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Publisher: Oxford University Press   (Total: 406 journals)

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Showing 1 - 200 of 406 Journals sorted alphabetically
ACS Symposium Series     Full-text available via subscription   (SJR: 0.189, CiteScore: 0)
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.79, CiteScore: 2)
Adaptation     Hybrid Journal   (Followers: 9, SJR: 0.143, CiteScore: 0)
Advances in Nutrition     Hybrid Journal   (Followers: 53, SJR: 2.196, CiteScore: 5)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.434, CiteScore: 1)
Aesthetic Surgery J. Open Forum     Open Access  
African Affairs     Hybrid Journal   (Followers: 66, SJR: 1.869, CiteScore: 2)
Age and Ageing     Hybrid Journal   (Followers: 90, SJR: 1.989, CiteScore: 4)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 19, SJR: 1.376, CiteScore: 3)
American Entomologist     Full-text available via subscription   (Followers: 8)
American Historical Review     Hybrid Journal   (Followers: 169, SJR: 0.467, CiteScore: 1)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 44, SJR: 2.113, CiteScore: 3)
American J. of Clinical Nutrition     Hybrid Journal   (Followers: 174, SJR: 3.438, CiteScore: 6)
American J. of Epidemiology     Hybrid Journal   (Followers: 197, SJR: 2.713, CiteScore: 3)
American J. of Health-System Pharmacy     Full-text available via subscription   (Followers: 52, SJR: 0.595, CiteScore: 1)
American J. of Hypertension     Hybrid Journal   (Followers: 25, SJR: 1.322, CiteScore: 3)
American J. of Jurisprudence     Hybrid Journal   (Followers: 19, SJR: 0.281, CiteScore: 1)
American J. of Legal History     Full-text available via subscription   (Followers: 9, SJR: 0.116, CiteScore: 0)
American Law and Economics Review     Hybrid Journal   (Followers: 27, SJR: 1.053, CiteScore: 1)
American Literary History     Hybrid Journal   (Followers: 16, SJR: 0.391, CiteScore: 0)
Analysis     Hybrid Journal   (Followers: 22, SJR: 1.038, CiteScore: 1)
Animal Frontiers     Hybrid Journal   (Followers: 1)
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 16, SJR: 1.423, CiteScore: 3)
Annals of Botany     Hybrid Journal   (Followers: 38, SJR: 1.721, CiteScore: 4)
Annals of Oncology     Hybrid Journal   (Followers: 56, SJR: 5.599, CiteScore: 9)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 10, SJR: 0.722, CiteScore: 1)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 34, SJR: 0.728, CiteScore: 2)
Antibody Therapeutics     Open Access  
AoB Plants     Open Access   (Followers: 4, SJR: 1.28, CiteScore: 3)
Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 17, SJR: 0.858, CiteScore: 2)
Applied Linguistics     Hybrid Journal   (Followers: 59, SJR: 2.987, CiteScore: 3)
Applied Mathematics Research eXpress     Hybrid Journal   (Followers: 1, SJR: 1.241, CiteScore: 1)
Arbitration Intl.     Full-text available via subscription   (Followers: 21)
Arbitration Law Reports and Review     Hybrid Journal   (Followers: 14)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 30, SJR: 0.731, CiteScore: 2)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 3)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
Astronomy & Geophysics     Hybrid Journal   (Followers: 44, SJR: 0.146, CiteScore: 0)
Behavioral Ecology     Hybrid Journal   (Followers: 52, SJR: 1.871, CiteScore: 3)
Bioinformatics     Hybrid Journal   (Followers: 338, SJR: 6.14, CiteScore: 8)
Biology Methods and Protocols     Hybrid Journal  
Biology of Reproduction     Full-text available via subscription   (Followers: 9, SJR: 1.446, CiteScore: 3)
Biometrika     Hybrid Journal   (Followers: 20, SJR: 3.485, CiteScore: 2)
BioScience     Hybrid Journal   (Followers: 29, SJR: 2.754, CiteScore: 4)
Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 1, SJR: 0.146, CiteScore: 0)
Biostatistics     Hybrid Journal   (Followers: 17, SJR: 1.553, CiteScore: 2)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 187, SJR: 2.115, CiteScore: 3)
BJA Education     Hybrid Journal   (Followers: 65)
Brain     Hybrid Journal   (Followers: 68, SJR: 5.858, CiteScore: 7)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 50, SJR: 2.505, CiteScore: 5)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 3, SJR: 2.15, CiteScore: 3)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 36, SJR: 2.161, CiteScore: 2)
British J. of Aesthetics     Hybrid Journal   (Followers: 25, SJR: 0.508, CiteScore: 1)
British J. of Criminology     Hybrid Journal   (Followers: 604, SJR: 1.828, CiteScore: 3)
British J. of Social Work     Hybrid Journal   (Followers: 86, SJR: 1.019, CiteScore: 2)
British Medical Bulletin     Hybrid Journal   (Followers: 6, SJR: 1.355, CiteScore: 3)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 34)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 4, SJR: 1.376, CiteScore: 1)
Cambridge J. of Economics     Hybrid Journal   (Followers: 70, SJR: 0.764, CiteScore: 2)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 12, SJR: 2.438, CiteScore: 4)
Cambridge Quarterly     Hybrid Journal   (Followers: 10, SJR: 0.104, CiteScore: 0)
Capital Markets Law J.     Hybrid Journal   (Followers: 2, SJR: 0.222, CiteScore: 0)
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.135, CiteScore: 5)
Cardiovascular Research     Hybrid Journal   (Followers: 14, SJR: 3.002, CiteScore: 5)
Cerebral Cortex     Hybrid Journal   (Followers: 47, SJR: 3.892, CiteScore: 6)
CESifo Economic Studies     Hybrid Journal   (Followers: 22, SJR: 0.483, CiteScore: 1)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.42, CiteScore: 3)
Children and Schools     Hybrid Journal   (Followers: 6, SJR: 0.246, CiteScore: 0)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 5, SJR: 0.412, CiteScore: 0)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 22, SJR: 0.329, CiteScore: 0)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 10, SJR: 1.392, CiteScore: 2)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 10, SJR: 0.183, CiteScore: 0)
