Archives of Cardiovascular Diseases最新文献

{"title":"Assessment of remote digital auscultation for identifying significant aortic stenosis: A pilot study.","authors":"Yuval Avidan, Vsevolod Tabachnikov, Amir Aker","doi":"10.1016/j.acvd.2025.06.072","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.06.072","url":null,"abstract":"<p><strong>Background: </strong>Aortic stenosis (AS) is the most common valvular disease in the Western world. Technological advances, such as the TytoCare™ device, have introduced remote telemedicine-based cardiac auscultation. Its utility in diagnosing and grading AS remains unexplored. This study aims to evaluate the reliability of the TytoCare™ for assessing AS.</p><p><strong>Methods: </strong>Sixty patients were classified by standard echocardiogram into three groups: significant AS (at least moderate AS; n=20), non-significant AS (aortic sclerosis or mild AS; n=20) and controls (n=20). Heart sounds were self-recorded using the TytoCare™ stethoscope. Fifteen blinded physicians - five each from primary care, internal medicine and cardiology - reviewed the recordings using standardized equipment and assigned diagnoses based on a categorical scale: 0=insufficient data, 1=normal, 2=mild AS and 3=at least moderate AS.</p><p><strong>Results: </strong>The study groups had comparable baseline characteristics, with a mean±standard deviation age of 72.6±9.1years. The correct response rate for significant AS was 85% (95% confidence interval [95% CI]: 80-88%), with both cardiologists and non-cardiologists achieving≥80%. In contrast, performance declined in non-significant AS (57%, 95% CI: 51-62%), but remained high in the control group (87%, 95% CI: 82-90%). Cardiologists outperformed other physicians, overall (P=0.029) and in significant AS cases (P=0.022), while no significant differences were found among non-cardiologists.</p><p><strong>Conclusions: </strong>TytoCare™ demonstrated high reliability in the remote assessment of significant AS by both cardiologists and non-cardiologists. Its intuitive and user-friendly design enables self-application, even among older populations, emphasizing its potential as an effective screening tool for AS across diverse healthcare settings.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644216","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 value of cardiac magnetic resonance imaging for myocardial infarction with non-obstructive coronary arteries: The CRIMINAL prospective registry.","authors":"Charlotte Dagrenat, Amine Douair, Antoine Apert, Grégoire Range, Jean Louis Georges, Olivier Nallet, Nicolas Delarche, Nadine Ferrier, Jérôme Rischner, Jérôme Clerc, Edouard Naoum Nehmé, Antoine Boge, Franck Barbou, Christophe Jeannot, Regis Delaunay, Laurent Michel, Franck Goiorani, Philippe Couppie, Hende Madiot, Loïc Belle, Pierre Leddet","doi":"10.1016/j.acvd.2025.06.071","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.06.071","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have investigated the use of cardiac magnetic resonance (CMR) imaging in patients with of myocardial infarction with non-obstructive coronary arteries (MINOCA).</p><p><strong>Aims: </strong>To assess the diagnostic and prognostic yield of CMR in patients presenting with a working diagnosis of MINOCA-like condition.</p><p><strong>Methods: </strong>Between May 2015 and August 2018, 457 consecutive patients with MINOCA-like condition were prospectively enrolled in an observational cohort study in 15 centres affiliated with the Collège National des Cardiologues des Hôpitaux (CNCH). Prior to CMR, the cardiologist established one provisional underlying mechanism. Using CMR findings, the cardiologist reassigned the patient to a final diagnosis.</p><p><strong>Results: </strong>Overall, 336 of 457 patients underwent CMR. Guided by CMR, the cardiologist provided a diagnosis in 90.5% (95% confidence interval [95% CI]: 87.3-93.6%) of cases and changed the underlying cause in 35.7% (95% CI: 30.6-40.8%) of patients. Specifically, 33.7% (95% CI: 23.7-43.7%) of type 1 myocardial infarctions (MIs) were misdiagnosed prior to CMR. A type 1 MI occurred for three patients (at 3, 4 and 6months of follow-up) with a CMR diagnosis of non-ischaemic underlying cause (1.2%), which is reassuring for therapeutic management guided by CMR. Patients with an inconclusive CMR had a longer median time to complete the CMR (17 vs. 7days; P<0.01) and lower conventional and high-sensitivity troponin values (1.1 vs. 3.6μg/L; P=0.002 and 433 vs. 707ng/L; P=0.007, respectively).