المؤلفون: Bay, Benjamin, Gloyer, Nils Ole, Remmel, Marko, Schell, Maximilian, Zelenak, Kamil, Seiffert, Moritz, Brunner, Fabian J., Clemmensen, Peter, Reichenspurner, Hermann, Blankenberg, Stefan, Thomalla, Goetz, Fiehler, Jens, Conradi, Lenard, Waldeyer, Christoph, Flottmann, Fabian

المصدر: Bay , B , Gloyer , N O , Remmel , M , Schell , M , Zelenak , K , Seiffert , M , Brunner , F J , Clemmensen , P , Reichenspurner , H , Blankenberg , S , Thomalla , G , Fiehler , J , Conradi , L , Waldeyer , C & Flottmann , F 2023 , ' Mechanical thrombectomy in ischemic stroke after cardiovascular procedures : A propensity-matched cohort analysis ' , Journal of NeuroInterventional Surgery , vol. 15 , no. e1 , 019152 , pp. e129-e135 . https://doi.org/10.1136/jnis-2022-019152Test

مصطلحات موضوعية: Stroke, Thrombectomy, Humans, Male, Stroke/etiology, Treatment Outcome, Thrombectomy/adverse effects, Ischemic Stroke/etiology, Female, Aged, Brain Ischemia/therapy, Retrospective Studies, Cohort Studies

الوصف: Background: Stroke after a cardiovascular procedure (CVP) is a devastating complication adversely affecting outcome. Mechanical thrombectomy (MT) has not been investigated systematically in this population. Objective: To carry out a retrospective study in patients undergoing MT for early stroke after CVP, aiming to further characterize this cohort of patients, and to evaluate the efficacy, safety, procedural characteristics, and outcome of MT. Methods: A single-center stroke registry of patients who received MT was analyzed. Baseline and procedural parameters, mortality, functional outcome, recanalization rates, and complications were evaluated. Propensity score matching was carried out, identifying a control cohort with non-periprocedural large vessel occlusion (LVO). Results: Overall 913 patients were included (mean age 73.0 (±13.0) years, 52.5% female, median National Institutes of Health Stroke Scale score 15 (10-19)). Eleven patients with a LVO after a recent (<30 days postoperatively) CVP were identified (n=3 transcatheter aortic valve and n=1 surgical aortic valve replacements (SAVR), n=3 coronary bypass grafting (CABG) surgeries, n=2 SAVR+CABG, and n=2 aortic surgeries). After matching, 8 patients in the CVP group were compared with 16 patients in the matched cohort. Comparable rates of reperfusion were achieved. Time from symptom onset to groin puncture (171.5 min (136.3, 178.3) vs 284.0 min (215.0, 490.5); p=0.039), as well as recanalization (195.0 min (146.0, 201.0) vs 419.0 min (274.0, 613.0); p=0.028) was faster in the CVP group. However, this was not reflected by an improved outcome (modified Rankin Scale score after 90 days: 5.5 (3.3, 6.0) vs 5.0 (4.0, 6.0), mortality after 90 days 50.0% vs 37.5%). Complications did not differ between the groups. Conclusions: Use of MT for LVO stroke in patients after a recent CVP is a safe and efficient treatment in comparison with patients with a non-periprocedural LVO undergoing MT.

وصف الملف: application/pdf

العلاقة: https://portal.findresearcher.sdu.dk/da/publications/ae461dbc-2025-4364-8dce-0d2499f48d69Test

الإتاحة: https://doi.org/10.1136/jnis-2022-019152Test
https://portal.findresearcher.sdu.dk/da/publications/ae461dbc-2025-4364-8dce-0d2499f48d69Test
https://findresearcher.sdu.dk/ws/files/239053129/Open_Access_Version.pdfTest

المؤلفون: Bay, Benjamin, Goßling, Alina, Blaum, Christopher M, Kroeger, Friederike, Koppe, Luise, Lorenz, Thiess, Koester, Lukas, Clemmensen, Peter, Westermann, Dirk, Kirchhof, Paulus, Blankenberg, Stefan, Zeller, Tanja, Seiffert, Moritz, Waldeyer, Christoph, Brunner, Fabian J

المصدر: Bay , B , Goßling , A , Blaum , C M , Kroeger , F , Koppe , L , Lorenz , T , Koester , L , Clemmensen , P , Westermann , D , Kirchhof , P , Blankenberg , S , Zeller , T , Seiffert , M , Waldeyer , C & Brunner , F J 2022 , ' Association of high-sensitivity troponin T and I blood concentrations with all-cause mortality and cardiovascular outcome in stable patients-results from the INTERCATH cohort ' , Journal of the American Heart Association , vol. 11 , no. ....

