Annales de cardiologie et d'angeiologie最新文献

{"title":"Coronarographie et angioplastie coronaire ambulatoire avant et après la pandémie de COVID-19 : expérience du centre hospitalier de Versailles","authors":"Taha Ettachfini ,&nbsp;Géraldine Gibault-Genty ,&nbsp;Elodie Blicq ,&nbsp;Guillaume Godeau ,&nbsp;Cheick-Hamala Fofana ,&nbsp;Grégoire Lefèvre ,&nbsp;Badreddine Ajlani ,&nbsp;Bernard Livarek","doi":"10.1016/j.ancard.2024.101809","DOIUrl":"10.1016/j.ancard.2024.101809","url":null,"abstract":"<div><h3>Background</h3><div>Same day discharge (SDD) diagnostic coronary angiography and percutaneous coronary interventions (PCIs) are increasingly performed, and indications extend to more complex procedures and more fragile patients. We report the evolution of SDD interventional cardiology activity in our centre since 2016, particularly before and after the COVID-19 pandemic. Secondarily, we analysed the feasibility and safety of SDD PCI.</div></div><div><h3>Materials and methods</h3><div>We analysed the number and percentage of SDD coronary angiograms and PCIs (elective or <em>ad hoc</em>), during 4 periods of 11 months each, from September 2016 to July 2024. Periods 1 and 2 took place before COVID-19, periods 3 and 4 after. We also compared the rate of complications and conversion to hospitalisation between periods 1-2 and 4.</div></div><div><h3>Results</h3><div>A total of 9587 procedures were analysed, including 1558 SDD procedures. The total number of SDD interventional cardiology procedures increased progressively over the 4 periods, from 146 SDD procedures (7.5%) in 2016–2017 to 620 (27.2%) in 2023–2024. This increase included both diagnostic coronary angiograms (respectively: 10.9%; 12.2%; 33.6% then 28.9%) and PCIs (respectively: 0.9%; 5.6%; 16.1% then 24.4%). In the immediate post-COVID-19 period, a significant increase, uncorrelated with the natural progression, was observed for SDD diagnostic coronary angiography and ad-hoc PCI. There were no deaths or serious complications, the rate of minor complications (1.1%) and conversion to conventional hospitalisation (4.5%) were low.</div></div><div><h3>Conclusion</h3><div>Provided a careful patient selection and rigorous organisation, SDD coronary angiography and PCI can safely be performed. The increase in the SDD interventional procedures, favoured by organisational (COVID-19) or economic constraints, need to be amplified.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101809"},"PeriodicalIF":0.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les patients hospitalisés en réanimation pour un syndrome coronarien aigu de 2012 à 2021 : une étude rétrospective monocentrique","authors":"A. Yesiloz ,&nbsp;S. Sanchez ,&nbsp;H. Mesrar ,&nbsp;J. Chrusciel ,&nbsp;M. Dacunka ,&nbsp;F. Raoul ,&nbsp;G. Simon ,&nbsp;D. Metz ,&nbsp;L. Chapoutot","doi":"10.1016/j.ancard.2024.101799","DOIUrl":"10.1016/j.ancard.2024.101799","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute Coronary Syndrome (ACS) are one of the main causes of mortality in France. Patients presenting with ACS are typically hospitalized in a specialized cardiology ward. The main objective of this study was to describe, characterize and evaluate the outcome of patients hospitalized for ACS in a generalist intensive care unit (rather than a cardiac care unit).</div></div><div><h3>Methods</h3><div>This was a retrospective study. Our population consisted of ACS patients admitted to an intensive care unit in a hospital center (Centre Hospitalier de Troyes) between 2012 and 2021. All patients admitted for ACS to the intensive care unit and who underwent coronary angiography were included.</div></div><div><h3>Results</h3><div>In 10 years, 104 patients, or 3.8% of ACS patients who underwent coronary angiography were admitted to intensive care. The majority were admitted after recovered cardiac arrest (72%) and were in cardiogenic shock (68%), accounting for a high in-hospital mortality (45.2%). In-hospital mortality was 45.2%. In multivariate analysis, the GRACE score was associated with in-hospital mortality (OR for each additional point = 1.024, 95% confidence interval 1.006–1.045, <em>p</em> = 0.01). Among the survivors, 88% had good neurological function when leaving the hospital.</div></div><div><h3>Discussion</h3><div>Mortality of ACS patients in intensive care was close to 50%. However, the neurological prognosis of the surviving patients was good. This population is rarely mentioned in the literature, and deserves to be evaluated by multicenter, prospective registries, with a view to improving management and prognosis.