Browsing by Subject "CONSENSUS DOCUMENT"

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  • Cameli, Matteo; Miglioranza, Marcelo Haertel; Magne, Julien; Mandoli, Giulia Elena; Benfari, Giovanni; Ancona, Roberta; Sibilio, Gerolamo; Reskovic Luksic, Vlatka; Dejan, Dosen; Griseli, Leonardo; Van de Heyning, Caroline M.; Mortelmans, Philippe; Michalski, Blazej; Kupczynska, Karolina; Di Giannuario, Giovanna; Devito, Fiorella; Dulgheru, Raluca; Ilardi, Federica; Salustri, Alessandro; Abushahba, Galal; Morrone, Doralisa; Fabiani, Iacopo; Penicka, Martin; Katbeh, Asim; Sammarco, Giuseppe; Esposito, Roberta; Santoro, Ciro; Pastore, Maria Concetta; Comenale Pinto, Salvatore; Kalinin, Artem; Pickure, Zanna; Azman Juvan, Katja; Zupan Meznar, Anja; Coisne, Augustine; Coppin, Amandine; Opris, Mihaela Maria; Nistor, Dan Octavian; Paakkanen, Riitta; Biering-Sorensen, Tor; Olsen, Flemming Javier; Lapinskas, Tomas; Vaskelyte, Jolanta Justina; Galian-Gay, Laura; Casas, Guillem; Motoc, Andreea Iulia; Papadopoulos, Constantinos Hristou; Loizos, Savvas; Agoston, Gergely; Szabo, Istvan; Hristova, Krasimira; Tsonev, Svetlin Netkov; Galli, Elena; Vinereanu, Dragos; Mihaila Baldea, Sorina; Muraru, Denisa; Mondillo, Sergio; Donal, Erwan; Galderisi, Maurizio; Cosyns, Bernard; Edvardsen, Thor; Popescu, Bogdan A. (2020)
    Two methods are currently available for left atrial (LA) strain measurement by speckle tracking echocardiography, with two different reference timings for starting the analysis: QRS (QRS-LASr) and P wave (P-LASr). The aim of MASCOT HIT study was to define which of the two was more reproducible, more feasible, and less time consuming. In 26 expert centers, LA strain was analyzed by two different echocardiographers (young vs senior) in a blinded fashion. The study population included: healthy subjects, patients with arterial hypertension or aortic stenosis (LA pressure overload, group 2) and patients with mitral regurgitation or heart failure (LA volume-pressure overload, group 3). Difference between the inter-correlation coefficient (ICC) by the two echocardiographers using the two techniques, feasibility and analysis time of both methods were analyzed. A total of 938 subjects were included: 309 controls, 333 patients in group 2, and 296 patients in group 3. The ICC was comparable between QRS-LASr (0.93) and P-LASr (0.90). The young echocardiographers calculated QRS-LASr in 90% of cases, the expert ones in 95%. The feasibility of P-LASr was 85% by young echocardiographers and 88% by senior ones. QRS-LASr young median time was 110 s (interquartile range, IR, 78-149) vs senior 110 s (IR 78-155); for P-LASr, 120 s (IR 80-165) and 120 s (IR 90-161), respectively. LA strain was feasible in the majority of patients with similar reproducibility for both methods. QRS complex guaranteed a slightly higher feasibility and a lower time wasting compared to the use of P wave as the reference.
  • Nordic Baltic Bifurcation Study; Kumsars, Indulis; Holm, Niels Ramsing; Niemelä, Matti; Kervinen, Kari; Eskola, Markku; Romppanen, Hannu; Laine, Mika; Pietila, Mikko; Hartikainen, Juha (2020)
    Background It is still uncertain whether coronary bifurcations with lesions involving a large side branch (SB) should be treated by stenting the main vessel and provisional stenting of the SB (simple) or by routine two-stent techniques (complex). We aimed to compare clinical outcome after treatment of lesions in large bifurcations by simple or complex stent implantation. Methods The study was a randomised, superiority trial. Enrolment required a SB >= 2.75 mm, >= 50% diameter stenosis in both vessels, and allowed SB lesion length up to 15 mm. The primary endpoint was a composite of cardiac death, non-procedural myocardial infarction and target lesion revascularisation at 6 months. Two-year clinical follow-up was included in this primary reporting due to lower than expected event rates. Results A total of 450 patients were assigned to simple stenting (n = 221) or complex stenting (n=229) in 14 Nordic and Baltic centres. Two-year follow-up was available in 218 (98.6%) and 228 (99.5%) patients, respectively. The primary endpoint of major adverse cardiac events (MACE) at 6 months was 5.5% vs 2.2% (risk differences 3.2%, 95% CI -0.2 to 6.8, p=0.07) and at 2 years 12.9% vs 8.4% (HR 0.63, 95% CI 0.35 to 1.13, p = 0.12) after simple versus complex treatment. In the subgroup treated by newer generation drug-eluting stents, MACE was 12.0% vs 5.6% (HR 0.45, 95% CI 0.17 to 1.17, p = 0.10) after simple versus complex treatment. Conclusion In the treatment of bifurcation lesions involving a large SB with ostial stenosis, routine two-stent techniques did not improve outcome significantly compared with treatment by the simpler main vessel stenting technique after 2 years.
  • Vilmi-Kerala, Tiina; Lauhio, Anneli; Tervahartiala, Taina; Palomaki, Outi; Uotila, Jukka; Sorsa, Timo; Palomaki, Ari (2017)
    Background: Gestational diabetes mellitus (GDM) has significant implications for the future health of the mother. Some clinical studies have suggested subclinical inflammation and vascular dysfunction after GDM. We aimed to study whether concentrations of high-sensitivity C-reactive protein (hsCRP), tissue inhibitor of metalloproteinase-1 (TIMP-1), matrix metalloproteinase-8 (MMP-8) and -9, as well as values of arterial stiffness differ between women with and without a history of GDM a few years after delivery. We also investigated possible effects of obesity on the results. Methods: We studied two cohorts-120 women with a history of GDM and 120 controls-on average 3.7 years after delivery. Serum concentrations of hsCRP were determined by immunonephelometric and immunoturbidimetric methods, MMP-8 by immunofluorometric assay, and MMP-9 and TIMP-1 by enzyme-linked immunosorbent assays. Pulse wave velocity (PWV) was determined using the foot-to-foot velocity method from carotid and femoral waveforms by using a SphygmoCor device. Arterial compliance was measured non-invasively by an HDI/PulseWave T CR-2000 arterial tonometer. All 240 women were also included in subgroup analyses to study the effect of obesity on the results. Multiple linear regression analyses were performed with adjustment for confounding factors. Results: PWV after pregnancy complicated by GDM was significantly higher than after normal pregnancy, 6.44 +/- 0.83 (SD) vs. 6.17 +/- 0.74 m/s (p = 0.009). Previous GDM was also one of the significant determinants of PWV in multiple linear regression analyses. On the other hand, compliance indices of both large (p = 0.092) and small (p = 0.681) arteries did not differ between the study cohorts. Serum TIMP-1 levels were significantly increased after previous GDM (p = 0.020). However, no differences were found in the serum levels of MMP-8, MMP-9 or hsCRP. In subgroup analyses, there were significantly higher concentrations of hsCRP (p = 0.015) and higher PWV (p <0.001) among obese women compared with non-obese ones. Conclusions: PWV values were significantly higher after GDM compared with normoglycemic pregnancies and were associated with prolonged TIMP-1 upregulation. Cardiovascular risk factors were more common in participants with high BMI than in those with previous GDM.