Classical Receptions J.     Hybrid Journal   (Followers: 27, SJR: 0.123, CiteScore: 0)
Clean Energy     Open Access   (Followers: 1)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 69, SJR: 5.051, CiteScore: 5)
Communication Theory     Hybrid Journal   (Followers: 24, SJR: 2.424, CiteScore: 3)
Communication, Culture & Critique     Hybrid Journal   (Followers: 27, SJR: 0.222, CiteScore: 1)
Community Development J.     Hybrid Journal   (Followers: 27, SJR: 0.268, CiteScore: 1)
Computer J.     Hybrid Journal   (Followers: 9, SJR: 0.319, CiteScore: 1)
Conservation Physiology     Open Access   (Followers: 3, SJR: 1.818, CiteScore: 3)
Contemporary Women's Writing     Hybrid Journal   (Followers: 9, SJR: 0.121, CiteScore: 0)
Contributions to Political Economy     Hybrid Journal   (Followers: 6, SJR: 0.906, CiteScore: 1)
Critical Values     Full-text available via subscription  
Current Developments in Nutrition     Open Access   (Followers: 2)
Current Legal Problems     Hybrid Journal   (Followers: 29)
Current Zoology     Full-text available via subscription   (Followers: 3, SJR: 1.164, CiteScore: 2)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 8, SJR: 1.791, CiteScore: 3)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 14, SJR: 0.259, CiteScore: 1)
Diplomatic History     Hybrid Journal   (Followers: 21, SJR: 0.45, CiteScore: 1)
DNA Research     Open Access   (Followers: 5, SJR: 2.866, CiteScore: 6)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 4)
Early Music     Hybrid Journal   (Followers: 17, SJR: 0.139, CiteScore: 0)
Econometrics J.     Hybrid Journal   (Followers: 32, SJR: 2.926, CiteScore: 1)
Economic J.     Hybrid Journal   (Followers: 111, SJR: 5.161, CiteScore: 3)
Economic Policy     Hybrid Journal   (Followers: 46, SJR: 3.584, CiteScore: 3)
ELT J.     Hybrid Journal   (Followers: 24, SJR: 0.942, CiteScore: 1)
English Historical Review     Hybrid Journal   (Followers: 56, SJR: 0.612, CiteScore: 1)
English: J. of the English Association     Hybrid Journal   (Followers: 17, SJR: 0.1, CiteScore: 0)
Environmental Entomology     Full-text available via subscription   (Followers: 11, SJR: 0.818, CiteScore: 2)
Environmental Epigenetics     Open Access   (Followers: 2)
Environmental History     Hybrid Journal   (Followers: 26, SJR: 0.408, CiteScore: 1)
EP-Europace     Hybrid Journal   (Followers: 3, SJR: 2.748, CiteScore: 4)
Epidemiologic Reviews     Hybrid Journal   (Followers: 9, SJR: 4.505, CiteScore: 8)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 19, SJR: 0.113, CiteScore: 0)
European Heart J.     Hybrid Journal   (Followers: 66, SJR: 9.315, CiteScore: 9)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 10, SJR: 3.625, CiteScore: 3)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 2)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. : Case Reports     Open Access  
European Heart J. Supplements     Hybrid Journal   (Followers: 8, SJR: 0.223, CiteScore: 0)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9, SJR: 1.681, CiteScore: 2)
European J. of Intl. Law     Hybrid Journal   (Followers: 200, SJR: 0.694, CiteScore: 1)
European J. of Orthodontics     Hybrid Journal   (Followers: 5, SJR: 1.279, CiteScore: 2)
European J. of Public Health     Hybrid Journal   (Followers: 20, SJR: 1.36, CiteScore: 2)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 10, SJR: 1.172, CiteScore: 2)
European Review of Economic History     Hybrid Journal   (Followers: 30, SJR: 0.702, CiteScore: 1)
European Sociological Review     Hybrid Journal   (Followers: 43, SJR: 2.728, CiteScore: 3)
Evolution, Medicine, and Public Health     Open Access   (Followers: 12)
Family Practice     Hybrid Journal   (Followers: 16, SJR: 1.018, CiteScore: 2)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 16, SJR: 1.492, CiteScore: 4)
Fems Microbiology Letters     Hybrid Journal   (Followers: 28, SJR: 0.79, CiteScore: 2)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 32, SJR: 7.063, CiteScore: 13)
Fems Yeast Research     Hybrid Journal   (Followers: 13, SJR: 1.308, CiteScore: 3)
Food Quality and Safety     Open Access   (Followers: 1)
Foreign Policy Analysis     Hybrid Journal   (Followers: 24, SJR: 1.425, CiteScore: 1)
Forest Science     Hybrid Journal   (Followers: 7, SJR: 0.89, CiteScore: 2)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 1.133, CiteScore: 3)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.104, CiteScore: 0)
French History     Hybrid Journal   (Followers: 33, SJR: 0.118, CiteScore: 0)
French Studies     Hybrid Journal   (Followers: 21, SJR: 0.148, CiteScore: 0)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.152, CiteScore: 0)
Gastroenterology Report     Open Access   (Followers: 2)
Genome Biology and Evolution     Open Access   (Followers: 16, SJR: 2.578, CiteScore: 4)
Geophysical J. Intl.     Hybrid Journal   (Followers: 39, SJR: 1.506, CiteScore: 3)
German History     Hybrid Journal   (Followers: 23, SJR: 0.161, CiteScore: 0)
GigaScience     Open Access   (Followers: 5, SJR: 5.022, CiteScore: 7)
Global Summitry     Hybrid Journal   (Followers: 1)
Glycobiology     Hybrid Journal   (Followers: 13, SJR: 1.493, CiteScore: 3)
Health and Social Work     Hybrid Journal   (Followers: 57, SJR: 0.388, CiteScore: 1)
Health Education Research     Hybrid Journal   (Followers: 16, SJR: 0.854, CiteScore: 2)
Health Policy and Planning     Hybrid Journal   (Followers: 24, SJR: 1.512, CiteScore: 2)
Health Promotion Intl.     Hybrid Journal   (Followers: 22, SJR: 0.812, CiteScore: 2)
History Workshop J.     Hybrid Journal   (Followers: 33, SJR: 1.278, CiteScore: 1)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 28, SJR: 0.105, CiteScore: 0)
Human Communication Research     Hybrid Journal   (Followers: 15, SJR: 2.146, CiteScore: 3)
Human Molecular Genetics     Hybrid Journal   (Followers: 9, SJR: 3.555, CiteScore: 5)
Human Reproduction     Hybrid Journal   (Followers: 72, SJR: 2.643, CiteScore: 5)
Human Reproduction Open     Open Access   (Followers: 1)
