Xavier Galloo

• MD
• University Hospital Brussels

Background Recent data suggest that the true incidence of atrial fibrillation (AF) after patent foramen ovale (PFO) closure has probably been underestimated, and may differ according to the type of closing device used. Objectives On the basis of continuous rhythm monitoring with an implantable device, this study aims to assess the incidence of sup...

Mixed valvular diseases (MVDs) are common but have received little attention in the literature, especially regarding the mitral valve (MV) and the right-sided cardiac valves. Whereas echocardiography plays a pivotal diagnostic role, the diagnosis is made difficult due to haemodynamic interactions that may invalidate common indices of severity used...

A moderate or severe tricuspid regurgitation (TR) is frequently associated with mitral regurgitation (MR) and may impact prognosis after mitral valve intervention. It is yet unclear whether both valves should be treated simultaneously, especially using a percutaneous approach. Therefore, we sought to determine the impact of TR on outcomes in patien...

Introduction Severe tricuspid regurgitation (TR) is associated with increased mortality if left untreated. Recently, the Tricuspid Valve Academic Research Consortium (TVARC) has published standardized definitions of disease aetiology and severity, as well as endpoints for future clinical trials. Right ventricular (RV) function assessment represents...

Systemic sclerosis (SSc) is a multisystemic autoimmune disorder in which cardiac involvement is frequent and portends negative prognosis. Left ventricular (LV) diastolic dysfunction is one of the most common cardiac alterations in these patients, and left atrial (LA) reservoir strain (ƐR) measurement using speckle tracking echocardiography has been...

Background Significant secondary mitral regurgitation (SMR) is known to be associated with worse prognosis. However, data focusing specifically on moderate SMR and associated risk factors are lacking. In the present study, clinical and echocardiographic parameters associated with outcomes were evaluated in a large cohort of patients with moderate S...

Background and aims: Severe tricuspid regurgitation (TR) is associated with increased mortality rates, but benefit of its correction and ideal timing are not clearly determined. This study aimed to identify patient subsets who might benefit from surgery. Methods: In TRIGISTRY, an international cohort study of consecutive patients with severe isola...

Aims Cardiac resynchronization therapy (CRT) may induce left ventricular (LV) reverse remodelling (=LV response) in patients with heart failure. Intraventricular pressure gradients can be quantified using echocardiography-derived haemodynamic forces (HDF). The aim was to evaluate the association between baseline HDF and LV response and to compare t...

We describe the case of a 55-year-old patient with cardiogenic shock postsurgical mitral valve replacement, because of a native aortic valve paravalvular leak due to surgical trauma. The patient was successfully treated with a muscular ventricular septum defect device. To the best of our knowledge, this is the first report describing percutaneous d...

Background: Previous studies demonstrated the prognostic value of baseline cardiac damage staging as well as left ventricular global longitudinal strain (LVGLS) in patients undergoing transcatheter aortic valve implantation (TAVI). The aim of the present study was to evaluate the changes in cardiac damage stage and LVGLS after TAVI and to investiga...

Purpose Systemic sclerosis (SSc) is a multisystemic autoimmune disorder in which cardiac involvement is frequent and portends negative prognosis. Left ventricular (LV) diastolic dysfunction is one of the most common cardiac alterations in these patients and left atrial (LA) reservoir strain (ƐR) measurement using speckle tracking echocardiography h...

(1) Background: Left ventricular global longitudinal (LVGLS) and right ventricular free wall strain (RVFWS) demonstrated separate prognostic values in patients with severe aortic stenosis (AS). However, studies evaluating the combined assessment of LVGLS and RVFWS have shown contradictory results. This study explored the prognostic value of combini...

(1) Background: infective endocarditis (IE) is a significant health concern associated with important morbidity and mortality. Only limited, often monocentric, retrospective data on IE in Belgium are available. This prospective study sought to assess the clinical characteristics and outcomes of Belgian IE patients in the ESC EORP European endocardi...

Background Mitral regurgitation (MR) is one of the complications after pacemaker (PM) implantation. However, the underlying mechanism leading to MR progression after PM implantation is not yet fully understood. There is also a lack of information on the clinical impact of the development of MR after PM implantation. Purpose This study aims to eval...