مصطلحات موضوعية: Aged, Biomarkers, C-Reactive Protein, Cholesterol, Coronary Artery Disease/diagnostic imaging, Female, Humans, Lipoproteins, LDL, Male, Middle Aged, Natriuretic Peptide, Brain, Peptide Fragments, Prognosis, Risk Factors, Troponin I, Troponin T

الوصف: Background The association between high-sensitivity troponin T (hsTnT) and high-sensitivity troponin I (hsTnI) and outcome when adjusted for confounders including the angiographical severity of coronary artery disease (CAD) remains largely unknown. We therefore aimed to explore whether hsTnT and hsTnI blood levels increase with CAD severity and add independent predictive information for future major adverse cardiovascular events and all-cause mortality in stable patients. Methods and Results Patients from the INTERCATH cohort with available coronary angiography and hsTnT and hsTnI concentrations were included. Troponin concentrations were quantified via hsTnT (Roche Elecsys) and hsTnI (Abbott ARCHITECT STAT). To investigate the association of hsTnT and hsTnI with outcome, a multivariable analysis adjusting for classical cardiovascular risk factors, low-density lipoprotein cholesterol, estimated glomerular filtration rate, hs-CRP (high-sensitivity C-reactive protein), NT-proBNP (N-terminal pro-brain natriuretic peptide), and Gensini score was carried out. Of 1829 patients, 27.9% were women, and the mean age was 68.6±10.9 years. Troponin blood concentrations were higher in patients with diagnosed CAD compared with those without. Using a linear regression model current smoking, arterial hypertension, estimated glomerular filtration rate, hs-CRP, NT-proBNP, and CAD severity as graded by the Gensini and SYNTAX scores were associated with high-sensitivity troponin levels. Patients were followed for 4.4 years (25th and 75th percentiles: 4.3, 4.4). After multivariable adjustment, all-cause mortality was predicted by hsTnT (hazard ratio [HR], 1.7 [95% CI, 1.5-2.2], P<0.001) as well as hsTnI (HR, 1.5 [95% CI, 1.2-1.8], P<0.001). However, only hsTnI (HR, 1.2 [95% CI, 1.0-1.4], P=0.032) remained as an independent predictor of major adverse cardiovascular events after adjusting for most possible confounders, including CAD severity (hsTnT: HR, 1.0 [95% CI, 0.9-1.2], P=0.95). Conclusions After adjusting for classical ...

وصف الملف: application/pdf

العلاقة: https://portal.findresearcher.sdu.dk/da/publications/7c66a687-bf71-4110-81f7-706c9ed36b98Test

الإتاحة: https://doi.org/10.1161/JAHA.121.024516Test
https://portal.findresearcher.sdu.dk/da/publications/7c66a687-bf71-4110-81f7-706c9ed36b98Test
https://findresearcher.sdu.dk/ws/files/209217863/JAHA.121.024516.pdfTest

المؤلفون: Westermann, Dirk, Ludwig, Sebastian, Kalbacher, Daniel, Spink, Clemens, Linder, Matthias, Bhadra, Oliver D., Nikorowitsch, Julius, Waldschmidt, Lara, Demal, Till, Voigtländer, Lisa, Schaefer, Andreas, Seiffert, Moritz, Pecha, Simon, Schofer, Niklas, Greenbaum, Adam B., Reichenspurner, Hermann, Blankenberg, Stefan, Conradi, Lenard, Schirmer, Johannes

المصدر: http://lobid.org/resources/99370674986806441Test#!, 110(12):1900-1911.