</p><p><strong>Conclusion: </strong>The systematic use of CMR plays a pivotal role in identifying the underlying cause of myocardial injury, impacting patients, health professionals and society at large.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621253","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":"Immune checkpoint inhibitor rechallenge after myocarditis: Time for reappraisal?","authors":"Guillaume Bailly, Ariel Cohen, Franck Boccara, Joe-Elie Salem","doi":"10.1016/j.acvd.2025.06.069","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.06.069","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644217","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":"Left atrial strain reservoir in amyloid cardiomyopathy: A strong predictor of mid-term incident atrial fibrillation.","authors":"Tiphaine Bollon, Antoine Jobbe-Duval, Nathan Mewton, Laurent Sebbag, Anissa Bouali, Brahim Harbaoui, Pierre Lantelme, Hélène Thibault, Pierre-Yves Courand","doi":"10.1016/j.acvd.2025.06.070","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.06.070","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621254","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":"The dawn of in silico clinical trials in cardiovascular diseases: Lessons from the SIRIUS programme.","authors":"Denis Angoulvant, Jean-Pierre Boissel","doi":"10.1016/j.acvd.2025.06.068","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.06.068","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565535","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":"Letter in response to the article entitled \"Reevaluating the role of left atrial strain in systemic cardiomyopathies: A call for nuanced metrics and broader inclusion\" by Sharma et al.","authors":"Charles Massie","doi":"10.1016/j.acvd.2025.06.066","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.06.066","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562081","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":"Single-lead electrocardiograms and artificial intelligence for managing cardiac rhythm irregularities in general practice: A French general practitioners' survey.","authors":"Victor Decroocq, Marie Decroocq, Clémence Riolet, François Dievart, Valentine Pecriaux, Jeremy Layec, Guillaume Viart, Yves Guyomar, Sylvestre Marechaux, Aymeric Menet","doi":"10.1016/j.acvd.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.05.008","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rhythm irregularities, including atrial fibrillation, atrial premature beats and ventricular premature beats, are the reason for about 33% of electrocardiogram tests performed by general practitioners. Artificial intelligence has shown diagnostic accuracy in electrocardiogram analysis equivalent to that of cardiologists, and single-lead electrocardiograms offer simplified usability.</p><p><strong>Aims: </strong>To assess the acceptability and utility of a simplified single-lead electrocardiogram device in general practice, integrated with artificial intelligence-based interpretation and a clinical decision support tree derived from artificial intelligence analysis.</p><p><strong>Methods: </strong>A decision tree based on artificial intelligence-interpreted electrocardiography was developed for managing cardiac irregularities, and validated by expert cardiologists. Between October 2023 and March 2024, a survey was conducted among 1102 general practitioners in France to assess all the study objectives.</p><p><strong>Results: </strong>Of the 221 general practitioners who responded to the survey, 44% owned an electrocardiogram device, and 58% routinely performed electrocardiograms when rhythm irregularities are suspected. Seventy-seven percent believed that a single-lead electrocardiogram device would simplify electrocardiogram use in practice. A key factor for general practitioners that would enhance electrocardiogram use in their practice is publication of official guidelines. Seventy-two percent of general practitioners reported that they would use electrocardiograms more often if artificial intelligence were available for interpretation, and 57% of general practitioners considered artificial intelligence to be a diagnostic aid, rather than a fully autonomous system. The relevance of the decision tree was rated at 8 out of 10.