Archives of Cardiovascular Diseases最新文献

{"title":"MARFANPOWER: Results of a home-based cardiorespiratory and muscle rehabilitation program for children and young adults with Marfan syndrome","authors":"A. Guitarte Vidaurre,&nbsp;Y. Dulac,&nbsp;F. Bajanca,&nbsp;M. Langeois,&nbsp;E. Garrigue,&nbsp;B. Chesneau,&nbsp;T. Edouard","doi":"10.1016/j.acvd.2024.07.037","DOIUrl":"10.1016/j.acvd.2024.07.037","url":null,"abstract":"<div><h3>Introduction</h3><p>Marfan or associated syndromes (MFS) are some rare genetic diseases leading to a multisystem damage related to connective tissue fragility. Chronic fatigue and decreased physical endurance are almost constant complaints of patients with MFS. Muscle mass worsens through adolescence, which could explain the bone-mass deficit observed in this population.</p></div><div><h3>Objective</h3><p>We hypothesize that a personalized exercise rehabilitation program will improve fitness and quality of life (QoL) of these patients.</p></div><div><h3>Methods</h3><p>Self-controlled study with a 6-month home-based cyclo-ergometer and muscular strengthening personalised rehabilitation program based on first ventilatory-threshold. Baseline evaluation was performed 3<!--> <!-->months prior to the start of the rehabilitation program, then at the beginning of the rehabilitation program and at 6<!--> <!-->months, with a mid-term evaluation at 3<!--> <!-->months.</p></div><div><h3>Results</h3><p>We included 28 MFS patients between 7 and 20<!--> <!-->years (mean 12.8<!--> <!-->±<!--> <!-->3.69<!--> <!-->years), of which 11 were females, with a mild aortic dilatation for 50% (mean z-score +2.4), no major valvopathy, no cardiac impairment and a history of pneumothorax for 3 of them; most where under preventive beta-blocker treatment (93%).</p><p>After a 6-month rehabilitation program no progression in aortic diameters was found. Significant improvement in first ventilatory-threshold was achieved (+15.8% of expected value; <em>P</em> <!-->&lt;<!--> <!-->0.05), alongside an increase in maximal sustained workload with a mean of +24.5 Watts (17.37–31.63; <em>P</em> <!-->&lt;<!--> <!-->0.05) associated to a significant increase in VO₂ (+131.58<!--> <!-->mL.min⁻¹; 30.17–232.99; <em>P</em> <!-->&lt;<!--> <!-->0.05), whereas maximal heart rate at effort was reduced by 29.95 bpm (16.17–43.73; <em>P</em> <!-->&lt;<!--> <!-->0.05). Muscular strength gain was shown both by dominant hand-grip (mean +4.3<!--> <!-->kg; 2.45–5.2; <em>P</em> <!-->&lt;<!--> <!-->0.05) and dominant leg strength (+67.33<!--> <!-->Nm; 25.08–109.59; <em>P</em> <!-->&lt;<!--> <!-->0.05). Overall, self and proxy-reported QoL of participants improved (<span><span>Fig. 1</span></span>).</p></div><div><h3>Conclusion</h3><p>Young patients with MFS can safely benefit for a home-based rehabilitation program personalised according to their baseline capacities, improving both their overall fitness, muscular strength and cardiovascular health; with a favourable impact in their global QoL.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac amyloidosis prevalence and 1-year outcome in patients with aortic stenosis undergoing transaortic valve implantation: Findings from the CAMPOS-TAVI study","authors":"Jérôme Costa ,&nbsp;Ahmed El-Ali ,&nbsp;David Morland ,&nbsp;Sebastien Dejust ,&nbsp;Dimitri Papathanassiou ,&nbsp;Pierre Nazeyrollas ,&nbsp;Damien Metz","doi":"10.1016/j.acvd.2024.04.007","DOIUrl":"10.1016/j.acvd.2024.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Transthyretin amyloid cardiomyopathy (ATTR-CM) can manifest as rhythm disorders, heart failure, but also valvular degeneration. Despite aortic stenosis (AS) being prevalent among the elderly, data on ATTR-CM prevalence and outcome in patients with AS undergoing transaortic valve implantation (TAVI) remain scarce.</div></div><div><h3>Aim</h3><div>To determine ATTR-CM prevalence and evaluate 1-year survival in patients undergoing TAVI.