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BETA
Flachskampf, Frank
Alternative names
Publications (10 of 86) Show all publications
Knebel, F., Frumkin, D. & Flachskampf, F. (2019). Infectious Endocarditis. Deutsche Medizinische Wochenschrift, 144(2), 114-127
Open this publication in new window or tab >>Infectious Endocarditis
2019 (English)In: Deutsche Medizinische Wochenschrift, ISSN 0012-0472, E-ISSN 1439-4413, Vol. 144, no 2, p. 114-127Article in journal (Refereed) Published
Abstract [en]

Infective endocarditis is a severe, mostly bacterial disease characterized by high mortality and morbidity. Both diagnosis and therapy are difficult, and mortality rates have not improved over decades. We review diagnostic and management problems, the disease's modern face in the era of widespread cardiac implants and valve interventions, and current diagnostic and therapeutic recommendations.

National Category
Biochemistry and Molecular Biology
Identifiers
urn:nbn:se:uu:diva-378211 (URN)10.1055/s-0043-110658 (DOI)000458801100015 ()30674060 (PubMedID)
Available from: 2019-03-05 Created: 2019-03-05 Last updated: 2019-03-05Bibliographically approved
Nagueh, S. F., Abraham, T. P., Aurigemma, G. P., Bax, J. J., Beladan, C., Browning, A., . . . Xu, J. (2019). Interobserver Variability in Applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 Guidelines for Estimation of Left Ventricular Filling Pressure. Circulation Cardiovascular Imaging, 12(1), Article ID e008122.
Open this publication in new window or tab >>Interobserver Variability in Applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 Guidelines for Estimation of Left Ventricular Filling Pressure
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2019 (English)In: Circulation Cardiovascular Imaging, ISSN 1941-9651, E-ISSN 1942-0080, Vol. 12, no 1, article id e008122Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Assessment of left ventricular (LV) filling pressure is among the important components of a comprehensive echocardiographic report. Previous studies noted wide limits of agreement using 2009 American Society of Echocardiography/European Association of Echocardiography guidelines, but reproducibility of 2016 guidelines update in estimating LV filling pressure is unknown.

METHODS:

Echocardiographic and hemodynamic data were obtained from 50 patients undergoing cardiac catheterization for clinical indications. Clinical and echocardiographic findings but not invasive hemodynamics were provided to 4 groups of observers, including experienced echocardiographers and cardiology fellows. Invasively acquired LV filling pressure was the gold standard.

RESULTS:

In group I of 8 experienced echocardiographers from the guidelines writing committee, sensitivity for elevated LV filling pressure was 92% for all observers, and specificity was 93 +/- 6%. Fleiss kappa-value for the agreement in group I was 0.80. In group II of 4 fellows in training, sensitivity was 91 +/- 2%, and specificity was 95 +/- 2%. Fleiss kappa-value for the agreement in group II was 0.94. In group III of 9 experienced echocardiographers who had not participated in drafting the guidelines, sensitivity was 88 +/- 5%, and specificity was 91 +/- 7%. Fleiss kappa-value for the agreement in group III was 0.76. In group IV of 7 other fellows, sensitivity was 91 +/- 3%, and specificity was 92 +/- 5%. Fleiss kappa-value for the agreement in group IV was 0.89.

CONCLUSIONS:

There is a good level of agreement and accuracy in the estimation of LV filling pressure using the American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 recommendations update, irrespective of the experience level of the observer.

Keywords
diastole, echocardiography, echocardiography, Doppler, guideline, humans
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-379243 (URN)10.1161/CIRCIMAGING.118.008122 (DOI)000459456800005 ()30632389 (PubMedID)
Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-03-18Bibliographically approved
Flachskampf, F. (2018). Aortic Stenosis in Cancer Survivors After Chest Radiation. JACC Cardiovascular Imaging, 11(8), 1081-1083
Open this publication in new window or tab >>Aortic Stenosis in Cancer Survivors After Chest Radiation
2018 (English)In: JACC Cardiovascular Imaging, ISSN 1936-878X, E-ISSN 1876-7591, Vol. 11, no 8, p. 1081-1083Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
aortic stenosis, outcomes, progression, radiation heart disease
National Category
Radiology, Nuclear Medicine and Medical Imaging Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-366310 (URN)10.1016/j.jcmg.2018.04.020 (DOI)000440865100006 ()29909099 (PubMedID)
Available from: 2018-11-20 Created: 2018-11-20 Last updated: 2018-11-20Bibliographically approved
Harms, H. J., Hansson, N. H., Kero, T., Baron, T., Tolbod, L. P., Kim, W. Y., . . . Sörensen, J. (2018). Automatic calculation of myocardial external efficiency using a single 11C-acetate PET scan.. Journal of Nuclear Cardiology, 25(6), 1937-1944
Open this publication in new window or tab >>Automatic calculation of myocardial external efficiency using a single 11C-acetate PET scan.
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2018 (English)In: Journal of Nuclear Cardiology, ISSN 1071-3581, E-ISSN 1532-6551, Vol. 25, no 6, p. 1937-1944Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Myocardial external efficiency (MEE) is defined as the ratio of kinetic energy associated with cardiac work [forward cardiac output (FCO)*mean systemic pressure] and the chemical energy from oxygen consumed (MVO2) by the left ventricular mass (LVM). We developed a fully automated method for estimating MEE based on a single 11C-acetate PET scan without ECG-gating.

