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European heart journal cardiovascular Imaging 17건

  1. [해외논문]   Left atrial function index predicts long-term survival in stable outpatients with systolic heart failure   SCIE

    Sargento, Luis (Heart Failure Unit, Cardiology Department, Pulido Valente Hospital, Lisbon North Hospital Centre, Rua Manuel Costa Silva 7-2A, 1750-335 Lisbon, Portugal ) , Vicente Simõ (Internal Medicine, Pulido Valente Hospital, Lisbon North Hospital Centre, Lisbon, Portugal ) , es, Andre (Heart Failure Unit, Cardiology Department, Pulido Valente Hospital, Lisbon North Hospital Centre, Rua Manuel Costa Silva 7-2A, 1750-335 Lisbon, Portugal ) , Longo, Susana (Heart Failure Unit, Cardiology Department, Pulido Valente Hospital, Lisbon North Hospital Centre, Rua Manuel Costa Silva 7-2A, 1750-335 Lisbon, Portugal ) , Lousada, Nuno (Cardiology Department, Pulido Valente Hospital, Lisbon North Hospital Centre, Lisbon, Portugal) , Palma dos Reis, Roberto
    European heart journal cardiovascular Imaging v.18 no.2 ,pp. 119 - 127 , 2017 , 2047-2404 ,

    초록

    Aims Left atrial (LA) function index (LAFI) is a rhythm-independent index that combines LA emptying fraction (LAEF), adjusted LA volume (LAVi), and stroke volume. We evaluated LAFI as a predictor of long-term survival in outpatients with heart failure with reduced ejection fraction (HFrEF). Methods and results For 3 years, we followed up 203 outpatients with a left ventricular ejection fraction <40%, who were clinically stable and on optimal therapy. The endpoint was all-cause death. LAFI was calculated as LAFI = ([LAEF × left ventricular outflow tract-velocity time integral]/[LAVi]), and was categorized into quartiles (9.26/16.56/31.92) and median (16.57). Incremental Cox regression models adjusted for significant confounders were used for survival analyses. The 3-year death rate was 30%. Higher quartiles had lower death rates (43.1%/45.1%/25.5%/6%, P < 0.001). The receiver operating characteristic curve for death was associated with LAFI (area under curve = 0.695, 95% CI 0.62–0.77, P < 0.001). In the direct comparison with LAVi and LAEF, LAFI (HRcox 0.93, 95% CI 0.89–0.97, P < 0.001) was the only predictor of survival. LAFI (HRcox 0.95, 95% CI 0.88–1.01, P = 0.099), LAFI quartiles (HR 0.29, 95% CI 0.125–0.672, P = 0.004), and LAFI ≥16.57 (HRcox 0.62, 95% CI 0.38–1.02, P = 0.058) were adjusted predictors of survival. Subgroup analysis by heart rhythm (sinus vs. atrial fibrillation) showed that LAFI per unit increase and LAFI quartiles were independent predictors of death in both subgroups. Conclusion LAFI determination in HFrEF stable outpatients is a predictor of long-term survival and provides increased prognostic value over a wide range of confounder risk factors.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  2. [해외논문]   Aortic fenestration mimicking aortic perforation   SCIE

    Ganguli, Shankho , Jain, Renuka , Barragry, Thomas , Khandheria, Bijoy
    European heart journal cardiovascular Imaging v.18 no.2 ,pp. 127 - 127 , 2017 , 2047-2404 ,

