Archives of Cardiovascular Diseases最新文献

{"title":"A new imaging era aided by artificial intelligence to enhance cardio-oncology care. Tun-AI Enhance Study","authors":"D. Aouadi,&nbsp;F. Mghaeith,&nbsp;F. Daly,&nbsp;M. Chedly,&nbsp;A. Ben Salem,&nbsp;Z. Jebberi,&nbsp;S. Boudiche,&nbsp;M.S. Mourali","doi":"10.1016/j.acvd.2025.04.030","DOIUrl":"10.1016/j.acvd.2025.04.030","url":null,"abstract":"<div><h3>Background</h3><div>3D echocardiography is recommended as the preferred echocardiographic modality to measure left ventricular ejection fraction (LVEF). This technique needs an experimented operators and expensive machines. Artificial Intelligence (AI) based systems were reported to be of clinical interest.</div></div><div><h3>Objectives</h3><div>This study aims to compare performances and variability of echocardiographic measures between a 3D-equipped ultrasound system and an AI equipped one for cancer patients while assessing inter-oberver variability between different expertise level operators.</div></div><div><h3>Methods</h3><div>This was a prospective study done between May 2023 and February 2024 in the cardiology departement of Rabta hospital. It included patients<!--> <!-->&gt;<!--> <!-->18 years with a malignant tumor and candidates for cardiotoxic chemotherapy. We excluded patients who had started chemotherapy and who had an irregular rythm. TTE were performed by a senior operator, using a Philips EPIC7 ultrasound system to measure the 3D LVEF. An Echonous Kosmos system equipped with an US2-AI software was used for automatic LVEF measurement by a senior operator and a junior one.</div></div><div><h3>Results</h3><div>This study included 47 patients (mean age 50<!--> <!-->±<!--> <!-->12 years, 68% female). There was no statistically significant difference in LVEF measurments when performed by the senior operator using the 3D echocradiography or the AI systems (<em>P</em> <!-->=<!--> <!-->0.16). When using the AI system, there was no statiscally significant difference between the results found by the senior and the junior doctor (<em>P</em> <!-->=<!--> <!-->0.918). There was a correlation between 3D measured LVEF and AI-measured LVEF when done by the senior operator (<em>r</em> <!-->=<!--> <!-->0.43, <em>P</em> <!-->=<!--> <!-->0.003). A correlation between AI-measured LVEF by the senior operator and the junior operator was found (<em>r</em> <!-->=<!--> <!-->0.571, <em>P</em> <!-->&lt;<!--> <!-->10⁻³).</div></div><div><h3>Conclusion</h3><div>The AI echocardiography system demonstrates potential to reduce inter-observer variability, minimize expertise-related errors and improve test performance in the assessment of left ventricular function.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S233-S234"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167530","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":"Artificial intelligence empowers Novice Users to acquire Diagnostic-Quality echocardiography","authors":"S. Lafitte ,&nbsp;L. Rodrigues ,&nbsp;C. Ong ,&nbsp;A. Dezellus ,&nbsp;Y. Goldberg ,&nbsp;M. Bouchat ,&nbsp;E. Roger ,&nbsp;O. Moal ,&nbsp;V. Singh ,&nbsp;B. Moal ,&nbsp;B. Trost","doi":"10.1016/j.acvd.2025.04.039","DOIUrl":"10.1016/j.acvd.2025.04.039","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac ultrasound exams provide critical real-time data to guide clinical decisions; however, echocardiography typically requires highly trained experts, which can limit its utilization, particularly in resource-poor settings. Artificial intelligence (AI) using deep learning algorithms to guide novices in acquiring diagnostic echocardiographic exams may broaden access and improve care.</div></div><div><h3>Objectives</h3><div>This clinical trial evaluated whether nurses without prior ultrasound experience (novices) could obtain diagnostic-quality acquisitions of 10 echocardiographic views using AI-based software.