Presse Medicale最新文献

{"title":"Electrical therapies in heart failure: Evolving technologies and indications","authors":"Cecilia Linde","doi":"10.1016/j.lpm.2023.104192","DOIUrl":"10.1016/j.lpm.2023.104192","url":null,"abstract":"<div><p>Device therapy for heart failure has rapidly evolved over 2 decades. The knowledge of indications, assessment lead and device technology has expanded to include CRT, leadless pacing and conduction system pacing such as His bundle and left bundle branch area pacing. But there is still a lack of evidence for these new technologies as well as for common indications such as atrial fibrillation and upgrading from a previous device. The role of personalized medicine will become increasingly important when selecting candidates for CRT, primary preventive ICD  ablation procedures and emerging new devices such as cardiac contractility modulation (CCM). Rapidity of therapy is associated with outcome which will be a challenge. If properly implemented devices and drugs will have a large positive affect of HF outcomes.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"53 1","pages":"Article 104192"},"PeriodicalIF":2.7,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0755498223000295/pdfft?md5=308445461c6b675bf60093ce261c8143&pid=1-s2.0-S0755498223000295-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart failure with preserved ejection fraction: New challenges and new hopes","authors":"Damien Logeart","doi":"10.1016/j.lpm.2023.104185","DOIUrl":"10.1016/j.lpm.2023.104185","url":null,"abstract":"<div><p>Heart failure (HF) is a major public health<span><span> problem affecting millions of adults worldwide. HF with preserved ejection fraction<span>, i.e. &gt; 50 %, (HFpEF) accounts for more than half of all HF cases, and its incidence and prevalence are increasing with the aging of the population and the growing prevalence of metabolic disorders<span> such as obesity, diabetes and hypertension. Diagnosis of HFpEF<span> requires a combination of numerous echocardiographic parameters and also results of natriuretic peptide assays, to which may be added the need for a stress test. HFpEF is characterized by complex, interrelated pathophysiological mechanisms, which must be understood. This complexity probably accounts for the lack of evidence-based medicine compared with HF with reduced EF. Nevertheless, significant progress has been made recently, with a high level of evidence obtained for the </span></span></span></span>SGLT2 inhibitor<span> class on the one hand, and promising data with new drugs targeting more specifically certain mechanisms such as obesity and inflammation on the other.</span></span></p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"53 1","pages":"Article 104185"},"PeriodicalIF":2.7,"publicationDate":"2023-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New insights in acute heart failure","authors":"Ayu Asakage ,&nbsp;Alexandre Mebazaa ,&nbsp;Benjamin Deniau","doi":"10.1016/j.lpm.2023.104184","DOIUrl":"10.1016/j.lpm.2023.104184","url":null,"abstract":"<div><p><span><span><span>Acute heart failure (AHF) is a clinical complex disease and a worldwide issue due to its inconsistent diagnosis and poor prognosis. The cornerstone of </span>pathophysiology<span><span> of AHF is systemic venous congestion, which is led by the underlying structural and functional cardiac condition. Systemic venous congestion is a major target for AHF management because it causes symptoms and organs dysfunction, and is associated with poor prognosis. The mainstay of decongestive therapy is </span>diuresis with intravenous </span></span>loop diuretics<span><span> combined with other diuretics including </span>thiazides when necessary, and non-invasive ventilation. The presence of unresolved congestion at discharge can lead heart failure related rehospitalization, and careful follow-up is required especially during “vulnerable phase”, several months </span></span>after discharge<span><span>. The updated recommendation for management of AHF has been provided by latest guidelines from European Society of Cardiology and American Heart Association/American College of Cardiology/Heart Failure Society of America. Several large studies have currently demonstrated the benefits of guideline-directed oral medical therapies, and trials are ongoing on medication such as selective sodium-glucose transport proteins 2 inhibitors and protocols for congestive therapy. This review aimed to summarize the latest insights in AHF, based primarily on the most recent guidelines and large </span>randomized controlled trials.</span></p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"53 1","pages":"Article 104184"},"PeriodicalIF":2.7,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49681531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facing the Evidences with Type 2 Diabetes: Contemporary Challenges","authors":"Michel Marre","doi":"10.1016/j.lpm.2023.104179","DOIUrl":"10.1016/j.lpm.2023.104179","url":null,"abstract":"","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"52 1","pages":"Article 104179"},"PeriodicalIF":2.7,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41145528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severity of kidney involvement as predictor of death, severe heart failure and renal events in patients with type 2 diabetes: data from a prospective cohort","authors":"Samy Hadjadj ,&nbsp;Pierre Jean Saulnier ,&nbsp;Bertrand Cariou ,&nbsp;SURDIAGENE study investigators","doi":"10.1016/j.lpm.2023.104177","DOIUrl":"10.1016/j.lpm.2023.104177","url":null,"abstract":"<div><p>Type 2 diabetes is associated with an increased risk for end-stage renal disease and heart failure, contributing to premature death. All these 3 events are inter-related, suggesting common risk factors and/or pathophysiological pathways.