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Vánky, Farkas
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Publications (10 of 45) Show all publications
Nilsson, L., Appel, C.-F., Hultkvist, H. & Vánky, F. (2015). Evaluation of the Valve Academic Research Consortium-2 Criteria for Myocardial Infarction in Transcatheter Aortic Valve Implantation: A Prospective Observational Study. PLoS ONE, 10(6), e0130423
Open this publication in new window or tab >>Evaluation of the Valve Academic Research Consortium-2 Criteria for Myocardial Infarction in Transcatheter Aortic Valve Implantation: A Prospective Observational Study
2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 6, p. e0130423-Article in journal (Refereed) Published
Abstract [en]

Objective To evaluate the relevance of the individual components of the Valve Academic Research Consortium (VARC)-2 criteria for periprocedural myocardial infarction (MI) in transcatheter aortic valve implantation (TAVI). The association between biomarkers and adverse procedural outcome has been established. However, the additive prognostic importance of signs and symptoms are more uncertain. Methods A total of 125 consecutive TAVI patients were prospectively included in this study. Biomarkers for MI were analyzed and signs and symptoms according to VARC-2 criteria were collected from clinical records. Results The criteria of elevated biomarkers and of signs or symptoms were found in 27 (22%) and 32 (26%) of the patients, respectively. According to VARC-2 definition, 12 (10%) had MI. VARC-2 definition of MI, Troponin T (TnT) greater than 600 ng/L, and presence of signs or symptoms correlated with 6 months mortality, prolonged ICU stay, elevation of N-terminal prohormone brain natriuretic peptide, and renal impairment. No signs or symptoms were found in 7 (44%) of the patients who fulfilled the criterion of elevated TnT greater than 600 ng/L. In the group with positive TnT criterion, there were no significant differences between those with and without signs or symptoms in respect to levels of TnT (1014 [585-1720] ng/L versus 704 [515-905] ng/L, p = 0.17) or creatine kinase-MB (36 [25-52] mu g/L versus 29 [25-39] mu g/L, p = 0.32). In the multivariate Cox regression analysis, TnT greater than 600 ng/L was the only significant independent variable associated with 6-months postprocedural mortality. Conclusions Myocardial injury in TAVI, measured with biomarkers, correlates well with adverse procedural outcome. In this study it is also the strongest predictor for early postprocedural mortality. The additional requirement of signs or symptoms for the diagnosis of MI results in omission of a considerable number of clinically significant MI.

Place, publisher, year, edition, pages
Public Library of Science, 2015
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-120231 (URN)10.1371/journal.pone.0130423 (DOI)000356327000157 ()26069958 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden [FORSS-12657, FORSS-23891, FORSS-159851, FORSS-311341]; ALF founding, County Council of Ostergotland, Sweden

Available from: 2015-07-21 Created: 2015-07-20 Last updated: 2017-12-04
Vánky, F., Hultkvist, H., Svedjeholm, R. & Nilsson, L. (2015). Is the present definition of mycardial infarction in transcatheter aortic valve implantation relevant for the postprocedulal outcome?. In: : . Paper presented at 7th joint Scandinavian Conference in Cardiothoracic Surgery,Bergen, Norway, 3-5 September 2015 (pp. 30-30).
Open this publication in new window or tab >>Is the present definition of mycardial infarction in transcatheter aortic valve implantation relevant for the postprocedulal outcome?
2015 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Background: The association between biomarkers and adverse procedural outcome has been established. However, the additive prognostic importance of signs and symptoms according to the Valve Academic Research Consortium (VARC)-2 criteria for periprocedural myocardial infarction (MI) are more uncertain.

Aim: To evaluate the relevance of the individual components of the VARC-2 criteria for periprocedural myocardial infarction (MI) in transcatheter aortic valve implantation (TAVI).Methods: A total of 125 consecutive TAVI patients were prospectively included in this study. Biomarkers for MI were analyzed and signs and symptoms according to VARC-2 criteria were collected from clinical records.

