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Article ; Online: Impact of Preoperative Left Atrial Dimension on Outcome in Patients in Sinus Rhythm Undergoing Surgical Valve Repair for Severe Mitral Regurgitation due to Mitral Valve Prolapse.

Szymanski, Catherine / Bohbot, Yohann / Rusinaru, Dan / Touati, Gilles / Tribouilloy, Christophe

2019 Volume 142, Issue 3, Page(s) 189–193

Abstract: Background: Left atrial (LA) enlargement has been previously identified as a predictor of mortality in patients with medically managed mitral regurgitation (MR) due to mitral valve prolapse (MVP). No study has specifically assessed the prognostic value ... ...

Abstract	Background: Left atrial (LA) enlargement has been previously identified as a predictor of mortality in patients with medically managed mitral regurgitation (MR) due to mitral valve prolapse (MVP). No study has specifically assessed the prognostic value of LA size in patients undergoing mitral valve repair (MVRp). Objective: We aimed to investigate the relationship between LA area and mortality in patients in sinus rhythm (SR) undergoing MVRp for MVP. Methods: We included 305 patients in SR who underwent MVRp for MVP. Median follow-up time was 7.9 years. Patients were divided into 3 groups: LA area ≤25 cm2 (reference group), LA 26-30 cm2, and LA >30 cm2. Results: Compared with patients with an LA area ≤25 cm2, those with an LA area >30 cm2 had a lower 10-year survival (98 ± 2 vs. 86 ± 4%; p = 0.037). In multivariate analysis, after adjustment for established outcome predictors including age, symptoms, EuroSCORE, and left ventricular size and function, LA enlargement >30 cm2 was associated with increased mortality (adjusted HR = 2.20, 95% CI 1.03-4.90; p = 0.042), whereas LA enlargement between 26 and 30 cm2 was not (adjusted HR = 1.37, 95% CI 0.56-3.56; p = 0.52). Conclusion: LA enlargement is independently predictive of long-term mortality after MVRp in patients in SR with severe MR due to MVP. Our findings suggest that MVRp should be considered before the LA area exceeds 30 cm2.
MeSH term(s)	Aged ; Atrial Function, Left ; Cardiac Surgical Procedures ; Echocardiography ; Female ; France/epidemiology ; Heart Atria/diagnostic imaging ; Heart Atria/pathology ; Heart Valve Prosthesis Implantation ; Humans ; Male ; Middle Aged ; Mitral Valve Insufficiency/diagnostic imaging ; Mitral Valve Insufficiency/mortality ; Mitral Valve Insufficiency/surgery ; Mitral Valve Prolapse/diagnostic imaging ; Mitral Valve Prolapse/mortality ; Mitral Valve Prolapse/surgery ; Multivariate Analysis ; Predictive Value of Tests ; Survival Analysis
Language	English
Publishing date	2019-06-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	80092-2
ISSN	1421-9751 ; 0008-6312
ISSN (online)	1421-9751
ISSN	0008-6312
DOI	10.1159/000499577
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Article ; Online: Screening of Native Valvular Heart Disease Using a Pocket-Sized Transthoracic Echocardiographic Device.

Kikoïne, John / Hauguel-Moreau, Marie / Hergault, Hélène / Aidan, Vincent / Ouadahi, Mounir / Dubourg, Olivier / Szymanski, Catherine / Mansencal, Nicolas

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography

2021 Volume 35, Issue 2, Page(s) 196–202

Abstract: Background: The authors assessed the performance of pocket-sized transthoracic echocardiography (pTTE) compared with standard transthoracic echocardiography (sTTE) and auscultation for early screening of valvular heart disease (VHD). Early diagnosis of ... ...

