Archives of Cardiovascular Diseases最新文献

{"title":"Dapagliflozin in Adult Patients with Failing Fontan (DAPA-FONTAN): A Prospective Multicentre Study","authors":"Mathieu Albertini ,&nbsp;Victor Waldmann ,&nbsp;Valentin Baland ,&nbsp;Elise Barre ,&nbsp;Jelena Radojevic ,&nbsp;Laurianne Le Gloan ,&nbsp;Patrice Guérin ,&nbsp;Fabien Labombarda ,&nbsp;Fanny Dion ,&nbsp;Reaksmei Ly ,&nbsp;François Godart ,&nbsp;Pamela Moceri ,&nbsp;Pauline David ,&nbsp;Alexis Barat ,&nbsp;Antoine Legendre ,&nbsp;Anne-Solene Chaussade ,&nbsp;Sebastien Hascoet ,&nbsp;Laurence Iserin","doi":"10.1016/j.acvd.2025.06.009","DOIUrl":"10.1016/j.acvd.2025.06.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) is the leading cause of death in adults with congenital heart disease, particularly in patients with a univentricular heart and Fontan circulation. Over time, this circulation is associated with increasing morbidity, especially in cases of circulatory failure (Failing Fontan–FF). FF has multiple causes: systolic or diastolic dysfunction of the single ventricle, elevated pulmonary vascular resistance, significant valve regurgitation, or stenoses within the Fontan circuit. Therapeutic options are limited, and Dapagliflozin—currently recommended for left-sided HF—may offer functional benefits in this specific population.</div></div><div><h3>Objective</h3><div>To assess the impact of Dapagliflozin on functional capacity in adult patients with FF due to systolic or diastolic dysfunction.</div></div><div><h3>Methods</h3><div>A 6-month prospective, multicenter, observational study.<strong>Inclusion criteria</strong> include adults older than 18 years with FF confirmed by right heart catheterization within the past 6 months, defined by:</div><div>– Systolic dysfunction with single ventricular ejection fraction (EF)<!--> <!-->≤<!--> <!-->40% and ventricular end-diastolic pressure (VEDP) or pulmonary artery wedge pressure (PAWP)<!--> <!-->≥<!--> <!-->15<!--> <!-->mmHg.</div><div>– Diastolic dysfunction with EF<!--> <!-->≥<!--> <!-->41% and VEDP or PAWP<!--> <!-->≥<!--> <!-->15<!--> <!-->mmHg.<strong>Exclusion criteria</strong> include severe atrioventricular valve regurgitation, elevated pulmonary vascular resistance, Fontan circuit stenosis, pregnancy, eGFR<!--> <!-->&lt;<!--> <!-->25<!--> <!-->ml/min/1.73 m², and systolic BP<!--> <!-->&lt;<!--> <!-->95<!--> <!-->mmHg.<strong>Primary endpoint:</strong> Change in VO₂ max on cardiopulmonary exercise testing (CPET) between baseline and 6 months.<strong>Secondary endpoints:</strong> NYHA class, quality of life (KCCQ-12), NT-proBNP levels, EF, number of HF-related hospitalizations, diuretic dosage, liver and kidney function, blood pressure, and adverse events.</div></div><div><h3>Expected Results</h3><div>An improvement in exercise capacity, NYHA class, quality of life, and biological parameters is expected, with good clinical and biological tolerance of the treatment.</div></div><div><h3>Perspectives</h3><div>This study may support the targeted use of Dapagliflozin in FF patients with systolic or diastolic dysfunction and lay the groundwork for future randomized trials in this high-risk population.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages S251-S252"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934220","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":"Efficacy and safety of sacubitril/valsartan in pediatric heart failure: A prospective study","authors":"Amal Kchaou ,&nbsp;Rania Gargouri ,&nbsp;Ikram Chamtouri ,&nbsp;Marwa Jarraya ,&nbsp;Mariem Jabeur ,&nbsp;Leila Abid","doi":"10.1016/j.acvd.2025.06.024","DOIUrl":"10.1016/j.acvd.2025.06.024","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Pediatric heart failure is associated with significant morbidity and mortality and can be a source of major disability for the child and their family. Therapeutic options are limited, and managing this condition presents multiple challenges. Although the use of sacubitril/valsartan is well established in adults heart failure, its efficacy and safety in children remain uncertain. Its clinical effects and safety profile are not yet well established in the paediatric population.