Archives of Cardiovascular Diseases最新文献

{"title":"Letter in response to the article entitled “Comparative efficacy and safety of intravascular lithotripsy versus rotational atherectomy in coronary artery calcification: An updated meta-analysis” by A.M.A. Kayani et al.","authors":"Ankur Sharma , Varshini Vadhithala , Arun Kumar , Sushma Verma , Sushma Narsing Katkuri","doi":"10.1016/j.acvd.2025.12.009","DOIUrl":"10.1016/j.acvd.2025.12.009","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 5","pages":"Page 368"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133503","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":"Experts’ recommendations for the management of adult patients with cardiogenic shock","authors":"Nadia Aissaoui ,&nbsp;Clement Delmas ,&nbsp;Hamid Merdji ,&nbsp;Guillaume Schurtz ,&nbsp;Guillaume Baudry ,&nbsp;Antoine Beurton ,&nbsp;Florence Boissier ,&nbsp;Laurent Bonello ,&nbsp;Bernard Cholley ,&nbsp;Nicolas Combaret ,&nbsp;Alain Combes ,&nbsp;Charles-Henri David ,&nbsp;Daniel De Backer ,&nbsp;Pierre Grégoire Guinot ,&nbsp;Olfa Hamzaoui ,&nbsp;Brahim Harbaoui ,&nbsp;Julien Imbault ,&nbsp;Nicolas Nesseler ,&nbsp;Antoine Kimmoun ,&nbsp;Michel Kindo ,&nbsp;Khaldoun Kuteifan","doi":"10.1016/j.acvd.2026.02.001","DOIUrl":"10.1016/j.acvd.2026.02.001","url":null,"abstract":"<div><div>The last specific international European recommendations regarding the management of cardiogenic shock (CS) regardless of the etiology were issued over 10<!--> <!-->years ago. We present herein recommendations for the management of CS in adults, developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of from the French Intensive Care Society [Société de réanimation de langue française (SRLF)] and the French Society of Cardiology [Société française de cardiologie (SFC)], with the participation of the French Society of Anesthesia and Intensive Care [Société française d’anesthésie et de réanimation (SFAR)], and the French Society of Thoracic and Cardiovascular Surgery [Société française de chirurgie thoracique et cardio-vasculaire (SFCTCV)]. The recommendations covered six fields of application: CS teams and expert centers, symptomatic medical management, etiological management, organ support, temporary circulatory support and de-escalation and early post-CS management. Twenty-three “Patient Intervention Comparator Outcome” (PICO) questions were identified, leading to 41 recommendations regarding management of CS in adult patients. Seven recommendations were scored with high level of evidence (Grade 1), 11 with moderate level of evidence (Grade 2) and 17 with low level of evidence (Expert opinion). In 6 cases, the experts were not able to give an answer. All of the recommendations obtained strong agreement from the expert committee. The experts highlight the fact that optimal management of CS requires organization including a structured, multidisciplinary shock team and regional referral network, applying standardized protocols for diagnosis and staging. Early etiological treatment—such as culprit-lesion revascularization or urgent valve intervention—is central to improve outcomes. Hemodynamic support should prioritize norepinephrine as first-line vasopressor and privilege selective inotrope use. Temporary mechanical circulatory support (Impella, VA-ECMO) should be reserved for carefully selected patients following discussion by the expert team.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 5","pages":"Pages 370-389"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516945","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":"Obstructive sleep apnoea syndrome and recurrent vasovagal syncope: Insights from a multicentre observational study","authors":"Vincent Puel ,&nbsp;Frédéric Gagnadoux ,&nbsp;Isabelle Godard ,&nbsp;George Papaioannou ,&nbsp;Naima Zarqane ,&nbsp;Sarz Ibrahim ,&nbsp;Nicolas Molinari ,&nbsp;Jean-Louis Pepin ,&nbsp;AbdelKebir Sabil","doi":"10.1016/j.acvd.2025.09.008","DOIUrl":"10.1016/j.acvd.2025.