Jeroen J Bax

Leiden University, Leyden, South Holland, Netherlands

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Publications (834)5809.36 Total impact

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    ABSTRACT: The adipokine omentin is highly and selectively expressed in visceral adipose tissue and its circulating levels are decreased in obesity and type 2 diabetes mellitus (T2DM). In this study, we assessed the relationships between plasma omentin levels and cardiometabolic variables in T2DM men and age-matched overweight healthy controls. Next, only in the T2DM men, the effects of 24-wk treatment with pioglitazone or metformin on plasma omentin levels were investigated.
    11/2015; 9(3):109-109. DOI:10.1007/s12467-011-0052-1
  • Victoria Delgado · Jeroen J Bax
    Circulation Cardiovascular Imaging 09/2015; 8(9). DOI:10.1161/CIRCIMAGING.115.003985 · 5.32 Impact Factor
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    ABSTRACT: Intramyocardial bone marrow cell injection is associated with improvements in myocardial perfusion and anginal symptoms in patients with refractory angina pectoris. This study evaluates the effect of repeated intramyocardial bone marrow cell injection in patients with residual or recurrent myocardial ischemia. Twenty-three patients (17 men; 69±9 years) who had improved myocardial perfusion after the first injection but had residual or recurrent angina and ischemia on single-photon emission computed tomographic myocardial perfusion imaging were included. Patients again received intramyocardial injection of 100×10(6) autologous bone marrow mononuclear cells, 4.6±2.5 years after their first injection. No periprocedural complications occurred. Myocardial perfusion assessed using single-photon emission computed tomographic myocardial perfusion imaging improved from a summed stress score of 27.3±5.8 at baseline to 24.5±4.4 at 3 months (P=0.002) and 25.4±4.9 at 12 months of follow-up (P=0.002). Perfusion improvement after 3 months was comparable with the effect of the first injection (P=0.379). Anginal complaints improved ≤12 months after cell injection in Canadian Cardiovascular Society score (mean change at 3, 6, and 12 months: 0.6±0.9%, 0.5±0.9%, and 0.6±0.9%, respectively; Pslope=0.007, first versus repeated; P=0.188) and in quality of life score as measured by Seattle Angina Questionnaire (mean change at 3, 6, and 12 months: 7±14%, 8±14%, and 7±15%, respectively; Pslope=0.020, first versus repeated; P=0.126). Repeated bone marrow cell injection in previously responding patients with refractory angina is associated with improvements in myocardial perfusion, anginal complaints, and quality of life score ≤12 months of follow-up. URL: Unique identifier: NTR2664. © 2015 American Heart Association, Inc.
    Circulation Cardiovascular Interventions 09/2015; 8(8). DOI:10.1161/CIRCINTERVENTIONS.115.002740 · 6.22 Impact Factor
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    ABSTRACT: We sought to determine whether peri-infarct pacing prevents left ventricular (LV) remodelling and improves functional and clinical outcomes in patients with large first myocardial infarction (MI). A total of 126 patients at 27 international sites within 10 days of onset of anterior or non-anterior MI with creatine phosphokinase >3000 U/L and QRS duration ≤120 ms were randomized 1:1:1 to dual-site biventricular pacing vs. single-site LV only pacing vs. non-implanted control. The primary endpoint was the echocardiographic core laboratory-assessed change in LV end-diastolic volume (ΔLVEDV) from baseline to 18 months between the pooled pacing therapy groups and the control group. ΔLVEDV increased by 15.3 ± 28.6 mL in the control group and by 16.7 ± 30.5 mL in the pooled pacing groups during follow-up (adjusted mean difference (95% CI) = 0.6 (-12.3, 13.5) mL, P = 0.92). There were also no significant between-group differences in the change in LV end-systolic volume or ejection fraction over time. Quality of life, as assessed by the Minnesota Living with Heart Failure (HF) and European Quality of Life-5 Dimension questionnaires and New York Heart Association class, was also similar between groups during 18-month follow-up. Six-minute walk distance improved during follow-up to an equal degree between groups, and there were no significant differences in the 18-month rates of death or HF hospitalization between the pooled pacing therapy vs. control groups (17.4 vs. 21.7% respectively, P = 0.59). In the present multicentre, randomized trial, peri-infarct pacing did not prevent LV remodelling or improve functional or clinical outcomes during 18-month follow-up in patients with large first MI. NCT01213251. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email:
    European Heart Journal 08/2015; DOI:10.1093/eurheartj/ehv436 · 15.20 Impact Factor
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    ABSTRACT: Bicuspid aortic valve (BAV) anatomy is associated with increased growth rate of the aortic root compared to tricuspid aortic valves. Statins decrease the growth rate of abdominal aneurysms; however their effect on the aortic root growth rate has not been elucidated. The present study evaluated the association between use of statins and aortic root growth in patients with BAV. A total of 199 patients (43 ± 15 years, 69 % male) with BAV who underwent ≥2 echocardiographic measurements of the aortic root ≥1 year apart were included in this retrospective observational study. Median follow-up duration was 4.7 years (interquartile range 2.7-8.3 years). Growth rate (mm/year) of the aortic root was compared between statin users (n = 41) and non-users (n = 158). Statin users were significantly older and had more cardiovascular risk factors than their counterparts. Ascending aorta diameter was significantly smaller at baseline and at follow-up in statin users compared with non-users when adjusted for coronary artery disease, age and medication. The average annual growth rate was 0.08 mm/year (95 % confidence interval 0.03-0.13) for the aortoventricular junction, 0.16 mm/year (0.11-0.21) for the sinus of Valsalva, 0.12 mm/year (0.07-0.17) for the sinotubular junction and 0.45 mm/year (0.37-0.53) for the ascending aorta. The dilation rate of the aortic segments was not different between statin users and non-users. In conclusion, in patients with BAV, although the use of statins was associated with smaller ascending aorta, the annual dilation rate of the aortic root was not influenced by the use of statins.
    The international journal of cardiovascular imaging 08/2015; DOI:10.1007/s10554-015-0749-0 · 1.81 Impact Factor
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    European Heart Journal 08/2015; DOI:10.1093/eurheartj/ehv320 · 15.20 Impact Factor
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    European Heart Journal 08/2015; DOI:10.1093/eurheartj/ehv416 · 15.20 Impact Factor
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    ABSTRACT: Residual ischemia detection after ST-segment elevation myocardial infarction (STEMI) during dobutamine stress echocardiography (DSE) using visual analysis is challenging. The aim of the present study was to investigate the feasibility and accuracy of two-dimensional speckle-tracking strain DSE to detect significant coronary artery disease (CAD) after STEMI. First STEMI patients (n = 105; mean age, 60 ± 11 years; 86% men) treated with primary percutaneous coronary intervention undergoing full-protocol DSE at 3 months and repeat coronary angiography within 1 year were retrospectively included. Using two-dimensional speckle-tracking echocardiography, segmental and global left ventricular peak longitudinal systolic strain (PLSS) at rest and peak stress and change (Δ) in PLSS were measured. Significant CAD was defined as detection of >70% diameter stenosis at coronary angiography. In total, 1,653 (93%) and 1,645 (92%) segments were analyzable at rest and peak stress, respectively. At follow-up, 38 patients (36%) showed significant angiographic CAD. These patients demonstrated greater worsening in global PLSS from rest to peak (-16.8 ± 0.5% to -12.6 ± 0.5%) compared with patients without significant CAD (-16.6 ± 0.4% to -14.3 ± 0.3%; group-stage interaction P < .001). The optimal cutoff of ΔPLSS for the detection of significant CAD on receiver operating characteristic curve analysis was ≥1.9% (area under the curve, 0.70; sensitivity, 87%; specificity, 46%; accuracy, 60%). Using a sentinel segment approach (apex, midposterior, and midinferior for the left anterior descending, left circumflex, and right coronary artery territories, respectively), larger segmental ΔPLSS was also independently associated with significant CAD (odds ratio, 1.1; 95% CI, 1.1-1.2). Two-dimensional speckle-tracking echocardiographic strain analysis is feasible on DSE after STEMI and represents a promising new technique to detect significant angiographic CAD at follow-up. Copyright © 2015 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.
    Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography 08/2015; DOI:10.1016/j.echo.2015.07.023 · 4.06 Impact Factor
  • Jeroen J Bax · Victoria Delgado
    European Heart Journal Cardiovascular Imaging 08/2015; DOI:10.1093/ehjci/jev200 · 4.11 Impact Factor
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    ABSTRACT: Global longitudinal strain (GLS) measured by 2-dimensional longitudinal speckle-tracking echocardiography may be a more sensitive measure of left ventricular (LV) mechanics than conventional LV ejection fraction (EF) to characterize adverse post-ST-segment elevation myocardial infarction (STEMI) remodeling. The aim of the present evaluation was to compare changes in LV GLS in patients with versus without diabetes after the first STEMI. Patients with first STEMI and diabetes (n = 143; age 64 ± 12 years; 68% men; 50% left anterior descending artery as culprit vessel) and 290 patients with first STEMI and without diabetes matched on age, gender, and infarct location were included. LV volumes and function and 2-dimensional LV GLS were measured after primary percutaneous coronary intervention (baseline) and at 6-month follow-up. At baseline, patients with and without diabetes had similar LVEF (46.8 ± 0.7% vs 48.0 ± 0.5%, p = 0.19) and infarct size (peak cardiac troponin T: 3.1 [1.2 to 6.5] vs 3.7 [1.3 to 7.3] μg/l, p = 0.10; peak creatine phosphokinase:1,120 [537 to 2,371] vs 1,291 [586 to 2,613] U/l, p = 0.17), whereas LV GLS was significantly more impaired in diabetic patients (-13.7 ± 0.3% vs -15.3 ± 0.2%, p <0.001). Although diabetic patients showed an improvement in LVEF over time similar to nondiabetic patients (52.0 ± 0.8% vs 53.1 ± 0.6%, p = 0.25), GLS remained more impaired at 6-month follow-up compared with nondiabetic patients (-15.8 ± 0.3% vs -17.3 ± 0.2%, p <0.001). After adjusting for clinical and echocardiographic characteristics, diabetes was independently associated with changes in GLS from baseline to 6-month follow-up (β 1.41, 95% confidence interval 0.85 to 1.96, p <0.001). In conclusion, after STEMI, diabetic patients show more impaired LV GLS at both baseline and follow-up compared with a matched group of patients without diabetes, despite having similar infarct size and LVEF at baseline and follow-up.
    The American journal of cardiology 08/2015; DOI:10.1016/j.amjcard.2015.07.061 · 3.28 Impact Factor
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    ABSTRACT: Dobutamine stress echocardiography (DSE) is frequently performed to assess left ventricular (LV) contractile reserve in patients following myocardial infarction (STEMI). Given that resting LV sublayer twist assessment has been proposed as a marker of infarct transmurality, this study aimed to investigate whether response of LV subepicardial twist on DSE represents a novel quantitative marker of contractile reserve. First STEMI patients treated with primary percutaneous coronary intervention with a resting wall motion abnormality in greater than or equal to two segment(s) at 3 months who underwent full protocol DSE were included. Two-dimensional speckle-tracking was used to calculate LV subepi- and subendocardial twist-defined as the net difference (in degrees) of apical and basal rotation for each sublayer-at rest and peak-dose stages. Primary end point was a ≥5% absolute LV ejection fraction (LVEF) improvement between 3 and 6 months. In total, 61 patients (mean age 61 ± 12, 87% male) were included, of whom 48% (n = 29) demonstrated follow-up LVEF improvement. Mean change in both LV subepicardial (ΔLVsubepi) twist (2.4 ± 3.0 vs. 0.00 ± 2.0°, P = 0.001) and LV subendocardial (ΔLVsubendo) twist (2.7 ± 4.5 vs. 0.25 ± 4.5°, P = 0.04) from rest to peak was significantly higher in LVEF improvers. ΔLVsubepi (odds ratio, OR 1.5, 95% confidence interval, CI 1.1-2.0, P = 0.007), but not ΔLVsubendo (OR 1.1, 95% CI 0.99-1.3, P = 0.07), twist was independently associated with follow-up LVEF improvement following adjustment for baseline LVEF and β-blockade. In post-STEMI patients with resting regional dysfunction, the response of LV subepicardial twist on DSE is associated with follow-up LV function improvement, suggesting recruitment in subepicardial function following STEMI reflects greater extent of contractile reserve. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email:
    European Heart Journal Cardiovascular Imaging 07/2015; DOI:10.1093/ehjci/jev184 · 4.11 Impact Factor
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    ABSTRACT: Mitral regurgitation (MR) is one of the most prevalent valve disorders and has numerous etiologies, including primary (organic) MR, due to underlying degenerative/structural mitral valve (MV) pathology, and secondary (functional) MR, which is principally caused by global or regional left ventricular remodeling and/or severe left atrial dilation. Diagnosis and optimal management of MR requires integration of valve disease and heart failure specialists, MV cardiac surgeons, interventional cardiologists with expertise in structural heart disease, and imaging experts. The introduction of transcatheter MV therapies has highlighted the need for a consensus approach to pragmatic clinical trial design and uniform endpoint definitions to evaluate outcomes in patients with MR. The Mitral Valve Academic Research Consortium is a collaboration between leading academic research organizations and physician-scientists specializing in MV disease from the United States and Europe. Three in-person meetings were held in Virginia and New York during which 44 heart failure, valve, and imaging experts, MV surgeons and interventional cardiologists, clinical trial specialists and statisticians, and representatives from the U.S. Food and Drug Administration considered all aspects of MV pathophysiology, prognosis, and therapies, culminating in a 2-part document describing consensus recommendations for clinical trial design (Part 1) and endpoint definitions (Part 2) to guide evaluation of transcatheter and surgical therapies for MR. The adoption of these recommendations will afford robustness and consistency in the comparative effectiveness evaluation of new devices and approaches to treat MR. These principles may be useful for regulatory assessment of new transcatheter MV devices, as well as for monitoring local and regional outcomes to guide quality improvement initiatives. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
    European Heart Journal 07/2015; 66(3). DOI:10.1093/eurheartj/ehv281 · 15.20 Impact Factor
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    ABSTRACT: Diabetic patients with coronary artery disease (CAD) are often free of chest pain syndrome. A useful modality for non-invasive assessment of CAD is coronary computed tomography angiography (CTA). However, the prognostic value of CAD on coronary CTA in diabetic patients without chest pain syndrome is relatively unknown. Therefore, the aim was to investigate the long-term prognostic value of coronary CTA in a large population diabetic patients without chest pain syndrome. Between 2005 and 2013, 525 diabetic patients without chest pain syndrome were prospectively included to undergo coronary artery calcium (CAC)-scoring followed by coronary CTA. During follow-up, the composite endpoint of all-cause mortality, non-fatal myocardial infarction (MI), and late revascularization (>90 days) was registered. In total, CAC-scoring was performed in 410 patients and coronary CTA in 444 patients (431 interpretable). After median follow-up of 5.0 (IQR 2.7-6.5) years, the composite endpoint occurred in 65 (14%) patients. Coronary CTA demonstrated a high prevalence of CAD (85%), mostly non-obstructive CAD (51%). Furthermore, patients with a normal CTA had an excellent prognosis (event-rate 3%). An incremental increase in event-rate was observed with increasing CAC-risk category or coronary stenosis severity. Finally, obstructive (50-70%) or severe CAD (>70%) was independently predictive of events (HR 11.10 [2.52;48.79] (P = .001), HR 15.16 [3.01;76.36] (P = .001)). Obstructive (50-70%) or severe CAD (>70%) provided increased value over baseline risk factors. Coronary CTA provided prognostic value in diabetic patients without chest pain syndrome. Most importantly, the prognosis of patients with a normal CTA was excellent.