مصطلحات موضوعية: Coronary Vessels/diagnostic imaging [MeSH], Fluoroscopy [MeSH], Aged, 80 and over [MeSH], Aged [MeSH], Aortic Valve/surgery [MeSH], Postoperative Complications/diagnosis [MeSH], Coronary obstruction, Tomography, X-Ray Computed [MeSH], Coronary Occlusion/prevention, Male [MeSH], Postoperative Complications/prevention, Echocardiography [MeSH], Heart Valve Prosthesis/adverse effects [MeSH], Aortic Valve Stenosis/surgery [MeSH], Prosthesis Design [MeSH], Female [MeSH], Iatrogenic Disease/prevention, Follow-Up Studies [MeSH], Aortic Valve/diagnostic imaging [MeSH], Humans [MeSH], Retrospective Studies [MeSH], Transcatheter Aortic Valve Replacement/adverse effects [MeSH], Coronary Angiography [MeSH], Original Paper, Coronary Occlusion/diagnosis [MeSH], Transcatheter aortic valve implantation, Bioprosthesis/adverse effects [MeSH], BASILICA

الوصف: Objectives!#!This study aimed to assess the clinical outcome of the bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary obstruction (BASILICA) technique in a single-center patient cohort considered at high or prohibitive risk of transcatheter aortic valve implantation (TAVI)-induced coronary obstruction.!##!Methods!#!Between October 2019 and January 2021, a total of 15 consecutive patients (age 81.0 [78.1, 84.4] years; 53.3% female; EuroSCORE II 10.6 [6.3, 14.8] %) underwent BASILICA procedure prior to TAVI at our institution. Indications for TAVI were degeneration of stented (n = 12, 80.0%) or stentless (n = 1, 6.7%) bioprosthetic aortic valves, or calcific stenosis of native aortic valves (n = 2, 13.3%), respectively. Individual risk of TAVI-induced coronary obstruction was assessed by pre-procedural computed tomography analysis. Procedural and 30-day outcomes were documented in accordance with Valve Academic Research Consortium (VARC)-2 criteria.!##!Results!#!BASILICA was attempted for single left coronary cusp in 12 patients (80.0%), for single right coronary cusp in 2 patients (13.3%), and for both cusps in 1 patient (6.7%), respectively. The procedure was feasible in 13 patients (86.7%) resulting in effective prevention of coronary obstruction, whilst TAVI was performed without prior successful bioprosthetic leaflet laceration in two patients (13.3%). In one of these patients (6.7%), additional chimney stenting immediately after TAVI was performed. No all-cause deaths or strokes were documented after 30 days.!##!Conclusion!#!The BASILICA technique appears to be a feasible, safe and effective concept to avoid iatrogenic coronary artery obstruction during TAVI in both native and bioprosthetic valves of patients at high or prohibitive risk. ClinicalTrials.gov Identifier: NCT04227002 (Hamburg AoRtic Valve cOhoRt).

العلاقة: https://repository.publisso.de/resource/frl:6450918Test; https://doi.org/10.1007/s00392-021-01881-4Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8639537Test/

الإتاحة: https://doi.org/10.1007/s00392-021-01881-4Test
https://repository.publisso.de/resource/frl:6450918Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8639537Test/

المؤلفون: Voigtländer, Lisa, Kim, Won-Keun, Mauri, Victor, Goßling, Alina, Renker, Matthias, Sugiura, Atsushi, Linder, Matthias, Schmidt, Tobias, Schofer, Niklas, Westermann, Dirk, Reichenspurner, Hermann, Nickenig, Georg, Blankenberg, Stefan, Hamm, Christian, Conradi, Lenard, Adam, Matti, Sinning, Jan-Malte, Seiffert, Moritz

المصدر: http://lobid.org/resources/99370674986806441Test#!, 110(12):1957-1966.

