Archives of Cardiovascular Diseases最新文献

{"title":"Effect of mavacamten on left ventricular diastolic function and left atrial remodelling in obstructive hypertrophic cardiomyopathy","authors":"Nicolas Cohen,&nbsp;Claire Lucas,&nbsp;Chiara Idini,&nbsp;Elsa Conte,&nbsp;Mary Philip,&nbsp;Gregoire Stolpe,&nbsp;Hélène Martel,&nbsp;Sylvie Quaranta,&nbsp;Gilbert Habib","doi":"10.1016/j.acvd.2026.01.006","DOIUrl":"10.1016/j.acvd.2026.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive hypertrophic cardiomyopathy (HCM) is characterized by dynamic left ventricular outflow tract (LVOT) obstruction, leading to disabling symptoms. Mavacamten, a selective cardiac myosin inhibitor, improves obstruction and symptoms. Its beneficial effects on left ventricular diastolic indices have been documented, whereas its impact on left atrial strain has only recently been explored.</div></div><div><h3>Aim</h3><div>To assess the effect of mavacamten on diastolic function, left atrial remodelling and ventricular filling pressures in patients with obstructive HCM.</div></div><div><h3>Methods</h3><div>In this prospective, single-centre study, 55 symptomatic patients with obstructive HCM (mean age 68<!--> <!-->±<!--> <!-->12 years, 40% male) were evaluated before and after individualized mavacamten titration. Echocardiographic, clinical and biomarker parameters were collected at baseline and after stabilization: left atrial end-systolic volume (LAESV), E/E′ ratio, E/A ratio, peak atrial longitudinal strain (PALS) and peak atrial contraction strain (PACS), LVOT gradients, left ventricular ejection fraction (LVEF), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and NYHA class.</div></div><div><h3>Results</h3><div>After a mean titration of 5 months (final median maintenance dose 5<!--> <!-->mg/day), NYHA class improved from 2.5 to 1.4 (<em>P</em> <!-->&lt;<!--> <!-->0.001) and NT-proBNP decreased from 1431 to 158<!--> <!-->pg/mL (<em>P</em> <!-->&lt;<!--> <!-->0.001). LVOT gradients dropped at rest (65.0<!--> <!-->mmHg [41.0–89.0] to 12.0<!--> <!-->mmHg [6.0–18.0], <em>P</em> <!-->&lt;<!--> <!-->0.001) and after Valsalva (101.0<!--> <!-->mmHg [78.0–126.0] to 19.0<!--> <!-->mmHg [10.0–28.0]; <em>P</em> <!-->&lt;<!--> <!-->0.001). Indexed LAESV declined from 50.8 to 39.9<!--> <!-->mL/m² (<em>P</em> <!-->&lt;<!--> <!-->0.001) and E/E′ from 14.2 to 9.5 (<em>P</em> <!-->&lt;<!--> <!-->0.001). E/A ratio remained unchanged. PALS and PACS worsened (PALS: 20.0% to 18.0%, <em>P</em> <!-->=<!--> <!-->0.003; PACS: 11.0% to 8.0%, <em>P</em> <!-->=<!--> <!-->0.002).</div></div><div><h3>Conclusions</h3><div>In this prospective, observational study, mavacamten initiation was associated with improvements in diastolic parameters and reductions in left atrial volume, together with favourable changes in clinical and haemodynamic measures in patients with obstructive HCM. The observed decrease in atrial strain parameters may reflect persistent atrial mechanical dysfunction or delayed functional recovery. Further studies with longer follow-up and controlled designs are needed to clarify the long-term effects on atrial remodelling.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages 566-571"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146196152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole-genome trio sequencing approach to explore de novo variants in sporadic young-onset atrioventricular block","authors":"Keiko Shimamoto,&nbsp;Estelle Baron,&nbsp;Pierre Lindenbaum,&nbsp;Nathalie Behar,&nbsp;Alexandre Bodin,&nbsp;Didier Klug,&nbsp;Bruno Lefort,&nbsp;Alice Maltret,&nbsp;Jacques Mansourati,&nbsp;Frédéric Sacher,&nbsp;Victor Waldmann,&nbsp;Aurélie Thollet,&nbsp;Jean-Baptiste Gourraud,&nbsp;Vincent Probst,&nbsp;Alban-Elouen Baruteau,&nbsp;Jean-Jacques Schott,&nbsp;Julien Barc","doi":"10.1016/j.acvd.2026.06.071","DOIUrl":"10.1016/j.acvd.2026.06.071","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Young-onset atrioventricular block (AVB) is a rare but clinically important condition that may require lifelong pacing. When immune-mediated and structural causes are excluded, the underlying cause often remains unknown. Although monogenic causes have been described in various cardiac and syndromic disorders, the genetic basis of isolated sporadic AVB is poorly defined. We therefore performed trio-based whole-genome sequencing (WGS) to identify candidate coding and regulatory &lt;em&gt;de novo&lt;/em&gt; variants in sporadic young-onset AVB.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Young-onset atrioventricular block (AVB) is a rare but clinically important condition that may require lifelong pacing. When immune-mediated and structural causes are excluded, the underlying cause often remains unknown. Although monogenic causes have been described in various cardiac and syndromic disorders, the genetic basis of isolated sporadic AVB is poorly defined. We therefore performed trio-based whole-genome sequencing (WGS) to identify candidate coding and regulatory &lt;em&gt;de novo&lt;/em&gt; variants in sporadic young-onset AVB.