Background Aortic stenosis (AS) is the most prevalent valvular heart disease in the aging population and has significant impact on cardiac function. In these patients, previous studies proposed an extra-valvular cardiac damage staging, which demonstrated a strong prognostic value. Left ventricular global longitudinal strain (LVGLS) has also been sh...

Background Cardiac resynchronization therapy (CRT) improves outcome in selected heart failure patients and can induce left ventricular (LV) reverse remodeling. Echocardiography-derived hemodynamic forces (HDF) are a new clinical tool which provides insight in fluid dynamics. Purpose To evaluate whether baseline HDF parameters are associated with L...

Background/Introduction ST-elevation myocardial infarction (STEMI) remains a healthcare burden not only through increased mortality risk, but also development of chronic cardiac pathologies like atrial fibrillation (AF). Left atrial (LA) reservoir strain is a known predictor of incident AF in the general population. Purpose Our aim was to explore...

Aims We sought to evaluate the mechanism of angiotensin‐converting enzyme inhibitor (ARNI) sacubitril/valsartan therapy and compare it with a valsartan‐only control group in HFrEF patients. Methods and results The study was a phase IV, prospective, randomized, double‐blind, parallel‐group study in patients with NYHA class II‐III heart failure (HF)...

Objective Severe secondary tricuspid regurgitation (STR) causes significant right atrial (RA) volume overload, resulting in structural and functional RA-remodelling. This study evaluated whether patients with severe STR and reduced RA function, as assessed by RA-reservoir-strain (RASr), show lower long-term prognosis. Methods Consecutive patients,...

This editorial refers to ‘Incidence, risk factors, and outcomes of atrial functional mitral regurgitation in patients with atrial fibrillation or sinus rhythm’, by J.A. Naser et al., https://doi.org/10.1093/ehjci/jead199. Mitral regurgitation (MR) has long been classified as primary (or organic), when resulting from a structural abnormality of the...

Background and aims: Benefit of tricuspid regurgitation (TR) correction and timing of intervention are unclear. This study aimed to compare survival rates after surgical or transcatheter intervention to conservative management according to TR clinical stage as assessed using the TRI-SCORE. Methods: 2,413 patients with severe isolated functional...

Patients with heart failure (HF) and reduced ejection fraction (HFrEF) are complex patients who often have a high prevalence of co-morbidities and risk factors. In the present study, we investigated the prognostic significance of left ventricular (LV) global longitudinal strain (GLS) along with important clinical and echocardiographic variables in...

Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): EACVI Training Grant App000073275. Background Aortic stenosis (AS) is the most common valvular heart disease in developed countries and when indicated can be treated with transcatheter aortic valve implantation (TAVI). Recently, a cardiac...

Funding Acknowledgements Type of funding sources: None. Background Atrial functional tricuspid regurgitation (A-FTR), defined as TR due to prominent right atrial (RA) dilatation without significant right ventricular (RV) remodelling, has recently emerged as a distinct subtype of FTR, and can be distinguished from ventricular FTR (V-FTR), defined b...

Funding Acknowledgements Type of funding sources: None. Background A new mathematical model allows calculation of hemodynamic forces (HDF) from routine transthoracic echocardiographic images. In large cohorts, the evolution of HDF parameters in patients after onset of cardiac resynchronization therapy (CRT) has not been investigated. Purpose To c...

Cardiac resynchronization therapy (CRT) is an effective therapy in selected patients with advanced heart failure that reduces all-cause mortality at short-term follow-up. However, data regarding long-term mortality after CRT implantation are scarce, with no separate analysis available of the covariates associated with respectively short-term and lo...

Aims: Atrial functional tricuspid regurgitation (AFTR) has shown distinctive pathophysiological and anatomical differences compared with ventricular functional tricuspid regurgitation (VFTR) with potential implications for interventions. However, little is known about the difference in long-term prognosis between these two FTR-aetiologies, which w...

Background Atrial fibrillation (AF) and aortic stenosis (AS) are both highly prevalent and often coexist. Various studies have focused on the prognostic value of AF in patients with AS, but rarely considered left ventricular (LV) diastolic function as a prognostic factor. Objective To evaluate the prognostic impact of AF in patients with AS while...

