The Experts below are selected from a list of 240 Experts worldwide ranked by ideXlab platform
Thomas H. Marwick - One of the best experts on this subject based on the ideXlab platform.
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Impact of right ventricular end systolic Volume and mitral regurgitation on survival in patients with severe ischemic cardiomyopathy
Journal of Cardiovascular Magnetic Resonance, 2013Co-Authors: Deborah Kwon, Zoran B. Popović, Milind Y. Desai, Scott D. Flamm, Thomas H. Marwick, Rory HachamovitchAbstract:Background Mitral regurgitation (MR) and right ventricular dysfunction have been shown to be an independent predictors of mortality in patients with severe ischemic cardiomyopathy (ICM). However, it is unclear how right ventricular end systolic Volume index (RVESVi) modifies risk in patients with ischemic mitral regurgitation. We sought to assess impact of RVESVi, MR, and the interaction of these variables on outcomes in patients with ICM.
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Survival in patients with severe ischemic cardiomyopathy undergoing revascularization versus medical therapy: association with End-Systolic Volume and viability.
Circulation, 2012Co-Authors: Deborah H. Kwon, Milind Y. Desai, Scott D. Flamm, Rory Hachamovitch, Randall C. Starling, Bruce W. Lytle, Zoran B Popovic, Thomas H. MarwickAbstract:The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by End-Systolic Volume index (ESVi). Delayed hyperenhancement-MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.8 ± 10.7 years; mean left ventricular ejection fraction, 23 ± 9%; mean ESVi, 115 ± 50 mL) from 2002 to 2006. SB was quantified as scar percentage (infarcted mass/total left ventricular mass). Subsequent surgical revascularization was performed in 245 (54%) patients and subsequent percutaneous coronary interventions were performed in 28 (6%) patients. A propensity score was developed for revascularization. Cox proportional hazards models of all-cause mortality were used for risk adjustment. Over a mean follow-up of 5.8 ± 2.7 years, 186 (41%) deaths occurred. After adjusting for prior revascularization, sex, diabetes, age, use of cardiac resynchronization therapy, implantable cardioverter defibrillator, mitral regurgitation, and mitral valve procedures; an interaction between scar percentage and ESVi (P=0.016) and an interaction between post-MRI revascularization and ESVi (P=0.0017) were independently associated with mortality. ESVi demonstrated a significant interaction with revascularization and female sex, such that enhanced survival was associated with ESVi. ESVi also showed an interaction with SB; better survival was associated with lower Volumes and less scar. ESVi and SB provide independent, incremental prognostic value in patients with severe ischemic cardiomyopathy. The risk associated with SB should not be assessed in isolation.
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Survival in Patients With Severe Ischemic Cardiomyopathy Undergoing Revascularization Versus Medical Therapy Association With End-Systolic Volume and Viability
Circulation, 2012Co-Authors: Deborah H. Kwon, Zoran B. Popović, Milind Y. Desai, Scott D. Flamm, Rory Hachamovitch, Randall C. Starling, Bruce W. Lytle, Thomas H. MarwickAbstract:Background—The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by End-Systolic Volume index (ESVi). Methods and Results—Delayed hyperenhancement–MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.8±10.7 years; mean left ventricular ejection fraction, 23±9%; mean ESVi, 115±50 mL) from 2002 to 2006. SB was quantified as scar percentage (infarcted mass/total left ventricular mass). Subsequent surgical revascularization was performed in 245 (54%) patients and subsequent percutaneous coronary interventions were performed in 28 (6%) patients. A propensity score was developed for revascularization. Cox proportional hazards models of all-cause mortality were used for risk adjustment. Over a mean fol...
