Archives of Cardiovascular Diseases最新文献

{"title":"Effect of early application of a sodium-glucose cotransporter-2 inhibitor on ventricular remodelling and prognosis in patients with anterior wall acute myocardial infarction.","authors":"Fangyuan Chen, Ping Liu, Ling Bai, Juanli Li, Tao Chen","doi":"10.1016/j.acvd.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.acvd.2024.11.003","url":null,"abstract":"<p><strong>Background: </strong>The role of sodium-glucose cotransporter-2 inhibitors in patients with acute myocardial infarction remains elusive.</p><p><strong>Aim: </strong>To evaluate the effect of early application of a sodium-glucose cotransporter-2 inhibitor on ventricular remodelling and prognosis in patients with anterior wall acute myocardial infarction.</p><p><strong>Methods: </strong>In this prospective study, 102 patients diagnosed with anterior wall acute myocardial infarction were enrolled and divided into intervention and control groups according to the use of dapagliflozin within 24hours after admission. Demographic and clinical data, including age, sex, associated co-morbidities, number of lesions, length of hospital stay, N-terminal prohormone of brain natriuretic peptide, left ventricular ejection fraction, left ventricular end-systolic and end-diastolic diameters and drug-related adverse reactions, were collected and analysed between the two groups. All patients were followed up 1, 3 and 6 months after discharge.</p><p><strong>Results: </strong>At 6 months, left ventricular ejection fraction was higher (55.98±7.17% vs. 52.71±7.78%; P=0.03) and N-terminal prohormone of brain natriuretic peptide was lower (141.52±83.18 vs. 203.69±152.13pg/mL; P=0.01) in the intervention group versus the control group. Left ventricular end-systolic diameter (35.68±4.32 vs. 38.00±5.01mm; P=0.01) and left ventricular end-diastolic diameter (50.48±4.90 vs. 52.67±4.91mm; P=0.03) were smaller in the intervention group versus the control group. Event-free survival rates were better in the intervention group than in the control group (90% vs. 74.5%; P=0.03). The cumulative incidence of drug-related adverse reactions was similar in the two groups (14% vs. 4.0%; P=0.15).</p><p><strong>Conclusions: </strong>Use of dapagliflozin within 24hours after admission can improve cardiac function, inhibit ventricular remodelling, improve clinical prognosis and have high safety in patients with anterior wall acute myocardial infarction during 6-month follow-up.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411694","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":"Cyanosis period: A key factor influencing exercise cardiac performance after Fontan procedure.","authors":"Pauline David, Elena Panaioli, Laurence Iserin, Julie Karila-Cohen, Anne-Solène Chaussade, Sophie Malekzadeh-Milani, Fanny Bajolle, Damien Bonnet, Diala Khraiche, Antoine Legendre","doi":"10.1016/j.acvd.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.01.003","url":null,"abstract":"<p><strong>Background: </strong>Most patients with Fontan circulation struggle to increase cardiac output during exercise, affecting aerobic capacity and quality of life.</p><p><strong>Aim: </strong>We sought to identify factors in the preFontan period and in management that influence their exercise cardiac performance.</p><p><strong>Methods: </strong>We retrospectively collected anatomical, clinical and pre- and postFontan invasive haemodynamic data, including ventricular filling pressure in 57 consecutive Fontan patients who underwent cardiopulmonary exercise testing. Exercise cardiac performance was assessed by peak cardiac index measurement using a thoracic bioelectrical impedance device.</p><p><strong>Results: </strong>The median age at Fontan procedure was 6.3 (interquartile range 2.8) years, and 43 patients had concomitant fenestration. Age at cardiopulmonary exercise testing was 14.7 (interquartile range 5.4) years. In multivariable models, peak cardiac index was influenced by cyanosis duration (B=-0.272; P<0.0001) and by the Norwood procedure (-1.977; P=0.002). Peak indexed stroke volume was influenced by cyanosis duration (B=-1.109; P=0.0002), whereas peak heart rate was influenced by preFontan peripheral oxygen saturation (B=0.602; P=0.009). Cyanosis duration≤6.9 years predicted a peak indexed stroke volume≥45mL/m² (area under the curve=0.747; P=0.001). Furthermore, peak indexed stroke volume and peak heart rate were correlated with postFontan ventricular filling pressure: r_p=-0.539 (P=0.012) and r_p=-0.552 (P=0.010), respectively. PostFontan ventricular filling pressure was correlated with bidirectional cavopulmonary shunt duration (r_s=0.498; P=0.023).