</p><p>The SURDIAGENE (SUrvie Rénale DIAbète et GENEtique) cohort is a single centre hospital-based cohort of persons living with type 2 diabetes, recruiting participants at Poitiers university hospital, France, from 2002 to 2011 with further follow-up till 2015.</p><p>Here, we describe the cumulative prevalence of hard renal events (sustained doubling of serum creatinine and/or renal replacement therapy), heart failure leading to hospitalization (HFH) and all-cause death, according to the KDIGO classification, which considers CKD stages according to CKD EPI equation <span>[1]</span>, <span>[2]</span>, <span>[3]</span>, <span>[4]</span>, <span>[5]</span> and albuminuria (A1, A2, A3) according to albumin/creatinine ratio with thresholds at 30 and 300 mg/g. We considered 1450 participants with KDIGO stage available at baseline.</p><p>Considering a cumulated follow-up duration of 10667 patient.years with 100 renal events, 247 HFH and 527 deaths, our study showed that the more severe the KDIGO stage, the higher the incidence rate not only for renal event, but also for HFH and for all-cause death. For instance, in CKD1A1 and CKD4A3 the incidence rates for hard renal events, HFH and death were 0.98 and 140.70, 4.46 and 107.09, 13.64 and 156.56 per 1000 patient.years, respectively. Interestingly, the incidence of renal event was lower than the incidence of all-cause death in all KDIGO stages, at variance with the data from recent renal outcome trials on SGLT2 inhibitors and finerenone.</p><p>We conclude that KDIGO stages should be considered for renal but also for HFH risk classification. The analysis of the respective incidence of renal events and deaths in observational studies and RCTs deserves further evaluation in type 2 diabetes.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"52 1","pages":"Article 104177"},"PeriodicalIF":2.7,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41145870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Trials with reno-vascular end points in patients with diabetes: Changing the scenario over the past 20 years","authors":"Tomasz J. Block ,&nbsp;Mark E. Cooper","doi":"10.1016/j.lpm.2023.104178","DOIUrl":"10.1016/j.lpm.2023.104178","url":null,"abstract":"<div><p>Major clinical advances over the last 25 years in the area of diabetic kidney disease (DKD) have been confirmed in large seminal clinical trials. These findings add to the previously identified benefits resulting from intensive glucose and blood pressure control therapies. Furthermore, newer glucose lowering treatments such as SGLT2 inhibitors and GLP-1 agonists appear very promising and are likely to transform the management and outlook of DKD over the next decade. In addition, newer mineralocorticoid receptor antagonists and a recently reported trial with an endothelin receptor blocker also have the potential to change clinical practice.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"52 1","pages":"Article 104178"},"PeriodicalIF":2.7,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41125791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Criteria and Etiopathogenesis of Type 2 Diabetes and Its Complications: Lessons from the Pima Indians","authors":"Helen C Looker ,&nbsp;Douglas C Chang ,&nbsp;Leslie J Baier ,&nbsp;Robert L Hanson ,&nbsp;Robert G Nelson","doi":"10.1016/j.lpm.2023.104176","DOIUrl":"10.1016/j.lpm.2023.104176","url":null,"abstract":"<div><p>The Phoenix Epidemiology and Clinical Research Branch of the National Institute of Diabetes and Digestive and Kidney Diseases has conducted prospective studies of diabetes and its complications in the Pima Indians living in Arizona, USA for over 50 years. In this review we highlight areas in which these studies provided vital insights into the criteria used to diagnose type 2 diabetes, the pathophysiologic changes that accompany the development of type 2 diabetes, and the course and determinants of diabetes complications—focusing specifically on diabetic kidney disease. We include data from our longitudinal population-based study of diabetes and its complications, studies on the role of insulin resistance and insulin secretion in the pathophysiology of type 2 diabetes, and in-depth studies of diabetic kidney disease that include measures of glomerular function and research kidney biopsies. We also focus on the emerging health threat posed by youth-onset type 2 diabetes, which was first seen in the Pima Indians in the 1960s and is becoming an increasing issue worldwide.