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End systolic Volume and scar burden are incremental and independent predictors of survival in patients with severe ischemic cardiomyopathy
Journal of Cardiovascular Magnetic Resonance, 2012Co-Authors: Deborah Kwon, Zoran B. Popović, Scott D. Flamm, Rory Hachamovitch, Thomas H. MarwickAbstract:Background Scar burden has been shown to be an independent predictor of mortality in patients with severe ischemic cardiomyopathy (ICM). However, it is unclear how both scar burden and end systolic Volume (ESV) impact outcomes in patients with severe ischemic (ICM). Purpose In patients with severe ICM, we sought to assess the association of ESV and scar burden with outcomes in severe ICM. Methods 450 patients with > 70% stenosis in ≥1 epicardial coronary artery (75% men, median age 63 years, median LV ejection fraction (EF) 22%, median ESVi 106ml, median scar % of 29%) underwent delayed hyperenhancementMRI (Siemens 1.5-T scanner, Erlangen, Germany) between 2003-2007. CMR evaluation included long and short axis assessment of LV function on balanced steady state free precession images along with assessment of myocardial scar (on phase-sensitive inversion recovery DHE-CMR sequence ~ 10-20 minutes after injection of 0.2 mmol/kg of Gadolinium dimenglumine). Scar was identified as regions of interest > 2 SD above normal myocardium. LV scar was was recorded as a percentage of the total myocardium and transmural extent (0 = none, 1 = 1-25%, 2 = 26-50%, 3 = 51-75%, and 4 = > 75%). Total scar score was determined from the summed scar score of 17 segments per patient divided by 17. Cox proportional hazards survival modeling, using a primary end-point of all-cause mortality, was used to risk-adjust comparisons. Results
Rory Hachamovitch - One of the best experts on this subject based on the ideXlab platform.
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Impact of right ventricular end systolic Volume and mitral regurgitation on survival in patients with severe ischemic cardiomyopathy
Journal of Cardiovascular Magnetic Resonance, 2013Co-Authors: Deborah Kwon, Zoran B. Popović, Milind Y. Desai, Scott D. Flamm, Thomas H. Marwick, Rory HachamovitchAbstract:Background Mitral regurgitation (MR) and right ventricular dysfunction have been shown to be an independent predictors of mortality in patients with severe ischemic cardiomyopathy (ICM). However, it is unclear how right ventricular end systolic Volume index (RVESVi) modifies risk in patients with ischemic mitral regurgitation. We sought to assess impact of RVESVi, MR, and the interaction of these variables on outcomes in patients with ICM.
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Survival in patients with severe ischemic cardiomyopathy undergoing revascularization versus medical therapy: association with End-Systolic Volume and viability.
Circulation, 2012Co-Authors: Deborah H. Kwon, Milind Y. Desai, Scott D. Flamm, Rory Hachamovitch, Randall C. Starling, Bruce W. Lytle, Zoran B Popovic, Thomas H. MarwickAbstract:The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by End-Systolic Volume index (ESVi). Delayed hyperenhancement-MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.8 ± 10.7 years; mean left ventricular ejection fraction, 23 ± 9%; mean ESVi, 115 ± 50 mL) from 2002 to 2006. SB was quantified as scar percentage (infarcted mass/total left ventricular mass). Subsequent surgical revascularization was performed in 245 (54%) patients and subsequent percutaneous coronary interventions were performed in 28 (6%) patients. A propensity score was developed for revascularization. Cox proportional hazards models of all-cause mortality were used for risk adjustment. Over a mean follow-up of 5.8 ± 2.7 years, 186 (41%) deaths occurred. After adjusting for prior revascularization, sex, diabetes, age, use of cardiac resynchronization therapy, implantable cardioverter defibrillator, mitral regurgitation, and mitral valve procedures; an interaction between scar percentage and ESVi (P=0.016) and an interaction between post-MRI revascularization and ESVi (P=0.0017) were independently associated with mortality. ESVi demonstrated a significant interaction with revascularization and female sex, such that enhanced survival was associated with ESVi. ESVi also showed an interaction with SB; better survival was associated with lower Volumes and less scar. ESVi and SB provide independent, incremental prognostic value in patients with severe ischemic cardiomyopathy. The risk associated with SB should not be assessed in isolation.
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Survival in Patients With Severe Ischemic Cardiomyopathy Undergoing Revascularization Versus Medical Therapy Association With End-Systolic Volume and Viability
Circulation, 2012Co-Authors: Deborah H. Kwon, Zoran B. Popović, Milind Y. Desai, Scott D. Flamm, Rory Hachamovitch, Randall C. Starling, Bruce W. Lytle, Thomas H. MarwickAbstract:Background—The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by End-Systolic Volume index (ESVi). Methods and Results—Delayed hyperenhancement–MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.8±10.7 years; mean left ventricular ejection fraction, 23±9%; mean ESVi, 115±50 mL) from 2002 to 2006. SB was quantified as scar percentage (infarcted mass/total left ventricular mass). Subsequent surgical revascularization was performed in 245 (54%) patients and subsequent percutaneous coronary interventions were performed in 28 (6%) patients. A propensity score was developed for revascularization. Cox proportional hazards models of all-cause mortality were used for risk adjustment. Over a mean fol...
