Publications by authors named "Jeroen Bax"
Background: Coronary artery disease (CAD) comprises one of the leading causes of morbidity and mortality both in the European population and globally. All established clinical risk stratification scores and models require blood lipids and physical measurements. The latest reports of the European Commission suggest that attracting health professionals to collect these data can be challenging, both from a logistic and cost perspective, which limits the usefulness of established models and makes them unsuitable for population-wide screening in resource-limited settings, i.
View Article and Find Full Text PDFBackground: The prevalence and impact of right ventricular dysfunction (RVD) in degenerative mitral regurgitation (DMR) is unknown. We aimed to determine whether RVD assessed by echocardiography in routine clinical practice is independently associated with mortality in patients with DMR.
Methods And Results: We used data from the MIDA-Q (Mitral Regurgitation International DAtabase-Quantitative) registry, which included patients with isolated DMR due to mitral valve prolapse from January 2003 to January 2020 from 5 tertiary centers across North America, Europe, and the Middle East.
Timing of Aortic Valve Intervention in the Management of Aortic Stenosis.
JACC Cardiovasc Interv
November 2024
Aortic stenosis (AS) affects about 12% of people aged ≥75 years. Accumulating evidence on the prognostic importance of cardiac damage in patients with asymptomatic and less than severe AS supports the proposition of advancing aortic valve replacement (AVR) to earlier disease stages. Potential benefits of earlier treatment, including prevention of cardiac damage progression and reduced cardiovascular hospitalizations, need to be balanced against the earlier procedural risk and subsequent lifetime management after AVR.
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- - This study examined the effects of transcatheter aortic valve replacement (TAVR) on patients with heart failure and moderate aortic stenosis, comparing TAVR with clinical surveillance followed by valve replacement if the condition worsened.
- - A total of 178 patients were randomly assigned to either TAVR or surveillance, and results indicated that TAVR was associated with better clinical outcomes, though the statistical significance was borderline.
- - TAVR led to a more substantial improvement in heart failure symptoms, as measured by the Kansas City Cardiomyopathy Questionnaire, compared to the surveillance group after one year of follow-up.
Systemic sclerosis (SSc) is a multisystemic autoimmune disorder in which cardiac involvement is frequent and portends negative prognosis. Left ventricular (LV) diastolic dysfunction is one of the most common cardiac alterations in these patients, and left atrial (LA) reservoir strain (Ɛ) measurement using speckle tracking echocardiography has been proposed as a novel parameter for a better assessment of LV diastolic function. Therefore, the aim of this study was to test the prognostic value of Ɛ in a large multicenter cohort of SSc patients.
View Article and Find Full Text PDFPurpose: Left ventricular myocardial work (LVMW) has been shown to better characterize LV function in patients with severe aortic stenosis by correcting LV afterload. The aim of this study was to evaluate the evolution in LVMW indices after transcatheter aortic valve replacement (TAVR) and their prognostic value.
Methods: The following LVMW indices were calculated before and immediately after TAVR in 255 patients (median age 82 years, 51% male): global work index (GWI), global constructive work (GCW), global wasted work (GWW) and global work efficiency (GWE).
Article Synopsis
- The study investigates the significance of cardiac troponin (cTn) levels in predicting mortality in patients with Takotsubo syndrome (TTS), analyzing data from the International Takotsubo Registry.
- It identifies that a cTn increase greater than 28.8 times the upper reference limit signals clinically relevant myocardial injury, correlating with a higher risk of mortality over 5 years (adjusted HR 1.58).
- The findings enhance understanding of patient risk profiles in TTS, emphasizing the need for increased monitoring and follow-up for those with significant troponin elevations.
Article Synopsis
- Researchers studied moderate secondary mitral regurgitation (SMR) to assess its impact on patient outcomes, noting that it’s linked to worse prognoses but lacks specific data on moderate cases.
