Archives of Cardiovascular Diseases最新文献

{"title":"Long-term risk of ventricular arrhythmia in dilated cardiomyopathy by response to cardiac resynchronization therapy.","authors":"Amine Tazibet, Staniel Ortmans, Charlotte Potelle, Christelle Marquie, Cédric Klein, Laurence Guedon, Eric Verbrugge, Claude Kouakam, François Brigadeau, Didier Klug, Sandro Ninni","doi":"10.1016/j.acvd.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.06.003","url":null,"abstract":"<p><strong>Background: </strong>Improvements in pharmacological treatments and cardiac resynchronization therapy (CRT) raise questions about the benefit of implantable cardioverter defibrillators (ICDs) in non-ischaemic dilated cardiomyopathy (NI-DCM). In this context, the long-term incidence of ventricular arrhythmia events (VAEs) by response to CRT remains under-reported.</p><p><strong>Aims: </strong>To assess the long-term risk of VAE by response to CRT in patients with NI-DCM.</p><p><strong>Methods: </strong>Patients who underwent CRT-defibrillator (CRT-D) implantation for primary prevention of NI-DCM (left ventricular ejection fraction [LVEF]≤35%, bundle branch block>130ms) from February 2002 to January 2020 were retrospectively included. CRT response was defined as an increase in LVEF≥10%, with LVEF≥35% at first transthoracic echocardiography (TTE) evaluation. VAE was defined as a sudden arrhythmic death, sustained ventricular arrhythmia or device-treated ventricular arrhythmia, occurring after the first TTE evaluation.</p><p><strong>Results: </strong>A total of 192 patients (mean age 61years, 68% female, mean LVEF 25%) were included and followed for a median of 91months. Median time to first TTE evaluation after CRT-D implantation was 14months. The overall incidence of VAE was 18.8% (annual rate of 2.9%). CRT response was associated with a reduced risk of VAE (hazard ratio [HR]: 0.27, 95% CI: 0.14-0.55; P<0.001). Super responders to CRT had a lower risk of VAE compared to partial responders (HR: 0.06, 95% CI: 0.02-0.17; P<0.001). Among responders who were VAE free before generator replacement, super responders exhibited a lower incidence of VAE compared to partial responders (HR: 0.13, 95% CI: 0.02-0.82; P=0.04) after generator replacement.</p><p><strong>Conclusion: </strong>In patients with NI-DCM undergoing CRT-D implantation for primary prevention, the CRT response was associated with a 73% decrease in the risk of VAE. Partial responders present a higher rate of VAE compared to super responders, persisting after generator 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":"144565534","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":"Why has a learned society of cardiology created an expert group on artificial intelligence?","authors":"Marc Villaceque, Thierry Garban, Stéphane Lafitte","doi":"10.1016/j.acvd.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.06.001","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531241","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":"Comment on 'Propensity score analysis of very long-term outcome after coronary thrombus aspiration in acute myocardial infarction'.","authors":"Yan Du, Yimao Wu, Kaisen Huang, Xiaojian Deng","doi":"10.1016/j.acvd.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.06.002","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512797","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":"Antithrombotic approach in percutaneous pulmonary valve implantation (PPVI): What is our standard of care? A study endorsed by the Association for European Paediatric and Congenital Cardiology.","authors":"Alessia Callegari, Gianfranco Butera, Thomas Krasemann, Ruth Heying, Ina Michel-Behnke, Damien Bonnet, Sophie Malekzadeh-Milani","doi":"10.1016/j.acvd.2025.04.056","DOIUrl":"10.1016/j.acvd.2025.04.056","url":null,"abstract":"<p><strong>Background: </strong>Despite the widespread adoption of percutaneous pulmonary valve implantation, there remains a lack of consensus on the optimal management of peri-interventional and long-term antithrombotic therapies because of a lack of evidence.