Human Reproduction Update     Hybrid Journal   (Followers: 20, SJR: 5.317, CiteScore: 10)
Human Rights Law Review     Hybrid Journal   (Followers: 62, SJR: 0.756, CiteScore: 1)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 58, SJR: 1.591, CiteScore: 3)
ICSID Review : Foreign Investment Law J.     Hybrid Journal   (Followers: 10)
ILAR J.     Hybrid Journal   (Followers: 2, SJR: 1.732, CiteScore: 4)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.679, CiteScore: 1)
IMA J. of Management Mathematics     Hybrid Journal   (SJR: 0.538, CiteScore: 1)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.496, CiteScore: 1)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 1.987, CiteScore: 2)
Industrial and Corporate Change     Hybrid Journal   (Followers: 9, SJR: 1.792, CiteScore: 2)
Industrial Law J.     Hybrid Journal   (Followers: 39, SJR: 0.249, CiteScore: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 47, SJR: 2.511, CiteScore: 4)
Information and Inference     Free  
Innovation in Aging     Open Access  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 9, SJR: 1.319, CiteScore: 2)
Integrative Biology     Full-text available via subscription   (Followers: 6, SJR: 1.36, CiteScore: 3)
Integrative Organismal Biology     Open Access  
Interacting with Computers     Hybrid Journal   (Followers: 11, SJR: 0.292, CiteScore: 1)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7, SJR: 0.762, CiteScore: 1)
Intl. Affairs     Hybrid Journal   (Followers: 66, SJR: 1.505, CiteScore: 3)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 26)
Intl. Health     Hybrid Journal   (Followers: 6, SJR: 0.851, CiteScore: 2)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 2.167, CiteScore: 4)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 36, SJR: 1.348, CiteScore: 2)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 64, SJR: 0.601, CiteScore: 1)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 246, SJR: 3.969, CiteScore: 5)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 5, SJR: 0.202, CiteScore: 1)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 28, SJR: 0.223, CiteScore: 1)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 10, SJR: 0.285, CiteScore: 1)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.403, CiteScore: 1)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.808, CiteScore: 4)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 11, SJR: 1.545, CiteScore: 1)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 38, SJR: 0.389, CiteScore: 1)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 11, SJR: 0.724, CiteScore: 2)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.168, CiteScore: 1)
Intl. Political Sociology     Hybrid Journal   (Followers: 40, SJR: 1.465, CiteScore: 3)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 23, SJR: 0.401, CiteScore: 1)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 9, SJR: 0.983, CiteScore: 1)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 49, SJR: 2.581, CiteScore: 2)
Intl. Studies Review     Hybrid Journal   (Followers: 25, SJR: 1.201, CiteScore: 1)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 2, SJR: 0.15, CiteScore: 0)
ITNOW     Hybrid Journal   (Followers: 1, SJR: 0.103, CiteScore: 0)
J. of African Economies     Hybrid Journal   (Followers: 17, SJR: 0.533, CiteScore: 1)
J. of American History     Hybrid Journal   (Followers: 46, SJR: 0.297, CiteScore: 1)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 14, SJR: 1.065, CiteScore: 2)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 15, SJR: 2.419, CiteScore: 4)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 5, SJR: 0.585, CiteScore: 1)
J. of Biochemistry     Hybrid Journal   (Followers: 41, SJR: 1.226, CiteScore: 2)
J. of Breast Imaging     Full-text available via subscription  
J. of Burn Care & Research     Hybrid Journal   (Followers: 10, SJR: 0.768, CiteScore: 2)

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Similar Journals
Journal Cover
European Heart Journal - Cardiovascular Imaging
Journal Prestige (SJR): 3.625
Citation Impact (citeScore): 3
Number of Followers: 10  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 2047-2404 - ISSN (Online) 2047-2412
Published by Oxford University Press Homepage  [406 journals]
  • Haemodynamic management of patients with left ventricular assist devices
           using echocardiography: the essentials
    • Authors: Bouchez S; Van Belleghem Y, De Somer F, et al.
      Pages: 373 - 382
      Abstract: Mechanical circulatory support with continuous-flow left ventricular assist devices (LVADs) has emerged as a viable treatment modality for patients with advanced heart failure. LVAD support results in unique haemodynamic and echocardiographic alterations that must be understood to provide optimal care for these patients. In this review, we propose essential echocardiographic and haemodynamic elements for the assessment of optimal LVAD function based on the literature and the use of simulation software. A key element of LVAD physiology remains the interaction between an unloaded left ventricle and a loaded right ventricle. The echocardiographic assessment and treatment of the pathophysiology of the right-sided part of the heart remains critical to maintaining optimal LVAD support.
      PubDate: Wed, 30 Jan 2019 00:00:00 GMT
      DOI: 10.1093/ehjci/jez003
      Issue No: Vol. 20, No. 4 (2019)
  • Coronary calcium and mortality: expanding the range of fatal outcomes
    • Authors: Juarez-Orozco L; Knuuti J.
      Pages: 383 - 384
      Abstract: This editorial refers to ‘Coronary artery calcium and the competing long-term risk of cardiovascular vs. cancer mortality: the CAC Consortium’, by S.P. Whelton et al., pp. 389–395.
      PubDate: Thu, 10 Jan 2019 00:00:00 GMT
      DOI: 10.1093/ehjci/jey214
      Issue No: Vol. 20, No. 4 (2019)
  • There is not such a long time between late and too late: look at it
    • Authors: Cosyns B; Magne J, Piérard L.