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;This prospective, observational, multicenter study included symptomatic children aged between 1 month and 18 years with systemic ventricular dysfunction (LVEF&lt;!--&gt; &lt;!--&gt;≤&lt;!--&gt; &lt;!--&gt;45% or RF&lt;!--&gt; &lt;!--&gt;≤&lt;!--&gt; &lt;!--&gt;22.5%) who were symptomatic (NYHA&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2 or ROSS&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2) from March 2024 to March 2025. Patients were assessed at baseline and 3 months after initiating sacubitril/valsartan. The primary endpoint was clinical improvement using the Global Rank End Point, which is a hierarchical composite clinical score. Secondary endpoints included NT-proBNP, quality of life (PGIS and Ped Q life), NYHA and Ross classifications, ultrasound parameters mainly LVEF and global longitudinal strain, and potential treatment-related side effects.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 20 patients were included. Mean age was 5.3 years (range: 1–15 years) 13 children (65%) were girls, 9 (45%) had primitive cardiomyopathy 8 (40%) had secondary cardiomyopathy (metabolic abnormality5%neuromuscular disease5% Dilated cardiomyopathy post myocarditis 20% ischemic heart disease 10%) and 3 (15%) had congenital heart disease. At 3 months follow up, the primary endpoint showed significant improvement: 65% (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;13) progressed favorably (category 5) 10% (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2) remained stable (Category 4) 5% (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;1) worsened (Category 3) 10% (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2) had poor progression (Category 2-A) 10% (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2) died from non-cardiac causes (Category1) (&lt;span&gt;&lt;span&gt;Table 1&lt;/span&gt;&lt;/span&gt;) Secondary endpoints also demonstrated statistically significant improvements in NT-proBNP (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.00008) quality of life (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.05) PedQ Life (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.05) and echographic parameters: left ventricular, global longitudinal strain (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.05) LVEF (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.05) and NYHA and ROSS scores also improved significantly. The treatment was well tolerated, with 35% (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;7) experiencing non-serious adverse effects (hyperkalemia hypotension nausea). No treatment discontinuations occurred.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;These findings suggest that sacubtril/valsartan is well tolerated in pediatric heart failure and is associated with improvement in quality of life and left ventricula","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S260"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934225","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":"MYH6 and CHDs: Phenotypic characterization in a cohort of 28 patients","authors":"Elise Daire ,&nbsp;Antoine Moktadir ,&nbsp;Kahia Messaouidi ,&nbsp;Walaa Darwiche ,&nbsp;Florence Jobic ,&nbsp;Sabine Dirani ,&nbsp;Alexis Hermida ,&nbsp;Olivia Domanski ,&nbsp;Luisa Marsili ,&nbsp;Isabelle Perthus ,&nbsp;Sophie Julia ,&nbsp;Noémie Celton ,&nbsp;Anne Claire Brehin ,&nbsp;Patrice Bouvagnet ,&nbsp;Julie Thomas ,&nbsp;Claire Beneteau ,&nbsp;Vincent Michaud ,&nbsp;Caroline Rooryck-Thambo ,&nbsp;Guillaume Jedraszak","doi":"10.1016/j.acvd.2025.06.016","DOIUrl":"10.1016/j.acvd.2025.06.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital Heart diseases (CHDs) are one of the most frequent congenital anomalies and represent a significant source of morbidity and mortality in infants. The underlying causes of CHDs are still not well understood, though it has long been hypothesized to involve both genetic and environmental contributions. Variants in <em>MYH6</em> have emerged as potential genetic contributors to congenital heart disease (CHDs), though genotype-phenotype correlations remain incompletely described. The aim is to provide a detailed description of cardiac phenotypes in patients with CHDs and carriers of <em>MYH6</em> variants, in a French cohort.