</p><p><strong>Aim: </strong>To clarify current practices in peri/postprocedural antithrombotic strategies for percutaneous pulmonary valve implantation.</p><p><strong>Methods: </strong>An online survey was submitted to the Interventional Working Group of the Association for European Paediatric and Congenital Cardiology, and was completed by 76 congenital interventional cardiologists in 2023-2024.</p><p><strong>Results: </strong>Overall, 86% had standardized protocols for anticoagulation/antiaggregation. Intraprocedural heparin administration of 100IU/kg was common (83%), and postprocedural strategies mostly included acetylsalicylic acid (aspirin) (45%) or a combination of antiaggregation and anticoagulation (29%). Long-term strategies comprised antiaggregation (88%), no therapy (11%) and anticoagulation only (1%). Acetylsalicylic acid monotherapy was prescribed by 91%, whereas 9% used dual antiaggregation therapy. Dual antiaggregation therapy was continued for suspicious medical history of thrombotic complication or microthrombi for 3-6 months. Testing for acetylsalicylic acid resistance was infrequent (36%), and only if clinically indicated. When patients had pre-established anticoagulation therapy, 59% changed their strategy. Treatment changes based on valve type were rare (8%). The primary reasons for anticoagulation/antiaggregation were to increase valve longevity (26%) and for both longevity and endocarditis prophylaxis (68%). Acute valve thrombosis was reported in 11 cases.</p><p><strong>Conclusions: </strong>The survey reveals variability in practices after percutaneous pulmonary valve implantation. Most interventional cardiologists prefer acetylsalicylic acid for postprocedural and long-term management, whereas dual antiaggregation therapy is sometimes used in specific cases. Anticoagulation is limited to pre-existing therapy cases or isolated experiences for 3 months.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340724","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":"Revisiting the role of percutaneous coronary intervention in acute coronary syndrome with elevated platelet count - A constructive perspective: A letter in response to the article entitled \"Percutaneous coronary intervention in patients with acute coronary syndromes and increased platelet count\" by Zhang et al.","authors":"Naveed Ahmad, Aleena Mumtaz","doi":"10.1016/j.acvd.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.05.006","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327843","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":"Exploring platelet count thresholds and long-term implications of percutaneous coronary intervention in acute coronary syndromes with thrombocytosis: A letter in response to the article entitled \"Percutaneous coronary intervention in patients with acute coronary syndromes and increased platelet count\" by Zhang et al.","authors":"Yan Du, Yimao Wu, Kaisen Huang, Xiaojian Deng","doi":"10.1016/j.acvd.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.05.005","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487211","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":"Diffuse coronary artery disease: A challenge in diagnosis and treatment.","authors":"Ikram El Marzouki, Gilles Barone-Rochette","doi":"10.1016/j.acvd.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.05.004","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287167","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":"Maintenance or improvement of functional capacity, health status, and quality of life with vutrisiran in patients with transthyretin amyloidosis with cardiomyopathy: Data from the HELIOS-B study","authors":"F.H. Sheikh ,&nbsp;G. Habib ,&nbsp;W.H.W. Tang ,&nbsp;J. Gillmore ,&nbsp;U. Egolum ,&nbsp;S. Longhi ,&nbsp;G. Jia ,&nbsp;E. Aldinc ,&nbsp;M. Fontana","doi":"10.1016/j.acvd.2025.04.024","DOIUrl":"10.1016/j.acvd.2025.04.024","url":null,"abstract":"<div><h3>Background</h3><div>Transthyretin amyloidosis with cardiomyopathy (ATTR-CM) progressively impairs patients’ (pts) functional capacity, health status, and quality of life (QOL). In HELIOS-B, vutrisiran reduced all-cause mortality and cardiovascular events compared with placebo (pcb) in pts with ATTR-CM and demonstrated significant benefit on multiple clinical measures of disease progression.