Archives of Cardiovascular Diseases最新文献

{"title":"Fractional flow reserve versus quantitative flow ratio to assess the non-infarct-related arteries in patients with ST-segment elevation myocardial infarction: Insights from the FLOWER-MI trial","authors":"Pierre Boubon , Alexandre Lafont , Nathan El Beze , Juliette Djadi-Prat , Nicolas Danchin , Etienne Puymirat , for the FLOWER-MI study investigators","doi":"10.1016/j.acvd.2024.09.003","DOIUrl":"10.1016/j.acvd.2024.09.003","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages 78-80"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481647","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":"2023 SFMU/GICC-SFC/SFGG expert recommendations for the emergency management of older patients with acute heart failure. Part 2: Therapeutics, pathway of care and ethics","authors":"Nicolas Peschanski , Florian Zores , Jacques Boddaert , Bénedicte Douay , Clément Delmas , Amaury Broussier , Delphine Douillet , Emmanuelle Berthelot , Thomas Gilbert , Cédric Gil-Jardiné , Vincent Auffret , Laure Joly , Jérémy Guénézan , Michel Galinier , Marion Pépin , Pierrick Le Borgne , Philippe Le Conte , Nicolas Girerd , Frédéric Roca , Mathieu Oberlin , Anthony Chauvin","doi":"10.1016/j.acvd.2024.09.004","DOIUrl":"10.1016/j.acvd.2024.09.004","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages 6-16"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513459","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":"Automatized quantitative electrocardiography from digitized paper electrocardiograms: A new avenue for risk stratification in patients with Brugada syndrome","authors":"Pierre-Léo Laporte ,&nbsp;Martino Vaglio ,&nbsp;Isabelle Denjoy ,&nbsp;Pierre Maison-Blanche ,&nbsp;Charlène Coquard ,&nbsp;Nathan El Bèze ,&nbsp;Philippe Maury ,&nbsp;Alexis Hermida ,&nbsp;Didier Klug ,&nbsp;Alice Maltret ,&nbsp;Fabio Badilini ,&nbsp;Antoine Leenhardt ,&nbsp;Fabrice Extramiana","doi":"10.1016/j.acvd.2024.05.123","DOIUrl":"10.1016/j.acvd.2024.05.123","url":null,"abstract":"<div><h3>Background</h3><div>Arrhythmic risk stratification is a major challenge in Brugada syndrome. Studies have evaluated risk stratification based on manually measured electrocardiogram (ECG) parameters at baseline and/or after drug challenge.</div></div><div><h3>Aim</h3><div>To assess the predictive value of multiple ECG parameters measured automatically from digitized paper ECGs.</div></div><div><h3>Methods</h3><div>During a prospective, multicentre cohort study that included patients with Brugada syndrome with type 1 ECG (spontaneously or drug-induced), paper ECGs were digitized and analysed. Major events were sudden cardiac death, aborted cardiac arrest and appropriate implantable cardioverter-defibrillator (ICD) therapy in the ventricular fibrillation (VF) zone. The predictive value of clinical and ECG parameters was assessed using univariable and multivariable Cox models.</div></div><div><h3>Results</h3><div>ECGs from 301 patients (74% male, mean age 43.1<!--> <!-->±<!--> <!-->13.3<!--> <!-->years, mean follow-up 7.1<!--> <!-->±<!--> <!-->5.6<!--> <!-->years) were analysed. Major events occurred in 6% of patients before diagnosis and 8% during follow-up. Two baseline ECG parameters were independently associated with major events: QRS prolongation in lead V1<!--> <!-->&gt;<!--> <!-->113<!--> <!-->ms (hazard ratio [HR] 3.49, 95% confidence interval [CI] 1.72–7.09; <em>P</em> <!-->&lt;<!--> <!-->0.001) and S duration on DI<!--> <!-->&gt;<!--> <!-->33.5<!--> <!-->ms (HR 3.56, 95% CI 1.52–8.31; <em>P</em> <!-->&lt;<!--> <!-->0.01). In drug-induced patients, changes in the Tpeak-Tend interval on V2 were associated with major events (HR 4.69, 95% CI 1.21–18.17; <em>P</em> <!-->=<!--> <!-->0.014).</div></div><div><h3>Conclusion</h3><div>Paper ECG datasets could be used for automatic quantitative ECG measurements. We confirmed the association of previously described parameters with events and identified useful new parameters. Multi-parametric ECG quantification may be used to assess risk in patients with Brugada syndrome.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages 17-25"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632865","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":"At the heart of the JESFC 2025: Cardiology 3.0","authors":"","doi":"10.1016/j.acvd.2025.01.002","DOIUrl":"10.1016/j.acvd.2025.01.002","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S3-S4"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016724","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":"Management of heart failure in private practice: Current situation","authors":"M. Villaceque ,&nbsp;F. Zorès ,&nbsp;F. Mouquet ,&nbsp;A.