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Bouazzi Shema Tayal Bhupendar Hansen Thomas Fritz Vinther Michael Kisslo Joseph Gorcsan John Svendsen Jesper Hastrup Søgaard Peter Saba Samir Risum Niels 《The international journal of cardiovascular imaging》2021,37(6):1843-1851
The International Journal of Cardiovascular Imaging - Cardiac resynchronization therapy (CRT) reduces the risk of ventricular arrhythmias (VA) in heart failure (HF) patients with left bundle branch... 相似文献
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Bhupendar Tayal Dany Debs Faisal Nabi Maan Malahfji Stephen H. Little Michael Reardon William Zoghbi Neal Kleiman Dipan J. Shah 《JACC: Cardiovascular Imaging》2021,14(4):812-822
ObjectivesThe objective of the present study was to use cardiovascular magnetic resonance (CMR) to examine the natural history of secondary MR severity and the implication of left ventricular (LV) scar on its prognostic significance.BackgroundThere is a need for further understanding of the prognostic implication of secondary mitral regurgitation (MR) given the heterogeneous findings of the 2 recent randomized trials on percutaneous mitral intervention in patients with secondary MR.MethodsPatients with heart failure were enrolled into a prospective observational registry between 2008 and 2019. Outcomes were a composite of all-cause death, heart transplantation, or LV assist device implantation at follow-up. CMR was used to quantify the mitral regurgitation volume and mitral regurgitation fraction (MRF) along with scar burden utilizing late gadolinium enhancement. Patients were categorized into 4 subgroups based on presence and tertiles of scar extent: no scar, limited scar (scar burden 1% to 4%), intermediate scar (scar burden 5% to 20%), and extensive scar (scar burden >20%).ResultsAmong patients (n = 441) included in the study (age 59 ± 14 years, 43% with ischemic etiology), 85 (19%) experienced an adverse event. MRF ≥30% was associated with increased risk of events among the study group (hazard ratio: 1.74; 95% confidence interval: 1.10 to 2.76; p = 0.02). When stratified by presence or absence of scar, MRF ≥30% was associated with events only among patients with scar (hazard ratio: 1.67; 95% confidence interval: 1.02 to 2.76; p = 0.04) but not among patients without scar. On further classification of patients with scar, the prognostic significance of secondary MR was observed primarily among patients with intermediate scar burden.ConclusionsThe natural history of secondary MR is complex, and outcomes are affected by severity of MR and vary depending upon the extent of scar. (DeBakey Cardiovascular Magnetic Resonance Study [DEBAKEY-CMR]; NCT04281823) 相似文献
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Hofrichter Phillipp Hagendorff Andreas Laufs Ulrich Fikenzer Sven Hepp Pierre Marshall Robert Percy Tayal Bhupendar Stöbe Stephan 《The international journal of cardiovascular imaging》2021,37(8):2369-2386
The International Journal of Cardiovascular Imaging - 2D speckle tracking echocardiography (2DSTE) is established to analyse left ventricular (LV) longitudinal function. The analysis of LV... 相似文献
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Lyng Lindgren Filip Tayal Bhupendar Bundgaard Ringgren Kristian Ascanius Jacobsen Peter Hay Kragholm Kristian Zaremba Tomas Holmark Andersen Niels Møgelvang Rasmus Biering-Sørensen Tor Hagendorff Andreas Schnohr Peter Jensen Gorm Søgaard Peter 《The international journal of cardiovascular imaging》2022,38(10):2177-2190
The International Journal of Cardiovascular Imaging - Assessment of the left ventricular (LV) function by three-dimensional echocardiography (3DE) is potentially superior to 2D echo... 相似文献
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Bhupendar Tayal John Gorcsan Jeroen J. Bax Niels Risum Niels Thue Olsen Jagmeet P. Singh William T. Abraham Jeffrey S. Borer Kenneth Dickstein Daniel Gras Henry Krum Josep Brugada Michele Robertson Ian Ford Johannes Holzmeister Frank Ruschitzka Peter Sogaard 《Journal of the American College of Cardiology》2018,71(12):1325-1333
Background
Cross correlation analysis (CCA) using tissue Doppler imaging has been shown to be associated with outcome after cardiac resynchronization therapy (CRT) in patients with heart failure (HF) with wide QRS. However, its significance in patients with narrow QRS treated with CRT is unknown.Objectives
The aim of the current study was to investigate the association of mechanical activation delay by CCA with study outcome in patients with HF enrolled in the EchoCRT trial.Methods
Baseline CCA could be performed from tissue Doppler imaging in the apical views in 807 of 809 (99.7%) enrolled patients, and 6-month follow-up could be performed in 610 of 635 (96%) patients with available echocardiograms. Patients with a pre-specified maximal activation delay ≥35 ms were considered to have significant delay. The study outcome was HF hospitalization or death.Results
Of 807 patients, 375 (46%) did not have delayed mechanical activation at baseline by CCA. Patients without delayed mechanical activation who were randomized to CRT-On compared with CRT-Off had an increased risk of poor outcome (hazard ratio: 1.70; 95% confidence interval: 1.13 to 2.55; p = 0.01) with a significant interaction term (p = 0.04) between delayed mechanical activation and device randomization for the endpoint. Among patients with paired baseline and follow-up data with no events before 6-month follow-up (n = 541), new-onset delayed mechanical activation in the CRT-On group showed a significant increase in unfavorable events (hazard ratio: 3.73; 95% confidence interval: 1.15 to 12.14; p = 0.03).Conclusions
In the EchoCRT population, absence of delayed mechanical activation by CCA was significantly associated with poor outcomes, possibly due to the onset of new delayed mechanical activation with CRT pacing. (Echocardiography Guided Cardiac Resynchronization Therapy [EchoCRT] Trial; NCT00683696) 相似文献6.