</div></div><div><h3>Method</h3><div>We included patients with CHDs in whom genetic testing identified relevant <em>MYH6</em> variants ascertained through a collaborative network of French genetics laboratories. Clinical data, follow up and familial data were retrospectively collected from medical records. All cardiac lesions were included, and each patient had defined a principal phenotype.</div></div><div><h3>Results</h3><div>We included 28 patients, from whom 67.9% had left heart diseases as principal phenotype notably hypoplastic left heart syndrome (39.3%), left heart obstructions at mutiples sites (17.9%), and coarctation of aorta (10.7%) (<span><span>Figure 1</span></span>). One third of patients had other CHDs such as tetralogy of Fallot, pulmonary stenosis and septal defects. An unexpected high prevalence (35.7%) of persistent left superior caval vein (LSCV) was found compared to literature reports (0.2–5%), raising its potential as a clinical marker for <em>MYH6</em> variants. The 19 variants were most of time first described, heterozygous, missenses and inherited for 60.7% of the cohort. Family screening demonstrated incomplete penetrance and variable phenotypic expressivity.</div></div><div><h3>Conclusion</h3><div>Our findings support broad indications of molecular testing for <em>MYH6</em> in left heart diseases and other CHDs particularly when familial recurrence is uncertain. LSCV could represent a clinical indicator associated with <em>MYH6</em> carriers.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages S255-S256"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934238","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":"Change in health-related quality of life in CHD from childhood to adulthood over a decade: The multicenter European QUALIDECADE cohort study","authors":"Marion Audié ,&nbsp;Alyssia Venna ,&nbsp;Helena Huguet ,&nbsp;Mathieu Andrianoely ,&nbsp;Lauriane Cornuault ,&nbsp;Hamouda Abassi ,&nbsp;Sophie Guillaumont ,&nbsp;Marie Vincenti ,&nbsp;Stéphane Moniotte ,&nbsp;Caroline Neyraud ,&nbsp;Marie-Christine Picot ,&nbsp;Pascal Amédro","doi":"10.1016/j.acvd.2025.06.011","DOIUrl":"10.1016/j.acvd.2025.06.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Medical advances in the management of congenital heart disease (CHD) have shifted the focus from mortality to life-long morbidity, with a stronger attention on patient-reported outcomes. Health-related quality of life (HRQoL) has been increasingly used as primary outcomes in cross-sectional or randomized controlled trials in CHD, however few cohort studies have measured the change in HRQoL over significant periods of time. This study aimed to prospectively measure HRQoL in CHD from childhood to adulthood over a decade and identify the predictors of HRQoL in this population.</div></div><div><h3>Method</h3><div>A multicenter cohort of 282 children with CHD was prospectively followed from 2012 to 2022 in three European tertiary care centers. The baseline HRQoL and clinical data were previously reported (<span><span>https://doi.org/10.1007/s00246-015-1201-x</span><svg><path></path></svg></span>). Ten years after patient enrolment, HRQoL and clinical data were collected again. Change in HRQoL using the PedsQL™ 4.0 generic instrument during the 10-year follow-up and predictors of HRQoL at 10-year follow-up were assessed, with adjustment on sex and age, and using multivariate analysis.</div></div><div><h3>Results</h3><div>From the baseline population of 282 children with CHD (mean age 12.3<!--> <!-->±<!--> <!-->3.0 years, sex ratio 1.9), 121 patients (mean age 21.3<!--> <!-->±<!--> <!-->2.7 years, sex ratio 1.4) participated in the cohort study (mean 9.9<!--> <!-->±<!--> <!-->1.5 year follow-up). Overall, HRQoL scores remain stable over a decade, with a mean 78.1<!--> <!-->±<!--> <!-->15.9 total score in young adults (mean change of 0.9<!