</div></div><div><h3>Methods</h3><div>Between December 2020 and September 2021, 100 consecutive patients underwent TAVI and were screened prospectively for ATTR-CM using bone scintigraphy (BS). Monoclonal gammopathy was ruled out in case of cardiac uptake on BS. All patients were followed prospectively for 1<!--> <!-->year after TAVI.</div></div><div><h3>Results</h3><div>The proportion of patients aged<!--> <!-->≥<!--> <!-->75<!--> <!-->years or with a EuroSCORE II<!--> <!-->&gt;<!--> <!-->8% and possible femoral access was 99%. The abnormal cardiac uptake rate on BS was 7% (95% confidence interval: 2–12%); 86% of these patients were male. The RAISE (remodelling, age, injury, system and electrical) score, indicative of ATTR-CM risk, was higher in case of positive BS (<em>P</em> <!-->=<!--> <!-->0.04). Patients with positive BS were older and exhibited wider QRS complexes on electrocardiography (<em>P</em> <!-->=<!--> <!-->0.003), a higher frequency of reduced LVEF (57% vs. 17%), impaired basal LV strain (<em>P</em> <!-->=<!--> <!-->0.02) and a lower voltage/mass ratio (<em>P</em> <!-->=<!--> <!-->0.01). History of pacemaker implantation before TAVI was higher in the positive BS group (<em>P</em> <!-->=<!--> <!-->0.0004) and remained the only statistically significant factor after adjustment using the Holm–Bonferroni method. One-year survival of patients with positive BS did not differ from that of patients with isolated AS.</div></div><div><h3>Conclusions</h3><div>Prevalence of ATTR-CM in patients treated with TAVI, underscoring the need for continued surveillance for potential development of ATTR-CM after TAVI. Caution is warranted regarding the 1-year survival because of the lack of study power. Further investigations are needed to define long-term prognosis of AS with ATTR-CM.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141945022","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":"Mitochondrial respiration and oxidative stress in congenital heart disease","authors":"S. Mimoun ,&nbsp;J. Radojevic-Liegeois ,&nbsp;C. Pistea ,&nbsp;A.L. Charles ,&nbsp;I. Enache ,&nbsp;C. Evrard ,&nbsp;B. Geny","doi":"10.1016/j.acvd.2024.07.021","DOIUrl":"10.1016/j.acvd.2024.07.021","url":null,"abstract":"<div><h3>Introduction</h3><p>Cardiopulmonary exercise test (CPET) is the key examination in the follow-up of congenital heart disease (CHD), reflecting aerobic metabolism leading to ATP production by mitochondria. Peripheral blood mononuclear cells (PBMCs) and mitochondrial respiration is related to the severity of acquired heart disease and heart failure.</p></div><div><h3>Objective</h3><p>To assess PBMC's mitochondrial respiration in patients with CHD and investigate its correlation with CPET and echocardiographic parameters.</p></div><div><h3>Methods</h3><p>Peripheral blood sample withdrawal were obtained from 26 adult patients with CHD: tetralogy of Fallot (TOF, <em>n</em> <!-->=<!--> <!-->10), transposition of great arteries (TGA, <em>n</em> <!-->=<!--> <!-->6) and left sided obstructive lesions (LSOLs, <em>n</em> <!-->=<!--> <!-->10) as part of their routine blood tests. Healthy volunteers (<em>n</em> <!-->=<!--> <!-->15, matched for sex and age) were also recruited. Blood samples were tested for mitochondrial respiration (using the Oroboros Oxygraph system) and production of reactive oxygen species (ROS). CPET and echocardiography were performed the same day.</p></div><div><h3>Expected results</h3><p>We aim to understand how the energetic metabolism is linked with the functional status of patients with CHD.</p><p>Based on previous studies, we expect to observe impairments in mitochondrial respiration and increased oxidative stress proportional to the gravity of the cardiopathy and the alteration of the CPET.</p><p>Preliminary results show a declining trend of the coupling efficiency (or RCR, ratio of mitochondrial respiration) in oxidative phosphorylation compared to healthy controls, notably in ToF group (<em>P</em> <!-->=<!--> <!-->0.03) (<span><span>Fig. 1</span></span>). Surprisingly we did not observe any significant differences in production of ROS (<span><span>Fig. 1</span></span>).