</div></div><div><h3>Methods</h3><div>This international clinical trial is prospective and multicentric. Ultrasound exams were acquired on adult patients: one conducted by a novice using AI guidance and one by an expert (sonographer/cardiologist) without the guidance. Four primary endpoints were evaluated by 5 cardiologists, to assess whether the exam performed by a novice was of sufficient quality to visually analyze the left ventricular size/function, the right ventricular size, and the presence of non-trivial pericardial effusion. Secondary endpoints included the assessment of 8 additional cardiac parameters. The cardiologists evaluated the diagnostic quality of each clip, and a qualitative and quantitative assessment of the ultrasound measurements was performed.</div></div><div><h3>Results</h3><div>In total, 240 patients (mean 62.6<!--> <!-->±<!--> <!-->15.1 years; 117 women (48.8%); mean body mass index 26.6<!--> <!-->±<!--> <!-->5.4<!--> <!-->kg/m²) completed the study. 100% of the exams performed by novices with the studied software were of sufficient quality to assess the primary endpoints. Overall agreement of the cardiologists in assessing 12 clinical key parameters as normal/borderline or abnormal, was greater than 85% (range 87.1–99.6). Cardiac parameters assessed in exams conducted by novices and experts were strongly correlated.</div></div><div><h3>Conclusion</h3><div>AI-based software is safe and reliable to use in clinical practice. It provides a means for novices to perform diagnostic quality cardiac ultrasounds after a short training period.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S238"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167143","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 vutrisiran on outpatient worsening heart failure in patients with transthyretin amyloidosis with cardiomyopathy in the HELIOS-B trial","authors":"M. Fontana ,&nbsp;M.S. Maurer ,&nbsp;J.D. Gillmore ,&nbsp;S. Bender ,&nbsp;E. Aldinc ,&nbsp;S. Eraly ,&nbsp;P.Y. Jay ,&nbsp;A. Zaroui ,&nbsp;S.D. Solomon","doi":"10.1016/j.acvd.2025.04.023","DOIUrl":"10.1016/j.acvd.2025.04.023","url":null,"abstract":"<div><h3>Background</h3><div>Transthyretin amyloidosis with cardiomyopathy (ATTR-CM) is a fatal disease. Methods are needed to monitor patients with disease progression and optimize treatment decisions. Outpatient worsening heart failure (HF) (oral diuretic intensification or initiation) has been shown to be prognostic of mortality in patients with ATTR-CM. In the HELIOS-B trial, vutrisiran reduced the risk of all-cause mortality (ACM) and recurrent CV events vs placebo in patients with ATTR-CM.</div></div><div><h3>Objectives</h3><div>To investigate the clinical and prognostic value of–in addition to the effect of vutrisiran on–outpatient worsening HF in patients with ATTR-CM.</div></div><div><h3>Methods</h3><div>Associations between outpatient worsening HF and the HELIOS-B primary composite of ACM and recurrent CV events, ACM alone, and other disease progression-related endpoints were evaluated. The impact of vutrisiran over 36<!--> <!-->M on outpatient worsening HF and an expanded composite of ACM, recurrent CV events, and outpatient worsening HF was also assessed.</div></div><div><h3>Results</h3><div>In the overall population (<em>n</em> <!-->=<!--> <!-->655 randomized), 321 (49.1%) patients had<!--> <!-->≥<!--> <!-->1 outpatient worsening HF event, 245 (37.5%) had<!--> <!-->≥<!--> <!