Archives of Cardiovascular Diseases最新文献

{"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":"117 8","pages":"Page S229"},"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":"117 8","pages":"Page S232"},"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":"117 8","pages":"Pages S244-S245"},"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":"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":"117 8","pages":"Pages S233-S234"},"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":"117 8","pages":"Page S225"},"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":"117 8","pages":"Page S244"},"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}

{"title":"Éditorial","authors":"Le Comité d’organisation local,&nbsp;Philippe Acar,&nbsp;Nicolas Combes,&nbsp;Clément Karsenty,&nbsp;toute l’équipe médico-chirurgicale toulousaine","doi":"10.1016/j.acvd.2024.09.001","DOIUrl":"10.1016/j.acvd.2024.09.001","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Page S217"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271229","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":"Correlation between cardiopulmonary exercise test variables and health-related quality of life among children with idiopathic or heritable pulmonary hypertension","authors":"V. Dubois ,&nbsp;C. Soulatges ,&nbsp;F. El Louali ,&nbsp;C. Ovaert","doi":"10.1016/j.acvd.2024.07.034","DOIUrl":"10.1016/j.acvd.2024.07.034","url":null,"abstract":"<div><h3>Introduction</h3><p>Pulmonary hypertension (PH) is a progressive disease characterized by elevation of pulmonary vascular resistance, ultimately leading to right ventricular failure and premature death. Traditionally, physical activity has been restricted for these patients, but there's a current trend to customize exercise programs based on CPET results.</p><p>Quality of life (QoL) now stands as a determinant “patient-related outcome” and is frequently used as a secondary endpoint in cardiovascular clinical trials. Little is known about the relation between CPET data and QoL in patients with idiopathic or heritable pulmonary hypertension in children.</p></div><div><h3>Objective</h3><p>The primary objective was to correlate self and parent-reported QoL with CPET variables, while the secondary objective was to correlate QoL and CPET variables with other clinical, biological, echocardiographic or hemodynamic parameters.</p></div><div><h3>Methods</h3><p>The study was conducted retrospectively at Marseille University Hospital, involving nine children (7 heritable PH, 2 idiopathic PH) who underwent CPET and completed QoL questionnaires.</p><p>Following data were extracted from clinical files for analysis: peak of VO2, ventilatory anaerobic threshold (AT), VE/VCO2 slope and ST-wave changes on CPET; pediatric quality of life (PedsQL 4.0TM) on QoL questionnaires; age and years since diagnosis, last available RV to LV pressure ratio, mPA pressure and indexed pulmonary resistance, RV ejection fraction, NT-proBNP level.</p></div><div><h3>Expected results</h3><p>Characteristics at time of diagnosis are summarized in <span><span>Table 1</span></span>. Results are summarized in <span><span>Table 2</span></span>.</p><p>CPET parameters are very abnormal in this population and might correlate with QoL, but also with other clinical and hemodynamic severity indexes.</p><p>It is important to mention that all CPET were performed in stable conditions (once optimal treatment was achieved) and were all uneventful.</p></div><div><h3>Perspectives</h3><p>To our opinion, CPET is an important and useful tool to assess QoL but also to guide clinical management, and elaborate appropriate rehabilitation programs. This small study might serve as a pilot study before a large multicentric study.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Page S235"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271309","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":"Reference values of cardiopulmonary exercise test parameters in the contemporary paediatric population","authors":"A. Gavotto ,&nbsp;P. Amedro ,&nbsp;S. Guillaumont ,&nbsp;G. De La Villeon ,&nbsp;M. Vincenti ,&nbsp;H. Huguet ,&nbsp;M.C. Picot ,&nbsp;T. Mura","doi":"10.1016/j.acvd.2024.07.030","DOIUrl":"10.1016/j.acvd.2024.07.030","url":null,"abstract":"<div><h3>Introduction</h3><p>The evaluation of health status by cardiopulmonary exercise test (CPET) has shown increasing interest in the paediatric population. Our group recently established reference Z-score values for paediatric cycle ergometer VO₂max, applicable to normal and extreme weights, from a cohort of 1141 healthy children. There are currently no validated reference values for the other CPET parameters in the paediatric population.