-F. Plane ,&nbsp;C. Bachelet ,&nbsp;B. Gellen ,&nbsp;B. Lequeux ,&nbsp;E. Berthelot","doi":"10.1016/j.acvd.2024.10.029","DOIUrl":"10.1016/j.acvd.2024.10.029","url":null,"abstract":"<div><h3>Introduction</h3><div>The optimization of care for heart failure (HF) patients often remains imperfect, particularly in terms of increasing pharmacological treatments and monitoring warning signs at home. To enhance practices in this field, we conducted a survey to better understand the habits of private cardiologists and the current obstacles to managing HF patients.</div></div><div><h3>Objective</h3><div>To better understand the habits of private cardiologists and the current obstacles to manage HF patients.</div></div><div><h3>Method</h3><div>A working group of private cardiologists who are members of the GICC established a questionnaire distributed to all private cardiologists between January and March 2024 via a QR code during JESFC events, as well as email dissemination and social media through the cardiologists’ union and the SFC. Responses were collected anonymously.</div></div><div><h3>Results</h3><div>252 cardiologists completed the questionnaire, although 52 were not usable. The average age was 54 years, with a majority practicing in group practices (107) and 34% combining practice in both outpatient clinics and hospitals. Responding cardiologists reported seeing an average of 15 HF patients per week. 98% of them believe that private cardiologists play an important role in HF management, especially for compensated chronic HF. Obstacles to this management included lack of training, complexity of care, and lack of time. Regarding available tools for HF management, 41% utilized tele-expertise and 48% telemonitoring. Reasons for not utilizing tele-expertise included perceived complexity (30%), unfamiliarity with the tool (25%), work habits (preference for phone calls for 20% of practitioners), or perceived uselessness (18%). Reasons for not using telemonitoring included complexity (45%), unfamiliarity with the tools (22%), low reimbursement (12%), or perceived uselessness (10%). Private cardiologists expressed a need for specific training in HF management in the form of Continuing Professional Development (57%) or practical guidelines (49%), facilitated by the GICC (68%).</div></div><div><h3>Conclusion</h3><div>This sample of private cardiologists believes they have a key role in managing chronic HF. However, they face the complexity of this task and express a need for specific training. Greater awareness of new telemedicine tools could contribute to improving patient management.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S37"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149737","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":"Heart failure therapeutic units enhance adherence to ESC guidelines","authors":"O. Ferchichi ,&nbsp;Z. Ibn El Hadj ,&nbsp;L. Mariem ,&nbsp;Z. Oumayma ,&nbsp;H. Ben Arbia ,&nbsp;A. Sghaier ,&nbsp;M.A. Almi ,&nbsp;S. Bousnina ,&nbsp;R. Chaabouni ,&nbsp;S. Allegui ,&nbsp;S. Aouni ,&nbsp;A. Ben Halima ,&nbsp;E. Bennour ,&nbsp;I. Kammoun","doi":"10.1016/j.acvd.2024.10.028","DOIUrl":"10.1016/j.acvd.2024.10.028","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure persists as a widespread health concern globally, affecting approximately 1–2% of the population in developed nations. Despite medical advancements, heart failure remains a significant cause of morbidity and mortality, primarily attributed to inadequate adherence to the latest ESC guidelines.</div></div><div><h3>Objective</h3><div>To underscore the importance of heart failure therapeutic units (HFTU) in aligning with ESC guidelines.</div></div><div><h3>Method</h3><div>This study was a prospective, descriptive, single-center investigation carried out in our cardiology department over a duration of 12 months. We included 159 patients diagnosed with chronic heart failure, who were divided into two groups to receive care either in the HFTU or usual care, regardless of their initial ejection fraction. Patients allocated to the HFTU had more frequent follow-up visits, prompt initiation of optimal treatment, and transition to second-line therapy if symptoms persisted compared to those receiving usual care. At the end of the follow-up period, we investigated the relationship between enrollment in the HFTU and adherence to ESC guidelines.