</p><p><strong>Conclusions: </strong>Cyanosis duration and low preFontan peripheral oxygen saturation affect exercise cardiac performance after Fontan, partly through ventricular dysfunction. Early Fontan procedure and limited postFontan cyanosis could promote better long-term exercise cardiac performance.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384009","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":"From bench to bedside: The critical need for standardized senescence detection.","authors":"Jagrut Shah, Amel Al-Hashimi, Magela Benedetto, Prashant Jay Ruchaya","doi":"10.1016/j.acvd.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.acvd.2024.12.008","url":null,"abstract":"<p><p>Cellular senescence, identified as a state of permanent cell cycle arrest, has become central to understanding aging and disease. Initially seen as a cellular aging mechanism, it is now recognized for its roles in development, tissu repair and tumour suppression. However, the accumulation of senescent cells with age contributes to chronic diseases such as diabetes, atherosclerosis and neurodegeneration. Recent efforts have focused on \"senotherapeutics\", including senolytics, which aim to eliminate senescent cells to mitigate age-related decline. Despite significant advances, senescence research faces critical challenges because of inconsistent detection methods. Common markers, such as p16INK4a and senescence-associated β-galactosidase, vary across tissues and contexts, complicating cross-study comparisons and clinical applications. A standardized multifaceted approach to senescence detection is essential, and should incorporate complementary methods, clear thresholds for senescence classification and considerations for cell type-specific variations. Such standardization would enhance reproducibility, streamline research and facilitate clinical translation, advancing therapeutic applications in aging and disease management.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411695","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":"Temporal trends in population characteristics and type of device among primary prevention implantable cardioverter defibrillator recipients: The DAI-PP programme.","authors":"Diana My Frodi, Serge Boveda, Victor Fournier, Fawzi Kerkouri, Frederic Anselme, Jean-Claude Deharo, Fabrice Extramiana, Laurent Fauchier, Estelle Gandjbakhch, Daniel Gras, Alexis Hermida, Laurence Jesel-Morel, Christophe Leclercq, Nicolas Lellouche, Aymeric Menet, Kumar Narayanan, Olivier Piot, Vincent Probst, Nicolas Sadoul, Jerome Taieb, Pascal Defaye, Eloi Marijon, Rodrigue Garcia","doi":"10.1016/j.acvd.2024.10.335","DOIUrl":"https://doi.org/10.1016/j.acvd.2024.10.335","url":null,"abstract":"<p><strong>Background: </strong>Patient characteristics, technology and clinical practice surrounding primary prevention implantable cardioverter defibrillators have evolved continuously over time.</p><p><strong>Aim: </strong>To explore the temporal changes in patient characteristics, pharmacological therapy and device types among implantable cardioverter defibrillator recipients implanted for the primary prevention of sudden cardiac death over the last two decades in France.</p><p><strong>Methods: </strong>Characteristics of participants and type of device from the retrospective DAI-PP Pilot Study (2002-2012) were compared with those from the ongoing prospective DAI-PP Consortium (2018 onwards).</p><p><strong>Results: </strong>This study included 9588 participants overall (DAI-PP Pilot Study, n=5539; DAI-PP Consortium, n=4049). Compared with the DAI-PP Pilot Study, the DAI-PP Consortium subjects were older at implantation (62.5 vs 65.2 years; P=0.001) and had a higher proportion of women (15.1% vs 20.6%; P<0.001), a similar proportion of ischaemic heart disease (60.2% vs 60.2%; P=0.98), a higher left ventricular ejection fraction (27±7% vs 30±8%; P<0.001) and more patients with narrow QRS complexes (30.5% vs 46.0%; P<0.001). The proportion of patients treated with heart failure drugs increased significantly (70.1% vs 83.1%; P<0.001), whereas the use of amiodarone became much less frequent (22.7% vs 14.7%; P<0.001). Finally, the proportions of cardiac resynchronization therapy defibrillators (53.8% vs 46.4%; P<0.001) and dual-chamber defibrillators (23.3% vs 17.3%; P<0.001) decreased, whereas subcutaneous implantable cardioverter defibrillators now account for a sizeable proportion of implants (14.6%).</p><p><strong>Conclusions: </strong>Over a 20-year period, the primary prevention implantable cardioverter defibrillator population has evolved significantly, with an older age and a higher proportion of women. The type of device has changed, with fewer cardiac resynchronization therapy defibrillators and more subcutaneous implantable cardioverter defibrillators.