</p><p>Work is in ongoing to establish a strong statistical correlation with clinical data, primarily with the severity of the CHD.</p></div><div><h3>Perspectives</h3><p>Exploring energetic metabolism could be a useful non-invasive complementary tool in evaluating the severity of CHD. Further studies, with larger effectives, may confirm these values as reliable biomarkers for prognosis or support other clinical assessments. Finally, mitochondrial modulation could become a new therapeutic target.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271051","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":"Interventional treatment of acute right ventricular outflow track (RVOT) infectious endocarditis as bridge to surgery or percutaneous pulmonary valve implantation","authors":"A. Callegari ,&nbsp;M. Albertini ,&nbsp;L. Iserin ,&nbsp;D. Bonnet ,&nbsp;S. Malekzadeh-Milani","doi":"10.1016/j.acvd.2024.07.029","DOIUrl":"10.1016/j.acvd.2024.07.029","url":null,"abstract":"<div><h3>Introduction</h3><p>Infectious endocarditis (IE) is life threatening after pulmonary valve replacement. In case of obstructive cardiogenic shock or severe RVOTO an emergency percutaneous treatment can allow clinical stabilization to delay valve replacement.</p></div><div><h3>Objective</h3><p>This study aims to assess procedural success and clinical outcome in 16 consecutive patients (mean<!--> <!-->±<!--> <!-->SD age 27.2<!--> <!-->±<!--> <!-->15.7) with IE and primary percutaneous treatment.</p></div><div><h3>Methods</h3><p>Patients were retrospectively included.</p></div><div><h3>Results</h3><p>IE affected a Melody® valve in 9/16 (57%) cases (3/9 in a native RVOT, 1/9 with a Melody® valve in each PA, 1/9 in a Contegra VenPro™, 2/9 in a Hancock® bioprosthesis, 2/9 in a pulmonary homograft); a Contegra VenPro™ in 6/16 (37%); and a BioPulmonic Valve™ in 1/16 (6%).</p><p>Diagnosis of IE was 58.1<!--> <!-->±<!--> <!-->34.3<!--> <!-->months after last intervention/surgery and delay from diagnosis of IE to emergency percutaneous treatment was 9.8<!--> <!-->±<!--> <!-->13.5<!--> <!-->days. Clinical presentation was obstructive cardiogenic shock in 50%, septic shock in 25% or fever/shivering with severe RVOTO in 25%. At time of intervention 68% had an active bacteremia. On echo RVOT velocity was 4.6<!--> <!-->±<!--> <!-->0.4<!--> <!-->m/s and RV function was severely reduced in 68%.</p><p>Procedural time was 76<!--> <!-->±<!--> <!-->48<!--> <!-->min. Invasive RV-systolic-pressure 86<!--> <!-->±<!--> <!-->21<!--> <!-->mmHg, mean-PA pressure 19<!--> <!-->±<!--> <!-->5<!--> <!-->mmHg, and systolic-aortic-pressure 95<!--> <!-->±<!--> <!-->13<!--> <!-->mmHg. Procedural approach (<span><span>Table 1</span></span>) was dilatation in 3 patients, uncovered-stent implantation in 5, covered-stent implantation in 7, Melody® valve in 1.</p><p>Immediate resolution of the RVOTO was obtained in all patients. Post-procedural systolic-RV-pressure was 42<!--> <!-->±<!--> <!-->11<!--> <!-->mmHg, while RVOT systolic gradient was 19<!--> <!-->±<!--> <!-->7<!--> <!-->mmHg. There were no periprocedural deaths but one severe complication (rupture of a tricuspid valve corda, repaired with the following surgery).</p><p>Surgical repair (68%) and percutaneous pulmonary valve implantation (18%) were performed after 12<!--> <!-->±<!--> <!-->34 months. One patient died of IE relapse after 3-months and one during surgery. One had cardiac transplantation due to uncontrolled sepsis.</p></div><div><h3>Conclusion</h3><p>Emergency interventional relieve of RVOTO was effective in all patients and permitted to delay pulmonary valve replacement in these critically ill patients.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271054","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":"4D flow magnetic resonance imaging evaluation after transcatheter closure of sinus venosus defects","authors":"C. Batteux,&nbsp;S. Hascoet,&nbsp;G. Albenque,&nbsp;A. Azarine,&nbsp;G. Reverdito","doi":"10.1016/j.acvd.2024.07.054","DOIUrl":"10.1016/j.acvd.2024.07.054","url":null,"abstract":"<div><h3>Introduction</h3><p>Transcatheter correction of sinus venosus defects (SVD) with covered stent has recently emerged, with promising results, as an alternative to surgery. Our aim was to assess the feasibility and diagnostic value of 4D flow MRI in patients who underwent transcatheter repair of SVD.