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Resolution of recurrent syncopal episodes after the diagnosis and treatment of obstructive sleep apnoea syndrome (OSA) has been reported in a few cases, but it is unknown whether a true syncope is associated with OSA.</div></div><div><h3>Aim</h3><div>To evaluate the impact of diagnosing and treating OSA on the frequency of recurrent vasovagal syncope (RVS) episodes in patients with OSA and co-morbid RVS.</div></div><div><h3>Methods</h3><div>A multicentre interventional observational study was conducted in patients with OSA and RVS. Patients underwent continuous positive airway pressure (CPAP) therapy for at least 12 months. The frequency of RVS episodes (with and without loss of consciousness), quality of life and polysomnographic variables were assessed during the 6 months before CPAP initiation and during the last 6 months before the follow-up visits after CPAP therapy.</div></div><div><h3>Results</h3><div>Twenty-seven patients (66.7% female; mean age 42.1<!--> <!-->±<!--> <!-->12.8 years; mean body mass index 25.6<!--> <!-->±<!--> <!-->3.5<!--> <!-->kg/m²; mean apnoea-hypopnoea index 22.2<!--> <!-->±<!--> <!-->12.1 events/hour) completed 12 months of CPAP therapy. The frequency of RVS episodes decreased significantly following treatment. Episodes with loss of consciousness declined from 25.7<!--> <!-->±<!--> <!-->38.6 to 17.7<!--> <!-->±<!--> <!-->40.3 (<em>P</em> <!-->&lt;<!--> <!-->0.05), and episodes without loss of consciousness dropped from 39.7<!--> <!-->±<!--> <!-->78.6 to 9.3<!--> <!-->±<!--> <!-->8.5 (<em>P</em> <!-->&lt;<!--> <!-->0.05). CPAP therapy was also associated with significant improvements in daytime sleepiness (Epworth Sleepiness Scale: 9.3<!--> <!-->±<!--> <!-->6.5 to 3.9<!--> <!-->±<!--> <!-->5.7; <em>P</em> <!-->=<!--> <!-->0.0016; 95% confidence interval 2.24 to 8.50), fatigue (Pichot Scale: 16.0<!--> <!-->±<!--> <!-->9.8 to 3.9<!--> <!-->±<!--> <!-->5.1; <em>P</em> <!-->=<!--> <!-->0.000001; 95% confidence interval 8.13 to 16.09) and percentage of patients with positive depression scores (35.3% to 9.1%; <em>P</em> <!-->=<!--> <!-->0.00025; 95% confidence interval –4.96 to–1.96). No statistically significant changes were observed in heart rate variability or 24-hour blood pressure variables.</div></div><div><h3>Conclusions</h3><div>CPAP therapy significantly reduces RVS recurrence in patients with OSA, suggesting that it is a modifiable risk factor for RVS. These findings highlight the importance of OSA screening in patients with unexplained syncope. Randomized controlled trials are required to mitigate potential results bias caused by the observational study design.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 5","pages":"Pages 318-324"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575048","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":"Response to a letter from Ankur Sharma et al. on the article entitled “Comparative efficacy and safety of intravascular lithotripsy versus rotational atherectomy in coronary artery calcification: An updated meta-analysis”","authors":"Abdul Mueez Alam Kayani","doi":"10.1016/j.acvd.2026.01.004","DOIUrl":"10.1016/j.acvd.2026.01.004","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 5","pages":"Page 369"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138102","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":"Associated diseases and diuretic dosage to predict mortality in transthyretin amyloid cardiomyopathy","authors":"Vincent Algalarrondo ,&nbsp;Olivier Lairez ,&nbsp;Marion Narbeburu ,&nbsp;Pauline Fournier ,&nbsp;Jerome Costa ,&nbsp;Francoise Pelcot ,&nbsp;Agnes Farrugia ,&nbsp;Isabelle Durand-Zaleski ,&nbsp;Herve Lilliu ,&nbsp;Mathilde Bartoli ,&nbsp;Stephane Fievez ,&nbsp;Jeremie Rudant ,&nbsp;Agathe Coste ,&nbsp;Charlotte Noirot Cosson ,&nbsp;Pierre Alexandre Squara ,&nbsp;Giorgia Canali ,&nbsp;Bertrand de Neuville ,&nbsp;Michel S. Slama ,&nbsp;Philippe Charron ,&nbsp;Thibaud Damy","doi":"10.1016/j.acvd.2025.10.333","DOIUrl":"10.1016/j.acvd.2025.10.333","url":null,"abstract":"<div><h3>Background</h3><div>Transthyretin amyloidosis can lead to transthyretin amyloid cardiomyopathy (ATTR-CM) and heart failure.