    초록

    Aims Left atrial (LA) function index (LAFI) is a rhythm-independent index that combines LA emptying fraction (LAEF), adjusted LA volume (LAVi), and stroke volume. We evaluated LAFI as a predictor of long-term survival in outpatients with heart failure with reduced ejection fraction (HFrEF). Methods and results For 3 years, we followed up 203 outpatients with a left ventricular ejection fraction <40%, who were clinically stable and on optimal therapy. The endpoint was all-cause death. LAFI was calculated as LAFI = ([LAEF × left ventricular outflow tract-velocity time integral]/[LAVi]), and was categorized into quartiles (9.26/16.56/31.92) and median (16.57). Incremental Cox regression models adjusted for significant confounders were used for survival analyses. The 3-year death rate was 30%. Higher quartiles had lower death rates (43.1%/45.1%/25.5%/6%, P < 0.001). The receiver operating characteristic curve for death was associated with LAFI (area under curve = 0.695, 95% CI 0.62–0.77, P < 0.001). In the direct comparison with LAVi and LAEF, LAFI (HRcox 0.93, 95% CI 0.89–0.97, P < 0.001) was the only predictor of survival. LAFI (HRcox 0.95, 95% CI 0.88–1.01, P = 0.099), LAFI quartiles (HR 0.29, 95% CI 0.125–0.672, P = 0.004), and LAFI ≥16.57 (HRcox 0.62, 95% CI 0.38–1.02, P = 0.058) were adjusted predictors of survival. Subgroup analysis by heart rhythm (sinus vs. atrial fibrillation) showed that LAFI per unit increase and LAFI quartiles were independent predictors of death in both subgroups. Conclusion LAFI determination in HFrEF stable outpatients is a predictor of long-term survival and provides increased prognostic value over a wide range of confounder risk factors.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  3. [해외논문]   Left atrial function index: did we end up waiting for Godot?   SCIE

    Longobardo, Luca (Department of Clinical and Experimental Medicine - Section of Cardiology, University of Messina, Azienda Ospedaliera Universitaria “Policlinico G. Martino” and Universita' degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy ) , Zito, Concetta (Department of Clinical and Experimental Medicine - Section of Cardiology, University of Messina, Azienda Ospedaliera Universitaria “Policlinico G. Martino” and Universita' degli Studi di Messina, Via Consolare Valeria n.12, 98100 Messina, Italy ) , Khandheria, Bijoy K. (Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, 2801 W. Kinnickinnic River Parkway, #840, Milwaukee, WI 53215, USA)
    European heart journal cardiovascular Imaging v.18 no.2 ,pp. 128 - 129 , 2017 , 2047-2404 ,

    초록

    Aims Left atrial (LA) function index (LAFI) is a rhythm-independent index that combines LA emptying fraction (LAEF), adjusted LA volume (LAVi), and stroke volume. We evaluated LAFI as a predictor of long-term survival in outpatients with heart failure with reduced ejection fraction (HFrEF). Methods and results For 3 years, we followed up 203 outpatients with a left ventricular ejection fraction <40%, who were clinically stable and on optimal therapy. The endpoint was all-cause death. LAFI was calculated as LAFI = ([LAEF × left ventricular outflow tract-velocity time integral]/[LAVi]), and was categorized into quartiles (9.26/16.56/31.92) and median (16.57). Incremental Cox regression models adjusted for significant confounders were used for survival analyses. The 3-year death rate was 30%. Higher quartiles had lower death rates (43.1%/45.1%/25.5%/6%, P < 0.001). The receiver operating characteristic curve for death was associated with LAFI (area under curve = 0.695, 95% CI 0.62–0.77, P < 0.001). In the direct comparison with LAVi and LAEF, LAFI (HRcox 0.93, 95% CI 0.89–0.97, P < 0.001) was the only predictor of survival. LAFI (HRcox 0.95, 95% CI 0.88–1.01, P = 0.099), LAFI quartiles (HR 0.29, 95% CI 0.125–0.672, P = 0.004), and LAFI ≥16.57 (HRcox 0.62, 95% CI 0.38–1.02, P = 0.058) were adjusted predictors of survival. Subgroup analysis by heart rhythm (sinus vs. atrial fibrillation) showed that LAFI per unit increase and LAFI quartiles were independent predictors of death in both subgroups. Conclusion LAFI determination in HFrEF stable outpatients is a predictor of long-term survival and provides increased prognostic value over a wide range of confounder risk factors.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  4. [해외논문]   Prognostic impact of late gadolinium enhancement in the risk stratification of heart transplant patients   SCIE

