News
Sep 4, 2017

ESC Congress


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The year’s biggest happening within cardiology gathers cardiovascular professionals from over 140 countries, coming together to explore the latest research and development within the field. During the congress more than 4000 abstracts are showcased, selected from over 10 000 submitted ones in the relentless pursuit of excellence that ESC has taken as one of its core values.

As Jeroen J. Bax, FESC, President of the European Society of Cardiology, stated under the Inaugural Session on Saturday 26th of August, never before has the congress been so global and so accessible. Each year over 30 000 participants travel to a selected location in Europe to share their knowledge. In addition, the congress registered over 286 500 online visits last year.

Among those presenting the latest research results from the center were PhD fellows Øyvind Lie, MD and John Aalen, MD, which were both selected to present their research under the Rapid Fire Oral Sessions. Consultant cardiologist Mette-Elise Estensen, MD, PhD, discussed timing and mode of re-intervention in Tetralogy of Fallot under the session “Long-term management and risk assessment after Tetralogy of Fallot repair”.

Oslo University Hospital and CCI partakes in a Nordic multicenter study looking into the treatment and predictors for disease progress in arrhythmogenic cardiomyopathy (AC). Studies presented focused on predictors of ventricular arrhythmias in AC and primary prevention of sudden death with ICD therapy.

Category: General
Posted by: Piritta


Exercise dose and threshold for adverse outcome in arrhythmogenic cardiomyopathy.
O.H. Lie, J. Saberniak, L.A. Dejgaard, M.K. Stokke, T. Edvardsen, K.H. Haugaa

Patients with arrhythmogenic cardiomyopathy (AC) have worse outcome if they engage in competitive sports, but the actual dose of exercise needed to impose this phenomenon is unknown. In a rapid fire oral presentation, Øyvind Lie presented exercise data and outcome of 173 patients with AC. Doses equivalent to 2-4 hours of high intensity exercise per week were associated with adverse outcome, both life-threatening arrhythmia and impaired heart function. This is important information to AC patients, and especially to asymptomatic mutation carriers.

Read the full abstract on the ESC website

 


Patients with left bundle branch block are hypersensitive to afterload: moderate elevation of systolic pressure caused marked depression of left ventricular function.
J. Aalen, P. Storsten, J. Hisdal, E.W. Remme, C.K. Larsen, P.A. Sirnes, O. Gjesdal, H. Skulstad, O.A. Smiseth

In hypertensive patients, left bundle branch block (LBBB) is associated with development of heart failure.

In a rapid fire presentation at the ESC congress, John Aalen presented data showing that systolic function by ejection fraction and global longitudinal strain decreased markedly in LBBB patients in response to increased afterload, and this was due to septal dysfunction.

The finding may indicate that blood pressure treatment goals should be stricter for LBBB patients to prevent heart failure development.

Read the full abstract on the ESC website

 


Timing and mode of re-intervention in Tetralogy of Fallot. - Mette-Elise Estensen

Watch the full video presentation on the ESC website

The surgical correction of tetralogy of Fallot (ToF) is performed in early infancy with excellent results. Some of them need to be reoperated during adult life due to chronic postoperative complications, in particular pulmonary regurgutation. Mette-Elise Estensen presented an overview of timing, risk factors and mode of re-intervention/ operation. Pulmonary valve replacement (PVR) improves symptoms, right ventricle volume and function, however the right timing for PVR is currently unknown, and is one of the most debated subjects in the field of congenital heart disease.

The field of percutaneous valvular interventions is exciting and rapidly developing within interventional cardiology, offering non-surgical option for treating RVOT/pulmonary dysfunction in an increasing number of patients with ToF.

 


Exercise and gender differences in hypertrophic cardiomyopathy.
L.A. Dejgaard, T.F. Haland, O.H. Lie, M. Ribe, T. Edvardsen, K.H. Haugaa

There are several gender specific differences in disease expression in hypertrophic cardiomyopathy (HCM). At the ESC, Lars Dejgaard presented results from a study on gender differences in the effects of exercise in a HCM cohort.

Female HCM patients with a history of athletic exercise had milder cardiac disease, with thinner heart walls and larger left ventricle volumes. In males, there were no difference between athletes and non-athletes. The results imply a positive effect of exercise in females, alternatively gender specific behavioral changes to HCM diagnosis.