</p><p><strong>Conclusions: </strong>This general practitioner survey suggests that a single-lead electrocardiogram tool, integrating artificial intelligence-based trace interpretation with a decision tree derived from artificial intelligence analysis, could streamline the management of cardiac rhythm irregularities in general practice. However, its adoption requires the development of guidelines by scientific societies and approval from the national insurance system for reimbursement. Further research is needed to evaluate its feasibility and clinical relevance in real-world settings.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602328","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":"Association between lipoprotein(a) concentration and outcomes after percutaneous coronary intervention: A systematic review and meta-analysis.","authors":"Gianmarco Cancelli, Camilla S Rossi, Ovidio De Filippo, Antonino Di Franco, Lamia Harik, Irene Borzillo, Aina Hirofuji, Giovanni Soletti, Polina Mantaj, Busra Cangut, Talal Alzghari, Michele Dell'Aquila, Jordan Leith, Mudathir Ibrahim, Tulio Caldonazo, Mohamed Rahouma, Mario Gaudino, Fabrizio D'Ascenzo","doi":"10.1016/j.acvd.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.05.009","url":null,"abstract":"<p><strong>Background: </strong>Lipoprotein(a) is well known to be associated with the development of cardiovascular disease. Patients with an elevated baseline lipoprotein(a) concentration may be prone to unfavourable clinical outcomes following percutaneous coronary intervention.</p><p><strong>Aim: </strong>We performed a study-level meta-analysis to evaluate differences in clinical outcomes after percutaneous coronary intervention in patients with high and low serum lipoprotein(a) concentrations.</p><p><strong>Methods: </strong>A systematic literature search was conducted on Ovid MEDLINE, EMBASE and The Cochrane Library (Wiley) to identify studies reporting clinical outcomes in patients treated with percutaneous coronary intervention, stratified by preoperative lipoprotein(a) concentration. The lipoprotein(a) cut-off value of each individual study was considered for differentiation into low versus high lipoprotein(a) concentration groups. The primary outcome was all-cause death. Secondary outcomes were myocardial infarction, cardiovascular death, major adverse cardiovascular events and stroke.</p><p><strong>Results: </strong>Fourteen studies (40,241 patients) were included. At a mean follow-up of 4.9 years, patients with high lipoprotein(a) concentrations had significantly increased rates of all-cause death (incidence rate ratio 1.42, 95% confidence interval 1.16-1.75; P<0.001), myocardial infarction (incidence rate ratio 1.45, 95% confidence interval 1.18-1.78; P<0.001), cardiovascular death (incidence rate ratio 1.50, 95% confidence interval 1.27-1.77; P<0.001), major adverse cardiovascular events (incidence rate ratio 1.35 95% confidence interval 1.19-1.54; P<0.001) and stroke (incidence rate ratio 1.33, 95% confidence interval 1.13-1.56; P<0.001) compared with patients with low lipoprotein(a) concentrations. Leave-one-out and cumulative analyses were consistent with the main analysis.</p><p><strong>Conclusions: </strong>Among patients treated with percutaneous coronary intervention, high lipoprotein(a) concentrations are associated with higher rates of all-cause death, myocardial infarction, cardiovascular death, major adverse cardiovascular events and stroke compared with low lipoprotein(a) concentrations.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565533","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":"Beyond 2025: Projections of cardiothoracic surgeon demographics in France.","authors":"Gabriel Saiydoun, Saadé Saadé, Chadi Aludaat, Pascal Leprince, Guillaume Fadel, Jean-Philippe Verhoye, Andre Vincentelli, Pascal-Alexandre Thomas, Elsa Armand, Guillaume Lebreton, Erwan Flecher, Michel Kindo, Jean-Marc Baste, Xavier-Benoit D'Journo, Julien Guihaire, Christophe Jayle, Anne Boutet, Julie Giraud, Maroua Eid, Nicolas Venissac, Hugo Clermidy, Johann Cattan","doi":"10.1016/j.acvd.2025.04.057","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.04.057","url":null,"abstract":"<p><strong>Background: </strong>Cardiothoracic surgeons are essential healthcare practitioners but there are demographic challenges and training complexities. Understanding workforce trends is critical to ensure future capacity and adaptability in France.