--> <!-->±<!--> <!-->16, <em>P</em> <!-->=<!--> <!-->0.55). However, HRQoL scores were 10-points lower in female patients than in males (73.3<!--> <!-->±<!--> <!-->16.2 <em>vs.</em> 83.6<!--> <!-->±<!--> <!-->14.7, <em>P</em> <!-->&lt;<!--> <!-->0.001) and increased in men during the follow-up (+3.5<!--> <!-->±<!--> <!-->13.1, <em>P</em> <!-->=<!--> <!-->0.03 and +5.0<!--> <!-->±<!--> <!-->11.7, <em>P</em> <!-->&lt;<!--> <!-->0.001, in total and physical scores, respectively). Apart from gender, baseline predictors of poorer HRQoL at 10-year follow-up in multivariate analysis were physical deconditioning (low ventilatory anaerobic threshold), repeated cardiac catheter interventions, angiotensin-converting enzyme inhibitors, and anticoagulants.</div></div><div><h3>Conclusion</h3><div>Overall HRQoL in CHD remained stable from childhood to early adulthood over a decade of follow-up. However, HRQoL decreased with time in female patients, with a large magnitude of the difference with males at 10-year follow-up. Based on the modifiable predictors of HRQoL identified in this study, early cardiac rehabilitation could improve aerobic fitness and increase HRQoL in youth with CHD, especially in female patients.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages S252-S253"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934239","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":"Lower response to preventive cardiovascular interventions in adolescent and young adult female CHD patients","authors":"Alyssia Venna ,&nbsp;Marion Audié ,&nbsp;Sophie Guillaumont ,&nbsp;Caroline Neyraud ,&nbsp;Helena Huguet ,&nbsp;Marie-Christine Picot ,&nbsp;Mathieu Andrianoely ,&nbsp;Pascal Amédro","doi":"10.1016/j.acvd.2025.06.012","DOIUrl":"10.1016/j.acvd.2025.06.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Results from three randomized clinical trials (QUALIREHAB, TRANSITION, and SOPRHOCARE) carried out by our group were recently reported on the efficacy of a regimented preventive program on exercise capacity and quality of life (QOL) outcomes in adolescents and young adults with congenital heart disease (CHD). Leveraging this data, we aimed to investigate gender differences in outcomes of these three patient populations.</div></div><div><h3>Method</h3><div>A post-hoc analysis from 13-to-25 year-old CHD patients, enrolled in the intervention group of one of the 3 clinical trials was conducted. The QUALREHAB trial consisted of 70 randomized patients (54% females, mean age 17.1<!--> <!-->±<!--> <!-->3.5 years), the SOPHROCARE trial consisted of 99 randomized patients (58% females, mean age of 16.9<!--> <!-->±<!--> <!-->3.5 years), and the TRANSITION trial consisted of 94 randomized patients (44% females, mean age of 18.9<!--> <!-->±<!--> <!-->3.7 years). Gender differences were assessed across exercise capacity outcomes and QOL measures using intention-to-treat (ITT) analysis and the per-protocol analysis within each randomized clinical trial. Differences were also assessed within gender in the randomized and controlled groups. Absolute differences (AD) between groups were reported. All comparisons were adjusted for age and baseline values.</div></div><div><h3>Results</h3><div>Gender differences were identified in the ITT analysis for QUALIREHAB in physical and emotional QOL domains (AD<!--> <!-->=<!--> <!-->−<!--> <!-->9.68, <em>p</em> <!-->=<!--> <!-->0.0.3 and −9.95, <em>p</em> <!-->=<!--> <!-->0.01, respectively) and in the per-protocol analysis for QUALIREHAB in theoretical VO2max (AD<!--> <!-->=<!--> <!-->−<!--> <!-->8.49, <em>p</em> <!-->=<!--> <!-->0.05). Smaller gender differences were observed in the ITT analysis for the SOPHROCARE trial in VAT and VO2max domains (AD<!--> <!-->=<!--> <!-->−<!--> <!-->2.19, <em>p</em> <!-->=<!--> <!-->0.03 and −2.78, <em>p</em> <!-->=<!--> <!-->0.048, respectively) and in the per-protocol analysis for SOPHROCARE in VAT (AD<!--> <!-->=<!--> <!-->−<!--> <!-->3.29, <em>p</em> <!-->=<!--> <!-->0.0024). There were no gender differences observed in the ITT or per-protocol analyses for the TRANSITION trial, however differences existed between the females in randomized and controlled cohorts in both ITT and per-protocol analyses.