</div></div><div><h3>Aims</h3><div>To describe the prevalence of cardiac and extracardiac diseases in patients with ATTR-CM and examine mortality predictors, including diuretic dosage, using the French National Health Database.</div></div><div><h3>Methods</h3><div>Patients with ATTR-CM and their medical characteristics were identified from the French database from 2011 to 2019. Diuretic doses were categorized into four classes (furosemide dose: level 1<!--> <!-->&lt;<!--> <!-->20<!--> <!-->mg; level 2 20 to &lt;<!--> <!-->60<!--> <!-->mg; level 3 60 to<!--> <!-->&lt;<!--> <!-->120<!--> <!-->mg; level 4 ≥<!--> <!-->120<!--> <!-->mg). Predictive factors for mortality were examined.</div></div><div><h3>Results</h3><div>Of 7804 patients with ATTR-CM, 33.0% were on level 1 diuretics, 25.8% on level 2, 15.8% on level 3 and 25.3% on level 4 at diagnosis. Leading extracardiac conditions included kidney disease (37.0%), diabetes (29.5%), neurologic disorders (17.9%), gastrointestinal disorders (15.7%) and musculoskeletal conditions (11.8%). Median (95% confidence interval [CI]) survival was 3.1 (3.0–3.3) years. Multivariable analysis identified age at diagnosis (hazard ratio [HR] 1.482, 95% CI 1.400–1.558), male sex (HR 1.258, 95% CI 1.125–1.406), diuretic dose (HR 1.380, 95% CI 1.315–1.449), heart failure (HR 1.251, 95% CI 1.090–1.437), arrhythmia/conduction disorder (HR 1.143, 95% CI 1.001–1.306), kidney disease (HR 1.224, 95% CI 1.104–1.358), gastrointestinal disorder (HR 1.143, 95% CI 1.000–1.307) and diabetes (HR 1.192, 95% CI 1.071–1.326) as significantly associated with mortality.</div></div><div><h3>Conclusion</h3><div>Patients with ATTR-CM face a significant burden of associated diseases requiring comprehensive management alongside their ATTR-CM treatment. Beyond addressing these comorbidities, diuretic dosage emerges as a pivotal prognostic indicator.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 5","pages":"Pages 341-347"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042102","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":"Transcatheter aortic valve implantation-related vascular access complications: Are balloon-expandable stent grafts a good option?","authors":"Gabriel Saiydoun ,&nbsp;Romain Gallet ,&nbsp;Saadé Saadé ,&nbsp;Madjid Boukantar ,&nbsp;Camille Brasselet ,&nbsp;Paul-Mathieu Chiaroni ,&nbsp;Costin Radu ,&nbsp;Nicolas Lellouche ,&nbsp;Ziyad Gunga ,&nbsp;Thierry Folliguet ,&nbsp;Emmanuel Teiger","doi":"10.1016/j.acvd.2025.10.329","DOIUrl":"10.1016/j.acvd.2025.10.329","url":null,"abstract":"<div><h3>Background</h3><div>Among the most challenging complications of transfemoral transcatheter aortic valve implantation (TF-TAVI) are vascular access complications (VACs), with access-site bleeding frequently impacting outcomes despite preclosing techniques. Endovascular bailout strategies have become increasingly common despite historical concerns about stent placement in flexing zones.</div></div><div><h3>Aims</h3><div>To evaluate the efficacy and safety of balloon-expandable stent graft (BESG) implantation for VACs in patients undergoing TF-TAVI with a preclosure device.