METHODS AND RESULTS: Ten healthy controls, 34 patients with aortic valve stenosis (AVS), and 20 patients with mitral valve regurgitation (MVR) were recruited in a dual-center study. MVO2 was calculated using washout of 11C -acetate activity. FCO and LVM were calculated automatically using dynamic PET and parametric image formation. FCO and LVM were also obtained using cardiac magnetic resonance (CMR) in all subjects. The correlation between MEEPET-CMR and MEEPET was high (r = 0.85, P < 0.001) without significant bias. MEEPET was 23.6 ± 4.2% for controls and was lowered in AVS (17.2 ± 4.3%, P < 0.001) and in MVR (18.0 ± 5.2%, P = 0.004). MEEPET was strongly associated with both NYHA class (P < 0.001) and the magnitude of valvular dysfunction (mean aortic gradient: P < 0.001, regurgitant fraction: P = 0.009).

CONCLUSION: A single 11C-acetate PET yields accurate and automated MEE results on different scanners. MEE might provide an unbiased measurement of the phenotypic response to valvular disease.

Keywords
11C-acetate, Myocardial efficiency, myocardial energetics, positron emission tomography
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-356783 (URN)10.1007/s12350-018-1338-0 (DOI)000452340400009 ()29946824 (PubMedID)
Available from: 2018-08-07 Created: 2018-08-07 Last updated: 2019-01-24Bibliographically approved
Baron, T., Christersson, C., Hjorthén, G., Hedin, E.-M. & Flachskampf, F. (2018). Changes in global longitudinal strain and left ventricular ejection fraction during the first year after myocardial infarction: results from a large consecutive cohort. European Heart Journal Cardiovascular Imaging, 19(10), 1165-1173
Open this publication in new window or tab >>Changes in global longitudinal strain and left ventricular ejection fraction during the first year after myocardial infarction: results from a large consecutive cohort
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2018 (English)In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 19, no 10, p. 1165-1173Article in journal (Refereed) Published
Abstract [en]

Aims: To determine changes of global longitudinal strain (GLS) and their predictors in relation to classical echocardiographic parameters of left ventricular (LV) function, over 1 year, in consecutive patients with myocardial infarction (MI) and initially normal or impaired LV ejection fraction (EF).

Methods and results: A total of 285 patients with MI prospectively included in the REBUS (RElevance of Biomarkers for future risk of thromb-oembolic events in UnSelected post-myocardial infarction patients) study underwent echocardiography within 72 h from admission and after 1 year. At baseline, 213 (74.7%) of MI patients had a normal EF (≥52% in men or ≥54% in women), but in 70.4% of them, an impaired GLS ( ≥ -18.0%) was observed. During 1-year follow-up, in patients with normal EF at baseline, GLS improved from -15.8% to - 17.4% (10.1% relative change); EF decreased from 62.5% to 59.9% (4.0% relative change); indexed end-diastolic volume, indexed end-systolic volume, and indexed stroke volume increased with 15.6%, 24.8%, and 10.0% of relative change, respectively (P < 0.001 for all the comparisons). In the whole cohort, initial impairment of LV function [by EF, wall motion score index (WMSI), or GLS], male gender, non-smoking, and treatment with beta-blockers were the independent predictors of GLS improvement. In the group with initially impaired EF, over 1 year GLS improved from -11.9% to - 14.8% (24.4% relative change) and EF from 44.6% to 52.6% (18.2% relative change) (P < 0.001 for both). Improvement in GLS significantly correlated with EF increase in the group with impaired EF (r = -0.41, P = 0.001) but not in the patients with normal EF (r = -0.14, P = ns).

Conclusions: Despite diveregent evolution of GLS compared with EF and ventricular volumes, one year after MI GLS significantly improved in patients with initially both normal and impaired EF. Initial impairment of LV function (by EF, WMSI, or GLS), male gender, non-smoking, and treatment with beta-blockers were independent predictors of GLS improvement. LV remodelling was present even in patients with normal EF at baseline and during follow-up, confirming limited functional assessment by EF alone.

