Epicardial adipose tissue in long-term hemodialysis patients: its association with vascular calcification and long-term development.

Background: Epicardial adipose tissue (EAT) is associated with coronary artery disease (CAD) in the general population. EAT is suggested to promote CAD by paracrine mechanisms and local inflammation. We evaluated whether in chronic hemodialysis (HD) patients EAT associates with CAD, how the amount of EAT develops over time, and if EAT independently predicts the mortality risk.

Prevention of vasculopathy by vitamin K supplementation: can we turn fiction into fact?

With the discovery that vitamin K-dependent matrix Gla-protein (MGP) is a strong and modifiable factor in the prevention of arterial calcification, vitamin K was put forward as novel treatment option in cardiovascular disease. The vasculoprotective properties of vitamin K are in part based on the ability to improve gamma-glutamylcarboxylation of MGP, which is a prerequisite for MGP as a calcification inhibitor. Data from experimental animal models reveal that high intake of vitamin K can prevent and even reverse vascular calcifications.

Regional left ventricular function after transapical vs. transfemoral transcatheter aortic valve implantation analysed by cardiac magnetic resonance feature tracking.

Aims: This study analysed the impact of transapical (TA) vs. transfemoral (TF) access site transcatheter aortic valve implantation (TAVI) on post-procedural regional left ventricular (LV) function using cardiac magnetic resonance (CMR) feature tracking (FT).

Methods And Results: CMR was performed 3 months after TAVI on 44 consecutive patients with normal LV ejection fraction prior to TAVI.

Myocardial deformation imaging by two-dimensional speckle-tracking echocardiography for prediction of global and segmental functional changes after acute myocardial infarction: a comparison with late gadolinium enhancement cardiac magnetic resonance.

Background: Myocardial deformation analysis by speckle-tracking echocardiography (STE) has been shown to accurately predict viability in patients with chronic ischemic left ventricular (LV) dysfunction. The aim of this study was to evaluate two-dimensional STE for the prediction of global and segmental LV functional changes after acute myocardial infarction (AMI) in comparison with late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR).

Methods: In 93 patients (mean age, 60 ± 11 years) with first AMIs (55 with ST-segment elevation myocardial infarctions and 38 with non-ST-segment elevation myocardial infarctions) treated with acute percutaneous coronary intervention, global peak longitudinal strain was determined to describe global function by STE, and peak systolic circumferential and longitudinal strain was determined for segmental function analysis.

Sclerostin as a potential novel biomarker for aortic valve calcification: an in-vivo and ex-vivo study.

Background And Aim Of The Study: Sclerostin is a key negative regulator of bone formation. It was hypothesized that sclerostin might also play a potential role in the development of aortic valve calcification (AVC). The study aim was to evaluate serum sclerostin levels in patients with different degrees of AVC compared to a healthy control group, and to investigate local sclerostin expression in explanted calcified and non-calcified aortic valves.

Relationship between sclerostin and cardiovascular calcification in hemodialysis patients: a cross-sectional study.

Background: Sclerostin is a Wnt pathway antagonist regulating osteoblast activity and bone turnover. Here, we assessed the potential association of sclerostin with the development of coronary artery (CAC) and aortic valve calcifications (AVC) in haemodialysis (HD) patients.

Methods: We conducted a cross-sectional multi-slice computed tomography (MS-CT) scanning study in 67 chronic HD patients (59.

Impact of aortic valve calcification severity and impaired left ventricular function on 3-year results of patients undergoing transcatheter aortic valve replacement.

Objectives: To evaluate clinical pre-interventional predictors of 3-year outcome and mortality in high-risk patients with severe aortic valve stenosis treated with transcatheter aortic valve implantation (TAVI).

Methods: Among 367 patients included in the Aachen TAVI registry, 76 patients with baseline dual-source computed tomography (DSCT) for the quantification of aortic valve calcification (AVC) and a 3-year follow-up were identified.

Results: Survival at 30 days was 91 %, and it was 75 %, 66 % and 64 % at 1, 2 years and 3 years, respectively.

Layer-specific analysis of myocardial deformation for assessment of infarct transmurality: comparison of strain-encoded cardiovascular magnetic resonance with 2D speckle tracking echocardiography.