    Pedrotti, Patrizia (CMR Unit, Department of Cardiology and Cardiovascular Surgery, Niguarda Ca' Granda Hospital, Milan, Italy ) , Vittori, Claudia (CMR Unit, Department of Cardiology and Cardiovascular Surgery, Niguarda Ca' Granda Hospital, Milan, Italy ) , Facchetti, Rita (Health Science Department, Bicocca University, Milan, Italy ) , Pedretti, Stefano (Cardiology 3, Cardiovascular Department, Niguarda Ca' Granda Hospital, Milan, Italy ) , Dellegrottaglie, Santo (CMR Unit, Department of Cardiology and Cardiovascular Surgery, Niguarda Ca' Granda Hospital, Milan, Italy ) , Milazzo, Angela (CMR Unit, Department of Cardiology and Cardiovascular Surgery, Niguarda Ca' Granda Hospital, Milan, Italy ) , Frigerio, Maria (Heart Transplant Unit, Cardiology 2 Cardiovascular Department, Niguarda Ca' Granda Hospital, Milan, Italy ) , Cipriani, Manlio (Heart Transplant Unit, Cardiology 2 Cardiovascular Department, Niguarda Ca' Granda Hospital, Milan, Italy ) , Giannattasio, Cristina (Health Science Department, Bicocca University, Milan, Italy ) , Roghi, Alberto (CMR Unit, Department of Cardiology and Cardiovascular Surgery, Niguarda Ca' Granda Hospital, Milan, Italy ) , Rimoldi, Ornella (CNR IBFM, Segrate,)
    European heart journal cardiovascular Imaging v.18 no.2 ,pp. 130 - 137 , 2017 , 2047-2404 ,

    초록

    Aims The aim of the present study was to assess the association of the presence and amount of late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) with cardiovascular adverse events in patients with orthotopic heart transplantation (HTx). Methods and results We enrolled 48 patients (mean age, 54.7 ± 14.6 years; 37 men) at various stages after HTx. All patients underwent standard CMR at 1.5 T, to characterize both cardiac anatomy and LGE. Late gadolinium enhancement was detected in 26 patients (54%). All-cause and cardiovascular mortalities, and a composite of major adverse cardiovascular events (MACE) recurrence were evaluated during the follow-up period for a median of 5.16 years. Ten patients (21%) died and 26 (54%) were readmitted because of MACE. Multivariate Cox analysis identified as independent predictors of MACE a diagnosis of cardiac allograft vasculopathy (CAV) (HR 3.63; 1.5–8.7 95% CI; P = 0.0039), left ventricular end systolic volume index (HR 1.04; 95% CI 1.01–1.079; P = 0.008), LGE mass (HR 1.04; 1.01–1.06 95% CI; P = 0.0007), LGE % of left ventricular mass (HR 1.083; 1.03–1.13 95% CI; P = 0.0002). Independent predictors of all-cause death were CAV (HR 6.33; 95% CI 1.33–30.03; P = 0.0201), LGE mass (HR 1.04; 1.01–1.07 95% CI; P = 0.005), LGE % of left ventricular mass (HR 1.075; 1.02–1.13 95% CI; P = 0.007). Patients with CAV had a risk of MACE by 5 years of 67% (95% CI 0.309–0.851%); the addition of 7.9 LGE % to the risk model increased the predicted risk to 88% (95% CI 0.572–0.967%). Conclusions The current study demonstrated that the presence of CAV and the total amount of LGE have a significant independent association with MACE and mortality in HTx patients.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  5. [해외논문]   Role of a heart valve clinic programme in the management of patients with aortic stenosis   SCIE

    Zilberszac, Robert (Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria ) , Lancellotti, Patrizio (Department of Cardiology, Heart Valve Clinic, GIGA Cardiovascular Sciences, University of Liège Hospital, CHU Sart Tilman, Lièège, Belgium ) , Gilon, Dan (Department of Cardiology, Hadassah Medical Center, Jerusalem, Israel ) , Gabriel, Harald (Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria ) , Schemper, Michael (Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria ) , Maurer, Gerald (Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria ) , Massetti, Massimo (Institute of Cardiology, Catholic University of Sacred Heart, Rome, Italy ) , Rosenhek, Raphael (Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria)
    European heart journal cardiovascular Imaging v.18 no.2 ,pp. 138 - 144 , 2017 , 2047-2404 ,

