@phdthesis{Gaudron2011,
  author    = {Gaudron, Philipp},
  title     = {Differenzierung von frischen und alten linksventrikul{\"a}ren Thromben mittels Gewebedoppler- Echokardiographie},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-71175},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2011},
  abstract  = {Nach einem fulminanten Myokardinfarkt k{\"o}nnen sich, basierend auf Ver{\"a}nderungen der Blutstr{\"o}mungseigenschaften im Bereich von dys- /akinetischen Bereichen und Aneurysmen des linken Ventrikels, Thromben bilden. Da ein frischer Thrombus mit einem hohen Risiko f{\"u}r eine systemische Embolie einhergeht (13\%) und eine umgehende Vollantikoagulation des betroffenen Patienten erfordert, w{\"a}re es von klinischer Bedeutung eine Untersuchungsmethode zur Verf{\"u}gung zu haben, mit der man frische von alten Thromben eindeutig unterscheiden kannIm Rahmen dieser Studie wurden innerhalb von 2 Jahren 52 Patienten mit linksventrikul{\"a}ren Thromben nach Myokardinfarkt untersucht. Es wurden eine echokardio-graphische Standarduntersuchung und zus{\"a}tzlich Gewebedoppleraufnahmen angefertigt. Alle Studienteilnehmer wurden auf 2 verschiedene Studienteile aufgeteilt. In Studienteil 1 (n= 20) wurden die detektierten Thromben anhand der bekannten Altersanamnese des Thrombus als frisch (<3 Monate) oder alt (>3 Monate) klassifiziert. In Studienteil 2 (n=32) wurden die echokardiographischen Datens{\"a}tze der Patienten ohne Kenntnis der individuellen Krankheitsgeschichte, von einer untersucherunabh{\"a}ngigen Person analysiert und ausgewertet. Die Thromben wurden anhand der in Studienteil 1 gewonnen Erkenntnisse als frisch (n=17) oder alt (n=15) klassifiziert. Alle Patienten erhielten unabh{\"a}ngig vom Alter des Thrombus eine Therapie mittels Phenprocoumon zur systemischen Vollantikoagulation.Die Patienten des 2. Studienteils wurden nach 6 Monaten zu einem Follow-Up eingeladen. Im Rahmen eigener Vorarbeiten im 1. Studienteil konnte gezeigt werden, dass der signifikanteste Unterscheidungsparameter zwischen Thromben verschiedenen Alters in der Messung der Strain- Rate (SR 1/s)zu finden war. Hierzu wurde der maximale SR- Peak in der isovolumetrischen Relaxationsperiode gemessen. Es ließ sich bei einem Cut-off Wert von 1s-1 eine eindeutige Klassifikation nach Frisch und Alt durchf{\"u}hren. Im Rahmen der Follow-Up Untersuchungen nach 6 Monaten sahen wir alle 32 Patienten erneut. Es konnte gezeigt werden, dass die Thromben die anhand der geschilderten Kriterien als frisch (SR- Peak ≥ 1s-1) klassifiziert worden waren, sich in 16 von 17 F{\"a}llen unter antikoagulativer Therapie aufgel{\"o}st hatten. In 1 von 17 F{\"a}llen fand eine Gr{\"o}ßenreduktion um mehr als 50\% statt und das Residuum entsprach den Kriterien f{\"u}r einen alten Thrombus. Die als alt (SR- Peak < 1s-1) klassifizierten Thromben konnten, ebenfalls unter Therapie mit Phenprocoumon, in 14 von 15 F{\"a}llen unver{\"a}ndert in Ihrer Position, Gr{\"o}ße, Morphologie und Verformungseigenschaft gefunden werden. Es konnte in dieser Studie gezeigt werden, dass nach Durchf{\"u}hrung der beschriebenen Messmethoden und somit unter Kenntnis des Alters eines Thrombus, eine Wahrscheinlichkeit zur Aufl{\"o}sung von Thromben angegeben werden kann. F{\"u}r einen frischen Thrombus unter Therapie mit Phenprocoumon liegt diese Wahrscheinlichkeit bei 95 \%. Patienten mit alten Thromben profitieren bezogen auf die Aufl{\"o}sung von Thromben nicht von einer Therapie mit Phenprocoumon.},
  subject      = {Kardiologie},
  language  = {de}
}
@article{GassenmaierPetritschKunzetal.2015,
  author    = {Gassenmaier, Tobias and Petritsch, Bernhard and Kunz, Andreas S. and Gkaniatsas, Spyridon and Gaudron, Philipp D. and Weidemann, Frank and Nordbeck, Peter and Beer, Meinrad},
  title     = {Long term evolution of MRI characteristics in a case of atypical left lateral wall hypertrophic cardiomyopathy},
  series = {World Journal of Cardiology},
  volume    = {7},
  journal   = {World Journal of Cardiology},
  number    = {6},
  doi       = {10.4330/wjc.v7.i6.357},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124934},
  pages     = {357-360},
  year      = {2015},