      Pages: 385 - 386
      Abstract: This editorial refers to ‘The unique mechanism of functional mitral regurgitation in acute myocardial infarction: a prospective dynamic 4D quantitative echocardiographic study’, by T. Kimura et al., pp. 396–406.
      PubDate: Wed, 09 Jan 2019 00:00:00 GMT
      DOI: 10.1093/ehjci/jey212
      Issue No: Vol. 20, No. 4 (2019)
  • Left ventricular phenotype in the athlete’s heart: what makes the
    • Authors: Galderisi M; Santoro C, Sorrentino R, et al.
      Pages: 387 - 388
      Abstract: This editorial refers to ‘University athletes and changes in cardiac geometry: insight from the 2015 Gwangju Summer Universiade’, by J.Y. Cho et al., pp. 407–416.
      PubDate: Thu, 03 Jan 2019 00:00:00 GMT
      DOI: 10.1093/ehjci/jey215
      Issue No: Vol. 20, No. 4 (2019)
  • Corrigendum to: The unique mechanism of functional mitral regurgitation in
           acute myocardial infarction: a prospective dynamic 4D quantitative
           echocardiographic study
    • Pages: 406 - 406
      Abstract: [Eur Heart J Cardiovasc Imaging 2019; 20;396–406]
      PubDate: Mon, 18 Mar 2019 00:00:00 GMT
      DOI: 10.1093/ehjci/jez056
      Issue No: Vol. 20, No. 4 (2019)
  • The detection of retrograde flow from the left anterior descending artery
           into the main pulmonary artery by 4D-flow cardiac magnetic resonance in a
           patient with Bland-White-Garland syndrome
    • Authors: Tsuneta S; Oyama-Manabe N, Takeda A, et al.
      Pages: 488 - 488
      Abstract: A 10-year-old girl complained of pain in the chest owing to effort. Coronary computed tomography angiography revealed anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) and normal origin of a relatively large right coronary artery (RCA) from the ascending aorta (Panels A–C). ALCAPA is a rare congenital coronary anomaly also known as Bland-White-Garland (BWG) syndrome. In BWG syndrome, patient survival is dependent on the development of adequate collateral circulation. The developed collaterals were also observed at the right ventricular and septal surface.
      PubDate: Wed, 09 Jan 2019 00:00:00 GMT
      DOI: 10.1093/ehjci/jey222
      Issue No: Vol. 20, No. 4 (2019)
  • Coronary artery calcium and the competing long-term risk of cardiovascular
           vs. cancer mortality: the CAC Consortium
    • Authors: Whelton S; Al Rifai M, Dardari Z, et al.
      Pages: 389 - 395
      Abstract: AimsCoronary artery calcium (CAC) is the strongest predictor of cardiovascular disease (CVD), yet is also associated with chronic non-CVD such as cancer. We performed this analysis in order to describe the association of CAC with CVD vs. cancer mortality.Methods and resultsThe CAC Consortium is comprised of 66 636 scans performed in asymptomatic patients without known CVD. The mean age was 54 ± 11 years and 67% of participants were men. Cause of death was ascertained from death certificates. The association of CAC with cause-specific mortality was calculated using Fine and Gray sub-distribution hazard ratio (SHR) models, which account for competing causes of death. There were 3158 deaths over a median 12 ± 4 years follow-up (37% cancer and 32% CVD). Cancer was the leading cause of death when CAC = 0 (50%) with CVD overtaking cancer when baseline CAC >300. Compared to participants with CAC = 0, the SHR for CVD mortality was 1.44 [95% confidence interval (CI) 1.14–1.81], 2.26 (95% CI 1.76–2.90), and 3.68 (95% CI 2.90–4.67) for patients with CAC 1–99, 100–299, and ≥300, and the SHR for cancer was 1.04 (95% CI 0.88–1.23), 1.19 (95% CI 0.98–1.46), and 1.30 (95% CI 1.07–1.58).ConclusionCancer was the leading cause of death for patients with baseline CAC = 0, whereas CVD overtook cancer above a threshold of CAC >300. These results argue for a focused approach for patients at the extremes of CAC scoring while suggesting that combined CVD and cancer primary prevention strategies for patients with intermediate CAC scores may significantly decrease mortality from the two leading causes of death.
      PubDate: Mon, 24 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey176
      Issue No: Vol. 20, No. 4 (2018)
  • The unique mechanism of functional mitral regurgitation in acute
           myocardial infarction: a prospective dynamic 4D quantitative
           echocardiographic study
    • Authors: Kimura T; Roger V, Watanabe N, et al.
      Pages: 396 - 406
      Abstract: AimsMechanisms of chronic ischaemic mitral regurgitation (IMR) are well-characterized by apically tethered leaflet caused by papillary muscles (PMs) displacement and adynamic mitral apparatus. We investigated the unique geometry and dynamics of the mitral apparatus in first acute myocardial infarction (MI) by using quantified 3D echocardiography.Methods and resultsWe prospectively performed 3D echocardiography 2.3 ± 1.8 days after first MI, in 174 matched patients with (n = 87) and without IMR (n = 87). 3D echocardiography of left ventricular (LV) volumes and of mitral apparatus dynamics throughout cardiac cycle was quantified. Similar mitral quantification was obtained at chronic post-MI stage (n = 44). Mechanistically, acute IMR was associated with larger and flatter annulus (area 9.29 ± 1.74 cm2 vs. 8.57 ± 1.94 cm2, P = 0.002, saddle shape 12.7 ± 4.5% vs. 15.0 ± 4.6%, P = 0.001), and larger tenting (length 6.36 ± 1.78 mm vs. 5.60 ± 1.55 mm, P = 0.003) but vs. chronic MI, mitral apparatus displayed smaller alterations (all P < 0.01) and annular size, PM movement remained dynamic (all P < 0.01). Specific to acute IMR, without PM apical displacement (P > 0.70), greater separation (21.7 ± 4.9 mm vs. 20.0 ± 3.4 mm, P = 0.01), and widest angulation of PM (38.4 ± 6.2° for moderate vs. 33.5 ± 7.3° for mild vs. 31.4 ± 6.3° for no-IMR, P = 0.0009) wider vs. chronic MI (P < 0.01).Conclusions3D echocardiography of patients with first MI provides insights into unique 4D dynamics of the mitral apparatus in acute IMR. Mitral apparatus remained dynamic in acute MI and distinct IMR mechanism in acute MI is not PM displacement seen in chronic IMR but separation and excess angulation of PM deforming the mitral valve, probably because of sudden-onset regional wall motion abnormality without apparent global LV remodelling. This specific mechanism should be considered in novel therapeutic strategies for IMR complicating acute MI.