</p></div><div><h3>Objective</h3><p>This study aimed to establish, from the same cohort, reference Z-score values for the main paediatric cycle ergometer CPET parameters, apart from VO₂max.</p></div><div><h3>Methods</h3><p>Cross-sectional study.</p></div><div><h3>Results</h3><p>In total, 909 healthy children aged 5 to 18 years old underwent a CPET. Linear, quadratic, and polynomial mathematical regression equations were applied to identify the best CPET parameters Z-scores, according to anthropometric parameters (sex, age, height, weight, and BMI). This study provided Z-scores for maximal CPET parameters (heart rate, respiratory exchange ratio, workload, and oxygen pulse), submaximal CPET parameters (ventilatory anaerobic threshold, VE/VCO₂slope, and oxygen uptake efficiency slope), and maximum ventilatory CPET parameters (tidal volume, respiratory rate, breathing reserve, and ventilatory equivalent for CO₂ and O₂) (<span><span>Fig. 1</span></span>).</p></div><div><h3>Conclusion</h3><p>This study defined paediatric reference Z-score values for the main cycle ergometer CPET parameters, in addition to the existing reference values for VO₂max, applicable to children of normal and extreme weights. Providing Z-scores for CPET parameters in the paediatric population should be useful in the follow-up of children with various chronic diseases. Thus, new paediatric research fields are opening up, such as prognostic studies and clinical trials using cardiopulmonary fitness outcomes.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Page S233"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271055","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":"Abnormal movements following heart surgery: A series of pediatric post-pump chorea","authors":"S. Bernheim,&nbsp;E. Saarda,&nbsp;M. Hully,&nbsp;C.J. Roux,&nbsp;M. Kossorotof,&nbsp;F. Bajolle,&nbsp;D. Bonnet,&nbsp;O. Raisky","doi":"10.1016/j.acvd.2024.07.033","DOIUrl":"10.1016/j.acvd.2024.07.033","url":null,"abstract":"<div><h3>Introduction</h3><p>Neurological disorders following heart surgery are mainly attributable to strokes. However there is a rare cause of abnormal movement following heart surgery: post-pump chorea. This complication is rare and poorly described particularly with regard to its therapeutic management and evolution.</p></div><div><h3>Methods</h3><p>Descriptive monocentric retrospective study including all children with post-pump chorea over a 10-year period (2014–2023). Clinical presentation, radiological findings, and outcomes were analyzed based on clinical, biological, and cerebral imaging data.</p></div><div><h3>Results</h3><p>Over 10<!--> <!-->years, 7059 pediatric cardiac surgeries with cardiopulmonary bypass (CBP) were performed at Necker hospital, and 11 patients experienced post-pump chorea (0.15%), including 5 boys (45%). Median age at the diagnosis of post-pump chorea was 5.7<!--> <!-->years [0.45–9.9]. One patient was premature, and none had genetic syndromes. Median BMI was low (14.8 [11.9–17.4]). Six patients had cyanotic heart disease. Six patients (55%) had previously undergone surgery with CBP. Median CBP duration and length of stay in the intensive care unit were typical, at 132<!--> <!-->minutes [64–362] and 6<!--> <!-->days [1–186], respectively. The interval between surgery and symptom onset was 20<!--> <!-->days [4–64], with a median duration of 44<!--> <!-->days [3–181]. Abnormal movements primarily affected the face (100%) and were often bilateral (82%), involving the upper limbs (91%) and lower limbs (82%). Initial cerebral MRI did not show recent ischemic lesions. Six patients (55%) received medical treatment: tetrabenazine (<em>n</em> <!-->=<!--> <!-->2), intravenous immunoglobulins (<em>n</em> <!-->=<!--> <!-->1), corticosteroids (<em>n</em> <!-->=<!--> <!-->1), L-Dopa (<em>n</em> <!-->=<!--> <!-->1), cyamemazine (<em>n</em> <!-->=<!--> <!-->1). Chorea persisted beyond 6 months in only 1 out of 11 patients.</p></div><div><h3>Conclusion</h3><p>Post-pump chorea is extremely rare and can occur several months after cardiac surgery. It does not appear to be directly related to perioperative severity criteria. The prognosis is generally favorable within 6<!--> <!-->months following diagnosis.</p></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"117 8","pages":"Page S234"},"PeriodicalIF":2.3,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271158","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}