Archives of Cardiovascular Diseases最新文献

{"title":"Transcatheter edge-to-edge repair of tricuspid valve regurgitation in systemic right ventricle: Echocardiographic outcome","authors":"Y. Benadjaoud ,&nbsp;P. Guerin ,&nbsp;Z. Jalal ,&nbsp;L. Le Gloan ,&nbsp;J.B. Thambo ,&nbsp;X. Iriart","doi":"10.1016/j.acvd.2025.04.032","DOIUrl":"10.1016/j.acvd.2025.04.032","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter edge-to-edge repair (TEER) provides an alternative option for high risk patients with systemic tricuspid regurgitation (STR). Preliminary data of the French study has shown its feasibility and safety, but mid-term echocardiographic outcome is lacking.</div></div><div><h3>Objectives</h3><div>Echocardiographic outcome of TEER in systemic tricuspid regurgitation.</div></div><div><h3>Methods</h3><div>TEER French cohort is a multicentre, longitudinal, descriptive, prospective study of patients undergoing TEER for severe STR. 20 patients with severe or greater STR undergoing percutaneous repair with the MitraClip system were enrolled in the study between May 2019 and November 2024. A transthoracic echocardiography was performed at baseline, six months, one year and two years after the procedure. TR was assessed using standard 2-dimensional color Doppler methods and graded TR using the 5-class grading scheme: mild, moderate, severe, massive, and torrential. The number of clips and their localization was analyzed.</div></div><div><h3>Results</h3><div>A reduction of at least 1 grade in TR was achieved in all subjects. TR grade remained moderate or less in 83% of patients at 2-years follow-up. TR reduction was sustained at 2-years follow-up for all patients. Among 14 patients, 5 patients had one-clip implantation, and 9 patients had two or more clips implantation. TR grade seemed to be lower in the group of patient with 2 or more clips strategy: TR was mild in 67% of patients in 2 or more clips group and moderate in 100% of patients in 1-clip group.</div></div><div><h3>Conclusion</h3><div>TEER of systemic tricuspid regurgitation is found to be safe and effective, with sustained effects at 2 years in patients. Patients with two or more clips implantation seem to have a better outcome in the regurgitation grade, but additional data and a bigger cohort are needed to predict the outcome and define the optimal technical strategy.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S234-S235"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167446","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 reservoir strain in ischemic stroke","authors":"A. Maamri","doi":"10.1016/j.acvd.2025.04.035","DOIUrl":"10.1016/j.acvd.2025.04.035","url":null,"abstract":"<div><h3>Background</h3><div>The search for a potential cardiac source is a fundamental step in the urgent evaluation of an ischaemic stroke (IS). The most common cardioembolic cause of IS is atrial fibrillation (AF). Recent studies have demonstrated the superiority of left atrial function versus LA dimensions as a predictor of paroxysmal AF, especially with the study of deformation anomalies using 2D Speckle-Tracking. Alteration of the reservoir strain (RS) of the left atrium (LA) is associated with the incidence of IS.</div></div><div><h3>Objectives</h3><div>The aims were to identify the association between RS with the embolic origin (cardioembolic and ESUS) of a IS/TIA, as well as the association of RS with the occurrence of AF, in patients with no known AF prior to their stroke nor anticoagulation treatment.</div></div><div><h3>Methods</h3><div>This is a retrospective observational study in patients hospitalised at the neurology service for IS or transitor (TIA) from January 2022 to April 2023, with no history of AF nor anticoagulation treatment and ho had had transthoracic echocardiography (TTE). We compared embolic (cardioembolic and ESUS) groupe versus non embolic and left reservoir strain<!--> <!-->&lt;<!--> <!-->20% groupe versus<!--> <!-->&gt;<!--> <!-->20% groupe.</div></div><div><h3>Results</h3><div>79 patients were included, 56% of whom were men, with an median age of 72 years. The mean RS was 27% and the RS was<!--> <!-->&lt;<!--> <!-->39% in 86% of cases. 