Archives of Cardiovascular Diseases最新文献

{"title":"Cardiac rehabilitation recommendations of the Group Exercise Rehabilitation Sports – Prevention (GERS-P) of the French Society of Cardiology: 2023 update","authors":"Muriel Bigot , Jean Michel Guy , Catherine Monpere , Alain Cohen-Solal , Bruno Pavy , Marie Christine Iliou , Gilles Bosser , Sonia Corone , Herve Douard , Titi Farrokhi , Antoine Guerder , Pascal Guillo , Jean-Pierre Houppe , Theo Pezel , Bernard Pierre , Stephane Roueff , Daniel Thomas , Benedicte Verges , Jean Christophe Blanchard , Mohamed Ghannem , Dany Marcadet","doi":"10.1016/j.acvd.2024.05.119","DOIUrl":"10.1016/j.acvd.2024.05.119","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Pages 521-541"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697772","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":"Advanced myocardial deformation echocardiography for evaluation of the athlete's heart: Functional and mechanistic analysis","authors":"Eva Colne ,&nbsp;Nathalie Pace ,&nbsp;Antoine Fraix ,&nbsp;Félix Gauthier ,&nbsp;Christine Selton-Suty ,&nbsp;Bruno Chenuel ,&nbsp;Nicolas Sadoul ,&nbsp;Nicolas Girerd ,&nbsp;Zohra Lamiral ,&nbsp;Jérôme Felloni ,&nbsp;Karim Djaballah ,&nbsp;Laura Filippetti ,&nbsp;Olivier Huttin","doi":"10.1016/j.acvd.2024.05.121","DOIUrl":"10.1016/j.acvd.2024.05.121","url":null,"abstract":"<div><h3>Background</h3><div>Assessment of the athlete's heart is challenging because of a phenotypic overlap between reactive physiological adaptation and pathological remodelling. The potential value of myocardial deformation remains controversial in identifying early cardiomyopathy.</div></div><div><h3>Aim</h3><div>To identify the echocardiographic phenotype of athletes using advanced two-dimensional speckle tracking imaging, and to define predictive factors of subtle left ventricular systolic dysfunction.</div></div><div><h3>Methods</h3><div>In total, 191 healthy male athletes who underwent a preparticipation medical evaluation at Nancy University Hospital between 2013 and 2020 were included. Clinical and echocardiographic data were compared with 161 healthy male subjects from the STANISLAS cohort. Borderline global longitudinal strain value was defined as<!--> <!-->&lt;<!--> <!-->17.5%.</div></div><div><h3>Results</h3><div>Athletes demonstrated lower left ventricular ejection fraction (57.9<!--> <!-->±<!--> <!-->5.3% vs. 62.6<!--> <!-->±<!--> <!-->6.4%; <em>P</em> <!-->&lt;<!--> <!-->0.01) and lower global longitudinal strain (17.5<!--> <!-->±<!--> <!-->2.2% vs. 21.1<!--> <!-->±<!--> <!-->2.1%; <em>P</em> <!-->&lt;<!--> <!-->0.01). No significant differences were found between athletes with and without a borderline global longitudinal strain value regarding clinical characteristics, structural echocardiographic features and exercise capacity. A borderline global longitudinal strain value was associated with a lower endocardial global longitudinal strain (18.8<!--> <!-->±<!--> <!-->1.2% vs. 22.7<!--> <!-->±<!--> <!-->1.9%; <em>P</em> <!-->=<!--> <!-->0.02), a lower epicardial global longitudinal strain (14.0<!--> <!-->±<!--> <!-->1.1% vs. 16.6<!--> <!-->±<!--> <!-->1.2%; <em>P</em> <!-->&lt;<!--> <!-->0.01) and a higher endocardial/epicardial global longitudinal strain ratio (1.36<!--> <!-->±<!--> <!-->0.07 vs. 1.32<!--> <!-->±<!--> <!-->0.06; <em>P</em> <!-->&lt;<!--> <!-->0.01). No significant difference was found regarding mechanical dispersion (<em>P</em> <!-->=<!--> <!-->0.46).</div></div><div><h3>Conclusions</h3><div>Borderline global longitudinal strain value in athletes does not appear to be related to structural remodelling, mechanical dispersion or exercise capacity. The athlete's heart is characterized by a specific myocardial deformation pattern with a more pronounced epicardial layer strain impairment.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Pages 490-496"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997020","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":"Deaths and major cardiovascular events in patients with lymphoma: Analysis from a French nationwide hospitalization database","authors":"","doi":"10.1016/j.acvd.2024.05.117","DOIUrl":"10.1016/j.acvd.2024.05.117","url":null,"abstract":"<div><h3>Background</h3><div>There are few data assessing the risk of death and cardiovascular events in patients with lymphoma.</div></div><div><h3>Aim</h3><div>Using a nationwide hospitalization database, we aimed to address cardiovascular outcomes in patients with lymphoma.</div></div><div><h3>Methods</h3><div>From 01 January to 31 December 2013, 3,381,472 adults were hospitalized in French hospitals; 22,544 of these patients had a lymphoma. The outcome analysis (all-cause or cardiovascular death, myocardial infarction, ischaemic stroke, bleedings, new-onset heart failure and new-onset atrial fibrillation) was performed over a 5-year follow-up period. Each patient with lymphoma was matched with a patient without a lymphoma or other cancer (1:1). A competing risk analysis was also performed.