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed WGS in eight trios comprising probands diagnosed before 20 years of age and their unaffected parents. All probands had non-immune AVB without structural heart disease and no pathogenic variants in known AVB genes on prior panel testing. Trio analysis was used to identify heterozygous &lt;em&gt;de novo&lt;/em&gt; variants. Coding and splice-site variants were analyzed alongside non-coding variants, the latter restricted to cardiac open chromatin regions defined using integrated ATAC-seq datasets from healthy human cardiac tissues.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We performed WGS in eight trios comprising probands diagnosed before 20 years of age and their unaffected parents. All probands had non-immune AVB without structural heart disease and no pathogenic variants in known AVB genes on prior panel testing. Trio analysis was used to identify heterozygous &lt;em&gt;de novo&lt;/em&gt; variants. Coding and splice-site variants were analyzed alongside non-coding variants, the latter restricted to cardiac open chromatin regions defined using integrated ATAC-seq datasets from healthy human cardiac tissues.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;All probands were females and the median age at diagnosis was 4.0 years (IQR 1.5–10.0). We identified 11 rare &lt;em&gt;de novo&lt;/em&gt; coding variants and 14 rare &lt;em&gt;de novo&lt;/em&gt; non-coding variants within cardiac open chromatin regions. One potentially deleterious coding variant was identified in &lt;em&gt;SOS2&lt;/em&gt;, a gene reported in congenital heart disease. The other two coding variants involved genes with cardiac phenotypes in animal models. One non-coding variant was located upstream of a gene expressed in the atrioventricular canal during cardiac development. Several candidate genes showed supporting RNA and/or protein expression in cardiac tissue. No recurrent variants or genes were identified.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;All probands ","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages S273-S274"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816040","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":"A word of welcome","authors":"The Local Organizing Committee","doi":"10.1016/j.acvd.2026.06.005","DOIUrl":"10.1016/j.acvd.2026.06.005","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S240"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815861","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":"Right ventricular–Pulmonary arterial coupling after venus P-valve implantation: A longitudinal study","authors":"Carlo Barsali,&nbsp;Grégoire Albenque,&nbsp;Raymond Haddad,&nbsp;Papa Momar Guissé,&nbsp;Clément Batteux,&nbsp;Sebastien Hascoet","doi":"10.1016/j.acvd.2026.06.057","DOIUrl":"10.1016/j.acvd.2026.06.057","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Percutaneous pulmonary valve implantation (PPVI) with self-expanding devices such as the Venus P-valve has expanded treatment options for patients with large ventricular outflow tracts (RVOT). However, the impact of PPVI on right ventricular (RV) pulmonary arterial coupling remains incompletely understood. The TAPSE/PAPS ratio has emerged as a simple, non-invasive surrogate of RV coupling and may provide insights into RV adaptation following intervention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Percutaneous pulmonary valve implantation (PPVI) with self-expanding devices such as the Venus P-valve has expanded treatment options for patients with large ventricular outflow tracts (RVOT). However, the impact of PPVI on right ventricular (RV) pulmonary arterial coupling remains incompletely understood. The TAPSE/PAPS ratio has emerged as a simple, non-invasive surrogate of RV coupling and may provide insights into RV adaptation following intervention.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a longitudinal analysis of 77 patients undergoing PPVI with the Venus P-valve, evaluating echocardiographic parameters at three time points: baseline (T0), early post-procedural (T1), and 6-month follow-up (T2). Key parameters included tricuspid annular plane systolic excursion (TAPSE), pulmonary artery systolic pressure (PAPS), and the TAPSE/PAPS ratio. Paired comparisons between time points were performed to assess temporal changes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We conducted a longitudinal analysis of 77 patients undergoing PPVI with the Venus P-valve, evaluating echocardiographic parameters at three time points: baseline (T0), early post-procedural (T1), and 6-month follow-up (T2). Key parameters included tricuspid annular plane systolic excursion (TAPSE), pulmonary artery systolic pressure (PAPS), and the TAPSE/PAPS ratio. Paired comparisons between time points were performed to assess temporal changes.