Publications by authors named "Pellikka P"
Background: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous entity including patients with different phenotypes of near normal, normal, and supernormal left ventricular (LV) function.
Objectives: To assess the value of resting LV elastance (also known as force) with transthoracic echocardiography (TTE) to identify HFpEF phenotypes.
Methods: In a prospective, observational, multicenter study, 2380 HFpEF patients were recruited from July 2016 to May 2024.
Prevalence, Etiology and Outcomes of Native Pulmonary Regurgitation in the General Adult Population.
Eur Heart J Cardiovasc Imaging
January 2025
Aims: Pulmonary regurgitation (PR) after reparative intervention for congenital heart disease has been studied extensively. However, the burden, distribution of causes, and outcome of PR in adults is unknown. The study aimed to evaluate the prevalence, types, and outcomes of moderate/severe PR in adults in the community setting.
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- The study aimed to assess the prognostic value of right ventricle (RV) function and its coupling to pulmonary artery pressure in patients with tricuspid regurgitation (TR) to improve risk evaluation beyond an established clinical score.
- Researchers analyzed data from 417 patients with moderate TR and developed a new risk score by integrating RV function measures, finding significant correlations between these parameters and patient mortality during a median follow-up of nearly 4 years.
- Results showed that many patients initially categorized as low- or intermediate-risk were reclassified to higher risk when RV function metrics were included, indicating that incorporating these echocardiographic measures enhances mortality predictions in TR patients.
Background: During exercise stress echocardiography (ESE), there are patients with normal left ventricular ejection fraction (LVEF) who paradoxically develop reduced LVEF during exercise despite absence of coronary artery disease (CAD) and a significant hypertensive response. This study sought to describe the clinical features and outcomes of this population.
Methods: Among ESEs performed between 2003 and 2022, patients without CAD by angiogram within 90 days of ESE and resting LVEF ≥50% with a ≥5% LVEF decrease during ESE were included.
Background: Aortic regurgitation (AR) is a prevalent valve disease with a long latent period to symptoms. Recent data has suggested the role of novel markers of myocardial overload in assessing onset of decompensation.
Method: We sought to evaluate the role of unsupervised cluster analyses in identifying different clinical clusters, including clinical status, and a large number of echocardiographic variables including left ventricular (LV) volumes, and their association with mortality.
Background: The ideal timing for surgery in asymptomatic chronic aortic regurgitation (AR) remains unclear. New thresholds for left ventricular ejection fraction (LVEF), left ventricular (LV) indexed end-systolic volume (iESV), and global longitudinal strain (GLS) have been associated with mortality in these patients. These represent markers of early LV dysfunction.
View Article and Find Full Text PDFBackground: Tricuspid regurgitation (TR) and mitral regurgitation (MR) are common valvular conditions encountered in patients undergoing transcatheter aortic valve replacement (TAVR). This retrospective study investigates the impact of moderate or severe TR and MR on all-cause mortality in 1-year post-TAVR patients.
Methods: Consecutive patients who underwent TAVR at the 3 academic tertiary care centers in our health system between 2012 and 2018 were identified.
Article Synopsis
- Secondary tricuspid regurgitation (STR) can occur due to various heart and lung diseases, with heart failure and precapillary pulmonary hypertension being common causes that may sometimes be missed.
- This study aimed to determine how often heart failure with preserved ejection fraction (HFpEF) and precapillary pulmonary hypertension (PH) are seen in patients with severe STR and to assess the effectiveness of noninvasive tests in identifying HFpEF.
- Out of 54 adults with severe isolated STR, the majority were evaluated for tricuspid regurgitation, and the study aimed to analyze the prevalence of HFpEF and the usefulness of noninvasive methods for diagnosis.
Objective: Atrial cardiomyopathy is closely associated with atrial fibrillation (AF), and some patients exhibit no dysfunction at rest but demonstrate evident changes in left atrial (LA) function and LA volume during exercise. This study aimed to identify distinguishing signs during exercise stress echocardiography (ESE) among patients in sinus rhythm (SR), with and without history of paroxysmal/persistent AF (PAF).