      PubDate: Tue, 04 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey177
      Issue No: Vol. 20, No. 4 (2018)
  • University athletes and changes in cardiac geometry: insight from the 2015
           Gwangju Summer Universiade
    • Authors: Cho J; Kim K, Rink L, et al.
      Pages: 407 - 416
      Abstract: AimsThere is a paucity of data regarding the changes of cardiac geometry in highly trained international and multiracial university athletes. We aimed to investigate the incidence of structural cardiac abnormalities and changes of cardiac geometry in highly trained university athletes.Methods and resultsComprehensive echocardiographic studies were performed in 1185 university athletes through the Check-up Your Heart Program during the 2015 Gwangju Summer Universiade. Participants were divided into two groups: normal vs. abnormal left ventricular (LV) geometry (concentric remodelling, concentric hypertrophy, or eccentric hypertrophy). Structural heart diseases associated with sudden cardiac death were not identified, but minor structural cardiac abnormalities were common in university athletes. One hundred and fifty-six athletes (13.2%) had abnormal LV geometry; concentric remodelling (n = 73, 6.2%), concentric hypertrophy (n = 25, 2.1%), and eccentric hypertrophy (n = 58, 4.9%). Abnormal LV geometry was significantly more common in athletes of African descent and in endurance, mixed, or power disciplines. In multivariate logistic regression analysis, athletes of African descent [odds ratio (OR) 2.16, 95% confidence interval (CI) 1.34–3.46; P = 0.001], endurance disciplines (OR 1.79, 95% CI 1.26–2.54; P = 0.001), and training time (OR 1.01, 95% CI 1.00–1.02; P = 0.045) were independent predictors of abnormal LV geometry.ConclusionA large scale cardiovascular screening programme of the 2015 Summer Universiade demonstrated that abnormal LV geometry is not uncommon (13.2%) and concentric remodelling is the most common pattern of LV geometric change in young trained university athletes. Race, type of sport, and training time are significant predictors of abnormal LV geometry. Structural cardiac abnormalities are common in university athletes even though they are minor abnormalities.
      PubDate: Tue, 11 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey196
      Issue No: Vol. 20, No. 4 (2018)
  • Coronary computed tomography angiography vs. myocardial single photon
           emission computed tomography in patients with intermediate risk chest
           pain: a randomized clinical trial for cost-effectiveness comparison based
           on real-world cost
    • Authors: Lee S; Seo J, Hwang I, et al.
      Pages: 417 - 425
      Abstract: AimsTo compare the cost-effectiveness of coronary computed tomography angiography (CCTA) vs. myocardial single photon emission computed tomography (SPECT) in patients with stable intermediate risk chest pain.Methods and resultsNon-acute patients with 10–90% pre-test probability of coronary artery disease from three high-volume centres in Korea (n = 965) were randomized 1:1 to CCTA or myocardial SPECT as the initial non-invasive imaging test. Medical costs after randomization, the downstream outcome, including all-cause death, acute coronary syndrome, cerebrovascular accident, repeat revascularization, stent thrombosis, and significant bleeding following the initial test and the quality-adjusted life-years (QALYs) gained by the EuroQoL-5D questionnaire was compared between the two groups. In all, 903 patients underwent the initially randomized study (n = 460 for CCTA, 443 for SPECT). In all, 65 patients underwent invasive coronary angiography (ICA) in the CCTA and 85 in the SPECT group, of which 4 in the CCTA and 30 in the SPECT group demonstrated no stenosis on ICA [6.2% (4/65) vs. 35.3% (30/85), P-value < 0.001]. There was no difference in the downstream clinical events. QALYs gained was higher in the SPECT group (0.938 vs. 0.955, P-value = 0.039) but below the threshold of minimal clinically important difference of 0.08. Overall cost per patient was lower in the CCTA group (USD 4514 vs. 5208, P-value = 0.043), the tendency of which was non-significantly opposite in patients with 60–90% pre-test probability (USD 5807 vs. 5659, P-value = 0.845).ConclusionCCTA is associated with fewer subsequent ICA with no difference in downstream outcome. CCTA may be more cost-effective than SPECT in Korean patients with stable, intermediate risk chest pain.
      PubDate: Mon, 23 Jul 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey099
      Issue No: Vol. 20, No. 4 (2018)
  • Relation of regional myocardial structure and function in hypertrophic
           cardiomyopathy and amyloidois: a combined two-dimensional speckle tracking
           and cardiovascular magnetic resonance analysis
    • Authors: Pagourelias E; Mirea O, Vovas G, et al.
      Pages: 426 - 437
      Abstract: AimsWe aimed at investigating the relationship between segmental morphology [wall thickness (WT) and WT location (LT: base-mid-apex)], loading conditions and underlying pathological substrate [histology (H), hypertrophy vs. infiltration] with segmental longitudinal (SLS) and circumferential (SCS) strain in a group of patients with hypertrophic cardiomyopathy (HCM) and cardiac amyloidosis (CA).Methods and resultsWe included 30 patients with biopsy-proven CA (65.4 ± 10.7 years, 66% male, 76.7% AL type) and 50 patients with HCM matched for maximum WT (60 ± 16 years, 80% male). SLS and SCS were assessed with speckle-tracking echocardiography in an 18-segment model of left ventricle, while morphological parameters were measured in short-axis cardiovascular magnetic resonance cine loops which corresponded with echo segments. In total, 1440 segments were evaluated of which 198 (36.7%) in CA and 252 (28%) in HCM had WT >12 mm (maximum WT 18.1 ± 3.7 mm in CA vs. 18.6 ± 4.1 in HCM, P = 0.59). SLS showed association with WT [beta 0.49, 95% confidence interval (CI) 0.37–0.6; P < 0.0005], LT and H (P < 0.0005 for both), with CA segments demonstrating 5.94% more impaired SLS compared with HCM segments with the same WT and LT. On the other hand, there was no linear association between SCS and WT, with SCS being dependent on LT, H (P < 0.0005) and preload (P < 0.002).ConclusionOur study indicates that regional myocardial mechanics are differentially influenced by local morphological parameters. While SLS is dominated by WT, SCS is more determined by LT and H. These findings may have an important role in diagnosis and prognosis of patients with thickened hearts.
