal cardiac troponin concentration reflecting infarct size showed the strongest association with WMSI (β = 0.35), followed by LVEF (β = -0.29), MAPSE (β = -0.25), and indexed LV end-systolic volume (β = 0.19; P < 0.001 for all the models).

    CONCLUSION: In two-third of patients with MI and normal LVEF, at least one of the other markers of systolic function was outside of the normal range. WMSI reflected the size of MI better than global LV function parameters as LVEF or MAPSE.

  • 5. Bertella, E
    et al.
    Baggiano, A
    Petulla', M
    Mushtaq, S
    Beltrama, V
    Gripari, P
    Conte, E
    Russo, E
    Andreini, D
    Pontone, G
    Soukka, I
    Maaniitty, T
    Saraste, A
    Uusitalo, V
    Ukkonen, H
    Kajander, S
    Maki, M
    Bax, J
    Knuuti, J
    De Graaf, M A
    Caselli, C
    Lorenzoni, V
    Rovai, D
    Marinelli, M
    Del Ry, S
    Giannessi, D
    Bax, J J
    Scholte, A J
    Neglia, D
    Thackeray, J T
    Korf-Klingebiel, M
    Wang, Y
    Kustikova, O
    Bankstahl, J P
    Wollert, K C
    Bengel, F M
    Harms, H J
    Tolbod, L P
    Hansson, N H
    Kim, W Y
    Bouchelouche, K
    Wiggers, H
    Frokiaer, J
    Sörensen, Jens
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Maaniitty, T
    Stenstrom, I
    Saraste, A
    Uusitalo, V
    Ukkonen, H
    Kajander, S
    Maki, M
    Bax, J
    Knuuti, J
    Young Investigator Award Competition: Sunday 3 May 2015, 082015In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 16 Suppl 1Article in journal (Refereed)
  • 6.
    Blomstrand, Peter
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. City Hospital Ryhov, Jönköping, Sweden.
    Engvall, Martin
    Linköping University.
    Festin, Karin
    Linköping University.
    Lindstrom, Torbjorn
    Linköping University.
    Länne, Toste
    Linköping University.
    Maret, Eva
    Karolinska University Hospital, Stockholm.
    Nyström, Fredrik H.
    Linköping University.
    Maret-Ouda, John
    Karolinska University Hospital, Stockholm.
    Östgren, Carl Johan
    Linköping University.
    Engvall, Jan
    Linköping University.
    Left ventricular diastolic function, assessed by echocardiography and tissue Doppler imaging, is a strong predictor of cardiovascular events, superior to global left ventricular longitudinal strain, in patients with type 2 diabetes2015In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 16, no 9, p. 1000-1007Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of the study was to determine whether left ventricular systolic function, in terms of global left ventricular longitudinal strain (GLS), and diastolic function, expressed as the ratio between early diastolic transmitral flow and mitral annular motion velocities (E/e'), can predict cardiovascular events in patients with diabetes mellitus type 2.

    Methods and results: We prospectively investigated 406 consecutive patients, aged 55-65 years, with diabetes mellitus, who participated in the CARDIPP study. Echocardiography, pulse pressure (pp), and glycosylated haemoglobin (HbA1c) were analysed. Twelve cases of myocardial infarction and seven cases of stroke were identified during the follow-up period of 67 +/- 17 months. Univariate Cox regression analysis showed that E/e' was a strong predictor of cardiovascular events (hazards ratio 1.12; 95% confidence interval 1.06-1.18, P < 0.001). E/e' was prospectively associated with cardiovascular events independent of age, sex, GLS, left ventricular ejection fraction (LVEF), pp, and HbA1c in multivariate analysis. Receiver operating characteristic curves showed that E/e' and HbA1c were the strongest predictors for cardiovascular events, both having an area under the curve (AUC) of 0.71 followed by LVEF with an AUC of 0.65 and GLS of 0.61. In a Kaplan-Meyer analysis, the cumulative probability of an event during the follow-up period was 8.6% for patients with an E/e' ratio >15 compared with 2.6% for patients with E/e' <= 15, P = 0.011.

    Conclusion: In middle-aged patients with type 2 diabetes, E/e' is a strong predictor of myocardial infarction and stroke, comparable with HbA1c and superior to GLS and LVEF.

