Archives of Cardiovascular Diseases最新文献

{"title":"Impact of screening for myocardial ischemia and revascularization on cardiovascular outcomes: Insights from the Nancy ischemia registry","authors":"Z. Chati ,&nbsp;S. Tissier ,&nbsp;C. Balaj ,&nbsp;N. Benzaghou ,&nbsp;M. Angioi ,&nbsp;M. Amor ,&nbsp;J. Lemoine","doi":"10.1016/j.acvd.2025.04.037","DOIUrl":"10.1016/j.acvd.2025.04.037","url":null,"abstract":"<div><h3>Background</h3><div>Early detection and management of myocardial ischemia, particularly in high-risk individuals, represent a critical strategy for reducing major adverse cardiovascular events (MACE). The benefit of screening and revascularization in primary prevention remains less clear.</div></div><div><h3>Objectives</h3><div>Nancy Ischemia Registry aims to study the real-world impact of myocardial ischemia screening and revascularization on cardiovascular outcomes in both primary and secondary prevention settings.</div></div><div><h3>Methods</h3><div>Between May 2021 and December 2022, 3020 patients were prospectively enrolled.</div><div>Primary prevention: CACS, CCTA.</div><div>Secondary prevention: Stress Echo or Stress CMR.</div><div>Patients with suspected myocardial ischemia underwent coronary angiography. Revascularization was performed if at least one significant coronary lesion (stenosis<!--> <!-->≥<!--> <!-->70% or fractional flow reserve [FFR]<!--> <!-->≤<!--> <!-->0.80) was identified. The primary endpoint was the occurrence of MACE, defined as myocardial revascularization or cardiovascular death, by the end of 2023.</div></div><div><h3>Results</h3><div>Among the 3020 patients screened.</div><div>Primary prevention cohort (<em>n</em> <!-->=<!--> <!-->1732): 80% had no myocardial ischemia, while 9.6% (207 patients) underwent revascularization.</div><div>Secondary prevention cohort (<em>n</em> <!-->=<!--> <!-->693): 78% had no myocardial ischemia, while 11.6% (103 patients) underwent revascularization.</div><div>At follow-up: The cumulative incidence of MACE was 15% in the primary prevention group versus 20% in the secondary prevention group (HR: 1.06; 95% CI: [1.02–1.10]; <em>P</em> <!-->&lt;<!--> <!-->0.01).</div><div>Among patients with moderate ischemia but no indication for revascularization, MACE incidence was 4%, compared to 2% in those without ischemia (HR: 1.03; 95% CI: [1.01–1.06]; <em>P</em> <!-->&lt;<!--> <!-->0.05) (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>In a real-world clinical setting, screening for myocardial ischemia using anatomical imaging and implementing timely revascularization significantly reduced the incidence of major adverse cardiovascular events in high-risk patients. This benefit was particularly evident in the primary prevention cohort, highlighting the importance of early detection and intervention.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S237"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167451","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":"Rendu Osler Stress Echocardiography (ROSE)","authors":"C. Bergerot ,&nbsp;S. Dupuis-Girod ,&nbsp;A. Guilhem ,&nbsp;A.E. Fargeton ,&nbsp;T. Barret ,&nbsp;Q. Barrier ,&nbsp;H. Thibault","doi":"10.1016/j.acvd.2025.04.041","DOIUrl":"10.1016/j.acvd.2025.04.041","url":null,"abstract":"<div><h3>Background</h3><div>The hepatic involvement in Hereditary Hemorrhagic Telangiectasia (HHT) is characterized by arterio-sus-hepatic shunts that can lead to high cardiac output heart failure (HCO-HF). This develops from asymptomatic diastolic heart failure to rest pulmonary hypertension (PH), which is actually required for liver tranplantation (LT) candidacy. However, when PH is present, HCO-HF improvement after LT is uncertain since such referral may possibly occur too late.</div></div><div><h3>Objectives</h3><div>We hypothesized that abnormal pulmonary pressure response during exercice in HHT patients with hepatic involvement can precede rest PH can be detected during exercise echocardiography and may be partially related to rest cardiac output indexed to BSA (CO).