  abstract  = {We are reporting a long-time magnetic resonance imaging (MRI) follow-up in a rare case of cardiac left lateral wall hypertrophy. Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disorder and a significant cause of sudden cardiac death. Cardiac magnetic resonance (CMR) imaging can be a valuable tool for assessment of detailed information on size, localization, and tissue characteristics of hypertrophied myocardium. However, there is still little knowledge of long-term evolution of HCM as visualized by magnetic resonance imaging. Recently, our group reported a case of left lateral wall HCM as a rare variant of the more common forms, such as septal HCM, or apical HCM. As we now retrieved an old cardiac MRI acquired in this patient more than 20 years ago, we are able to provide the thrilling experience of an ultra-long MRI follow-up presentation in this rare case of left lateral wall hypertrophy. Furthermore, this case outlines the tremendous improvements in imaging quality within the last two decades of CMR imaging.},
  language  = {en}
}
@article{LiuHuNiemannetal.2013,
  author    = {Liu, Dan and Hu, Kai and Niemann, Markus and Herrmann, Sebastian and Cikes, Maja and St{\"o}rk, Stefan and Beer, Meinrad and Gaudron, Philipp Daniel and Morbach, Caroline and Knop, Stefan and Geissinger, Eva and Ertl, Georg and Bijnens, Bart and Weidemann, Frank},
  title     = {Impact of Regional Left Ventricular Function on Outcome for Patients with AL Amyloidosis},
  series = {PLoS ONE},
  volume    = {8},
  journal   = {PLoS ONE},
  number    = {3},
  doi       = {10.1371/journal.pone.0056923},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-130293},
  pages     = {e56923},
  year      = {2013},
  abstract  = {Objectives The aim of this study was to explore the left ventricular (LV) deformation changes and the potential impact of deformation on outcome in patients with proven light-chain (AL) amyloidosis and LV hypertrophy. Background Cardiac involvement in AL amyloidosis patients is associated with poor outcome. Detecting regional cardiac function by advanced non-invasive techniques might be favorable for predicting outcome. Methods LV longitudinal, circumferential and radial peak systolic strains (Ssys) were assessed by speckle tracking imaging (STI) in 44 biopsy-proven systemic AL amyloidosis patients with LV hypertrophy (CA) and in 30 normal controls. Patients were divided into compensated (n = 18) and decompensated (n = 26) group based on clinical assessment and followed-up for a median period of 345 days. Results Ejection fraction (EF) was preserved while longitudinal Ssys (LSsys) was significantly reduced in both compensated and decompensated groups. Survival was significantly reduced in decompensated group (35\% vs. compensated 78\%, P = 0.001). LSsys were similar in apical segments and significantly reduced in basal segments between two patient groups. LSsys at mid-segments were significantly reduced in all LV walls of decompensated group. Patients were further divided into 4 subgroups according to the presence or absence of reduced LSsys in no (normal), only basal (mild), basal and mid (intermediate) and all segments of the septum (severe). This staging revealed continuously worse prognosis in proportion to increasing number of segments with reduced LSsys (mortality: normal 14\%, mild 27\%, intermediate 67\%, and severe 64\%). Mid-septum LSsys<11\% suggested a 4.8-fold mortality risk than mid-septum LSsys≥11\%. Multivariate regression analysis showed NYHA class and mid-septum LSsys were independent predictors for survival. Conclusions Reduced deformation at mid-septum is associated with worse prognosis in systemic amyloidosis patients with LV hypertrophy.},
  language  = {en}
}
@article{LiuHuStoerketal.2014,
  author    = {Liu, Dan and Hu, Kai and St{\"o}rk, Stefan and Herrmann, Sebastian and Kramer, Bastian and Cikes, Maja and Gaudron, Philipp Daniel and Knop, Stefan and Ertl, Georg and Bijnens, Bart and Weidemann, Frank},
  title     = {Predictive Value of Assessing Diastolic Strain Rate on Survival in Cardiac Amyloidosis Patients with Preserved Ejection Fraction},
  series = {PLOS ONE},
  volume    = {9},
  journal   = {PLOS ONE},
  number    = {12},
  issn      = {1932-6203},
  doi       = {10.1371/journal.pone.0115910},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-118024},
  year      = {2014},