  • 7. Bouyoucef, S E
    et al.
    Uusitalo, V
    Kamperidis, V
    De Graaf, M A
    Maaniitty, T
    Stenstrom, I
    Broersen, A
    Scholte, A J
    Saraste, A
    Bax, J J
    Knuuti, J
    Furuhashi, T
    Moroi, M
    Awaya, T
    Masai, H
    Minakawa, M
    Kunimasa, T
    Fukuda, H
    Sugi, K
    Berezin, A
    Kremzer, A
    Clerc, O F
    Kaufmann, B
    Possner, M
    Liga, R
    Vontobel, J
    Mikulicic, F
    Graeni, C
    Benz, D C
    Kaufmann, P A
    Buechel, R B
    Ferreira, Mjv
    Cunha, M J
    Albuquerque, A
    Ramos, D
    Costa, G
    Lima, J
    Pego, M
    Peix, A
    Cisneros, L
    Cabrera, L O
    Padron, K
    Rodriguez, L
    Heres, F
    Carrillo, R
    Mena, E
    Fernandez, Y
    Huizing, E D
    Van Dijk, J D
    Van Dalen, J A
    Timmer, J R
    Ottervanger, J P
    Slump, C H
    Jager, P L
    Venuraju, S
    Jeevarethinam, A
    Yerramasu, A
    Atwal, S
    Mehta, V S
    Lahiri, A
    Arjonilla Lopez, A
    Calero Rueda, M J
    Gallardo, G
    Fernandez-Cuadrado, J
    Hernandez Aceituno, D
    Sanchez Hernandez, J
    Yoshida, H
    Mizukami, A
    Matsumura, A
    Smettei, O
    Abazid, R
    Sayed, S
    Mlynarska, A
    Mlynarski, R
    Golba, K
    Sosnowski, M
    Winther, S
    Svensson, M
    Jorgensen, H S
    Bouchelouche, K
    Gormsen, L C
    Holm, N R
    Botker, H E
    Ivarsen, P R
    Bottcher, M
    Cortes, C M
    Aramayo G, E N
    Daicz, M
    Casuscelli, J F
    Alaguibe, E D
    Neira Sepulveda, A
    Cerda, M
    Ganum, G E
    Embon, M
    Vigne, J
    Enilorac, B
    Lebasnier, A
    Valancogne, L
    Peyronnet, D
    Manrique, A
    Agostini, D
    Menendez, D
    Rajpal, S
    Kocherla, C
    Acharya, M
    Reddy, P
    Sazonova, I
    Ilushenkova, Yun
    Batalov, R E
    Rogovskaya, Y V
    Lishmanov, Y B
    Popov, S V
    Varlamova, N V
    Prado Diaz, S
    Jimenez Rubio, C
    Gemma, D
    Refoyo Salicio, E
    Valbuena Lopez, S C
    Moreno Yanguela, M
    Torres, M
    Fernandez-Velilla, M
    Lopez-Sendon, J L
    Guzman Martinez, G
    Puente, A
    Rosales, S
    Martinez, C
    Cabada, M
    Melendez, G M
    Ferreira, R
    Gonzaga, A
    Santos, J
    Vijayan, S
    Smith, Smg
    Smith, M
    Muthusamy, R
    Takeishi, Y
    Oikawa, M
    Goral, J L
    Napoli, J
    Montana, O R
    Damico, A C
    Quiroz, M C
    Damico, A E
    Forcada, P J
    Schmidberg, J M
    Zucchiatti, N E
    Olivieri, D B
    Jeevarethinam, A
    Venuraju, S
    Dumo, A
    Ruano, S
    Rakhit, R
    Davar, J
    Nair, D
    Cohen, M
    Darko, D
    Lahiri, A
    Yokota, S
    Ottervanger, J P
    Maas, Ahe
    Mouden, M
    Timmer, J R
    Knollema, S
    Jager, P L
    Sanja Mazic, S M
    Lazovic, B
    Marina Djelic, Mdj
    Jelena Suzic Lazic, J S
    Tijana Acimovic, T A
    Milica Deleva, M D
    Vesnina, Z H
    Zafrir, N
    Bental, T
    Mats, I
    Solodky, A
    Gutstein, A
    Hasid, Y
    Belzer, D
    Kornowski, R
    Ben Said, Rim
    Ben Mansour, N
    Ibn Haj Amor, H
    Chourabi, C
    Hagui, A
    Fehri, W
    Hawala, H
    Shugushev, Z
    Patrikeev, A
    Maximkin, D
    Chepurnoy, A
    Kallianpur, V
    Mambetov, A
    Dokshokov, G
    Teresinska, A
    Wozniak, O
    Maciag, A
    Wnuk, J
    Dabrowski, A
    Czerwiec, A
    Jezierski, J
    Biernacka, K
    Robinson, J
    Prosser, J
    Cheung, Gsm
    Allan, S
    Mcmaster, G
    Reid, S
    Tarbuck, A
    Martin, W
    Queiroz, R C
    Falcao, A
    Giorgi, McP
    Imada, R
    Nogueira, S A
    Chalela, W A
    Kalil Filho, R
    Meneghetti, W A
    Matveev, V V
    Bubyenov, A S
    Podzolkov, V I
    Shugushev, Z
    Maximkin, D
    Chepurnoy, A
    Baranovich, V
    Faibushevich, A
    Kolzhecova, Y
    Volkova, O
    Kallianpur, V
    Peix, A
    Cabrera, L O
    Padron, K
    Rodriguez, L
    Fernandez, J
    Lopez, G
    Mena, E
    Fernandez, Y
    Dondi, M
    Paez, D
    Butcher, Cjt
    Reyes, E
    Al-Housni, M B
    Green, R
    Santiago, H
    Ghiotto, F
    Hinton-Taylor, S
    Pottle, A
    Mason, M
    Underwood, S R
    Casans Tormo, I
    Diaz-Exposito, R
    Plancha-Burguera, E
    Elsaban, K
    Alsakhri, Hijji
    Yoshinaga, K
    Ochi, N
    Tomiyama, Y
    Katoh, C
    Inoue, M
    Nishida, M
    Suzuki, E
    Manabe, O
    Ito, Y M
    Tamaki, N
    Tahilyani, A
    Jafary, Fahim
    Ho Hee Hwa, H H
    Ozdemir, S
    Kirilmaz, B
    Barutcu, A
    Tan, Y Z
    Celik, F
    Sakgoz, S
    Cabada Gamboa, M
    Puente Barragan, A
    Morales Vitorino, N
    Medina Servin, M A
    Hindorf, C
    Akil, S
    Hedeer, F
    Jogi, J
    Engblom, H
    Martire, V D
    Pis Diez, E R
    Martire, M V
    Portillo, D O
    Hoff, C M
    Balche, A
    Majgaard, J
    Tolbod, L P
    Harms, H J
    Bouchelouche, K
    Soerensen, J
    Froekiaer, J
    Gormsen, L C
    Nudi, F
    Neri, G
    Procaccini, E
    Pinto, A
    Vetere, M
    Biondi-Zoccai, G
    Falcao, A
    Chalela, W A
    Giorgi, McP
    Imada, R
    Soares, J
    Do Val, R
    Oliveira, M A
    Kalil Filho, R
    Meneghetti, J C
    Tekabe, Y
    Anthony, T
    Li, Q
    Schmidt, A M
    Johnson, L
    Groenman, M
    Tarkia, M
    Kakela, M
    Halonen, P
    Kiviniemi, T
    Pietila, M
    Yla-Herttuala, S
    Knuuti, J
    Roivainen, A
    Saraste, A
    Nekolla, S
    Swirzek, S
    Higuchi, T
    Reder, S
    Schachoff, S
    Bschorner, M
    Laitinen, I
    Robinson, S
    Yousefi, B
    Schwaiger, M
    Kero, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Lindsjo, L
    Antoni, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Westermark, P
    Carlson, K
    Wikstrom, G
    Sörensen, Jens
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Lubberink, Mark
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Rouzet, F
    Cognet, T
    Guedj, K
    Morvan, M
    El Shoukr, F
    Louedec, L
    Choqueux, C
    Nicoletti, A
    Le Guludec, D
    Jimenez-Heffernan, A
    Munoz-Beamud, F
    Sanchez De Mora, E
    Borrachero, C
    Salgado, C
    Ramos-Font, C
    Lopez-Martin, J
    Hidalgo, M L
    Lopez-Aguilar, R
    Soriano, E
    Okizaki, A
    Nakayama, M
    Ishitoya, S
    Sato, J
    Takahashi, K
    Burchert, I
    Caobelli, F
    Wollenweber, T
    Nierada, M
    Fulsche, J
    Dieckmann, C
    Bengel, F M
    Shuaib, S
    Mahlum, D
    Port, S
    Gemma, D
    Refoyo, E
    Cuesta, E
    Guzman, G
    Lopez, T
    Valbuena, S
    Fernandez-Velilla, M
    Del Prado, S
    Moreno, M
    Lopez-Sendon, J L
    Harbinson, M
    Donnelly, L
    Einstein, A J
    Johnson, L L
    Deluca, A J
    Kontak, A C
    Groves, D W
    Stant, J
    Pozniakoff, T
    Cheng, B
    Rabbani, L E
    Bokhari, S
    Caobelli, F
    Schuetze, C
    Nierada, M
    Fulsche, J
    Dieckmann, C
    Bengel, F M
    Aguade-Bruix, S
    Pizzi, M N
    Romero-Farina, G
    Terricabras, M
    Villasboas, D
    Castell-Conesa, J
    Candell-Riera, J
    Brunner, S
    Gross, L
    Todica, A
    Lehner, S
    Di Palo, A
    Niccoli Asabella, A
    Magarelli, C
    Notaristefano, A
    Ferrari, C
    Rubini, G
    Sellem, A
    Melki, S
    Elajmi, W
    Hammami, H
    Ziadi, M C
    Montero, J
    Ameriso, J L
    Villavicencio, R L
    Benito Gonzalez, T F
    Mayorga Bajo, A
    Gutierrez Caro, R
    Rodriguez Santamarta, M
    Alvarez Roy, L
    Martinez Paz, E
    Barinaga Martin, C
    Martin Fernandez, J
    Alonso Rodriguez, D
    Iglesias Garriz, I
    Gemma, D
    Refoyo, E
    Cuesta, E
    Guzman, G
    Valbuena, S
    Rosillo, S
    Del Prado, S
    Torres, M
    Moreno, M
    Lopez-Sendon, J L
    Taleb, S
    Cherkaoui Salhi, G
    Regbaoui, Y
    Ait Idir, M
    Guensi, A
    Puente, A
    Rosales, S
    Martinez, C
    Cabada, M
    Benito Gonzalez, T F
    Mayorga Bajo, A
    Gutierrez Caro, R
    Rodriguez Santamarta, M
    Alvarez Roy, L
    Martinez Paz, E
    Martin Lopez, C E
    Castano Ruiz, M
    Martin Fernandez, J
    Iglesias Garriz, I
    Poster Session 2: Monday 4 May 2015, 082015In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 16 Suppl 1Article in journal (Refereed)
  • 8. Danad, Ibrahim
    et al.
    Raijmakers, Pieter G.
    Harms, Hendrik J.
    van Kuijk, Cornelis
    van Royen, Niels
    Diamant, Michaela
    Lammertsma, Adriaan A.
    Lubberink, Mark
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Section of Nuclear Medicine and PET.
    van Rossum, Albert C.
    Knaapen, Paul
    Effect of cardiac hybrid O-15-water PET/CT imaging on downstream referral for invasive coronary angiography and revascularization rate2014In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 15, no 2, p. 170-179Article in journal (Refereed)
    Abstract [en]