</div></div><div><h3>Conclusion</h3><div>Female patients with CHD may have lower exercise capacity and lower QOL scores following certain preventive interventions designed to improve these outcomes. While the TRANSITION trial did not show differences between genders, there was a difference between randomized and controlled females, indicating that the patient education component in this trial may play an important role in facilitating outcomes and should be further explored.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S253"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934240","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":"Mot de bienvenue","authors":"","doi":"10.1016/j.acvd.2025.06.004","DOIUrl":"10.1016/j.acvd.2025.06.004","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S248"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934275","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":"Epidemiological and clinical features of Kawasaki disease and risk factors for cardiac involvement: A study about 32 Tunisian children","authors":"Rania Gargouri ,&nbsp;Ines Maaloul ,&nbsp;Imen Chabchoub ,&nbsp;Hajer Aloulou ,&nbsp;Salma Charfeddine ,&nbsp;Leila Abid","doi":"10.1016/j.acvd.2025.06.036","DOIUrl":"10.1016/j.acvd.2025.06.036","url":null,"abstract":"<div><h3>Introduction</h3><div>Arteries in children. Untreated, approximately 25% of patients develop coronary complications, making KD the most common vasculitis in children under 5 years of age. While its incidence is highest in Japan, data from Tunisia remain limited. Early diagnosis and treatment with intravenous immunoglobulins (IVIG) significantly reduce the risk of coronary artery lesions (CAL).</div></div><div><h3>Method</h3><div>This study aimed to analyze the clinical and echocardiographic features of cardiovascular involvement in a cohort of Tunisian children with KD and identify risk factors associated with cardiac complications.</div></div><div><h3>Methods</h3><div>A retrospective, descriptive, and analytical study was conducted at Hédi Chaker University Hospital in Sfax, Tunisia, from January 2015 to December 2021. Children under 14 years diagnosed with complete or incomplete form of KD according to the American Heart Association (AHA) criteria were included. Data on clinical, biological, and echocardiographic features were collected. Statistical analysis was performed using IBM SPSS version 20, with multivariate logistic regression to identify risk factors for CAL.</div></div><div><h3>Results</h3><div>Among 32 patients (18 girls, 14 boys; mean age 3.6<!--> <!-->±<!--> <!-->2.6 years), 65.6% had incomplete KD. Cardiac involvement was observed in 78% of cases (n<!--> <!-->=<!--> <!-->25), including coronary artery dilation (n<!--> <!-->=<!--> <!-->23), hyperechogenicity of coronary arteries (n<!--> <!-->=<!--> <!-->15), and aneurysms (n<!--> <!-->=<!--> <!-->4). The left coronary artery was more frequently affected (n<!--> <!-->=<!--> <!-->19). Elevated C-reactive protein (CRP<!--> <!-->≥<!--> <!-->50<!--> <!-->mg/L; <em>p</em> <!-->=<!--> <!-->0.002) and leukocytosis (≥<!--> <!-->15,000/mm³; <em>p</em> <!-->=<!--> <!-->0.04) were independent predictors of CAL in multivariate analysis. All patients received IVIG (2<!--> <!-->g/kg) and acetylsalicylic acid, with favorable outcomes.</div></div><div><h3>Conclusion</h3><div>Incomplete form of KD was predominant in this Tunisian cohort, with a high prevalence of CAL. Elevated CRP and leukocytosis were significant risk factors for cardiac involvement. Early identification of these predictors may improve risk stratification and guide timely intervention to prevent coronary complications.