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Sökning: db:Swepub > (2010-2011) > Umeå universitet > Henein Michael Y

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1.
  • Bajraktari, Gani, et al. (författare)
  • Left ventricular asynchrony and raised filling pressure predict limited exercise performance assessed by 6 minute walk test
  • 2011
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 146:3, s. 385-389
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Six minute walking test (6-MWT) may serve as a reproducible test for assessing exercise capacity in heart failure (HF) patients and can be clinically predicted. We aimed in this study to ascertain if global markers of ventricular asynchrony can predict 6MWT distance in a group of patients with HF and left ventricular (LV) ejection fraction (EF) <45%.METHODS AND RESULTS: This study included 77 consecutive patients (60+/-12 years) with stable HF. LV end-diastolic and end-systolic dimensions, shortening fraction (SF), EF, myocardial velocities, t-IVT, and Tei index were measured, as well as 6-MWT distance. Patients with limited exercise performance (CONCLUSIONS: In heart failure patients, the higher the filling pressures and the more asynchronous the left ventricle, the poorer is the patient's exercise capacity. These findings highlight specific LV functional disturbances that should be targeted for better optimization of medical and/or electrical therapy.
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2.
  • Bajraktari, Gani, et al. (författare)
  • Persistent Ventricular Asynchrony after Coronary Artery Bypass Surgery Predicts Cardiac Events
  • 2010
  • Ingår i: Echocardiography. - : Wiley. - 0742-2822 .- 1540-8175. ; 27:1, s. 32-37
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The aim of this study was to identify echocardiographic LV systolic and diastolic measurements that predict clinical events post-coronary artery bypass graft (CABG) surgery. Methods: We collected data from 27 patients (age 70 +/- 7 years) who underwent elective CABG, before and within 6 weeks after surgery. LV systolic function was assessed by conventional echocardiographic parameters. A number of LV filling measurements were also made, which included total isovolumic time (t-IVT), Tei index, and restrictive filling pattern. Postoperative cardiac events were death or hospitalization for chest pain, breathlessness, or arrhythmia. Results: Patient's follow-up period was 17 +/- 10 months. Of the 27 patients (age 70 +/- 7 years, 22 male), 10 had postoperative cardiac events. LV ejection fraction (EF) and fractional shortening (FS) were lower (P = 0.01, and P = 0.007, respectively), t-IVT longer (P < 0.001), and Tei index was higher (P < 0.001) preoperatively in patients with events compared to those without. The same differences between groups remained after surgery; EF (P = 0.002), FS (P = 0.002), t-IVT (P < 0.001), and Tei index (P < 0.001). T-IVT was the only preoperative predictor of events (P = 0.038) but its postoperative value as well as that of FS predicted events (P = 0.034, and P = 0.042, respectively). T-IVT of 12.2 s/min and FS of 26% were 80% sensitive and 88% specific for predicting postoperative events. Conclusion: Despite successful surgical revascularization residual impairment of LV systolic function and persistent asynchrony in the form of prolonged t-IVT are associated with postoperative events. Since these abnormalities remained despite full medical therapy, they may thus suggest a need for electrical resynchronization therapy.
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3.
  • Boles, Usama, et al. (författare)
  • Coronary artery ectasia : remains a clinical dilemma.
  • 2010
  • Ingår i: Coronary Artery Disease. - : Lippincott Williams & Wilkins. - 0954-6928 .- 1473-5830. ; 21:5, s. 318-320
  • Tidskriftsartikel (refereegranskat)abstract
    • Coronary artery ectasia (CAE) is defined as localized coronary dilatation that exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times. The incidence of CAE varies from 1.5 to 5% in most literature; however, it was reported as high as 10% in some nations. Although, the pathogenesis of CAE is not fully understood, atherosclerosis remains the main association with CAE, in the western world. Kawasaki disease is another common cause of acquired heart disease in children, causing CAE. Kawasaki disease prevalence is overstated by its geographical distribution. Current modalities of investigation looked at the anatomical distribution of the disease and its possible ischemic effects. Biomarkers were studied in depth to explain the active nature of CAE; however, the common association with atherosclerosis weakens its significance. Here we reviewed CAE, its prevalence, relationship to other systemic anomalies in the vascular bed, pathogenesis and diagnostic tools currently in use.
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5.
  • Ding, Wen-Hong, et al. (författare)
  • Early and long-term survival after aortic valve replacement in septuagenarians and octogenarians with severe aortic stenosis.
  • 2010
  • Ingår i: International Journal of Cardiology. - : Elsevier. - 0167-5273 .- 1874-1754. ; 141:1, s. 24-31
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To evaluate the predictors for mortality following aortic valve replacement (AVR) in elderly patients with aortic stenosis (AS).METHODS: 112 consecutive elderly AS patients (aged 77+/-2 years) with AVR between 1998 and 2003 were studied. Clinical and echocardiographic data of LV function were recorded before and 46 months after AVR. Results were compared with 72 younger patients (aged 60+/-1 years). Outcome measures were 30-day and long-term all cause mortalities.RESULTS: Elderly patients had higher NYHA class, more frequent atrial fibrillation, coronary artery disease, emergency operation and use of bioprosthetic valves. They also had shorter E-wave deceleration time (DT) and larger left atria (p<0.05 for all). 30-day mortality was 12% vs 4% (Log Rank x(2)=3.02, p=0.08) and long term mortality was 18% vs 7% (Log Rank x(2)=4.38, p=0.04) in two groups respectively. Age was not related to mortality after adjustment for other variables. Among all variables, anemia (OR 4.20, CI: 1.02-6.86, p=0.04), cardiopulmonary bypass (CPB) time (OR 1.02, CI 1.01-1.04, p<0.01), significant prosthesis patient mismatch (PPM) (OR 5.43, CI 1.04-18.40, p<0.05) were associated with 30-day mortality in elderly patients. Their long-term mortality was related to CBP time (OR 1.02, CI 1.00-1.05, p=0.04), PPM (OR 4.64, CI 1.33-16.11, p=0.02) and raised left atrial pressure: DT (OR 0.94, CI 0.84-0.99, p=0.03) and pulmonary arterial systolic pressure (OR 1.12, CI 1.03-1.19, p<0.001).CONCLUSION: Peri-operative AVR survival is encouraging. While pre-operative anemia and a longer CBP time determine early mortality, long term mortality is related to PPM, LV diastolic dysfunction and secondary pulmonary hypertension.