    This study evaluates the impact of hybrid imaging on referral for invasive coronary angiography (ICA) and revascularization rates. A total of 375 patients underwent hybrid O-15-water positron emission tomography (PET)/computed tomography (CT)-based coronary angiography (CTCA) imaging for the evaluation of coronary artery disease (CAD). Downstream treatment strategy within a 60-day period after hybrid PET/CTCA imaging for ICA referral and revascularization was assessed. CTCA examinations were classified as showing no (obstructive) CAD, equivocal (borderline test result), or obstructive CAD, while the PET perfusion images were classified into normal or abnormal. On the basis of CTCA imaging, 182 (49) patients displayed no (obstructive) CAD. Only 10 (5) patients who showed no (obstructive) CAD on CTCA were referred for ICA, which were all negative. An equivocal CT study was observed in 80 (21) patients, among whom 56 (70) showed normal myocardial perfusion imaging (MPI), resulting in referral rates for ICA of 18 for normal MPI and 71 for abnormal MPI, respectively. No revascularizations were performed in the presence of normal MPI, while 59 of those with abnormal MPI were revascularized. CTCA indentified obstructive CAD in 113 (30) patients accompanied in 59 (52) patients with abnormal MPI. Referral rate for ICA was 57 for normal MPI and 88 for those with abnormal MPI, resulting in revascularization rates of 26 and 72, respectively. Hybrid O-15-water PET/CTCA imaging impacts clinical decision-making with regard to referral for ICA and revascularization procedures. Particularly, in the presence of an equivocal or abnormal CTCA, MPI could guide in the decision to refer for ICA and revascularization.

  • 9.
    Delgado, Victoria
    et al.
    Leiden Univ, Med Ctr, Dept Cardiol, Albinusdreff 2, NL-2300 RC Leiden, Netherlands..
    Cardim, Nuno
    Hosp da Luz, Dept Cardiol, Lisbon, Portugal.;Univ Nova Lisboa, Fac Ciencias Med, Lisbon, Portugal..
    Cosyns, Bernard
    Univ Ziekenhuis Brussel, CHVZ, Brussels, Belgium..
    Donal, Erwan
    CHU Rennes, Cardiol, Rennes, France.;CHU Rennes, CIC 1414, Rennes, France.;Univ Rennes 1, LTSI INSERM 1099, Rennes, France..
    Flachskampf, Frank
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Galderisi, Maurizio
    Federico II Univ Hosp, Dept Adv Biomed Sci, Naples, Italy..
    Gerber, Bernhard
    Clin Univ St Luc, Inst Rech Clin & Expt, Cardiovasc Ctr, Div Cardiol, Brussels, Belgium..
    Gimelli, Alessia
    CNR, Fdn Toscana, Pisa, Italy..
    Haugaa, Kristina H.
    Natl Hosp Norway, Oslo Univ Hosp, Ctr Cardiol Innovat, Dept Cardiol, Oslo, Norway.;Univ Oslo, Inst Clin Med, Oslo, Norway..
    Kaufmann, Philipp A.
    Univ Hosp Zurich, Cardiac Imaging, Dept Nucl Med, Zurich, Switzerland.;Univ Zurich, Zurich, Switzerland..
    Lancellotti, Patrizio
    CHU SantTilman, GIGA Cardiovasc Sci, Univ Liege Hosp, Dept Cardiol, Liege, Belgium.;Anthea Hosp, Grp Villa Maria Care & Res, Bari, Italy..
    Magne, Julien
    Hop Dupuytren, Serv Cardiol, CHU Limoges, Limoges, France.;Fac Med Limoges, INSERM 1094, 2 Rue Marcland, F-87000 Limoges, France..
    Masci, Pier Giorgio
    Lausanne Univ Hosp, Ctr Cardiac MRI, Rue Bugnon 46, CH-1011 Lausanne, Switzerland..
    Muraru, Denisa
    Univ Padua, Dept Cardiac Vasc & Thorac Sci, Padua, Italy..
    Habib, Gilbert
    La Timone Hosp, APHM, Dept Cardiol, Marseille, France.;Aix Marseille Univ, IRD, APHM, MEPHI,IHU Mediterranee Infect, Marseille, France..
    Edvardsen, Thor
    Natl Hosp Norway, Oslo Univ Hosp, Dept Cardiol, Oslo, Norway.;Univ Oslo, Oslo, Norway..
    Popescu, Bogdan A.
    Univ Med & Pharm Carol Davila, Euroecolab, Inst Cardiovasc Dis Prof Dr CC Iliescu, Bucharest, Romania..
    Criteria for recommendation, expert consensus, and appropriateness criteria papers: update from the European Association of Cardiovascular Imaging Scientific Documents Committee2018In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 19, no 8, p. 835-837Article in journal (Other academic)
  • 10.
    Eriksson, Jonatan
    et al.
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences.
    Bolger, Ann F.
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Clinical Physiology UHL.
    Ebbers, Tino
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Linköping University, Department of Science and Technology, Media and Information Technology.
    Carlhäll, Carl-Johan
    Linköping University, Center for Medical Image Science and Visualization, CMIV. Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Clinical Physiology UHL.
    Four-dimensional blood flow-specific markers of LV dysfunction in dilated cardiomyopathy2013In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 14, no 5, p. 417-424Article in journal (Refereed)
    Abstract [en]

    Aims : Patients with mild heart failure (HF) who are clinically compensated may have normal left ventricular (LV) stroke volume (SV). Despite this, altered intra-ventricular flow patterns have been recognized in these subjects. We hypothesized that, compared with normal LVs, flow in myopathic LVs would demonstrate a smaller proportion of inflow volume passing directly to ejection and diminished the end-diastolic preservation of the inflow kinetic energy (KE).

    Methods and results : In 10 patients with dilated cardiomyopathy (DCM) (49 ± 14 years, six females) and 10 healthy subjects (44 ± 17 years, four females), four-dimensional MRI velocity and morphological data were acquired. A previously validated method was used to separate the LV end-diastolic volume (EDV) into four flow components based on the blood's locations at the beginning and end of the cardiac cycle. KE was calculated over the cardiac cycle for each component. The EDV was larger (P = 0.021) and the ejection fraction smaller (P < 0.001) in DCM compared with healthy subjects; the SV was equivalent (DCM: 77 ± 19, healthy: 79 ± 16 mL). The proportion of the total LV inflow that passed directly to ejection was smaller in DCM (P = 0.000), but the end-diastolic KE/mL of the direct flow was not different in the two groups (NS).

    Conclusion : Despite equivalent LVSVs, HF patients with mild LV remodelling demonstrate altered diastolic flow routes through the LV and impaired preservation of inflow KE at pre-systole compared with healthy subjects. These unique flow-specific changes in the flow route and energetics are detectable despite clinical compensation, and may prove useful as subclinical markers of LV dysfunction.