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End systolic Volume and scar burden are incremental and independent predictors of survival in patients with severe ischemic cardiomyopathy
Journal of Cardiovascular Magnetic Resonance, 2012Co-Authors: Deborah Kwon, Zoran B. Popović, Scott D. Flamm, Rory Hachamovitch, Thomas H. MarwickAbstract:Background Scar burden has been shown to be an independent predictor of mortality in patients with severe ischemic cardiomyopathy (ICM). However, it is unclear how both scar burden and end systolic Volume (ESV) impact outcomes in patients with severe ischemic (ICM). Purpose In patients with severe ICM, we sought to assess the association of ESV and scar burden with outcomes in severe ICM. Methods 450 patients with > 70% stenosis in ≥1 epicardial coronary artery (75% men, median age 63 years, median LV ejection fraction (EF) 22%, median ESVi 106ml, median scar % of 29%) underwent delayed hyperenhancementMRI (Siemens 1.5-T scanner, Erlangen, Germany) between 2003-2007. CMR evaluation included long and short axis assessment of LV function on balanced steady state free precession images along with assessment of myocardial scar (on phase-sensitive inversion recovery DHE-CMR sequence ~ 10-20 minutes after injection of 0.2 mmol/kg of Gadolinium dimenglumine). Scar was identified as regions of interest > 2 SD above normal myocardium. LV scar was was recorded as a percentage of the total myocardium and transmural extent (0 = none, 1 = 1-25%, 2 = 26-50%, 3 = 51-75%, and 4 = > 75%). Total scar score was determined from the summed scar score of 17 segments per patient divided by 17. Cox proportional hazards survival modeling, using a primary end-point of all-cause mortality, was used to risk-adjust comparisons. Results
Scott D. Flamm - One of the best experts on this subject based on the ideXlab platform.
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Impact of right ventricular end systolic Volume and mitral regurgitation on survival in patients with severe ischemic cardiomyopathy
Journal of Cardiovascular Magnetic Resonance, 2013Co-Authors: Deborah Kwon, Zoran B. Popović, Milind Y. Desai, Scott D. Flamm, Thomas H. Marwick, Rory HachamovitchAbstract:Background Mitral regurgitation (MR) and right ventricular dysfunction have been shown to be an independent predictors of mortality in patients with severe ischemic cardiomyopathy (ICM). However, it is unclear how right ventricular end systolic Volume index (RVESVi) modifies risk in patients with ischemic mitral regurgitation. We sought to assess impact of RVESVi, MR, and the interaction of these variables on outcomes in patients with ICM.
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Survival in patients with severe ischemic cardiomyopathy undergoing revascularization versus medical therapy: association with End-Systolic Volume and viability.
Circulation, 2012Co-Authors: Deborah H. Kwon, Milind Y. Desai, Scott D. Flamm, Rory Hachamovitch, Randall C. Starling, Bruce W. Lytle, Zoran B Popovic, Thomas H. MarwickAbstract:The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by End-Systolic Volume index (ESVi). Delayed hyperenhancement-MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.8 ± 10.7 years; mean left ventricular ejection fraction, 23 ± 9%; mean ESVi, 115 ± 50 mL) from 2002 to 2006. SB was quantified as scar percentage (infarcted mass/total left ventricular mass). Subsequent surgical revascularization was performed in 245 (54%) patients and subsequent percutaneous coronary interventions were performed in 28 (6%) patients. A propensity score was developed for revascularization. Cox proportional hazards models of all-cause mortality were used for risk adjustment. Over a mean follow-up of 5.8 ± 2.7 years, 186 (41%) deaths occurred. After adjusting for prior revascularization, sex, diabetes, age, use of cardiac resynchronization therapy, implantable cardioverter defibrillator, mitral regurgitation, and mitral valve procedures; an interaction between scar percentage and ESVi (P=0.016) and an interaction between post-MRI revascularization and ESVi (P=0.0017) were independently associated with mortality. ESVi demonstrated a significant interaction with revascularization and female sex, such that enhanced survival was associated with ESVi. ESVi also showed an interaction with SB; better survival was associated with lower Volumes and less scar. ESVi and SB provide independent, incremental prognostic value in patients with severe ischemic cardiomyopathy. The risk associated with SB should not be assessed in isolation.