Results: The criteria of elevated biomarkers and of signs or symptoms were found in 27 ( 22%) and 32 ( 26%) of the patients, respectively. According to VARC-2 definition, 12 (10%) had MI. VARC-2 definition of MI, Troponin T (TnT) >600 ng/L, and presence of signs or symptoms correlated with 6 month mortality, prolonged ICU stay, elevation of N-terminal prohormone brain natriuretic peptide, and renal impairment. No signs or symptoms were found in 7 (4 4%) of the patients who fulfilled the criterion of elevated TnT>600 ng/L. In the group with positive TnT criterion, there were no significant differences between those with and without signs or symptoms in respect to levels of TnT (1014 [585-1720] ng/L versus 704 [515-905] ng/L, p=0.17) or creatine kinase-MB ( 36 [25-52] μg/L versus 29 [25-39] μg/L, p=0.32). In the multiple logistic regression model, TnT>600 ng/L turned out as the only independent variable associated with 6-month mortality, OR 7.89 (95% CI 2.21-28.1, p = 0.001).

Conclusion: Myocardial injury in TAVI, measured with TnT, correlates well with adverse procedural outcome. The additional requirement of signs or symptoms for the diagnosis of MI results in omission of a considerable number of clinically significant MI.

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-124325 (URN)
Conference
7th joint Scandinavian Conference in Cardiothoracic Surgery,Bergen, Norway, 3-5 September 2015
Available from: 2016-01-26 Created: 2016-01-26 Last updated: 2016-02-08Bibliographically approved
Holm, J., Vidlund, M., Vánky, F., Friberg, O., Håkanson, E., Walther, S. & Svedjeholm, R. (2014). EuroSCORE II and N-terminal pro-B-type natriuretic peptide for risk evaluation: an observational longitudinal study in patients undergoing coronary artery bypass graft surgery. British Journal of Anaesthesia, 113(1), 75-82
Open this publication in new window or tab >>EuroSCORE II and N-terminal pro-B-type natriuretic peptide for risk evaluation: an observational longitudinal study in patients undergoing coronary artery bypass graft surgery
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2014 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 113, no 1, p. 75-82Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Postoperative heart failure remains the major cause of death after cardiac surgery. As N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a predictor for postoperative heart failure, the aim was to evaluate if preoperative NT-proBNP could provide additional prognostic information to the recently launched EuroSCORE II.

METHODS:

A total of 365 patients with acute coronary syndrome (ACS) undergoing isolated coronary artery bypass graft (CABG) surgery were studied prospectively. Preoperative NT-proBNP and EuroSCORE II were evaluated with regard to severe circulatory failure after operation according to prespecified criteria. To assess what clinical outcomes are indicated by NT-proBNP levels in different risk categories, the patients were stratified according to EuroSCORE II. Based on receiver operating characteristics analysis, these cohorts were assessed with regard to preoperative NT-proBNP below or above 1028 ng litre(-1). The follow-up time averaged 4.4 (0.7) yr.

RESULTS:

Preoperative NT-proBNP≥1028 ng litre(-1) [odds ratio (OR) 9.9, 95% confidence interval (CI) 1.01-98.9; P=0.049] and EuroSCORE II (OR 1.24, 95% CI 1.06-1.46; P=0.008) independently predicted severe circulatory failure after operation. In intermediate-risk patients (EuroSCORE II 2.0-10.0), NT-proBNP≥1028 ng litre(-1) was associated with a higher incidence of severe circulatory failure (6.6% vs 0%; P=0.007), renal failure (14.8% vs 5.4%; P=0.03), stroke (6.6% vs 0.7%; P=0.03), longer intensive care unit stay [37 (35) vs 27 (38) h; P=0.002], and worse long-term survival.