Methods: A prospective cohort of 1055 patients in SR was enrolled across 12 centers.
Hypercontractile phenotype (HP) of the left ventricle (LV) is an actionable therapeutic target in patients with chronic coronary syndromes (CCS) or heart failure (HF), but its clinical recognition remains difficult. To assess the clinical variables associated with the HP. In a prospective, observational, multicenter study, we recruited 5122 patients (age 65 ± 11 years, 2974 males, 58%) with CCS and/or HF with preserved ejection fraction (EF).
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- Regional wall motion abnormalities (RWMA) can be absent during stress echocardiography in patients with chronic coronary syndromes, even when coronary flow velocity reserve (CFVR) indicates significant disease.
- A study involving 749 patients showed that those with inducible RWMA had lower CFVR and that 69% underwent coronary revascularization, with 10-year survival rates significantly better in those treated invasively versus conservatively.
- The findings suggest a physiology-driven approach based on CFVR may be valuable for coronary revascularization decisions in patients with significant left anterior descending coronary artery disease.
Article Synopsis
- An AI-based ECG model is effective in identifying patients at risk for low ejection fraction (EF), particularly noting that those with abnormal AI-ECG scores and normal EF (false positives or FPs) were more likely to develop low EF later on.
- This study analyzed echocardiographic features and all-cause mortality risk in a large cohort of patients, categorizing them into groups like true negatives (TN), false positives (FP), true positives (TP), and false negatives (FN), using these categorization techniques to assess heart health.
- Results showed that 97% of FPs had some echocardiographic abnormality; they faced a significantly higher risk of mortality compared to
Artificial intelligence (AI) is revolutionizing cardiac imaging, including echocardiography. However, AI has scarce penetration in resource-limited regions. The implementation of AI-aided echocardiography (AIE) poses unique challenges and opportunities in resource-limited areas.
View Article and Find Full Text PDFHigh-Gradient Aortic Stenosis With Valve Area >1.0 cm: The "Forgotten" Discordant Hemodynamic Phenotype.
JACC Cardiovasc Imaging
September 2024
Article Synopsis
- This study focuses on patients with high-gradient aortic stenosis (AS) who have an aortic valve area greater than 1.0 cm, analyzing their clinical features and outcomes.
- It found that this group was younger, mostly male, had fewer health issues, and a higher prevalence of a bicuspid valve compared to other AS patients.
- The results indicated that while these patients had a better overall prognosis, those who underwent aortic valve replacement experienced even better survival rates, emphasizing the benefits of timely treatment.
Degenerative mitral stenosis by echocardiography: presentation and outcome.
Eur Heart J Cardiovasc Imaging
December 2024
Aims: Degenerative mitral stenosis (DMS) is due to degenerative mitral annular calcification (MAC) and valvular calcification. However, DMS impacts on the outcome, and therefore, potential treatment needs are poorly known. We aimed at evaluating survival after DMS diagnosis by Doppler echocardiography in routine practice.
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- Aortic valve replacement (AVR) is crucial for patients with severe aortic regurgitation (AR), but some with moderate AR may also face high mortality if untreated.
- A study analyzed over 81,000 patients with AR to understand how various clinical factors, like left ventricular function and heart dilation, influence mortality risk.
- The findings indicate that both moderate and severe AR, along with specific cardiac damage markers, significantly increase mortality risk, suggesting a need for further investigation on AVR for those with less severe AR but concerning clinical features.
Eclipsed mitral regurgitation (MR) is a rare phenomenon of transient severe MR in patients with normal left ventricular function. This paper presents a case of a patient with recurrent heart failure exacerbations and transient, positional severe MR consistent with eclipsed MR, which improved after mitral transcatheter edge-to-edge repair.
View Article and Find Full Text PDFAortic regurgitation (AR) is associated with left ventricular (LV) volume and pressure overload, resulting in eccentric LV remodeling and enlargement. This condition may be well tolerated for years before the onset of myocardial dysfunction and symptoms. Echocardiography plays a crucial role in the diagnosis of AR, assessing its mechanism and severity, and detecting LV remodeling.
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