    초록

    Aims We sought to assess the efficacy of a heart valve clinic (HVC) follow-up programme for patients with severe aortic stenosis (AS). Methods and results Three hundred and eighty-eight consecutive patients with AS (age 71 ± 10 years; aortic-jet velocity 5.1 ± 0.6 m/s) and an indication for aortic valve replacement (AVR) were included. Of these, 290 patients presented with an indication for surgery at their first visit at the HVC and 98 asymptomatic patients who had been enrolled in an HVC monitoring programme developed indications for surgery during follow-up. Time to symptom detection was significantly longer in patients that presented with symptoms at baseline (352 ± 471 days) than in patients followed in the HVC (76 ± 75 days, P < 0.001). Despite being educated to recognize and promptly report new symptoms, 77 of the 98 patients in the HVC programme waited until the next scheduled consultation to report them. Severe symptom onset (NYHA or CCS Class ≥III) was present in 61% of patients being symptomatic at the initial visit and in 34% of patients in the HVC programme ( P < 0.001). Conclusion Delays in referral and symptom reporting as well as symptom denial are common in patients with AS. These findings support the concept of risk stratification to identify patients who may benefit from elective surgery. A structured HVC programme results in the detection of symptoms at an earlier and less severe stage and thus in an optimized timing of surgery.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  6. [해외논문]   Multimodality imaging of a congenital diverticulum of the left ventricular outflow tract   SCIE

    Sozzi, Fabiola B. (Ospedale Maggiore Policlinico Cà) , Hugues, Nicolas (Granda, IRCCS, Milan, Italy ) , Civaia, Filippo (Cardiothoracic Centre of Monaco (CCM), Avenue d'Ostende 11, 98004 Monaco, Monaco ) , Alexandrescu, Clara (Cardiothoracic Centre of Monaco (CCM), Avenue d'Ostende 11, 98004 Monaco, Monaco ) , Iacuzio, Laura (Cardiothoracic Centre of Monaco (CCM), Avenue d'Ostende 11, 98004 Monaco, Monaco )
    European heart journal cardiovascular Imaging v.18 no.2 ,pp. 144 - 144 , 2017 , 2047-2404 ,

    초록

    Aims We sought to assess the efficacy of a heart valve clinic (HVC) follow-up programme for patients with severe aortic stenosis (AS). Methods and results Three hundred and eighty-eight consecutive patients with AS (age 71 ± 10 years; aortic-jet velocity 5.1 ± 0.6 m/s) and an indication for aortic valve replacement (AVR) were included. Of these, 290 patients presented with an indication for surgery at their first visit at the HVC and 98 asymptomatic patients who had been enrolled in an HVC monitoring programme developed indications for surgery during follow-up. Time to symptom detection was significantly longer in patients that presented with symptoms at baseline (352 ± 471 days) than in patients followed in the HVC (76 ± 75 days, P < 0.001). Despite being educated to recognize and promptly report new symptoms, 77 of the 98 patients in the HVC programme waited until the next scheduled consultation to report them. Severe symptom onset (NYHA or CCS Class ≥III) was present in 61% of patients being symptomatic at the initial visit and in 34% of patients in the HVC programme ( P < 0.001). Conclusion Delays in referral and symptom reporting as well as symptom denial are common in patients with AS. These findings support the concept of risk stratification to identify patients who may benefit from elective surgery. A structured HVC programme results in the detection of symptoms at an earlier and less severe stage and thus in an optimized timing of surgery.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  7. [해외논문]   Fractional flow reserve by computerized tomography and subsequent coronary revascularization   SCIE

