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  • 1
    Online Resource
    Online Resource
    Prognostic Impact of Left Atrial Function Following Transcatheter Mitral Valve Repair
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of the American Heart Association Vol. 8, No. 9 ( 2019-05-07)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 9 ( 2019-05-07)
    Abstract: Left atrial ( LA ) function predicts clinical outcome in a variety of cardiovascular diseases. However, limited data are available in the setting of mitral regurgitation. The aim of the present study was to assess potential changes in LA ejection fraction (LAEF) and its prognostic value in patients following transcatheter mitral valve repair using the MitraClip. Methods and Results A total of 88 consecutive patients undergoing MitraClip implantation with complete echocardiography at baseline and follow‐up between 3 and 6 months postprocedure were enrolled. LAEF improved in 58% of the population. Change in LAEF was associated with residual mitral regurgitation, residual transmitral gradient and left ventricular ejection fraction changes. Compared with their counterparts, patients with residual mitral regurgitation ≥grade 2 (change in LAEF, −6% [Interquartile [IQR], −9–1%] versus 4% [IQR, −5–15%]; P =0.05) and with residual transmitral gradient ≥5 mm Hg (change in LAEF, −2% [IQR, −9–9%] versus 5% [IQR, −4–16%] ; P =0.03) showed a decline in LAEF , respectively. Furthermore, LAEF significantly correlated with changes in left ventricular ejection fraction ( r =0.40; P =0.001). With regards to clinical outcome, heart failure symptoms as assessed by New York Heart Association class were more severe in patients with worsened LAEF at follow‐up. Finally, LAEF change was identified as an independent predictor of all‐cause mortality (hazard ratio, 0.94; 95% CI, 0.90–0.98 [ P =0.008]). Conclusions The present analysis showed that changes in LA function in patients undergoing MitraClip implantation are associated with important measures including residual mitral regurgitation, elevated transmitral gradient, and left ventricular function. Importantly, LA function alterations represent a strong predictor for all‐cause mortality.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.118.011727
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2653953-6
    Library Location Call Number Volume/Issue/Year Availability
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    Online Resource
    Open Access Request
    Availability (electronic / print)
    BTU Cottbus
    Wissenschaftspark Albert Einstein
    EUV Frankfurt
    TH Wildau
    FH Potsdam
  • 2
    Online Resource
    Online Resource
    Postextrasystolic Blood Pressure Potentiation Predicts Poor Outcome of Cardiac Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Journal of the American Heart Association Vol. 3, No. 3 ( 2014-05-22)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 3, No. 3 ( 2014-05-22)
    Abstract: Postextrasystolic blood pressure potentiation (PESP), the pulse wave augmentation after an extrasystolic beat, is typically enhanced in heart failure (HF) patients. This study prospectively tested the association of PESP and mortality in cardiac patients. Methods and Results Consecutive patients (n=941; mean age, 61 years; 19% female) presenting with acute myocardial infarction were enrolled between May 2000 and March 2005 and followed up until August 2010. The main study outcome was 5‐year all‐cause mortality. Patients underwent noninvasive 30‐minute recordings of ECG and continuous blood pressure. PESP presence was based on the ratio between the first postectopic pulse wave amplitude and the mean of the subsequent 9 pulse wave amplitudes. A ratio above 1 was prospectively defined as PESP present. Ventricular premature complexes (VPCs) suitable for PESP quantification were present in recordings of 220 patients. PESP was present in 62 of these patients. Patients without suitable VPCs were classified as PESP absent. During the follow‐up, 72 patients died. Among the 220 patients in whom PESP was measurable, 27 died. Under univariable analysis, PESP was a significant predictor of death ( P 〈 0.001) as were GRACE score ( P 〈 0.001), left ventricular ejection fraction (LVEF) ( P 〈 0.001), and the number of recorded VPCs ( P 〈 0.001). Under multivariable analysis, PESP ( P 〈 0.001), GRACE score ( P 〈 0.001), and LVEF ( P =0.001) were independently associated with outcome. The combination of PESP presence and LVEF ≤35% identified a subgroup of patients with a particularly high mortality of 46.7%. Separate validation reproduced the finding in an unrelated population of 146 HF patients. Conclusions PESP, which likely reflects abnormalities of myocardial calcium cycling, predicts the mortality risk in postinfarction patients. Clinical Trial Registration URL: ClinicalTrials.gov . Unique identifier: NCT00196274.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.114.000857
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 2653953-6
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
    BTU Cottbus
    Wissenschaftspark Albert Einstein
    EUV Frankfurt
    TH Wildau
    FH Potsdam
  • 3
    Online Resource
    Online Resource
    Abstract 18949: Post-Extrasystolic T-Wave Change Predicts Mortality in Survivors of Myocardial Infarction
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Background: The T-wave of the first normal beat after a ventricular premature complex (VPC) often differs in shape in terms of a change in the T-wave amplitude or in the direction of the T-wave vector. The phenomenon of post-extrasystolic T-wave change (PEST) was first reported by White in 1915 and confirmed in many clinical and experimental studies. However, PEST has not led to a meaningful clinical application. In this study, we tested whether PEST provides prognostic information in contemporarily treated post-MI patients. Methods and Results: 941 consecutive patients (mean age 61 years, 19% female) presenting with acute MI were enrolled between May 2000 and March 2005. All patients underwent 30-minute recordings of high resolution ECG (1.6 kHz sampling of orthogonal XYZ leads). 224 patients showed VPCs during the 30-minutes. We quantified PEST by two variables (1) change in T-wave area and (2) change in the angle of the T-wave vector in each case compared to the average of three T-waves before and after the first post-extrasysolic beat. PEST was defined as ratio TPEST/T±3 area 〈 1 and ratio TPEST/T±3 angle ≥ 5°. PEST was present in 63 of the 224 patients. Primary endpoint was total mortality during a follow-up period of five years. Uni- and multivariable analyses were performed with traditional risk stratifiers like LVEF ≤ 35%, GRACE score ≥ 120 points and VPC count ≥ 5 per 30 minutes. During the follow-up, 26 of the patients died. PEST shows the strongest association with mortality in the univariable analysis followed by GRACE score, frequent VPCs and reduced LVEF In the multivariable analysis only PEST and GRACE score were independent predictors of mortality (see table). Conclusions: PEST is significantly associated with mortality in survivors of an acute myocardial infarction, and is independent of standard risk predictors. We assume that PEST might becaused by abnormal transmural gradients in action potential duration.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.18949
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
    BTU Cottbus
    Wissenschaftspark Albert Einstein
    EUV Frankfurt
    TH Wildau
    FH Potsdam
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