مصطلحات موضوعية: Small aortic annulus, Female [MeSH], Fluoroscopy [MeSH], Aortic Valve Stenosis/diagnosis [MeSH], Aged, 80 and over [MeSH], Aortic Valve/diagnostic imaging [MeSH], Aged [MeSH], Aortic stenosis, Humans [MeSH], Calcinosis/diagnosis [MeSH], Treatment Outcome [MeSH], Aortic Valve/surgery [MeSH], Retrospective Studies [MeSH], Calcinosis/surgery [MeSH], Aortic Valve/pathology [MeSH], Heart Valve Prosthesis [MeSH], Male [MeSH], Transcatheter Aortic Valve Replacement/methods [MeSH], Original Paper, Multidetector Computed Tomography [MeSH], Transcatheter aortic valve implantation, Aortic Valve Stenosis/surgery [MeSH], Prosthesis Design [MeSH]

الوصف: Background!#!A small aortic annulus is associated with increased risk of prosthesis-patient mismatch (PPM) after transcatheter aortic valve implantation (TAVI). Whether specific transcatheter heart valve (THV) designs yield superior hemodynamic performance in these small anatomies remains unclear.!##!Methods!#!Data from 8411 consecutive patients treated with TAVI from May 2012 to April 2019 at four German centers were retrospectively evaluated. A small aortic annulus was defined as multidetector computed tomography-derived annulus area < 400 mm!##!Results!#!A small annulus was found in 1069 (12.7%) patients. PPM was detected in 38.3% overall with a higher prevalence after implantation of a balloon-expanding intra-annular or mechanically expanding infra-annular THV compared to self-expanding intra- and supra-annular THV. Multivariable analysis linked self-expanding THV (Evolut: Odds ratio [OR] 0.341, Acurate-Neo: OR 0.436, Portico: OR 0.291), postdilatation (OR 0.648) and age (OR 0.968) to lower rates of PPM, while aortic valve calcification was associated with an increased risk (OR 1.001). Paravalvular regurgitation > mild was more frequent after TAVI with self-expanding THV (p = 0.04).!##!Conclusion!#!In this large contemporary multicenter patient population, a substantial number of patients with a small aortic anatomy were left with PPM after TAVI. Self-expanding supra- and intra-annular THV demonstrated superior hemodynamics in these patients at risk, however at the cost of higher rates of residual paravalvular regurgitation.

العلاقة: https://repository.publisso.de/resource/frl:6450884Test; https://doi.org/10.1007/s00392-021-01918-8Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8639544Test/

الإتاحة: https://doi.org/10.1007/s00392-021-01918-8Test
https://repository.publisso.de/resource/frl:6450884Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8639544Test/

المؤلفون: Becher, Peter Moritz, Schrage, Benedikt, Goßling, Alina, Fluschnik, Nina, Seiffert, Moritz, Westermann, Dirk, Bernhardt, Alexander M., Reichenspurner, Hermann, Kirchhof, Paulus, Blankenberg, Stefan

المصدر: http://lobid.org/resources/99370670818906441Test#!, 25(1):325.

مصطلحات موضوعية: Female [MeSH], Aged, 80 and over [MeSH], Aged [MeSH], Seasons [MeSH], Hospital Mortality/trends [MeSH], Humans [MeSH], Outcome Assessment, Health Care/statistics, Cardiogenic shock, Incidence [MeSH], Middle Aged [MeSH], Shock, Cardiogenic/epidemiology [MeSH], Germany/epidemiology [MeSH], Outcomes, Cardiogenic/complications [MeSH], Health Care/methods [MeSH], Mortality, Male [MeSH], Winter, Seasonal trends, Cardiogenic/mortality [MeSH], Myocardial infarction, Mechanical circulatory support, Research Letter

الوصف: Background!#!Outcome data about the use of tranexamic acid (TXA) in civilian patients in mature trauma systems are scarce. The aim of this study was to determine how severely injured patients are affected by the widespread prehospital use of TXA in Germany.!##!Methods!#!The international TraumaRegister DGU® was retrospectively analyzed for severely injured patients with risk of bleeding (2015 until 2019) treated with at least one dose of TXA in the prehospital phase (TXA group). These were matched with patients who had not received prehospital TXA (control group), applying propensity score-based matching. Adult patients (≥ 16) admitted to a trauma center in Germany with an Injury Severity Score (ISS) ≥ 9 points were included.!##!Results!#!The matching yielded two comparable cohorts (n = 2275 in each group), and the mean ISS was 32.4 ± 14.7 in TXA group vs. 32.0 ± 14.5 in control group (p = 0.378). Around a third in both groups received one dose of TXA after hospital admission. TXA patients were significantly more transfused (p = 0.022), but needed significantly less packed red blood cells (p ≤ 0.001) and fresh frozen plasma (p = 0.023), when transfused. Massive transfusion rate was significantly lower in the TXA group (5.5% versus 7.2%, p = 0.015). Mortality was similar except for early mortality after 6 h (p = 0.004) and 12 h (p = 0.045). Among non-survivors hemorrhage as leading cause of death was less in the TXA group (3.0% vs. 4.3%, p = 0.021). Thromboembolic events were not significantly different between both groups (TXA 6.1%, control 4.9%, p = 0.080).!##!Conclusion!#!This is the largest civilian study in which the effect of prehospital TXA use in a mature trauma system has been examined. TXA use in severely injured patients was associated with a significantly lower risk of massive transfusion and lower mortality in the early in-hospital treatment period. Due to repetitive administration, a dose-dependent effect of TXA must be discussed.