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"52 1","pages":"Article 104176"},"PeriodicalIF":2.7,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41131536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alpha1-antitrypsin deficiency: An updated review","authors":"Jean-François Mornex ,&nbsp;Julie Traclet ,&nbsp;Olivier Guillaud ,&nbsp;Magali Dechomet ,&nbsp;Christine Lombard ,&nbsp;Mathias Ruiz ,&nbsp;Didier Revel ,&nbsp;Philippe Reix ,&nbsp;Vincent Cottin","doi":"10.1016/j.lpm.2023.104170","DOIUrl":"10.1016/j.lpm.2023.104170","url":null,"abstract":"<div><p><span>Alpha1-antitrypsin deficiency (AATD) is a rare autosomal recessive disease associated with the homozygous Z variant of the </span><em>SERPINA1</em><span> gene. Clinical expression of AATD, reported 60 years ago associate a severe deficiency, pulmonary emphysema<span><span> and/or liver fibrosis. Pulmonary </span>emphysema is due to the severe alpha1-antitrypsin deficiency of the </span></span><em>ZZ</em> homozygous status and is favored by smoking. Liver fibrosis is due to the <em>ZZ</em><span> homozygous status and is favored by obesity and excessive chronic alcohol intake, with a risk of liver cancer. Diagnosis is based on serum level and either isoelectric focusing determination of the biochemical phenotype or PCR detection of some variants. </span><em>SERPINA1</em><span><span><span> gene sequencing is necessary in case of discrepancies between the results of these tests. No treatment is available for the liver disease in AATD. Although no specific trial has been performed, </span>COPD<span><span> in AATD should be treated as per COPD recommendations. Based on a randomized clinical trial, augmentation therapy is indicated in non-smoking adults less than 70 years of age with emphysema at chest CT, confirmed homozygous AATD, and FEV1 between 35% and 70% of predicted. In contrast Z </span>heterozygosis (MZ or SZ) brings a risk of lung or liver disease only in association with further risk factors. Early detection, in all patients with COPD and </span></span>chronic liver disease, is critical for the correct information of Z variant carriers. News ways of correcting the liver production of alpha1-antitrypsin will modify the care of AATD patients.</span></p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"52 3","pages":"Article 104170"},"PeriodicalIF":2.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10137364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary ciliary dyskinesia","authors":"Johanna Raidt ,&nbsp;Niki Tomas Loges ,&nbsp;Heike Olbrich,&nbsp;Julia Wallmeier,&nbsp;Petra Pennekamp ,&nbsp;Heymut Omran","doi":"10.1016/j.lpm.2023.104171","DOIUrl":"10.1016/j.lpm.2023.104171","url":null,"abstract":"<div><h3>Background and objectives</h3><p><span>Primary ciliary dyskinesia (PCD, ORPHA:244) is a group of rare genetic disorders characterized by dysfunction of </span>motile cilia<span>. It is phenotypically and genetically heterogeneous, with more than 50 genes involved. Thanks to genetic, clinical, and functional characterization, immense progress has been made in the understanding and diagnosis of PCD. Nevertheless, it is underdiagnosed due to the heterogeneous phenotype and complexity of diagnosis. This review aims to help clinicians navigate this heterogeneous group of diseases. Here, we describe the broad spectrum of phenotypes associated with PCD and address pitfalls and difficult-to-interpret findings to avoid misinterpretation.</span></p></div><div><h3>Method</h3><p>Review of literature</p></div><div><h3>Conclusion</h3><p>PCD diagnosis is complex and requires integration of history, clinical picture, imaging, functional and structural analysis of motile cilia and, if available, genetic analysis to make a definitive diagnosis. It is critical that we continue to expand our knowledge of this group of rare disorders to improve the identification of PCD patients and to develop evidence-based therapeutic approaches.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"52 3","pages":"Article 104171"},"PeriodicalIF":2.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10142488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic pulmonary fibrosis","authors":"Thomas Koudstaal,&nbsp;Marlies S. Wijsenbeek","doi":"10.1016/j.lpm.2023.104166","DOIUrl":"10.1016/j.lpm.2023.104166","url":null,"abstract":"<div><p>Idiopathic pulmonary fibrosis (IPF) is a progressive devastating lung disease with substantial morbidity. It is associated with cough, dyspnea and impaired quality of life. If left untreated, IPF has a median survival of 3 years.</p><p>IPF affects ∼3 million people worldwide, with increasing incidence in older patients. The current concept of pathogenesis is that pulmonary fibrosis results from repetitive injury to the lung epithelium, with fibroblast accumulation, myofibroblast activation, and deposition of matrix. These injuries, in combination with innate and adaptive immune responses, dysregulated wound repair and fibroblast dysfunction, lead to recurring tissue remodeling and self-perpetuating fibrosis as seen in IPF.</p><p>The diagnostic approach includes the exclusion of other interstitial lung diseases or underlying conditions and depends on a multidisciplinary team-based discussion combining radiological and clinical features and well as in some cases histology. In the last decade, considerable progress has been made in the understanding of IPF clinical management, with the availability of two drugs, pirfenidone and nintedanib, that decrease pulmonary lung function decline. However, current IPF therapies only slow disease progression and prognosis remains poor. Fortunately, there are multiple clinical trials ongoing with potential new therapies targeting different disease pathways.</p><p>This review provides an overview of IPF epidemiology, current insights in pathophysiology, diagnostic and therapeutic management approaches. Finally, a detailed description of current and evolving therapeutic approaches is also provided.</p></div>","PeriodicalId":20530,"journal":{"name":"Presse Medicale","volume":"52 3","pages":"Article 104166"},"PeriodicalIF":2.7,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9877518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}