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076567","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: Association between skin flora and infective endocarditis?","authors":"Julie Lourtet-Hascoët, Jerome Van Rothem, Nicolas Combes, Benjamin Honton, Sébastien Hascoët, Jean-Louis Galinier, Benoit Fontenel, Hélène Charbonneau, Eric Bonnet","doi":"10.1016/j.acvd.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.acvd.2024.12.007","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis is a rare but severe complication that may arise following transcatheter aortic valve implantation. Recent advances in microbiological epidemiology have highlighted staphylococci and enterococci as the primary pathogens involved.</p><p><strong>Aim: </strong>To investigate the prevalence of these bacteria in patients' cutaneous flora before and after transcatheter aortic valve implantation procedures, and to assess the implications for antibiotic prophylaxis recommendations.</p><p><strong>Methods: </strong>A single-centre prospective epidemiological study was conducted, enrolling patients admitted consecutively for transcatheter aortic valve implantation procedures between June 2021 and February 2022. Cutaneous samples were obtained from each patient at the puncture site of the transcatheter aortic valve implantation procedure, before and after skin detersion, and from operator hands after skin detersion.</p><p><strong>Results: </strong>One hundred patients were included, with a mean age of 82±6.1years, a male-to-female ratio of 0.48 and a mean body mass index of 29±4.4kg/m². Before skin detersion, cutaneous samples were positive in 58 patients; among them were coagulase-negative staphylococci (n=48, 82%, 95% confidence interval 71-91%), enterococci (n=12, 21%, 95% confidence interval: 11-33%), Staphylococcus aureus (n=2, 3%, 95% confidence interval 0-12%) and Enterobacteriaceae (n=4, 7%, 95% confidence interval: 2-17%).</p><p><strong>Conclusions: </strong>Enterococci are frequently present in patients' cutaneous flora at the puncture site before skin detersion, suggesting a potential source for infective endocarditis after transcatheter aortic valve implantation. These findings support considering amoxicillin-clavulanate as antibiotic prophylaxis before transcatheter aortic valve implantation procedures to mitigate the risk of infective endocarditis associated with enterococcal colonization.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076568","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":"Incidence of ventricular arrhythmias after implantable cardioverter-defibrillator implantation or replacement, and driving restriction consequences","authors":"Thomas Marc ,&nbsp;Karim Benali ,&nbsp;Pierre Groussin ,&nbsp;Redwane Rakza ,&nbsp;Joana Brito ,&nbsp;Nathalie Behar ,&nbsp;Philippe Mabo ,&nbsp;Dominique Pavin ,&nbsp;Christophe Leclercq ,&nbsp;Vincent Galand ,&nbsp;Raphaël P. Martins","doi":"10.1016/j.acvd.2024.10.005","DOIUrl":"10.1016/j.acvd.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Following implantation/replacement of an implantable cardioverter-defibrillator, patients are legally subjected to variable lengths of driving restrictions based on the indication (1 and 3 months after primary and secondary prevention, respectively; 1 week after device replacement).</div></div><div><h3>Aim</h3><div>To assess the incidence of ventricular arrhythmia during the theoretical driving restriction period in a large cohort of patients.</div></div><div><h3>Methods</h3><div>Patients who underwent implantable cardioverter-defibrillator implantation for primary or secondary prevention or device replacement between 2015 and 2021 were included retrospectively. The primary endpoint was the occurrence of ventricular arrhythmia during the theoretical driving restriction period, as defined by guidelines.</div></div><div><h3>Results</h3><div>A total of 914 patients were analysed, including 654 first implantations (438 and 216 for primary and secondary prevention, respectively) and 260 device replacements. The primary outcome occurred in 2/438 patients (0.004%) during the 1-month period following device implantation for primary prevention and in 25/216 patients (11.5%) during the 3-month period following device implantation for secondary prevention; it did not occur in the 1-week period following device replacement. The monthly calculated risk of harm remained below the accepted threshold of 0.005% for each group.