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See detailClinical trial design principles and endpoint definitions for transcatheter mitral valve repair and replacement: part 1: clinical trial design principles: A consensus document from the mitral valve academic research consortium.
Stone, Gregg W.; Vahanian, Alec S.; Adams, David H. et al

in European heart journal (2015), 36(29), 1851-77

Mitral regurgitation (MR) is one of the most prevalent valve disorders and has numerous aetiologies, including primary (organic) MR, due to underlying degenerative/structural mitral valve (MV) pathology ... [more ▼]

Mitral regurgitation (MR) is one of the most prevalent valve disorders and has numerous aetiologies, including primary (organic) MR, due to underlying degenerative/structural mitral valve (MV) pathology, and secondary (functional) MR, which is principally caused by global or regional left ventricular remodelling and/or severe left atrial dilation. Diagnosis and optimal management of MR requires integration of valve disease and heart failure specialists, MV cardiac surgeons, interventional cardiologists with expertise in structural heart disease, and imaging experts. The introduction of transcatheter MV therapies has highlighted the need for a consensus approach to pragmatic clinical trial design and uniform endpoint definitions to evaluate outcomes in patients with MR. The Mitral Valve Academic Research Consortium is a collaboration between leading academic research organizations and physician-scientists specializing in MV disease from the United States and Europe. Three in-person meetings were held in Virginia and New York during which 44 heart failure, valve, and imaging experts, MV surgeons and interventional cardiologists, clinical trial specialists and statisticians, and representatives from the U.S. Food and Drug Administration considered all aspects of MV pathophysiology, prognosis, and therapies, culminating in a 2-part document describing consensus recommendations for clinical trial design (Part 1) and endpoint definitions (Part 2) to guide evaluation of transcatheter and surgical therapies for MR. The adoption of these recommendations will afford robustness and consistency in the comparative effectiveness evaluation of new devices and approaches to treat MR. These principles may be useful for regulatory assessment of new transcatheter MV devices, as well as for monitoring local and regional outcomes to guide quality improvement initiatives. [less ▲]

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See detailThe year in cardiology 2014: valvular heart disease.
Pierard, Luc ULg; Vahanian, Alec

in European heart journal (2015)

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See detailCardioPulse: cardiac imaging of adult cancer patients on chemotherapy.
Galderisi, Maurizio; Lancellotti, Patrizio ULg

in European heart journal (2015), 36(15), 889-90

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See detail2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: The Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC).
Elliott, Perry M.; Anastasakis, Aris; Borger, Michael A. et al

in European heart journal (2014), 35(39), 2733-79

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See detail2014 ESC/ESA Guidelines on Non-cardiac Surgery: Cardiovascular Assessment and Management.
Kristensen, Steen Dalby; Knuuti, Juhani; Saraste, Antti et al

in European Heart Journal (2014), 35(35), 2383-431

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See detailTreatment of aortic stenosis with a self-expanding transcatheter valve: the International Multi-centre ADVANCE Study
Linke, Axel; Wenaweser, Peter; Gerckens, Ulrich et al

in European Heart Journal (2014)

Aim Transcatheter aortic valve implantation has become an alternative to surgery in higher risk patients with symptomatic aortic stenosis. The aim of the ADVANCE study was to evaluate outcomes following ... [more ▼]

Aim Transcatheter aortic valve implantation has become an alternative to surgery in higher risk patients with symptomatic aortic stenosis. The aim of the ADVANCE study was to evaluate outcomes following implantation of a self-expanding transcatheter aortic valve system in a fully monitored, multi-centre ‘real-world’ patient population in highly experienced centres. Methods and results Patients with severe aortic stenosis at a higher surgical risk inwhomimplantation of theCoreValve Systemwas decided by the Heart Teamwere included. Endpointswere a composite of major adverse cardiovascular and cerebrovascular events (MACCE; all-cause mortality, myocardial infarction, stroke, or reintervention) and mortality at 30 days and 1 year. Endpoint- related eventswere independently adjudicated based on Valve AcademicResearch Consortiumdefinitions.Atotal of 1015 patients [mean logistic EuroSCORE 19.4+12.3% [median (Q1,Q3), 16.0% (10.3, 25.3%)], age 81+6 years] were enrolled. Implantation of the CoreValve System led to a significant improvement in haemodynamics and an increase in the effective aortic valve orifice area. At 30 days, theMACCErate was 8.0% (95% CI: 6.3–9.7%), all-cause mortalitywas 4.5% (3.2–5.8%), cardiovascular mortality was 3.4% (2.3–4.6%), and the rate of stroke was 3.0% (2.0–4.1%). The lifethreatening or disabling bleeding rate was 4.0% (2.8–6.3%). The 12-month rates of MACCE, all-cause mortality, cardiovascular mortality, and stroke were 21.2% (18.4–24.1%), 17.9% (15.2–20.5%), 11.7% (9.4–14.1%), and 4.5% (2.9–6.1%), respectively. The 12-month rates of all-cause mortality were 11.1, 16.5, and 23.6% among patients with a logistic Euro- SCORE ≤10%, EuroSCORE 10–20%, and EuroSCORE .20% (P , 0.05), respectively. Conclusion The ADVANCE study demonstrates the safety and effectiveness of the CoreValve System with low mortality and stroke rates in higher risk real-world patients with severe aortic stenosis. [less ▲]

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See detailRemote ischaemic pre-conditioning in cardiac surgery: benefit or not?
Kolh, Philippe ULg

in European heart journal (2014), 35(3), 141-3

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See detailThe appropriate and justified use of medical radiation in cardiovascular imaging: a position document of the ESC Associations of Cardiovascular Imaging, Percutaneous Cardiovascular Interventions and Electrophysiology.
Picano, Eugenio; Vano, Eliseo; Rehani, Madan M. et al

in European heart journal (2014), 35(10), 665-72

The benefits of cardiac imaging are immense, and modern medicine requires the extensive and versatile use of a variety of cardiac imaging techniques. Cardiologists are responsible for a large part of the ... [more ▼]

The benefits of cardiac imaging are immense, and modern medicine requires the extensive and versatile use of a variety of cardiac imaging techniques. Cardiologists are responsible for a large part of the radiation exposures every person gets per year from all medical sources. Therefore, they have a particular responsibility to avoid unjustified and non-optimized use of radiation, but sometimes are imperfectly aware of the radiological dose of the examination they prescribe or practice. This position paper aims to summarize the current knowledge on radiation effective doses (and risks) related to cardiac imaging procedures. We have reviewed the literature on radiation doses, which can range from the equivalent of 1-60 milliSievert (mSv) around a reference dose average of 15 mSv (corresponding to 750 chest X-rays) for a percutaneous coronary intervention, a cardiac radiofrequency ablation, a multidetector coronary angiography, or a myocardial perfusion imaging scintigraphy. We provide a European perspective on the best way to play an active role in implementing into clinical practice the key principle of radiation protection that: 'each patient should get the right imaging exam, at the right time, with the right radiation dose'. [less ▲]

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See detailCardiovascular imaging.
Lancellotti, Patrizio ULg; Habib, Gilbert; Negila, Danilo et al

in European heart journal (2014), 35(18), 1161-2

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See detailESC working group on valvular heart disease position paper-heart valve clinics: organization, structure, and experiences
LANCELLOTTI, Patrizio ULg; Rosenhek, R; Pibarot, P et al

in European Heart Journal (2013)

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See detailLeft ventricular contractile reserve in asymptomatic primary mitral regurgitation
Magne, Julien ULg; Mahjoub, H; PIERARD, Luc ULg et al

in European Heart Journal (2013)

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