</p></div><div><h3>Methods</h3><p>Since may 2023, we scanned 16 patients who underwent transcatheter repair of SVD with cardiac magnetic resonance (CMR) including a 4D Flow MR sequence, using a 1.5T magnet. For all patients, balanced steady-state free precession (bSSFP) cine images were obtained for evaluation of left and right ventricle (RV) volumes and function. Coronal ECG-gated 4D flow MR sequences were performed, with complete thoracic coverage.</p><p>Global objective was, by a visual and quantitative analysis, to detect abnormal flow patterns and location of persistent shunts (PS). Pulmonary-to-systemic flow ratios (Qp/Qs) and RV end-diastolic volume indexed (RVEDVi) were also measured.</p></div><div><h3>Results</h3><p>CMR and 4D Flow MR were feasible and assessed global success of the procedure in all 16 patients. RVEDVi decreased in all patients. Average Qp/Qs was 1.24 (±<!--> <!-->0.33), with RVEDVi of 77<!--> <!-->mL/m² (±<!--> <!-->21).</p><p>Qp/Qs measured by catheterization, 4D Flow MR and RV/LV stroke volume ratio were well correlated.</p><p>Twelve out of 16 patients (75%) had no significant PS with Qp/Qs<!--> <!-->&lt;<!--> <!-->1.5, including 8 patients without any PS at all. Four patients showed significant shunting with Qp/Qs<!--> <!-->&gt;<!--> <!-->1.5.</p><p>PS visual analysis provided valuable insights into the understanding and the mechanism analysis of the PS.</p></div><div><h3>Conclusion</h3><p>We demonstrated the feasibility of 4D Flow MRI in all patients who had undergone transcatheter correction of SVD. 4D flow MRI accurately identified PS with comprehensive visualization of their location and mechanism, providing valuable information for their follow-up and to further discuss reintervention.</p><p>Qp/Qs ratio assessment using 4D Flow data showed good correlation compared to other functional measurements.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271153","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":"Chirurgie mini-invasive pour la prise en charge des communications inter-atriales type sinus venosus chez l’adulte","authors":"T. Dugast ,&nbsp;A. Mugniot ,&nbsp;L. Le Gloan ,&nbsp;F. Wautot ,&nbsp;J.C. Roussel","doi":"10.1016/j.acvd.2024.07.041","DOIUrl":"10.1016/j.acvd.2024.07.041","url":null,"abstract":"<div><h3>Introduction</h3><p>La communication inter-atriale (CIA) est la deuxième malformation congénitale du sujet adulte la plus fréquente après la bicuspidie aortique. Parmi les différentes formes de CIA, la sinus venosus représente 5 à 10 % des cas. Malgré le développement de dispositifs de fermeture percutanée, le <em>gold standard</em> reste la chirurgie conventionnelle par sternotomie médiane sous circulation extra-corporelle (CEC). Plusieurs études se sont intéressées à une prise en charge mini-invasive telle que la thoracoscopie ou la chirurgie robotique avec des résultats intéressants.</p></div><div><h3>Méthodes</h3><p>Il s’agit d’une étude rétrospective monocentrique ayant inclus 8 patients adultes (75 % d’hommes) âgés de 21 à 68 ans (moyenne : 47<!--> <!-->±<!--> <!-->14 ans) entre janvier et septembre 2023. La procédure a été réalisée en décubitus dorsal, par une courte thoracotomie utilitaire antérolatérale droite associée à 3 incisions satellites (caméra, canule d’aspiration, clamp aortique) et avec assistance vidéo 3D. La technique à deux patchs était utilisée pour la réparation avec une canulation fémorale pour la CEC.</p></div><div><h3>Résultats</h3><p>Tous les patients présentaient un CIA avec retour veineux pulmonaire anormal partiel et aucun n’avait de veine cave supérieure gauche. Un patient présentait une forme ostium secondum associée et un autre un foramen ovale perméable, fermés simultanément.</p><p>La durée moyenne de CEC était de 184<!--> <!-->±<!--> <!-->12 minutes avec une durée moyenne de clampage de 113<!