Abstract	Background: The authors assessed the performance of pocket-sized transthoracic echocardiography (pTTE) compared with standard transthoracic echocardiography (sTTE) and auscultation for early screening of valvular heart disease (VHD). Early diagnosis of significant VHD is a challenge, but it enables appropriate follow-up and implementation of the best therapeutic strategy. Methods: sTTE, pTTE, and auscultation were performed by three different experienced physicians on 284 unselected patients. All cases of VHD detected by each of these three techniques were noted. sTTE was the gold standard. Each physician performed one examination and was blinded to the results of other examinations. Results: We diagnosed a total of 301 cases of VHD, with a large predominance of regurgitant lesions: 269 cases (89.3%) of regurgitant VHD and 32 (10.7%) of stenotic VHD. pTTE was highly sensitive (85.7%) and specific (97.9%) for screening for VHD, while auscultation detected only 54.1%. All significant cases of VHD (at least mild severity) were detected on pTTE. The weighted κ coefficient between pTTE and sTTE for the assessment of mitral regurgitation was 0.71 (95% CI, 0.70-0.72), indicating good agreement. The weighted κ coefficients between pTTE and sTTE for the assessment of aortic regurgitation and aortic stenosis were 0.97 (95% CI, 0.96-0.98) and 0.98 (95% CI, 0.97-0.99), respectively, indicating excellent agreement. Conclusions: pTTE performed by physicians with level III competency in echocardiography is reliable for identifying significant VHD and should be proposed as a new screening tool.
MeSH term(s)	Aortic Valve Insufficiency ; Aortic Valve Stenosis/diagnostic imaging ; Echocardiography/methods ; Heart Valve Diseases/diagnostic imaging ; Humans ; Mitral Valve Insufficiency/diagnostic imaging
Language	English
Publishing date	2021-08-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1035622-8
ISSN	1097-6795 ; 0894-7317
ISSN (online)	1097-6795
ISSN	0894-7317
DOI	10.1016/j.echo.2021.08.013
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Article ; Online: Ischemic mitral regurgitation: new concepts.

Szymanski, Catherine / Messas, Emmanuel

Archives of cardiovascular diseases

2013 Volume 106, Issue 4, Page(s) 183–187

MeSH term(s)	Animals ; Heart Valve Prosthesis Implantation/adverse effects ; Humans ; Mitral Valve/physiopathology ; Mitral Valve/surgery ; Mitral Valve Annuloplasty/adverse effects ; Mitral Valve Insufficiency/etiology ; Mitral Valve Insufficiency/physiopathology ; Mitral Valve Insufficiency/surgery ; Mitral Valve Stenosis/etiology ; Mitral Valve Stenosis/physiopathology ; Myocardial Ischemia/complications ; Recurrence ; Treatment Outcome
Language	English
Publishing date	2013-04
Publishing country	Netherlands
Document type	Editorial
ZDB-ID	2408778-6
ISSN	1875-2128 ; 1875-2136
ISSN (online)	1875-2128
ISSN	1875-2136
DOI	10.1016/j.acvd.2013.03.058
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Article ; Online: Progression of Carcinoid Heart Disease in the Modern Management Era.

Baron, Emilie / Szymanski, Catherine / Hergault, Hélène / Lepère, Céline / Dubourg, Olivier / Hauguel-Moreau, Marie / Mansencal, Nicolas

Journal of the American Heart Association

2021 Volume 10, Issue 23, Page(s) e020475

Abstract: Background The development of carcinoid heart disease (CaHD) is still relatively unclear. It is difficult to define an optimal follow-up for patients without any cardiac involvement at baseline. The aim of this study was to assess the prevalence and ... ...

Abstract	Background The development of carcinoid heart disease (CaHD) is still relatively unclear. It is difficult to define an optimal follow-up for patients without any cardiac involvement at baseline. The aim of this study was to assess the prevalence and natural history of CaHD by annual echocardiographic examinations. Methods and Results We studied 137 consecutive patients (61±12 years, 53% men) with proven digestive endocrine tumor and carcinoid syndrome between 1997 and 2017. All patients underwent serial conventional transthoracic echocardiographic studies. Right-sided and left-sided CaHD were systematically assessed. We used a previous validated echocardiographic scoring system of severity for the assessment of CaHD. An increase of 25% of the score was considered to be significant. Mean follow-up was 54±45 months. Prevalence of CaHD was 27% at baseline and 32% at 5-year follow-up. Disease progression was reported in 28% of patients with initial CaHD followed up for >2 years (n=25). In patients without any cardiac involvement at baseline, occurrence of disease was 21%. CaHD occurred >5 years from the initial echocardiographic examination in 42% of our cases, especially in patients presenting with new recurrence of a digestive endocrine tumor. An increase of urinary 5-hydroxyindoleacetic acid by 25% during follow-up was identified as an independent predictor of CaHD occurrence during follow-up (hazard ratio [HR], 5.81; 95% CI, 1.19-28.38;
MeSH term(s)	Aged ; Carcinoid Heart Disease/diagnostic imaging ; Carcinoid Heart Disease/pathology ; Carcinoid Heart Disease/therapy ; Disease Progression ; Echocardiography ; Female ; Humans ; Male ; Middle Aged
Language	English
Publishing date	2021-11-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.120.020475
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Article ; Online: Occurrence of Atrial Fibrillation During Dobutamine Stress Echocardiography.