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 77 patients (mean age: 39.9&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;14.7 years), 45 were male, and 52 had Tetralogy of Fallot. After the PPVI a significant reduction in TAPSE was observed (T0 vs T1: −2.6&lt;!--&gt; &lt;!--&gt;mm; &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001), which persisted at 6 months (T0 vs T2: −3.2&lt;!--&gt; &lt;!--&gt;mm; &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001), with no further significant change between T1 and T2 (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.215). Conversely, PAPS showed a significant decrease both acutely (−3.5&lt;!--&gt; &lt;!--&gt;mmHg; &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.007) and over time (T1 vs T2: −1.8&lt;!--&gt; &lt;!--&gt;mmHg; &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.011), resulting in an overall reduction of −5.3&lt;!--&gt; &lt;!--&gt;mmHg at follow-up (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). Despite these changes, the TAPSE/PAPS ratio remained stable across all time points (T0 vs T1: &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.482; T0 vs T2: &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.741), with a non-significant trend toward improvement at 6&lt;!--&gt; &lt;!--&gt;months (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.064).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Of the 77 p","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S266"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816016","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":"Transcatheter aortic valve implantation in adults with complex and geriatric congenital heart disease","authors":"Mathieu Albertini,&nbsp;Thomas Lescure,&nbsp;Patrice Guérin,&nbsp;Georgios Sideris,&nbsp;Pechmajou Louis,&nbsp;Tanios Akiki,&nbsp;Victor Waldmann,&nbsp;Etienne Puymirat,&nbsp;Laurence Iserin,&nbsp;Chekrallah Chamandi","doi":"10.1016/j.acvd.2026.06.017","DOIUrl":"10.1016/j.acvd.2026.06.017","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The adult congenital heart disease (ACHD) population is steadily growing and aging, exposing patients to age-related cardiovascular conditions, particularly degenerative aortic valve disease. While transcatheter aortic valve implantation (TAVI) is a standard treatment in the general population, experience in ACHD remains very limited.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;The adult congenital heart disease (ACHD) population is steadily growing and aging, exposing patients to age-related cardiovascular conditions, particularly degenerative aortic valve disease. While transcatheter aortic valve implantation (TAVI) is a standard treatment in the general population, experience in ACHD remains very limited.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Retrospective single-center study including all ACHD patients who underwent TAVI between January 2024 and January 2026. Procedural characteristics, periprocedural outcomes, complications, and events during follow-up were analyzed. The primary endpoint was periprocedural mortality; secondary endpoints included complications, NT-proBNP changes, and aortic bioprosthesis function.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Retrospective single-center study including all ACHD patients who underwent TAVI between January 2024 and January 2026. Procedural characteristics, periprocedural outcomes, complications, and events during follow-up were analyzed. The primary endpoint was periprocedural mortality; secondary endpoints included complications, NT-proBNP changes, and aortic bioprosthesis function.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 8 patients (median age 67.5 years, 56.8–76.3) with moderate or complex CHD were included. Two had genetic syndromes (Williams–Beuren, trisomy 21), and seven (87.5%) had prior heart failure hospitalization. Median NT-proBNP was 2387&lt;!--&gt; &lt;!--&gt;pg/mL, and median systolic pulmonary artery pressure 56&lt;!--&gt; &lt;!--&gt;mmHg. Seven patients underwent transfemoral TAVI; one required a carotid approach due to severe diffuse arterial hypoplasia. One patient experienced ventricular fibrillation, which was successfully cardioverted during valve implantation, and another patient developed paroxysmal complete atrioventricular block requiring leadless pacemaker implantation. No periprocedural deaths occurred. At 3-month follow-up, all valves showed excellent hemodynamic performance, with no significant regurgitation or heart failure rehospitalization, and NT-proBNP decreased significantly (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.034).