-->1 CV event(s), and 120 (18.3%) died; 237 patients (36.2%) had no events. Patients with, vs those without, outpatient worsening HF had an increased risk of ACM and CV events (hazard ratio [HR] 2.58, 95% confidence interval [CI] 2.04, 3.27) and ACM (HR 2.45, 95% CI 1.70, 3.52) (<span><span>Fig. 1</span></span>), as well as greater deterioration in 6-MWT and KCCQ-OS, and a greater increase in NT-proBNP. In recurrent event analyses over the double-blind period, vutrisiran reduced the rate of outpatient worsening HF (relative rate ratio 0.66, 95% CI 0.56, 0.78) vs placebo. Vutrisiran also reduced the risk of the composite of ACM, recurrent CV events and outpatient worsening HF vs placebo (HR 0.69 [95% CI 0.57, 0.83]) (<span><span>Figure 1</span></span>, <span><span>Figure 2</span></span>).</div></div><div><h3>Conclusion</h3><div>Outpatient worsening HF was frequent in patients with ATTR-CM and was associated with an increased risk of mortality and recurrent CV events. Vutrisiran reduced the risk of outpatient worsening HF vs placebo.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S229"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167282","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":">Ours SFC","authors":"","doi":"10.1016/S1875-2136(25)00304-3","DOIUrl":"10.1016/S1875-2136(25)00304-3","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page iii"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167388","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":"Mitral annular calcification in severe aortic stenosis: Prognostic value of calcification severity and Mitral valve dysfunction","authors":"P. Vanhaecke,&nbsp;C. Tribouilloy,&nbsp;Y. Bohbot,&nbsp;E. Hucleux","doi":"10.1016/j.acvd.2025.04.050","DOIUrl":"10.1016/j.acvd.2025.04.050","url":null,"abstract":"<div><h3>Background</h3><div>Mitral Annular Calcification (MAC) is a degenerative condition affecting many elderly patients with cardiovascular risk factors, often leading to mitral valve dysfunction (MVD). Among patients with severe aortic stenosis (AS), MAC is prevalent, yet the impact of its severity and associated MVD on patient outcomes remains unclear.</div></div><div><h3>Objectives</h3><div>The aim of this study was to examine the prevalence of MAC and associated MVD to MAC among patients with severe AS and to assess their prognostic significance.</div></div><div><h3>Methods</h3><div>This retrospective study included 613 patients with severe AS. Patients were categorized by echocardiographic MAC severity, and the presence of MVD defined as a mean transmitral gradient (mTMG)<!--> <!-->≥<!--> <!-->5<!--> <!-->mmHg.</div></div><div><h3>Results</h3><div>Of the 613 patients, 309 (50.4%) had MAC (44% mild, 40% moderate and 16% severe), with 21% also exhibiting MVD. Patients with MAC had lower 6-year survival (47<!--> <!-->±<!--> <!-->3% vs. 64<!--> <!-->±<!--> <!-->3%, log-rank <em>P</em> <!-->&lt;<!--> <!-->0.001) even after adjustment by covariates of potential prognostic impact (Adjusted HR [95%CI]<!--> <!-->=<!--> <!-->1.43 [1.08–1.90]) (<span><span>Fig. 1</span></span>). Severe MAC was associated with older age, female sex, higher comorbidity scores and elevated pulmonary pressures (all <em>P</em> <!-->&lt;<!--> <!-->0.05), and with lower 6-year survival (23<!--> <!-->±<!--> <!-->7%) compared to mild (55<!--> <!-->±<!--> <!-->5%) or moderate MAC (50<!--> <!-->±<!--> <!-->5%) (<span><span>Fig. 2</span></span>). Patients with both MAC and MVD showed a 6-year survival rate of 28<!--> <!-->±<!--> <!-->7%, notably lower than the 53<!--> <!-->±<!--> <!-->4% in those with MAC but no MVD (<span><span>Fig. 3</span></span>). Multivariable analysis indicated that severe MAC (Adjusted HR [95%CI]<!--> <!-->=<!--> <!-->2.75 [1.67–4.50]) and MVD (Adjusted HR [95%CI]<!--> <!-->=<!--> <!-->2.08 [1.36–3.15]) were independent predictors of mortality (<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>MAC is highly prevalent among severe AS, present in more than 50% of patients. MAC is associated with reduced survival, particularly when mitral calcification are severe or in presence of MVD. This study emphasizes the importance of evaluating MAC severity and mTMG in AS patients to guide clinical decisions.