- A total of 1,061 patients were analyzed based on their New York Heart Association (NYHA) class and the cause of their SMR (atrial or ventricular), focusing on all-cause mortality and heart failure events over an average follow-up of 82 months.
- The study found that higher NYHA classes and specific types of ventricular SMR significantly correlated with increased risks of death and heart failure, especially in patients with lower left ventricular ejection fractions.
Article Synopsis
- An interatrial shunt is being studied as a potential treatment for heart failure, aimed at lowering left atrial pressure and improving symptoms and outcomes for patients.
- In a clinical trial involving 508 patients, participants were randomly assigned to receive either the shunt or a placebo, with their progress tracked over a maximum of two years.
- Results showed that while the shunt had no major safety issues, it did not significantly improve overall effectiveness compared to the placebo, although it appeared to reduce adverse cardiovascular events in patients with reduced left ventricular ejection fraction.
Background: The implications of pulmonary vein (PV) flow patterns in patients with heart failure (HF) and mitral regurgitation (MR) are uncertain. We examined PV flow patterns in the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation (COAPT) trial (NCT01626079), in which patients with HF and moderate-to-severe or severe functional MR were randomized to transcatheter edge-to-edge repair (TEER) with the MitraClip device plus guideline-directed medical therapy (GDMT) vs. GDMT alone.
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- - A randomized trial showed that adding delayed enhancement MRI-guided fibrosis ablation to pulmonary vein isolation (PVI) for treating atrial fibrillation (AF) didn’t improve outcomes, with similar recurrence rates between the two methods.
- - The study analyzed how effectively lesions delivered during ablation covered fibrotic areas, finding that a much higher percentage of targeted fibrosis was successfully ablated using MRI guidance compared to PVI alone.
- - While overall scar coverage didn’t significantly reduce AF recurrence, lower recurrence rates were noted in patients with less baseline fibrosis when fibrosis-targeted ablation was used, indicating variability in treatment effectiveness.
Article Synopsis
- The study investigated changes in demographics, risk factors, clinical presentations, and outcomes of takotsubo syndrome (TTS) patients from 2004 to 2021, using data from the InterTAK registry.
- Over the years, the proportion of male patients increased, and there was a rise in cases of midventricular TTS as well as significant growth in the incidence of physical triggers.
- There was also a notable increase in 60-day mortality rates, although no significant change in 1-year mortality when excluding early deaths was observed, indicating a complex evolution of TTS and its management in recent years.
Background And Aims: Severe tricuspid regurgitation is associated with increased mortality rates, but benefit of its correction and ideal timing are not clearly determined. This study aimed to identify patient subsets who might benefit from the surgery.
Methods: In TRIGISTRY, an international cohort study of consecutive patients with severe isolated functional tricuspid regurgitation (33 centres, 10 countries), survival rates up to 10 years were compared between patients who underwent isolated tricuspid valve surgery (repair or replacement) and those conservatively managed, overall and according to TRI-SCORE category (low: ≤3, intermediate: 4-5, and high: ≥6).
Background And Aims: To assess sex differences in disease characteristics and treatment of patients with severe native valvular heart disease (VHD) included in the VHD II EURObservational Research Programme.
Methods: A total of 5219 patients were enrolled in 208 European and North African centres and followed for 6 months [41.2% aortic stenosis (AS), 5.
Article Synopsis
- The study aimed to determine if the HFPEF score could predict heart failure outcomes in patients with hypertrophic cardiomyopathy (HCM) who have preserved left ventricular ejection fraction (LVEF).
- A total of 955 patients were analyzed, with those scoring higher on the HFPEF scale tending to have more severe symptoms and comorbidities, showing lower LVEF and impaired heart function.
- Findings indicated that a high HFPEF score is linked to poorer survival rates and higher rates of heart failure hospitalizations, particularly influencing outcomes based on factors like female sex, Asian ethnicity, and existing heart conditions.
Pericoronary adipose tissue for predicting long-term outcomes.