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;A total of 8 patients (median age 67.5 years, 56.8–76.3) with moderate or complex CHD were included. Two had genetic syndromes (Williams–Beuren, trisomy 21), and seven (87.5%) had prior heart failure hospitalization. Median NT-proBNP was 2387&lt;!--&gt; &lt;!--&gt;pg/mL, and median systolic pulmonary artery pressure 56&lt;!--&gt; &lt;!--&gt;mmHg. Seven patients underwent transfemoral TAVI; one required a carotid approach due to severe diffuse arterial hypoplasia. One patient experienced ventricular fibrillation, whi","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S247"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815913","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":"Surgical repair for mitral regurgitation in children: Fate of autologous pericardial patch for leaflet augmentation","authors":"Alexander Moiroux-Sahraoui,&nbsp;Emre Belli","doi":"10.1016/j.acvd.2026.06.061","DOIUrl":"10.1016/j.acvd.2026.06.061","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The surgical management of mitral regurgitation in children remains challenging. Leaflet augmentation using a patch has emerged as a promising technique for pediatric patients. This study aimed to evaluate the long-term results of mitral valve repair with leaflet augmentation in children.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;The surgical management of mitral regurgitation in children remains challenging. Leaflet augmentation using a patch has emerged as a promising technique for pediatric patients. This study aimed to evaluate the long-term results of mitral valve repair with leaflet augmentation in children.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We reviewed all consecutive patients under the age of 18 who underwent surgery for mitral valve regurgitation between January 2001 and December 2024. Patients with an atrioventricular septal defect were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We reviewed all consecutive patients under the age of 18 who underwent surgery for mitral valve regurgitation between January 2001 and December 2024. Patients with an atrioventricular septal defect were excluded.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 248 consecutive patients, primary repair was achieved in 241 (97.2%).&lt;/div&gt;&lt;div&gt;Leaflet augmentation using an autologous pericardial patch was performed in 44 (18.3%) patients. The median age at the time of surgery was 5.2 years (range, 44 days to 18 years), and 14 patients (31.8%) were younger than 1 year old. Coexistent mitral stenosis was present in 12 patients (27.3%). The median follow-up period was 9 years (range, 1 week to 19.3 years). The prevailing etiology was congenital mitral valve dysplasia (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;24, 54.5%). Anterior or posterior leaflet augmentation was performed in 70.5% (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;31) and 29.5% (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;13) of the patients, respectively. The hospital mortality rate was 4.5% (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2), and no late deaths were reported. Fifteen patients (34.1%) underwent a total of 22 reoperations. Ultimately, 10 patients (22.7%) required mechanical valve replacement due to fibrosis/calcification of the patch, which led to functional deterioration. Reoperation and valve replacement rates did not differ significantly between the anterior and posterior leaflet augmentation groups (OR 1.24; &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.76 and OR 0.97; &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.97, respectively). Freedom from death and/or reoperation at 5, 10, and 15 years was 81.5%, 78.7% and 71.2%, respectively (&lt;span&gt;&lt;span&gt;Figure 1&lt;/span&gt;&lt;/span&gt;). Independent predictors of reoperation included age under 1 year at the time of surgery and residual moderate or greater mitral regurgitation postoperatively (both &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Of 248 consecutive patients, primary repair was achieved in 241 (97.2%).