Read the full abstract on the ESC website

 


Relative downregulation of septal function and metabolism in TGA patients with atrial switch.
P. Storsten, J.G. Fjeld, A.G. Sherwani, E. Boe, E.W. Remme, O. Gjesdal, G. Erikssen, O.A. Smiseth,
H. Skulstad

In patients with transposition of the great arteries (TGA) and atrial switch, the right ventricle becomes the systemic ventricle. These patients have increased risk of heart failure. We have previously demonstrated reduced septal function by regional strain and work analyses. At the ESC congress, Petter Storsten presented an abstract on whether this is reflected in reduced metabolism measured by PET imaging.

TGA patients demonstrated markedly reduced septal function which was accompanied by reduction in septal metabolism. Global function of the systemic right ventricle was maintained due to preserved function of the RV free wall. The change in septal function and metabolism may be early markers of decompensation of the systemic ventricle.

Read the full abstract on the ESC website

 

 

OVERVIEW

Saturday 26th of August

Advances in Science

1. Predictors of ventricular arrhythmias in the Nordic arrhythmogenic right ventricular cardiomyopathy registry: first experience from the prospective multicenter Scandinavian cohort.
P.G. Platonov, K.H. Haugaa, A. Svensson, H.K. Jensen, T. Gilljam, H. Bundgaard, A.G. Holst, T. Edvardsen, J.H. Svendsen

Oslo University Hospital and CCI partakes in a Nordic multicenter study looking into the treatment and predictors for disease progress in ARVC. This study focused specifically on predictors of ventricular arrhythmias in ARVC.

From the abstract, read it in full on the ESC website

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is characterized by myocardial and genetic heterogeneity and variable clinical course of the disease, which affects development of strategies for risk stratification and primary prevention of sudden death. While most of data regarding the course of the disease comes from retrospective cohort studies, long-term follow-up studies of prospectively recruited cohorts remain limited. We aimed to assess predictors of ventricular arrhythmias in patients with definite ARVC prospectively enrolled in the Nordic ARVC registry.

Conclusion: In a Scandinavian cohort of prospectively enrolled patients with definite ARVC, over two thirds of patients remained asymptomatic during mid-term follow-up. In agreement with observations from other ARVC registries, history of VT or syncope and the presence of advanced repolarization abnormalities were associated with VT during follow-up. Our data further support repolarization abnormalities in inferior leads as an emerging risk indicator that independently predicted VT in our cohort.

See publications from the ARVC registry

2. Timing and mode of re-intervention in Tetralogy of Fallot. - Mette-Elise Estensen

3. Relative downregulation of septal function and metabolism in TGA patients with atrial switch.
P. Storsten, J.G. Fjeld, A.G. Sherwani, E. Boe, E.W. Remme, O. Gjesdal, G. Erikssen,
O.A. Smiseth, H. Skulstad

Sunday 27th of August

4. Mechanical dispersion predicts survival after ST-segment elevation myocardial infarction in patients treated with thrombolysis or percutaneous coronary intervention.
D. Melichova, T.M. Nguyen, B. Sjoli, S. Karlsen, T. Dahlslett, O.A. Smiseth, T. Edvardsen, K.H. Haugaa, H. Brunvand


From the abstract, read it in full on the ESC website

Background: New echocardiographic techniques have demonstrated improved prediction of cardiovascular events after revascularization of STEMI. The aim of this study was to investigate whether addition of strain echocardiography to conventional echocardiographic assessment of left ventricular function may improve prediction of outcome in patients with STEMI treated with thrombolysis or PCI.

Conclusions: Mechanical dispersion predicts adverse clinical events and indicates that increased heterogenous myocardial deformation after STEMI may affect outcome. This difference, however, was not reflected by LVEF and GLS which were similar in both revascularization groups. STEMI patients treated with thrombolysis had increased risk of ventricular arrhythmia and death compared to patients treated with primary PCI.