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Survival in Patients With Severe Ischemic Cardiomyopathy Undergoing Revascularization Versus Medical Therapy Association With End-Systolic Volume and Viability
Circulation, 2012Co-Authors: Deborah H. Kwon, Zoran B. Popović, Milind Y. Desai, Scott D. Flamm, Rory Hachamovitch, Randall C. Starling, Bruce W. Lytle, Thomas H. MarwickAbstract:Background—The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by End-Systolic Volume index (ESVi). Methods and Results—Delayed hyperenhancement–MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.8±10.7 years; mean left ventricular ejection fraction, 23±9%; mean ESVi, 115±50 mL) from 2002 to 2006. SB was quantified as scar percentage (infarcted mass/total left ventricular mass). Subsequent surgical revascularization was performed in 245 (54%) patients and subsequent percutaneous coronary interventions were performed in 28 (6%) patients. A propensity score was developed for revascularization. Cox proportional hazards models of all-cause mortality were used for risk adjustment. Over a mean fol...
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End systolic Volume and scar burden are incremental and independent predictors of survival in patients with severe ischemic cardiomyopathy
Journal of Cardiovascular Magnetic Resonance, 2012Co-Authors: Deborah Kwon, Zoran B. Popović, Scott D. Flamm, Rory Hachamovitch, Thomas H. MarwickAbstract:Background Scar burden has been shown to be an independent predictor of mortality in patients with severe ischemic cardiomyopathy (ICM). However, it is unclear how both scar burden and end systolic Volume (ESV) impact outcomes in patients with severe ischemic (ICM). Purpose In patients with severe ICM, we sought to assess the association of ESV and scar burden with outcomes in severe ICM. Methods 450 patients with > 70% stenosis in ≥1 epicardial coronary artery (75% men, median age 63 years, median LV ejection fraction (EF) 22%, median ESVi 106ml, median scar % of 29%) underwent delayed hyperenhancementMRI (Siemens 1.5-T scanner, Erlangen, Germany) between 2003-2007. CMR evaluation included long and short axis assessment of LV function on balanced steady state free precession images along with assessment of myocardial scar (on phase-sensitive inversion recovery DHE-CMR sequence ~ 10-20 minutes after injection of 0.2 mmol/kg of Gadolinium dimenglumine). Scar was identified as regions of interest > 2 SD above normal myocardium. LV scar was was recorded as a percentage of the total myocardium and transmural extent (0 = none, 1 = 1-25%, 2 = 26-50%, 3 = 51-75%, and 4 = > 75%). Total scar score was determined from the summed scar score of 17 segments per patient divided by 17. Cox proportional hazards survival modeling, using a primary end-point of all-cause mortality, was used to risk-adjust comparisons. Results
Deborah H. Kwon - One of the best experts on this subject based on the ideXlab platform.
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Survival in patients with severe ischemic cardiomyopathy undergoing revascularization versus medical therapy: association with End-Systolic Volume and viability.
Circulation, 2012Co-Authors: Deborah H. Kwon, Milind Y. Desai, Scott D. Flamm, Rory Hachamovitch, Randall C. Starling, Bruce W. Lytle, Zoran B Popovic, Thomas H. MarwickAbstract:The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by End-Systolic Volume index (ESVi). Delayed hyperenhancement-MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.8 ± 10.7 years; mean left ventricular ejection fraction, 23 ± 9%; mean ESVi, 115 ± 50 mL) from 2002 to 2006. SB was quantified as scar percentage (infarcted mass/total left ventricular mass). Subsequent surgical revascularization was performed in 245 (54%) patients and subsequent percutaneous coronary interventions were performed in 28 (6%) patients. A propensity score was developed for revascularization. Cox proportional hazards models of all-cause mortality were used for risk adjustment. Over a mean follow-up of 5.8 ± 2.7 years, 186 (41%) deaths occurred. After adjusting for prior revascularization, sex, diabetes, age, use of cardiac resynchronization therapy, implantable cardioverter defibrillator, mitral regurgitation, and mitral valve procedures; an interaction between scar percentage and ESVi (P=0.016) and an interaction between post-MRI revascularization and ESVi (P=0.0017) were independently associated with mortality. ESVi demonstrated a significant interaction with revascularization and female sex, such that enhanced survival was associated with ESVi. ESVi also showed an interaction with SB; better survival was associated with lower Volumes and less scar. ESVi and SB provide independent, incremental prognostic value in patients with severe ischemic cardiomyopathy. The risk associated with SB should not be assessed in isolation.