    Packard, René (Division of Cardiology, Department of Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA ) , R. Sevag (David Geffen School of Medicine at University of California, 650 Charles E. Young Dr. South, A2-237 CHS, Los Angeles, CA 90095, USA ) , Li, Dong (David Geffen School of Medicine at University of California, 650 Charles E. Young Dr. South, A2-237 CHS, Los Angeles, CA 90095, USA ) , Budoff, Matthew J. (David Geffen School of Medicine at University of California, 650 Charles E. Young Dr. South, A2-237 CHS, Los Angeles, CA 90095, USA) , Karlsberg, Ronald P.
    European heart journal cardiovascular Imaging v.18 no.2 ,pp. 145 - 152 , 2017 , 2047-2404 ,

    초록

    Aims Fractional flow reserve by computerized tomography (FFR-CT) provides non-invasive functional assessment of the hemodynamic significance of coronary artery stenosis. We determined the FFR-CT values, receiver operator characteristic (ROC) curves, and predictive ability of FFR-CT for actual standard of care guided coronary revascularization. Methods and results Consecutive outpatients who underwent coronary CT angiography (coronary CTA) followed by invasive angiography over a 24-month period from 2012 to 2014 were identified. Studies that fit inclusion criteria ( n = 75 patients, mean age 66, 75% males) were sent for FFR-CT analysis, and results stratified by coronary artery calcium (CAC) scores. Coronary CTA studies were re-interpreted in a blinded manner, and baseline FFR-CT values were obtained retrospectively. Therefore, results did not interfere with clinical decision-making. Median FFR-CT values were 0.70 in revascularized ( n = 69) and 0.86 in not revascularized ( n = 138) coronary arteries ( P < 0.001). Using clinically established significance cut-offs of FFR-CT ≤0.80 and coronary CTA ≥70% stenosis for the prediction of clinical decision-making and subsequent coronary revascularization, the positive predictive values were 74 and 88% and negative predictive values were 96 and 84%, respectively. The area under the curve (AUC) for all studied territories was 0.904 for coronary CTA, 0.920 for FFR-CT, and 0.941 for coronary CTA combined with FFR-CT ( P = 0.001). With increasing CAC scores, the AUC decreased for coronary CTA but remained higher for FFR-CT ( P < 0.05). Conclusion The addition of FFR-CT provides a complementary role to coronary CTA and increases the ability of a CT-based approach to identify subsequent standard of care guided coronary revascularization.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  8. [해외논문]   Incremental value of 3D over 2D echocardiography in a patient with multiple ICD leads in the right ventricle   SCIE

    Larsen, Carolyn M. (<sup>1</sup>Department of Cardiovascular Diseases, Mayo Clinic, 200 1<sup>st</sup>Street SW, Rochester, MN 55905, USA ) , Padang, Ratnasari (<sup>1</sup>Department of Cardiovascular Diseases, Mayo Clinic, 200 1<sup>st</sup>Street SW, Rochester, MN 55905, USA ) , Joyce, Lyle D. (<sup>2</sup>Division of Cardiovascular Surgery, Department of Surgery, Mayo Clinic 200 1<sup>st</sup>Street SW, Rochester, MN 55905, USA ) , Chandrasekaran, Krishnaswamy (<sup>1</sup>Department of Cardiovascular Diseases, Mayo Clinic, 200 1<sup>st</sup>Street SW, Rochester, MN 55905, USA ) , Malouf, Joseph F. (<sup>1</sup>Department of Cardiovascular Diseases, Mayo Clinic, 200 1<sup>st</sup>Street SW, Rochester, MN 55905, USA)
    European heart journal cardiovascular Imaging v.18 no.2 ,pp. 152 - 152 , 2017 , 2047-2404 ,

