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van der Boon RM Nuis RJ Van Mieghem NM Benitez LM van Geuns RJ Galema TW van Domburg RT Geleijnse ML Dager A de Jaegere PP 《Catheterization and cardiovascular interventions》2012,79(5):702-710
Objectives: To determine the prevalence of impaired left ventricular (LV) systolic function and its impact on the in‐hospital and long‐term outcome in patients who underwent Transcatheter Aortic Valve Implantation (TAVI). Background: Although impaired LV function may be considered a contra‐indication for aortic valve replacement, the hemodynamic characteristics of transcatheter valves may offer procedural and long‐term clinical benefit in such patients. Methods: 230 consecutive patients underwent TAVI with the Medtronic‐CoreValve System. Impaired LV function was defined by a Left Ventricular Ejection Fraction (LVEF) ≤ 35% (European Multicenter Study on Operative Risk Stratification and Long‐term Outcome in patients with Low‐Flow/Low‐Gradient Aortic Stenosis). Study endpoints were selected and defined according to the Valve Academic Research Consortium recommendations. Results: Compared with patients with a LVEF > 35% (n = 197), those with LVEF ≤ 35% (n = 33) were more often male (78.8 % vs. 46.7%, P < 0.001), more symptomatic (NYHA class III or IV, 97.0% vs. 77.2%, P = 0.008) and had a higher prevalence of prior coronary artery disease (63.6% vs. 43.1%, P = 0.029). The Logistic EuroSCORE was 14.8% and 22.8, respectively (P = 0.012). No difference was observed between the two groups in in‐hospital or 30‐day mortality (3.0% vs. 9.6%, P = 0.21), the Combined Safety Endpoint at 30 days (24.2% and 24.4%, P = 0.99) and survival free from readmission at one year (69.2% and 69.7%, P = 0.85). After adjustment, LVEF ≤ 35% was not associated with an increased risk of 30‐day mortality, in‐hospital complications and survival free from readmission at follow‐up. Conclusion: The immediate and long‐term outcome after TAVI did not differ between patients with an impaired and preserved LVEF. LVEF ≤ 35% did not predict adverse immediate and long‐term outcome. These findings suggest that TAVI should not be withheld in selected patients with impaired LV function. © 2011 Wiley Periodicals, Inc. 相似文献
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Nicolas M. Van Mieghem MD Carl J. Schultz MD PhD Robert MA van der Boon MD PhD Rutger‐Jan Nuis MSc Apostolos Tzikas MD PhD Marcel L. Geleijnse MD PhD Ron T. van Domburg MD PhD Patrick W. Serruys MD PhD Peter PT de Jaegere MD PhD 《Catheterization and cardiovascular interventions》2012,79(5):726-732
Objectives : To determine the incidence, timing and predictors of periprocedural valve dislodgment with the Medtronic Corevalve System (MCS). Background : Periprocedural valve dislodgment may occur during transcatheter aortic valve implantation (TAVI). Methods : Ninety‐eight consecutive patients underwent TAVI with the MCS after a comprehensive baseline assessment including invasive angiography, echocardiography, and Multi‐Slice Computed Tomography (MSCT). The invasive monitoring charts and angiographic studies of all TAVI procedures were reviewed to determine the incidence and timing of valve dislodgment. Results : Valve dislodgment occurred in 18 patients. Patients with valve dislodgment had a larger Aortic Valve Area (0.76 ± 0.25 cm2 vs. 0.61 ± 0.19 cm2, P = 0.007), lower mean transaortic gradient (37.65 ± 14.62 mm Hg vs. 47.11 ± 16.08 mm Hg, P = 0.03) and significantly less aortic root calcification (Agatston score median 1951 AU (IQR, 799–3103) vs. 3289 AU (IQR 2097–4481), P = 0.016). A lower aortic root calcium score (Agatston score < 2359 AU) was the single independent predictor for valve dislodgment (OR 3.10, 1.09–8.84). After valve dislodgment, the valve could be successfully retrieved and implanted in the proper anatomic location in all cases. Valve dislodgment was associated with a lower incidence of post‐procedural AR ≥ 2 (11.1% vs. 34.6%, P = 0.05). There were no relevant procedural or clinical implications to valve dislodgment. Conclusions : The incidence of periprocedural valve dislodgment was 18% in these series. Less aortic root calcification appeared the single independent predictor. © 2011 Wiley Periodicals, Inc. 相似文献
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Kaneshka Masdjedi MD Laurens JC van Zandvoort BSc Matthew M Balbi MD Rutger-Jan Nuis MD PhD Jeroen Wilschut MD Roberto Diletti MD PhD Peter P.T. de Jaegere MD PhD Felix Zijlstra MD PhD Nicolas M Van Mieghem MD PhD Joost Daemen MD PhD 《Catheterization and cardiovascular interventions》2021,98(4):671-677