</div></div><div><h3>Objectives</h3><div>Study aimed to establish the efficacy and safety of vutrisiran in a contemporary population of pts with ATTR-CM.</div></div><div><h3>Methods</h3><div>In HELIOS-B, 6-minute walk test (6MWT) and Kansas City Cardiomyopathy Questionnaire-Overall Summary (KCCQ-OS) score were secondary endpoints assessing functional capacity and health status/QOL. We present further details on the efficacy of vutrisiran on pts’ functional capacity, health status, and QOL.</div></div><div><h3>Results</h3><div>In the overall population at Month 30, the difference of LS-mean change from baseline (vutrisiran–pcb) was 26.46<!--> <!-->m (95% CI 13.38,39.55; <em>P</em> <!-->&lt;<!--> <!-->0.001) for the 6MWT and 5.80 points (95% CI 2.40,9.20; <em>P</em> <!-->&lt;<!--> <!-->0.001) for the KCCQ-OS. Over 30 months, in the overall population, 64% and 47% of pts treated with vutrisiran and pcb, respectively (<em>P</em> <!-->&lt;<!--> <!-->0.05) [monotherapy population; 65% and 38% (<em>P</em> <!-->&lt;<!--> <!-->0.05)], had an increase or<!--> <!-->&lt;<!--> <!-->5-point decrease in KCCQ-OS. Consistent benefits with vutrisiran were observed for both 6MWT and KCCQ-OS in prespecified subgroups, subdomains and different cut-off values/clinical thresholds. Similar trends were observed in the baseline tafamidis subgroup.</div></div><div><h3>Conclusion</h3><div>Significantly more pts treated with vutrisiran maintained or improved functional capacity and health status/QOL compared with pcb, providing further evidence of the disease-modifying effect of vutrisiran treatment. Secondary endpoint analyses of the HELIOS-B study demonstrated that vutrisiran preserved functional capacity (6MWT) and health status (KCCQ-OS) compared with pcb in pts with ATTR-CM. Benefits observed with vutrisiran were consistent in pre-specified subgroups, subdomains and different cut-off values/clinical thresholds.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S230"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167283","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":"Machine learning score using multiparametric assessment for death prediction in cardiac amyloidosis","authors":"R. Mirailles ,&nbsp;T. Pezel ,&nbsp;M. Kharoubi ,&nbsp;M. Nicol ,&nbsp;A. Cohen Solal ,&nbsp;P. Henry ,&nbsp;D. Logeart ,&nbsp;F. Beauvais ,&nbsp;M. Baudet ,&nbsp;T. Goncalves ,&nbsp;E.S. Canuti ,&nbsp;M. Le Maistre ,&nbsp;S. Oghina ,&nbsp;V. Tacher ,&nbsp;E. Audureau ,&nbsp;S. Toupin ,&nbsp;T. Damy","doi":"10.1016/j.acvd.2025.04.026","DOIUrl":"10.1016/j.acvd.2025.04.026","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac amyloidosis (CA) is a severe disease with poor prognosis and increasing incidence. Available scoring systems for prognostic stratification in light chain (AL) and transthyretin (ATTR) amyloidosis are based on limited biological parameters. Allowing process of a greater number and complexity of variables, machine learning (ML) could improve prognostic assessment.</div></div><div><h3>Objectives</h3><div>To investigate the feasibility and accuracy of supervised ML algorithms using clinical, biological and imaging features to predict all-cause mortality in CA patients.</div></div><div><h3>Methods</h3><div>Data were collected from the French Referral Center for Cardiac Amyloidosis database (Hôpital Henri-Mondor, Créteil), including 1513 patients with wild type ATTR (<em>n</em> <!-->=<!--> <!-->777), hereditary ATTR (<em>n</em> <!-->=<!--> <!-->304) and AL (<em>n</em> <!-->=<!--> <!-->432) CA between 2010 and 2023 (<span><span>Fig. 1</span></span>). Based on comprehensive clinical, biological and imaging features, we assessed accuracy of several supervised ML algorithms (Random Forest, Random Forest Ranger, XGBoost and LASSO) to predict all-cause mortality and compared with traditional logistic regression.