</div></div><div><h3>Results</h3><div>The mean age of our cohort was 62.5<!--> <!-->±<!--> <!-->11.7 years, with a male predominance at 80.5%. Among the 159 patients, 108 patients allocated to the HFTU while 51 received usual care. Ischemic heart disease was the most prevalent underlying condition, accounting for 57.9% of cases. The average left ventricular ejection fraction was 31.6<!--> <!-->±<!--> <!-->8.31%. The prescription rates of beta-blockers, Angiotensin-Converting Enzyme inhibitors/Angiotensin II Receptor Blockers, Sodium-Glucose Co-Transporter 2 inhibitors, and mineralocorticoid receptor antagonists were 98.1%, 85.6%, 84.3%, and 79.6% respectively, in the HFTU group compared to 94.1%, 70.6%, 31.4%, and 88.2% respectively, in the usual care group.</div><div>Throughout the follow-up period, the HFTU group demonstrated significantly greater adoption of optimal medical treatment compared to those receiving usual care (54,6% vs. 7,8%; <em>P</em> <!-->&lt;<!--> <!-->0,001).</div></div><div><h3>Conclusion</h3><div>HFTU enhance adherence to ESC guidelines, thus combating therapeutic inertia and potentially improving the prognosis of heart failure.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S37"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149738","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":"Role of a regional heart failure (HF) unit in facilitating access to heart transplantation (HTx) in a non-HTx facility","authors":"J. Costa,&nbsp;P. Marine,&nbsp;L. Trousselle,&nbsp;P. Durdon,&nbsp;L. Lombardot,&nbsp;J. Dangy,&nbsp;K. Caron,&nbsp;D. Metz","doi":"10.1016/j.acvd.2024.10.026","DOIUrl":"10.1016/j.acvd.2024.10.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Accessing heart transplantation (HTx) for patients with advanced heart failure (HF) can be difficult, especially in areas without local transplant centers. To address this issue, the University Hospital of Reims (UHR) has established a regional pathway within its HF unit since 2018.</div></div><div><h3>Objective</h3><div>To evaluate the effects of creating a dedicated HF unit on regional accessibility to HTx.</div></div><div><h3>Method</h3><div>This study utilized data from the Annual Medical and Scientific Report (RAMS) by the French Biomedicine Agency (ABM), covering the years 2014–2022. Three indicators of HTx activity in the former Champagne-Ardenne region were collected: the HTx listing rate per million inhabitants, the HTx transplantation rate per million inhabitants, and the cumulative 12-month HTx transplantation rate. Each indicator was transformed into a national index (the regional/national ratio) to adjust for annual variations. The trends from 2014 to 2022 were examined using regression analysis, and non-parametric tests assessed HTx activity before and after the establishment of the HF unit in 2018.</div></div><div><h3>Results</h3><div>Between 2014 and 2022, the median HTx-listing indicator was 1.04 (interquartile range (IQR): 0.95 to 1.22), showing a tendency to increase (<em>P</em> <!-->=<!--> <!-->0.12) (<span><span>Fig. 1</span></span>). Notably, from 2019 to 2022, the median HTx-listing indicator significantly increased to 1.51 (IQR: 1.18 to 1.83), in contrast to 0.95 (IQR: 0.83 to 0.96) during 2014–2018 (<em>P</em>-value<!--> <!-->=<!--> <!-->0.03) (<span><span>Fig. 2</span></span>A). The overall median HTx rate indicator was 1.29 (IQR: 1.15 to 1.60), with regression analysis indicating a non-significant upward trend (<em>P</em>-value<!--> <!-->=<!--> <!-->0.0624) throughout the period (<span><span>Fig. 1</span></span>). In the 2019–2022 timeframe, the median HTx indicator notably rose to 1.61 (IQR: 1.57 to 1.63), compared to 0.95 (IQR: 0.58 to 1.15) during 2014–2018 (<em>P</em>-value<!--> <!-->=<!--> <!-->0.02) (<span><span>Fig. 2</span></span>B). The overall median 12-month cumulative HTx indicator stood at 1.07 (IQR: 0.97 to 1.13), with regression analysis showing a statistically significant upward trend (<em>P</em>-value<!--> <!-->=<!--> <!-->0.0095) over the full period (<span><span>Fig. 1</span></span>). Specifically, in the 2019–2022 period, the median 12-month cumulative HTx indicator significantly climbed to 1.14 (IQR: 1.11 to 1.17), as opposed to 0.97 (IQR: 0.96 to 1.00) during 2014–2018 (<em>P</em>-value<!--> <!-->=<!--> <!-->0.032) (<span><span>Fig. 2</span></span>C).