العلاقة: https://repository.publisso.de/resource/frl:6463949Test; https://doi.org/10.1186/s13054-021-03656-9Test; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8420004Test/

الإتاحة: https://doi.org/10.1186/s13054-021-03656-9Test
https://repository.publisso.de/resource/frl:6463949Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8420004Test/

المؤلفون: Waldschmidt, Lara, Drolz, Andreas, Heimburg, Paula, Goßling, Alina, Ludwig, Sebastian, Voigtländer, Lisa, Linder, Matthias, Schofer, Niklas, Reichenspurner, Hermann, Blankenberg, Stefan, Westermann, Dirk, Conradi, Lenard, Kluwe, Johannes, Seiffert, Moritz

المصدر: http://lobid.org/resources/99370674986806441Test#!, 110(12):1939-1946.

مصطلحات موضوعية: Fluoroscopy [MeSH], Aged, 80 and over [MeSH], Aged [MeSH], Angiodysplasia/epidemiology [MeSH], Aortic Valve/surgery [MeSH], Angiodysplasia/complications [MeSH], Aortic Valve Stenosis/complications [MeSH], Germany/epidemiology [MeSH], Angiodysplasia, Male [MeSH], Aortic Valve Stenosis/surgery [MeSH], Prevalence [MeSH], Female [MeSH], Follow-Up Studies [MeSH], Aortic Valve/diagnostic imaging [MeSH], Heyde syndrome, Humans [MeSH], Syndrome [MeSH], Treatment Outcome [MeSH], Retrospective Studies [MeSH], Transcatheter Aortic Valve Replacement/methods [MeSH], Gastrointestinal Hemorrhage/complications [MeSH], Original Paper, TAVI, Gastrointestinal bleeding, Gastrointestinal Hemorrhage/epidemiology [MeSH]

الوصف: Background!#!Heyde syndrome (HS) is known as the association of severe aortic stenosis (AS) and recurrent gastrointestinal bleeding (GIB) from angiodysplasia. Data on the prevalence of HS and results after TAVI remain scarce.!##!Methods!#!2548 consecutive patients who underwent TAVI for the treatment of AS from 2008 to 2017 were evaluated for a history of GIB and the presence of HS. The diagnosis of HS was defined as a clinical triad of severe AS, a history of recurrent GIB, and an endoscopic diagnosis of angiodysplasia. These patients (Heyde) were followed to investigate clinical outcomes, bleeding complications and the recurrence of GIB and were compared to patients with GIB unrelated to HS (Non-Heyde).!##!Results!#!A history of GIB prior to TAVI was detected in 190 patients (7.5%). Among them, 47 patients were diagnosed with HS (1.8%). Heyde patients required blood transfusions more frequently compared to Non-Heyde patients during index hospitalization (50.0% vs. 31.9%, p = 0.03). Recurrent GIB was detected in 39.8% of Heyde compared to 21.2% of Non-Heyde patients one year after TAVI (p = 0.03). In patients diagnosed with HS and recurrent GIB after TAVI, the rate of residual ≥ mild paravalvular leakage (PVL) was higher compared to those without recurrent bleeding (73.3% vs. 38.1%, p = 0.05).!##!Conclusion!#!A relevant number of patients undergoing TAVI were diagnosed with HS. Recurrent GIB was detected in a significant number of Heyde patients during follow-up. A possible association with residual PVL requires further investigation to improve treatment options and outcomes in patients with HS.