</div></div><div><h3>Results</h3><div>After adjustment on all risk factors, cardiovascular and non-cardiovascular co-morbidities, the subdistribution hazard ratios for all-cause death, major bleeding, intracranial bleeding, new-onset heart failure and new-onset atrial fibrillation were higher in patients with lymphoma; conversely, the subdistribution hazard ratios for cardiovascular death, myocardial infarction and ischaemic stroke were lower in patients with lymphoma. In the matched analysis, the risk of all-cause death (subdistribution hazard ratio 1.936, 95% confidence interval 1.881–1.992) and major bleeding (subdistribution hazard ratio 1.117, 95% confidence interval 1.049–1.188) remained higher in patients with lymphoma.</div></div><div><h3>Conclusion</h3><div>In this large nationwide cohort study, patients with lymphoma had a higher incidence of all-cause death and major bleeding.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Pages 497-504"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141408346","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":"Outcomes of postoperative mediastinitis in children","authors":"S. Bernheim,&nbsp;S. Chikkhi,&nbsp;I. Foufa,&nbsp;A. Haydar,&nbsp;P. Parize,&nbsp;D. Bonnet,&nbsp;O. Raisky","doi":"10.1016/j.acvd.2024.07.046","DOIUrl":"10.1016/j.acvd.2024.07.046","url":null,"abstract":"<div><h3>Introduction</h3><p>Mediastinitis is a severe complication of heart surgery well described in the adult population. However very few studies focused on the description of mediastinitis and its outcomes in pediatric patients.</p></div><div><h3>Objective</h3><p>To describe the clinical features and outcomes of postoperative mediastinitis in children and identify risk factors for mortality.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed all children with mediastinitis over a period of 10 years (2013–2023). Mediastinitis was defined by a purulent discharge of the mediastinum requiring surgery or organisms cultured from discharge of the mediastinal area.</p></div><div><h3>Results</h3><p>The incidence of mediastinitis was 0.74% (57 cases). Median age at surgery was 12 days with 67% patients younger than 3 months old. Sixty percent had delayed sternal closure. Median delay between surgery and diagnosis was 8 days (range: 2–39). The most frequent germs were <em>Staphylococcus</em> (46%), gram negative bacteria (35%) and fungi (9%). All patients had surgical debridement: 46 (81%) in the operating room and 11 (19%) in the ICU. Median duration of antibiotic therapy was 44 days. Median duration of stay was 21 days (range: 10–113) in the ICU and 35 days (range: 11–188) until hospital discharge. Outcomes in the ICU included a median of 8 days of assisted ventilation. Nine patients needed veno-arterial ECMO. Mortality rate was 27% with 12 out of 15 deaths occurring in the ICU. Mortality risk factors were surgical revision in the ICU compared to the operating room (OR 4.9; CI95% 1.3 to 19.9), delayed sternal closure superior to 3 days (OR: 5.0; 95% CI: 1.3 to 16.5) and fungal mediastinitis (OR: 14.9; 95% CI: 2.0 to 185.4).</p></div><div><h3>Conclusion</h3><p>Mediastinitis leads to high mortality and morbidity in children. Mortality risk factors are: surgical revision in the ICU, prolonged delayed sternal closure and fungus infection. Patients with prolonged delayed sternal closure should be regularly screened for fungal colonization to prevent fungal mediastinitis.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Page S241"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271172","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 MRI characteristics and prognostic value in pediatric myocarditis","authors":"A. Moktadir,&nbsp;E. Daire,&nbsp;C. Renard,&nbsp;S. Dirani,&nbsp;M. Selegny","doi":"10.1016/j.acvd.2024.07.049","DOIUrl":"10.1016/j.acvd.2024.07.049","url":null,"abstract":"<div><h3>Introduction</h3><p>Acute myocarditis (AM) is a rare disease of the heart muscle. Diagnosis involves a combination of clinical, biological and radiological findings. Cardiac MRI is a highly effective diagnostic tool. Recent studies in both pediatric and adult patients have shown a connection between the location of fibrosis (scarring) detected on MRI and subsequent health issues. Patients with AM are at risk of developing dilated cardiomyopathy and major cardiovascular events.</p></div><div><h3>Objective</h3><p>Our objective is to investigate whether the location of fibrosis lesions found on cardiac MRI differs between children with and without cardiac dysfunction.