</div></div><div><h3>Conclusions</h3><div>Primary prevention patients, such as those who have undergone device replacement, have a low risk of ventricular arrhythmia, which could lead to a reduction in their driving restriction period. Secondary prevention patients experienced a higher risk of recurrent ventricular arrhythmia, supporting the 3-month driving restriction period.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages 35-42"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The significance of residual inflammation in mortality risk stratification for Takotsubo syndrome: Evaluating CRP measurement alongside the InterTAK Prognostic Score","authors":"L. Faucher ,&nbsp;B. Marchandot ,&nbsp;M. Kensuke ,&nbsp;L. Jesel ,&nbsp;K. Roulot ,&nbsp;A. Granier ,&nbsp;A. Carmona ,&nbsp;S. Kikuchi ,&nbsp;S. Amissi ,&nbsp;A. Trimaille ,&nbsp;P. Ohlmann ,&nbsp;T. Tatarcheh ,&nbsp;V. Schini-Kerth ,&nbsp;O. Morel","doi":"10.1016/j.acvd.2024.10.019","DOIUrl":"10.1016/j.acvd.2024.10.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Initially described as a benign acute cardiomyopathy, Takotsubo syndrome (TTS) has been linked to elevated mortality rates during both the acute phase and long-term follow-up. Emerging evidence suggests that unresolved myocardial inflammation may contribute to this adverse prognosis.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the incremental prognostic utility of C-reactive protein (CRP) in conjunction with the InterTAK Prognosis score for stratifying long-term mortality in TTS.</div></div><div><h3>Method</h3><div>A retrospective analysis was conducted on data from a multicenter registry encompassing 307 patients diagnosed with Takotsubo syndrome (TTS) between 2008 and 2020. Patients were stratified into quartiles based on the InterTAK Prognosis score. The discriminatory potential of C-reactive protein (CRP) in predicting long-term mortality was assessed. The primary endpoint was defined as all-cause mortality within 1 year.</div></div><div><h3>Results</h3><div>Stepwise increase of CRP at discharge that corresponds to INTERTAK quartiles was observed: 9.5<!--> <!-->mg/L (25th percentile) in the first quartile, 15.8<!--> <!-->mg/L (median) in the second quartile, 25.3<!--> <!-->mg/L (75th percentile) in the third quartile, and 41.2<!--> <!-->mg/L (maximum) in the fourth quartile. Receiver operating characteristic curves (ROC) analysis revealed that CRP value at discharge was predictive of one-year mortality (area under the curve [AUC]<!--> <!-->=<!--> <!-->0.81; 95% confidence interval [CI]<!--> <!-->=<!--> <!-->0.68–0.90) with an optimal threshold set at 33<!--> <!-->mg/L (Sensitivity: 65%; Specificity: 87%). When considering the InterTAK score, the incorporation of CRP at discharge with a cut-off of 33<!--> <!-->mg/L exhibited a significant enhancement in the prediction of one-year mortality in “intermediate” risk (25% vs. 1%; <em>P</em> <!-->=<!--> <!-->0.008) or “very high” risk (40% vs. 10%; <em>P</em> <!-->=<!--> <!-->0.02) patients. Receiver operating characteristic (ROC) curves indicated a tendency for the area under the curve (AUC) to increase when considering the CRP value at discharge (AUC 0.85 vs. 0.79, <em>P</em> <!-->=<!--> <!-->0.06). While the improvement in AUC did not attain statistical significance, discrimination improved from “acceptable” (AUC [0.7–0.8]) for the original InterTAK Prognosis score to “excellent” (AUC [0.8–0.9]) (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>In Takotsubo syndrome, the persistence of inflammatory burden at hospital discharge emerged as an independent predictor of one-year mortality, augmenting the predictive capacity of the conventional INTERTAK Prognosis score.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S32"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149778","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":"Pregnancy associated spontaneous coronary artery dissection: A multicenter case series study","authors":"S. Boudiche ,&nbsp;F. Boudiche El Ayech ,&nbsp;M. Saadi ,&nbsp;S. Haboubi ,&nbsp;Y. Khelil ,&nbsp;M. Chedly ,&nbsp;S. Charfeddine ,&nbsp;A. Noamen ,&nbsp;L. Abid ,&nbsp;L. Bezdah ,&nbsp;W. Fehri ,&nbsp;M.S. Mourali","doi":"10.1016/j.acvd.2024.10.075","DOIUrl":"10.1016/j.acvd.2024.10.075","url":null,"abstract":"<div><h3>Introduction</h3><div>Pregnancy-associated (P-) spontaneous coronary artery dissection (SCAD) is a rare and underdiagnosed but a potentially lethal complication of pregnancy.</div></div><div><h3>Objective</h3><div>The aim of this study was to describe a case series with a highlight on management strategies and outcomes of 6 P-SCAD women.</div></div><div><h3>Method</h3><div>A retrospective analysis of data of six patients of P-SCAD managed in four tertiary care centers from January 2011 to June 2023 was done. Clinical, angiographic, therapeutic, and follow-up data were analyzed.