</div></div><div><h3>Methods</h3><div>This retrospective single-centre study included all consecutive patients who underwent TF-TAVI between January 2010 and December 2020. BESG implantation was used for persistent femoral bleeding following closure failure. Baseline, procedural and clinical data were compared between BESG recipients and controls in accordance with Valve Academic Research Consortium 3 (VARC-3) criteria.</div></div><div><h3>Results</h3><div>Among 1248 patients (mean<!--> <!-->±<!--> <!-->standard deviation age 83.1<!--> <!-->±<!--> <!-->7.3 years; 52.3% female), 225 (18.0%) had persistent femoral bleeding, and 98 (7.8%) required BESG implantation. Compared with controls, patients with BESG had larger sheath sizes (e.g. size 18 Fr: 73.5% vs 47.8%, <em>P</em> <!-->&lt;<!--> <!-->0.001) and higher contrast use (199.2<!--> <!-->±<!--> <!-->81.9 vs 150.1<!--> <!-->±<!--> <!-->64.0<!--> <!-->mL, <em>P</em> <!-->&lt;<!--> <!-->0.001). At 1 year, the composite endpoint of all-cause death, vascular reintervention or new-onset claudication occurred in 34.7% of patients with BESG and 29.0% of controls (<em>P</em> <!-->=<!--> <!-->0.24). After propensity matching, outcomes remained comparable (risk ratio 0.98, 95% confidence interval 0.58-1.65; <em>P</em> <!-->=<!--> <!-->0.95).</div></div><div><h3>Conclusion</h3><div>In this retrospective single-centre cohort, BESG implantation appeared to be safe and may be an effective fully percutaneous bailout option for access-site bleeding after TF-TAVI.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 5","pages":"Pages 325-332"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727197","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":"Meta-analysis of the role of cardiac magnetic resonance in laminopathy","authors":"Sina Shahshenas ,&nbsp;Arash Anissian ,&nbsp;Mohammadreza Jalali Nadoushan ,&nbsp;Masood Soltanipur","doi":"10.1016/j.acvd.2026.02.003","DOIUrl":"10.1016/j.acvd.2026.02.003","url":null,"abstract":"<div><div>Lamin A/C (<em>LMNA</em>) cardiomyopathy is an inherited form of dilated cardiomyopathy associated with high rates of arrhythmias, conduction disease and sudden cardiac death, often preceding overt heart failure. Although LMNA mutations account for a minority of dilated cardiomyopathy cases, they portend a particularly malignant course. Cardiac magnetic resonance (CMR) imaging, particularly the detection of late gadolinium enhancement, has emerged as a valuable tool for assessing myocardial fibrosis and risk stratification in laminopathy. This study aims to systematically evaluate the structural, functional and prognostic CMR features in LMNA mutation carriers, and to quantify the diagnostic and clinical implications of myocardial fibrosis. A comprehensive literature search was conducted through June 2025. Studies involving genetically confirmed LMNA mutation carriers with CMR data were included. Outcomes included ventricular variables (left ventricular ejection fraction, left ventricular end-diastolic volume index, left ventricular end-systolic volume index, left ventricular wall mass index), late gadolinium enhancement (LGE) presence and arrhythmic events. Between-group comparisons were made: LMNA cardiomyopathy versus healthy controls; laminopathy with versus without LGE; and LMNA-positive versus LMNA-negative cardiomyopathy. We identified 10 studies involving 847 individuals. The LGE risk ratio for patients with LMNA cardiomyopathy versus healthy controls was 14.39 (<em>P</em> <!-->&lt;<!--> <!-->0.001); the LGE risk ratio for patients with LMNA-positive versus LMNA-negative cardiomyopathy was 2.14 (<em>P</em> <!-->&lt;<!--> <!-->0.001). In patients with laminopathy, LGE was associated with an increased risk of atrioventricular block (risk ratio 6.94; <em>P</em> <!-->=<!--> <!-->0.004) and a trend towards more ventricular tachyarrhythmia (risk ratio 3.32; <em>P</em> <!-->=<!--> <!