Keywords
global longitudinal strain, left ventricular function, myocardial infarction, remodelling
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-340847 (URN)10.1093/ehjci/jex260 (DOI)000455357200011 ()29145641 (PubMedID)
Funder
Erik, Karin och Gösta Selanders Foundation
Available from: 2018-02-04 Created: 2018-02-04 Last updated: 2019-02-01Bibliographically approved
Kavianipour, M., Farkhooy, A. & Flachskampf, F. (2018). Clinical outcome and functional characteristics of patients with asymptomatic low-flow low-gradient severe aortic stenosis with preserved ejection fraction are closer to high-gradient severe than to moderate aortic stenosis. The International Journal of Cardiovascular Imaging, 34(4), 545-552
Open this publication in new window or tab >>Clinical outcome and functional characteristics of patients with asymptomatic low-flow low-gradient severe aortic stenosis with preserved ejection fraction are closer to high-gradient severe than to moderate aortic stenosis
2018 (English)In: The International Journal of Cardiovascular Imaging, ISSN 1569-5794, E-ISSN 1875-8312, Vol. 34, no 4, p. 545-552Article in journal (Refereed) Published
Abstract [en]

Asymptomatic "paradoxic" severe low-flow low-gradient aortic stenosis with preserved ejection fraction (PAS) constitutes a challenging condition where the optimal management and follow-up remain elusive. We evaluated the clinical outcome in patients with PAS as compared to asymptomatic patients with moderate (MAS) or classical severe aortic stenosis (CAS). Consecutive asymptomatic moderate or severe aortic stenosis patients without concomitant other heart or lung disease (n = 121) were invited. Participants (n = 74) were assigned to three subgroups with regard to degree of aortic stenosis: MAS (n = 25), CAS (n = 22) and PAS (n = 27). Echocardiographic parameters at baseline and clinical outcome data after > 3 years of follow-up time were obtained. Patients with PAS had the smallest stroke volumes and the highest relative wall thickness (p < 0.05). Left ventricular mass index was highest in subjects with CAS, followed closely by PAS and eventually MAS subjects. Whereas ejection fraction was similar amongst the subgroups, a stepwise decrease in global longitudinal left ventricular strain with increasing degree of aortic stenosis was observed, with CAS patients displaying the lowest mean global longitudinal strain, followed by PAS and MAS. A trend towards increasing mortality rate by increasing degree of stenosis was observed. Patients with CAS underwent aortic valve replacement surgery more frequently than both PAS and MAS (p < 0.001). These data suggest that echocardiographic parameters and clinical outcome in patients with PAS bear closer resemblance to CAS than to MAS, but management of PAS is more conservative than in CAS.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-333365 (URN)10.1007/s10554-017-1264-2 (DOI)000427902300007 ()29124471 (PubMedID)
Available from: 2017-11-11 Created: 2017-11-11 Last updated: 2018-05-30Bibliographically approved
Delgado, V., Cardim, N., Cosyns, B., Donal, E., Flachskampf, F., Galderisi, M., . . . Popescu, B. A. (2018). Criteria for recommendation, expert consensus, and appropriateness criteria papers: update from the European Association of Cardiovascular Imaging Scientific Documents Committee. European Heart Journal Cardiovascular Imaging, 19(8), 835-837
Open this publication in new window or tab >>Criteria for recommendation, expert consensus, and appropriateness criteria papers: update from the European Association of Cardiovascular Imaging Scientific Documents Committee
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2018 (English)In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 19, no 8, p. 835-837Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2018
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-365170 (URN)10.1093/ehjci/jey079 (DOI)000441154400001 ()29905776 (PubMedID)
Available from: 2018-11-09 Created: 2018-11-09 Last updated: 2018-11-09Bibliographically approved
Carlsson, M., Heiberg, E., Ostenfeld, E., Steding-Ehrenborg, K., Kovács, S. J., Flachskampf, F. & Arheden, H. (2018). Functional Contribution of Circumferential Versus Longitudinal Strain: Different Concepts Suggest Conflicting Results.. Journal of the American College of Cardiology, 71(2), 254-255, Article ID S0735-1097(17)41601-9.
Open this publication in new window or tab >>Functional Contribution of Circumferential Versus Longitudinal Strain: Different Concepts Suggest Conflicting Results.
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2018 (English)In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 71, no 2, p. 254-255, article id S0735-1097(17)41601-9Article in journal (Refereed) Published
National Category
Cardiac and Cardiovascular Systems
Research subject
Cardiology
Identifiers
urn:nbn:se:uu:diva-368896 (URN)10.1016/j.jacc.2017.09.1156 (DOI)29325646 (PubMedID)
Available from: 2018-12-10 Created: 2018-12-10 Last updated: 2019-01-31Bibliographically approved
Almeida, J. G., Fontes-Carvalho, R., Sampaio, F., Ribeiro, J., Bettencourt, P., Flachskampf, F., . . . Azevedo, A. (2018). Impact of the 2016 ASE/EACVI recommendations on the prevalence of diastolic dysfunction in the general population. European Heart Journal Cardiovascular Imaging, 19(4), 380-386
Open this publication in new window or tab >>Impact of the 2016 ASE/EACVI recommendations on the prevalence of diastolic dysfunction in the general population
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2018 (English)In: European Heart Journal Cardiovascular Imaging, ISSN 2047-2404, E-ISSN 2047-2412, Vol. 19, no 4, p. 380-386Article in journal (Refereed) Published
Abstract [en]