</div></div><div><h3>Results</h3><div>All patients presented in the postpartum period, majority with severe initial clinical presentation: persistent and non-persistent ST segment elevation myocardial infarction were noted in 4 and 2 patients (of which 1 transient ST elevation myocardial infarction) respectively. Hemodynamic instability was reported in 3 patients: 2 cardiogenic shocks and 1 acute pulmonary oedema. Left main coronary artery (LMCA) and left anterior descending coronary artery were involved in 5 and 4 patients respectively. 5 out of 6 patients had multivessel dissections. All patients had angiographic type 1 SCAD angiographic pattern. 2 patients needed immediate primary (<em>n</em> <!-->=<!--> <!-->1) or rescue (<em>n</em> <!-->=<!--> <!-->1) percutaneous coronary intervention (PCI) with angiographic success. Conservative therapy was initially attempted in 4 patients with unfavorable evolution: dissection persistence (<em>n</em> <!-->=<!--> <!-->2) and extension (<em>n</em> <!-->=<!--> <!-->2). Dissection extension was associated with worsening clinical presentations with recurrent angina (<em>n</em> <!-->=<!--> <!-->1) and cardiogenic shock (<em>n</em> <!-->=<!--> <!-->1) mandating subsequent emergent PCI and coronary artery bypass grafting in the 2 patients respectively. Intra-aortic balloon pump (IABP) was inserted in 2 patients. In-hospital death occurred in 2 out of 6 patients.</div></div><div><h3>Conclusion</h3><div>P-SCAD women had severe clinical presentations. LMCA and multivessel involvement were often observed. Conservative strategy was attempted when it was possible with unfavorable angiographic outcome. Consequently, in-hospital mortality rate was as high as 33%.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S15"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150107","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":"One-year prognostic value of right ventricular to pulmonary arterial coupling among patients hospitalized for acute coronary syndrome: Insights from the ADDICT-ICCU study","authors":"C. Nogarede ,&nbsp;N. El Beze ,&nbsp;G. Schurtz ,&nbsp;J.C. Dib ,&nbsp;C. Delmas ,&nbsp;C. Bouleti ,&nbsp;V. Roule ,&nbsp;A. Boccara ,&nbsp;A. Trimaille ,&nbsp;F. Boccara ,&nbsp;S. Toupin ,&nbsp;J.-G. Dillinger ,&nbsp;P. Henry ,&nbsp;T. Pezel ,&nbsp;C. Fauvel","doi":"10.1016/j.acvd.2024.10.062","DOIUrl":"10.1016/j.acvd.2024.10.062","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Tricuspid annular plane systolic excursion over systolic pulmonary artery pressure (TAPSE/sPAP) assessed by echocardiography is a good non-invasive approach for right ventricular to pulmonary artery (RV-PA) coupling assessment. Although the prognostic value of this ratio is well known in many cardiovascular diseases, its prognostic value in acute coronary syndrome (ACS) is not established.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To assess one-year prognostic value of TAPSE/sPAP among patients hospitalised for ACS.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;In the prospective multicentric ADDICT-ICCU study, all consecutive patients hospitalized for ACS over two weeks in April 2021 at 39 centres across France were included. The TAPSE/sPAP ratio was measured using the first echocardiography performed within the first 24 hours of hospitalisation. The primary composite outcome was one-year major adverse cardiovascular event (MACE) including: all-cause death or urgent hospitalisation for acute cardiovascular reason (acute heart failure, urgent myocardial revascularisation). C-tree analysis was used to find the optimal TAPSE/sPAP cut-off to predict the primary outcome.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among the 772 ACS patients (age 64&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;12 years, 74% males) included, 113 (15%) experienced 1-year MACE. The best cut-off for TAPSE/sPAP to predict 1-year MACE was 0.67 mm/mmHg. Patients with TAPSE/Spap&lt;!--&gt; &lt;!--&gt;≤&lt;!--&gt; &lt;!--&gt;0.67 mm/mmHg were more likely older (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001), with previous atrial fibrillation (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001), a higher length of hospitalization in ICCU (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001), a higher NTproBNP (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.001) and a worse LVEF value (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). At one-year, all-cause death occurred in 27 (24%) patients with TAPSE/sPAP&lt;!--&gt; &lt;!--&gt;≤&lt;!--&gt; &lt;!