</div></div><div><h3>Methods</h3><div>ROSE is a pilot study of 40 HHT patients with hepatic involvement as defined by a hepatic artery diameter<!--> <!-->≥<!--> <!-->6<!--> <!-->mm,. Median CO value divided the population in 2 groups: high cardiac output (HCO group) vs normal cardiac output (NCO group). Patients were in sinus rhythm without betablocker treatment. Stress echocardiography was performed for CO, left ventricular (LV) and atrial (LA) volumes and functions, and systolic pulmonary arterial pressure (sPAP) at rest, 20<!--> <!-->W, and peak exercise. Endpoints were the comparison between groups of the evolution of sPAP (primary) and sPAP/CO slopes (secondary) from rest to peak exercise.</div></div><div><h3>Results</h3><div>Among 33 patients, we found no difference in sPAP at rest nor at peak exercise between HCO and NCO patients (<span><span>Table 1</span></span>). However, sPAP/CO slopes were higher in the HCO group especially in 4 patients exhibiting a greater sPAP increase for a relative smaller CO increase during exercise (<span><span>Figure 1</span></span>, <span><span>Figure 2</span></span>).</div></div><div><h3>Conclusion</h3><div>In HHT patients with hepatic involvement, sPAP assessment during exercise echocardiography for the identification of earlier stages of HCO-HF can be promising, especially when assessing the relationships between CO increase and sPAP increase. The sPAP/CO slope should be further investigated as an early marker nearly preceding rest PH.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S239-S240"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167542","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":"Feasability of wall motion analysis plus coronary flow reserve, and myocardial perfusion analysis during dobutamine stress echocardiography","authors":"P. Garcon ,&nbsp;Y. Moeuf ,&nbsp;Y. Antakly ,&nbsp;M. Youinou ,&nbsp;A. Prevot ,&nbsp;G. Roger ,&nbsp;J. Soltani ,&nbsp;N. Grinberg ,&nbsp;A. Jagu ,&nbsp;P. Abassade ,&nbsp;R. Cador","doi":"10.1016/j.acvd.2025.04.038","DOIUrl":"10.1016/j.acvd.2025.04.038","url":null,"abstract":"<div><h3>Background</h3><div>The 2024 ESC guidelines highlights the importance of myocardial perfusion (class 1, level B) and coronary flow reserve (CFR) (class 2b, level B) in stress echocardiography. However, these remain under-utilized in France, likely due to the predominant use of Dobutamine. This study assesses the feasibility of CFR and myocardial perfusion evaluation during Dobutamine stress echocardiography.</div></div><div><h3>Objectives</h3><div>To assess CFR measurement and myocardial perfusion feasibility during Dobutamine stress echocardiography.</div></div><div><h3>Methods</h3><div>Three years monocentric open interventional study. All consecutive patients receiving Dobutamine stress echocardiography were included. The test was performed following EAE guidelines. Sonovue® contrast was used for myocardial perfusion. CFR was calculated as the ratio of peak to resting diastolic velocity in the left anterior descending (LAD) artery. Myocardial perfusion was assessed using the Flash/Replenishment method before peak stress.</div></div><div><h3>Results</h3><div>Among 196 patients (mean age 71 years, 56% men), the target heart rate was achieved in 97%. CFR measurement was feasible in 90%, and myocardial perfusion in 98% (assessing<!--> <!-->≥<!--> <!-->80% of myocardial segments). Triple modality assessment (wall motion, CFR, and myocardial perfusion) was successful in 90% (<span><span>Fig. 1</span></span>). Median CFR was 2.55, lower in patients with wall motion abnormalities in the LAD territory (2.00, <span><span>Fig. 2</span></span>), and even lower in left ventricular dysfunction (1.61, <span><span>Figure 2</span></span>, <span><span>Figure 3</span></span>).