Aims: Separate analysis of endocardial and epicardial myocardial layer deformation has become possible using strain-encoded cardiovascular magnetic resonance (SENC) and 2D-dimensional speckle tracking echocardiography (Echo). This study evaluated and compared both modalities for the assessment of infarct transmurality as defined by late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR).

Methods And Results: In 29 patients (age 62.

Quantitative analysis of endocardial and epicardial left ventricular myocardial deformation-comparison of strain-encoded cardiac magnetic resonance imaging with two-dimensional speckle-tracking echocardiography.

Background: Quantitative analysis of segmental myocardial deformation of different myocardial layers has become possible using strain-encoded cardiac magnetic resonance imaging (SENC) and speckle-tracking echocardiography (STE). We evaluated and compared the quantitative analysis of myocardial deformation using SENC and STE.

Methods: In 44 patients (age 61 ± 13 years, 34 men), SENC by cardiac magnetic resonance imaging using a 1.

Layer-specific strain-encoded MRI for the evaluation of left ventricular function and infarct transmurality in patients with chronic coronary artery disease.

Background: The study aimed to evaluate whether layer-specific myocardial deformation imaging performed by strain-encoded imaging (SENC) allows quantification of regional left ventricular function and is related to scar transmurality defined by contrast-enhanced magnetic resonance imaging (ceMRI) in patients with chronic coronary artery disease (CAD).

Methods: 50 patients (mean age 62 ± 10 years) with CAD underwent ceMRI. Regional myocardial function was evaluated semi-quantitatively from steady-state free-precession cine sequences.

Aortic valve calcifications on chest films: how much calcium do I need?

Objective: Aortic valve calcifications (AVC) as seen on conventional chest films or on CT are associated with aortic valve stenosis (AVS). The absence of AVC on chest films does not exclude high grade AVS. The aim of this study was to analyse if there is a threshold for the detection of AVC from conventional chest films in patients suffering from high grade AVS.

Comparison of two-dimensional and three-dimensional imaging techniques for measurement of aortic annulus diameters before transcatheter aortic valve implantation.

Aims: Different two-dimensional (2D) and three-dimensional (3D) imaging techniques are used for procedure planning and selection of prosthesis size before transcatheter aortic valve implantation. This study sought to compare different 2D and 3D imaging techniques and determine the accuracy of 3D transoesophageal echocardiography (TEE) for accurate analysis of aortic annulus dimensions.

Methods: In 49 consecutive patients with severe aortic stenosis undergoing transcatheter aortic valve implantation angiography, 2D transthoracic echocardiography (TTE), 2D and 3D TEE, and dual-source CT (DSCT) were performed to determine aortic annulus diameters.

Layer-specific analysis of myocardial function for accurate prediction of reversible ischaemic dysfunction in intermediate viability defined by contrast-enhanced MRI.

Background: Contrast-enhanced MRI (ceMRI) has impaired accuracy in the prediction of functional recovery after revascularisation in cases of intermediate myocardial viability.

Objective: To evaluate the predictive value of layer-specific myocardial deformation analysis for improvement in ischaemic dysfunction after revascularisation.

Methods: In 132 patients with ischaemic left ventricular dysfunction undergoing revascularisation, myocardial viability was assessed by pixel-tracking-derived myocardial deformation imaging and ceMRI.

Electrocardiographic and imaging predictors for permanent pacemaker requirement after transcatheter aortic valve implantation.

Background And Aim Of The Study: Pacemaker (PM) implantation is a possible requirement after transcatheter aortic valve implantation (TAVI). The study aim was to evaluate the electrocardiographic and imaging predictors of the need for PM implantation after TAVI.

Methods: A total of 80 consecutive patients (mean age 82 +/- 6 years) who had been referred for TAVI were included in the study.

Evaluation of aortic root for definition of prosthesis size by magnetic resonance imaging and cardiac computed tomography: implications for transcatheter aortic valve implantation.

Background: This study sought to compare cardiac magnetic resonance imaging (CMR) with dual source computed tomography (DSCT) for analysis of aortic root dimensions prior to transcatheter aortic valve implantation (TAVI). In addition, the potential impact of CMR and DSCT measurements on TAVI strategy defined by 2D-transesophageal echocardiography (TEE) was evaluated.