    초록

    Aims Fractional flow reserve by computerized tomography (FFR-CT) provides non-invasive functional assessment of the hemodynamic significance of coronary artery stenosis. We determined the FFR-CT values, receiver operator characteristic (ROC) curves, and predictive ability of FFR-CT for actual standard of care guided coronary revascularization. Methods and results Consecutive outpatients who underwent coronary CT angiography (coronary CTA) followed by invasive angiography over a 24-month period from 2012 to 2014 were identified. Studies that fit inclusion criteria ( n = 75 patients, mean age 66, 75% males) were sent for FFR-CT analysis, and results stratified by coronary artery calcium (CAC) scores. Coronary CTA studies were re-interpreted in a blinded manner, and baseline FFR-CT values were obtained retrospectively. Therefore, results did not interfere with clinical decision-making. Median FFR-CT values were 0.70 in revascularized ( n = 69) and 0.86 in not revascularized ( n = 138) coronary arteries ( P < 0.001). Using clinically established significance cut-offs of FFR-CT ≤0.80 and coronary CTA ≥70% stenosis for the prediction of clinical decision-making and subsequent coronary revascularization, the positive predictive values were 74 and 88% and negative predictive values were 96 and 84%, respectively. The area under the curve (AUC) for all studied territories was 0.904 for coronary CTA, 0.920 for FFR-CT, and 0.941 for coronary CTA combined with FFR-CT ( P = 0.001). With increasing CAC scores, the AUC decreased for coronary CTA but remained higher for FFR-CT ( P < 0.05). Conclusion The addition of FFR-CT provides a complementary role to coronary CTA and increases the ability of a CT-based approach to identify subsequent standard of care guided coronary revascularization.

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  9. [해외논문]   Prognostic value of cardiac power output to left ventricular mass in patients with left ventricular dysfunction and dobutamine stress echo negative by wall motion criteria   SCIE

    Cortigiani, Lauro (Division of Cardiology, San Luca Hospital, Lucca, Italy ) , Sorbo, Simone (Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, Azienda Universitaria-Ospedaliera Pisana, Via Paradisa, 2, Pisa 56124, Italy ) , Miccoli, Mario (Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy ) , Scali, Maria Chiara (Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, Azienda Universitaria-Ospedaliera Pisana, Via Paradisa, 2, Pisa 56124, Italy ) , Simioniuc, Anca (Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, Azienda Universitaria-Ospedaliera Pisana, Via Paradisa, 2, Pisa 56124, Italy ) , Morrone, Doralisa (Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, Azienda Universitaria-Ospedaliera Pisana, Via Paradisa, 2, Pisa 56124, Italy ) , Bovenzi, Francesco (Division of Cardiology, San Luca Hospital, Lucca, Italy ) , Marzilli, Mario (Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, Azienda Universitaria-Ospedaliera Pisana, Via Paradisa, 2, Pisa 56124, Italy ) , Dini, Frank Lloyd (Cardiac, Thoracic and Vascular Department, Un)
    European heart journal cardiovascular Imaging v.18 no.2 ,pp. 153 - 158 , 2017 , 2047-2404 ,

    초록

    Aims Cardiac power output to left ventricular mass (power/mass) is an index of myocardial efficiency reflecting the rate at which cardiac work is delivered with respect to the potential energy stored in the left ventricular mass. In the present study, we sought to investigate the capability of power/mass assessed at peak of dobutamine stress echocardiography to predict mortality in patients with ischaemic cardiomyopathy and no inducible ischaemia. Methods and results One-hundred eleven patients (95 males; age 68 ± 10 years) with 35 ± 7% mean left ventricular ejection fraction and a dobutamine stress echocardiography (up to 40 µg/kg/min) negative by wall motion criteria formed the study population. Power/mass at peak stress was obtained as the product of a constant ( K = 2.22 × 10 −1 ) with cardiac output and the mean arterial pressure divided by left ventricular mass to convert the units to W/100 g. Patients were followed up for a median of 29 months (inter-quartile range 16–72 months). All-cause mortality was the only accepted clinical end point. Mean peak-stress power/mass was 0.70 ± 0.31 W/100 g. During follow-up, 29 deaths (26%) were registered. With a receiver operating characteristic analysis, a peak-stress power/mass ≤0.50 W/100 g [area under curve 0.72 (95% CI 0.63; 0.80), sensitivity 59%, specificity 80%] was the best value for predicting mortality. Univariate prognostic indicators were age, male sex, peak-stress ejection fraction, peak-stress stroke volume, peak-stress cardiac output, peak-stress cardiac power output ≤1.48 W, and peak-stress power/mass ≤0.50 W/100 g. At multivariate analysis, age (HR 1.08, 95% CI 1.04; 1.14; P = 0.004) and peak-stress power/mass ≤0.50 W/100 g (HR 4.05, 95% CI 1.36; 12.00; P = 0.01) provided independent prognostic information. Three-year mortality was 14% in patients with peak-stress power/mass >0.50 W/100 g and 47% in those with peak-stress power/mass ≤0.50 W/100 g (log-rank 20.4; P < 0.0001). Conclusion Power/mass assessed at peak of dobutamine stress echocardiography allows effective prognostication in patients with ischaemic cardiomyopathy and test result negative by wall motion criteria. In particular, a peak-stress power/mass ≤50 W/100 g is a strong and multivariable predictor of mortality.