This editorial refers to ‘Normative values of the aortic valve area and Doppler measurements using two-dimensional transthoracic echocardiography: results from the Multicenter World Alliance of Societies of Echocardiography Study’, by J.I. Cotella et al. https://doi.org/10.1093/ehjci/jeac220. Aortic valve (AV) disease is related to high morbidity a...

Background Changes in right ventricular (RV) dimensions and function after tricuspid valve (TV) surgery and their association with long-term outcomes remain largely unexplored. The current study evaluated RV reverse remodeling, based on changes in RV dimensions and function, after TV surgery for significant (moderate or severe) tricuspid regurgitat...

Background Patients with heart failure (HF) and reduced ejection fraction (HFrEF) are complex patients who often have a high prevalence of comorbidities and cardiovascular risk factors. However, risk stratification and treatment decision in these patients mainly depend on simple measurements of left ventricular (LV) ejection fraction (EF). In the p...

Background Cardiac damage in heart failure (HF) with reduced ejection fraction (HFrEF) often involves structural and functional left atrial (LA) abnormalities. Speckle-tracking echocardiography derived LA reservoir strain (LARS) is a sensitive measurement for early detection of LA dysfunction. However, the prognostic value of LARS is not well estab...

Background Right ventricular (RV) adverse remodelling is a complex process, consisting of progressive RV dilatation and RV systolic dysfunction. Both parameters individually are important prognostic markers in patients receiving cardiac resynchronization therapy (CRT). The prognostic value of assessing both parameters into one model has not been ev...

Background Atrial fibrillation (AF) and aortic stenosis (AS) are both highly prevalent and increasing with age. Various studies have focused on the complex relationship between these entities that frequently coexist. AS might induce adverse cardiac remodelling, which is associated with poor prognosis in severe AS. Left atrial remodelling, especiall...

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia and it is associated with a high risk of cardiovascular complications [1]. Cryoballoon ablation (CBA) has emerged as a safe and efficient therapeutic option for AF [2]. However, AF recurrence occurs in more than 25% of the patients, which leads to repeated ablations and incre...

Background Left atrial (LA) function is a strong prognostic marker in patients with heart failure and patients with functional mitral regurgitation (MR). Although cardiac resynchronization therapy (CRT) has shown to improve MR severity, the interaction between a reduction in MR severity and an improvement in LA function, as well as their associatio...

Background Renal and hepatic dysfunction complicate the treatment course of patients with heart failure and negatively affect outcomes. Because the right atrium functions as a reservoir between the right ventricle and the venous circulation, a reduced right atrial compliance may enhance venous congestion, thereby promoting worsening renal function...

Background Cryoballoon ablation (CBA) has emerged a one of the safest and efficient therapeutic options for atrial fibrillation (AF) [1]. However, AF recurrence rate after CBA remains as high as 25–30%, leading to increased rates of complications and repeated procedures [2]. Left atrial (LA) structural remodeling, defined as LA dilation has been pr...

Worsening heart failure (HF), defined as hospitalization for worsening signs and symptoms of HF or the need for urgent intravenous diuretics, is often considered a surrogate of poor prognosis in clinical trials. However, data on the prognostic implications of worsening HF in patients with HF and reduced ejection fraction is limited. Patients who ha...

Purpose of Review The present article reviews the role of multimodality imaging to improve risk stratification and timing of intervention in patients with valvular heart disease (VHD), and summarizes the latest developments in transcatheter valve interventions. Recent Findings Growing evidence suggests that intervention at an earlier stage may imp...

Aims Left atrial (LA) function is a strong prognostic marker in patients with heart failure and functional mitral regurgitation (MR). Although cardiac resynchronization therapy (CRT) has shown to improve MR severity, the interaction between a reduction in MR severity and an increase in LA function, as well as its association with outcomes, has not...

Backgrounds: This study aimed to investigate the association between left atrioventricular coupling index (LACI) and the occurrence of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM). Methods A total of 373 patients with HCM and no history of AF were evaluated by transthoracic echocardiography. LACI was defined by the ra...

Background This study evaluated the prognostic value of staging right heart failure in patients with significant tricuspid regurgitation undergoing tricuspid valve surgery. Methods Patients with significant tricuspid regurgitation who underwent tricuspid valve surgery were divided into 4 right heart failure stages according to the presence of righ...