Eur Heart J Cardiovasc Imaging
September 2024
Aims: Pericoronary adipose tissue (PCAT) attenuation obtained by coronary computed tomography angiography (CCTA) has been associated with coronary inflammation and outcomes. Whether PCAT attenuation is predictive of major adverse cardiac events (MACE) during long-term follow-up is unknown.
Methods And Results: Symptomatic patients with coronary artery disease (CAD) who underwent CCTA were included, and clinical outcomes were evaluated.
Background: The pulmonary vein (PV) flow pattern is influenced by the presence of mitral regurgitation (MR). After a successful reduction in MR severity, the pattern is expected to be changed. We aimed to evaluate the prognostic value of a change in the PV flow pattern in patients with primary MR undergoing mitral valve repair (MVR).
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- Immunological therapies, including immune checkpoint inhibitors (ICIs) and cell-based therapies like CAR-T, have transformed cancer treatment by enabling the immune system to target cancer cells.
- While these therapies are generally effective, they can cause immune-related adverse events (irAEs) that vary in severity and timing, from mild skin rashes to serious complications such as myocarditis or cytokine release syndrome.
- The statement discusses the growing understanding of cardiovascular toxicities associated with these therapies, outlines their diagnosis and management, and identifies gaps in current research that need further exploration.
Epicardial adipose tissue in patients with systemic sclerosis.
Eur Heart J Imaging Methods Pract
September 2023
Aims: Epicardial adipose tissue (EAT) has emerged as a mediator between systemic inflammatory disorders and cardiovascular disease, and may therefore play a role in the pathophysiology of cardiac involvement in systemic sclerosis (SSc). The aim of this study was to assess the correlation between EAT and left ventricular (LV) function, and to determine the prognostic value of EAT in patients with SSc.
Methods And Results: Consecutive patients with SSc who underwent non-contrast thorax computed tomography and echocardiography were included.
Aims: Cardiac resynchronization therapy (CRT) may induce left ventricular (LV) reverse remodelling (=LV response) in patients with heart failure. Intraventricular pressure gradients can be quantified using echocardiography-derived haemodynamic forces (HDF). The aim was to evaluate the association between baseline HDF and LV response and to compare the change of HDF after CRT between LV responders and LV non-responders.
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- - The study evaluated how various cardiometabolic risk factors, such as metabolic syndrome and individual factors like high fasting glucose and low HDL cholesterol, impact the progression of coronary plaque and the likelihood of major cardiovascular events in patients with stable coronary artery disease.
- - In a cohort of 1,200 patients followed over several years, 28% experienced rapid coronary plaque progression, identified primarily through increased atheroma volume, which indicates worsening arterial health.
- - The findings suggest that a combination of risk factors, particularly high blood sugar and blood pressure, significantly forecast both plaque progression and serious cardiovascular incidents, highlighting the importance of monitoring these factors in at-risk patients.
Previous studies demonstrated the prognostic value of baseline cardiac damage staging as well as left ventricular global longitudinal strain (LVGLS) in patients undergoing transcatheter aortic valve implantation (TAVI). The aim of the present study was to evaluate the changes in cardiac damage stage and LVGLS after TAVI and to investigate their prognostic values when integrated into the follow-up assessment. Patients with severe aortic stenosis undergoing TAVI were hierarchically classified into cardiac damage stages based on echocardiographic criteria before TAVI and at a 6-month follow-up.
View Article and Find Full Text PDFAims: To evaluate the prognostic implications of the left atrial reservoir strain-defined diastolic dysfunction (LARS-DD) grade in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) and to determine whether post-TAVI LARS was more closely associated with new-onset atrial fibrillation than pre-TAVI LARS.
Methods And Results: Pre-TAVI LARS-DD was evaluated by speckle-tracking echocardiography and was assigned as Grade 0 to 1 (LARS ≥24%), Grade 2 (LARS 19-24%), and Grade 3 (LARS <19%). Patients were followed up for the primary endpoint of all-cause mortality from the date of TAVI.