      PubDate: Wed, 01 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey107
      Issue No: Vol. 20, No. 4 (2018)
  • Myocardial oedema lesion with echocardiography in a patient with cardiac
    • Authors: Morishita M; Abe Y, Matsumura Y, et al.
      Pages: 437 - 437
      Abstract: An 80-year-old woman complained of dyspnoea on exertion and was admitted to our hospital for suspected coronary artery disease. High values of troponin T and soluble interleukin 2 receptor (sIL-2R) were seen in the blood test (0.037 ng/mL and 1216 U/mL, respectively). There was no significant stenosis in coronary angiography. Interestingly, a low-echoic area of 20 mm × 17 mm in the myocardium of the left ventricular posterior wall was found in transthoracic echocardiography (TTE) (Panel A, Supplementary data onlineSupplementary data online, Video S1Video S1). Cardiac sarcoidosis was suspected by positron emission tomography/computed tomography, in which the striking 18-fluoro-deoxyglucose accumulation in the left ventricular posterior wall and the right ventricular free wall was found (Panel B). The hyperenhancement at the epicardial side of the left ventricular posterior wall was found in delayed gadolinium enhancement magnetic resonance imaging (Panel C). Then, bronchoscopy was performed, and Langhans-type multinucleated giant cells and epithelial cells were observed in the bronchoalveolar lavage fluid. Consequently, she was diagnosed as having systemic sarcoidosis with cardiac involvement. Oral prednisolone was administrated and sIL-2R normalized. In TTE, the low-echoic area in the myocardium of the left ventricular posterior wall disappeared (Panel D, Supplementary data onlineSupplementary data online, Video S2Video S2). There has been no previous report where a local low-echoic lesion can be seen in patients with cardiac sarcoidosis. We speculated that the low-echoic area in our patient represented regional myocardial oedema associated with the inflammation due to sarcoidosis because it disappeared with the anti-inflammatory therapy.
      PubDate: Fri, 28 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey207
      Issue No: Vol. 20, No. 4 (2018)
  • Prominent longitudinal strain reduction of left ventricular basal segments
           in treatment-na├»ve Anderson-Fabry disease patients
    • Authors: Esposito R; Galderisi M, Santoro C, et al.
      Pages: 438 - 445
      Abstract: AimsLittle is known about regional longitudinal strain (LS) distribution in early stages of Anderson-Fabry disease (AFD) cardiomyopathy. We investigated regional left ventricular (LV) patterns of LS strain and base-to-apex behaviour of LS in treatment-naïve AFD patients.Methods and resultsTwenty-three consecutive AFD patients at diagnosis and 23 healthy controls without cardiovascular risk factors and matched for age and sex to the patients, underwent a comprehensive evaluation of target organs. An echo-Doppler exam, including determination of regional and global LS strain (GLS) was obtained. The average LS of 6 basal (BLS), 6 middle (MLS), and 5 apical (ALS) segments and relative regional strain ratio [ALS/(BLS + MLS)] were also calculated. Ejection fraction and diastolic indices did not differ between the two groups. LV mass index was greater in AFD (P < 0.01). GLS (P = 0.006), BLS (P < 0.0001), and MLS (P = 0.003), but not ALS, were lower in AFD patients and relative regional strain ratio was higher in AFD (P < 0.01) than in controls. These analyses were confirmed separately in the two genders and even after excluding patients with wall hypertrophy. By subdividing AFD patients according to lysoGB3 levels, 9 patients with lysoGB3 ≥ 1.8 ng/L had lower ALS compared to 11 patients with lysoGB3 < 1.8 ng/L (P < 0.01).ConclusionIn naïve AFD patients, we observed an early reduction of LV LS, involving mainly LV basal myocardial segments. Nevertheless, the association found between the higher lysoGB3 levels and the lower apical cap LS demonstrates that apical segments LS, despite still normal, is not spared at diagnosis.
      PubDate: Mon, 06 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey108
      Issue No: Vol. 20, No. 4 (2018)
  • Impact of right ventricular dysfunction and end-diastolic pulmonary artery
           pressure estimated from analysis of tricuspid regurgitant velocity
           spectrum in patients with preserved ejection fraction
    • Authors: Baruch G; Rothschild E, Kapusta L, et al.
      Pages: 446 - 454
      Abstract: AimsWe aimed to analyse the association between right haemodynamic parameters, right ventricular (RV) dysfunction parameters, and outcomes in patients with preserved ejection fraction (EF).Methods and resultsRetrospective analysis of right haemodynamic (systolic pulmonary pressure and end-diastolic pulmonary pressure based on tricuspid regurgitation (TR) velocity at pulmonary valve opening time), and RV parameters including size (end-diastolic and end-systolic area), function (RV fractional area change, Tei index, Tricuspid Annular Plane Systolic Excursion, and speckle tracking derived free wall strain), from 557 consecutive patients with preserved EF [EF ≥ 50%; age 64.9 + 20; 52% female; co-morbidity Charlson index 4.7 (2.9, 6.4)]. All cause and cardiac mortality were retrospectively analysed and correlated to echo haemodynamic and co-morbid parameters. TR velocity at pulmonary valve opening time and calculated end-diastolic pulmonary artery pressure were obtainable in 71% of patients. The best haemodynamic univariate predictor of mortality was calculated end-diastolic pulmonary artery pressure [hazard ratio 1.06 (1.04–1.07); P < 0.0001], superior to TR peak velocity and systolic pulmonary artery pressure. Elevated end-diastolic pulmonary artery pressure was associated with all cause and cardiac mortality even when adjusted for all significant clinical (age, gender, and Charlson index), and echo (stroke volume index, left atrial volume index, systolic pulmonary pressure, E/e', and Tei index) parameters. Tei index was superior to all other RV functional parameters (P < 0.05 for all parameters).ConclusionTR velocity at pulmonary valve opening time and calculated end-diastolic pulmonary artery pressure are obtainable in most patients, and add prognostic information on top of clinical and routine haemodynamic and diastolic parameters.