    Journal of Nuclear Cardiology 07/2015; DOI:10.1007/s12350-015-0213-5 · 2.94 Impact Factor
  • Thomas H Schindler · Jeroen J Bax
    European Heart Journal 06/2015; DOI:10.1093/eurheartj/ehv246 · 15.20 Impact Factor
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    ABSTRACT: Low gradient severe aortic stenosis (AS) with preserved left ventricular ejection fraction (LVEF) may be attributed to aortic valve area index (AVAi) underestimation due to the assumption of a circular shape of the left ventricular outflow tract (LVOT) with 2-dimensional echocardiography. The current study evaluated whether fusing Doppler and multidetector computed tomography (MDCT) data to calculate AVAi results in significant reclassification of inconsistently graded severe AS. In total, 191 patients with AVAi < 0.6 cm(2)/m(2) and LVEF ≥ 50% (mean age 80 ± 7 years, 48% male) were included in the current analysis. Patients were classified according to flow (stroke volume index <35 or ≥35 mL/m(2)) and gradient (mean transaortic pressure gradient ≤40 or >40 mmHg) into four groups: normal flow-high gradient (n = 72), low flow-high gradient (n = 31), normal flow-low gradient (n = 46), and low flow-low gradient (n = 42). Left ventricular outflow tract area was measured by planimetry on MDCT and combined with Doppler haemodynamics on continuity equation to obtain the fusion AVAi. The group of patients with normal flow-low gradient had significantly larger AVAi and LVOT area index compared with the other groups. Although MDCT-derived LVOT area index was comparable among the four groups, the fusion AVAi was significantly larger in the normal flow-low gradient group. By using the fusion AVAi, 52% (n = 24) of patients with normal flow-low gradient and 12% (n = 5) of patients with low flow-low gradient would have been reclassified into moderate AS due to AVAi ≥ 0.6 cm(2)/m(2). The fusion AVAi reclassifies 52% of normal flow-low gradient and 12% of low flow-low gradient severe AS into true moderate AS, by providing true cross-sectional LVOT area. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email:
    European Heart Journal 06/2015; 36(31). DOI:10.1093/eurheartj/ehv188 · 15.20 Impact Factor
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    ABSTRACT: In EchoCRT, a randomized trial evaluating the effect of cardiac resynchronization therapy (CRT) in patients with a QRS duration of <130 ms and echocardiographic evidence of left ventricular dyssynchrony, the primary outcome occurred more frequently in the CRT when compared with the control group. According to current heart failure guidelines, CRT is recommended in patients with a QRS duration of ≥120 ms. However, there is some ambiguity from clinical trial data regarding the benefit of patients with a QRS duration of 120-130 ms. The main EchoCRT trial was prematurely terminated due to futility. For the current subgroup analysis we compared data for CRT-ON vs. -OFF in patients with QRS < 120 (n = 661) and QRS 120-130 ms (n = 139). On uni- and multivariable analyses, no significant interaction was observed between the two groups and randomized treatment for the primary or any of the secondary endpoints. On multivariable analysis, a higher risk for the primary endpoint was observed in patients with a QRS duration of 120-130 ms randomized to CRT-ON vs. CRT-OFF (hazard ratio 2.18, 95% CI 1.02-4.65; P = 0.044). However, no statistically significant interaction, compared with patients with QRS < 120 ms randomized to CRT-ON vs. CRT-OFF, was noted (P-interaction = 0.160). In this pre-specified subgroup analysis of EchoCRT, no benefit of CRT was evident in patients with a QRS duration of 120-130 ms. These data further question the usefulness of CRT in this patient population. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email:
    European Heart Journal 05/2015; 36(30). DOI:10.1093/eurheartj/ehv242 · 15.20 Impact Factor
  • Victoria Delgado · Jeroen J Bax