--&gt;0.67, compared to 7 (6%) with TAPSE/Spap&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;0.67 (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001), and 32 (28%) patients with TAPSE/sPAP&lt;!--&gt; &lt;!--&gt;≤&lt;!--&gt; &lt;!--&gt;0.67 were hospitalised for acute cardiovascular reason against 20 (18%) with TAPSE/sPAP&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;0.67 (&lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.006). After adjustment for all traditional prognosticators, grouped in models, TAPSE/sPAP&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.67 mm/mmHg remained independently associated with the primary outcome: model 1 (comorbidities): HR 2.82, 95% CI [2.92–4.38], &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001, model 2 (echocardiography): HR&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2.38, 95% CI [1,40–4,03], &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). &lt;span&gt;&lt;span&gt;Fig. 1&lt;/span&gt;&lt;/span&gt; shows that patients with TAPSE/sPAP ≤0.67 mm/mmHg had worse event-free survival for the primary outcome: HR&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2.92, 95% CI [1.98–4.29], &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;TAPSE/sPAP was independently associated with 1-year MACE in patients hospitalised f","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S8-S9"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150432","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":"Optimization of the treatment of Heart Failure with Reduced Ejection Fraction following the updated European Society of Cardiology guidelines","authors":"B. El Boussaadani ,&nbsp;S. Mayoussi ,&nbsp;H. Bendoudouch ,&nbsp;L. Hara ,&nbsp;A. Ech-Chenbouli ,&nbsp;Z. Raissouni","doi":"10.1016/j.acvd.2024.10.041","DOIUrl":"10.1016/j.acvd.2024.10.041","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) is a prevalent global health issue Guideline-directed medical therapy (GDMT) has been pivotal in managing HF with reduced ejection fraction (HFrEF), emphasizing the use of four key drug classes.</div></div><div><h3>Objective</h3><div>Our main objective was to query the Moroccan cardiology community about the sequencing approach of heart failure medications and general compatibility with current guidelines.</div></div><div><h3>Method</h3><div>Our study is a large-sample survey study is based on questionnaire form previously used in an international survey on heart failure, published in 2022. The form was distributed via e-mail to Moroccan cardiologists. This questionnaire was translated into French to meet the specific requirements of our study and facilitate the collection of information.</div><div>Three predefined subgroup analyses were systematically performed: sex (male vs female), age (&lt;30, 30–50, and &gt;50 years), and practitioner type (residents in cardiology vs cardiology specialists).</div></div><div><h3>Results</h3><div>63 cardiologists practicing in northern Morocco responded to the survey. 65% of the participants considered LVEF<!--> <!-->≤<!--> <!-->40% was the threshold to define HFrEF. The majority of participants (76.19%) would initiate HFrEF medical treatment with an ARNi instead of ACEi/ARB. 39.62% responded that adding another class of HFrEF medications is more important than increasing the dose of those already started. The “classic approach” of sequencing appears to be the most common, starting with ACEi or ARNi first (41%). Concerning the order of introduction of medications for heart failure, the “classic approach” appears to be the most common, starting with ACEi or ARNi first (41%), BB second (37%), and MRA third (45%) (<span><span>Fig. 1</span></span>). Nearly all participants believed it was feasible to initiate all four classes of heart failure medications during the first hospitalization. Beta-blockers were considered the most effective heart failure medication by 43% of participants followed by ARNIs (30%), but no practitioner aged<!--> <!-->&gt;<!--> <!-->50 considered that betablockers are the most effective medication. 65% of participants were hesitant to introduce mineralocorticoid receptor antagonists (MRA) when glomerular filtration rate (GFR) is<!--> <!-->&lt;<!--> <!-->30<!--> <!-->ml/min.</div></div><div><h3>Conclusion</h3><div>Our results show that our practice needs more adherence to recent guidelines on the medical management of HFrEF, but young practitioners seem to join this journey compared to older generations, which would help advance in the management of our heart failure patients.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S43-S44"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150455","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}