  • 11. Ferreira, Mjv
    et al.
    Robalo, M M
    Saraiva, T
    Cunha, M J
    Goncalves, L
    Albuquerque, A
    Ramos, D
    Costa, G
    Lima, J
    Pego, M
    Peovska, I
    Davceva Pavlovska, J
    Pop Gorceva, D
    Zdravkovska, M
    Vavlukis, M
    Kostova, N
    Bulugahapitiya, D S
    Feben, A
    Avison, M
    Foley, J
    Martin, J
    De Graaf, M A
    Van Den Hoogen, I J
    Leen, A C
    Kharagjitsingh, A V
    Kroft, L J
    Jukema, J W
    Bax, J J
    Scholte, A J
    Patel, K
    Mahan, M
    Ananthasubramaniam, K
    Durmus Altun, G
    Alpay, M
    Altun, A
    Andreini, D
    Pontone, G
    Mushtaq, S
    Bertella, E
    Conte, E
    Segurini, C
    Volpato, V
    Petulla, M
    Baggiano, A
    Pepi, M
    Van Dijk, J D
    Huizing, E D
    Jager, P L
    Slump, C H
    Ottervanger, J P
    Van Dalen, J A
    Yambao, E
    Calleja, H B
    Sibulo, A S
    Ramirez Moreno, A
    Siles Rubio, J R
    Noureddine, M
    Munoz-Bellido, J
    Bravo, R
    Martinez, F
    Valle, A
    Milan, A
    Inigo-Garcia, L
    Velasco, T
    Ramaiah, V L
    Devanbu, J S
    Taywade, S K
    Hejjaji, V S
    Zafrir, N
    Bental, T
    Gutstein, A
    Solodky, A
    Mats, I
    Kornowski, R
    Lagan, J
    Hasleton, J
    Meah, M
    Mcshane, J
    Trent, R
    Massalha, S
    Israel, O
    Koskosi, A
    Kopelovich, M
    Marai, I
    Venuraju, S
    Jeevarethinam, A
    Dumo, A
    Ruano, S
    Darko, D
    Cohen, M
    Nair, D
    Rosenthal, M
    Rakhit, R
    Lahiri, A
    Pizzi, M N
    Roque, A
    Fernandez-Hidalgo, N
    Cuellar-Calabria, H
    Gonzalez-Alujas, M T
    Oristrell, G
    Rodriguez-Palomares, J
    Tornos, P
    Aguade-Bruix, S
    Smettei, O
    Abazid, R
    Ahmed, W M K
    Samy, W
    Behairy, N
    Tayeh, O
    Hassan, A
    Berezin, A
    Kremzer, A
    Samura, T
    Berezina, T
    Scrima, G
    Bertuccio, G
    Canseco Nadia, Ncl
    Cruz Raul, C R
    Gonzalez Cristian, G C
    Hernandez Salvador, S H
    Alexanderson Erick, Ear
    Zerahn, B
    Shugushev, Z
    Maximkin, D
    Chepurnoy, A
    Volkova, O
    Tsedenova, A
    Faibushevich, A
    Baranovich, V
    Yoshida, H
    Mizukami, A
    Matsumura, A
    Keller, M
    Silber, S
    Falcao, A
    Imada, R
    Azouri, L O
    Giorgi, McP
    Santos, R D
    Mello, S L
    Kalil Filho, R
    Meneghetti, J C
    Chalela, W A
    Kanni, L
    Ohrman, T
    Nygren, A T
    Irabi, R D
    Falcao, A
    Imada, R
    Azouri, L O
    Parisotto, T
    Soares, J
    Kalil Filho, R
    Meneghetti, J C
    Chalela, W A
    Burrell, S
    Burrell, S
    Lo, C
    Zavadovskyi, K
    Gulya, M
    Lishmanov, Y U
    Amin, A
    Kandeel, Ahmed
    Shaban, Mahmud
    Nawito, Zeinab
    Caobelli, F
    Soffientini, A
    Thackeray, J T
    Bengel, F M
    Pizzocaro, C
    Guerra, U P
    Hellberg, S E
    Silvola, Jmu
    Kiugel, M
    Liljenback, H
    Savisto, N
    Thiele, A
    Laine, Vjo
    Knuuti, J
    Roivainen, A
    Saraste, A
    Ismail, B
    Hadizad, T
    Dekemp, Rob
    Beanlands, Rob
    Dasilva, J N
    Hyafil, F
    Sorbets, E
    Duchatelle, V
    Rouzet, F
    Le Guludec, D
    Feldman, L
    Martire, V D
    De Pierris, C
    Martire, M V
    Pis Diez, E R
    Ramaiah, V
    Devanbu, J S
    Hejjaji, V S
    Lebasnier, A
    Legallois, D
    Peyronnet, D
    Desmonts, C
    Zalcman, G
    Bienvenu, B
    Agostini, D
    Manrique, A
    Solomyanyy, V
    Mintale, I
    Zabunova, M
    Narbute, I
    Ratniece, M
    Jakobsons, E
    Kaire, K
    Kamzola, G
    Briede, I
    Jegere, S
    Erglis, A
    Mostafa, S
    Abdelkader, M
    Abdelkader, H
    Abdelkhlek, S
    Khairy, E
    Huidu, S
    Popescu, A
    Lacau, S
    Huidu, A
    Dimulescu, D
    Abazid, R
    Smettei, O
    Sayed, S
    Al Harby, F
    Habeeb, A
    Saqqah, H
    Merganiab, S
    Selvanayagam, J
    Harms, H J
    Tolbod, L P
    Hansson, N H
    Kero, T
    Orndahl, L H
    Kim, W Y
    Bouchelouche, K
    Wiggers, H
    Frokiaer, J
    Sorensen, J
    Hansson, N H
    Tolbod, L
    Harms, H J
    Wiggers, H
    Kim, W Y
    Hansen, E
    Zaremba, T
    Frokiaer, J
    Sorensen, J
    Harms, H J
    Tolbod, L P
    Hansson, N H
    Kero, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Orndahl, L H
    Kim, W Y
    Bouchelouche, K
    Wiggers, H
    Frokiaer, J
    Sörensen, Jens
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Poster Session 3: Tuesday 5 May 2015, 082015In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 16 Suppl 1Article in journal (Refereed)
  • 12.
    Flachskampf, Frank A.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Martensson, Mattias
    How should tissue Doppler tracings be measured?2014In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 15, no 7, p. 828-829Article in journal (Other academic)
  • 13.
    Flachskampf, Frank A
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Wouters, Patrick F
    Edvardsen, Thor
    Evangelista, Artur
    Habib, Gilbert
    Hoffman, Piotr
    Hoffmann, Rainer
    Lancellotti, Patrizio
    Pepi, Mauro
    Recommendations for transoesophageal echocardiography: EACVI update 20142014In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 15, no 4, p. 353-365Article in journal (Refereed)
    Abstract [en]

    With this document, we update the recommendations for transoesophageal echocardiography (TOE) of the European Association of Cardiovascular Imaging. The document focusses on the areas of interventional TOE, in particular transcatheter aortic, mitral, and left atrial appendage interventions, as well as on the role of TOE in infective endocarditis, adult congenital heart disease, and aortic disease.