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S266"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934298","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":"Echocardiographic predictors of double disc-self-centering device embolization after transcatheter closure of ostium secundum atrial septal defects","authors":"Grégoire Albenque ,&nbsp;Estíbaliz Valdeolmillos ,&nbsp;Marine Cachanado ,&nbsp;Jerome Petit ,&nbsp;clement Batteux ,&nbsp;Sebastien Hascoet","doi":"10.1016/j.acvd.2025.06.048","DOIUrl":"10.1016/j.acvd.2025.06.048","url":null,"abstract":"<div><h3>Introduction</h3><div>Transcatheter closure of ostium secundum atrial septal defect (osASD) has been the first-line treatment since the 2000s, with the Amplatzer Septal Occluder (ASO) being the most commonly used device. Device embolization is the most frequent major complication. This study aims to identify key echocardiographic predictors of device embolization in a large patient cohort.</div></div><div><h3>Method</h3><div>This prospective, single-center cohort study included patients who underwent transcatheter osASD closure with ASO between 1998 and 2021 at Marie Lannelongue Hospital. Echocardiographic assessments included osASD size and rim evaluation. Rim deficiency was defined as &lt;<!--> <!-->5<!--> <!-->mm. The osASD size-to-body surface area (BSA) ratio was calculated. Logistic regression models identified factors associated with embolization.</div></div><div><h3>Results</h3><div>Among 1901 patients with complete echocardiographic data, 19 (1%) experienced device embolization within 48<!--> <!-->hours. Eleven occurred in adults and eight in patients under 18years old. Ten devices embolized within the right heart cavities or pulmonary trunk while nine migrated into the left cavities or aorta. Thirteen devices were successfully retrieved by catheterisation and in four cases osASD closure was successfully performed during a second attempt using a larger prosthesis. Embolization was significantly associated with larger osASD size (22<!--> <!-->±<!--> <!-->9<!--> <!-->mm <em>vs.</em> 18<!--> <!-->±<!--> <!-->7<!--> <!-->mm, <em>p</em> <!-->=<!--> <!-->0.031) and an osASD size/BSA ratio<!--> <!-->≥<!--> <!-->20<!--> <!-->mm/m² (OR 5.27 [1.95–14.22], <em>p</em> <!-->=<!--> <!-->0.001). IVC, antero-inferior, and postero-inferior rim deficiencies were also significant predictors (<em>p</em> <!-->&lt;<!--> <!-->0.001, <em>p</em> <!-->&lt;<!--> <!-->0.001, and <em>p</em> <!-->=<!--> <!-->0.023, respectively). The absence of balloon sizing increased embolization risk (<em>p</em> <!-->=<!--> <!-->0.002). In multivariate analysis, IVC rim deficiency (OR 15.38 [3.58–66.08], <em>p</em> <!-->&lt;<!--> <!-->0.001) and an osASD size/BSA ratio<!--> <!-->≥<!--> <!-->20<!--> <!-->mm/m² (OR 4.27 [1.46–12.53], <em>p</em> <!-->=<!--> <!-->0.008) remained independent predictors.</div></div><div><h3>Conclusion</h3><div>Transcatheter osASD closure is highly successful with low major complication rates. However, device embolization is associated with IVC rim deficiency and an osASD size/BSA ratio<!--> <!-->≥<!--> <!-->20<!--> <!-->mm/m².</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Pages S272-S273"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934170","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":"New Anatomical Classification to Plan Transcatheter Sinus Venosus Defect Correction Based on 3D Models","authors":"Clement Batteux ,&nbsp;Vlad Ciobotaru ,&nbsp;Grégoire Albenque ,&nbsp;Sebastien Hascoet","doi":"10.1016/j.acvd.2025.06.058","DOIUrl":"10.1016/j.acvd.2025.06.058","url":null,"abstract":"<div><h3>Introduction</h3><div>Superior sinus venosus defect (SVD) is a complex congenital heart disease (CHD) with a wide spectrum of anatomical variations. The innovative procedure of transcatheter SVD correction (TCSVD) is feasible in selected cases, highlighting the need for a detailed morphological understanding. This study aims to provide an anatomical classification of SVD using 3D models.</div></div><div><h3>Method</h3><div>Cardiac computed tomography (CT) scans with superior SVD were 3D-modeled using semi-automatic segmentation. Key parameters such as superior vena cava (SVC) size, SVC overriding, caudal defect extension, and the size/orientation of anomalous pulmonary vein return (APVR) were analyzed in this single center cohort study.</div></div><div><h3>Results</h3><div>A total of 197 patients with superior SVD were studied. SVC overriding was absent in 38% of cases, and &gt;<!