CONCLUSIONS:

Combining EuroSCORE II and preoperative NT-proBNP appears to improve risk prediction with regard to severe circulatory failure after isolated CABG for ACS. NT-proBNP may be particularly useful in patients at intermediate risk according to EuroSCORE II.

Place, publisher, year, edition, pages
Oxford University Press, 2014
Keywords
acute coronary syndrome; coronary artery bypass surgery; natriuretic peptides; risk assessment
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-109246 (URN)10.1093/bja/aeu088 (DOI)000338598700011 ()24727704 (PubMedID)
Available from: 2014-08-12 Created: 2014-08-11 Last updated: 2017-12-05Bibliographically approved
Tajik, B., Vidlund, M., Sundbom, P., Friberg, Ö., Holm, J., Vanky, F. & Svedjeholm, R. (2014). Intravenous glutamatereduces the need for inotropes in patients with heart failure after CABG foracute coronary syndrome?. In: : . Paper presented at 29th Annual meeting of the European Association of Cardiothoracic Anesthesiologists, Florence, Italy.
Open this publication in new window or tab >>Intravenous glutamatereduces the need for inotropes in patients with heart failure after CABG foracute coronary syndrome?
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2014 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-114367 (URN)
Conference
29th Annual meeting of the European Association of Cardiothoracic Anesthesiologists, Florence, Italy
Available from: 2015-02-19 Created: 2015-02-19 Last updated: 2015-11-09
Svedjeholm, R., Tajik, B., Vidlund, M., Friberg, Ö., Holm, J., Vanky, F. & Håkansson, E. (2014). Intravenous glutamatereduces the need for inotropes in patients with heart failure after CABG foracute coronary syndrome?. In: : . Paper presented at 6th Joint Scandinavian conference in Cardiothoracic Surgery, Gothenburg, Sweden.
Open this publication in new window or tab >>Intravenous glutamatereduces the need for inotropes in patients with heart failure after CABG foracute coronary syndrome?
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2014 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-114365 (URN)
Conference
6th Joint Scandinavian conference in Cardiothoracic Surgery, Gothenburg, Sweden
Available from: 2015-02-19 Created: 2015-02-19 Last updated: 2015-03-31
Baranowski, J., Wallby, L., Nylander, E., Boano, G., Vanky, F., Löfstöm, L., . . . Nielsen, N.-E. (2014). MitraClip after myocardial infarction with papillary muscle rupture and as treatment of systolic anterior motion of the mitral valve.. In: : . Paper presented at ICI&CSI 2014, Frankfurt, Tyskland.
Open this publication in new window or tab >>MitraClip after myocardial infarction with papillary muscle rupture and as treatment of systolic anterior motion of the mitral valve.
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2014 (English)Conference paper, Oral presentation only (Refereed)
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-114081 (URN)
Conference
ICI&CSI 2014, Frankfurt, Tyskland
Available from: 2015-02-07 Created: 2015-02-07 Last updated: 2015-03-30
Forsberg, L. M., Tamás, E., Vánky, F., Engvall, J. & Nylander, E. (2013). Differences in recovery of left and right ventricular function following aortic valve interventions: a longitudinal echocardiographic study in patients undergoing surgical, transapical or transfemoral aortic valve implantation. Catheterization and cardiovascular interventions, 82(6), 1004-1014
Open this publication in new window or tab >>Differences in recovery of left and right ventricular function following aortic valve interventions: a longitudinal echocardiographic study in patients undergoing surgical, transapical or transfemoral aortic valve implantation
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2013 (English)In: Catheterization and cardiovascular interventions, ISSN 1522-1946, E-ISSN 1522-726X, Vol. 82, no 6, p. 1004-1014Article in journal (Refereed) Published
Abstract [en]

Objectives

To evaluate longitudinal left and right ventricular function (LVF and RVF) after transcatheter aortic valve implantation (TAVI) as compared to surgical aortic valve replacement (SAVR) and LVF and RVF after TAVI by the transfemoral (TF) or transapical (TA) approach.