  • 14.
    Frank A, Flachskampf
    et al.
    Uppsala Universitet, Institutionen för Medicinska Vetenskaper, Akademiska sjukhuset.
    Mattias, Mårtensson
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    How should tissue Doppler tracings be measured?2014In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 15, no 7, p. 828-829Article in journal (Refereed)
  • 15.
    Galderisi, Maurizio
    et al.
    ] Federico II Univ Hosp, Interdept Lab Cardiac Imaging, Naples, Italy.
    Cosyns, Bernard
    Univ Ziekenhuis Brussel, CHVZ Ctr Hart Vaatziekten, Brussels, Belgium.
    Edvardsen, Thor
    Univ Oslo, Dept Cardiol, Oslo Univ Hosp, Rikshosp, Oslo, Norway.
    Cardim, Nuno
    Hosp da Luz, Echocardiog Lab, Lisbon, Portugal.
    Delgado, Victoria
    Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands.
    Di Salvo, Giovanni
    Royal Brompton Hosp, Pediat Cardiol, London, England.
    Donal, Erwan
    Univ Rennes, Cardiol, LTSI INSERM , Rennes, France.
    Sade, Leyla Elif
    Baskent Univ, Ankara, Turkey.
    Ernande, Laura
    Univ Paris Est Creteil, Henri Mondor Hosp, AP HP, Dept Physiol, Creteil, France.
    Garbi, Madalina
    Kings Coll Hosp NHS Fdn Trust, Denmark Hill, London, England.
    Grapsa, Julia
    Imperial Coll London, Dept Cardiovascular Sci, London, England.
    Hagendorff, Andreas
    Univ Leipzig, Dept Cardiol Angiol, Echokardiog Labore Univ Klinikums AoR, Leipzig, Germany.
    Kamp, Otto
    Vrije Univ Amsterdam, Med Ctr, Dept Cardiol, Amsterdam, Netherlands.
    Magne, Julien
    CHU Limoges, Hop Dupuytren, Serv Cardiol, F-87042 Limoges, France.
    Santoro, Ciro
    Federico II Univ Hosp, Interdept Lab Cardiac Imaging, Naples, Italy.
    Stefanidis, Alexandros
    Gen Hosp Nikea, Dept Cardiol 1, 3 P Mela Str, Athens, Greece.
    Lancellotti, Patrizio
    Univ Liege Hosp, GIGA Cardiovasc Sci, Heart Valve Clin, Imaging Cardiol, Liege, Belgium.
    Popescu, Bogdan
    Univ Med & Pharm Carol Davila Euroecolab, Inst Cardiovasc Dis, Bucharest, Romania.
    Habib, Gilbert
    Aix Marseille Univ, Aix Aix Marseille Univ, URMITE, UM63,CNRS 7278,IRD 198,INSERM 1095, Marseille, France.
    Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations: an expert consensus document of the European Association of Cardiovascular Imaging2017In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 18, no 12, p. 1301-1310Article in journal (Refereed)
    Abstract [en]

    Aims This European Association Cardiovascular Imaging (EACVI) Expert Consensus document aims at defining the main quantitative information on cardiac structure and function that needs to be included in standard echocardiographic report following recent ASE/EACVI chamber quantification, diastolic function, and heart valve disease recommendations. The document focuses on general reporting and specific pathological conditions such as heart failure, coronary artery and valvular heart disease, cardiomyopathies, and systemic diseases. Methods and results Demographic data (age, body surface area, blood pressure, and heart rhythm and rate), type (vendor and model) of ultrasound system used and image quality need to be reported. In addition, measurements should be normalized for body size. Reference normal values, derived by ASE/EACVI recommendations, shall always be reported to differentiate normal from pathological conditions. This Expert Consensus document suggests avoiding the surveillance of specific variable using different ultrasound techniques (e.g. in echo labs with high expertise in left ventricular ejection fraction by 3D and not by 2D echocardiography). The report should be also tailored in relation with different cardiac pathologies, quality of images, and needs of the caregivers. Conclusion The conclusion should be concise reflecting the status of left ventricular structure and function, the presence of left atrial and/or aortic dilation, right ventricular dysfunction, and pulmonary hypertension, leading to an objective communication with the patient health caregiver. Variation over time should be considered carefully, taking always into account the consistency of the parameters used for comparison.

  • 16. Lang, Roberto M.
    et al.
    Badano, Luigi P.
    Mor-Avi, Victor
    Afilalo, Jonathan
    Armstrong, Anderson
    Ernande, Laura
    Flachskampf, Frank A.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Foster, Elyse
    Goldstein, Steven A.
    Kuznetsova, Tatiana
    Lancellotti, Patrizio
    Muraru, Denisa
    Picard, Michael H.
    Rietzschel, Ernst R.
    Rudski, Lawrence
    Spencer, Kirk T.
    Tsang, Wendy
    Voigt, Jens-Uwe
    Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging2015In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 16, no 3, p. 233-271Article in journal (Refereed)
    Abstract [en]

    The rapid technological developments of the past decade and the changes in echocardiographic practice brought about by these developments have resulted in the need for updated recommendations to the previously published guidelines for cardiac chamber quantification, which was the goal of the joint writing group assembled by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. This document provides updated normal values for all four cardiac chambers, including three-dimensional echocardiography and myocardial deformation, when possible, on the basis of considerably larger numbers of normal subjects, compiled from multiple databases. In addition, this document attempts to eliminate several minor discrepancies that existed between previously published guidelines.

  • 17.
    Nagueh, Sherif F.
    et al.
    Methodist DeBakey Heart & Vasc Ctr, Houston, TX USA..
    Smiseth, Otto A.
    Univ Oslo, Oslo, Norway..
    Appleton, Christopher P.
    Mayo Clin Arizona, Phoenix, AZ USA..
    Byrd, Benjamin F., III
    Vanderbilt Univ, Sch Med, Nashville, TN 37212 USA..
    Dokainish, Hisham
    McMaster Univ, Hamilton, ON, Canada..
    Edvardsen, Thor
    Univ Oslo, Oslo, Norway..
    Flachskampf, Frank A.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Gillebert, Thierry C.
    Univ Ghent, Ghent, Belgium.;Univ Hosp, Ghent, Belgium..
    Klein, Allan L.
    Cleveland Clin, Cleveland, OH 44106 USA..
    Lancellotti, Patrizio
    Univ Liege Hosp, Liege, Belgium..
    Marino, Paolo
    Univ Piemonte Orientale, Novara, Italy..
    Oh, Jae K.
    Mayo Clin, Rochester, MN USA..
    Popescu, Bogdan Alexandru
    Univ Med & Pharm Carol Davila, Inst Cardiovasc Dis, Bucharest, Romania..
    Waggoner, Alan D.
    Washington Univ, Sch Med, St Louis, MO USA..
    Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging2016In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 17, no 12, p. 1321-1360Article in journal (Refereed)
  • 18. Nagy, Aniko I.
    et al.
    Sahlen, Anders
    Manouras, Aristomenis
    KTH, School of Technology and Health (STH). Karolinska Institute, Sweden.
    Henareh, Loghman
    da Silva, Cristina
    KTH, School of Technology and Health (STH). Karolinska Institute, Sweden.
    Gunyeli, Elif
    Apor, Astrid A.
    Merkely, Bela
    Winter, Reidar
    KTH, School of Technology and Health (STH). Karolinska Institute, Sweden.
    Combination of contrast-enhanced wall motion analysis and myocardial deformation imaging during dobutamine stress echocardiography2015In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 16, no 1, p. 88-95Article in journal (Refereed)
    Abstract [en]

    Background The combination of deformation analysis with conventional wall motion scoring (WMS) has been shown to increase the diagnostic sensitivity of dobutamine stress echocardiography (DSE). The feasibility and diagnostic power of WMS is largely improved by contrast agents; however, they are not used in combination with deformation analysis, as contrast agents are generally considered to render strain measurement unfeasible. Aims To assess the feasibility of tissue velocity (TVI)- and 2D speckle tracking (ST)-based strain analysis during contrast-enhanced DSE; and to show whether there is an incremental value in combining deformation analysis with contrast-enhanced WMS. Methods DS echocardiograms containing native, tissue Doppler, and contrast-enhanced loops of 60 patients were analysed retrospectively. The feasibility of WMS, TVI-, and ST-strain measurement was determined in 40 patients according to pre-defined criteria. The diagnostic ability of a combined protocol integrating data from contrast-WMS and TVI-strain measurement was then compared with contrast-WMS alone in all 60 patients, using coronary angiograms as a gold standard. Results Both TVI- and ST-based strain analysis were feasible during contrast-DSE (feasibility at peak stress: 87 and 75%). At the patient level, the diagnostic accuracy of the combined method did not prove superior to contrast-WMS (82 vs. 78%); a trend towards improved sensitivity and specificity for detecting coronary artery disease in the right coronary artery circulation (sensitivity: 85 vs. 77%, P = NS; specificity: 96 vs. 94%) was, however, observed. Conclusion Both TVI- and ST-based myocardial deformation analysis are feasible during contrast-enhanced DSE, however, our results fail to demonstrate a clear diagnostic benefit of additional strain analysis over expert WMS alone.