</div></div><div><h3>Conclusion</h3><div>The establishment of a dedicated Heart Failure (HF) unit within a non-Heart Transplant (HTx) facility has potentially increased the regional HTx accessibility, underscoring the importance of HF units in improving HTx access.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S35-S36"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149758","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":"PRADOC: A multicentre randomized controlled trial to assess the efficiency of PRADO-IC, a nationwide pragmatic transition care management plan for hospitalized patients with heart failure in France","authors":"F. Roubille ,&nbsp;J.-P. Labarre ,&nbsp;M. Galinier ,&nbsp;P. Berdague ,&nbsp;N. Erika ,&nbsp;Q. Delbaere ,&nbsp;M. Robin ,&nbsp;E. Prunet ,&nbsp;F. Leclercq ,&nbsp;J.-L. Pasquie ,&nbsp;L. Papinaud ,&nbsp;G. Mercier ,&nbsp;J.-E. Ricci ,&nbsp;G. Cayla","doi":"10.1016/j.acvd.2024.10.021","DOIUrl":"10.1016/j.acvd.2024.10.021","url":null,"abstract":"<div><h3>Introduction</h3><div>The PRADO-IC is a transition care programme designed to improve the coordination of care between hospital and home that was generalized in France in 2014. The PRADO-IC consists of an administrative assistant who visits patients during hospitalization to schedule follow-up visits.</div></div><div><h3>Objective</h3><div>The aim of the present study was to evaluate the PRADO-IC programme based on the hypotheses provided by health authorities.</div></div><div><h3>Method</h3><div>The PRADOC study is a multicentre controlled randomized open-label mixed-method trial of the transition programme PRADO-IC vs. usual management in patients hospitalized with heart failure (SOC group; <span><span>NCT03396081</span><svg><path></path></svg></span>).</div></div><div><h3>Results</h3><div>A total of 404 patients were recruited between April 2018 and May 2021 (<span><span>Fig. 1</span></span>).</div><div>The mean patient age was 75 years (±12 years) in both groups. The two groups were well balanced regarding severity indices. At discharge, patients homogeneously received the recommended drugs. There was no difference between groups regarding hospitalizations for acute heart failure at 1 year, with 24.60% in the SOC group and 25.40% in the PRADO-IC group during the year following the index hospitalization [hazard ratio (HR)<!--> <!-->=<!--> <!-->1.04, 95% confidence interval (CI)<!--> <!-->=<!--> <!-->0.69–1.56; <em>P</em> <!-->=<!--> <!-->0.85] or cardio-vascular mortality (HR<!--> <!-->=<!--> <!-->0.67, 95% CI<!--> <!-->=<!--> <!-->0.34–1.31; <em>P</em> <!-->=<!--> <!-->0.24).</div></div><div><h3>Conclusion</h3><div>The PRADO-IC has not significantly improved clinical outcomes, though a trend toward reduced cardiovascular mortality is evident. These results will help in understanding how transitional care programmes remain to be integrated in current patients’ pathways, including telemonitoring, and to better tailor individualized approaches.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S33"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149779","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":"Management of DES coronary restenosis in a real-life setting in North African centers","authors":"F. Boukerche ,&nbsp;M. Kerrouche","doi":"10.1016/j.acvd.2024.10.078","DOIUrl":"10.1016/j.acvd.2024.10.078","url":null,"abstract":"<div><h3>Introduction</h3><div>One of the main causes of failure of angioplasty with stent implantation is in-stent restenosis (ISR). Even though its incidence has considerably decreased in recent years, it remains the Achilles’ heel of the interventional approach in patients with coronary disease.</div></div><div><h3>Objective</h3><div>We aimed to determine the predisposing factors of the different types of restenosis and evaluate the comparative efficacy and safety of the 2 most frequently used treatments of stent restenosis: drug-eluting balloon (DEB) and placement of a new drug-eluting stent (redo-DES).</div></div><div><h3>Method</h3><div>A prospective longitudinal analytical bicentric study, including all consenting patients presenting on coronary angiography in-stent restenosis, whether in the context of the exploration of stable angina or acute coronary syndrome. The different characteristics, mechanisms (analysis of initial PCI procedure, stent enhancement, and IVUS) management, and prognosis were noted. An angiographic control was systematically carried out between 6 and 12 months in patients treated with a Redo-DES or DEB (<span><span>Fig. 1</span></span>).