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6.
  • El-Maasarany, Shirley H, et al. (författare)
  • A-V nodal artery anatomy and relations to the posterior septal space and its contents
  • 2010
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 141:1, s. 92-98
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND AIM: Radiofrequency catheter ablation treats resistant nodal re-entrant tachycardia but carries a risk to AV conduction system and its vessels. We aimed to study the origin of the A-V nodal artery (AVNA) and its course within the posterior septal space (PSS). METHODS: Twenty embalmed human hearts of both sexes (16 males) age, 25-60 years, were dissected to study the PPS and its arteries down to their destination. RESULTS: The PSS is a four sided pyramidal space, at the crux of the heart, with its base made of the pericardium. It is made of four; right upper and lower and left upper and lower walls corresponding to the right atrium and ventricle and left atrium and ventricle, respectively. The right coronary artery (RCA) crossed the base from the right to the left angle, to lie inferior and adherent to the terminal part of the coronary sinus (CS). The posterior interventricular artery, the ventricular branches of the RCA, the middle cardiac vein and the ventricular veins, all crossed the base of the space to their final destination. AVNA originated from either the RCA itself or one of its branches. Double AVNA was encountered in 14 specimens with the upper artery larger and passed between the right and left atria and the lower artery smaller and crossed the space adjacent to the right ventricle. CONCLUSIONS: These findings highlight the importance of the PSS and its structural relations, in particular to the AVNA, that should be considered during various interventional procedures.
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7.
  • Galderisi, Maurizio, et al. (författare)
  • Recommendations of the European Association of Echocardiography : how to use echo-Doppler in clinical trials
  • 2011
  • Ingår i: European Journal of Echocardiography. - : Oxford University Press (OUP). - 1525-2167 .- 1532-2114. ; 12:5, s. 339-353
  • Tidskriftsartikel (refereegranskat)abstract
    • The European Association of Echocardiography (EAE) has developed the present recommendations to assist clinical researchers in the design, implementation, and conduction of echocardiographic protocols for clinical trials and to guarantee their quality. Clinical trials should be designed and conducted based on the knowledge of the pathophysiology of the clinical condition studied, the technical characteristics of the echo-Doppler modalities, and the variability of the tested parameters. These procedures are important to choose the most reliable and reproducible techniques and parameters. Quality assurance must be guaranteed by adequate training of peripheral site operators to obtain optimal echo-Doppler data and by using a core laboratory for accurate and reproducible data analysis.
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8.
  • Hellström, Monica, et al. (författare)
  • Innocent left ventricular outflow tract membrane.
  • 2011
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 15:150(2), s. e65-e66
  • Tidskriftsartikel (refereegranskat)abstract
    • Innocent left ventricular outflow tract membranes are rare finding, and may have no significant haemodynamic effect. Thanks to the high resolution of the recent echocardiographs these membranes can be seen in detail. Various shapes and forms of such membranes need to be adequately studied and documented.
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9.
  • Henein, Mark, et al. (författare)
  • Atrial interaction in the form of 'cross talk' in patients with ventricular outflow tract obstruction.
  • 2011
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 17:147(3), s. 388-392
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The Bernheim 'a' wave in the jugular venous pulse of patients with left ventricular hypertrophy has been shown to reflect accentuated right atrial activity. OBJECTIVE: To study possible atrial interaction in patients with right and left ventricular outflow tract obstruction due to significant pulmonary (PS) and aortic valvular stenosis (AS) respectively. METHODS: We studied 41 PS patients (age 36+/-10 year) and 41 AS patients (age 35+/-12 year) and their results were compared with those of 27 controls (age 30+/-7 year). RV and LV filling were recorded by conventional PW Doppler. Biventricular segmental function was studied using the PW tissue Doppler imaging (TDI) and M-mode techniques. RESULTS: The 2 patient groups had similar degree of ventricular outflow tract obstruction. Long axis function was impaired while global systolic function was preserved in the pressure-overloaded ventricle. Patients had higher peak late filling (A wave) and TDI late diastolic (Aa) velocities recorded in the disease-free ventricles despite having similar peak early filling velocities (E wave), E wave deceleration time and E/Ea ratios were not different from controls (p>0.05 for all). Such accentuation of atrial activity (A wave) was moderately correlated with the degree of contralateral ventricular outflow tract obstruction (p<0.001 for both). CONCLUSIONS: Long axis function is more sensitive than global function in revealing myocardial dysfunction in the pressure-overloaded ventricles. The increased contralateral atrial systolic activity suggests an evidence for atrial interaction in the form of 'cross talk'.
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10.
  • Henein, Michael Y (författare)
  • Atrial electromechanical function
  • 2011
  • Ingår i: Europace. - London : Harcourt Publishers. - 1099-5129 .- 1532-2092. ; 13:12, s. 1665-1666
  • Tidskriftsartikel (refereegranskat)
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