&lt;/div&gt;&lt;div&gt;Leaflet augmentation using an autologous pericardial patch was performed in 44 (18.3%) patients. The median age at the time of surgery was 5.2 years (range, 44 da","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S268"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815933","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":"Evolving strategy in pediatric mechanical circulatory support: Comparable outcomes with BiVAD vs. LVAD only support","authors":"Bastien Provost,&nbsp;Andrea Maurich,&nbsp;Aamir Jeewa,&nbsp;Estíbaliz Valdeolmillos,&nbsp;Osami Honjo","doi":"10.1016/j.acvd.2026.06.064","DOIUrl":"10.1016/j.acvd.2026.06.064","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;While biventricular assist device (BiVAD) support has historically been used in children with advanced heart failure, contemporary management favors left ventricular assist device (LVAD) only support. We aimed to compare outcomes between LVAD and BiVAD support and to evaluate temporal trends in device strategy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;While biventricular assist device (BiVAD) support has historically been used in children with advanced heart failure, contemporary management favors left ventricular assist device (LVAD) only support. We aimed to compare outcomes between LVAD and BiVAD support and to evaluate temporal trends in device strategy.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This retrospective, single centre, observational study included all consecutive patients who underwent Berlin Heart EXCOR implantation from 2004 to 2025. Patients were stratified into LVAD and BiVAD groups. Primary outcome was survival to transplant or explantation. Secondary outcomes included stroke and duration of support.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;This retrospective, single centre, observational study included all consecutive patients who underwent Berlin Heart EXCOR implantation from 2004 to 2025. Patients were stratified into LVAD and BiVAD groups. Primary outcome was survival to transplant or explantation. Secondary outcomes included stroke and duration of support.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 76 patients received either LVAD (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;53, 70%) or BiVAD (23, 30%). For the entire cohort, the median age at implantation was 21 months (IQR 7.2–116.8), median weight was 10.6&lt;!--&gt; &lt;!--&gt;kg (IQR 7.0–26.9), and median time on support was 55 days (21.0–138.0). Diagnosis was dilated cardiomyopathy in 67 (88.2%), congenital heart disease in nine (11.8%). There was no significant difference between LVAD and BiVAD in preoperative diagnosis, weight or right ventricular (RV) function. BiVAD represented 90% of VAD support in the early era &lt;em&gt;versus&lt;/em&gt; 6% in the most recent era (&lt;span&gt;&lt;span&gt;Figure 1&lt;/span&gt;&lt;/span&gt;). Overall, 56 patients (73.6%) underwent heart transplantation, 13 patients (17.1%) underwent device explantation, six (7.8%) died on support, with one still on support at analysis. Survival to transplant or recovery was similar between groups (LVAD: 92.3% &lt;em&gt;vs.&lt;/em&gt; BiVAD: 91.6%). Patients on LVAD support were more likely to undergo device explantation (23% &lt;em&gt;vs.&lt;/em&gt; 0%) and had fewer strokes compared to those on BIVAD support (0.16%/day on support &lt;em&gt;vs.&lt;/em&gt; 0.33%, &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;A total of 76 patients received either LVAD (n&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;53, 70%) or BiVAD (23, 30%). For the entire cohort, the median age at implantation was 21 months (IQR 7.2–116.8), median weight was 10.6&lt;!--&gt; &lt;!--&gt;kg (IQR 7.0–26.9), and median time on support was 55 days (21.0–138.0). Diagnosis was dilated cardiomyopathy in 67 (88.2%), congenital heart disease in nine (11.8%). There was no significant difference b","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S270"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of pulmonary artery branch stenting: A multicenter retrospective study","authors":"Rémi Barbaud,&nbsp;Jean Issa,&nbsp;Grégoire Albenque,&nbsp;Clément Batteux,&nbsp;Sebastien Hascoet,&nbsp;Paul Padovani,&nbsp;Alban-Elouen Baruteau,&nbsp;Paul Neville,&nbsp;Jean-Marc El Arid,&nbsp;Bruno Lefort","doi":"10.1016/j.acvd.2026.06.048","DOIUrl":"10.1016/j.acvd.2026.06.048","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Pulmonary branch stenting is a relatively recent technique, now widely used worldwide, but remains insufficiently studied, particularly regarding its long-term efficacy and tolerability. The objectives of our study were to assess long-term stent efficacy and survival in pulmonary branches, to evaluate the effectiveness of subsequent redilations, to document procedure-related complications, and to identify predictive factors associated with stent survival.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Pulmonary branch stenting is a relatively recent technique, now widely used worldwide, but remains insufficiently studied, particularly regarding its long-term efficacy and tolerability. The objectives of our study were to assess long-term stent efficacy and survival in pulmonary branches, to evaluate the effectiveness of subsequent redilations, to document procedure-related complications, and to identify predictive factors associated with stent survival.