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John S Gottdiener - One of the best experts on this subject based on the ideXlab platform.
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association of annular Calcification and aortic valve sclerosis with brain findings on magnetic resonance imaging in community dwelling older adults the cardiovascular health study
Journal of the American College of Cardiology, 2011Co-Authors: Carlos J Rodriguez, Traci M Bartz, W T Longstreth, Jorge R Kizer, Eddy Barasch, Donald M Lloydjones, John S GottdienerAbstract:Objectives The objective of this study was to investigate the associations of mitral annular Calcification, aortic annular Calcification, and aortic valve sclerosis with covert magnetic resonance imaging (MRI)–defined brain infarcts. Background Clinically silent brain infarcts defined by MRI are associated with increased risk for cognitive decline, dementia, and future overt stroke. Left-sided cardiac valvular and annular Calcifications are suspected as risk factors for clinical ischemic stroke. Methods A total of 2,680 CHS (Cardiovascular Health Study) participants without clinical histories of stroke or transient ischemic attack underwent brain MRI in 1992 and 1993, 1 to 2 years before echocardiographic exams (1994 to 1995). Results The mean age of the participants was 74.5 ± 4.8 years, and 39.3% were men. The presence of any annular or valvular Calcification (mitral annular Calcification, aortic annular Calcification, or aortic valve sclerosis), mitral annular Calcification alone, or aortic annular Calcification alone was significantly associated with a higher prevalence of covert brain infarcts in unadjusted analyses (p Conclusions Left-sided cardiac annular and valvular Calcifications are associated with covert MRI-defined brain infarcts. Further study is warranted to identify mechanisms and determine whether intervening in the progression of annular and valvular Calcification could reduce the incidence of covert brain infarcts as well as the associated risk for cognitive impairment and future stroke.
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association of annular Calcification and aortic valve sclerosis with brain findings on magnetic resonance imaging in community dwelling older adults
Journal of the American College of Cardiology, 2011Co-Authors: Carlos J Rodriguez, Traci M Bartz, W T Longstreth, Jorge R Kizer, Eddy Barasch, Donald M Lloydjones, John S GottdienerAbstract:Objectives The objective of this study was to investigate the associations of mitral annular Calcification, aortic annular Calcification, and aortic valve sclerosis with covert magnetic resonance imaging (MRI)–defined brain infarcts. Background Clinically silent brain infarcts defined by MRI are associated with increased risk for cognitive decline, dementia, and future overt stroke. Left-sided cardiac valvular and annular Calcifications are suspected as risk factors for clinical ischemic stroke. Methods A total of 2,680 CHS (Cardiovascular Health Study) participants without clinical histories of stroke or transient ischemic attack underwent brain MRI in 1992 and 1993, 1 to 2 years before echocardiographic exams (1994 to 1995). Results The mean age of the participants was 74.5 ± 4.8 years, and 39.3% were men. The presence of any annular or valvular Calcification (mitral annular Calcification, aortic annular Calcification, or aortic valve sclerosis), mitral annular Calcification alone, or aortic annular Calcification alone was significantly associated with a higher prevalence of covert brain infarcts in unadjusted analyses (p < 0.01 for all). In models adjusted for age, sex, race, body mass index, physical activity, creatinine, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking, diabetes, coronary heart disease, and congestive heart failure, the presence of any annular or valve Calcification remained associated with covert brain infarcts (risk ratio: 1.24; 95% confidence interval: 1.05 to 1.47). The degree of annular or valvular Calcification severity showed a direct relation with the presence of covert MRI findings. Conclusions Left-sided cardiac annular and valvular Calcifications are associated with covert MRI-defined brain infarcts. Further study is warranted to identify mechanisms and determine whether intervening in the progression of annular and valvular Calcification could reduce the incidence of covert brain infarcts as well as the associated risk for cognitive impairment and future stroke.
Giovanni Zuliani - One of the best experts on this subject based on the ideXlab platform.