</p></div><div><h3>Methods</h3><p>This retrospective study was conducted at Amiens University Hospital. The study included children diagnosed with AM who underwent both an initial cardiac MRI and a follow-up MRI. We recorded the number of segments showing edema and late enhancement (scarring) on the MRI images. Additionally, we assessed cardiac function and collected all relevant clinical and biological data.</p></div><div><h3>Results</h3><p>A total of 31 children with AM, with an average age of 12<!--> <!-->years, were included in the study. Most of the children exhibited typical involvement of the left ventricle in the inferolateral region. We found no association between the typical MRI localization and initial cardiac dysfunction (OR<!--> <!-->=<!--> <!-->0.25 [0.04, 1.24], <em>P</em> <!-->=<!--> <!-->0.091). However, patients with extensive edema experienced a decrease in subsequent MRI sequelae (scarring) by 0.69 [0.42, 0.97] per additional affected segment (<em>P</em> <!-->=<!--> <!-->0.029). Furthermore, children with more than 2 affected segments had longer hospital stays (OR<!--> <!-->=<!--> <!-->4.8 [1.03; 26.09], <em>P</em> <!-->=<!--> <!-->0.045) (<span><span>Fig. 1</span></span>).</p></div><div><h3>Conclusion</h3><p>The presence of initial edema appears to have a protective effect against subsequent MRI sequelae (scarring). Further studies are necessary to identify a specific subgroup of patients who are at a higher risk of developing dilated cardiomyopathy or major cardiovascular events.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Pages S242-S243"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271175","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":"Acute myocarditis according to age: Presentation, management, and early outcomes","authors":"C. Karsenty ,&nbsp;P. Vignaud-Marighetto ,&nbsp;C. Brusq ,&nbsp;P. Moceri ,&nbsp;P. Lim ,&nbsp;C. Ovaert ,&nbsp;S. Di Filippo ,&nbsp;C. Delmas","doi":"10.1016/j.acvd.2024.07.006","DOIUrl":"10.1016/j.acvd.2024.07.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Acute myocarditis (AM) is a rare but severe disease affecting patients of all age. Large multicentric data comparing children and adults are lacking.</p></div><div><h3>Objective</h3><p>We aimed to elucidate differences in presentation, management, and outcomes of AM across age groups.</p></div><div><h3>Methods</h3><p>A comprehensive French national cohort study, encompassing 53 pediatric and adult units from March 2020 to November 2021, was analysed. Baseline characteristics and evolution, management and in-hospital complications were collected. Major cardiovascular events (MACE) within 30 days included all-cause death, cardiogenic shock, cardiac arrest, ventricular arrhythmias, or complete AV block.</p></div><div><h3>Results</h3><p>We included 745 AM patients (328 children and 417 adults), mainly male (73.4%) with a median age of 19.8 years [IQR: 12.5–30.9]. Multisystem inflammatory syndrome (MIS) was more prevalent among pediatric cases (69.8%), whereas infectious aetiology dominated in adults (13.4 vs. 52.4%). Children exhibited a more severe clinical presentation, with increased risk of heart failure (15.9 vs. 7.2%) and cardiogenic shock (14.4 vs. 6.9%), requiring higher use of inotropes (25.0 vs. 9.4%), vasopressors (12.0 vs. 6.2%), and ventilatory support (12.5 vs. 7.7%). Cardiac treatments such as beta-blockers (33.4 vs. 84.4%) or ACE/ARB (37.3 vs. 63.1%) were less often used in children whereas corticosteroids (68.3 vs. 14.3%) and immunomodulators (65.1 vs. 4.5%) were more often used. MACE occurrence was substantial but not significantly different between children and adults (18.1 vs. 13.4%). Extra-cardiac manifestations at admission were significant predictors of MACE (aOR: 2.40 [1.43–4.38]), regardless of multisystem inflammatory syndrome (MIS) status.</p></div><div><h3>Conclusion</h3><p>AM exhibits variations in presentation, aetiologies, and management, but shares a comparable 30-day prognosis in children and adults.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Pages S221-S222"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271235","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":"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":"117 8","pages":"Pages S236-S237"},"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":"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":"117 8","pages":"Page S239"},"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":"117 8","pages":"Page S243"},"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":"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":"117 8","pages":"Pages 461-469"},"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}