      PubDate: Tue, 28 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey116
      Issue No: Vol. 20, No. 4 (2018)
  • Comparison of mitral valve geometrical effect of percutaneous edge-to-edge
           repair between central and eccentric functional mitral regurgitation:
           clinical implications
    • Authors: Utsunomiya H; Itabashi Y, Kobayashi S, et al.
      Pages: 455 - 466
      Abstract: AimsPercutaneous edge-to-edge repair alters mitral valve (MV) geometry in functional mitral regurgitation (FMR). We sought to characterize MV morphology in patients with central and eccentric FMR, compare the geometrical effect of MitraClip therapy, and elucidate different mechanisms of MR improvement according to FMR subtypes.Methods and resultsSeventy-six symptomatic patients with Grade 3 to 4+ FMR (central, n = 39; eccentric, n = 37) underwent three-dimensional transoesophageal echocardiography during MitraClip implantation. We defined procedural success as a reduction of MR by ≥1 grade with having a residual mitral regurgitation (MR) of ≤ grade 2+. Procedural success rate was similar between central and eccentric FMR (77% vs. 78%, P = 0.55). After MitraClip, the reduction in anterior-posterior diameter did not differ between FMR subtypes, but patients with eccentric FMR had a greater reduction in the averaged tethering angle difference (P < 0.001) with less reduction in tenting volume and height (both P < 0.001) than did patients with central FMR. On multivariable analysis, in central FMR, MR reduction post-clip was associated with shortening in anterior-posterior diameter [coefficient 0.388, 95% confidence interval (CI) 0.216–0.561; P < 0.001] and an increase in coaptation area (coefficient 0.117, 95% CI 0.039–0.194; P = 0.004), whereas in eccentric FMR MR reduction was mainly associated with a decrease in the averaged tethering angle difference (coefficient 0.050, 95% CI 0.021–0.078; P = 0.001).ConclusionMV geometrical effect and its association with MR improvement after MitraClip therapy differ according to FMR subtypes. Our results indicate the MR jet direction and the leaflet tethering pattern may be considered in the strategy for percutaneous treatment for FMR.
      PubDate: Thu, 09 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey117
      Issue No: Vol. 20, No. 4 (2018)
  • Longitudinal 18F-FDG PET imaging in a rat model of autoimmune myocarditis
    • Authors: Werner R; Wakabayashi H, Bauer J, et al.
      Pages: 467 - 474
      Abstract: AimsAlthough mortality rate is very high, diagnosis of acute myocarditis remains challenging with conventional tests. We aimed to elucidate the potential role of longitudinal 2-Deoxy-2-18F-fluoro-D-glucose (18F-FDG) positron emission tomography (PET) inflammation monitoring in a rat model of experimental autoimmune myocarditis.Methods and resultsAutoimmune myocarditis was induced in Lewis rats by immunizing with porcine cardiac myosin emulsified in complete Freund’s adjuvant. Time course of disease was assessed by longitudinal 18F-FDG PET imaging. A correlative analysis between in- and ex vivo18F-FDG signalling and macrophage infiltration using CD68 staining was conducted. Finally, immunohistochemistry analysis of the cell-adhesion markers CD34 and CD44 was performed at different disease stages determined by longitudinal 18F-FDG PET imaging. After immunization, myocarditis rats revealed a temporal increase in 18F-FDG uptake (peaked at week 3), which was followed by a rapid decline thereafter. Localization of CD68 positive cells was well correlated with in vivo18F-FDG PET signalling (R2 = 0.92) as well as with ex vivo18F-FDG autoradiography (R2 = 0.9, P < 0.001, respectively). CD44 positivity was primarily observed at tissue samples obtained at acute phase (i.e. at peak 18F-FDG uptake), while CD34-positive staining areas were predominantly identified in samples harvested at both sub-acute and chronic phases (i.e. at 18F-FDG decrease).Conclusion18F-FDG PET imaging can provide non-invasive serial monitoring of cardiac inflammation in a rat model of acute myocarditis.
      PubDate: Wed, 08 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey119
      Issue No: Vol. 20, No. 4 (2018)
  • Prognostic value of right ventricular longitudinal strain in patients with
           pulmonary hypertension: a systematic review and meta-analysis
    • Authors: Hulshof H; Eijsvogels T, Kleinnibbelink G, et al.
      Pages: 475 - 484
      Abstract: AimsPulmonary hypertension (PH) is associated with high morbidity and mortality and the predictive capacity of traditional functional echocardiographic measures is poor. Recent studies assessed the predictive capacity of right ventricular longitudinal strain (RVLS). Diversity in methods between these studies resulted in conflicting outcomes. The purpose of this systematic review and meta-analysis was to determine the independent prognostic value of RVLS for PH-related events and all-cause mortality.Methods and resultsA systematic search in Pubmed (MEDLINE), Embase, the Cochrane Library, and Web of Science was performed to identify studies that examined the prognostic value of RVLS in patients with PH. Studies reporting Cox regression based hazard ratios (HRs) for a combined endpoint of mortality and PH-related events or all-cause mortality for echocardiographic derived RVLS were included. A weighted mean of the multivariate HR was used to determine the independent predictive value of RVLS. Eleven studies met our criteria, including 1169 patients with PH (67% female, 0.6–3.8 years follow-up). PH patients with a relative reduction of RVLS of 19% had a significantly higher risk for the combined endpoint [HR 1.22, 95% confidence interval (CI) 1.07–1.40], while patients with a relative reduction of RVLS of 22% had a significantly higher risk for all-cause mortality (HR 2.96, 95% CI 2.00–4.38).ConclusionThis systematic review and meta-analysis showed that RVLS has independent prognostic value for a combined endpoint and all-cause mortality in patients with PH. Collectively, these findings emphasize that RVLS may have value for optimizing current predictive models for clinical events or mortality in patients with PH.