39% of strokes were Cryptogenic (of which 26% were TIA), 23% Cardio-embolic, 14% ESUS. Among the cardioembolic causes (18 patients): 33% were secondary to AF, 39% to PFO, 16% to severe LV dysfunction. With a threshold of 20% and p value 0.012, the RS demonstrate a significant association with embolic stroke (group PFO excluded). RS<!--> <!-->&lt;<!--> <!-->20% was significantly associated with the occurence of AF with <em>P</em>-value 0.040.</div></div><div><h3>Conclusion</h3><div>Our study found that a left atrial reservoir strain<!--> <!-->&lt;<!--> <!-->20%, measured on echocardiography, in the acute phase of an IS, in patients with no history of AF or anticoagulant treatment.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S236"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167449","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":"Pulmonary embolism in COVID-19 patients in intensive care: Risk factors, management, and prognosis","authors":"El Mahi,&nbsp;A. Arous","doi":"10.1016/j.acvd.2025.04.036","DOIUrl":"10.1016/j.acvd.2025.04.036","url":null,"abstract":"<div><h3>Background</h3><div>While COVID-19 primarily affects the respiratory system, its impact extends far beyond. Increasing evidence highlights its role in triggering severe thrombotic complications, particularly pulmonary embolism. By worsening hypoxemia and further impairing respiratory function, PE can significantly deteriorate the prognosis of critically ill patients in intensive care. Understanding its incidence, risk factors, and clinical outcomes is essential to improving survival rates.</div></div><div><h3>Objectives</h3><div>Assess the incidence of PE in COVID-19 in intensive care, identify associated risk factors, and evaluate its impact on mortality.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted in the ICU of CHU Ibn Rochd in Casablanca between 2020 and 2022. It included 108 patients hospitalized for severe COVID-19 confirmed by PCR, all undergoing clinical, biological, and radiological follow-up. PE was diagnosed through CT pulmonary angiography. D-dimer and other biological markers were analyzed, and statistical assessments were performed to examine correlations between thromboembolic complications and mortality.</div></div><div><h3>Results</h3><div>PE was diagnosed in 21 patients (19.6%), with 84% showing elevated D-dimer levels. The overall mortality rate was 60.2%, with PE directly involved in 15.7% of deaths. Multivariate analysis identified several independent mortality risk factors, including advanced age, male sex, acute respiratory distress syndrome, septic shock, and thromboembolic complications. While corticosteroid therapy helped reduce pulmonary inflammation, it was linked to worsening respiratory distress in 32.7% of patients.</div></div><div><h3>Conclusion</h3><div>PE is a severe complication in critical COVID-19 cases, with high mortality. Early monitoring of <span>d</span>-dimer levels and personalized anticoagulation are key to improving outcomes.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S236"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167450","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":"Comparison between cardiac magnetic resonance and echocardiography to evaluate risk of post-operative left ventricular dysfunction in primary mitral regurgitation","authors":"A. Altes ,&nbsp;V. Hanet ,&nbsp;I. Belhakia ,&nbsp;N. Selin ,&nbsp;D. Vancraeynest ,&nbsp;A. Pasquet ,&nbsp;F. Delelis ,&nbsp;M. Toledano ,&nbsp;V. Silvestri ,&nbsp;B. Gerber ,&nbsp;S. Marechaux","doi":"10.1016/j.acvd.2025.04.046","DOIUrl":"10.1016/j.acvd.2025.04.046","url":null,"abstract":"<div><h3>Background</h3><div>Among patients with primary mitral regurgitation (MR) undergoing mitral valve (MV) surgery, some are at an increased risk of developing postoperative left ventricular (LV) dysfunction. It remains unclear whether CMR-assessed LV volumes and function offer advantages over echocardiographic measurements in identifying patients at risk of LV systolic dysfunction after MV surgery.</div></div><div><h3>Objectives</h3><div>We sought to compare relations between preoperative LV characteristics assessed by cardiac magnetic resonance imaging (CMR) or echocardiography (Echo) and risk of post-operative LV systolic dysfunction in primary MR patients.