--> <!-->50% in 7%. A single anomalous pulmonary vein ostium was identified in 52%, while additional ostia were observed in 48%. Among children &gt;<!--> <!-->12 years, 83% had a SVC diameter larger than 14<!--> <!-->mm (first quartile of adult population). SVD were classified in two types: Fenestration (30%) and Cavo-atrial (70%), based on overriding degree and defect extension (<span><span>Figure 1</span></span>). Associated lesions included left superior vena cava (15%) and ostium secundum atrial septal defect (8%).</div></div><div><h3>Conclusion</h3><div>3D segmentation of a large cohort of SVD provides a new accurate and simplified anatomical description and classification, enabling tailored strategies for TCSVD.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S279"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934219","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":"Physiology of Neonatal Post-Hypoxic Myocardial Failure: Insights from an Experimental Model for Postnatal Management","authors":"Naïma Abshir Ali ,&nbsp;Maeva Sanchez ,&nbsp;Alexane Tournier ,&nbsp;Charles Garabedian ,&nbsp;Ali Houeijeh","doi":"10.1016/j.acvd.2025.06.027","DOIUrl":"10.1016/j.acvd.2025.06.027","url":null,"abstract":"<div><h3>Introduction</h3><div>Hemodynamic and myocardial alterations, as well as compensatory mechanisms during perinatal asphyxia, are not yet fully understood.</div><div>To investigate hemodynamic and myocardial function changes during prolonged umbilical cord occlusion (UCO).</div></div><div><h3>Method</h3><div>This is the first study with real time assessment of cardiac performance in alive sheep foetus. Five near-term fetal sheep were surgically instrumented under general anaesthesia. A venous central catheter was placed for blood sampling, a controlled occlusion system was positioned around the UC, and a 5 Fr. pressure-volume impendance catheter was inserted into the left ventricle through a 6Fr. introducer placed into the right carotid artery. The foetus was then repositioned into the uterus. Hemodynamic responses were assessed during long UCO (12<!--> <!-->minutes) through analysis of ventricular pressures and volumes, pressure-volume loops, allowing estimation of ventricular (Ees) and arterial (Ea) elastance. Longer UCO was done to determine the time of hemodynamic failure.</div></div><div><h3>Results</h3><div>A biphasic response to complete cord occlusion was observed. An initial adaptive phase (30 s) was characterized by abrupt bradycardia (mean heart rate dropped from 175 bpm to 126, −28%), decreased stroke volume (4,43<!--> <!-->mL to 2,8<!--> <!-->mL, −35%) and cardiac output (775 to 348<!--> <!-->mL/min, −52%), along with increased myocardial workload as reflected by a rise in Ea/Ees ratio (+12%) (<span><span>Figure 1</span></span>, A). This was followed by a transient compensatory phase with partial recovery of heart rate (+25%), SV (+20%), and CO (+25%), while the Ea/Ees ratio decreased but remained slightly elevated (+3%) compared to baseline. Left ventricular end-diastolic pressure progressively increased (+ 30%) despite volume reduction. (<span><span>Figure 1</span></span>, B and C). The hemodynamic parameters recovered quickly after UCO relieve (<span><span>Figure 1</span></span>, D). Hemodynamic markers remained stable during the compensatory phase. In prolonged UCO, lactic acidosis occurred at the 15^th minutes, before a hemodynamic collapse and severe systolic dysfunction at 17<!--> <!-->minutes, marked by a 50% drop in SV and CO, and a significant Ea/Ees imbalance (−20%), ultimately resulting in irreversible arterial hypotension.</div></div><div><h3>Conclusion</h3><div>Umbilical cord blood flow interruption is associated with a rapid and sustained increase in myocardial workload and diastolic dysfunction before the systolic dysfunction. Diastolic function should be assessed in all newborns with perinatal asphyxia.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 8","pages":"Page S261"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934223","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}