</div></div><div><h3>Conclusion</h3><div>A multiparametric approach integrating WMA, CFR, and myocardial perfusion during Dobutamine stress echocardiography is highly feasible. CFR measurement was feasible in 90%, and myocardial perfusion in 98%, despite small attenuation artifacts. The lower CFR in patients with regional wall motion abnormalities and LV dysfunction suggests a strong link with myocardial ischemia. This supports CFR's role in refining ischemia assessment beyond wall motion analysis alone. Further studies are needed to evaluate its diagnostic impact.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S237-S238"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167142","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":"Virtual Reality for surgical and interventional planning for sinus venosus atrial septal defect repair","authors":"P. Pyra,&nbsp;K. Hadeed,&nbsp;Y. Dulac,&nbsp;P. Acar,&nbsp;C. Karsenty,&nbsp;R.N. Ghenghea","doi":"10.1016/j.acvd.2025.04.033","DOIUrl":"10.1016/j.acvd.2025.04.033","url":null,"abstract":"<div><h3>Background</h3><div>Surgical correction is the standard of care for sinus venosus atrial septal defects (SVASD). Transcatheter closure has been recently achieved through placement of a coated stent in the SVC in selected patients with favorable anatomy. However, patient's selection stays challenging.</div></div><div><h3>Objectives</h3><div>We aimed to assess the utility of the Virtual reality (VR) in patient selection for surgical or transcatheter closure.</div></div><div><h3>Methods</h3><div>7 patients were included with a median age of 50 years (5 adults et 2 infants). Patient-specific cardiac scanner data were obtained to create accurate 3D models of the heart using DICOM to PRINT software (v1.0.3.3038, 3D Systems Inc, USA). Cardiac models were then imported into a VR environment (HTC Vive Pro 2 and SteamVR 2.2.3), allowing exploration of the anatomy in immersive details.</div></div><div><h3>Results</h3><div>In all patients, VR provided a comprehensive understanding of SVASD anatomy, including its relationship with adjacent structures. In 3 of 5 adult cases, VR allowed for confirmation of the possibility of percutaneous correction without pulmonary vein obstruction by placing the OPTIMUS XXL® stent in the SVC. For the last 2 adults, VR confirmed that the intra-cardiac anatomy was unfavorable for the percutaneous treatment with a risk of pulmonary vein obstruction. These findings were consistent with the multidisciplinary reports for all five patients, which was not known before the simulation (<span><span>Figure 1</span></span>, <span><span>Figure 2</span></span>, <span><span>Figure 3</span></span>).</div><div>In the two pediatric cases, it facilitated the choice of surgical technic (tunnelization patch or Warden procedure). Surgeons and cardiologists reported enhanced spatial awareness and improved insight into potential surgical approaches.</div></div><div><h3>Conclusion</h3><div>VR facilitated interdisciplinary collaboration and seems to be a valuable tool for interventional and surgical planning in SVASD repair due to its ability to provide immersive, patient-specific visualization. Further research is warranted to validate its efficacy in larger cohorts and assess its impact on surgical and interventional outcomes.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S235"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167447","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":"Characteristics and risk factors for mortality of patients managed for left-sided infective endocarditis: A prospective study in a high-volume center","authors":"C. Granger ,&nbsp;C. Combacau ,&nbsp;P. Devos ,&nbsp;J. Farwati ,&nbsp;E. Dhouieb ,&nbsp;A. Srour ,&nbsp;G. Lebreton ,&nbsp;A. Bleibtreu ,&nbsp;A. Gavaud ,&nbsp;B. Rached ,&nbsp;G. Montalescot ,&nbsp;J. Silvain ,&nbsp;G. Hekimian ,&nbsp;N. Hammoudi","doi":"10.1016/j.acvd.2025.04.045","DOIUrl":"10.1016/j.acvd.2025.04.045","url":null,"abstract":"<div><h3>Background</h3><div>Infective endocarditis (IE) is associated with high mortality. Available prospective data are scarce, further knowledge from prospective cohorts could help optimize the prognosis of patients with IE.