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S246-S247"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167144","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":"Incremental prognostic value of late gadolinium enhancement granularity using cardiac MRI in patients with hypertrophic cardiomyopathy","authors":"J. Florence ,&nbsp;J. Garot ,&nbsp;S. Toupin ,&nbsp;T. Pezel","doi":"10.1016/j.acvd.2025.04.027","DOIUrl":"10.1016/j.acvd.2025.04.027","url":null,"abstract":"<div><h3>Background</h3><div>To enhance risk stratification for SCD, the ESC has added the extent of LGE using cardiac MRI in the guidelines, setting a threshold at<!--> <!-->≥<!--> <!-->15% of LV mass. The prognostic impact of additional LGE features is not well established.</div></div><div><h3>Objectives</h3><div>We aimed to assess the incremental prognostic value of the granularity of LGE using cardiac MRI including extent, location, and pattern in patients with HCM to predict all-cause death.</div></div><div><h3>Methods</h3><div>Between 2008 and 2021, all patients referred for HCM assessment using cardiac MRI, without unrecognized MI or clinical history of myocarditis were prospectively recruited in two French centers. The outcome was all-cause death. The concept of “LGE granularity” was defined as a model combining LGE extent, location, and pattern. Using nested Cox proportional hazard models, the additional predictive value of LGE granularity was assessed by the C-index, the NRI, the IDI and the global Chi².</div></div><div><h3>Results</h3><div>Among 2672 included patients (52<!--> <!-->±<!--> <!-->7 years, 56% males), 862 (32%) had LGE. After a median (IQR) follow-up of 9 (7–11) years, 447 (17%) patients died. The presence of LGE was associated with all-cause death (adjusted hazard ratio (HR) 3.96, 95% CI: 3.26–4.80, <em>P</em> <!-->&lt;<!--> <!-->0.001, <span><span>Fig. 1</span></span>A). In patients with LGE (<em>n</em> <!-->=<!--> <!-->862), survival curves showed that the “LGE granularity model” was associated with a higher risk of all-cause death (all <em>P</em> <!-->&lt;<!--> <!-->0.001, <span><span>Fig. 1</span></span>B). An ajusted nested Cox model showed that the LGE extent, location and pattern were all independently associated with all-cause death (all <em>P</em> <!-->&lt;<!--> <!-->0.001, <span><span>Fig. 2</span></span>). The “LGE granularity model” combining all these LGE features showed the best improvement in model discrimination and reclassification over and above known prognosticators (C-statistic improvement: 0.90; NRI<!--> <!-->=<!--> <!-->41.9%; IDI<!--> <!-->=<!--> <!-->13.2%, Chi² global<!--> <!-->=<!--> <!-->450, all <em>P</em> <!-->&lt;<!--> <!-->0.001; LR-test <em>P</em> <!-->&lt;<!--> <!-->0.001, <span><span>Fig. 2</span></span>).</div></div><div><h3>Conclusion</h3><div>In a large cohort of HCM, the “LGE granularity model” combining extent, location, and pattern of LGE had an incremental prognostic value above traditional prognosticators to predict all-cause death.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S231-S232"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167286","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":"Midterm outcomes of transcatheter edge to edge repair for Primary MR according to the anatomy","authors":"C. Chong-Nguyen,&nbsp;D. Samim,&nbsp;Y. Hausammann,&nbsp;M. Nakase,&nbsp;D. Tomii,&nbsp;D. Angellotti,&nbsp;N. Brugger,&nbsp;J. Lanz,&nbsp;T. Pilgrim,&nbsp;D. Reineke,&nbsp;S. Windecker,&nbsp;P. Biaggi,&nbsp;F. Praz,&nbsp;P.M. Wenaweser","doi":"10.1016/j.acvd.2025.04.042","DOIUrl":"10.1016/j.acvd.2025.04.042","url":null,"abstract":"<div><h3>Background</h3><div>Impact of anatomical complexity in Mitral Transcatheter Edge-To-Edge Repair (M-TEER) outcomes in patients with primary mitral regurgitation (PMR) at high or prohibitive surgical risk are scarce and conflicting.