Advanced echocardiography and clinical surrogates to risk stratify and manage patients with structural heart disease

Debonnaire, Philippe Jean Marc Rita (2016)

Doctoral Thesis

Part I focuses on the potential role of 3-dimensional echocardiography. At first a clinical risk score model for prediction of outcome in patients undergoing TAVI is presented (Chapter 2). Second the role of 3D-echocardiography is explored in depth in patients with mitral valve disease. Different non-invasive cardiac imaging modalities to evaluate mitral valve function and anatomy are described and the use of 3D-echocardiography is put into perspective (Chapter 3). We then evaluate the role of the latter to gain insights in patients with functional mitral regurgitation (Chapter 4), to select patients and guide procedures regarding percutaneous mitral valve repair using Mitra-Clip (Chapter 5) and to assess the effect of Mitra-Clip on the mitral valve (Chapter 6). In Part II we further elaborate the potential role of risk stratification by ECG and myocardial deformation imaging (strain), as surrogate markers of fibrosis. Surface ECG fragmentation in primary HCM is first evaluated (Chapter 7). The important future role of fibrosis imaging in valvular heart disease patients is then reviewed (Chapter 8). Finally the role of left atrial structure and function is evaluated in patients with mitral regurgitation (Chapter 9) and primary HCM (Chapter 10, 11).

• 3D
• Strain
• Hypertrophic Cardiomyopathy
• Valvular Heart Disease
• Cardiac Imaging

• All authors: Debonnaire, Philippe Jean Marc Rita
• Supervisor: Bax, J.J.
• Co-supervisor: Delgado, V.; Ajmone Marsan, N.
• Qualification: Doctor (dr.)
• Awarding Institution: Department of Cardiology, Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2016-04-28
• ISBN (print): 9789461698087