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Margo Schrieken Janne Visser Iris Oosterling Daphne van Steijn Daniëlle Bons Jos Draaisma Rutger-Jan van der Gaag Jan Buitelaar Rogier Donders Nanda Rommelse 《European child & adolescent psychiatry》2013,22(1):35-43
Pre/perinatal risk factors and body growth abnormalities have been studied frequently as early risk markers in autism spectrum disorder (ASD), yet their interrelatedness in ASD has received very little research attention. This is surprising, given that pre/perinatal risk factors can have a substantial impact on growth trajectories in the first years of life. We aimed to determine which pre/perinatal factors were more prevalent in ASD children and if these factors differentially influenced body growth in ASD and control children. A total of 96 ASD and 163 control children matched for gender participated. Data of growth of head size and body length during the first 13 months of life were collected. Data on pre/perinatal risk factors were retrospectively collected through standardized questionnaires. Results indicated that after matching for SES, prematurity/low birth weight and being first born were more prevalent in the ASD versus the control group. In addition, with increasing age children with ASD tended to have a proportionally smaller head circumference compared to their height. However, the effect of prematurity/low birth weight on head growth corrected for height was significantly different in ASD and control children: premature/low birth weight control children showed a disproportionate larger head circumference in relation to height during their first year of life, whereas this effect was absent in premature/low birth weight ASD children. This may suggest that the etiology of abnormal growth is potentially different in ASD and control children: where abnormal growth in control children is related to suboptimal conditions in the uterus, abnormal growth in ASD may be more strongly related to the causal factors that also increase the risk for ASD. However, prospective studies measuring growth and ASD characteristics in both premature/low birth weight and a terme children are necessary to support this conclusion. 相似文献
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Willemieke S. Tummers Sarah E. Miller Nutte T. Teraphongphom Adam Gomez Idan Steinberg David M. Huland Steve Hong Sri-Rajasekhar Kothapalli Alifia Hasan Robert Ertsey Bert A. Bonsing Alexander L. Vahrmeijer Rutger-Jan Swijnenburg Teri A. Longacre George A. Fisher Sanjiv S. Gambhir George A. Poultsides Eben L. Rosenthal 《Annals of surgical oncology》2018,25(7):1880-1888
Background
Operative management of pancreatic ductal adenocarcinoma (PDAC) is complicated by several key decisions during the procedure. Identification of metastatic disease at the outset and, when none is found, complete (R0) resection of primary tumor are key to optimizing clinical outcomes. The use of tumor-targeted molecular imaging, based on photoacoustic and fluorescence optical imaging, can provide crucial information to the surgeon. The first-in-human use of multimodality molecular imaging for intraoperative detection of pancreatic cancer is reported using cetuximab-IRDye800, a near-infrared fluorescent agent that binds to epidermal growth factor receptor.Methods
A dose-escalation study was performed to assess safety and feasibility of targeting and identifying PDAC in a tumor-specific manner using cetuximab-IRDye800 in patients undergoing surgical resection for pancreatic cancer. Patients received a loading dose of 100 mg of unlabeled cetuximab before infusion of cetuximab-IRDye800 (50 mg or 100 mg). Multi-instrument fluorescence imaging was performed throughout the surgery in addition to fluorescence and photoacoustic imaging ex vivo.Results
Seven patients with resectable pancreatic masses suspected to be PDAC were enrolled in this study. Fluorescence imaging successfully identified tumor with a significantly higher mean fluorescence intensity in the tumor (0.09?±?0.06) versus surrounding normal pancreatic tissue (0.02?±?0.01), and pancreatitis (0.04?±?0.01; p?<?0.001), with a sensitivity of 96.1% and specificity of 67.0%. The mean photoacoustic signal in the tumor site was 3.7-fold higher than surrounding tissue.Conclusions
The safety and feasibilty of intraoperative, tumor-specific detection of PDAC using cetuximab-IRDye800 with multimodal molecular imaging of the primary tumor and metastases was demonstrated.7.