Aims: Diastolic dysfunction (DD) is frequent in the general population; however, the assessment of diastolic function remains challenging. We aimed to evaluate the impact of the recent 2016 American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) recommendations in the prevalence and grades of DD compared with the 2009 guidelines and the Canberra Study Criteria (CSC).

Methods and results: Within a population-based cohort, a total of 1000 individuals, aged ≥45 years, were evaluated retrospectively. Patients with previously known cardiac disease or ejection fraction <50% were excluded. Diastolic function was assessed by transthoracic echocardiography. DD prevalence and grades were determined according to the three classifications. The mean age was 62.0 ± 10.5 years and 37% were men. The prevalence of DD was 1.4% (n = 14) with the 2016 recommendations, 38.1% (n = 381) with the 2009 recommendations, and 30.4% (n = 304) using the CSC. The concordance between the updated recommendations and the other two was poor (from k = 0.13 to k = 0.18, P < 0.001). Regarding the categorization in DD grades, none of the 14 individuals with DD by the 2016 guidelines were assigned to Grade 1 DD, 64% were classified as Grade 2, 7% had Grade 3, and 29% had indeterminate grade.

Conclusion: The application of the new 2016 ASE/EACVI recommendations resulted in a much lower prevalence of DD. The concordance between the classifications was poor. The updated algorithm seems to be able to diagnose only the most advanced cases.

Keywords
diastole, echocardiography, diastolic dysfunction, heart failure
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-355691 (URN)10.1093/ehjci/jex252 (DOI)000431296600004 ()29236978 (PubMedID)
Available from: 2018-07-04 Created: 2018-07-04 Last updated: 2018-07-04Bibliographically approved
Čelutkienė, J., Plymen, C. M., Flachskampf, F., de Boer, R. A., Grapsa, J., Manka, R., . . . Nihoyannopoulos, P. (2018). Innovative imaging methods in heart failure: a shifting paradigm in cardiac assessment. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology. European Journal of Heart Failure, 20(12), 1615-1633
Open this publication in new window or tab >>Innovative imaging methods in heart failure: a shifting paradigm in cardiac assessment. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology
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2018 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 20, no 12, p. 1615-1633Article in journal (Refereed) Published
Abstract [en]

Myriad advances in all fields of cardiac imaging have stimulated and reflected new understanding of cardiac performance, myocardial damage and the mechanisms of heart failure. In this paper, the Heart Failure Association assesses the potential usefulness of innovative imaging modalities in enabling more precise diagnostic and prognostic evaluation, as well as in guiding treatment strategies. Many new methods have gradually penetrated clinical practice and are on their way to becoming a part of routine evaluation. This paper focuses on myocardial deformation and three- dimensional ultrasound imaging; stress tests for the evaluation of contractile and filling function; the progress of magnetic resonance techniques; molecular imaging and other sound innovations. The Heart Failure Association aims to highlight the ways in which paradigms have shifted in several areas of cardiac assessment. These include reassessing of the simplified concept of ejection fraction and implementation of the new parameters of cardiac performance applicable to all heart failure phenotypes; switching from two-dimensional to more accurate and reproducible three-dimensional ultrasound volumetric evaluation; greater tissue characterization via recently developed magnetic resonance modalities; moving from assessing cardiac function and congestion at rest to assessing it during stress; from invasive to novel non-invasive hybrid techniques depicting coronary anatomy and myocardial perfusion; as well as from morphometry to the imaging of pathophysiologic processes such as inflammation and apoptosis. This position paper examines the specific benefits of imaging innovations for practitioners dealing with heart failure aetiology, risk stratification and monitoring, and, in addition, for scientists involved in the development of future research.

Keywords
Imaging, Heart failure, Echocardiography, Speckle tracking, Stress echocardiography, Cardiac magnetic resonance, Computed tomography, Global longitudinal strain, Molecular imaging, Nuclear imaging, Hybrid imaging
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-373375 (URN)10.1002/ejhf.1330 (DOI)000453600400002 ()30411833 (PubMedID)
Available from: 2019-01-14 Created: 2019-01-14 Last updated: 2019-01-14Bibliographically approved
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