Objective: This study aimed to determine whether lower values of feature-tracking cardiovascular magnetic resonance (CMR)-derived left atrial (LA) reservoir strain (LARS) and impaired left ventricular (LV) global longitudinal strain (GLS) were associated with the presence of symptoms and long-term prognosis in patients with systemic sclerosis (SSc...

Aims: Tricuspid regurgitation (TR) is common in patients with heart failure (HF) and is associated with worse outcome. This study investigated the effect of cardiac resynchronization therapy (CRT) on TR severity and long-term outcome. Methods and results: Tricuspid regurgitation severity was assessed at baseline and 6 months after CRT implantati...

Introduction Right ventricular (RV) function is of particular importance in systemic sclerosis (SSc), since common SSc complications, such as interstitial lung disease and pulmonary hypertension may affect RV afterload. Cardiovascular magnetic resonance (CMR) is the gold standard for measuring RV function. CMR-derived RV and right atrial (RA) strai...

Aims: Chronic pressure overload and right ventricular (RV) dysfunction can lead to RV-pulmonary artery (PA) uncoupling in patients with heart failure. The evolution and prognostic values of RV-PA coupling assessed by echocardiography in patients undergoing cardiac resynchronization therapy (CRT) have not been thoroughly investigated. The aim of th...

Aims: Left atrial (LA) function is a marker of prognosis in patients with heart failure. The prognostic implications of an improvement in LA function in addition to an improvement in left ventricular (LV) function after cardiac resynchronization therapy (CRT) implantation are unknown. This study aimed to evaluate the prognostic value of a signific...

Funding Acknowledgements Type of funding sources: None. Background The association of known cardiovascular risk factors with poor prognosis of coronavirus disease 2019 (COVID-19) has been recently emphasized (1). Coronary artery calcium (CAC) score is considered a risk modifier in primary prevention of cardiovascular disease and has shown to impro...

Funding Acknowledgements Type of funding sources: None. Background In patients with hypertrophic cardiomyopathy (HCM) accurate risk stratification for new onset atrial fibrillation (AF) has important prognostic implications. Left atrioventricular coupling index (LACI) has been recently associated with the occurrence of AF in patients without histo...

Funding Acknowledgements Type of funding sources: None. Background Inconsistent changes in right ventricular (RV) dimensions and function have been observed after tricuspid valve (TV) surgery and their associations with long-term outcomes have not been explored. Purpose To evaluate RV remodelling and RV function in patients with significant (mode...

Background Left ventricular (LV) dilatation may limit LV reverse remodelling after cardiac resynchronization therapy (CRT). Objective To evaluate the impact of baseline LV volumes on LV reverse remodelling after CRT and whether this is associated with improved survival. Methods Patients were stratified into quintiles according to baseline LV end-...

Background Cardiac resynchronization therapy (CRT) candidates often present with significant mitral and tricuspid regurgitation, pulmonary hypertension and right ventricular dysfunction when referred for device implantation. This study investigated the prognostic value of a novel cardiac staging system, based on the extent of cardiac remodeling pri...

Background Left ventricular global longitudinal strain (LV GLS) has been proposed as sensitive marker of myocardial damage in patients with chronic severe aortic regurgitation (AR) and preserved left ventricular ejection fraction (LVEF). However, LV GLS does not take into account the afterload. Non-invasive LV myocardial work is a novel parameter o...

Right ventricular (RV) function is an important prognostic marker in cardiac resynchronization therapy (CRT) recipients. Measuring RV systolic function with echocardiography, however, remains challenging due to the complexity of right heart morphology. Evaluation of RV function with RV free wall strain (FWS) may improve risk stratification in recip...

Cryoballoon ablation (CBA) is a safe and efficient therapeutic option for atrial fibrillation (AF). However, AF recurrence occurs in 25% of the patients, leading to repeated ablations and complications. Previous reports have shown that left atrium (LA) assessed by M-Mode and two-dimensional echocardiography (2DE) predicts AF recurrence. Nevertheles...

Objective Atrial fibrillation (AF) recurrence occurs in approximately 25% of the patients undergoing cryoballoon ablation (CBA), leading to repeated ablations and complications. Left atrial (LA) dilation has been proposed as a predictor of AF recurrence. However, LA strain is a surrogate marker of LA mechanical dysfunction, which might appear befor...