</div></div><div><h3>Results</h3><div>Among 1513 CA included, 636 (42%) died during a median follow-up of 1.5 years (IQR: 0.5–3.1). ML score using XGBoost exhibited a higher area under the curve compared with logistic regression for prediction of all-cause mortality (AUC 0.76 vs 0.67, <em>P</em> <!-->&lt;<!--> <!-->0.001; <span><span>Fig. 2</span></span>). In ATTR cohort, ML score using Random Forest ranger evidenced better performance compared with logistic regression (AUC ML score 0.77 vs 0.72 with logistic regression, <em>P</em> <!-->=<!--> <!-->0.008). However, in AL cohort, ML scores were not associated with an incremental prognostic value.</div></div><div><h3>Conclusion</h3><div>A ML-model including clinical, biological and imaging parameters showed the best accuracy to predict all-cause mortality in CA patients compared with any traditional methods.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S231"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167285","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":"Cardiac magnetic resonance imaging in patients referred for premature ventricular contractions: Is it useful and for which patient?","authors":"A. Gomez,&nbsp;E. Vermes,&nbsp;A. Otmani,&nbsp;C. Tribouilloy,&nbsp;L. Leborgne,&nbsp;M. Gun","doi":"10.1016/j.acvd.2025.04.022","DOIUrl":"10.1016/j.acvd.2025.04.022","url":null,"abstract":"<div><h3>Background</h3><div>The role of cardiac magnetic resonance (CMR), in case of premature ventricular complexes (PVCs), is not clearly defined.</div></div><div><h3>Objectives</h3><div>The purpose of this study was assess the performance of CMR to detect structural abnormalities in patients routinely referred for PVCs after an initial workup and to determine predictive factors of abnormalities.</div></div><div><h3>Methods</h3><div>200 patients were retrospectively included; all referred by their cardiologist after an initial workup including ECG, echocardiography and treadmill exercise ECG test. Images were acquired on a 1.5 and 3 Tesla scanner with a standard protocol (cine imaging and late gadolinium enhancement sequences after contrast administration). The performance of CMR was defined as the detection of structural abnormalities not previously not found on the initial workup.</div></div><div><h3>Results</h3><div>CMR revealed structural abnormalities in 48% of cases, mainly non-ischemic fibrosis (25.5%) followed by ischemic fibrosis (9%) and mixed fibrosis (2%), as well as the diagnosis of 5 cardiomyopathies. In multivariate analysis, the main predictors of structural abnormalities were age<!--> <!-->&gt;<!--> <!-->64 years (HR 2.23; <em>P</em> <!-->=<!--> <!-->0.028), male sex (HR 2.59; <em>P</em> <!-->=<!--> <!-->0.012), diabetes (HR 6.13; <em>P</em> <!-->=<!--> <!-->0.006), known cardiomyopathy (HR 4.34; <em>P</em> <!-->=<!--> <!-->0.001), and pleomorphic PVCs (HR 3.74; <em>P</em> <!-->=<!--> <!-->0.007). In contrast, left bundle branch block morphology PVCs with inferior axis decreasing with effort in young non-diabetic subjects without known cardiomyopathy and with normal echocardiography all have a normal CMR (<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>CMR is essential in the assessment of PVCs as it enables the detection of structural abnormalities not found with the initial workup in almost half of the cases (48%). Predictive factors of structural abnormalities include men,<!--> <!-->&gt;<!--> <!-->64 years, diabetic with a known cardiomyopathy and pleomorphic PVCs. On the opposite, young and non diabetic patients with normal echocardiography and left bundle branch block morphology PVCs with inferior axis decreasing with effort have a normal CMR in 100% and could potentially not need this examination.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S228-S229"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167442","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}