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Henein, Michael Y.
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Publications (10 of 276) Show all publications
Henein, M. Y., Tossavainen, E., Aroch, R., Söderberg, S. & Lindqvist, P. (2019). Can Doppler echocardiography estimate raised pulmonary capillary wedge pressure provoked by passive leg lifting in suspected heart failure?. Clinical Physiology and Functional Imaging, 39(2), 128-134
Open this publication in new window or tab >>Can Doppler echocardiography estimate raised pulmonary capillary wedge pressure provoked by passive leg lifting in suspected heart failure?
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2019 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 39, no 2, p. 128-134Article in journal (Refereed) Published
Abstract [en]

AIMS: Non-invasive estimation of left ventricular filling pressure (LVFP) during stress is important for explaining exertional symptoms in patients with heart failure (HF). The aim of this study was to evaluate ability of Doppler echocardiographic measures of elevated LVFP with passive leg lifting (PLL) in patients with suspected HF.

METHODS: Twenty-nine patients with clinical signs of HF who underwent simultaneous Doppler echocardiography and right heart catheterization (RHC) at rest and during PLL were consecutively investigated. Seventeen patients had normal PCWP (≤15 mmHg) at rest and during PLL and 12 with normal PCWP at rest but >15 mmHg with PLL. Conventional echo and 2D strain were used to assess early diastolic blood flow velocity (E), LV strain rate during early diastole (LVSRe), left atrial SR during atrial contraction (LASRa) and myocardial tissue Doppler velocities to assess lateral e' and further calculate E/e' and E/LVSRe and their relationship with PCWP, at rest and during PLL.

RESULTS: Resting LAVI (β = 0·45, P = 0·009) and LASRa (β = -0·51, P = 0·004) were independently related to PCWP during PLL. Also, LASRa (β = -0·77, P<0·001), E/e' (β = 0·40, P = 0·04) and E/LVSRe (β = 0·47, P = 0·021) during PLL correlated with PCWP during PLL. Multiple regression analysis identified E/LVSRe (β = 0·46, P = 0·001) and LASRa (β = -0·58, P = 0·002) during PLL as being independently associated with PCWP during PLL.

CONCLUSION: Left atrial volume and myocardial contraction (LASRa) at rest both predict unstable LV filling pressures measured as raised PCWP when provoked by PLL. Furthermore, LASRa at PLL seems to have the strongest association to PCWP during PLL.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
deformation, passive leg lifting, pulmonary capillary wedge pressures, strain rate
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-152550 (URN)10.1111/cpf.12547 (DOI)000458316200003 ()30298591 (PubMedID)
Funder
Swedish Heart Lung Foundation
Available from: 2018-10-11 Created: 2018-10-11 Last updated: 2019-05-10Bibliographically approved
Faggiano, P., Dasseni, N., Gaibazzi, N., Rossi, A., Henein, M. & Pressman, G. (2019). Cardiac calcification as a marker of subclinical atherosclerosis and predictor of cardiovascular events: A review of the evidence. European Journal of Preventive Cardiology, 26(11), 1191-1204
Open this publication in new window or tab >>Cardiac calcification as a marker of subclinical atherosclerosis and predictor of cardiovascular events: A review of the evidence
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2019 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 26, no 11, p. 1191-1204Article, review/survey (Refereed) Published
Abstract [en]