Methods: Aortic root dimensions were measured using CMR and DSCT in 58 patients referred for evaluation of TAVI.

Functional cardiac MR imaging with true fast imaging with steady-state free precession before and after intravenous injection of contrast medium: comparison of image quality and accuracy.

Objective: To compare image quality and accuracy of left ventricular function of cine SSFP (steady-state free precession) images before and after injection of Gd-DTPA.

Methods: In 30 patients T1 times of LV blood and myocardium were measured before and after injection of 0.2 mmol/kg body weight Gd-DTPA.

Characterisation and potential diagnostic value of circulating matrix Gla protein (MGP) species.

Matrix γ-carboxyglutamate (Gla) protein (MGP) is an important local inhibitor of vascular calcification, which can undergo two post-translational modifications: vitamin K-dependent γ-glutamate carboxylation and serine phosphorylation. While carboxylation is thought to have effects upon binding of calcium-ions, phosphorylation is supposed to affect the cellular release of MGP. Since both modifications can be exerted incompletely, various MGP species can be detected in the circulation.

Long-term clinical outcome of sirolimus-eluting stent implantation in metabolic syndrome and diabetes.

Background: Patients with metabolic syndrome (MetS) are at increased risk of cardiovascular events. The long-term effectiveness of sirolimus-eluting stents (SES) in patients with MetS and in diabetic patients is not well defined.

Methods: 563 consecutive patients with 629 de novo coronary lesions (< 50 mm lesion length, reference diameter < 3.

Association of aortic valve calcification severity with the degree of aortic regurgitation after transcatheter aortic valve implantation.

Background: This study sought to examine a possible relationship between the severity of aortic valve calcification (AVC), the distribution of AVC and the degree of aortic valve regurgitation (AR) after transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS).

Methods: 57 patients (22 men, 81 ± 5 years) with symptomatic AS and with a logistic EuroSCORE of 24 ± 12 were included. 38 patients (67%) received a third (18F)-generation CoreValve® aortic valve prosthesis, in 19 patients (33%) an Edwards SAPIEN™ prosthesis was implanted.

Association of fetuin-A levels with the progression of aortic valve calcification in non-dialyzed patients.

Aims: Fetuin-A has been identified as a potent circulating inhibitor of ectopic calcification. We investigated the relationship between baseline fetuin-A serum levels and the rate of progression of aortic valve calcification (AVC) in non-dialyzed patients with aortic valve disease (AVD).

Methods And Results: Seventy-seven patients (mean age 70 +/- 8 years) with echocardiographically proven AVD were collected.

Relation of circulating Matrix Gla-Protein and anticoagulation status in patients with aortic valve calcification.

Matrix-Gla Protein (MGP) is a vitamin K-dependent protein acting as a local inhibitor of vascular calcification. Vitamin K-antagonists (oral anticoagulant; OAC) inhibit the activation of MGP by blocking vitamin K-metabolism. The aim of this study was to investigate the effect of long-term OAC treatment on circulating MGP levels in humans and on MGP expression in mice.

Feasibility and initial experience of assessment of mechanical dyssynchrony using cardiovascular magnetic resonance and semi-automatic border detection.

Background: The systolic dyssynchrony index (SDI) has been introduced as a measure of mechanical dyssynchrony using three-dimensional echocardiography to select patients who may benefit from cardiac resynchronization therapy (CRT). However, three-dimensional echocardiography may be inadequate in a number of patients with suboptimal acoustic window and no single echocardiographic measure of dyssynchrony has proven to be of value in selecting patients for CRT. Thus, the aim of this study was to determine the value of cardiovascular magnetic resonance (CMR) for the assessment of the SDI in patients with reduced LV function as well as in healthy controls using semi-automatic border tracking.

Functional imaging in the assessment of myocardial infarction: MR imaging vs. MDCT vs. SPECT.

Purpose: To intraindividually compare magnetic resonance (MR) imaging, ECG-gated multi-detector spiral computed tomography (MDCT) and gated single photon emission computed tomography (SPECT) for the evaluation of global and regional myocardial function and the identification of myocardial perfusion abnormalities.

Materials And Methods: Nine patients (8 men; 55.1+/-8.