</div></div><div><h3>Methods</h3><div>The study population included 223 patients (median age: 60 years, 21% women) with chronic significant primary MR who underwent Echo and CMR before MV repair surgery. The primary endpoint was post-operative LV dysfunction (LV ejection fraction [EF]<!--> <!-->&lt;<!--> <!-->50%).</div></div><div><h3>Results</h3><div>Forty-one (18%) patients had post-operative LV dysfunction (median follow-up time 8.7 [IQR: 6.7–12.5] months). These patients exhibited higher LV end-systolic diameters (ESD) and volumes (ESV) (all <em>P</em> <!-->≤<!--> <!-->0.009), lower CMR-LVEF (<em>P</em> <!-->=<!--> <!-->0.003), and a trend for lower Echo-LVEF (<em>P</em> <!-->=<!--> <!-->0.072). Optimal threshold values for LV characteristics associated with post-operative LV dysfunction were: LVESD<!--> <!-->≥<!--> <!-->36<!--> <!-->mm, indLVESD<!--> <!-->≥<!--> <!-->19<!--> <!-->mm/m², Echo-indLVESV<!--> <!-->≥<!--> <!-->40<!--> <!-->ml/m², Echo-LVEF<!--> <!-->≤<!--> <!-->63%, CMR-indLVESV<!--> <!-->≥<!--> <!-->45<!--> <!-->ml/m² and CMR-LVEF<!--> <!-->≤<!--> <!-->59%. Their AUCs ranged from 0.59 (0.49–0.68) (Echo-LVEF) to 0.70 (0.61–0.78) (Echo-indLVESD), without significant differences in pairwise comparisons (all <em>P</em> <!-->&gt;<!--> <!-->0.081). A preoperative echocardiographic assessment using combinations of LVESD, indLVESD, Echo-indLVESV, and Echo-LVEF provided similar diagnostic accuracy to a CMR-based assessment using CMR-indLVESV and CMR-LVEF (<span><span>Figure 1</span></span>, <span><span>Figure 2</span></span>, <span><span>Figure 3</span></span>).</div></div><div><h3>Conclusion</h3><div>In this cohort of patients with significant primary MR undergoing MV surgery, preoperative Echo and CMR LV volumetric and functional characteristics were comparably effective to detect those at higher risk for post-operative LV systolic dysfunction.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S244"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167526","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 the left-to-right ventricular ratio and aortic regurgitation severity: An echocardiographic and cardiac magnetic resonance imaging study","authors":"B. Cardot ,&nbsp;V. Hanet ,&nbsp;D. Vancraeynest ,&nbsp;A. Pasquet ,&nbsp;F. Delelis ,&nbsp;A. Lebouazda ,&nbsp;F. Tartare ,&nbsp;D. Tristram ,&nbsp;M. Toledano ,&nbsp;V. Silvestri ,&nbsp;B. Gerber ,&nbsp;S. Marechaux ,&nbsp;A. Altes","doi":"10.1016/j.acvd.2025.04.047","DOIUrl":"10.1016/j.acvd.2025.04.047","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular (LV) dilation in chronic significant aortic regurgitation (AR) is commonly assessed using LV diameters and volumes, but these metrics are influenced by body surface area, sex, and age. We hypothesized that the left-to-right ventricular end-diastolic volume ratio (LV/RV ratio), which remains close to 1 in healthy individuals, could provide a more individualized assessment of adverse LV remodeling in AR patients.</div></div><div><h3>Objectives</h3><div>We investigated the relationship between the LV/RV ratio, conventional LV metrics, and AR severity.</div></div><div><h3>Methods</h3><div>This bi-center study included 258 patients (median age: 55 years, 18% female) with at least chronic moderate AR, assessed using echocardiography (Echo) and cardiac magnetic resonance imaging (CMR). LV and RV volumes were measured from short-axis steady-state free precession cine-CMR images. The relationships between the LV/RV ratio, conventional LV metrics, and AR severity (Significant AR: grade 3-4 [Echo], Regurgitant fraction<!--> <!-->≥<!--> <!-->33% [CMR]) were analyzed using area under the curve (AUC) and logistic regression models.</div></div><div><h3>Results</h3><div>The median LV/RV ratio was 1.54 [1.30; 1.88], with no significant difference by age or sex. A strong association was observed between the LV/RV ratio and significant AR, assessed by Echo (AUC 0.75, 95% CI [0.68–0.82]) and CMR (AUC 0.82, 95% CI [0.76–0.87]), remaining significant after adjustment for age and sex (Echo: OR 3.57, 95% CI [2.12–6.02], <em>P</em> <!-->&lt;<!--> <!-->0.001; CMR: OR 5.55, 95% CI [3.41–9.02], <em>P</em> <!-->&lt;<!--> <!-->0.001). The LV/RV ratio correlated more strongly with CMR AR-RegFrac (<em>r</em> <!