</div></div><div><h3>Objectives</h3><div>The aim of this study was to assess mid-term prognosis after M-TEER and identify prognostic factors according to PMR aetiology and anatomy.</div></div><div><h3>Methods</h3><div>Patients who underwent M-TEER for PMR between July 2013 and October 2023 at two high-volume centres in Switzerland were classified according to the anatomy: A2P2 Prolapse/Flail vs Non-A2P2 Prolapse/Flail. In a sub-group of patients, we estimated survival after M-TEER based on mitral valve (MV) anatomical complexity (defined as presence of<!--> <!-->≥<!--> <!-->1 of the following criteria:<!--> <!-->≥<!--> <!-->moderate calcifications, Barlow disease, multiple or commissural prolapses).</div></div><div><h3>Results</h3><div>A total of 315 patients (mean age 82.2 (±6.3) years, 46.3% female,EuroScore II 5.1% (±4.1)) with symptomatic PMR (15.6% grade 3+, 84.4% grade 4+) underwent M-TEER. WIth a median follow up of 13 months, compared with the Non-A2P2 Prolapse/Flail group, the A2P2 Prolapse/Flail group demonstrated more effective reduction in MR at discharge (residual MR<!--> <!-->≤<!--> <!-->1+: 70.5% vs. 60.4%, <em>P</em> <!-->=<!--> <!-->0.031). A2P2 Prolapse/Flail group showed superior symptomatic improvement at 1 year (NYHA class<!--> <!-->≤<!--> <!-->II: 91.4% vs. 74.5%, <em>P</em> <!-->=<!--> <!-->0.017). No significant difference was observed between both groups in all-cause mortality at 1 year (15.1% vs. 18.8%, <em>P</em> <!-->=<!--> <!-->0.492). In a subgroup of patients classified according to MV anatomy (<em>n</em> <!-->=<!--> <!-->143), patients with complex MV anatomy (<em>n</em> <!-->=<!--> <!-->68) had a higher all-cause mortality at a median last follow-up of 22 months compared with patients with non-complex MV anatomy (51.5% vs 34.7%, <em>P</em> <!-->=<!--> <!-->0.042). Using multivariate analysis, complex MV anatomy (HR 10.01 [1.30–77.04], <em>P</em> <!-->=<!--> <!-->0.027) and severe renal failure (HR 19.80 [2.68–146.04], <em>P</em> <!-->=<!--> <!-->0.003) were identified as predictors of 1-year mortality (<span><span>Figure 1</span></span>, <span><span>Figure 2</span></span>).</div></div><div><h3>Conclusion</h3><div>Complex anatomical characteristics are strongly associated with poorer outcomes in patients with PMR undergoing M-TEER.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S240-S241"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167543","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":"Hemodynamic Forces: A novel Cardiac MRI parameter to assess early cardiac involvement in Sarcoidosis patients","authors":"A. Kante ,&nbsp;A. Afana ,&nbsp;D. Sene ,&nbsp;K. Champion ,&nbsp;V. Pagis ,&nbsp;W. Bigot ,&nbsp;V. Delcey ,&nbsp;A. Lopes ,&nbsp;B.A. Amador-Borrero ,&nbsp;R. Burlacu ,&nbsp;A. Tazi ,&nbsp;B. Crestani ,&nbsp;C. Baladi ,&nbsp;V. Bousson ,&nbsp;T. Goncalves ,&nbsp;E. Ballout ,&nbsp;S. Toupin ,&nbsp;S. Mouly ,&nbsp;J.G. Dillinger ,&nbsp;P. Henry ,&nbsp;T. Pezel","doi":"10.1016/j.acvd.2025.04.028","DOIUrl":"10.1016/j.acvd.2025.04.028","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac sarcoidosis (CS) is an underdiagnosed condition potentially leading to high comorbidity. Hemodynamic forces (HDFs) measure the global force exchanged between blood volume and myocardium in cardiac magnetic resonance imaging (CMR), and are a novel noninvasive parameter to detect cardiac dysfunction. HDFs have not yet been studied in patients with suspected CS.</div></div><div><h3>Objectives</h3><div>To investigate left ventricle (LV) HDFs in suspected CS compared to healthy controls (HC) and to evaluate the diagnostic role of HDFs in differentiating between confirmed CS and non-CS patients within the suspected CS group.