Risk prediction of future atherothrombotic cardiovascular events is currently based on conventional risk factor assessment and the use of validated algorithms, such as the Framingham Risk Score, the Pooled Cohort Equations, and the European SCORE Risk Charts. However, the identification of subclinical organ damage has emerged as a potentially more accurate predictor of individual risk. Several imaging modalities have been proposed for identification of preclinical atherosclerosis. Coronary artery calcification scanning performed using cardiac computed tomography and calculation of the Agatston score is the most commonly used technique in clinical practice for detection of subclinical disease, prognostic stratification of asymptomatic individuals and implementation of preventive strategies. Furthermore, conventional echocardiographic examination may offer an assessment of cardiac calcifications at different sites, such as the mitral apparatus (including annulus, leaflets and papillary muscles), aortic valve and ascending aorta, that are associated with the clinical manifestation of atherosclerotic disease and are predictive of future cardiovascular events. The aim of this paper is to summarize available evidence on the clinical use of cardiac calcification, review the pathogenetic mechanisms involved, including similarities with atherosclerosis, and evaluate its potential for risk stratification and prevention of clinical events in the primary prevention setting.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Subclinical atherosclerosis, risk prediction, aortic valve sclerosis, mitral annulus, valve calcification, calcium score
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-161580 (URN)10.1177/2047487319830485 (DOI)000472573700012 ()30845832 (PubMedID)
Available from: 2019-07-25 Created: 2019-07-25 Last updated: 2019-07-25Bibliographically approved
Henein, M. & Vancheri, F. (2019). Carotid arterial stiffness and intima-media thickness: A little impact of uric acid. Monaldi Archives for Chest Disease, 89(1), Article ID 1057.
Open this publication in new window or tab >>Carotid arterial stiffness and intima-media thickness: A little impact of uric acid
2019 (English)In: Monaldi Archives for Chest Disease, ISSN 1122-0643, Vol. 89, no 1, article id 1057Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
PAGEPress, 2019
Keywords
Cardiovascular risk, uric acid, beta stiffness index, intima-media thickness
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-159889 (URN)10.4081/monaldi.2019.1057 (DOI)000468399900001 ()30968655 (PubMedID)
Available from: 2019-06-10 Created: 2019-06-10 Last updated: 2019-06-10Bibliographically approved
Bytyçi, I., Bajraktari, G., Lindqvist, P. & Henein, M. Y. (2019). Compromised left atrial function and increased size predict raised cavity pressure: a systematic review and meta-analysis. Clinical Physiology and Functional Imaging, 39(5), 297-307
Open this publication in new window or tab >>Compromised left atrial function and increased size predict raised cavity pressure: a systematic review and meta-analysis
2019 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 39, no 5, p. 297-307Article, review/survey (Refereed) Published
Abstract [en]

Aim: This meta-analysis assesses left atrial (LA) cavity and myocardial function measurements that predict pulmonary capillary wedge pressure (PCWP). Methods: PubMed-MEDLINE, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry were searched up to December 2018 for studies on the relationship of LA diameter, LA indexed volume (LAVI max, LAVI min), peak atrial longitudinal (PALS), peak atrial contraction (PACS) strain and total emptying fraction (LAEF) with PCWP. Eighteen studies with 1343 patients were included. sensitivity and specificity (with 95% CI) for evaluation of diagnostic accuracy and the best cut-off values for different LA indices in predicting raised PCWP were estimated using summary receiver operating characteristic analysis. Results: The pooled analysis showed association between PCWP and LA diameter: Cohen's d = 0 center dot 87, LAVI max: d = 0 center dot 92 and LAVI min: d = 1 center dot 0 (P<0 center dot 001 for all). A stronger correlation was found between PCWP and PALS: d = 1 center dot 26, and PACS: d = 1 center dot 62, total EF d = 1 center dot 22 (P<0 center dot 0001 for all). PALS <= 19% had a summary sensitivity of 80% (65-90) and summary specificity of 77% (52-92), positive likelihood ratio (LR+) 3 center dot 74, negative likelihood ratio (LR-) DOR > 15 center dot 1 whereas LAVI >= 34 ml m(-2) had summary sensitivity of 75% (55-89) and summary specificity 77% (57-90), with LR+ >3, LR- 0 center dot 32 and DOR >10 center dot 1. Conclusions: Compromised LA myocardial function and increased size predict raised cavity pressure. These results should assist in optimum follow-up of patients with fluctuating LA pressure.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
left atrial, left atrial function, left atrial size, left atrial strain, pulmonary capillary wedge pressure
National Category
Physiology
Identifiers
urn:nbn:se:umu:diva-162835 (URN)10.1111/cpf.12587 (DOI)000479117100001 ()31136072 (PubMedID)
Available from: 2019-09-13 Created: 2019-09-13 Last updated: 2019-09-13Bibliographically approved
Boles, U., Wiklund, U., Santhosh, D., Ahmed, K. & Henein, M. Y. (2019). Coronary artery ectasia carries worse prognosis: a long-term follow-up study [Letter to the editor]. Polish Archives of Internal Medicine
Open this publication in new window or tab >>Coronary artery ectasia carries worse prognosis: a long-term follow-up study
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2019 (English)In: Polish Archives of Internal Medicine, ISSN 0032-3772, E-ISSN 1897-9483Article in journal, Letter (Refereed) Epub ahead of print
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-163322 (URN)10.20452/pamw.14959 (DOI)31469119 (PubMedID)
Available from: 2019-09-16 Created: 2019-09-16 Last updated: 2019-09-23
Xue, C., Zhao, Y., Zhang, Y., Gu, X., Han, J., Henein, M. & He, Y. (2019). Double-chambered left ventricle diagnosis by 2D and 3D echocardiography: From fetus to birth. Echocardiography, 36(1), 196-198
Open this publication in new window or tab >>Double-chambered left ventricle diagnosis by 2D and 3D echocardiography: From fetus to birth
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2019 (English)In: Echocardiography, ISSN 0742-2822, E-ISSN 1540-8175, Vol. 36, no 1, p. 196-198Article in journal, Editorial material (Other academic) Published
Abstract [en]