-->=<!--> <!-->0.66, <em>P</em> <!-->&lt;<!--> <!-->0.001) than conventional LV metrics and showed superior diagnostic performance, with a threshold of 1.5 identifying significant AR (<span><span>Figure 1</span></span>, <span><span>Figure 2</span></span>).</div></div><div><h3>Conclusion</h3><div>In chronic AR patients, the LV/RV ratio showed a stronger association with AR severity assessed by Echo and CMR than conventional LV metrics. These findings suggest its potential as an individualized marker for adverse LV remodeling in chronic AR, warranting further studies on its relationship with clinical outcomes.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S245"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167527","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 expanding role of Nurse Practitioners in optimizing heart failure treatment","authors":"P.E. Astie ,&nbsp;L. Filippetti ,&nbsp;N. Girerd","doi":"10.1016/j.acvd.2025.04.040","DOIUrl":"10.1016/j.acvd.2025.04.040","url":null,"abstract":"<div><h3>Background</h3><div>Achieving optimal care for heart failure (HF) remains challenging in clinical practice, with a significant proportion of HF patients not receiving guideline-recommended treatments.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the role of Nurse practitioner (NP)-Enhanced Therapeutic Management on therapeutic management after discharge of patients hospitalized for acute HF.</div></div><div><h3>Methods</h3><div>We studied 187 consecutive patients hospitalized for acute HF with LVEF<!--> <!-->&lt;<!--> <!-->50% in our Cardiology department in 2022–2023. Patients were analyzed whether they underwent a classic follow-up by a cardiologist alone or a cardiologist associated with a NP, who was qualified to provide patient education and adjust heart failure medications. The association of NP-enhanced follow-up on HF medication dosages (assessed via the KCMO score) and the composite outcome of all-cause mortality and HF readmission was evaluated at the first post-discharge consultation and 6 months later.</div></div><div><h3>Results</h3><div>Fifty-five patients underwent combined monitoring by NPs and cardiologists and 132 monitoring by cardiologists alone. KCMO score progression was significantly more important in the “NP<!--> <!-->+<!--> <!-->cardiologist group” (ΔKCMO 11.5 vs 1.4 with a mean difference of 9.83 [3.01 to 16.65]; <em>P</em> <!-->=<!--> <!-->0.005). Patients in the “NP<!--> <!-->+<!--> <!-->cardiologist” monitoring group received more non-pharmacological care for HF, including home-visiting programs (94.5% vs 34.4%; <em>P</em> <!-->&lt;<!--> <!-->0.0001), telemonitoring (83.6% vs 16.2%; <em>P</em> <!-->&lt;<!--> <!-->0.0001), and therapeutic patient education (43.6% vs 6.1%; <em>P</em> <!-->&lt;<!--> <!-->0.0001), compared to usual follow-up. Composite criteria was 50% lower in the “NP<!--> <!-->+<!--> <!-->cardiologist” group six months after discharge (HR, 0.50 [95% CI, 0.27–0.93]; <em>P</em> <!-->=<!--> <!-->0.028) (<span><span>Figure 1</span></span>, <span><span>Figure 2</span></span>, <span><span>Figure 3</span></span>).</div></div><div><h3>Conclusion</h3><div>NP-enhanced management is associated with a more rapid up-titration of HF GDMT and higher inclusions in non-pharmaceutical care programs six months after discharge for acute HF.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S239"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167541","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":"Evaluation of left atrial characteristics and its impact on Prognosis in ESUS Patients: Insights from a cohort of AIS patients treated with mechanical thrombectomy or thrombolysis","authors":"M. Touma ,&nbsp;C. Bergerot ,&nbsp;T. Barret ,&nbsp;J. Fort ,&nbsp;C. Haddad ,&nbsp;L. Mechtouff ,&nbsp;H. Thibault","doi":"10.1016/j.acvd.2025.04.034","DOIUrl":"10.1016/j.acvd.2025.04.034","url":null,"abstract":"<div><h3>Background</h3><div>Embolic strokes of undetermined source (ESUS) represent 1/6 ischemic stroke (IS) and have high recurrence rate. Their physiopathology is not fully understood. Studying ESUS patients and their left atrial (LA) characteristics may lead to more specific management strategies.