5. 3D shape assessment from 2D echocardiography using machine learning
G. Bernardino, C. Butakoff, M. Nunez-Garcia, S. Sarvari, M. Rodriguez-Lopez, F. Crispi,
M.A. Gonzalez-Ballester, M. De Craene, B. Bijnens

From the abstract, read it in full on the ESC website

In the context of cardiac remodelling, shape assessment of the heart is important for diagnosis and follow up. Despite offering a full view of the heart, 3D imaging presents some disadvantages, such as the poor acoustic window of 3D echography, ionisation in the case of Computed Tomography, and the cost in the case of Magnetic Resonance. Given that 2D echocardiographic data are widely available, we investigated the feasibility of machine learning for assessing the 3D left ventricular (LV) end-diastolic shape from 2D measurements enriched with clinical information.

In conclusion, using only the recommended 2D measurements limited ventricular shape prediction to the symmetric components. The prediction deteriorated with increased measurement noise. However, adding extra measurements, or relevant clinical information, some asymmetrical components can be regressed. We believe that this work is a promising first step towards deriving more complete shape measurements from routinely available 2D data.

6. Exercise and gender differences in hypertrophic cardiomyopathy.
L.A. Dejgaard, T.F. Haland, O.H. Lie, M. Ribe, T. Edvardsen, K.H. Haugaa

Chair duty

7. ECHO FOR CARDIAC FUNCTION: BREAD AND BUTTER FOR THE CLINICIAN
Chairperson(s): O.A. Smiseth (Oslo, NO); E. Donal (Rennes, FR)

8. DIASTOLIC FUNCTION AND LEFT ATRIAL FUNCTION
Chairperson(s): F. Flachskampf (Uppsala, SE); O.A. Smiseth (Oslo, NO)


Monday 28th of August


Rapid Fire

9. Patients with left bundle branch block are hypersensitive to afterload: moderate elevation of systolic pressure caused marked depression of left ventricular function.
J. Aalen, P. Storsten, J. Hisdal, E.W. Remme, C.K. Larsen, P.A. Sirnes, O. Gjesdal, H. Skulstad, O.A. Smiseth


10. Primary prevention of sudden death with ICD therapy in the Nordic arrhythmogenic cardiomyopathy registry.
P.G. Platonov, K.H. Haugaa, H.K. Jensen, H.K. Bundgaard, A. Svensson, T. Gilljam, J. Hansen, A.G. Holst, T. Edvardsen, J.H. Svendsen

From the abstract, read it in full on the ESC website

Background: Implantable cardioverter-defibrillator (ICD) therapy remains a corner stone of sudden death (SCD) prevention in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). However risk stratification and predictors of ICD interventions are not fully clarified. We aimed to assess predictors of appropriate ICD interventions in AC patients who received ICD implants for primary prevention of sudden death enrolled in the Nordic ARVC registry.

Conclusion: While history of VT and syncope are well accepted indications for ICD therapy in patients with ARVC, our data further support the role of ECG markers of electrical instability of ventricular myocardium such as T-wave inversion in the precordial leads meeting major repolarization criterion according to the Task Force 2010 definitions.


Tuesday 29th of August

Rapid Fire

11. Exercise dose and threshold for adverse outcome in arrhythmogenic cardiomyopathy.
O.H. Lie, J. Saberniak, L.A. Dejgaard, M.K. Stokke, T. Edvardsen, K.H. Haugaa

Chair duty

12. DEFORMATION IMAGING AND OUTCOME
Chairperson(s): T. Edvardsen (Oslo, NO)

13. ROLE OF IMAGING IN COMMON CLINICAL SCENARIOS – UPDATE ON PRACTICE RECOMMENDATIONS - European Association of Cardiovascular Imaging 
Chairperson(s): T. Edvardsen (Oslo, NO), G. Habib (Marseille, FR)


Abstract


14. Pitfalls in automated QTc measurements. Experience from a manual review
J. Thalamus, C.C. Gibbs, K.H. Haugaa, J. Hysing, K. Heldal

From the abstract, read it in full on the ESC website

Background: To accurately determine the corrected QTc interval is an important but difficult task for most physicians. Automated ECG interpretation could be a useful tool, but is it reliable in everyday practice?

Purpose: We wanted to investigate the accuracy of automated measurements of the QTc interval compared to manual assessment in ECGs where the automated measurement suggests marked QTc prolongation.

Conclusion: Agreement between manually and automated QTc measurement was 88% in ECGs in sinus rhythm and with adequate technical quality indicating reliable automated QTc in absence of atrial fibrillation and other rhythm disturbances.


Discussant

15. BEST POSTERS IN STABLE CAD  - Mette-Elise Estensen

Heart SFI