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bilateral strio pallido dentate calcinosis fahr s disease report of seven cases and revision of literature
BMC Neurology, 2016Co-Authors: E Savino, Cecilia Soavi, Eleonora Capatti, Massimo Borrelli, Giovanni Battista Vigna, Angelina Passaro, Giovanni ZulianiAbstract:Fahr’s disease is rare a neurodegenerative idiopathic condition characterized by symmetric and bilateral Calcifications of basal ganglia, usually associated with progressive neuropsychiatric dysfunctions and movement disorders. The term “Fahr’s syndrome” is used in presence of Calcifications secondary to a specific cause, but the variability of etiology, pathogenesis, and clinical picture underlying this condition have raised the question of the real existence of a syndrome. Several classifications based on the etiology, the location of brain Calcifications and the clinical presentation have been proposed. Here we describe seven clinical cases of basal ganglia Calcifications, in order to search for pathognomonic features and correlations between clinical picture and imaging findings. The patients came to our attention for different reasons (most of them for memory/behavior disturbances); all underwent neuro-psychologic evaluation and neuro-imaging. All patients showed variable degrees of deterioration in cognitive function; anxiety and depression were frequent too, and resistant to treatment in all cases. Less frequent, but severe if present, were psychotic symptoms, with different grade of structure and emotional involvement, and always resistant to treatment. We observed only few cases of extrapyramidal disorders related to the disease itself; anyway, mild extrapyramidal syndrome occurred quite frequently after treatment with antipsychotics. Based on these findings we discourage the use of the term “Fahr’s syndrome”, and suggest to refer to Idiopathic or Secondary basal ganglia Calcification. Unlike early onset forms (idiopathic or inherited), the clinical presentation of late onset form and Secondary basal ganglia Calcification seems to be really heterogeneous. Case–control studies are necessary to determine the actual significance of basal ganglia Calcification in the adult population and in the elderly, in cognitive, physical and emotional terms.
Carlos J Rodriguez - One of the best experts on this subject based on the ideXlab platform.
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association of annular Calcification and aortic valve sclerosis with brain findings on magnetic resonance imaging in community dwelling older adults the cardiovascular health study
Journal of the American College of Cardiology, 2011Co-Authors: Carlos J Rodriguez, Traci M Bartz, W T Longstreth, Jorge R Kizer, Eddy Barasch, Donald M Lloydjones, John S GottdienerAbstract:Objectives The objective of this study was to investigate the associations of mitral annular Calcification, aortic annular Calcification, and aortic valve sclerosis with covert magnetic resonance imaging (MRI)–defined brain infarcts. Background Clinically silent brain infarcts defined by MRI are associated with increased risk for cognitive decline, dementia, and future overt stroke. Left-sided cardiac valvular and annular Calcifications are suspected as risk factors for clinical ischemic stroke. Methods A total of 2,680 CHS (Cardiovascular Health Study) participants without clinical histories of stroke or transient ischemic attack underwent brain MRI in 1992 and 1993, 1 to 2 years before echocardiographic exams (1994 to 1995). Results The mean age of the participants was 74.5 ± 4.8 years, and 39.3% were men. The presence of any annular or valvular Calcification (mitral annular Calcification, aortic annular Calcification, or aortic valve sclerosis), mitral annular Calcification alone, or aortic annular Calcification alone was significantly associated with a higher prevalence of covert brain infarcts in unadjusted analyses (p Conclusions Left-sided cardiac annular and valvular Calcifications are associated with covert MRI-defined brain infarcts. Further study is warranted to identify mechanisms and determine whether intervening in the progression of annular and valvular Calcification could reduce the incidence of covert brain infarcts as well as the associated risk for cognitive impairment and future stroke.