</div></div><div><h3>Objectives</h3><div>To describe the characteristics and determinants of mortality of left-sided IE in a high-volume center.</div></div><div><h3>Methods</h3><div>From September 15, 2020, to April 30, 2024, all hospitalized patients for left-sided IE at Pitié-Salpêtrière Hospital were prospectively included. Determinants of in-hospital mortality of prosthetic valve IE (PVE) and native valve IE (NVE) subgroups were assessed separately, using a multivariate logistic regression model including any covariate associated in univariate analysis (<em>P</em> <!-->&lt;<!--> <!-->0.1).</div></div><div><h3>Results</h3><div>A total of 317 patients were included, 141 (44%) with PVE and 176 (56%) with NVE. Median age was 68 (58–76) years and 77% of patients were male (<span><span>Table 1</span></span>). Initial admission in intensive care unit (ICU) was required for 70 (25%) patients. In 292 (92%) cases, the microorganism was identified, Streptococcus, Staphylococcus, or Enterococcus were the most documented germs (82%). A cardiac abscess was identified in 24% of cases and surgery was performed in 172 (54%) patients. Compared to PVE the patients with NVE were younger and Staphylococcus aureus was more frequently involved but the number of abscess and surgery rate were similar. In the PVE subgroup (Table 1), predictors of in-hospital death (24/141, 17%) were age (OR<!--> <!-->=<!--> <!-->1.07; 95%CI: 1.02–1.13), cardiac abscess (OR<!--> <!-->=<!--> <!-->2.9, 95%CI: 1.03–8.2) and severe valvular leak (OR<!--> <!-->=<!--> <!-->3.4; 95CI: 1.03–11.3). In the NVE subgroup (Table 2), predictors of death (40/176, 23%) were age (OR<!--> <!-->=<!--> <!-->1.05; 95%CI: 1.01–1.09), HIV infection (OR<!--> <!-->=<!--> <!-->22.5; 95%CI: 1.4–374.6), chronic alcoholic abuse (OR<!--> <!-->=<!--> <!-->4.1; 95%CI: 1.2–13.5) and initial ICU admission (OR<!--> <!-->=<!--> <!-->3.7; 95%CI: 1.4–9.7) (<span><span>Table 2</span></span>).</div></div><div><h3>Conclusion</h3><div>In this cohort, patients had frequent severe initial presentation and multiple comorbidities with high mortality. Determinants of mortality seem to differ between PVE and NVE.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S243"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167525","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":"Potential additive prognostic value of late gadolinium enhancement to the risk prediction score for life-threatening ventricular tachyarrhythmias in laminopathy: Results from a multicentric retrospective study","authors":"C. Darricaud ,&nbsp;B. Guyomarch ,&nbsp;D. Khraiche ,&nbsp;R. Ben Yaou ,&nbsp;A. Thollet ,&nbsp;C. Chikhaoui ,&nbsp;J.N. Trochu ,&nbsp;E. Panaioli ,&nbsp;V. Probst ,&nbsp;K. Wahbi ,&nbsp;N. Piriou","doi":"10.1016/j.acvd.2025.04.021","DOIUrl":"10.1016/j.acvd.2025.04.021","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac laminopathy is associated with a high burden of life-threatening ventricular tachyarrhythmias (LTVTA). A LMNA-LTVTA risk calculator was previously validated and implantable cardioverter defibrillator is recommended in patients with a 5 years calculated risk<!--> <!-->≥<!--> <!-->10%, but additional prognostic markers in patients with lower risk are missing.</div></div><div><h3>Objectives</h3><div>To study the potential additive value of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) for LTVTA risk stratification in laminopathy.</div></div><div><h3>Methods</h3><div>LMNA pathogenic variant carriers with CMR data available including patients with cardiac laminopathy and asymptomatic relatives were included in a retrospective multicentric study. LGE phenotype was compared to cardiac laminopathy characteristics. The additive prognostic value of LGE presence on the risk of occurrence of the composite endpoint of cardiovascular death and LTVTA was studied (<span><span>Figure 1</span></span>, <span><span>Figure 3</span></span>).</div></div><div><h3>Results</h3><div>121 patients were included (mean age 38<!