  • 19. Nielsen, Roni Ranghøj
    et al.
    Sörensen, Jens
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Department of Clinical Medicine, Faculty of Health, Aarhus University, Palle Juul-Jensens Boulevard 99, Aarhus DK-8200, Denmark;Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus DK-8200, Denmark .
    Tolbod, Lars
    Alstrup, Aage Kristian Olsen
    Iversen, Peter
    Frederiksen, Christian Alcaraz
    Wiggers, Henrik
    Jorsal, Anders
    Frøkier, Jørgen
    Harms, Hendrik Johannes
    Quantitative estimation of extravascular lung water volume and preload by dynamic 15O-water positron emission tomography2019In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 20, no 10, p. 1120-1128Article in journal (Refereed)
    Abstract [en]

    AIMS: Left ventricular filling pressure (preload) can be assessed by pulmonary capillary wedge pressure (PCWP) during pulmonary arterial catheterization (PAC). An emerging method [pulse indexed contour cardiac output (PICCO)] can estimate preload by global end-diastolic volume (GEDV) and congestion as extravascular lung water (EVLW) content. However, no reliable quantitative non-invasive methods are available. Hence, in a porcine model of pulmonary congestion, we evaluated EVLW and GEDV by positron emission tomography (PET). The method was applied in 35 heart failure (HF) patients and 9 healthy volunteers.

    METHODS AND RESULTS: Eight pigs were studied. Pulmonary congestion was induced by a combination of beta-blockers, angiotensin-2 agonist and saline infusion. PAC, PICCO, computerized tomography, and 15O-H2O-PET were performed. EVLW increased from 521 ± 76 to 973 ± 325 mL (P < 0.001) and GEDV from 1068 ± 170 to 1254 ± 85 mL (P < 0.001). 15O-H2O-PET measures of EVLW increased from 566 ± 151 to 797 ± 231 mL (P < 0.001) and GEDV from 364 ± 60 to 524 ± 92 mL (P < 0.001). Both EVLW and GEDV measured with PICCO and 15O-H2O-PET correlated (r2 = 0.40, P < 0.001; r2 = 0.40, P < 0.001, respectively). EVLW correlated with Hounsfield units (HU; PICCO: r2 = 0.36, P < 0.001, PET: r2 = 0.46, P < 0.001) and GEDV with PCWP (PICCO: r2 = 0.20, P = 0.01, PET: r2 = 0.29, P = 0.002). In human subjects, measurements were indexed (I) for body surface area. Neither EVLWI nor HU differed between chronic stable HF patients and healthy volunteers (P = 0.11, P = 0.29) whereas GEDVI was increased in HF patients (336 ± 66 mL/m2 vs. 276 ± 44 mL/m2, P = 0.01).

    CONCLUSION: The present study demonstrates that 15O-H2O-PET can assess pulmonary congestion and preload quantitatively. Hence, prognostic information from 15O-H2O-PET examinations should be evaluated in clinical trials.

  • 20. Pellegrino, T
    et al.
    Petretta, M
    Boemio, A
    Piscopo, V
    Carotenuto, R
    Russo, B
    Pellegrino, S
    De Matteis, G
    Cuocolo, A
    Ryzhkova, D V
    Kostina, I S
    Azevedo Coutinho, M C
    Cortez-Dias, N
    Cantinho, G
    Guimaraes, T
    Silva, G L
    Menezes, M N
    Francisco, A R
    Placido, R
    Conceicao, I
    Pinto, F
    Nakajima, K
    Nakata, T
    Matsuo, S
    Jacobson, A
    Paterson, C A
    Al Jabri, A J
    Robinson, J
    Martin, W
    Reid, S
    Smith, S A
    Harms, H J
    Tolbod, L P
    Kero, Tanja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Bouchelouche, K
    Frokiaer, J
    Sörensen, Jens
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Matsuo, S
    Nakajima, K
    Kinuya, S
    Yamagishi, M
    Moderated Poster Session 3: Monday 4 May 2015, 102015In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 16 Suppl 1Article in journal (Refereed)
  • 21.
    Queiros, Sandro
    et al.
    Katholieke University of Leuven, Belgium; ICVS 3Bs PT Govt Associate Lab, Portugal; University of Minho, Portugal.
    Barbosa, Daniel
    ICVS 3Bs PT Govt Associate Lab, Portugal; DIGARC Polytech Institute Cavado and Ave, Portugal.
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Ebbers, Tino
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Nagel, Eike
    University Hospital Frankfurt Main, Germany.
    Sarvari, Sebastian I.
    Oslo University Hospital, Norway; Oslo University Hospital, Norway.
    Claus, Piet
    Katholieke University of Leuven, Belgium.
    Fonseca, Jaime C.
    University of Minho, Portugal.
    Vilaca, Joao L.
    ICVS 3Bs PT Govt Associate Lab, Portugal; DIGARC Polytech Institute Cavado and Ave, Portugal.
    Dhooge, Jan
    Katholieke University of Leuven, Belgium.
    Multi-centre validation of an automatic algorithm for fast 4D myocardial segmentation in cine CMR datasets2016In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 17, no 10, p. 1118-1127Article in journal (Refereed)
    Abstract [en]

    Aims Quantitative analysis of cine cardiac magnetic resonance (CMR) images for the assessment of global left ventricular morphology and function remains a routine task in clinical cardiology practice. To date, this process requires user interaction and therefore prolongs the examination (i.e. cost) and introduces observer variability. In this study, we sought to validate the feasibility, accuracy, and time efficiency of a novel framework for automatic quantification of left ventricular global function in a clinical setting. Methods and results Analyses of 318 CMR studies, acquired at the enrolment of patients in a multi-centre imaging trial (DOPPLER-CIP), were performed automatically, as well as manually. For comparative purposes, intra-and inter-observer variability was also assessed in a subset of patients. The extracted morphological and functional parameters were compared between both analyses, and time efficiency was evaluated. The automatic analysis was feasible in 95% of the cases (302/318) and showed a good agreement with manually derived reference measurements, with small biases and narrow limits of agreement particularly for end-diastolic volume (-4.08 +/- 8.98 mL), end-systolic volume (1.18 +/- 9.74 mL), and ejection fraction (-1.53 +/- 4.93%). These results were comparable with the agreement between two independent observers. A complete automatic analysis took 5.61 +/- 1.22 s, which is nearly 150 times faster than manual contouring (14 +/- 2 min, P amp;lt; 0.05). Conclusion The proposed automatic framework provides a fast, robust, and accurate quantification of relevant left ventricular clinical indices in real-world cine CMR images.