</div></div><div><h3>Objectives</h3><div>To compare characteristics and prognosis of ESUS patients to those with atrial fibrillation (AF) and non-atrial causes, and to identify factors associated with MACE.</div></div><div><h3>Methods</h3><div>This study included patients with IS who underwent thrombectomy or thrombolysis and were followed for 1 year. Patients were classified by stroke etiology. The ESUS group was compared to AF (permanent and non-permanent) and a non-atrial causes group. Factors associated with MACE (overall mortality, stroke recurrence, and hospitalization for heart failure) were analyzed.</div></div><div><h3>Results</h3><div>The study included 337 patients: 64 with permanent and 84 with non-permanent AF, 106 with non-atrial causes, and 83 with ESUS. ESUS patients were older than the non-atrial group but younger than the AF groups. No difference was found in ECG LA myopathy criteria. Echocardiographic parameters showed the ESUS group was closer to the non-atrial group, with less LA remodeling, and significantly lower minimal and maximal indexed LA volumes and better strains in the three components than the AF groups. Reservoir strain in ESUS patients had a heterogeneous distribution (<span><span>Fig. 1</span></span>). The ESUS group had the worst prognosis. Factors associated with MACE were age, stroke history, peripheral artery disease, high blood pressure, inter-atrial blocks, and LV ejection fraction. LA strain tended to be associated with MACE.</div></div><div><h3>Conclusion</h3><div>In our cohort, the ESUS group presented less LA remodeling and dysfunction than the AF groups and were more similar to the non-atrial causes group. This could explain the lack of benefit from systematic anticoagulation treatments reported in ESUS groups. Further research is needed to better characterize this heterogeneous group.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S235-S236"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167448","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":"Functional versus anatomical method for defining the LV base by CMR in Barlow's disease: What is the best approach for quantifying mitral regurgitation?","authors":"S. Leboube ,&nbsp;A. Panagiotis ,&nbsp;D. Auberson ,&nbsp;G. Tzimas ,&nbsp;A. Masi ,&nbsp;S. Hugelshofer ,&nbsp;J. Schwitter ,&nbsp;O. Muller ,&nbsp;P. Monney","doi":"10.1016/j.acvd.2025.04.048","DOIUrl":"10.1016/j.acvd.2025.04.048","url":null,"abstract":"<div><h3>Background</h3><div>In bileaflet mitral valve prolapse (BMVP), Doppler-based echocardiographic quantification techniques of mitral regurgitation (MR) severity may be inaccurate and volumetric assessment by Cardiac Magnetic Resonance (CMR), might better reflect volume overload. However, the optimal method for measuring Left Ventricular End Systolic Volume (LVESV) in the presence of severe prolapse is unknown. Indeed, at end-systole, the LV base can either be defined at the annulus (functional method) or at the leaflets’ level (anatomical method).</div></div><div><h3>Objectives</h3><div>We aimed to compare these two methods and their association with post-surgical cardiac remodeling.</div></div><div><h3>Methods</h3><div>Consecutive patients referred for evaluation of MR were assessed with echocardiography and/or CMR at baseline and patients were invited to repeat CMR within 12 months of surgical repair/replacement (when performed). Only patients with BMVP were analyzed. Mitral regurgitant volume was calculated using direct quantitative method with LVESV measured either at the annulus or at the leaflets, and the respective correlations with the absolute reduction in LV end-diastolic volume after surgery were compared (<span><span>Figure 1</span></span>, <span><span>Figure 2</span></span>).</div></div><div><h3>Results</h3><div>Among 33 BMVP patients included, 14 eventually underwent surgery and 11 had both pre- and post-operative CMR. Pre-operative LVEF was 59.5<!--> <!-->±<!--> <!-->5.6% in the functional group versus 49.1<!--> <!-->±<!--> <!-->8.2% in the anatomical group. The mitral Regurgitant Volume (MRV) was overestimated by 23.8<!--> <!-->±<!--> <!-->14.5<!--> <!