--> <!-->±<!--> <!-->20 minutes. Aucune conversion par sternotomie n’a été nécessaire. La durée moyenne du séjour en en réanimation était de 2,9<!--> <!-->±<!--> <!-->2,4 jours et de 7,1<!--> <!-->±<!--> <!-->3 jours pour le séjour hospitalier.</p><p>À deux mois de suivi, aucun décès ni shunt résiduel n’ont été observé pour l’ensemble des patients.</p></div><div><h3>Conclusion</h3><p>Une prise en charge chirurgicale mini-invasive par vidéo-thoracoscopie 3D apparaît comme une alternative fiable et reproductible à la sternotomie pour le traitement des CIA sinus venosus.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271156","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":"Transposition of great arteries in developing world: Early mortality and predictive factors","authors":"M. Louati,&nbsp;R. Gargouri,&nbsp;M. Jarraya,&nbsp;M. Jabeur,&nbsp;S. Charfeddine,&nbsp;L. Abid","doi":"10.1016/j.acvd.2024.07.051","DOIUrl":"10.1016/j.acvd.2024.07.051","url":null,"abstract":"<div><h3>Introduction</h3><p>Transposition of great arteries (TGA) is a prevalent congenital heart defect presenting a diagnostic and therapeutic emergency. Its immediate prognosis is currently much improved by initial palliative treatment. However, in the absence of early complementary surgical repair, the prognosis remains extremely poor, with a high rate of mortality.</p></div><div><h3>Objective</h3><p>In this study, we sought to investigate the preoperative in-hospital mortality of newborns with TGA born in Sfax in Tunisia, a developing country with limited resources where surgical repair is not possible and most children undergo surgery abroad.</p></div><div><h3>Methods</h3><p>Monocentric retrospective analysis of all newborns with TGA hospitalized in CHU Hedi Chaker of Sfax in Tunisia during 2014–2022. Infants with simple TGA (±<!--> <!-->small VSD) and with complex TGA (large VSD, pulmonary stenosis or aortic coarctation) were included. Factors associated with preoperative in-hospital mortality were analyzed.</p></div><div><h3>Results</h3><p>The study included 51 patients divided into two groups: group I, 42 cases of simple TGA and group II, 9 cases with complex TGA. The overall preoperative mortality was 19.6% (10 of 51 patients) and it did not differ significantly between the two groups (group I 21.4% vs. group II 11%, <em>P</em> <!-->=<!--> <!-->0.667). The mean age of death was 19<!--> <!-->days (IQR<!--> <!-->=<!--> <!-->[8–44]). The mean time of death after diagnosis of TGA was 11<!--> <!-->days with the earliest death occurring within the first 24<!--> <!-->hours after diagnosis and the latest 36<!--> <!-->days later. Major hypoxemia and infections were main causes of death, responsible of 90% of all deaths. Early mortality was significantly associated with a lower birth weight (2885 vs. 3317; <em>P</em> <!-->=<!--> <!-->0.014) with a higher rate in female patients. On the other hand, age of discovery (<em>P</em> <!-->=<!--> <!-->0.429) and antenatal diagnosis of TGA (<em>P</em> <!-->=<!--> <!-->0.537) were not significantly associated with preoperative mortality. However, this is statistically insignificant result due to the limited prenatal detection (6%). No ultrasound predictive factor was identified with a higher rate of early death in the presence of incongruence between the pulmonary artery and the aorta (27.3% vs. 17.5%, <em>P</em> <!-->=<!--> <!-->0.47) and in cases of banana-like LV shape (33.3% vs. 18.8%, <em>P</em> <!-->=<!--> <!-->0.537). Failed balloon atrial septostomy was significantly associated with early mortality (75% vs. 16%; <em>P</em> <!-->=<!--> <!-->0.028).</p></div><div><h3>Conclusion</h3><p>In our study, lower birth weight and insufficient interatrial shunt were independent factors predicting preoperative early death in TGA patients.