Background

Knowledge about differences in recovery of LVF and RVF after TAVI and SAVR is scarce.

Methods

Sixty patients (age 81 ± 7 years, logistic EuroSCORE 16 ± 10%), undergoing TAVI (TF: n = 35 and TA: n  = 25), were examined by echocardiography including atrioventricular plane displacement (AVPD) and peak systolic velocities (PSV) by tissue Doppler at basal RV free wall, LV lateral wall and septum preprocedurally, 7 weeks and 6 months postprocedurally. Twenty-seven SAVR patients were matched to 27 TAVI patients by age, gender and LVF.

Results

Early postintervention, TAVI patients had improved longitudinal LVF. However, when analyzed separately, only TF, but not TA patients, had improved LV lateral and septal AVPD and PSV (all P ≤ 0.01). All TAVI patients, as well as the TF and TA group had unchanged longitudinal LVF between the early and late follow-ups (all P > 0.05). The SAVR group had higher septal LVF than the matched TAVI group preprocedurally, while postoperatively this difference was diminished. Longitudinal RVF was better in the TF group than in the TA group pre- and postprocedurally. Although the SAVR group had superior longitudinal RVF preoperatively, this was inferior to TAVI postoperatively.

Conclusions

Postprocedural longitudinal LVF and RVF in patients undergoing TF-TAVI, TA-TAVI, or SAVR differ considerably. Preservation of longitudinal RVF after TAVI might influence the selection of aortic valve intervention in the future.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-81050 (URN)10.1002/ccd.24812 (DOI)000326532300036 ()
Available from: 2012-09-06 Created: 2012-09-06 Last updated: 2017-12-07Bibliographically approved
Holm, J., Vidlund, M., Vanky, F., Friberg, Ö., Håkanson, E. & Svedjeholm, R. (2013). Does preoperative NT-proBNP provide additional prognostic information to EuroSCORE II in patients undfergoing CABG?. In: : . Paper presented at 28th Annual meeting of the European Association of Cardiothoracic Anesthesiologists, Barcelona, Spain, June 6-8, 2013.
Open this publication in new window or tab >>Does preoperative NT-proBNP provide additional prognostic information to EuroSCORE II in patients undfergoing CABG?
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2013 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103348 (URN)
Conference
28th Annual meeting of the European Association of Cardiothoracic Anesthesiologists, Barcelona, Spain, June 6-8, 2013
Available from: 2014-01-17 Created: 2014-01-17 Last updated: 2014-02-04
Svedjeholm, R., Westberg, K. & Vanky, F. (2013). Long-term outcome of a simplified technique to improve revascularization of diffusely diseased LAD. In: : . Paper presented at 21st Annual meeting of the Asian Society for Cardiovascular and Thoracic Surgery, Kobe, Japan, April 4-7, 2013.
Open this publication in new window or tab >>Long-term outcome of a simplified technique to improve revascularization of diffusely diseased LAD
2013 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103214 (URN)
Conference
21st Annual meeting of the Asian Society for Cardiovascular and Thoracic Surgery, Kobe, Japan, April 4-7, 2013
Available from: 2014-01-15 Created: 2014-01-15 Last updated: 2014-01-17
Svedjeholm, R., Vanhanen, I., Vanky, F. & Håkanson, E. (2013). Metabolic Intervention for weaning problems in patients with preoperative left ventricular dysfunction. In: : . Paper presented at 21st Annual meeting of the Asian Society for Cardiovascular and Thoracic Surgery, Kobe, Japan, April 4-7, 2013.
Open this publication in new window or tab >>Metabolic Intervention for weaning problems in patients with preoperative left ventricular dysfunction
2013 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103217 (URN)
Conference
21st Annual meeting of the Asian Society for Cardiovascular and Thoracic Surgery, Kobe, Japan, April 4-7, 2013
Available from: 2014-01-15 Created: 2014-01-15 Last updated: 2014-01-29
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