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    ABSTRACT: Development of effective atrial fibrillation (AF) prevention strategies has become a research priority to reduce the global burden of this arrhythmia. With an estimated prevalence in 2010 of 8.8 million adults aged >55 years and a projected prevalence of 17.9 million by 2060 in the European Union,1 AF is the most frequent cardiac arrhythmia and is associated with increased morbidity and mortality. Data from several North American and Western European registries provide important information to better understand the epidemiology of AF and form the basis for the development of effective AF preventive interventions. Creation of models that predict the occurrence of AF is one of the first steps to identify the demographic characteristics and cardiovascular risk factors that can be modified or treated to reduce the burden of AF. Furthermore, the assessment of the structural substrate associated with an increased risk of AF (inflammation, fibrosis, structural and electrical remodelling of the left atrium) is also important. The addition of echocardiographic parameters (left atrial (LA) diameter, the sum of diastolic interventricular septal and posterior wall thickness and LV fractional shortening) to … [Full text of this article]
    Heart (British Cardiac Society) 05/2015; 101(16). DOI:10.1136/heartjnl-2015-307885 · 5.60 Impact Factor
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    ABSTRACT: To develop an alternative method for Vp-assessment using high-temporal velocity-encoded magnetic resonance imaging (VE-MRI). Left ventricular (LV) inflow propagation velocity (Vp) is considered a useful parameter in the complex assessment of LV diastolic function and is measured by Color M-mode echocardiography. A total of 43 patients diagnosed with ischemic heart failure (61 ± 11 years) and 22 healthy volunteers (29 ± 13 years) underwent Color M-mode echocardiography and VE-MRI to assess the inflow velocity through the mitral valve (mean interexamination time 14 days). Temporal resolution of VE-MRI was 10.8-11.8 msec. Local LV inflow velocity was sampled along a 4-cm line starting from the tip of the mitral leaflets and for consecutive sample points the point-in-time was assessed when local velocity exceeded 30 cm/s. From the position-time relation, Vp was calculated by both the difference quotient (Vp-MRI-DQ) as well as from linear regression (Vp-MRI-LR). Good correlation was found between Vp-echo and both Vp-MRI-DQ (r = 0.83, P < 0.001) and Vp-MRI-LR (r = 0.84, P < 0.001). Vp-MRI showed a significant but small underestimation as compared to Vp measured by echocardiography (Vp-MRI-DQ: 5.5 ± 16.2 cm/s, P = 0.008; Vp-MRI-LR: 9.9 ± 15.2 cm/s, P < 0.001). Applying age-related cutoff values for Vp to identify LV impaired relaxation, kappa-agreement with echocardiography was 0.72 (P < 0.001) for Vp-MRI-DQ and 0.69 (P < 0.001) for Vp-MRI-LR. High temporal VE-MRI represents a novel approach to assess Vp, showing good correlation with Color M-mode echocardiography. In healthy subjects and patients with ischemic heart failure, this new method demonstrated good agreement with echocardiography to identify LV impaired relaxation. J. Magn. Reson. Imaging 2015. © 2015 Wiley Periodicals, Inc.
    Journal of Magnetic Resonance Imaging 04/2015; 17(Suppl 1). DOI:10.1002/jmri.24905 · 3.21 Impact Factor
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    ABSTRACT: Despite considerable improvements in the medical management of patients with myocardial infarction (MI), patients with large MI still have substantial risk to develop heart failure. In the early post MI setting, implantable cardioverter defibrillators have reduced arrhythmic deaths but have no impact on overall mortality. Hence, additional interventions are required to further reduce the overall morbidity and mortality of patients with large MI. The pacing remodeling prevention therapy (PRomPT) trial is designed to study the effects of peri-infarct pacing in preventing adverse post-MI remodeling. Up to 250 subjects with a peak creatine phosphokinase (CPK) > 3000 U/L (or a troponin T (TnT) > 10 mcg/L) at time of MI will be randomized to either dual-site or single-site biventricular pacing with the LV lead implanted in a peri-infarct region or a non-implanted control. Those randomized to a device will be blinded to the pacing mode, however randomization to a device or control cannot be blinded. Subjects randomized to pacing will have the device implanted within 10 days of MI. The primary objective is to assess the change in left ventricular end diastolic volume (LVEDV) from baseline to 18 months. Secondary objectives are to assess changes in clinical and mechanistic parameters between the groups, including rates of hospitalization for heart failure and cardiovascular events, the incidence of sudden cardiac death and all-cause mortality, NYHA functional class, 6 minute walking distance, and quality of life CONCLUSIONS: The PRomPT trial will provide important evidence regarding the potential of peri-infarct pacing to interrupt adverse remodeling in patients with large MI. Copyright © 2015 Elsevier Inc. All rights reserved.