  • 22.
    Rundqvist, Louise
    et al.
    Jönköping University, Sweden.
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Faresjö, Maria
    Jonköping University, Sweden.
    Carlsson, Emma
    Jönköping University, Sweden.
    Blomstrand, Peter
    Jonköping University, Sweden; Department Clin Physiol, Sweden.
    Regular endurance training in adolescents impacts atrial and ventricular size and function2017In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 18, no 6, p. 681-687Article in journal (Refereed)
    Abstract [en]

    Aims The aims of the study were to explore the effects of long-term endurance exercise on atrial and ventricular size and function in adolescents and to examine whether these changes are related to maximal oxygen uptake (VO2max). Methods and results Twenty-seven long-term endurance-trained adolescents aged 13-19 years were individually matched by age and gender with 27 controls. All participants, 22 girls and 32 boys, underwent an echocardiographic examination at rest, including standard and colour tissue Doppler investigation. VO2max was assessed during treadmill exercise. All heart dimensions indexed for body size were larger in the physically active group compared with controls: left ventricular end-diastolic volume 60 vs. 50 mL/m(2) (P amp;lt; 0.001), left atrial volume 27 vs. 19 mL/m(2) (P amp;lt; 0.001), and right ventricular (RV) and right atrial area 15 vs. 13 and 9 vs. 7 cm(2)/m(2), respectively (P amp;lt; 0.001 for both). There were strong associations between the size of the cardiac chambers and VO2max. Further, we found improved systolic function in the active group compared with controls: left ventricular ejection fraction 61 vs. 59% (P = 0.036), tricuspid annular plane systolic excursion 12 vs. 10 mm/m(2) (P = 0.008), and RV early peak systolic velocity s 11 vs. 10 cm/s (P = 0.031). Conclusion Cardiac remodelling to long-term endurance exercise in adolescents is manifested by an increase in atrial as well as ventricular dimensions. The physically active group also demonstrated functional remodelling with an increase in TAPSE and systolic RVwall velocity. These findings have practical implications when assessing cardiac enlargement and function in physically active youngsters.

  • 23.
    Rundqvist, Louise
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Engvall, Jan
    Department of Clinical Physiology, Department of Medical and Health Sciences, Linköping University, Linköping.
    Faresjö, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Carlsson, Emma
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Blomstrand, Peter
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Regular endurance training in adolescents impacts atrial and ventricular size and function2017In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 18, no 6, p. 681-687Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of the study were to explore the effects of long-term endurance exercise on atrial and ventricular size and function in adolescents and to examine whether these changes are related to maximal oxygen uptake (VO2max).

    Methods and results: Twenty-seven long-term endurance-trained adolescents aged 13–19 years were individually matched by age and gender with 27 controls. All participants, 22 girls and 32 boys, underwent an echocardiographic examination at rest, including standard and colour tissue Doppler investigation. VO2max was assessed during treadmill exercise. All heart dimensions indexed for body size were larger in the physically active group compared with controls: left ventricular end-diastolic volume 60 vs. 50 mL/m2 (P <0.001), left atrial volume 27 vs. 19 mL/m2 (P <0.001), and right ventricular (RV) and right atrial area 15 vs. 13 and 9 vs. 7 cm2/m2, respectively (P <0.001 for both). There were strong associations between the size of the cardiac chambers and VO2max. Further, we found improved systolic function in the active group compared with controls: left ventricular ejection fraction 61 vs. 59% (P= 0.036), tricuspid annular plane systolic excursion 12 vs. 10 mm/m2 (P= 0.008), and RV early peak systolic velocity s′ 11 vs. 10 cm/s (P = 0.031).

    Conclusion: Cardiac remodelling to long-term endurance exercise in adolescents is manifested by an increase in atrial as well as ventricular dimensions. The physically active group also demonstrated functional remodelling with an increase in TAPSE and systolic RV wall velocity. These findings have practical implications when assessing cardiac enlargement and function in physically active youngsters.

  • 24.
    Selmeryd, Jonas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vastmanland Cty Hosp, Dept Clin Physiol, SE-72189 Vasteras, Sweden.
    Henriksen, Egil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vastmanland Cty Hosp, Dept Clin Physiol, SE-72189 Vasteras, Sweden.
    Leppert, Jerzy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Hedberg, Pär
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Vastmanland Cty Hosp, Dept Clin Physiol, SE-72189 Vasteras, Sweden.
    Interstudy heterogeneity of definitions of diastolic dysfunction severely affects reported prevalence.2016In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 17, no 8, p. 892-899Article in journal (Refereed)
    Abstract [en]

    AIMS: The aim of this article is to examine how the European Association of Cardiovascular Imaging (EACVI) and the American Society of Echocardiography (ASE) recommendations on the classification of diastolic dysfunction (DDF) are interpreted in the scientific community and to explore how variations in the DDF definition affect the reported prevalence.

    METHODS AND RESULTS: A systematic review of studies citing the EACVI/ASE consensus document 'Recommendations for the evaluation of left ventricular diastolic function by echocardiography' was performed. The definition of DDF used in each study was recorded. Subsequently, several possible interpretations of the EACVI/ASE classification scheme were used to obtain DDF prevalence in a community-based sample (n = 714). In the systematic review, 60 studies were included. In 13 studies, no specification of DDF definition was presented, a one-level classification tree was used in 13, a two-level classification tree in 18, and in the remaining 16 studies, a DDF definition was presented but no grading of DDF was performed. In 17 studies, the DDF definition relied solely on early diastolic tissue velocity and/or left atrial size. In eight of these studies, a single parameter was used, in two studies the logical operator AND was used to combine two or more parameters, and the remaining seven studies used the logical operator OR. The resulting prevalence of DDF in the community-based sample varied from 12 to 84%, depending on the DDF definition used.

    CONCLUSION: A substantial heterogeneity of definitions of DDF was evident among the studies reviewed, and the different definitions had a substantial impact on the reported prevalence of DDF.

  • 25.
    Steeds, Richard P.
    et al.
    Univ Hosp Birmingham NHS Fdn Trust, Mindelsohn Rd, Birmingham B15 2GW, W Midlands, England.;Univ Birmingham, Honorary Reader, Inst Cardiovasc Sci, Birmingham, W Midlands, England..
    Garbi, Madalina
    Kings Coll Hosp NHS Fdn Trust, Denmark Hill, London SE5 9RS, England..
    Cardim, Nuno
    Hosp Luz, Echocardiog Lab, Av LusUada 100-500-650, Lisbon, Portugal..
    Kasprzak, Jaroslaw D.
    Univ Lodz, Dept Cardiol, Bieganski Hosp Med, Kniaziewicza 1-5, PL-91347 Lodz, Poland..
    Sade, Elif
    Baskent Univ, Dept Cardiol, Sch Med, Fevzi Uakmak Cad 10 Sok Bahcelievler, TR-06490 Ankara, Turkey..
    Nihoyannopoulos, Petros
    Imperial Coll London, NHLI Hammersmith Hosp, Du Cane Rd, London W12 0NN, England.;Univ Athens, Athens, Greece..
    Popescu, Bogdan Alexandru
    Univ Med & Pharm Carol Davila Euroecolab, Inst Cardiovasc Dis, Sos Fundeni 258,Sect 2, Bucharest 022328, Romania..
    Stefanidis, Alexandros
    Gen Hosp Nikea, Dept Cardiol 1, 3 P Mela Str, Athens 18454, Greece..
    Cosyns, Bernard
    Univ Ziekenhuis, CHVZ, VUB, Dept Cardiol, Laarbeeklaan 101,1090 Jette, Brussels, Belgium..
    Monaghan, Mark
    Kings Coll Hosp NHS Fdn Trust, Denmark Hill, London SE5 9RS, England..
    Aakhus, Svend
    Oslo Univ Hosp, Dept Cardiol, Rikshosp, Postboks 4950 Nydalen, N-0424 Oslo, Norway.;Norwegian Univ Sci & Technol, Fac Med, NTNU, N-7491 Trondheim, Norway..
    Edvardsen, Thor
    Oslo Univ Hosp, Rikshosp, Dept Cardiol, Sognsvannsveien 20,NO 0027, Oslo, Norway..
    Flachskampf, Frank
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Galiuto, Leonarda
    Univ Cattolica Sacro Cuore, Policlin Agostino Gemelli, Dept Cardiovasc Sci, Largo A Gemelli 8, I-00168 Rome, Italy..
    Athanassopoulos, George
    Onassis Cardiac Surg Ctr, Cardiol Sect, Athens 17674, Greece..
    Lancellotti, Patrizio
    Univ Liege Hosp, Dept Cardiol, GIGA Cardiovasc Sci Heart Valve Clin, CHU Sart Tilman, Liege, Belgium.;Anthea Hosp, Grp Villa Maria Care & Res, Bari, Italy..
    EACVI appropriateness criteria for the use of transthoracic echocardiography in adults: a report of literature and current practice review2017In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 18, no 11, p. 1191-1204Article, review/survey (Refereed)
    Abstract [en]