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a retrospective, multicentre, observational study including all patients who underwent percutaneous or surgical implantation of a stent in one or both pulmonary artery (PA) branches. The primary endpoint was stent survival free from surgical removal, percutaneous re-stenting, branch occlusion, or cardiac-related death.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We conducted a retrospective, multicentre, observational study including all patients who underwent percutaneous or surgical implantation of a stent in one or both pulmonary artery (PA) branches. The primary endpoint was stent survival free from surgical removal, percutaneous re-stenting, branch occlusion, or cardiac-related death.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Between 2004 and 2025, 159 patients (55% male; mean age 7.5&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;9.1 years) underwent 215 pulmonary branch stent implantations. The most frequent underlying congenital heart diseases were pulmonary atresia with ventricular septal defect (28%), tetralogy of Fallot (24%) and single ventricle physiology (14%). A genetic abnormality was identified in 19% of patients. Most stents were implanted percutaneously (65%), predominantly in paediatric patients (88%), and resulted in a significant increase in the pulmonary branch minimal diameter &lt;em&gt;Z&lt;/em&gt;-score (from −5.0&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;2.6 to 0.0&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;1.7, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). Mean follow-up was 6.3&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;5.0 years, covering 206 stents (95%). The primary endpoint occurred in 24% of stents after a mean of 2.3&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;3.2 years. Stent survival free from the primary endpoint was 78% at 10 years. Factors associated with endpoint occurrence were younger age and lower weight at implantation, smaller baseline pulmonary artery diameter, and the use of non-redilatable stents. Long-term complications included 41 cases of in-stent proliferation (20%), 21 fractures (10%), 7 migrations (3%), and rarer events (PA–aortic fistula, aortic compression, disse","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages S261-S262"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816079","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":"Thirty-year trends in one-year survival and pregnancy termination in congenital heart defects","authors":"Neil Derridj,&nbsp;Isabelle Monier,&nbsp;Marine Wojciechowski,&nbsp;Damien Bonnet,&nbsp;Francois Goffinet,&nbsp;Nathalie Lelong,&nbsp;Babak Khoshnood","doi":"10.1016/j.acvd.2026.06.021","DOIUrl":"10.1016/j.acvd.2026.06.021","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Survival of children with congenital heart defects (CHD) has improved substantially, but recent studies suggest a plateau, and the contribution of changes in prenatal diagnosis and termination of pregnancy for fetal anomaly (TOPFA) remains unclear.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Survival of children with congenital heart defects (CHD) has improved substantially, but recent studies suggest a plateau, and the contribution of changes in prenatal diagnosis and termination of pregnancy for fetal anomaly (TOPFA) remains unclear.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;To assess long-term trends in one-year survival among infants with CHD and in TOPFA, and the extent to which changes in TOPFA may explain survival trends, separately for isolated and non-isolated CHD.&lt;/div&gt;&lt;div&gt;We conducted a population-based study using data from the Paris Registry of Congenital Anomalies (1994–2023). Isolated CHD were defined as CHD without associated genetic or extracardiac anomalies, as opposed to non-isolated CHD. One-year survival among live-born infants was estimated using Kaplan–Meier methods. Temporal trends in survival and TOPFA were analyzed using logistic regression, with assessment of non-linearity (fractional polynomials) and slope changes (segmented models).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;To assess long-term trends in one-year survival among infants with CHD and in TOPFA, and the extent to which changes in TOPFA may explain survival trends, separately for isolated and non-isolated CHD.