</div></div><div><h3>Methods</h3><div>In a single-center study, patients with suspected CS and biopsy-proven sarcoidosis were included and matched to healthy controls (HCs) (<span><span>Fig. 1</span></span>). HDFs were measured using an advanced post-processing software. In sarcoidosis patients, cardiac involvement was confirmed using World Association for Sarcoidosis and Other Granulomatous diseases 2014 criteria. HDFs diagnostic performance for CS was studied using a logistic regression.</div></div><div><h3>Results</h3><div>Among 45 sarcoidosis patients with suspected CS, 60% had confirmed-CS (22% positive cardiac FDG-PET, 11% scintigraphy perfusion defects, 85% LGE). HDFs were significantly altered compared to HC (LV impulse, <em>P</em> <!-->=<!--> <!-->0.045; LV systolic ratio, <em>P</em> <!-->=<!--> <!-->0.018; LV systolic-diastolic transition, <em>P</em> <!-->=<!--> <!-->0.012; LV diastolic deceleration, <em>P</em> <!-->=<!--> <!-->0.013). In sarcoidosis patients, LV strain and LVEF (median [IQR]%) were not significantly different between CS (56 [53–60]) and non-CS (60 [55–64]). LV longitudinal force (<em>P</em> <!-->=<!--> <!-->0.041), LV impulse (<em>P</em> <!-->=<!--> <!-->0.018), and LV systolic peak (<em>P</em> <!-->=<!--> <!-->0.035) were significantly altered in confirmed-CS. The combination of LV longitudinal force, impulse, and systolic peak enabled diagnosis of CS among sarcoidosis patients with an AUC of 0.88 (<span><span>Fig. 2</span></span>).</div></div><div><h3>Conclusion</h3><div>Sarcoidosis patients with suspected CS had altered HDFs compared to HC due to altered LV geometry and mechanics. HDFs were superior to traditional volumetric and functional CMR parameters to predict cardiac involvement in sarcoidosis patients (<span><span>Fig. 3</span></span>).</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S232-S233"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167529","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":"Propensity score-matched analysis in isolated left ventricular dilation and non-ischaemic dilated cardiomyopathy","authors":"T. Gonçalves ,&nbsp;T. Pezel ,&nbsp;S. Duhamel ,&nbsp;F. Sanguineti ,&nbsp;P. Garot ,&nbsp;T. Unterseeh ,&nbsp;T. Hovasse ,&nbsp;E. Gall ,&nbsp;P.J. Martial ,&nbsp;E. Ballout ,&nbsp;R. Mirailles ,&nbsp;B. Sibilia ,&nbsp;A. Unger ,&nbsp;A. Bondue ,&nbsp;J. Florence ,&nbsp;J.G. Dillinger ,&nbsp;P. Henry ,&nbsp;V. Bousson ,&nbsp;S. Toupin ,&nbsp;J. Garot","doi":"10.1016/j.acvd.2025.04.025","DOIUrl":"10.1016/j.acvd.2025.04.025","url":null,"abstract":"<div><h3>Background</h3><div>The presence of late gadolinium enhancement (LGE) assessed by cardiac magnetic resonance imaging (CMR) is a strong prognosticators of death in patients with non-ischaemic dilated cardiomyopathy (DCM), defined as left ventricular (LV) dilation and left ventricular ejection fraction (LVEF)<!--> <!-->&lt;<!--> <!-->50%. Although the current guidelines defined the concept of “isolated LV dilation” (ILVD) as LV dilation with preserved LVEF<!--> <!-->≥<!--> <!-->50%, the prognostic value of the “LGE granularity” is not established in this population.</div></div><div><h3>Objectives</h3><div>To assess the prognostic value of the concept of “LGE granularity” including its extent, location, and pattern for predicting all-cause death above traditional prognosticators in patients with DCM or ILVD, separately.</div></div><div><h3>Methods</h3><div>Between 2008 and 2021, all consecutive patients with DCM and ILVD were included in two centres. The primary outcome was all-cause death. A propensity score matching was performed to balance characteristics in patients with DCM vs. those with ILVD.</div></div><div><h3>Results</h3><div>Of 2752 patients analysed (age 52<!--> <!-->±<!--> <!-->8 years, 56% male), 15% patients died after a median follow-up of 9 (7–12) years. In the propensity-score matched population (<em>n</em> <!-->=<!--> <!-->1084 in DCM subgroup and <em>n</em> <!-->=<!--> <!