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271177","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":"Effectiveness of simulation-based echocardiography training for neonatology residents: A randomized controlled trial","authors":"A. Blanchetière ,&nbsp;E. Guillouët ,&nbsp;G. Favrais ,&nbsp;C. Lardennois ,&nbsp;A. Bellot ,&nbsp;B. Savey","doi":"10.1016/j.acvd.2024.07.031","DOIUrl":"10.1016/j.acvd.2024.07.031","url":null,"abstract":"<div><h3>Introduction</h3><p>Transthoracic echocardiography (TTE) is a valuable tool in neonatal intensive care units (NICUs) and allows rapid hemodynamic evaluation. Increasingly, fast TTE is performed not only by cardiologists but also by neonatologists, to support bedside clinical decision-making. These changes imply a new need for training, which is not easy to achieve due to the instability of critically ill neonatal patients, who do not always tolerate long-lasting TTE, necessary for good-quality teaching. Also, simulation-based training using high-technology neonatal echocardiography simulators might be a good approach for residents training.</p></div><div><h3>Objective</h3><p>This study aimed to demonstrate the benefits of simulation-based training for neonatal echocardiography learning.</p></div><div><h3>Methods</h3><p>This study was a multicentered randomized controlled trial, involving residents from 3 French NICUs, comparing a control group with theorical and bedside training, with a simulation group with theorical training, a 3-hour simulation session and bedside training. An evaluation using the EchoComNeo simulator was conducted at 3 and 6<!--> <!-->months from initial training based on two scoring methods by two evaluators: a reference score for quality of TTE sections, and a custom-made score to assess the recognition of the anatomical structures. TTE duration and resident's satisfaction was also assessed.</p></div><div><h3>Results</h3><p>From May 2021 to May 2023, 52 residents were randomized, 17 in the control group and 35 in the simulation group. At 3<!--> <!-->months, residents in the simulation group exhibited a higher mean score for both the reference score (11.5<!--> <!-->±<!--> <!-->2.3 points versus 7.4<!--> <!-->±<!--> <!-->3.4 points, <em>P</em> <!-->&lt;<!--> <!-->0.001) and the custom-made score (25.8<!--> <!-->±<!--> <!-->5.3 points versus 16.9<!--> <!-->±<!--> <!-->7.8 points, <em>P</em> <!-->&lt;<!--> <!-->0.001) than residents in the control group. At 6<!--> <!-->months, the difference between groups remained significant. TTE duration did not significantly differ between groups. The custom-made score showed good agreement with the reference score (<span><span>Fig. 1</span></span>).</p></div><div><h3>Conclusion</h3><p>Simulation-based training seems to be a valuable approach for echocardiography training of NICU residents and should be developed to more extensive training courses.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271056","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":"Safety and efficacy of dapagliflozin in patients with systemic right ventricular dysfunction: Preliminary results","authors":"M. Albertini ,&nbsp;V. Waldmann ,&nbsp;P. David ,&nbsp;A. Barat ,&nbsp;A.S. Chaussade ,&nbsp;L. Iserin ,&nbsp;M. Ladouceur","doi":"10.1016/j.acvd.2024.07.011","DOIUrl":"10.1016/j.acvd.2024.07.011","url":null,"abstract":"<div><h3>Introduction</h3><p>Heart failure (HF) is the leading cause of death in adults with a systemic right ventricle (sRV). Dapagliflozin has been shown to reduce hospitalization for HF and all-cause death in patients with HF and reduced ejection fraction. The impact of dapagliflozin in patients with a sRV remains unknown.</p></div><div><h3>Objective</h3><p>We aimed to evaluate the efficacy and safety of dapagliflozin in patients with sRV.</p></div><div><h3>Methods</h3><p>This was a prospective, observational, single-center study. All symptomatic (NYHA<!--> <!-->≥<!--> <!-->2) patients with a sRV dysfunction despite optimal medical treatment were included from March 2023 to March 2024. Patients were assessed at baseline and 3, 6 and 12<!--> <!-->months after dapagliflozin introduction. The primary endpoint was the 6-minute walk distance. Secondary endpoints included NT-proBNP, quality of life (KCCQ-12), NYHA class, systemic and sub-pulmonary ventricular systolic function, and potential treatment-related side effects.