العلاقة: https://repository.publisso.de/resource/frl:6450890Test; https://doi.org/10.1007/s00392-021-01905-zTest; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8639542Test/

الإتاحة: https://doi.org/10.1007/s00392-021-01905-zTest
https://repository.publisso.de/resource/frl:6450890Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8639542Test/

المؤلفون: Irmscher, Sarah, Zipfel, Svante L. H., Halder, Luke D., Ivanov, Lia, Gonzalez-Delgado, Andres, Waldeyer, Christoph, Seiffert, Moritz, Brunner, Fabian J., von der Heide, Monika, Löschmann, Ina, Wulf, Sonia, Czamara, Darina, Papac-Milicevic, Nikolina, Strauß, Olaf, Lorkowski, Stefan, Reichenspurner, Hermann, Holers, Michael V., Banda, Nirmal K., Zeller, Tania, Binder, Elisabeth B., Binder, Christoph J., Wiech, Thorsten, Zipfel, Peter F., Skerka, Christine

المصدر: Scientific Reports, Vol 11, Iss 1, Pp 1-15 (2021)
Scientific Reports

مصطلحات موضوعية: Male, Molecular biology, Science, Immunology, Cardiology, Diseases, Pathogenesis, Article, Necrosis, Medical research, Genetics, Complement C3b Inactivator Proteins, Humans, Complement Activation, Aged, Sequence Deletion, Inflammation, Molecular medicine, Gene Expression Profiling, Homozygote, Middle Aged, Atherosclerosis, Lipids, Oxygen, Gene Expression Regulation, Cardiovascular Diseases, embryonic structures, Medicine, Female, Chromosome Deletion

الوصف: Atherosclerotic cardiovascular disease (ACVD) is a lipid-driven inflammatory disease and one of the leading causes of death worldwide. Lipid deposits in the arterial wall lead to the formation of plaques that involve lipid oxidation, cellular necrosis, and complement activation, resulting in inflammation and thrombosis. The present study found that homozygous deletion of the CFHR1 gene, which encodes the plasma complement protein factor H-related protein 1 (FHR-1), was protective in two cohorts of patients with ACVD, suggesting that FHR-1 accelerates inflammation and exacerbates the disease. To test this hypothesis, FHR-1 was isolated from human plasma and was found to circulate on extracellular vesicles and to be deposited in atherosclerotic plaques. Surface-bound FHR-1 induced the expression of pro-inflammatory cytokines and tissue factor in both monocytes and neutrophils. Notably, plasma concentrations of FHR-1, but not of factor H, were significantly (p

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::db31de9b855b6db54a3f46b54f33c487Test
https://doaj.org/article/f4fef222f3624b56b6f873bb7fc7bb7aTest

المؤلفون: Yan, Isabell, Schrage, Benedikt, Weimann, Jessica, Dabboura, Salim, Hilal, Rafel, Beer, Benedikt N., Becher, Peter Moritz, Seiffert, Moritz, Magnussen, Christina, B. Schnabel, Renate, Kirchhof, Paulus, Blankenberg, Stefan, Westermann, Dirk

المصدر: ESC Heart Failure, Vol 8, Iss 3, Pp 1775-1783 (2021)
ESC Heart Failure

مصطلحات موضوعية: Male, Sex Characteristics, Shock, Cardiogenic, Heart failure, Middle Aged, Original Research Articles, RC666-701, Humans, Diseases of the circulatory (Cardiovascular) system, Female, Sex‐related differences, Original Research Article, Heart-Assist Devices, Hospital Mortality, Cardiogenic shock, Aged, Retrospective Studies