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Survival in Patients With Severe Ischemic Cardiomyopathy Undergoing Revascularization Versus Medical Therapy Association With End-Systolic Volume and Viability
Circulation, 2012Co-Authors: Deborah H. Kwon, Zoran B. Popović, Milind Y. Desai, Scott D. Flamm, Rory Hachamovitch, Randall C. Starling, Bruce W. Lytle, Thomas H. MarwickAbstract:Background—The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by End-Systolic Volume index (ESVi). Methods and Results—Delayed hyperenhancement–MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.8±10.7 years; mean left ventricular ejection fraction, 23±9%; mean ESVi, 115±50 mL) from 2002 to 2006. SB was quantified as scar percentage (infarcted mass/total left ventricular mass). Subsequent surgical revascularization was performed in 245 (54%) patients and subsequent percutaneous coronary interventions were performed in 28 (6%) patients. A propensity score was developed for revascularization. Cox proportional hazards models of all-cause mortality were used for risk adjustment. Over a mean fol...
Milind Y. Desai - One of the best experts on this subject based on the ideXlab platform.
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Impact of right ventricular end systolic Volume and mitral regurgitation on survival in patients with severe ischemic cardiomyopathy
Journal of Cardiovascular Magnetic Resonance, 2013Co-Authors: Deborah Kwon, Zoran B. Popović, Milind Y. Desai, Scott D. Flamm, Thomas H. Marwick, Rory HachamovitchAbstract:Background Mitral regurgitation (MR) and right ventricular dysfunction have been shown to be an independent predictors of mortality in patients with severe ischemic cardiomyopathy (ICM). However, it is unclear how right ventricular end systolic Volume index (RVESVi) modifies risk in patients with ischemic mitral regurgitation. We sought to assess impact of RVESVi, MR, and the interaction of these variables on outcomes in patients with ICM.
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Survival in patients with severe ischemic cardiomyopathy undergoing revascularization versus medical therapy: association with End-Systolic Volume and viability.
Circulation, 2012Co-Authors: Deborah H. Kwon, Milind Y. Desai, Scott D. Flamm, Rory Hachamovitch, Randall C. Starling, Bruce W. Lytle, Zoran B Popovic, Thomas H. MarwickAbstract:The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by End-Systolic Volume index (ESVi). Delayed hyperenhancement-MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.8 ± 10.7 years; mean left ventricular ejection fraction, 23 ± 9%; mean ESVi, 115 ± 50 mL) from 2002 to 2006. SB was quantified as scar percentage (infarcted mass/total left ventricular mass). Subsequent surgical revascularization was performed in 245 (54%) patients and subsequent percutaneous coronary interventions were performed in 28 (6%) patients. A propensity score was developed for revascularization. Cox proportional hazards models of all-cause mortality were used for risk adjustment. Over a mean follow-up of 5.8 ± 2.7 years, 186 (41%) deaths occurred. After adjusting for prior revascularization, sex, diabetes, age, use of cardiac resynchronization therapy, implantable cardioverter defibrillator, mitral regurgitation, and mitral valve procedures; an interaction between scar percentage and ESVi (P=0.016) and an interaction between post-MRI revascularization and ESVi (P=0.0017) were independently associated with mortality. ESVi demonstrated a significant interaction with revascularization and female sex, such that enhanced survival was associated with ESVi. ESVi also showed an interaction with SB; better survival was associated with lower Volumes and less scar. ESVi and SB provide independent, incremental prognostic value in patients with severe ischemic cardiomyopathy. The risk associated with SB should not be assessed in isolation.
-
Survival in Patients With Severe Ischemic Cardiomyopathy Undergoing Revascularization Versus Medical Therapy Association With End-Systolic Volume and Viability
Circulation, 2012Co-Authors: Deborah H. Kwon, Zoran B. Popović, Milind Y. Desai, Scott D. Flamm, Rory Hachamovitch, Randall C. Starling, Bruce W. Lytle, Thomas H. MarwickAbstract:Background—The value of assessment of viability as a predictor of surgical revascularization benefit in ischemic cardiomyopathy has recently been questioned in a large trial. We sought to determine whether the contribution of viability as myocardial scar burden (SB) to predict revascularization outcomes could be modulated by End-Systolic Volume index (ESVi). Methods and Results—Delayed hyperenhancement–MRI was obtained in 450 patients with ≥70% stenosis in ≥1 epicardial coronary artery (75% men; median age, 62.8±10.7 years; mean left ventricular ejection fraction, 23±9%; mean ESVi, 115±50 mL) from 2002 to 2006. SB was quantified as scar percentage (infarcted mass/total left ventricular mass). Subsequent surgical revascularization was performed in 245 (54%) patients and subsequent percutaneous coronary interventions were performed in 28 (6%) patients. A propensity score was developed for revascularization. Cox proportional hazards models of all-cause mortality were used for risk adjustment. Over a mean fol...