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101799"},"PeriodicalIF":0.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L'angioplastie du Tronc commun gauche en ambulatoire : Comment s'y prendre ?","authors":"Nicolas Amabile ,&nbsp;Philippe Garot","doi":"10.1016/j.ancard.2024.101797","DOIUrl":"10.1016/j.ancard.2024.101797","url":null,"abstract":"<div><div>The steady development of same-day discharge (SDD) PCIs in recent years means that, by 2024, we will be able to tackle increasingly complex lesions, including those of the left main artery. This strategy is supported by the literature, but requires an appropriate patient selection (based on medical and social criteria) and precise assessment of the anatomical complexity of the lesion and the foreseeable risks of the PCI. Strict adherence to pre-established service protocols for patient preparation and follow-up, as well as the establishment of clinical and paraclinical criteria for discharge to a conventional hospital unit, are essential to the success of an SDD PCI program.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101797"},"PeriodicalIF":0.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance du score de probabilité à 4 niveaux 4PEPS pour le diagnostic de l'embolie pulmonaire dans une population d'Afrique subsaharienne : données du Registre des Embolies Pulmonaires du Centre Hospitalier Universitaire de Bogodogo, Burkina Faso","authors":"Taryètba André Arthur Seghda ,&nbsp;Temoua Dan Naibé ,&nbsp;Yirtièrou Eric Dabiré ,&nbsp;Martin Wendlassida Nacanabo ,&nbsp;Sandrine Damoué Seghda ,&nbsp;Djième Claudine Dah ,&nbsp;Abouga Loya Mireille ,&nbsp;Nobila Valentin Yaméogo ,&nbsp;Georges R.C Millogo ,&nbsp;Anna Tall Thiam ,&nbsp;Laurence Flork ,&nbsp;André K Samadoulougou ,&nbsp;Patrice Zabsonré","doi":"10.1016/j.ancard.2024.101798","DOIUrl":"10.1016/j.ancard.2024.101798","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the performance of the 4PEPS score in the diagnosis of pulmonary embolism at the University Hospital of Bogodogo from January 1, 2021 to July 31, 2023.</div></div><div><h3>Methodology</h3><div>This was a cross-sectional descriptive and analytical diagnostic study, running from January 1, 2021 to July 31, 2023. It took place in the infectious and tropical diseases departments, including a pneumology unit and a cardiology unit, of the Bogodogo University Hospital. Patients of both sexes with suspected pulmonary embolism who had undergone CT scan were included. The 4PEPS score was calculated and dichotomized into probable and improbable. It thus constituted the diagnostic test. CT scan was the gold standard. The accuracy of the diagnostic test was judged by the area under the ROC curve. An area under the curve between 0.70 and 1 would mean that the score was moderately informative to perfect.</div></div><div><h3>Results</h3><div>Our study included 472 patients with suspected pulmonary embolism out of a total population of 1228 patients. Hospital prevalence was 21.7%. The mean age of patients was 54.3 years. Females accounted for 52.1% of cases, with a sex ratio of 0.93. The prevalence of pulmonary embolism in the different probability levels of the 4PEPS score was 13.3% for the very low level, 11.7% for the low level, 84.6% for the intermediate level and 93.3% for the high level. Sensitivity and specificity were 92.1% and 86.82% respectively. The positive and negative predictive values were 90.1% and 89.4% respectively. The area under the ROC curve was 0.91.</div></div><div><h3>Conclusion</h3><div>In our study, the 4PEPS score showed good negative and positive predictive values. The use of this score will enable practitioners faced with diagnostic difficulties to make therapeutic decisions, reducing inappropriate prescriptions for thoracic angioscan.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101798"},"PeriodicalIF":0.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Évaluation préliminaire de l'intérêt d'une cellule d'optimisation thérapeutique sur la titration des traitements de l'insuffisance cardiaque à fraction d’éjection ventriculaire gauche réduite et la qualité de vie des patients","authors":"Hanane Aissaoui,&nbsp;Stéphane Pichard,&nbsp;Violaine Gaulupeau,&nbsp;Elodie Gautron,&nbsp;Thibault Wajchert,&nbsp;Franck Assayag,&nbsp;Floriane Gilles,&nbsp;Paul Duvillier,&nbsp;Jean-Louis Georges,&nbsp;Géraldine Gibault-Genty","doi":"10.1016/j.ancard.2024.101802","DOIUrl":"10.1016/j.ancard.2024.101802","url":null,"abstract":"<div><h3>Introduction</h3><div>A multidisciplinary therapeutic optimization unit (COT) was created in January 2023 at Versailles Hospital, aimed at therapeutic optimisation of patients with chronic heart failure with reduced left ventricular ejection fraction. The objective of the study was to assess the impact of the first year of COT activity on the sequential implementation and titration of heart failure treatments, the clinical evolution, and improvement of patients’ quality of life.