</p><p><strong>Aims: </strong>This study assessed the current state of the cardiothoracic surgery workforce in France and projected demographic trends through 2040.</p><p><strong>Methods: </strong>Data from the French Society of Thoracic and Cardiovascular Surgery (2023) were used to analyse all active cardiothoracic surgeons and residents. The study included statistical analysis with an Opportunity Index to forecast surgeon inflow and outflow over 15years.</p><p><strong>Results: </strong>The cardiothoracic workforce comprised 958 individuals, marking a 15% increase since 2012. Among senior surgeons, 52% practiced cardiac and 48% thoracic surgery. Public institutions employed 60%, while the private sector accounted for 40%. The median age of residents was 29years, with females representing 55% of the 2022 surgical training cohort. Regional disparities were noted, with Limoges and Caen presenting the best future opportunities. Growth in surgeon numbers is expected to continue steadily until 2040, but challenges in securing permanent positions for trainees, especially in cardiac surgery, may arise after 2035.</p><p><strong>Conclusion: </strong>The outlook for cardiothoracic surgery in France is balanced, with significant demographic shifts such as increased female representation. To sustain growth and align with patient and practitioner needs, workforce adaptation and inclusivity should be prioritized.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602327","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":"Redo surgical aortic valve replacement: An outdated technique in the era of valve-in-valve procedures?","authors":"Johannes Petersen, Roman Stiefel, Sumi Westhofen, Eik Vettorazzi, Till Demal, Beate Reiter, Björn Sill, Lenard Conradi, Yousuf Al Assar, Hermann Reichenspurner, Christian Detter","doi":"10.1016/j.acvd.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.05.007","url":null,"abstract":"<p><strong>Background: </strong>The treatment of degenerative prosthetic aortic valves is increasingly important. However, redo surgical aortic valve replacement (Re-SAVR) carries higher perioperative risks than primary surgical aortic valve replacement.</p><p><strong>Aim: </strong>This study aims to identify predictors of early morbidity and death after Re-SAVR.</p><p><strong>Methods: </strong>A retrospective analysis of 220 patients scheduled for elective Re-SAVR between 2009 and 2017 was conducted. Patients were divided into isolated (n=87) and combined (n=133) redo procedures. The primary endpoint was in-hospital death, and secondary endpoints were postoperative complications, such as stroke, dialysis and pacemaker implantation. Regression analysis identified independent predictors of death.</p><p><strong>Results: </strong>Among the patients undergoing Re-SAVR (mean age, 62.6±13.2years; 71% male; mean EuroSCORE II, 12.6±11.1%), 86.4% received biological prostheses and 13.6% received mechanical prostheses. The in-hospital death rate was 5.7% for isolated Re-SAVR and 18.0% for combined procedures (P=0.003). Excluding patients with endocarditis, the in-hospital death rate was 0% for isolated Re-SAVR and 19.7% for combined procedures (P=0.002). The incidence of postoperative complications after an isolated procedure was similar to that after a combined procedure. Independent predictors of 30-day death were previous coronary artery bypass grafting (odds ratio: 14.12, 95% confidence interval: 4.40-51.35; P<0.001), a combined procedure (odds ratio: 7.01, 95% confidence interval: 2.09-31.54; P=0.004) and New York Heart Association functional class III/IV (odds ratio: 3.73, 95% confidence interval: 1.31-12.58; P=0.020).</p><p><strong>Conclusions: </strong>The perioperative risk of death after isolated Re-SAVR in patients without endocarditis was 0%. Independent predictors of in-hospital death included previous coronary artery bypass grafting, combined procedures and New York Heart Association class III/IV. These findings may inform the decision-making process of the heart team regarding the optimal approach (surgical or transcatheter) for redo aortic valve replacement.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562082","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}