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  10. [해외논문]   Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis   SCIE

    Iannaccone, Mario (Division of Cardiology, Cittèà) , D'Ascenzo, Fabrizio (Della Salute e Della Scienza, Turin, Italy ) , Templin, Christian (Division of Cardiology, Cittèà) , Omedè (Della Salute e Della Scienza, Turin, Italy ) , , Pierluigi (University Heart Center, Cardiology, University Hospital, Zurich, Switzerland ) , Montefusco, Antonio (Division of Cardiology, Cittèà) , Guagliumi, Giulio (Della Salute e Della Scienza, Turin, Italy ) , Serruys, Patrick W. (Division of Cardiology, Cittèà) , Di Mario, Carlo (Della Salute e Della Scienza, Turin, Italy ) , Kochman, Janusz (Cardiovascular Department, Ospedali Riuniti di Bergamo, Bergamo, Italy ) , Quadri, Giorgio (Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands ) , Biondi-Zoccai, Giuseppe (National Institute of Health Research Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK ) , Luscher, Thomas F. (Department of Cardiology, Warsaw Medical University, Warszawa, Poland ) , Moretti, Claudio (Division of Cardiology, Cittèà) , D'amico, Maurizio (Della Salute e Della Scienza, Turin, Italy ) , Gaita, Fiorenzo (Department of Medico-Surgical Sciences and Biotechnologies, Sapie) , Stone, Gregg W.
    European heart journal cardiovascular Imaging v.18 no.2 ,pp. 159 - 166 , 2017 , 2047-2404 ,

    초록

    Aims The intermediate-term incidence of strut malapposition (SM) and uncovered struts (US), and the degree of neointimal thickness (NIT) according to stent type have not been characterized. Methods and results All studies of >50 patients in which optical coherence tomography was performed between 6 and 12 months after stent implantation were included. The incidences of SM and US were the co-primary end points, while NIT was the secondary end point. A total of 458 citations were initially appraised at the abstract level, and 11 full-text studies (280 652 analysed struts, 921 patients) were assessed. The 6–12 months incidences of SM and US were 5.0 and 7.8%, respectively, and the mean NIT was 206 μm. Biolimus-eluting stents (BES) and bioresorbable vascular scaffolds (BVS) had the highest SM rates (2.7 and 3.8%, respectively), while everolimus-eluting stents (EES) and fast-release zotarolimus-eluting stents (ZES) had the lowest SM rates (0.9 and 0.1%, respectively). BES and sirolimus-eluting stents (SES) had the highest US rates (7.7 and 8.8%, respectively), while bare metal stents (BMS) and ZES had the lowest US rates (0.3 and 0.3%, respectively). BMS had the greatest NIT (340 μm), while SES, EES, and BES had the least NIT. Conclusion Second-generation drug-eluting stents (DES) have better intermediate-term strut apposition and coverage than first-generation DES, BVS, and BMS. EES demonstrate the overall best combination of healing with suppression of neointimal hyperplasia at 6–12 months. Further studies with clinical correlation are warranted to determine the implications of these findings.

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