      PubDate: Thu, 30 Aug 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey120
      Issue No: Vol. 20, No. 4 (2018)
  • A mechanical prosthesis in a porcelain box
    • Authors: González-Pacheco H; Palma-Carbajal R, Orozco-Moreno J, et al.
      Pages: 484 - 484
      Abstract: A 55-year-old female patient was admitted to our hospital for coronary angiography as part of elective tricuspid valve surgery evaluation. Her history revealed mitral valve replacement with a Medtronic Hall (30 mm) 18 years earlier for rheumatic mitral stenosis and atrial fibrillation. Coronary angiography and ventriculography showed normal left and right coronary arteries, a normally functioning prosthetic valve and porcelain atrium (Panels A and B) which is a very rare condition characterized by massive calcification of the left atrium walls, it has been associated with rheumatic valve disease and it has a predilection for females with chronic atrial fibrillation between 50 years old and 60 years old. Although a large percentage of our patient population has sequelae of rheumatic fever these findings are exceptional. Computed tomography confirmed calcification of the left atrium wall with involvement of the interatrial septum (black arrow, Panel C). It is detected as decreased signal intensity on magnetic resonance imaging (black arrow, Panel D). Coronary angiography and ventriculography are displayed in the Supplementary material onlineSupplementary material online. When calcification of the interatrial septum is present as in our patient, mitral valve surgery can be very difficult and contraindicated in some cases.
      PubDate: Mon, 24 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey213
      Issue No: Vol. 20, No. 4 (2018)
  • Transfemoral mitral valve-in-valve implantation for prosthetic mitral
    • Authors: Gandhi S; Eckstein J, Fam N, et al.
      Pages: 485 - 485
      Abstract: An 84-year-old male patient with heart failure. Past medical history included prior mitral valve replacement with a St. Jude Medical Epic 29 mm bioprosthetic valve. Transthoracic echocardiogram (TTE) showed the left ventricle was normal size with a normal ejection fraction of 64%, the right ventricle was dilated with systolic dysfunction, moderate tricuspid regurgitation, right ventricle systolic pressure (RVSP) of 121 mmHg consistent with severe pulmonary hypertension. Transoesophageal echocardiogram (TOE) showed a flail prosthetic cusp with severe intravalvular regurgitation (Panels A and B). The patient underwent balloon septostomy under TOE guidance followed by deployment of a 26 mm SAPIEN 3 within the mitral prosthesis (Panel C) with no residual intravalvular regurgitation or paravalvular leak (Panels D and E). Post-procedure, there was a large iatrogenic atrial septal defect with bidirectional shunting treated with an 18 mm Amplatzer atrial septal defect closure device (Panel F). Post-procedure there was no residual shunting across the interatrial septum.
      PubDate: Sat, 15 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey205
      Issue No: Vol. 20, No. 4 (2018)
  • Longitudinal strain under dobutamine stress echocardiography in patient
           with light chain cardiac amyloidosis
    • Authors: Nemchyna O; Gebker R, Schoenrath F, et al.
      Pages: 486 - 486
      Abstract: A 59-year-old female patient presented with significant left ventricular (LV) hypertrophy, moderate LV outflow tract (LVOT) obstruction, normal LV ejection fraction (EF), and Grade II diastolic dysfunction on echocardiography. Global longitudinal strain (GLS) was reduced (−12.3%), mostly because of impaired longitudinal function of middle and basal segments. Cardiac magnetic resonance imaging (MRI) revealed increased T1 signal (1200 ms at 1.5 T), diffuse late gadolinium enhancement (LGE) with basal infero-lateral and antero-lateral accentuation (Panels A and B), and increased extracellular volume up to 41%. Cardiac biopsy confirmed light chain cardiac amyloidosis.
      PubDate: Sat, 15 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey206
      Issue No: Vol. 20, No. 4 (2018)
  • Trespassing stent
    • Authors: Papitsas M; Walker N, Theodoropoulos K, et al.
      Pages: 487 - 487
      Abstract: A 68-year-old patient, who presented with inferior ST-segment elevation myocardial infarction (STEMI), underwent a coronary angiogram, which showed moderate to severe disease at the bifurcation of the left anterior descending (LAD) artery and first diagonal branch (D1), and also mild disease in the proximal right coronary artery (RCA). The catheterization was complicated with iatrogenic dissection of RCA along its length, and a 38 mm drug-eluting stent was deployed from the ostium to the proximal RCA, but it was not possible to restore flow down the vessel. Due to ongoing pain and ischaemic electrocardiogram changes, the patient was transferred to the cardiac theatre for emergency coronary artery bypass surgery. The LAD, D1, and distal RCA were grafted. The second post-operative day the patient suffered a stroke. A routine transthoracic echocardiogram (TTE), showed an echogenic, immobile tubular structure at the level of the sinuses of Valsalva. (Panel A, TTE, arrow; RVOT, right ventricular outflow tract) This was further investigated with a transoesophageal echocardiogram (TOE) and using 3D modality, it was understood that the tubular structure was apparently the RCA stent which had migrated 17 mm into the aorta (Panels B, 2D-TOE, D, 3D-TOE processed with TrueVue visualization technique, Philips®, Andover, MA, and E, 3D-TOE, arrows) (see also Supplementary data onlineSupplementary data online, Videos S1–S3Videos S1–S3). No thrombus was seen attached to the stent, but due to the recent cerebrovascular accident and the close proximity of the stent to the aortic valve (Panel C, 2D-TOE, arrow; RCC, right coronary cusp), it was considered reasonable to remove the stent surgically and inspect the RCA and the aortic valve. The stent was removed easily, and the aortic valve was found to be intact. The patient recovered well from the operation and had no residual neurological deficit.
      PubDate: Sat, 22 Dec 2018 00:00:00 GMT
      DOI: 10.1093/ehjci/jey208
      Issue No: Vol. 20, No. 4 (2018)
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