&lt;/div&gt;&lt;div&gt;We conducted a population-based study using data from the Paris Registry of Congenital Anomalies (1994–2023). Isolated CHD were defined as CHD without associated genetic or extracardiac anomalies, as opposed to non-isolated CHD. One-year survival among live-born infants was estimated using Kaplan–Meier methods. Temporal trends in survival and TOPFA were analyzed using logistic regression, with assessment of non-linearity (fractional polynomials) and slope changes (segmented models).&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 5674 CHD cases, 66.1% were isolated and 33.9% were non-isolated; 4210 were live births, 1325 TOPFA and 139 stillbirths. One-year survival was 90.9% (95% CI 89.9–91.7), reaching 95.0% in isolated CHD and 76.3% in non-isolated CHD (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). Survival improved over time with a non-linear pattern, with annual gains declining from 0.6–0.7% before the late 2000s to 0.1–0.2% thereafter. This improvement was driven by isolated CHD, in which survival increased despite a decline in TOPFA. In contrast, in non-isolated CHD, both survival and TOPFA rates remained stable over time.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Among 5674 CHD cases, 66.1% were isolated and 33.9% were non-isolated; 4210 were live births, 1325 TOPFA and 139 stillbirths. One-year survival was 90.9% (95% CI 89.9–91.7), reaching 95.0% in isolated CHD and 76.3% in non-isolated CHD (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). Survival improved over time with a non-linear pattern, with annual gains decli","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Page S249"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816092","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":"Chronic total occlusion and outcomes after out-of-hospital cardiac arrest with ST-segment elevation myocardial infarction","authors":"Vincent Pham,&nbsp;Andrea Cupiraggi,&nbsp;Thibault Gasparato,&nbsp;Alain Cariou,&nbsp;Olivier Varenne,&nbsp;Manveer Singh,&nbsp;Fabien Picard","doi":"10.1016/j.acvd.2025.12.011","DOIUrl":"10.1016/j.acvd.2025.12.011","url":null,"abstract":"<div><h3>Background</h3><div>Out-of-hospital cardiac arrest in the setting of ST-segment elevation myocardial infarction is associated with high death rates. Chronic total occlusions are frequent in coronary artery disease, and have been linked to poor outcomes in acute coronary syndromes, but their prognostic impact in patients with out-of-hospital cardiac arrest in the setting of ST-segment elevation myocardial infarction is unclear.</div></div><div><h3>Aim</h3><div>To evaluate the prognostic impact of coronary chronic total occlusions in patients resuscitated from out-of-hospital cardiac arrest with ST-segment elevation myocardial infarction.</div></div><div><h3>Methods</h3><div>We analysed data from the prospective PROCAT registry including consecutive patients with out-of-hospital cardiac arrest with return of spontaneous circulation and ST-segment elevation myocardial infarction who underwent emergent coronary angiography between 2007 and 2024. The presence of chronic total occlusion was assessed at baseline. The primary endpoint was 90-day all-cause death; secondary endpoints included in-hospital death. Logistic regression and Cox models were used to assess associations between chronic total occlusion and outcomes.</div></div><div><h3>Results</h3><div>Among 352 patients included, chronic total occlusion was present in 58 (16%). Patients with chronic total occlusion were older, had more co-morbidities and exhibited more extensive coronary artery disease. Rates of in-hospital death (55.2% vs. 39.8%; <em>P</em> <!-->=<!--> <!-->0.030) and 90-day death (69.0% vs. 49.0%; <em>P</em> <!-->=<!--> <!-->0.005) were higher in the chronic total occlusion group. In the univariate analysis, chronic total occlusion was associated with increased in-hospital deaths (odds ratio: 1.86, 95% confidence interval: 1.05–3.29) and 90-day deaths (hazard ratio: 1.76, 95% confidence interval: 1.18–2.62). However, after multivariable adjustment for clinical and resuscitation-related factors, chronic total occlusion was not independently associated with either endpoint.</div></div><div><h3>Conclusions</h3><div>In patients resuscitated from out-of-hospital cardiac arrest with ST-segment elevation myocardial infarction, chronic total occlusion is associated with increased crude death rates, but does not independently predict outcomes after adjustment. Chronic total occlusion probably reflects a higher atherosclerotic burden rather than being a direct driver of early death. The detection of chronic total occlusion remains clinically relevant for long-term management.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 8","pages":"Pages 536-544"},"PeriodicalIF":2.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146196154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}