</div></div><div><h3>Results</h3><div>A total of 73 patients were evaluated: the mean age was 61.3<!--> <!-->±<!--> <!-->10.2 years and 80.8% were male. The more frequent risk factor was diabetes with 67.1% (47 patients), and the main clinical presentation was CCS in 56.2% (41patients). The mean delay of in-stent restenosis occurrence was 20 months (4–48 months). The related artery includes the LAD in 61.6% and the two main characteristics of the initial lesion were calcified in 68.5% and the longest (&gt;<!--> <!-->24 mm) in 53.4% of patients. Stent under expansion was the most found mechanism in 54.8%. More than a half of the patients were treated with Redo-stenting and 34.2% with a DEB. The angiographic control was good with only two significant redo-restenosis in patients treated with a DEB and three in patients treated with a DES.</div></div><div><h3>Conclusion</h3><div>Diabetes mellitus, calcified and long lesions are the most important factors related to in-stent restenosis. Stent under expansion was the most found mechanism. Redo-stenting and DEB are safe and efficient treatments.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S16-S17"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150179","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":"What about markers inflammation on cardiac amyloidosis?","authors":"A. Zaroui ,&nbsp;G. Neculae ,&nbsp;B. Mélanie ,&nbsp;M. Kharoubi ,&nbsp;S. Oghina ,&nbsp;G.S. Chadha ,&nbsp;S. Bourgoin-Voillard ,&nbsp;J.-P. Bastard ,&nbsp;S. Fellahi ,&nbsp;T. Damy","doi":"10.1016/j.acvd.2024.10.051","DOIUrl":"10.1016/j.acvd.2024.10.051","url":null,"abstract":"<div><h3>Introduction</h3><div>Prognosis in cardiac amyloidosis has always been associated with amyloid infiltration, but there is increasing evidence of the role of inflammation and systemic immune response caused by the toxicity of free light chains and amyloid fibrils. However, there is very little knowledge about the systemic inflammation markers, their differential value, and prognostic significance in amyloidosis subtypes.</div></div><div><h3>Objective</h3><div>Differential value of inflammation markers and prognostic significance in amyloidosis subtypes.</div></div><div><h3>Method</h3><div>Prognostic markers well-known in AA amyloidosis, such as IL-6, calprotectin, and amyloide serique A (SAA), were measured at diagnosis and compared among AL, ATTR amyloidoses, and other cardiopathies.</div></div><div><h3>Results</h3><div>Pilot study of 147 patients (25 AL, 80 ATTR, and 42 others) with respective median ages of 76 years, 83 years, and 70 years, the median left ventricular function was 51.5% (±5), 52% (±4), and 48% (±6), with a median follow-up of 563 [20–590] days. Results showed a high incidence of inflammation with dissociation of markers in AL and ATTR-CA, For AL, the markers were higher,for ATTR-CA, there was some inflammatory substrate, less marked than in AL but more significant than in other cardiopathies. A certain population of ATTR-CA had a higher inflammatory profile (calprotectin and SAA). For other cardiopathies, the profile was rather homogeneous: the IL-6 was at 25.4<!--> <!-->±<!--> <!-->37 pg/ml, the Calprotectin at 10.3<!--> <!-->±<!--> <!-->21<!--> <!-->mg/L, and the SAA at 14.8<!--> <!-->±<!--> <!-->37<!--> <!-->mg/L compared to 8.5<!--> <!-->±<!--> <!-->9.9 pg/ml, 3.3<!--> <!-->±<!--> <!-->5.6<!--> <!-->mg/L, and 10.5<!--> <!-->±<!--> <!-->9.2<!--> <!-->mg/L, respectively, for ATTR and others cardopathies. Patients with elevated IL-6 levels were the most severe (higher Troponin, NT-proBNP, and lower LVEF). Calprotectin was well correlated with NT-proBNP and LVEF (<em>R</em> <!-->=<!--> <!-->0.76 and 0.77, <em>P</em> <!-->=<!--> <!-->0.04 and 0.001, respectively). IL-6 was the only marker with iprognostic value with a Hazard ratio of mortality at 2 years at 1.67 [1.11–12.45] in AL and ATTR amyloidoses (independent of troponin, LVEF, and NT-proBNP), and a value above 22 pg/ml increased mortality at 2 years by 20% in ATTR and early mortality by 33% in AL (3 months).</div></div><div><h3>Conclusion</h3><div>Inflammation is part of the pathophysiology of amyloidosis and increases morbidity and mortality, especially in AL amyloidosis. Treating amyloidosis would likely involve addressing this aspect in addition to others.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S48-S49"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150462","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}