</div></div><div><h3>Methods</h3><div>This prospective study included consecutive patients treated by the COT after hospitalisation for acute heart failure, from January to December 2023. Clinical, biological, titration, and tolerance data were analysed. Quality of life was assessed at baseline and at the end of the follow-up by COT, using standardized SF-12 and EQ-5D questionnaires.</div></div><div><h3>Results</h3><div>We included 90 patients (men 73%, mean age 67 years). The mean left ventricular ejection fraction was 34 ± 10 %. At final visit (median number of visits 4 ; median follow-up duration 156 days), 76.7% of patients achieved optimisation with respect to maximum individually tolerated doses, but only 13.3% with respect to theoretical maximum doses for the four therapeutic classes. At 1-year follow up, total mortality was 4.4% (4/90), and 9 patients (10%) were rehospitalised unplanned for acute heart failure. COT monitoring was associated with significant improvement in NYHA class, left ventricular ejection fraction, and SF-12 and EQ-5D-5L quality of life scores.</div></div><div><h3>Conclusion</h3><div>Although titration of heart failure treatments remained suboptimal, significant improvement was observed for NYHA class, left ventricular ejection fraction, and patient quality of life parameters.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101802"},"PeriodicalIF":0.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocardite de Libman-Sachs et accident vasculaire cérébral ischémique : à propos d'un cas","authors":"M.C. Hoara ,&nbsp;B. Simorre ,&nbsp;M.R. Belabed ,&nbsp;P. Berdague ,&nbsp;F. Georger","doi":"10.1016/j.ancard.2024.101801","DOIUrl":"10.1016/j.ancard.2024.101801","url":null,"abstract":"<div><div>Libman-Sacks endocarditis is a rare cardiac manifestation of anti-phospholipid syndromes, in which non-infectious thrombotic vegetations are found on the heart valves. Most patients are asymptomatic whereas the risk of thromboembolism is considerable. Diagnostic work-up is based on questioning and clinical examination data looking for extracardiac signs, biological data and also on imaging, and, above all, echocardiography.</div><div>We report the case of a 47-year-old female patient with no known history who is admitted to hospital with paresthesia of the right hemi-body associated with dysarthria. Cerebral CT scan confirms a paraventricular ischemic stroke. The etiological work-up for stroke is negative except the transesophageal echocardiogram which reveals mitral valve vegetations. Further investigations lead to the diagnosis of Libman-Sacks endocarditis. Treatment with Coumadin is started, with a target INR of between 2 and 3, as recommended. The clinical course was favourable, with stable lesions on transoesophageal echocardiography carried out later.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101801"},"PeriodicalIF":0.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TAVIGER : Intérêt d’une expertise coordonnée gériatrique et cardiologique dans le bilan d’éligibilité des patients âgés à un remplacement valvulaire aortique par voie percutanée","authors":"A. Manier ,&nbsp;C. Seunes ,&nbsp;D. Broucqsault ,&nbsp;M. Verhaeghe ,&nbsp;H. Behal ,&nbsp;V. Petit ,&nbsp;G. Hannebicque","doi":"10.1016/j.ancard.2024.101800","DOIUrl":"10.1016/j.ancard.2024.101800","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter aortic valve implantation (TAVI) is the gold standard treatment for aortic stenosis in the elderly. Pre-identification of patients likely to benefit from this procedure remains crucial. A standardised geriatric assessment is used to identify the major geriatric syndromes likely to influence postoperative outcomes.</div></div><div><h3>Objective</h3><div>To identify factors associated with lack of TAVI management and to compare one-year survival in TAVI vs. non-TAVI patients.</div></div><div><h3>Methods</h3><div>Retrospective study, between 2016 and 2020, at the Arras hospital. Patients aged 70 years and older with symptomatic severe aortic stenosis who had undergone geriatric assessment were included.</div></div><div><h3>Results</h3><div>One hundred and ninety-two (192) patients, mean age 82.3 years. The 1-year mortality rate was 18% in the TAVI group and 44% in the non-TAVI group (<em>p</em> &lt; 0.001).