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  • 1.
    Byström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Örnsköldsvik Hospital.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Henein, Michael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    The right ventricle: knowing what is right2008In: The International Journal of Cardiovascular Imaging, ISSN 1569-5794, E-ISSN 1875-8312, Vol. 24, no 7, p. 701-702Article in journal (Refereed)
  • 2.
    Cameli, Matteo
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Lisi, Matteo
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Reccia, Rosanna
    Bennati, Elena
    Malandrino, Angela
    Solari, Marco
    Bigio, Elisa
    Biagioli, Bonizella
    Righini, Francesca Maria
    Maccherini, Massimo
    Chiavarelli, Mario
    Henein, Michael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Mondillo, Sergio
    Pre-operative left atrial strain predicts post-operative atrial fibrillation in patients undergoing aortic valve replacement for aortic stenosis2014In: The International Journal of Cardiovascular Imaging, ISSN 1569-5794, E-ISSN 1875-8312, Vol. 30, no 2, p. 279-286Article in journal (Refereed)
    Abstract [en]

    Post-operative atrial fibrillation (AF) is a common and serious complication in patients undergoing aortic valve replacement (AVR). Speckle tracking echocardiography (STE) has recently enabled the quantification of longitudinal myocardial left atrial (LA) deformation dynamics. Our aim was to investigate LA preoperative mechanical function in patients undergoing AVR for aortic stenosis using STE and determine predictors of post-operative AF. 76 patients with aortic stenosis in sinus rhythm, undergoing AVR, were prospectively enrolled. Conventional echocardiographic parameters, and peak atrial longitudinal strain (PALS) were measured in all subjects the day before surgery. PALS values were obtained by averaging all segments in the 4- and 2-chamber views (global PALS). All patients received biological valve prostheses and a standard postoperative care. Postoperative AF occurred in 15 patients (19.7 %). On univariate analysis among all clinical and echocardiographic variables, global PALS showed the highest diagnostic accuracy (HR 6.55 p < 0.0001; AUC of 0.89) with a cut-off value < 16.9 %, having sensitivity and specificity of 86 and 91 %, respectively, in predicting postoperative AF. LA volume indexed and E/e' ratio had lower diagnostic accuracy (AUC 0.76 and 0.51, respectively). On multivariate analysis global PALS remains a significant predictor of postoperative AF (p < 0.0001). STE analysis of LA myocardial deformation is considered a promising tool for the evaluation of LA subclinical dysfunction in patients undergoing AVR, giving a potentially better risk stratification for the occurrence of postoperative AF.

  • 3. D'Ascenzi, Flavio
    et al.
    Cameli, Matteo
    Henein, Michael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Iadanza, Alessandro
    Reccia, Rosanna
    Lisi, Matteo
    Curci, Valeria
    Sinicropi, Giuseppe
    Torrisi, Andrea
    Pierli, Carlo
    Mondillo, Sergio
    Left atrial remodelling in patients undergoing transcatheter aortic valve implantation: a speckle-tracking prospective, longitudinal study.2013In: The International Journal of Cardiovascular Imaging, ISSN 1569-5794, E-ISSN 1875-8312, Vol. 29, no 8, p. 1717-1724Article in journal (Refereed)
    Abstract [en]

    Aortic stenosis (AS) results in several left ventricular (LV) disturbances as well as progressive left atrial (LA) enlargement and dysfunction. Transcatheter aortic valve implantation (TAVI) reverses LV remodelling and improves overall systolic function but its effect on LA function remains undetermined. The aim of this prospective, longitudinal study was to investigate the effects of TAVI on LA structure and function. We studied thirty-two patients with severe symptomatic AS who underwent TAVI, using standard and 2-dimensional speckle-tracking echocardiography before, at 40-day and at 3-month follow-up. Following TAVI, mean transvalvular gradient decreased (p < 0.001). Both LA area index and LA volume index decreased at 40-day follow-up (16.2 ± 6.4 vs. 12.5 ± 2.9 cm(2)/m(2), and 47.3 ± 12.0 vs. 42.8 ± 12.5 mL/m(2), respectively, p < 0.05) and values remained unchanged at 3 months. The reduction of LA size was accompanied by a significant increase in global peak atrial longitudinal strain (14.4 ± 3.9 vs. 19.1 ± 4.7 %, p < 0.001) and in global peak atrial contraction strain (8.4 ± 2.5 vs. 11.0 ± 4.1 %, p < 0.05) at 3-month follow-up. LA stiffness measurements significantly decreased 3 months after TAVI (0.93 ± 0.59 vs. 0.65 ± 0.37, respectively, p < 0.001). Trans-aortic mean gradient change and pre-procedural LA volume were identified as predictors of global peak atrial longitudinal strain increase (β = -0.41, β = -0.35, respectively, p < 0.0001) while pre-procedural LA volume and trans-aortic mean gradient change as predictor of LA volume index reduction 3 months after TAVI (β = -0.37, β = -0.28, respectively, p < 0.0001). TAVI is associated with significant recovery of LA structure and function suggesting a reverse cavity remodelling. Such functional recovery is primarily determined by the severity of pre-procedural valve stenosis.

  • 4.
    Henein, Michael Y
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Holmgren, Anders
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
    Left atrial function in volume versus pressure overloaded left atrium2015In: The International Journal of Cardiovascular Imaging, ISSN 1569-5794, E-ISSN 1875-8312, Vol. 31, no 5, p. 959-965Article in journal (Refereed)
    Abstract [en]

    Left atrial (LA) pressure and volume overload both result in cavity enlargement and complications. LA volume has been shown to predict such complications, but it does not reflect myocardial function, which can be accurately assessed using myocardial deformation measurements. We hypothesized that volume overloaded LA have maintained myocardial function compared to pressure overloaded ones. We tested this hypothesis in 44 patient (mean age 62 ± 12 years) with LA volume overload (LAVOL) due to severe mitral regurgitation (MR) with no indirect signs of elevated left ventricular (LV) filling pressures based on Doppler measured isovolumic relaxation time >60 ms. We compared them with 24 (mean age 64 ± 12 years) patient with LA pressure overload (LAPOL) who proved to have PCWP >15 mmHg on right heart catheterization. Twenty-seven healthy controls (mean age 57 ± 10 years) constituted a control group. Patients with LAVOL had larger LA volumes, higher LV ejection fraction, global LV strain (LVGLS) and transmitral and pulmonary veins flow velocities (p < 0.05) and better LA atrial strain rate (LASR) function compared to LAPOL (p < 0.001). In LAVOL, the LASR during atrial contraction (LASRa) was lower than in controls (p < 0.05) indicating LA mechanical disturbances. LVGLS correlated with peak atrial longitudinal systolic strain in the whole group (r = -0.65, p < 0.001) and less so with LASRa (r = -0.43, p < 0.001) Conclusion: Irrespective of a smaller LA volume, LAVOL had less negative effect on LA myocardial function than LAPOL. Thus, monitoring atrial myocardial contraction might be useful in following patients with significant MR.

  • 5. Lindqvist, Per
    et al.
    Broyd, Chris
    Henein, Michael Y
    E/E': a prime number?2009In: The International Journal of Cardiovascular Imaging, ISSN 1569-5794, E-ISSN 1875-8312, Vol. 25, no 1, p. 41-42Article in journal (Refereed)
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  • fi-FI
  • nn-NO
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  • text
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