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The role of electromechanical dyssynchrony in heart failure gained prominence in literature with the results of trials of cardiac resynchronization therapy(CRT).CRT has shown to significantly decrease heart failure hospitalization and mortality in heart failure patients with dyssynchrony.Current guidelines recommend the use of electrical dyssynchrony based on a QRS>150 ms and a left bundle branch block pattern on surface electrocardiogram to identify dyssynchrony in patients who will benefit from CRT implantation.However,predicting response to CRT remains a challenge with nearly one-third of patients gaining no benefit from the device.Multiple echocardiographic measures of mechanical dyssynchrony have been studied over the past two decade.However,trials where mechanical dyssynchrony used as an additional or lone criteria for CRT failed to show any benefit in the response to CRT.This shows that a deeper understanding of cardiac mechanics should be applied in the assessment of dyssynchrony.This review discusses the evolving role of imaging techniques in assessing cardiac dyssynchrony and their application in patients considered for device therapy. 相似文献
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Monika Bhadauria Satendra Kumar Nirala Sadhana Shrivastava Abhilasha Sharma Sonia Johri Bal Krishan Chandan Bhupendar Singh Ajit Kumar Saxena Sangeeta Shukla 《Hepatology research》2009,39(3):290-300
Aim: The curative effect of emodin (1,3,8-trihydroxy-6-methyl anthraquinone), an active compound of the plant species Ventilago maderaspatana Gaertn, was evaluated against carbon tetrachloride (CCl4 ) induced hepatic cytochrome P450 (CYP) enzymatic and ultrastructural alterations in rats.
Methods: Female rats were administered CCl4 (1.5 mL/kg, ip) followed by varying doses of emodin (20, 30 and 40 mg/kg, oral po) after 24 h of CCl4 administration. Animals were euthanized after 24 h of last administration to determine liver function tests in serum, hepatic light microscopic and ultrastructural changes, activity of CYP enzymes, microsomal lipid peroxidation and protein contents, hexobarbitone induced sleep time and bromosulphalein retention.
Results: The CCl4 induced-toxic effects were observed with sharp elevation in the release of serum transaminases, alkaline phosphatase, lactate dehydrogenase and γ-glutamyl transpeptidase. An initial study for an optimum dose of emodin among different dose levels revealed that a 30 mg/kg dose was effective in restoring all the enzymatic variables and liver histoarchitecture in a dose dependent manner. Exposure to CCl4 diminished the activities of CYP enzymes (i.e. aniline hydroxylase and amidopyrine-N-demethylase and microsomal protein contents with concomitant increase in microsomal lipid peroxidation). Emodin at 30 mg/kg effectively reversed the CCl4 induced hepatotoxic events, which was consistent with ultrastructural observations. Hexobarbitone-induced sleep time and plasma bromosulphalein retention also improved liver functions after emodin therapy.
Conclusion: By reversal CYP activity and ultrastructural changes, emodin shows a strong hepatoprotective abilities. 相似文献
Methods: Female rats were administered CCl
Results: The CCl
Conclusion: By reversal CYP activity and ultrastructural changes, emodin shows a strong hepatoprotective abilities. 相似文献
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Christoffer Polcwiartek MD Daniel J. Friedman MD Kasper Emerek MD PhD Claus Graff MScBME PhD Peter L. Sørensen MScBME Joseph Kisslo MD Zak Loring MD Steen M. Hansen MD PhD Kristian Kragholm MD PhD Bhupendar Tayal MD PhD Svend E. Jensen MD PhD Peter Søgaard MD DMSc Christian Torp-Pedersen MD DMSc Brett D. Atwater MD 《Pacing and clinical electrophysiology : PACE》2020,43(11):1333-1343
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