</div><div>Parameters associated with no TAVI were Euroscore (ESL) 1 (19.6 ± 10.9 vs. 23.2 ± 13.5, <em>p</em> = 0.020), malnutrition (14% vs. 35%, <em>p</em> = 0.004), walking speed &lt; 0.8 m/s (39% vs. 75%, <em>p</em> = 0.001), Activities of Daily Life (ADL) score (5.4 ± 1 vs. 4.2 ± 1. 6, <em>p</em> &lt; 0. 001) and Instrumental Activities of Daily Life (IADL) score (2.6 ± 1.2 vs. 1.8 ± 1.4, <em>p</em> = 0.002), Mini Geriatric Depression Scale (mini GDS) ≥ 1 (16% vs. 38%, <em>p</em> = 0.045), Mini Mental State Examination (MMSE) score (25.1 ± 3.5 vs. 21.6 ± 4.3 &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Geriatric syndromes are important determinants of TAVI candidacy. Cardiological surgical risk scores are not effective in discriminating between patients. Coordinated assessment may optimise selection. Therefore, geriatric assessment should be systematically performed as part of the pre-TAVI evaluation.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101800"},"PeriodicalIF":0.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardite aiguë secondaire à une maladie de Basedow : à propos d'un cas","authors":"Laura Eouzan-Dahan ,&nbsp;Alexandre Neyret ,&nbsp;Thibaut Wajchert ,&nbsp;Virginie Desforges-Bullet ,&nbsp;Géraldine Gibault-Genty ,&nbsp;Jean-Louis Georges","doi":"10.1016/j.ancard.2024.101808","DOIUrl":"10.1016/j.ancard.2024.101808","url":null,"abstract":"<div><p>The relationships between the thyroid and the heart are close and complex. In rare cases, hyperthyroidism induced by Graves' disease can be complicated by an acute myocarditis, which may be life-threatening. We report the case of a 41-year-old woman with Graves' disease not controlled by antithyroid drugs, hospitalized for odynophagia, palpitations due to atrial fibrillation, diffuse ST elevation on ECG and an increase in cardiac troponin. Coronary angiography was normal, cardiac MRI confirmed acute myocarditis. The evolution was favorable after a phase marked by supraventricular and ventricular rhythm disorders. The diagnostic and therapeutic challenge of this association are discussed, with a review of the literature.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101808"},"PeriodicalIF":0.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronarographie et angioplastie coronaire ambulatoire ; pourquoi, comment, pour quels patients ?","authors":"Marine Quillot ,&nbsp;Raphaël Lasserre ,&nbsp;Karim Moussa ,&nbsp;Mathieu Pankert ,&nbsp;Candice Venturelli ,&nbsp;Stéphane Andrieu","doi":"10.1016/j.ancard.2024.101805","DOIUrl":"10.1016/j.ancard.2024.101805","url":null,"abstract":"<div><p>There is great heterogeneity in lengths of stay in interventional cardiology but the number of outpatient procedures is increasing. The expected benefits of an outpatient procedure are numerous and non-inferiority of this strategy has been demonstrated. Proper selection of patients eligible for this treatment is essential to minimize the risks of unplanned hospitalization and early complications. It is based on clinical, medico-social and organizational criteria. Perfect management of the care pathway based on an organizational unit and a geographical unit is essential.</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101805"},"PeriodicalIF":0.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Le coroscanner peut-il être réalisé en dépistage à grande échelle en prévention des syndromes coronaires aigus et de l'insuffisance cardiaque ischémique ?","authors":"Adrien Pasteur-Rousseau ,&nbsp;Karam Souibri ,&nbsp;Fabien Vannier ,&nbsp;Laurent Sebagh","doi":"10.1016/j.ancard.2024.101807","DOIUrl":"10.1016/j.ancard.2024.101807","url":null,"abstract":"<div><p>Coronary CT-Scan permits non-invasive visualization of all stages of coronary artery atherosclerosis allowing early therapeutic interventions, lifestyle changes and accurate follow-up all of which result in an improved prognosis. We discuss the possibility of a systematic coronary CT-scan in the global population at certain ages such as fifty or sixty years-old (or both). May this strategy decrease the onset of myocardial infarction or ischemic chronic heart failure thus improving quality (and quantity) of life? May it also reduce the medical costs for the individual and the society? Is it technically possible to deploy such a strategy? What would be the obstacles for its set up and what solutions might be proposed?</p></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101807"},"PeriodicalIF":0.3,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}