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association of annular Calcification and aortic valve sclerosis with brain findings on magnetic resonance imaging in community dwelling older adults
Journal of the American College of Cardiology, 2011Co-Authors: Carlos J Rodriguez, Traci M Bartz, W T Longstreth, Jorge R Kizer, Eddy Barasch, Donald M Lloydjones, John S GottdienerAbstract:Objectives The objective of this study was to investigate the associations of mitral annular Calcification, aortic annular Calcification, and aortic valve sclerosis with covert magnetic resonance imaging (MRI)–defined brain infarcts. Background Clinically silent brain infarcts defined by MRI are associated with increased risk for cognitive decline, dementia, and future overt stroke. Left-sided cardiac valvular and annular Calcifications are suspected as risk factors for clinical ischemic stroke. Methods A total of 2,680 CHS (Cardiovascular Health Study) participants without clinical histories of stroke or transient ischemic attack underwent brain MRI in 1992 and 1993, 1 to 2 years before echocardiographic exams (1994 to 1995). Results The mean age of the participants was 74.5 ± 4.8 years, and 39.3% were men. The presence of any annular or valvular Calcification (mitral annular Calcification, aortic annular Calcification, or aortic valve sclerosis), mitral annular Calcification alone, or aortic annular Calcification alone was significantly associated with a higher prevalence of covert brain infarcts in unadjusted analyses (p < 0.01 for all). In models adjusted for age, sex, race, body mass index, physical activity, creatinine, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, smoking, diabetes, coronary heart disease, and congestive heart failure, the presence of any annular or valve Calcification remained associated with covert brain infarcts (risk ratio: 1.24; 95% confidence interval: 1.05 to 1.47). The degree of annular or valvular Calcification severity showed a direct relation with the presence of covert MRI findings. Conclusions Left-sided cardiac annular and valvular Calcifications are associated with covert MRI-defined brain infarcts. Further study is warranted to identify mechanisms and determine whether intervening in the progression of annular and valvular Calcification could reduce the incidence of covert brain infarcts as well as the associated risk for cognitive impairment and future stroke.
Lutz Buellesfeld - One of the best experts on this subject based on the ideXlab platform.
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extent and distribution of Calcification of both the aortic annulus and the left ventricular outflow tract predict aortic regurgitation after transcatheter aortic valve replacement
Eurointervention, 2014Co-Authors: Lutz Buellesfeld, Stefan Stortecky, Dik Heg, Steffen Gloekler, Bernhard Meier, Peter Wenaweser, Stephan WindeckerAbstract:Aims: We sought to analyse local distribution of aortic annulus and left ventricular outflow tract (LVOT) Calcification in patients undergoing transcatheter aortic valve replacement (TAVR) and its impact on aortic regurgitation (AR) immediately after device placement. Methods and results: A group of 177 patients with severe aortic stenosis undergoing multislice computed tomography of the aortic root followed by TAVR were enrolled in this single-centre study. Annular and LVOT Calcifications were assessed per cusp using a semi-quantitative grading system (0: none; 1 [mild]: small, non-protruding Calcifications; 2 [moderate]: protruding [>1 mm] or extensive [>50% of cusp sector] Calcifications; 3 [severe]: protruding and extensive Calcifications). Any Calcification of the annulus or LVOT was present in 107 (61%) and 63 (36%) patients, respectively. Prevalence of annulus/LVOT Calcifications in the left coronary cusp was 42% and 25%, respectively, in the non-coronary cusp 28% and 13%, in the right coronary cusp 13% and 5%. AR grade 2 to 4 assessed by the method of Sellers immediately after TAVR device implantation was observed in 55 patients (31%). Multivariate regression analysis revealed that the overall annulus Calcification (OR [95% CI] 1.48 [1.10-2.00]; p=0.0106), the overall LVOT Calcification (1.93 [1.26-2.96]; p=0.0026), any moderate or severe LVOT Calcification (5.37 [1.52-18.99]; p=0.0092), and asymmetric LVOT Calcification were independent predictors of AR. Conclusions: Calcifications of the aortic annulus and LVOT are frequent in patients undergoing TAVR, and both the distribution and the severity of Calcifications appear to be independent predictors of aortic regurgitation after device implantation. - See more at: http://www.pcronline.com/eurointervention/77th_issue/126/#sthash.Hzodgju5.dpuf