-->1084 in ILVD), the LGE presence was associated with death (HR<!--> <!-->=<!--> <!-->2.98, 95%CI: 1.97–4.50, <em>P</em> <!-->&lt;<!--> <!-->0.001). In ILVD patients with LGE (<em>n</em> <!-->=<!--> <!-->265), the LGE extent (HR<!--> <!-->=<!--> <!-->1.41, 95%CI: 1.09–1.83, <em>P</em> <!-->=<!--> <!-->0.009), the presence of LGE in multiple areas (HR<!--> <!-->=<!--> <!-->3.86, 95%CI: 1.73–8.61, <em>P</em> <!-->&lt;<!--> <!-->0.001) and the septal location (HR<!--> <!-->=<!--> <!-->2.97, 95%CI: 1.37–6.46, <em>P</em> <!-->=<!--> <!-->0.006) were strong prognosticators of death after adjustment for traditional prognosticators. Similarly, in DCM patients with LGE (<em>n</em> <!-->=<!--> <!-->268), the LGE extent (HR<!--> <!-->=<!--> <!-->1.42, 95%CI: 1.07–1.89, <em>P</em> <!-->=<!--> <!-->0.014), the presence of LGE in multiple areas (HR<!--> <!-->=<!--> <!-->8.41, 95%CI: 3.32–21.3, <em>P</em> <!-->&lt;<!--> <!-->0.001) and the septal location (HR<!--> <!-->=<!--> <!-->6.65, 95% CI: 3.02–14.6, <em>P</em> <!-->&lt;<!--> <!-->0.001) were strongly associated with death (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>The concept of “LGE granularity” was independently associated with all-cause death after adjustment for all traditional prognosticators in both DCM and ILVD.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Pages S230-S231"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167284","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":"Long-term cardiological follow-up of patients with neuroendocrine tumors","authors":"P. Boisson De Chazournes,&nbsp;C. Marcel,&nbsp;G. Chevrot,&nbsp;T. Levesque,&nbsp;M. Hauguel-Moreau,&nbsp;O. Dubourg,&nbsp;N. Mansencal","doi":"10.1016/j.acvd.2025.04.049","DOIUrl":"10.1016/j.acvd.2025.04.049","url":null,"abstract":"<div><h3>Background</h3><div>Neuroendocrine tumors are rare and have a slow evolution. The developement of carcinoid heart disease affects the prognosis. The development of carcinoid heart disease remains unclear today and few data are available concerning the long-term cardiological follow-up of these patients.</div></div><div><h3>Objectives</h3><div>The aim of this study was to assess the prevalence and the evolution of carcinoid heart disease by performing at least annual echocardiographic follow-up.</div></div><div><h3>Methods</h3><div>We studied a population of 149 patients with an echocardiographic follow-up at the Ambroise-Paré University Hospital between 1998 and 2022. All patients had histologically proven neuroendocrine tumors and presented with carcinoid syndrome. We collected demographic, echocardiographic and tumor pathology data. After analysis of the overall population, we studied the long-term echocardiographic follow-up (&gt;<!--> <!-->8 years).</div></div><div><h3>Results</h3><div>The mean duration of follow-up was 4.7<!--> <!-->±<!--> <!-->5 years. The prevalence of carcinoid heart disease was 25% at baseline and 34% at the end of follow-up. 41% of patients with carcinoid heart disease at the beginning of follow-up experienced worsening of their heart disease during follow-up. Urinary 5-HIAA levels were significantly higher in patients who developed cardiac involvement (<em>P</em> <!-->&lt;<!--> <!-->0.0001). The study of patients with an ETT follow-up of more than 8 years showed that 23% of patients developed carcinoid heart disease after more than 8 years of evolution without cardiac involvement.</div></div><div><h3>Conclusion</h3><div>Patients with neuroendocrine tumors and carcinoid syndrome should have regular long-term cardiological follow-up. Follow-up should be closer in patients with reactivation of tumor pathology with increased urinary 5-HIAA levels.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 6","pages":"Page S246"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167443","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}