  abstract  = {Objectives: Since diastolic abnormalities are typical findings of cardiac amyloidosis (CA), we hypothesized that speckle-tracking-imaging (STI) derived longitudinal early diastolic strain rate (LSRdias) could predict outcome in CA patients with preserved left ventricular ejection fraction (LVEF >50\%). Background: Diastolic abnormalities including altered early filling are typical findings and are related to outcome in CA patients. Reduced longitudinal systolic strain (LSsys) assessed by STI predicts increased mortality in CA patients. It remains unknown if LSRdias also related to outcome in these patients. Methods: Conventional echocardiography and STI were performed in 41 CA patients with preserved LVEF (25 male; mean age 65±9 years). Global and segmental LSsys and LSRdias were obtained in six LV segments from apical 4-chamber views. Results: Nineteen (46\%) out of 41 CA patients died during a median of 16 months (quartiles 5-35 months) follow-up. Baseline mitral annular plane systolic excursion (MAPSE, 6±2 vs. 8±3 mm), global LSRdias and basal-septal LSRdias were significantly lower in non-survivors than in survivors (all p<0.05). NYHA class, number of non-cardiac organs involved, MAPSE, mid-septal LSsys, global LSRdias, basal-septal LSRdias and E/LSRdias were the univariable predictors of all-cause death. Multivariable analysis showed that number of non-cardiac organs involved (hazard ratio [HR] = 1.96, 95\% confidence interval [CI] 1.17-3.26, P = 0.010), global LSRdias (HR = 7.30, 95\% CI 2.08-25.65, P = 0.002), and E/LSRdias (HR = 2.98, 95\% CI 1.54-5.79, P = 0.001) remained independently predictive of increased mortality risk. The prognostic performance of global LSRdias was optimal at a cutoff value of 0.85 S-1 (sensitivity 68\%, specificity 67\%). Global LSRdias <0.85 S-1 predicted a 4-fold increased mortality in CA patients with preserved LVEF. Conclusions: STI-derived early diastolic strain rate is a powerful independent predictor of survival in CA patients with preserved LVEF.},
  language  = {en}
}
@article{GaudronLiuScholzetal.2016,
  author    = {Gaudron, Philipp Daniel and Liu, Dan and Scholz, Friederike and Hu, Kai and Florescu, Christiane and Herrmann, Sebastian and Bijnens, Bart and Ertl, Georg and St{\"o}rk, Stefan and Weidemann, Frank},
  title     = {The septal bulge - an early echocardiographic sign in hypertensive heart disease},
  series = {Journal of the American Society of Hypertension},
  volume    = {10},
  journal   = {Journal of the American Society of Hypertension},
  number    = {1},
  doi       = {10.1016/j.jash.2015.11.006},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-191433},
  pages     = {70-80},
  year      = {2016},
  abstract  = {Patients in the early stage of hypertensive heart disease tend to have normal echocardiographic findings. The aim of this study was to investigate whether pathology-specific echocardiographic morphologic and functional parameters can help to detect subclinical hypertensive heart disease. One hundred ten consecutive patients without a history and medication for arterial hypertension (AH) or other cardiac diseases were enrolled. Standard echocardiography and two-dimensional speckle tracking -imaging analysis were performed. Resting blood pressure (BP) measurement, cycle ergometer test (CET), and 24-hour ambulatory BP monitoring (ABPM) were conducted. Patients were referred to "septal bulge (SB)" group (basal-septal wall thickness >= 2 mm thicker than mid-septal wall thickness) or "no-SB" group. Echocardiographic SB was found in 48 (43.6\%) of 110 patients. In this SB group, 38 (79.2\%) patients showed AH either by CET or ABPM. In contrast, in the no-SB group (n = 62), 59 (95.2\%) patients had no positive test for AH by CET or ABPM. When AH was solely defined by resting BP, SB was a reasonable predictive sign for AH (sensitivity 73\%, specificity 76\%). However, when AH was confirmed by CET or ABPM the echocardiographic SB strongly predicted clinical AH (sensitivity 93\%, specificity 86\%). In addition, regional myocardial deformation of the basal-septum in SB group was significantly lower than in no-SB group (14 +/- 4\% vs. 17 +/- 4\%; P < .001). In conclusion, SB is a morphologic echocardiographic sign for early hypertensive heart disease. Sophisticated BP evaluation including resting BP, ABPM, and CET should be performed in all patients with an accidental finding of a SB in echocardiography.},
  language  = {en}
}