Mansencal, Nicolas / Mustafic, Hazrije / Hauguel-Moreau, Marie / Lannou, Simon / Szymanski, Catherine / Dubourg, Olivier

The American journal of cardiology

2019 Volume 123, Issue 8, Page(s) 1277–1282

Abstract: Dobutamine stress echocardiography (DSE) is a widely used examination for assessment of coronary ischemia, but several complications have been reported. The aim of this study was to assess the incidence of atrial fibrillation (AF) during DSE, and a ... ...

Abstract	Dobutamine stress echocardiography (DSE) is a widely used examination for assessment of coronary ischemia, but several complications have been reported. The aim of this study was to assess the incidence of atrial fibrillation (AF) during DSE, and a systematic review and meta-analysis were also performed to determine an accurate estimate of the AF incidence. Over a 16-year period, we reviewed all patients referred for DSE. We systematically analyzed all ECG performed during DSE to detect AF during the examination. DSE was completely performed in 4,818 patients (mean age: 62.1 ± 11.7 years). AF was observed in 40 patients (31 men, mean age: 79.7 ± 8.9 years). Incidence of AF during DSE was 0.83%. Regarding the meta-analysis, the combined AF incidence was 0.86%. In our study, patients with AF occurrence had more frequent previous history of paroxysmal AF (p = 0.02) were also older (p < 0.0001) and incidence of AF during DSE increased with age: 0% below 60 years, 0.45% in patients 60 to 69 years, 1.3% in patients 70 to 79 years, and 4% in patients >80 years (p < 0.0001). In multivariate analysis, the factors significantly associated with an increased risk of AF were age (adjusted odds ratio (aOR) = 2.4, 95% confidence interval: 1.5 to 3.3, p = 0.003) and previous history of paroxysmal AF (aOR = 1.5, 95% confidence interval: 1.1 to 1.9; p = 0.04). In conclusion, AF is uncommon during DSE, and elderly patients and patients with previous history of paroxysmal AF are at risk of AF during DSE.
MeSH term(s)	Aged ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/etiology ; Cardiotonic Agents/adverse effects ; Dobutamine/adverse effects ; Echocardiography, Stress/adverse effects ; Electrocardiography ; Female ; Follow-Up Studies ; Forecasting ; France/epidemiology ; Humans ; Incidence ; Male ; Middle Aged ; Myocardial Ischemia/diagnosis ; Retrospective Studies ; Risk Factors
Chemical Substances	Cardiotonic Agents ; Dobutamine (3S12J47372)
Language	English
Publishing date	2019-01-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2019.01.022
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Article: Usefulness of Longitudinal Strain Adjusted to Regional Thickness in Hypertrophic Cardiomyopathy.

Urtado, Sophie / Hergault, Hélène / Binsse, Stephen / Aidan, Vincent / Ouadahi, Mounir / Szymanski, Catherine / Mallet, Sophie / Hauguel-Moreau, Marie / Carlier, Robert Yves / Dubourg, Olivier / Mansencal, Nicolas

Journal of clinical medicine

2022 Volume 11, Issue 8

Abstract: Background. We assessed the usefulness of a longitudinal strain adjusted to regional thickness in hypertrophic cardiomyopathy (HCM). Indeed, with conventional software, the width of the region of interest (ROI) is the same over the entire myocardial wall, ...