-->0.056). Despite these fibrotic changes, left ventricular volumes and wall mass did not differ significantly from controls. CMR imaging identifies a high burden of fibrosis in LMNA cardiomyopathy, even in early disease, with strong prognostic implications. LGE presence is a key risk marker for arrhythmia and conduction disease, supporting early imaging-based risk stratification and possible preventive implantable cardioverter-defibrillator implantation in mutation carriers.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 5","pages":"Pages 357-367"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678783","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":"Mental health and cardiovascular disease: A significant reciprocal impact","authors":"Jean-Jacques Monsuez","doi":"10.1016/j.acvd.2025.11.007","DOIUrl":"10.1016/j.acvd.2025.11.007","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 5","pages":"Pages 315-317"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696432","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":"Contemporary management of patients with native mitral regurgitation in heart valve centres","authors":"Augustin Coisne ,&nbsp;Andrea Scotti ,&nbsp;Yohann Bohbot ,&nbsp;Julien Dreyfus ,&nbsp;Anne Bernard ,&nbsp;Yoan Lavie Badie ,&nbsp;Natacha Rousse ,&nbsp;Arnaud Sudre ,&nbsp;Christophe Tribouilloy ,&nbsp;Marcel Peltier ,&nbsp;Sebastian Ludwig ,&nbsp;Bertrand Marcheix ,&nbsp;Damien Eyharts ,&nbsp;Matthieu Steinecker ,&nbsp;Mohammed Nejjari ,&nbsp;Marie Luciani ,&nbsp;Christophe Saint Etienne ,&nbsp;Julien Ternacle ,&nbsp;Guillaume Bonnet ,&nbsp;Guillaume L’Official ,&nbsp;Thomas Modine","doi":"10.1016/j.acvd.2025.10.332","DOIUrl":"10.1016/j.acvd.2025.10.332","url":null,"abstract":"<div><h3>Background</h3><div>Despite a key role in the latest guidelines, the screening process of patients with mitral regurgitation (MR) referred to Heart Valve Centres (HVCs) remains unexplored.</div></div><div><h3>Aims</h3><div>To investigate characteristics, management and outcomes of patients with native MR referred to HVCs.</div></div><div><h3>Methods</h3><div>Between January 2017 and May 2021, all patients with MR referred to seven French HVCs for medico-surgical evaluation were included. Individual management was left to the local interdisciplinary HVC. Patients eligible to mitral valve (MV) intervention were compared with those deemed ineligible and left on medical therapy. The primary endpoint was 2-year all-cause mortality.</div></div><div><h3>Results</h3><div>After exclusion for treatment refusal or non-MV surgery, a total of 823 patients were analysed: 662 eligible versus 161 ineligible to MV intervention. Among the 662 eligible patients, 382 (57.7%) underwent transcatheter edge-to-edge repair, 215 (32.5%) MV surgery, 40 (6.0%) transcatheter MV replacement and 25 (3.8%) were either on the waiting list at the end of follow-up (<em>n</em> <!-->=<!--> <!-->12) or had died before intervention (<em>n</em> <!-->=<!--> <!-->13). Ineligible patients had higher surgical risk scores (median EuroSCORE II 4.2% vs. 3.3%; <em>P</em> <!-->=<!--> <!-->0.003; median Society of Thoracic Surgeons mortality risk score 4.3% vs. 3.5%; <em>P</em> <!-->=<!--> <!-->0.023) and more advanced left ventricular (LV) impairment (mean LV ejection fraction 49.7% vs. 56.6%; <em>P</em> <!-->&lt;<!--> <!-->0.001). At 2<!--> <!-->years, all-cause mortality was significantly higher in ineligible versus eligible patients (36.3% vs. 18.0%; <em>P</em> <!-->&lt;<!--> <!-->0.0001). After multivariable adjustment, HVC-defined eligibility for MV intervention was associated with lower 2-year mortality (hazard ratio: 0.54, 95% confidence interval: 0.35–0.84; <em>P</em> <!-->=<!--> <!-->0.006).</div></div><div><h3>Conclusion</h3><div>HVC interdisciplinary evaluation of severe native MR results in MV intervention in most cases. Eligibility for MV intervention was associated with lower risk of 2-year mortality.