Background Coronavirus disease 2019 (COVID-19) pandemic continues to overwhelm healthcare systems worldwide, due to high numbers of critical cases over a short period of time (1,2). Elevated cardiac troponin (cTn), suggestive for myocardial damage, was associated with increased mortality of COVID-19 patients (3,4). However, data addressing the role...

Introduction Mortality of tricuspid valve (TV) surgery for severe secondary tricuspid regurgitation (TR) remains relatively high. Current guidelines advise surgery in patients with symptomatic severe TR as a concomitant procedure to left-sided valve surgery. Right ventricular (RV) dysfunction is an important prognostic marker and may appear late in...

Background The association between known cardiovascular risk factors and poor prognosis of patients diagnosed with coronavirus disease 2019 (COVID-19) has been recently emphasized (1). Coronary artery calcium (CAC) score assessed by computed tomography (CT) is considered a risk modifier in primary prevention of cardiovascular disease and has shown...

BACKGROUND: Coronavirus disease 2019 (COVID-19) emerged as a worldwide health crisis, overwhelming healthcare systems. Elevated cardiac troponin T (cTn T) at admission was associated with increased in-hospital mortality. However, data addressing the role of cTn T in major adverse cardiovascular events (MACE) in COVID-19 are scarce. Therefore, we as...

Background: The association of known cardiovascular risk factors with poor prognosis of coronavirus disease 2019 (COVID-19) has been recently emphasized. Coronary artery calcium (CAC) score is considered a risk modifier in the primary prevention of cardiovascular disease. We hypothesized that the absence of CAC might have an additional predictive v...

Background: Oral anticoagulation therapy (OAC) remains the gold standard for ischaemic stroke prevention in patients with non-valvular atrial fibrillation (NVAF) and elevated stroke risk. Percutaneous left atrial appendage occlusion (LAAO) has emerged as a potential alternative for stroke prevention in patients who cannot tolerate OAC. Although no...

BACKGROUND: Only few direct comparative studies evaluated the effectiveness of telemedicine-guided home blood pressure (tele-HBPM) compared to 24 h ambulatory blood pressure monitoring (ABPM) in assessing blood pressure (BP) and BP control. MATERIAL AND METHODS: This prospective clinical trial included patients with arterial hypertension, with (n =...

A detailed medical history is vital in the correct interpretation of medical images: Peer‐to‐peer feedback and a thorough medical history can help avoid diagnostic pitfalls and unnecessary therapy.

Background Clinical management of vaso-vagal syncope (VVS) remains challenging since no therapy has proven to completely prevent VVS recurrence. Objective The purpose of this study was to analyze the mid-term outcome of cryoballoon (CB) cardioneuroablation achieved by pulmonary vein isolation (PVI) in patients with VVS. Methods Patients who under...

Differential diagnosis between hypertrophic cardiomyopathy (HCM) and cardiac amyloidosis (CA) is mandatory since the prognosis is very different, but not always possible as both diseases present with increased myocardial thickness and mass. Despite better knowledge of the pathophysiology of both HCM and CA, and new developments in diagnosis, many p...

Background: Pulmonary vein isolation (PVI) modulates the intrinsic cardiac autonomic nervous system (ANS). We evaluated the impact of PVI on 5 non-invasive autonomic tests. Methods: Thirty patients (76% male, mean age 60.37 ± 9.02 years) with paroxysmal atrial fibrillation (AF) underwent cryoballoon-guided PVI. Five autonomic tests were performe...

A 29-year-old male presented at the Emergency Department (ED) with chest pain and neck tenderness after intranasal cocaine usage. Physical exam of the patient demonstrated moderate subcutaneous emphysema on the right side of his neck. The ECG did not demonstrate any changes associated with cocaine-induced cardiac ischemia, and blood analysis was no...

Objective: To evaluate the effectiveness of telemedicine-guided home blood pressure (tele-HBPM) compared to 24 h ambulatory blood pressure monitoring (ABPM) in assessing blood pressure (BP) and BP control, as only few direct comparative studies are available. Design and method: We conducted a prospective clinical trial in 57 subjects, of which 16 n...