--> <!-->±<!--> <!-->16, 47% males), among which 81 (67%) had a cardiac laminopathy phenotype. 51 (42%) exhibited LGE. Patients with LGE had more atrio-ventricular blocks and more reduced left ventricular ejection fraction at the time of CMR than patients without (53% vs 38% <em>P</em> <!-->=<!--> <!-->0.03; 49<!--> <!-->±<!--> <!-->14% vs 60<!--> <!-->±<!--> <!-->10% <em>P</em> <!-->&lt;<!--> <!-->0.0001 respectively). 61% of patients with LGE had a calculated LMNA-LTVTA risk<!--> <!-->≥<!--> <!-->10% versus 25% without (<em>P</em> <!-->=<!--> <!-->0.0003), but LTVTA history was not more frequent in LGE patients (8% vs 11% in patients without, <em>P</em> <!-->=<!--> <!-->0.5) (<span><span>Fig. 2</span></span>). During a median follow-up of 4 years (range 1–25), 38 patients (31%) experienced LTVTA (<em>n</em> <!-->=<!--> <!-->29, 24%) or cardiovascular death (<em>n</em> <!-->=<!--> <!-->9, 7%). On multivariate analysis, LGE presence did not provide additional prognostic value to LMNA-LTVTA calculated risk. There was no significant interaction between LGE presence and occurrence of LTVTA or cardiovascular death within the different LMNA-LTVTA calculated risk categories (<em>P</em> <!-->=<!--> <!-->0.9).</div></div><div><h3>Conclusion</h3><div>LGE did not provide additional prognostic value to the LMNA-LTVTA risk calculator for LTVTA or cardiovascular death risk prediction.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S227-S228"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167441","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":"Assessment of tricuspid annulus in children with CHD using 3D echocardiography","authors":"R. Ghenghea","doi":"10.1016/j.acvd.2025.04.031","DOIUrl":"10.1016/j.acvd.2025.04.031","url":null,"abstract":"<div><h3>Background</h3><div>The tricuspid annulus (TA) in children with congenital heart diseases (CHD) may undergo significant changes in size, shape, and function due to hemodynamic overload.</div></div><div><h3>Objectives</h3><div>This study aimed to compare TA remodeling in children with CHD, based on the type of right ventricle (RV) overload, using three-dimensional transthoracic echocardiography (3D-TTE).</div></div><div><h3>Methods</h3><div>We enrolled 30 patients with pre-tricuspid overload (atrial septal defect and partial anomalous pulmonary venous connection), 33 with post-tricuspid overload (pulmonary regurgitation after right ventricular outflow tract surgery), and 27 healthy controls. Using 3D-TTE, we assessed the dimensions of the right chambers, the surface area, and the tenting volume of the TA and analyzed the correlation between these measurements.</div></div><div><h3>Results</h3><div>3D TA surface was larger in the pre-tricuspid group than in the post-tricuspid group (median 6.60<!--> <!-->cm²/m² versus 5.16<!--> <!-->cm²/m², <em>P</em> <!-->=<!--> <!-->0.01) and was correlated to right atrial (RA) volume (<em>P</em> <!-->=<!--> <!-->0.0001, <em>r</em> <!-->=<!--> <!-->0.66) and RA surface (<em>P</em> <!-->&lt;<!--> <!-->0.0001, <em>r</em> <!-->=<!--> <!-->0.74) in the pre-tricuspid group. The tenting volume was greater in the post-tricuspid group than the control group but did not differ significantly between the pre-tricuspid and the post-tricuspid groups and between the post-tricuspid group and the control group. 3D TA surface and tenting volume were not correlated to RVEDV in none of the groups (Figs. 1–3).</div></div><div><h3>Conclusion</h3><div>3D modeling of the TA using 3D-TTE is feasible and provides insights into TA remodeling in different RV overload conditions. RA volume and surface area are key determinants of TA size, which could have an impact on the therapeutic strategies in patients with tricuspid regurgitation.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S234"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167445","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 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}