Double-chambered left ventricle (DCLV) is a rare cardiac anomaly and is characterized by the division of the left ventricle by abnormal muscle and/or fiber bundles into two chambers. We hereby report a fetus which was diagnosed with DCLV in utero by 2D and 3D Fetal echocardiography and the findings were confirmed after birth.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
double-chambered left ventricle, echocardiography, fetus
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-155768 (URN)10.1111/echo.14215 (DOI)000455100300027 ()30592776 (PubMedID)
Available from: 2019-01-28 Created: 2019-01-28 Last updated: 2019-01-28Bibliographically approved
Charisopoulou, D., Koulaouzidis, G., Rydberg, A. & Henein, M. (2019). Exercise worsening of electromechanical disturbances: a predictor of arrhythmia in long QT syndrome. Clinical Cardiology, 42(2), 235-240
Open this publication in new window or tab >>Exercise worsening of electromechanical disturbances: a predictor of arrhythmia in long QT syndrome
2019 (English)In: Clinical Cardiology, ISSN 0160-9289, E-ISSN 1932-8737, Vol. 42, no 2, p. 235-240Article in journal (Refereed) Published
Abstract [en]

Background; Electromechanical (EM) coupling heterogeneity is significant in long QT syndrome (LQTS), particularly in symptomatic patients; EM window (EMW) has been proposed as an indicator of interaction and a better predictor of arrhythmia than QTc. Hypothesis To investigate the dynamic response of EMW to exercise in LQTS and its predictive value of arrhythmia.

Methods: Forty-seven LQTS carriers (45 +/- 15 years, 20 with arrhythmic events), and 35 controls underwent exercise echocardiogram. EMW was measured as the time difference between aortic valve closure on Doppler and the end of QT interval on the superimposed electrocardiogram (ECG). Measurements were obtained at rest, peak exercise (PE) and 4 minutes into recovery.

Results: Patients did not differ in age, gender, heart rate, or left ventricular ejection fraction but had a negative resting EMW compared with controls (-42 +/- 22 vs 17 +/- 5 ms, P < 0.0001). EMW became more negative at PE (-89 +/- 43 vs 16 +/- 7 ms, P = 0.0001) and recovery (-65 +/- 39 vs 16 +/- 6 ms, P = 0.001) in patients, particularly the symptomatic, but remained unchanged in controls. PE EMW was a stronger predictor of arrhythmic events than QTc (AUC:0.765 vs 0.569, P < 0.001). B-blockers did not affect EMW at rest but was less negative at PE (BB: -66 +/- 21 vs no-BB: -113 +/- 25 ms, P < 0.001). LQT1 patients had worse PE EMW negativity than LQT2.

Conclusion: LQTS patients have significantly negative EMW, which worsens with exercise. These changes are more pronounced in patients with documented arrhythmic events and decrease with B-blocker therapy. Thus, EMW assessment during exercise may help improve risk stratification and management of LQTS patients.

Place, publisher, year, edition, pages
Wiley Periodicals, Inc., 2019
Keywords
arrhythmia, electromechanical window, exercise echocardiography, long QT syndrome
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-156883 (URN)10.1002/clc.23132 (DOI)000458424300004 ()30537240 (PubMedID)
Available from: 2019-03-11 Created: 2019-03-11 Last updated: 2019-03-11Bibliographically approved
Hellman, U., Mörner, S. & Henein, M. (2019). Genetic variants in cardiac calcification in Northern Sweden. Medicine (Baltimore, Md.), 98(15), Article ID e15065.
Open this publication in new window or tab >>Genetic variants in cardiac calcification in Northern Sweden
2019 (English)In: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 98, no 15, article id e15065Article in journal (Refereed) Published
Abstract [en]

Extensive coronary calcification without significant stenosis, described as calcific coronary artery disease (CCAD) may cause abnormal myocardial perfusion and hence generalized ischemia. There is a discrepancy in the expression pattern of CCAD compared to the well-known atherosclerotic disease which raises questions about the exact pathophysiology of coronary calcification and whether there is a genetic etiology for it.

In this pilot study we studied 3 candidate genes, ectonucleotide pyrophosphatase/phosphodiesterase (ENPP1), ATP Binding Cassette Subfamily C Member 6 (ABCC6), and 5'-Nucleotidase Ecto (NT5E) involved in pyrophosphate (PPi) and inorganic phosphate (Pi) metabolism, which may predispose to coronary arterial or valvular calcification. We studied 70 patients with calcific cardiac disease; 65 with CCAD (age 43-83 years) and 5 with calcific aortic valve disease (CAVD) (age 76-82 years).

