68 research outputs found
Echocardiographic parameters of ventricular dyssynchrony validation in patients with heart failure using sequential biventricular pacing
No full text© 2004 American College of Cardiology Foundation Published by Elsevier Inc.ObjectivesWe sought to evaluate the relationship between hemodynamic and ventricular dyssynchrony parameters in patients undergoing simultaneous and sequential biventricular pacing (BVP).BackgroundVarious echocardiographic parameters of ventricular dyssynchrony have been proposed to screen and optimize BVP therapy.MethodsForty-one patients with heart failure undergoing BVP implantation were studied. Echocardiography coupled with tissue tracking and pulsed Doppler tissue imaging (DTI) was performed before and after BVP implantation and after three months of optimized BVP. Indexes of inter- or intraventricular dyssynchrony were correlated with hemodynamic changes during simultaneous and sequential BVP (10 intervals of right ventricular [RV] or left ventricular [LV] pre-excitation).ResultsVariations in intra-LV delay(peak), intra-LV delay(onset), and index of LV dyssynchrony measured by pulsed DTI were highly correlated with those of cardiac output (r = -0.67, r = -0.64, and r = -0.67, respectively; p ConclusionsSpecific echocardiographic measurements of ventricular dyssynchrony are highly correlated with hemodynamic changes and may be a useful adjunct in the selection and optimization of BVP. Individually optimized sequential BVP provided a significant early hemodynamic improvement compared with simultaneous BVP.Pierre Bordachar, Stephane Lafitte, Sylvain Reuter, Prashanthan Sanders, Pierre Jaïs, Michel Haïssaguerre, Raymond Roudaut, Stephane Garrigue and Jacques Clement
Biventricular pacing and left ventricular pacing in heart failure: similar hemodynamic improvement despite marked electromechanical differences
No full textThe definitive version is available at www.blackwell-synergy.comIntroduction: We conducted an acute echocardiographic study comparing hemodynamic and ventricular dyssynchrony parameters during left ventricular pacing (LVP) and biventricular pacing (BVP). We sought to clarify the mechanisms responsible for similar hemodynamic improvement despite differences in electrical activation. Methods and Results: Thirty-three patients underwent echocardiography prior to implantation with a multisite pacing device (spontaneous rhythm [SR]) and 2 days after implantation (BVP and LVP). Interventricular dyssynchrony (pulsed-wave Doppler), extent of myocardium displaying delayed longitudinal contraction (%DLC; tissue tracking), and index of LV dyssynchrony (pulsed-wave tissue Doppler imaging) were assessed. Compared to SR, BVP and LVP caused similar significant improvement of cardiac output (LVP: 3.2 ± 0.5, BVP: 3.1 ± 0.7, SR: 2.3 ± 0.6 L/min; P < 0.01) and mitral regurgitation (LVP: 25.1 ± 10, BVP: 24.7 ± 11, baseline: 37.9 ± 14% jet area/left atria area; P < 0.01). LVP resulted in a smaller index of LV dyssynchrony than BVP (29 ± 10 vs 34 ± 14; P < 0.05). However, LVP exhibited a longer aortic preejection delay (220 ± 34 vs 186 ± 28 msec; P < 0.01), longer LV electromechanical delays (244.5 ± 39 vs 209.5 ± 47 msec; P < 0.05), greater interventricular dyssynchrony (56.6 ± 18 vs 31.4 ± 18; P < 0.01), and higher%DLC (40.1 ± 08 vs 30.3 ± 09; P < 0.05), leading to shorter LV filling time (387 ± 54 vs 348 ± 44 msec; P < 0.05) compared to BVP. Conclusion: Although LVP and BVP provide similar hemodynamic improvement, LVP results in more homogeneous but substantially delayed LV contraction, leading to shortened filling time and less reduction in postsystolic contraction. These data may influence the choice of individual optimal pacing configuration.Pierre Bordachar, Stephane Lafitte, Sylvain Reuter, Stephane Garrigue, Prashanthan Sanders, Raymond Roudaut, Pierre Jaïs, Michel Haïssaguerre, Jacques Clement
Long-term outcomes of concomitant suture bicuspidization technique to treat mild or moderate tricuspid regurgitation in patients undergoing mitral valve surgery
No full textObjectives: The aim of this study was to investigate the long-term outcomes of concomitant suture bicuspidization to treat mild or moderate tricuspid regurgitation at the time of mitral valve (MV) surgery. Methods: Data from patients who underwent MV surgery for degenerative MV regurgitation with mild or moderate tricuspid regurgitation and annular dilatation between January 2009 and December 2017 were analysed. The cohort was divided into 2 groups: mitral valve surgery alone (MVA) and MV surgery with concomitant tricuspid valve (TV) repair. Results: A total of 196 patients were included in the study. MVA and MV surgery with concomitant TV repair were performed in 91 (46.4%) and 105 (53.6%) patients, respectively. Propensity score matching analysis identified 54 pairs. In the matched cohort, 30-day mortality (0.0% vs 1.9%, P = 1.0) and new permanent pacemaker implantation (11.1% vs 7.4%, P = 0.740) did not differ significantly between groups. After a mean follow-up of 6.0 (2.8) years, MV surgery with concomitant TV repair was not associated with increased mortality risk compared to MVA (hazard ratio 1.04, 95% confidence interval 0.47-2.28, P = 0.927) with 10-year overall survival rates of 69.9% and 77.2%, respectively. Furthermore, MV surgery with concomitant TV repair was associated with a significantly reduced progression of TV regurgitation (P < 0.001). Conclusions: Patients undergoing MV surgery with concomitant TV repair had similar 30-day and long-term survival, similar permanent pacemaker implantation rate and reduced progression of TV regurgitation compared to those undergoing MVA