-->ml in the functional compared to the anatomical group (<span><span>Fig. 1</span></span>). Only the anatomical measure of the MRV was significantly correlated with post-operative left ventricular remodeling (<em>r</em> <!-->=<!--> <!-->0.65, <em>P</em> <!-->&lt;<!--> <!-->0.05) (<span><span>Fig. 2</span></span>).</div></div><div><h3>Conclusion</h3><div>Our results indicate a better ability to predict post-surgical LV remodeling with the anatomical compared to the functional method in BMVP. The anatomical method may be the method of choice for the quantification of MR severity with CMR in BMVP but these preliminary results need to be confirmed in a larger cohort.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S245-S246"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167540","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":"Comite scientifique","authors":"","doi":"10.1016/S1875-2136(25)00305-5","DOIUrl":"10.1016/S1875-2136(25)00305-5","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page iv"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167389","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":"Impact of elevated transmitral mean gradient on cardiovascular outcomes after transcatheter mitral valve implantation","authors":"C. Chong-Nguyen,&nbsp;P. Duvillier,&nbsp;E. Brochet,&nbsp;A. Cailliau,&nbsp;C. Delhomme,&nbsp;N. El Beze,&nbsp;D. Himbert,&nbsp;B. Iung,&nbsp;P. Ou,&nbsp;M. Urena","doi":"10.1016/j.acvd.2025.04.043","DOIUrl":"10.1016/j.acvd.2025.04.043","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter mitral valve implantation (TMVI) has emerged as an alternative to surgery in high-risk patients with failing mitral bioprosthesis (valve-in-valve) or annuloplasties (valve-in-ring).</div></div><div><h3>Objectives</h3><div>We aim to evaluate the prognostic impact of an elevated mean gradient<!--> <!-->&gt;<!--> <!-->5<!--> <!-->mmHg after the procedure.</div></div><div><h3>Methods</h3><div>Patients undergoing TMVI from 2010 to 2024 were classified in three groups according to mean gradient after the procedure: Group 1<!--> <!-->&lt;<!--> <!-->5<!--> <!-->mmHg, Group 2 between 5 and 10<!--> <!-->mmHg and Group 3<!--> <!-->≥<!--> <!-->10<!--> <!-->mmHg.</div></div><div><h3>Results</h3><div>Among the 175 patients included, indications for TMVI were bioprosthesis failure in 131 patients (74.9%) and ring annuloplasty failure in 44 patients (25.1%), with a median age of 69 (52.5–80) and 155 (88.6%) in NYHA class III or IV. 50 patients were in group 1, 111 in group 2 and 14 in group 3, without any difference in baseline characteristics except for age (<em>P</em> <!-->=<!--> <!-->0.02) and hemoglobin level (<em>P</em> <!-->&lt;<!--> <!-->0.001) or procedural findings. At 30 days, the rates of all-cause mortality and rehospitalization for heart failure were similar in the three groups. At a median follow up of 3 years, 43 patients have died (35 for cardiovascular reasons) with a cumulative rate of all-cause mortality at 1 and 2 years of 18.7% and 19.2% respectively. The presence of an elevated mean gradient was not associated with increased risk of mortality (HR 1,11 (0.93–1.31), <em>P</em> <!-->=<!--> <!-->0.25) but associated with an increase risk of cardiovascular mortality with a HR of 1.22 (1.05–1.42), <em>P</em> <!-->=<!--> <!-->0.01) and of heart failure (1.15 (1.01–1.31), <em>P</em> <!-->=<!--> <!-->0.04). At one year, an improvement of NYHA class was observed in the two groups with mean gradient<!--> <!-->&lt;<!--> <!-->10<!--> <!-->mmHg (<em>P</em> <!-->&lt;<!--> <!-->0.01) compared to baseline without any difference for the group 3 (<em>P</em> <!-->=<!--> <!-->0.33). Median sPAP also significantly improved in groups 1 and 2 (<em>P</em> <!-->&lt;<!--> <!-->0.01) compared to baseline without improvement in group 3 (<em>P</em> <!-->=<!--> <!-->1) (<span><span>Figure 1</span></span>, <span><span>Figure 2</span></span>).</div></div><div><h3>Conclusion</h3><div>An elevated mean gradient post-TMVI<!--> <!-->≥<!--> <!-->10<!--> <!-->mmHg was associated with cardiovascular death and hospitalization for heart failure, without significant functional improvement.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S241"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167523","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}