Five DNA variants potentially affecting protein function were found in 6 patients. One variant is a known disease-causing mutation in the ABCC6 gene. Our findings support that disturbances in the PPi and Pi metabolism might influence the development of CCAD and CAVD. However, segregation in the families must first be performed to ascertain any damaging effect of these variants we have found.

We report 4 new genetic variants potentially related to coronary calcification, through the disturbed Pi and PPi metabolism. The search for direct causative genetic variants in coronary artery and aortic valve calcification must be broadened with other genes particularly those involved with Pi and PPi metabolism.

Place, publisher, year, edition, pages
Wolters Kluwer, 2019
Keywords
arterial calcification, coronary artery disease, gene
National Category
Cardiac and Cardiovascular Systems
Research subject
Cardiology
Identifiers
urn:nbn:se:umu:diva-158611 (URN)10.1097/MD.0000000000015065 (DOI)000467331500017 ()30985656 (PubMedID)2-s2.0-85064852879 (Scopus ID)
Available from: 2019-05-02 Created: 2019-05-02 Last updated: 2019-06-18Bibliographically approved
Faggiano, P., Dasseni, N. & Henein, M. (2019). Imaging subclinical atherosclerosis promises better cardiovascular primary prevention. European Journal of Preventive Cardiology, 26(12), 1310-1312
Open this publication in new window or tab >>Imaging subclinical atherosclerosis promises better cardiovascular primary prevention
2019 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 26, no 12, p. 1310-1312Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Sage Publications, 2019
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-161886 (URN)10.1177/2047487319849323 (DOI)000475458800012 ()31067127 (PubMedID)2-s2.0-85065705858 (Scopus ID)
Available from: 2019-08-08 Created: 2019-08-08 Last updated: 2019-08-08Bibliographically approved
Bytyci, I., Bajraktari, G., Fabiani, I., Lindqvist, P., Poniku, A., Pugliese, N. R., . . . Henein, M. (2019). Left atrial compliance index predicts exercise capacity in patients with heart failure and preserved ejection fraction irrespective of right ventricular dysfunction. Echocardiography, 36(6), 1045-1053
Open this publication in new window or tab >>Left atrial compliance index predicts exercise capacity in patients with heart failure and preserved ejection fraction irrespective of right ventricular dysfunction
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2019 (English)In: Echocardiography, ISSN 0742-2822, E-ISSN 1540-8175, Vol. 36, no 6, p. 1045-1053Article in journal (Refereed) Published
Abstract [en]

Background and Aim: Predictors of exercise capacity in heart failure (HF) with preserved ejection fraction (HFpEF) remain of difficult determination. The aim of this study was to identify predictors of exercise capacity in a group of patients with HFpEF and right ventricle (RV) dysfunction

Methods: In 143 consecutive patients with HFpEF (age 62 ± 9 years, LV EF ≥45) and 41 controls, a complete echocardiographic study was performed. In addition to conventional measurements, LA compliance was calculated using the formula: [LAV max − LAV min/LAV min × 100]. Exercise capacity was assessed using the six‐minute walking test (6‐MWT). Tricuspid annular plane systolic excursion (TAPSE) < 1.7 cm was utilized to categorize patients with RV dysfunction (n = 40) from those with maintained RV function (n = 103).

Results: Patients with RV dysfunction were older (= 0.002), had higher NYHA class (= 0.001), higher LV mass index (= 0.01), reduced septal and lateral MAPSE (all < 0.001), enlarged LA (= 0.001) impaired LA compliance index (< 0.001) and exhibited a more compromised 6‐MWT (= 0.001). LA compliance index correlated more closely with 6‐MWT (= 0.51, < 0.001) compared with the other LA indices (AP diameter, transverse diameter and volume indexed; = −0.30, = −0.35 and = −0.38, respectively). In multivariate analysis, LA compliance index <60% was 88% sensitive and 61% specific (AUC 0.80, CI = 0.67–0.92 = 0.001) in predicting exercise capacity.

Conclusion: An impairment in LA compliance was profound in patients with HFpEF and RV dysfunction and seems to be most powerful independent predictor of limited exercise capacity.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
exercise capacity, heart failure with preserved ejection fraction, left atrial compliance, right ventricular dysfunction, six-minute walking test
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-161526 (URN)10.1111/echo.14377 (DOI)000471831300004 ()31148237 (PubMedID)
Available from: 2019-07-11 Created: 2019-07-11 Last updated: 2019-07-11Bibliographically approved
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