Abstract	Background. We assessed the usefulness of a longitudinal strain adjusted to regional thickness in hypertrophic cardiomyopathy (HCM). Indeed, with conventional software, the width of the region of interest (ROI) is the same over the entire myocardial wall, wherein the software analyzes only partially the left ventricular (LV) hypertrophic segments. Methods. We included 110 patients: 55 patients with HCM (HCM group) and 55 healthy subjects (age- and sex-matched control group). The global longitudinal strain (GLS) and regional strain for each of the 17 segments was calculated with standard software (for two groups) and with software adjusted to the myocardial wall thickness (for the HCM group). Results. GLS was significantly decreased in the HCM group compared to the control group (−15.1 ± 4.8% versus −20.5 ± 4.3%, p < 0.0001). In the HCM group, GLS (standard method versus adjusted to thickness) measurements were not significantly different (p = 0.34). Interestingly, the regional strain adjusted to thickness was significantly lower than the standard strain in the hypertrophic segments, especially in the basal inferoseptal segment (p = 0.0002), median inferoseptal segment (p < 0.001) and median anteroseptal segment (p = 0.02). The strain adjusted to thickness was still significantly lower in the most hypertrophic segments (≥20 mm) (−3.7 ± 3%, versus −5.9 ± 4.4%, p = 0.049 in the basal inferoseptal segment and −5.7 ± 3.5% versus −8.3 ± 4.5%, p = 0.0007 in the median inferoseptal segment). In the segments with significant myocardial fibrosis, the longitudinal strain adjusted to thickness was significantly lower than the conventional strain (−8.3 ± 3.3% versus −11.4 ± 4.5%, p = 0.002). The analysis of the strain adjusted to thickness had a better feasibility (97.5% versus 99%, p = 0.01). Conclusions. The analysis of a longitudinal strain adjusted to regional thickness is feasible in HCM and allows a better evaluation of myocardial deformation, especially in the most LV hypertrophic segments.
Language	English
Publishing date	2022-04-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11082089
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Article ; Online: Assessment of atrial function by myocardial deformation techniques in hypertrophic cardiomyopathy.

Siam-Tsieu, Valerie / Urtado, Sophie / Charron, Philippe / Hergault, Hélène / Szymanski, Catherine / Mallet, Sophie / Dubourg, Olivier / Mansencal, Nicolas

Echocardiography (Mount Kisco, N.Y.)

2020 Volume 38, Issue 2, Page(s) 230–237

Abstract: Background: Diastolic dysfunction in hypertrophic cardiomyopathy (HCM) is common, but its assessment is difficult using conventional echocardiography.: Aims: To assess left atrial (LA) function in HCM by longitudinal strain and determine its role in ... ...

Abstract	Background: Diastolic dysfunction in hypertrophic cardiomyopathy (HCM) is common, but its assessment is difficult using conventional echocardiography. Aims: To assess left atrial (LA) function in HCM by longitudinal strain and determine its role in understanding of symptoms. Methods: We studied 144 patients divided into 3 age- and sex-matched groups: 48 consecutive patients with HCM, 48 control subjects, and 48 athlete subjects. We assessed LA function by conventional echocardiographic parameters and by longitudinal atrial strain (early-diastolic left atrial strain during reservoir phase [LASr]; end-diastolic left atrial strain during conduit phase; end-systolic peak of the left atrial strain during contraction phase). Results: NYHA classification was as follows in HCM group: I in 46%, II in 31%, III in 19%, and IV in 4%. Conventional echocardiographic parameters of diastolic function were depressed in the HCM group as compared to the control and athlete groups, but not related to symptoms. All longitudinal atrial strain parameters were significantly reduced in HCM group as compared to two groups (P < .0001). LASr was significantly correlated to peak VO2 (r = 0.44, P = .01) and was the best parameter for detecting symptomatic patients presenting with HCM, with a cutoff value of 15%: Sensitivity was 71%, specificity was 79%, PPV was 77%, and NPV was 73%. Conclusion: Assessment of LA function in HCM is feasible using longitudinal strain, and this technique is more reliable than conventional echocardiographic parameters for the understanding of determinants of symptoms.
MeSH term(s)	Atrial Function, Left ; Cardiomyopathy, Hypertrophic/diagnostic imaging ; Echocardiography ; Heart Atria/diagnostic imaging ; Humans ; Myocardium
Language	English
Publishing date	2020-12-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	843645-9
ISSN	1540-8175 ; 0742-2822
ISSN (online)	1540-8175
ISSN	0742-2822
DOI	10.1111/echo.14968
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Article ; Online: New insights into the haemodynamic effects of dipyridamole.

Piérard, Luc A / Szymanski, Catherine

Journal of cardiovascular medicine (Hagerstown, Md.)