    Journal of cardiac failure 03/2015; 21(7). DOI:10.1016/j.cardfail.2015.03.005 · 3.05 Impact Factor
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    Jeroen J Bax · Victoria Delgado
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    ABSTRACT: Chronic heart failure is a major public-health problem with a high prevalence, complex treatment, and high mortality. A careful and comprehensive analysis is needed to provide optimal (and personalized) therapy to heart failure patients. The main 4 non-invasive imaging techniques (echocardiography, magnetic resonance imaging, multi-detector-computed tomography, and nuclear imaging) provide information on cardiovascular anatomy and function, which form the basis of the assessment of the pathophysiology underlying heart failure. The selection of imaging modalities depends on the information that is needed for the clinical management of the patients: (1) underlying etiology (ischemic vs non-ischemic); (2) in ischemic patients, need for revascularization should be evaluated (myocardial ischemia/viability?); (3) left ventricular function and shape assessment; (4) presence of significant secondary mitral regurgitation; (5) device therapy with cardiac resynchronization therapy and/or implantable cardiac defibrillator (risk of sudden cardiac death). This review is dedicated to assessment of myocardial viability, however "isolated assessment of myocardial viability" may be clinically not meaningful and should be considered among all those different variables. This complete information will enable personalized treatment of the patient with ischemic heart failure.
    Journal of Nuclear Cardiology 03/2015; 22(2). DOI:10.1007/s12350-015-0096-5 · 2.94 Impact Factor

Publication Stats

35k Citations
5,809.36 Total Impact Points


  • 2002–2015
    • Leiden University
      Leyden, South Holland, Netherlands
  • 1997–2015
    • Leiden University Medical Centre
      • Department of Cardiology
      Leyden, South Holland, Netherlands
  • 2012
    • Paris Diderot University
      Lutetia Parisorum, Île-de-France, France
  • 2010
    • Emory University
      • Department of Radiology
      Atlanta, GA, United States
  • 2009
    • ICL
      Londinium, England, United Kingdom
  • 2000–2009
    • Erasmus MC
      • • Department of Anesthesiology
      • • Department of Vascular Surgery
      • • Department of Cardiology
      Rotterdam, South Holland, Netherlands
    • University of Manitoba
      Winnipeg, Manitoba, Canada
  • 2008
    • Johns Hopkins Medicine
      • Division of Cardiology
      Baltimore, MD, United States
    • Universitair Ziekenhuis Leuven
      • Department of Cardiology
      Louvain, Flanders, Belgium
    • Aarhus University Hospital
      Aarhus, Central Jutland, Denmark
  • 1997–2008
    • Erasmus Universiteit Rotterdam
      • • Department of Cardiology
      • • Department of Nuclear Medicine
      Rotterdam, South Holland, Netherlands
  • 2007
    • Hôpital Bichat - Claude-Bernard (Hôpitaux Universitaires Paris Nord Val de Seine)
      • Service de Cardiologie
      Paris, Ile-de-France, France
  • 2006
    • Marshfield Clinic
      MFI, Wisconsin, United States
  • 2004
    • Sacred Heart University
      Феърфилд, Connecticut, United States
    • Royal Brompton and Harefield NHS Foundation Trust
      Harefield, England, United Kingdom
  • 1996
    • Medisch Centrum Alkmaar
      • Department of Cardiology
      Alkmaar, North Holland, Netherlands
  • 1995
    • University of Amsterdam
      • Department of Cardiology
      Amsterdamo, North Holland, Netherlands