Detrimental ventricular remodeling in patients with congenital complete heart block and chronic right ventricular apical pacing
No full text© 2004 American Heart Association, Inc.BackgroundAlthough dual-chamber pacing improves cardiac function in patients with complete congenital atrioventricular block (CCAVB) by restoring physiological heart rate and atrioventricular synchronization, the long-term detrimental effect of asynchronous electromechanical activation induced by apical right ventricular pacing (RVP) has not been well clarified.Methods and resultsTwenty-three CCAVB adults (24+/-3 years) with a DDD transvenous pacemaker underwent conventional echocardiography before implantation and, after at least 5 years of RVP, an exercise test and echocardiography coupled with tissue Doppler imaging and tissue tracking. They were compared with 30 matched healthy control subjects. After 10+/-3 years of RVP, CCAVB adults had significantly higher values versus controls in terms of intra-left ventricular (LV) asynchrony (respectively, 59+/-18 versus 19+/-9 ms, PConclusionsProlonged ventricular dyssynchrony induced by long-term endovenous RVP is associated with deleterious LV remodeling, LV dilatation, LV asymmetrical hypertrophy, and low exercise capacity. These new data highlight the importance of the ventricular activation sequence in all patients with chronic ventricular pacing.Jean-Benoît Thambo; Pierre Bordachar; Stephane Garrigue; Stephane Lafitte; Prashanthan Sanders; Sylvain Reuter; Romain Girardot; David Crepin; Patricia Reant; Raymond Roudaut; Pierre Jaïs; Michel Haïssaguerre; Jacques Clementy; Maria Jimene
Do We Need New Echocardiographic Prognosticators for the Management of Heart Failure Patients?⁎⁎Editorials published in the Journal of the American College of Cardiologyreflect the views of the authors and do not necessarily represent the views of JACCor the American College of Cardiology.
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José Silvestre de los Dolores White Lafitte: Afro-Cuban-French Violin Virtuoso, Pedagogue, and Composer — An Argument for the Inclusion of Six Concert Pieces for Violin and Piano in the Performance and Teaching Canon
No full textViolin virtuoso, pedagogue, and composer José Silvestre de los Dolores White Lafitte (1835-1918) enjoyed a prominent performing and teaching career and was recognized as one of the foremost violinists of his generation. He was also an influential figure in the development of the French School of violin playing. Despite receiving recognition during his lifetime, his works are not regularly presented in the modern concert and pedagogical canons.This document aims to recenter White as a significant musical figure and highlights his influence as a performer, pedagogue, and composer. Turning to six of White’s virtuoso concert works for violin and piano, the author creates pedagogical outlines that provide an avenue for artist performers, teachers, and students to program and present these works. The document also presents thematic programs with the aim of elevating and contextualizing these works within the established canon. On a more holistic level, the document argues that increasing the diversity of repertoire makes for richer concert and pedagogical experiences. It is the author’s hope that the presentation of these six concert works inspires increased programming and further study of White’s music, including rediscovery of his other works.</p
How to perform stress/exercise echocardiography in -hypertrophic cardiomyopathy?
No full textInternational audienc
José Silvestre de los Dolores White Lafitte: Afro-Cuban-French Violin Virtuoso, Pedagogue, and Composer — An Argument for the Inclusion of Six Concert Pieces for Violin and Piano in the Performance and Teaching Canon
No full textViolin virtuoso, pedagogue, and composer José Silvestre de los Dolores White Lafitte (1835-1918) enjoyed a prominent performing and teaching career and was recognized as one of the foremost violinists of his generation. He was also an influential figure in the development of the French School of violin playing. Despite receiving recognition during his lifetime, his works are not regularly presented in the modern concert and pedagogical canons.This document aims to recenter White as a significant musical figure and highlights his influence as a performer, pedagogue, and composer. Turning to six of White’s virtuoso concert works for violin and piano, the author creates pedagogical outlines that provide an avenue for artist performers, teachers, and students to program and present these works. The document also presents thematic programs with the aim of elevating and contextualizing these works within the established canon. On a more holistic level, the document argues that increasing the diversity of repertoire makes for richer concert and pedagogical experiences. It is the author’s hope that the presentation of these six concert works inspires increased programming and further study of White’s music, including rediscovery of his other works.</p
The new place of imaging in cardiology, from diagnosis to treatment
No full textInternational audienc
Numerical study and ex vivo assessment of HIFU treatment time reduction through optimization of focal point trajectory
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