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 5","pages":"Pages 333-340"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783390","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":"Refining the phenotype of patients with atrial fibrillation and spontaneous restoration of sinus rhythm","authors":"Lucile Ducousso-Balouzet ,&nbsp;Ariel Cohen ,&nbsp;Kimia Sadreddini ,&nbsp;Stephane Ederhy ,&nbsp;Sylvie Lang ,&nbsp;Johann Reisberg ,&nbsp;Pierre-Antoine Le Bos ,&nbsp;Emmanuel Patte ,&nbsp;Lucas Benoudiba-Campanini ,&nbsp;Claire Boivineau ,&nbsp;Nasser Ferrouk ,&nbsp;Elodie Capderou ,&nbsp;Iris Benhamou-Tarallo ,&nbsp;Maharajah Ponnaiah ,&nbsp;Clément Davril ,&nbsp;Marine Thuillot ,&nbsp;Guillaume Bailly ,&nbsp;Christopher Malhaire ,&nbsp;Franck Boccara ,&nbsp;Stéphane Hatem ,&nbsp;Laurie Soulat-Dufour","doi":"10.1016/j.acvd.2025.09.003","DOIUrl":"10.1016/j.acvd.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>In atrial fibrillation (AF), few studies have focused on the influence of the mode of restoration of sinus rhythm (SR) on cardiac cavities remodelling, especially after spontaneous restoration.</div></div><div><h3>Objectives</h3><div>To determine the phenotype of patients with AF and spontaneous restoration of SR.</div></div><div><h3>Methods</h3><div>We prospectively studied 184 patients hospitalized for AF with restoration of SR at 6-month follow-up. Patients were divided into two groups at 6 months according to the type of restoration of SR: spontaneous (Spontaneous SR group; <em>n</em> <!-->=<!--> <!-->57) or active (pharmacological and/or electrical and/or ablation; Active SR group; <em>n</em> <!-->=<!--> <!-->127). Each patient underwent comprehensive clinical, biological and two-dimensional (2D) transthoracic echocardiography studies at 6-month follow-up. 2D parameters, including strain parameters, were analysed offline using Ultrasound Workspace software (Philips).</div></div><div><h3>Results</h3><div>At 6-month follow-up, 111 patients (60.3%) were male, the median (interquartile range) age was 66.7 (55.6–73.4) years and 48 (26.1%) had a CHA₂DS₂-VA score<!--> <!-->≥<!--> <!-->2. On univariate analysis, the Spontaneous SR group had lower body surface area, less heart failure (HF) associated with AF, lower glycated haemoglobin, lower B-type natriuretic peptide and higher high-density lipoprotein cholesterol than the Active SR group at 6-month follow-up. Concerning the echocardiographic evaluation, the Spontaneous SR group had lower biplane left atrial (LA) volume, higher LA reservoir, conduit and contractile strains, and higher right ventricular free wall strain than the Active SR group at 6-month follow-up. Lower body surface area (odds ratio [OR] 0.79 per 0.1 m² increase, 95% confidence interval [CI] 0.65–0.95; <em>P</em> <!-->=<!--> <!-->0.012), absence of HF associated with AF (OR 0.17 for HF, 95% CI 0.05–0.54; <em>P</em> <!-->=<!--> <!-->0.003) and higher LA reservoir strain (OR 1.21 per 5% increase, 95% CI 1.02–1.45; <em>P</em> <!-->=<!--> <!-->0.028) remained significantly associated with spontaneous restoration of SR after multivariable adjustment.</div></div><div><h3>Conclusions</h3><div>Spontaneous restoration of SR corresponds to a distinct phenotypic group of patients with AF with less atrial remodelling. LA reservoir strain appears to be an interesting biomarker for differentiating the degree of atrial remodelling. Further investigations are warranted to determine the impact of such abnormalities on the risk of AF recurrence and cardiovascular events.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 5","pages":"Pages 348-356"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395278","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}