Publications by authors named "Nicolas M D A Van Mieghem"

Article Synopsis
  • ECMO (Extracorporeal Membrane Oxygenation) has high complication rates, prompting the need for improved management strategies, which led to the development of the REMAP ECMO platform to investigate effective patient management techniques.* -
  • The REMAP ECMO platform allows for multiple adaptive randomized controlled trials, with the first focusing on the effects of early left ventricular unloading via intra-aortic balloon pumping compared to ECMO alone for cardiogenic shock patients in the ICU.* -
  • The primary outcome aims to determine successful weaning from ECMO at 30 days, while secondary outcomes include intervention needs, survival rates, and quality of life, all analyzed using a flexible Bayesian statistical framework.*
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Article Synopsis
  • Heart failure (HF) is a widespread issue that requires improved predictive tools for better treatment, particularly focusing on congestion, which leads to hospitalizations.
  • The BioMEMS study, part of the MONITOR-HF trial, collects blood samples from participants to analyze the relationship between biomarker patterns and pulmonary artery pressures over time.
  • By adopting a dynamic approach to biomarker measurement rather than relying on single baseline values, the study aims to enhance understanding of HF progression and tailor therapies for individual patients.
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Aims: Invasive haemodynamic monitoring of heart failure (HF) is used to detect deterioration in an early phase thereby preventing hospitalizations. However, this invasive approach is costly and presently lacks widespread accessibility. Hence, there is a pressing need to identify an alternative non-invasive method that is reliable and more readily available.

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Background And Aims: In patients with chronic heart failure (HF), the MONITOR-HF trial demonstrated the efficacy of pulmonary artery (PA)-guided HF therapy over standard of care in improving quality of life and reducing HF hospitalizations and mean PA pressure. This study aimed to evaluate the consistency of these benefits in relation to clinically relevant subgroups.

Methods: The effect of PA-guided HF therapy was evaluated in the MONITOR-HF trial among predefined subgroups based on age, sex, atrial fibrillation, diabetes mellitus, left ventricular ejection fraction, HF aetiology, cardiac resynchronization therapy, and implantable cardioverter defibrillator.

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Photon-counting detector CT (PCD CT) has increasingly garnered interest in cardiothoracic imaging due to its high spatial resolution and ability to perform spectral imaging. CT plays an important role in the planning and postprocedural assessment of transcatheter aortic valve replacement (TAVR). Limitations of current CT technology resulting in blooming and metal artifacts may be addressed with PCD CT.

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Aims: Low wall shear stress (WSS) is acknowledged to play a role in plaque development through its influence on local endothelial function. Also, lipid-rich plaques (LRPs) are associated with endothelial dysfunction. However, little is known about the interplay between WSS and the presence of lipids with respect to plaque progression.

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Article Synopsis
  • Endomyocardial biopsy (EMB) is critical for diagnosing new-onset acute heart failure (new-AHF) when noninvasive tests are not feasible, but safety data for patients on veno-arterial ECMO (VA-ECMO) is limited.
  • A study comparing patients undergoing EMB on VA-ECMO with those not on it found that major complications occurred in 8.3% of procedures, significantly higher in the VA-ECMO group at 26.1%.
  • Despite the risks, EMB provided a histopathologic diagnosis for 78.3% of patients on VA-ECMO, primarily identifying myocarditis, highlighting the need for improved procedural safety while exploring underlying causes of new-A
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Backgrounds: Transcatheter-implanted aortic valve infective endocarditis (TAVI-IE) is difficult to diagnose when relying on the Duke Criteria. Our aim was to assess the additional diagnostic value of F-fluorodeoxyglucose (F-FDG) positron emission/computed tomography (PET/CT) and cardiac computed tomography angiography (CTA) in suspected TAVI-IE.

Methods: A multicenter retrospective analysis was performed in all patients who underwent F-FDG-PET/CT and/or CTA with suspected TAVI-IE.

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Tricuspid regurgitation (TR) is a frequent and complex problem, commonly combined with left-sided heart disease, such as mitral regurgitation. Significant TR is associated with increased mortality if left untreated or recurrent after therapy. Tricuspid regurgitation was historically often disregarded and remained undertreated.

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Article Synopsis
  • The study explores the future potential of tissue-engineered heart valves (TEHV) and the need for early health technology assessments to determine their cost-effectiveness before clinical use.
  • A conceptual model (CM) was created based on clinical guidelines and compared with existing cost-effectiveness models, followed by discussions with a Delphi panel of medical experts.
  • The CM outlines patient outcomes post-implantation, factors influencing these outcomes, and aims to provide a basis for decision-making on the development and adoption of TEHV in clinical settings.
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Objectives: This study sought to report on clinical outcomes beyond 1 year of the BVS Expand registry.

Background: Multiple studies have proven feasibility and safety of the Absorb bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California). However, data on medium- to long-term outcomes are limited and available only for simpler lesions.

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Aortic valve stenosis is a common heart valve disorder in adults. Its prevalence increases with age and is therefore especially seen in older patients. Thirty to forty per cent of patients with symptomatic aortic valve stenosis are not referred for surgical valve replacement because of high age, their medical history or comorbidities.

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