Apostolos Tzikas MD Nicolo Piazza MD Bas M. van Dalen MD Carl Schultz MD PhD Marcel L. Geleijnse MD PhD Robert‐Jan van Geuns MD PhD Tjebbe W. Galema MD Rutger‐Jan Nuis MSc Amber Otten MSc Juan‐Luis Gutierrez‐Chico MD PhD Patrick W. Serruys MD PhD Peter P. de Jaegere MD PhD 《Catheterization and cardiovascular interventions》2010,75(1):43-49
Objectives : To assess the acute and intermediate changes in mitral regurgitation (MR) severity after transcatheter aortic valve implantation (TAVI) with the CoreValve Revalving SystemTM (CRS). Background : Following surgical aortic valve replacement, improvement in MR is reported in 27–82% of the patients. The changes in MR severity following CRS implantation are unknown. Methods : Transthoracic echocardiography was performed in 79 consecutive patients before and after treatment, and at the first outpatient visit. Left ventricular dimensions and ejection fraction (LVEF), left atrial (LA) size, and aortic gradient were measured. MR was assessed by color flow mapping and was graded as none, mild, moderate, or severe. It was defined as organic or functional. The depth of CRS implantation was measured by angiography. Results : Post‐treatment, the mean gradient decreased from 48 ± 16 mm Hg to 9 ± 5 mm Hg (P < 0.0001). There was no significant change in the left ventricular dimensions, LA size, and LVEF. MR pretreatment was mild, moderate, or severe in 57%, 18%, and 1% of the patients, respectively. It was defined as organic in 27 patients (36%) and functional in 27 patients (36%). The degree of MR remained unchanged in 61% of the patients, improved in 17%, and worsened in 22%. MR improvement was associated with a lower baseline LVEF (P = 0.02). There was no association between the changes in MR severity and the depth of CRS implantation. Conclusions : Most patients who underwent TAVI had some degree of MR. Overall there was no change in the degree of MR post‐treatment. Patients in whom MR improved had a lower LVEF at baseline. © 2009 Wiley‐Liss, Inc. 相似文献
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Groen WB Zwiers MP van der Gaag RJ Buitelaar JK 《Neuroscience and biobehavioral reviews》2008,32(8):1416-1425
Although impaired communication is one of the defining criteria in autism, linguistic functioning is highly variable among people with this disorder. Accumulating evidence shows that language impairments in autism are more extensive than commonly assumed and described by formal diagnostic criteria and are apparent at various levels. Phenotypically, most people with autism have semantic, syntactic and pragmatic deficits, a smaller number are known to have phonological deficits. Neurophysiologically, abnormal processing of low-level linguistic information points to perceptual difficulties. Also, abnormal high-level linguistic processing of the frontal and temporal language association cortices indicates more self-reliant and less connected neural subsystems. Early sensory impairments and subsequent atypical neural connectivity are likely to play a part in abnormal language acquisition in autism. This paper aims to review the available data on the phenotype of language in autism as well as a number of structural, electrophysiological and functional brain-imaging studies to provide a more integrated view of the linguistic phenotype and its underlying neural deficits, and to provide new directions for research and therapeutic and experimental applications. 相似文献
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Frederik T. W. Groenland MD Annemieke C. Ziedses des Plantes BSc Tara Neleman BSc Alessandra Scoccia MD Jurgen M. R. Ligthart RT Karen T. Witberg RN Karim D. Mahmoud MD PhD Rutger-Jan Nuis MD PhD Wijnand K. den Dekker MD PhD Jeroen M. Wilschut MD Roberto Diletti MD PhD Felix Zijlstra MD PhD Nicolas M. Van Mieghem MD PhD Joost Daemen MD PhD 《Catheterization and cardiovascular interventions》2023,102(2):191-199
Background
Dedicated prospective studies investigating high-definition intravascular ultrasound (HD-IVUS)-guided primary percutaneous coronary intervention (PCI) are lacking. The aim of this study was to qualify and quantify culprit lesion plaque characteristics and thrombus using HD-IVUS in patients presenting with ST-segment elevation myocardial infarction (STEMI).Methods
The SPECTRUM study is a prospective, single-center, observational cohort study investigating the impact of HD-IVUS-guided primary PCI in 200 STEMI patients (NCT05007535). The first 100 study patients with a de novo culprit lesion and a per-protocol mandated preintervention pullback directly after vessel wiring were subject to a predefined imaging analysis. Culprit lesion plaque characteristics and different thrombus types were assessed. An IVUS-derived thrombus score, including a 1-point adjudication for a long total thrombus length, long occlusive thrombus length, and large maximum thrombus angle, was developed to differentiate between low (0–1 points) and high (2–3 points) thrombus burden. Optimal cut-off values were obtained using receiver operating characteristic curves.Results
The mean age was 63.5 (±12.1) years and 69 (69.0%) patients were male. The median culprit lesion length was 33.5 (22.8–38.9) mm. Plaque rupture and convex calcium were appreciated in 48 (48.0%) and 10 (10.0%) patients, respectively. Thrombus was observed in 91 (91.0%) patients (acute thrombus 3.3%; subacute thrombus 100.0%; organized thrombus 22.0%). High IVUS-derived thrombus burden was present in 37/91 (40.7%) patients and was associated with higher rates of impaired final thrombolysis in myocardial infarction flow (grade 0–2) (27.0% vs. 1.9%, p < 0.001).Conclusions
HD-IVUS in patients presenting with STEMI allows detailed culprit lesion plaque characterization and thrombus grading that may guide tailored PCI. 相似文献10.
Annemieke J. Brouwer Floris Groenendaal Corine Koopman Rutger-Jan A. Nievelstein Sen K. Han Linda S. de Vries 《Neuroradiology》2010,52(6):567-576