</p></div><div><h3>Expected results</h3><p>A total of 32 patients were included. Mean age was 48<!--> <!-->years (range: 19–79), 20 (62%) of patients were male, 12 (38%) had congenitally corrected transposition of the great arteries and 20 (62%) had transposition of the great arteries with atrial switch. Preliminary results at 6<!--> <!-->months were available in 20 patients. There was no statistically significant improvement in 6-minute walk distance (558.0<!--> <!-->m vs. 599.5, <em>P</em> <!-->=<!--> <!-->0.11) nor NT-proBNP (355.5<!--> <!-->pg/mL vs. 293.5, <em>P</em> <!-->=<!--> <!-->0.81). However, the quality of life of patients (80.5 vs. 92.0, <em>P</em> <!-->&lt;<!--> <!-->0.01) and the right ventricle global longitudinal strain (−11.2% vs. −12.9, <em>P</em> <!-->&lt;<!--> <!-->0.01) significantly improved. The drug was well tolerated with no side effects reported (<span><span>Fig. 1</span></span>).</p></div><div><h3>Perspectives</h3><p>These preliminary results suggest that dapagliflozin is well tolerated and associated with improved quality of life and right ventricle global longitudinal strain in patients with sRV dysfunction. Final results will bring important data on long-term outcomes associated with dapagliflozin use in this population.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The neuro-heart program: The importance of early postoperative screening","authors":"A. Barat","doi":"10.1016/j.acvd.2024.07.052","DOIUrl":"10.1016/j.acvd.2024.07.052","url":null,"abstract":"<div><h3>Introduction</h3><p>Recent studies highlight a high prevalence of difficulties at school and neurodevelopmental disorders in children with operated congenital heart disease.</p></div><div><h3>Objective</h3><p>The objective of this study was to evaluate the application of this program 2<!--> <!-->years after its introduction.</p></div><div><h3>Methods</h3><p>A systematic screening program for neurodevelopmental disorders was recently developed within our institution for every patient who had cardiac surgery before the age of one year. The “neuro-heart program” involves an antenatal, preoperative and postoperative assessment allowing the child to be assigned to pathway A (screening for neurodevelopmental disorders by parental questionnaires at key ages), pathway B (reassessment necessary at 3<!--> <!-->months) or pathway C (specific follow-up at CAMPS with support from physiotherapist, speech therapist, psychomotor therapists, etc.).</p></div><div><h3>Results</h3><p>Between October 2020 and November 2022, 78 patients operated under extracorporeal circulation before the age of one year were included in the “neuro-heart program”. Concerning antenatal evaluation: 43 children benefited from an antenatal diagnosis, including 30 with complex or ductal-dependent heart disease but only 10 brain MRIs were performed. Concerning the preoperative evaluation: only 14/31 patients with duct-dependent heart disease benefited from a preoperative neurological evaluation while 38/48 with non-duct-dependent heart disease benefited from it. Concerning the postoperative neurological assessment: 100% of patients were pointed towards a care pathway: 33 patients were referred to pathway A, 6 to pathway B and 39 to pathway C. Concerning the children in pathway C, we found a prevalence of genetic syndrome (<em>P</em> <!-->=<!--> <!-->0.003) and a higher age at surgery (<em>P</em> <!-->=<!--> <!-->0.0008) compared to the children of pathway A. There was no significant difference between the 2 groups concerning pre- or postoperative electroencephalogram anomalies and pre- or postoperative brain MRI anomalies.</p></div><div><h3>Conclusion</h3><p>Preoperative neurological assessment methods are sometimes difficult, especially in duct-dependent patients. The implementation of a screening and monitoring program for neurodevelopmental disorders can be carried out postoperatively.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271178","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}