2011 Volume 12, Issue 7, Page(s) 453–454

MeSH term(s)	Blood Pressure ; Coronary Artery Disease/diagnosis ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/physiopathology ; Dipyridamole ; Echocardiography, Stress ; Echocardiography, Three-Dimensional ; Heart Rate ; Hemodynamics ; Humans ; Models, Cardiovascular ; Myocardial Contraction ; Predictive Value of Tests ; Treatment Outcome ; Vasodilator Agents ; Ventricular Function, Left
Chemical Substances	Vasodilator Agents ; Dipyridamole (64ALC7F90C)
Language	English
Publishing date	2011-07
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2223461-5
ISSN	1558-2035 ; 1558-2027
ISSN (online)	1558-2035
ISSN	1558-2027
DOI	10.2459/JCM.0b013e328348c2d5
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Article: Impact of Preoperative Left Atrial Dimension on Outcome in Patients in Sinus Rhythm Undergoing Surgical Valve Repair for Severe Mitral Regurgitation due to Mitral Valve Prolapse

Szymanski, Catherine / Bohbot, Yohann / Rusinaru, Dan / Touati, Gilles / Tribouilloy, Christophe

Cardiology

2019 Volume 142, Issue 3, Page(s) 189–193

Institution	Department of Cardiology, Amiens University Hospital, Amiens, France EA 7517 MP3CV Jules Verne University of Picardie, Amiens, France Department of Cardiac Surgery, Amiens University Hospital, Amiens, France
Abstract	Background: Left atrial (LA) enlargement has been previously identified as a predictor of mortality in patients with medically managed mitral regurgitation (MR) due to mitral valve prolapse (MVP). No study has specifically assessed the prognostic value of LA size in patients undergoing mitral valve repair (MVRp). Objective: We aimed to investigate the relationship between LA area and mortality in patients in sinus rhythm (SR) undergoing MVRp for MVP. Methods: We included 305 patients in SR who underwent MVRp for MVP. Median follow-up time was 7.9 years. Patients were divided into 3 groups: LA area ≤25 cm<sup>2</sup> (reference group), LA 26–30 cm<sup>2</sup>, and LA >30 cm<sup>2</sup>. Results: Compared with patients with an LA area ≤25 cm<sup>2</sup>, those with an LA area >30 cm<sup>2</sup> had a lower 10-year survival (98 ± 2 vs. 86 ± 4%; p = 0.037). In multivariate analysis, after adjustment for established outcome predictors including age, symptoms, EuroSCORE, and left ventricular size and function, LA enlargement >30 cm<sup>2</sup> was associated with increased mortality (adjusted HR = 2.20, 95% CI 1.03–4.90; p = 0.042), whereas LA enlargement between 26 and 30 cm<sup>2</sup> was not (adjusted HR = 1.37, 95% CI 0.56–3.56; p = 0.52). Conclusion: LA enlargement is independently predictive of long-term mortality after MVRp in patients in SR with severe MR due to MVP. Our findings suggest that MVRp should be considered before the LA area exceeds 30 cm<sup>2</sup>.
Keywords	Left atrial area ; Mitral valve prolapse ; Mitral valve repair ; Outcome ; Mitral regurgitation
Language	English
Publishing date	2019-06-21
Publisher	S. Karger AG
Publishing place	Basel, Switzerland
Document type	Article
Note	Valvular Heart Disease: Brief Report
ZDB-ID	80092-2
ISSN	1421-9751 ; 0008-6312
ISSN (online)	1421-9751
ISSN	0008-6312
DOI	10.1159/000499577
Database	Karger publisher's database

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Article ; Online: Should LVEF be replaced by global longitudinal strain?

Szymanski, Catherine / Lévy, Franck / Tribouilloy, Christophe

Heart (British Cardiac Society)

2014 Volume 100, Issue 21, Page(s) 1655–1656

MeSH term(s)	Humans ; Risk Assessment ; Stroke Volume/physiology ; Ventricular Dysfunction, Left/mortality ; Ventricular Dysfunction, Left/physiopathology
Language	English
Publishing date	2014-11
Publishing country	England
Document type	Comment ; Editorial
ZDB-ID	1303417-0
ISSN	1468-201X ; 1355-6037
ISSN (online)	1468-201X
ISSN	1355-6037
DOI	10.1136/heartjnl-2014-306186
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