الوصف: Aims Differences between female and male patients in clinical presentation, causes and treatment of cardiogenic shock (CS) are poorly understood. We aimed to investigate sex differences in presentation with and treatment of CS. Methods and results We analysed data of 978 patients presenting with CS to a tertiary care hospital between October 2009 and October 2017. Multivariable adjusted logistic/Cox regression models were fitted to investigate the association between sex and clinical presentation, use of treatments and 30 day mortality. Median age was 70 years (interquartile range 58–79 years), and 295 (30.2%) patients were female. After adjustment for multiple relevant confounders, female patients were more likely to be older [odds ratio (OR) 1.21, 95% confidence interval (CI) 1.02–1.42, P = 0.027], but other relevant presentation characteristics did not differ between both sexes. Despite the similar presentation, female patients were less likely to be treated with percutaneous left ventricular assist devices (OR 0.78, 95% CI 0.64–0.94, P = 0.010), but more likely to be treated with catecholamines (OR 1.21, 95% CI 1.02–1.44, P = 0.033) or vasopressors (OR 1.26, 95% CI 1.05–1.50, P = 0.012). A 30 day mortality risk in female patients was as high as in male patients (hazard ratio 1.08, 95% CI 1.00–1.18, P = 0.091). Conclusions In this large, contemporary cohort, clinical presentation was comparable in female and male patients, and both sexes were associated with a comparably high mortality risk. Nevertheless, female patients received different treatment for CS and were most importantly less likely to be treated with percutaneous left ventricular assist devices.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::e50a5c43d917c9895ae3fdbcc03c479bTest
https://doaj.org/article/b27b9b4929de48e0b6b4713598d19c7cTest

المؤلفون: Alperi, Alberto, Rodés-Cabau, Josep, Simonato, Matheus, Tchetche, Didier, Charbonnier, Gaetan, Ribeiro, Henrique B, Latib, Azeem, Montorfano, Matteo, Barbanti, Marco, Bleiziffer, Sabine, Redfors, Björn, Abdel-Wahab, Mohamed, Allali, Abdelhakim, Bruschi, Giuseppe, Napodano, Massimo, Agrifoglio, Marco, Petronio, Anna Sonia, Giannini, Cristina, Chan, Albert, Kornowski, Ran, Pravda, Nili Schamroth, Adam, Matti, Iadanza, Alessandro, Noble, Stéphane Laurent, Chatfield, Andrew, Erlebach, Magdalena, Kempfert, Jörg, Ubben, Timm, Wijeysundera, Harindra, Seiffert, Moritz, Pilgrim, Thomas, Kim, Won-Keun, Testa, Luca, Hildick-Smith, David, Nerla, Roberto, Fiorina, Claudia, Brinkmann, Christina, Conzelmann, Lars, Champagnac, Didier, Saia, Francesco, Nissen, Henrik, Amrane, Hafid, Whisenant, Brian, Shamekhi, Jasmin, Søndergaard, Lars, Webb, John G, Dvir, Danny

المصدر: ISSN: 0735-1097 ; Journal of the American College of Cardiology, vol. 77, no. 18 (2021) p. 2263-2273.

مصطلحات موضوعية: info:eu-repo/classification/ddc/616, Pacemaker, Transcatheter aortic valve replacement, Valve in valve, Aged, 80 and over, Female, Humans, Male, Artificial, Prosthesis Implantation, Registries, Transcatheter Aortic Valve Replacement / methods

الوصف: Background: Permanent pacemaker implantation (PPI) remains one of the main drawbacks of transcatheter aortic valve replacement (TAVR), but scarce data exist on PPI after valve-in-valve (ViV) TAVR, particularly with the use of newer-generation transcatheter heart valves (THVs). Objectives: The goal of this study was to determine the incidence, factors associated with, and clinical impact of PPI in a large series of ViV-TAVR procedures. Methods: Data were obtained from the multicenter VIVID Registry and included the main baseline and procedural characteristics, in-hospital and late (median follow-up: 13 months [interquartile range: 3 to 41 months]) outcomes analyzed according to the need of periprocedural PPI. All THVs except CoreValve, Cribier-Edwards, Sapien, and Sapien XT were considered to be new-generation THVs. Results: A total of 1,987 patients without prior PPI undergoing ViV-TAVR from 2007 to 2020 were included. Of these, 128 patients (6.4%) had PPI after TAVR, with a significant decrease in the incidence of PPI with the use of new-generation THVs (4.7% vs. 7.4%; p = 0.017), mainly related to a reduced PPI rate with the Evolut R/Pro versus CoreValve (3.7% vs. 9.0%; p = 0.002). There were no significant differences in PPI rates between newer-generation balloon-and self-expanding THVs (6.1% vs. 3.9%; p = 0.18). In the multivariable analysis, older age (odds ratio [OR]: 1.05 for each increase of 1 year; 95% confidence interval [CI]: 1.02 to 1.07; p = 0.001), larger THV size (OR: 1.10; 95% CI: 1.01 to 1.20; p = 0.02), and previous right bundle branch block (OR: 2.04; 95% CI: 1.00 to 4.17; p = 0.05) were associated with an increased risk of PPI. There were no differences in 30-day mortality between the PPI (4.7%) and no-PPI (2.7%) groups (p = 0.19), but PPI patients exhibited a trend toward higher mortality risk at follow-up (hazard ratio: 1.39; 95% CI: 1.02 to 1.91; p = 0.04; p = 0.08 after adjusting for age differences between groups). Conclusions: In a contemporary large series of ViV-TAVR patients, the ...