    The European Association for Cardiovascular Imaging (EACVI) has outlined the rationale for setting appropriate use criteria (AUC) in cardiovascular (CV) imaging. Transthoracic echocardiography (TTE) is the most common imaging modality in CV disease and is a central tool in diagnosis, follow-up, management planning and intervention. The purpose of AUC is to inform referrers, both to avoid under-use, which may result in incomplete or incorrect diagnosis and treatment, and also over-use, which may delay correct diagnosis, lead to 'treatment cascade', and wastes resources. The first step in defining AUC for TTE in the adult has been for a panel of experts in echocardiography to review the evidence, guidelines, recommendations, and position papers from the European Society of Cardiology, EACVI and other specialist societies, and current state-of-the-art clinical practice. The attached document summarizes this work, which will be used to under-pin the development of AUC.

  • 26.
    Tossavainen, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Grönlund, Christer
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Gonzalez, Manuel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Henein, Michael Y
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Pulmonary artery acceleration time in identifying pulmonary hypertension patients with raised pulmonary vascular resistance2013In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 14, no 9, p. 890-897Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In patients with pulmonary hypertension (PH), ascertaining raised vascular resistance as a cause is a clinical objective, for which various Doppler-based measurements have been proposed, but with modest accuracy. We hypothesize that pulmonary acceleration time (PAcT) and the ratio of PAcT/peak pulmonary artery systolic pressure (PASP) reflect better the extent of the vascular resistance, compared with other available methods, and can differentiate accurately between pre- and post-capillary PH.

    METHODS AND RESULTS: We investigated 56 patients (mean age 61 ± 13 years, 23 males) in a simultaneous echocardiography and right heart catheterization (RHC) study. Based on the RHC, pulmonary vascular resistance (PVR), and pulmonary capillary wedge pressure (PCWP), patients were divided into four groups: Group 1 = normal PVR [<3 WU (Wood units)] and PCWP (<12 mmHg), Group 2 = raised PVR but normal PCWP, Group 3 = raised PVR and PCWP; and Group 4 = normal PVR but raised PCWP. We used spectral Doppler to measure PAcT (corrected for heart rate) and to estimate PASP (peak tricuspid regurgitation pressure drop + estimated right atrial pressure of 7 mmHg). We also tested other available methods for assessing PVR. There were small age differences between patient groups but no age difference between Groups 2 and 4. PAcT and PAcT/PASP were both significantly (P = 0.008) reduced in Groups 2 and 3 compared with Groups 1 and 4. PAcT ≤90 had an 84% sensitivity and an 85% specificity in identifying patients with PVR ≥3 WU with a positive and a negative predictive value of 88% and 81%, respectively. The non-linear relationship between PVR and PAcT gave a quadratic r = 0.61, P < 0.001. ROC curve analysis showed PAcT having the best accuracy (83%) in detecting a PVR ≥3 WU.

    CONCLUSION: PAcT <90 ms can serve as a strong non-invasive predictor of PVR >3 WU, which could differentiate patients with pre- and post-capillary PH.

  • 27.
    Vanoli, Davide
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Wiklund, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Henein, Michael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Näslund, Ulf
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Successful novice's training in obtaining accurate assessment of carotid IMT using an automated ultrasound system2014In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 15, no 6, p. 637-642Article in journal (Refereed)
    Abstract [en]

    Aims The aim of this study was to assess the feasibility and learning curve of training novice operators in using automated ultrasound to achieve satisfactory carotid intima-media thickness (CIMT) measurements.

    Methods and results Four novices underwent 4 weeks carotid ultrasound training using a newly developed automated ultrasonograph. A longitudinal B-mode image of the distal right common carotid artery (CCA) was acquired in 96 patients. The interoperator CIMT reproducibility was analysed by the coefficient of variation (CV) and intraclass correlation coefficient (ICC) for every week and compared with that from an expert operator. The weekly mean CV of the measurements on the 24 patients made by all novices was consistently reduced: 0.06, 0.05, 0.03, and 0.02, respectively. For the expert, the mean CV was 0.02, 0.02, 0.03, and 0.02, respectively. The novices' standard deviation (SD) of CVs also reduced weekly from 0.04 in the first week to 0.01 in the last week (P < 0.05). The corresponding weekly variation in the SD for the expert was 0.02 for the first week to 0.01 in the last week (P = 0.27). The agreement between measurements made by the novices was expressed by the ICC being 0.97 (P < 0.001) in the first week and increased to 0.99 (P < 0.001) in the fourth week.

    Conclusion CIMT assessment by novices using an automated ultrasound could be reliably achievable after a short training period. These results may have encouraging implications when designing screening programmes for primary prevention in community health service.

  • 28.
    Zhao, Ying
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Henein, Michael Y
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Mörner, Stellan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Gustavsson, Sandra
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Holmgren, Anders
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Residual compromised myocardial contractile reserve after valve replacement for aortic stenosis2012In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 13, no 4, p. 353-360Article in journal (Refereed)
    Abstract [en]

    Objective: Despite recovery of left ventricular (LV) function and morphology after aortic valve replacement (AVR) for aortic stenosis (AS), its relationship with exercise capacity remains unknown. Twenty-one AVR patients (age 61 +/- 12 years, 14 male) with normal ejection fraction (EF, 64 +/- 7%) and 21 age- and sex-matched controls (57 +/- 9 years, 10 male, EF 68 +/- 8%) were studied.Methods and results: All subjects performed semi-supine bicycle exercise and speckle tracking echocardiography (STE) study. Peak oxygen consumption (pVO(2)) was collected during semi-supine bicycle exercise. Systolic (GLSRs) and early diastolic (GLSRe) longitudinal strain rate using STE and Doppler echocardiographic parameters were measured at rest, submaximal, peak exercise, and 4 min after exercise. The two groups had comparable resting echocardiographic measurements. At peak exercise, pVO(2) was lower in patients than controls (18.5 +/- 4.5 vs. 22.1 +/- 4.3 L/min/kg, P < 0.05). GLSRs (0.98 +/- 0.28 vs. 1.55 +/- 0.30 1/s, P < 0.001), septal Sm (7.9 +/- 1.4 vs. 11.1 +/- 2.3 cm/s, P < 0.001) and their changes between rest and peak exercise (Delta GLSRs: 0.16 +/- 0.33 vs. 0.68 +/- 0.27 1/s, P < 0.001; Delta Sm 2.29 +/- 2.23 vs. 4.63 +/- 2.29 cm/s, P < 0.01) were significantly lower in patients than controls. There was no correlation between pVO(2) and any echocardiographic measurements in controls. In patients, pVO(2) correlated with peak exercise GLSRs (r = 0.60, P = 0.0007), septal Sm (r = 0.65, P = 0.002), and Em (r = 0.57, P = 0.009). In a multivariate model, peak exercise GLSRs (beta = 7.18, P = 0.03) was the only independent predictor of pVO(2) in the patients group.Conclusion: Exercise capacity is subnormal after AVR for AS, irrespective of normal LVEF suggesting residual compromised myocardial functional reserve.

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