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correlation of device landing zone Calcification and acute procedural success in patients undergoing transcatheter aortic valve implantations with the self expanding corevalve prosthesis
Jacc-cardiovascular Interventions, 2010Co-Authors: Daniel John, Lutz Buellesfeld, Seyrani Yuecel, Ralf Mueller, Georg Latsios, Harald Beucher, Ulrich Gerckens, Eberhard GrubeAbstract:Objectives The aim of this study was to assess the influence of amount and distribution of Calcifications of the aortic valve and the left ventricular outflow tract on the acute procedural outcome of patients undergoing transcatheter aortic valve implantation (TAVI). Background Transcatheter aortic valve implantation is a new percutaneous technique especially for elderly, high-risk patients with significant aortic valve stenosis (AS). After TAVI, post-interventional paravalvular aortic regurgitations (PAR) can occur, which is believed to be related partially to valve Calcifications. Methods We prospectively analyzed 100 symptomatic patients with severe AS scheduled for TAVI with the CoreValve ReValving (Medtronic, Minneapolis, Minnesota) prosthesis. In all patients, a native and contrast-enhanced multislice cardiac computed tomography was performed pre-interventionally. Calcification load of the valve and the adjacent outflow tract was estimated by the Agatston Score (AgS), and the amount and distribution of Calcification was semi-quantitatively assessed and graded on a 1 to 4 scale (device “landing zone” Calcification score [DLZ-CS]). Aortography was performed to evaluate the PAR pre-interventionally, after initial device release (PAR0) and after termination of the procedure (PAR1). Transthoracic echocardiography was performed 2 weeks after implantation (PAR2). Results The AgS and DLZ-CS showed a significant correlation with the grade of PAR0 (AgS: r = 0.329, p = 0.001; DLZ-CS: r = 0.356, p Conclusions Calcification in the CoreValve device “landing zone” shows a significant positive correlation to PAR after TAVI. Furthermore, the need for “second maneuvers” (i.e., post-dilation after initial device release) can be predicted by these Calcification scores (AgS and DLZ-CS).
Wolfgang A Wall - One of the best experts on this subject based on the ideXlab platform.
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impact of Calcifications on patient specific wall stress analysis of abdominal aortic aneurysms
Biomechanics and Modeling in Mechanobiology, 2010Co-Authors: Andreas Maier, Michael W Gee, Christian Reeps, Hanshenning Eckstein, Wolfgang A WallAbstract:As a degenerative and inflammatory desease of elderly patients, about 80% of abdominal aortic aneurysms (AAA) show considerable wall Calcification. Effect of Calcifications on computational wall stress analyses of AAAs has been rarely treated in literature so far. Calcifications are heterogeneously distributed, non-fibrous, stiff plaques which are most commonly found near the luminal surface in between the intima and the media layer of the vessel wall. In this study, we therefore investigate the influence of Calcifications as separate AAA constituents on finite element simulation results. Thus, three AAAs are reconstructed with regard to intraluminal thrombus (ILT), Calcifications and vessel wall. Each patient-specific AAA is simulated twice, once including all three AAA constituents and once neglecting Calcifications as it is still common in literature. Parameters for constitutive modeling of Calcifications are thereby taken from experiments performed by the authors, showing that Calcifications exhibit an almost linear stress–strain behavior with a Young’s modulus E ≥ 40 MPa. Simulation results show that Calcifications exhibit significant load-bearing effects and reduce stress in adjacent vessel wall. Average stress within the vessel wall is reduced by 9.7 to 59.2%. For two out of three AAAs, peak wall stress decreases when taking Calcifications into consideration (8.9 and 28.9%). For one AAA, simulated peak wall stress increases by 5.5% due to stress peaks near Calcification borders. However, such stress singularities due to sudden stiffness jumps are physiologically doubtful. It can further be observed that large Calcifications are mostly situated in concavely shaped regions of the AAA wall. We deduce that AAA shape is influenced by existent Calcifications, thus crucial errors occur if they are neglected in computational wall stress analyses. A general increase in rupture risk for calcified AAAs is doubted.