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/33958122; https://archive-ouverte.unige.ch/unige:161540Test; unige:161540

الإتاحة: https://doi.org/10.1016/j.jacc.2021.03.228Test
https://archive-ouverte.unige.ch/unige:161540Test

المؤلفون: Eggebrecht, Holger, Vaquerizo, Beatriz, Moris, Cesar, Bossone, Eduardo, Lämmer, Johannes, Czerny, Martin, Zierer, Andreas, Schröfel, Holger, Kim, Won-Keun, Walther, Thomas, Scholtz, Smita, Rudolph, Tanja, Hengstenberg, Christian, Kempfert, Jörg, Spaziano, Marco, Lefevre, Thierry, Bleiziffer, Sabine, Schofer, Joachim, Mehilli, Julinda, Seiffert, Moritz, Naber, Christoph, Biancari, Fausto, Eckner, Dennis, Cornet, Charles, Lhermusier, Thibault, Philippart, Raphael, Siljander, Antti, Giuseppe Cerillo, Alfredo, Blackman, Daniel, Chieffo, Alaide, Kahlert, Philipp, Czerwinska-Jelonkiewicz, Katarzyna, Szymanski, Piotr, Landes, Uri, Kornowski, Ran, D'Onofrio, Augusto, Kaulfersch, Carl, Søndergaard, Lars, Mylotte, Darren, Mehta, Rajendra H, De Backer, Ole

المساهمون: Eggebrecht, Holger, Vaquerizo, Beatriz, Moris, Cesar, Bossone, Eduardo, Lämmer, Johanne, Czerny, Martin, Zierer, Andrea, Schröfel, Holger, Kim, Won-Keun, Walther, Thoma, Scholtz, Smita, Rudolph, Tanja, Hengstenberg, Christian, Kempfert, Jörg, Spaziano, Marco, Lefevre, Thierry, Bleiziffer, Sabine, Schofer, Joachim, Mehilli, Julinda, Seiffert, Moritz, Naber, Christoph, Biancari, Fausto, Eckner, Denni, Cornet, Charle, Lhermusier, Thibault, Philippart, Raphael, Siljander, Antti, Giuseppe Cerillo, Alfredo, Blackman, Daniel, Chieffo, Alaide, Kahlert, Philipp, Czerwinska-Jelonkiewicz, Katarzyna, Szymanski, Piotr, Landes, Uri, Kornowski, Ran, D'Onofrio, Augusto, Kaulfersch, Carl, Søndergaard, Lar, Mylotte, Darren, Mehta, Rajendra H, De Backer, Ole

مصطلحات موضوعية: Aged, 80 and over, Aortic Valve Stenosi, Cardiac Surgical Procedure, Emergency Treatment, Europe, Female, Hospital Mortality, Human, Incidence, Male, Registrie, Risk Assessment, Transcatheter Aortic Valve Replacement

الوصف: Life-threatening complications occur during transcatheter aortic valve implantation (TAVI) which can require emergent cardiac surgery (ECS). Risks and outcomes of patients needing ECS during or immediately after TAVI are still unclear.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/29253177; info:eu-repo/semantics/altIdentifier/wos/WOS:000426146300010; volume:39; issue:8; firstpage:676-684; journal:EUROPEAN HEART JOURNAL; http://hdl.handle.net/11577/3387665Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85042608097

الإتاحة: https://doi.org/10.1093/eurheartj/ehx713Test
http://hdl.handle.net/11577/3387665Test