Annales de cardiologie et d'angeiologie最新文献

{"title":"Experiment of Read’Hy : A hybrid, mix of home and centre, cardiac rehabilitation program","authors":"Sonia Corone ,&nbsp;Romain Carpentier David ,&nbsp;Christelle Pierre ,&nbsp;Céline Chouhan ,&nbsp;Titi Farrokhi ,&nbsp;Aude Brucker ,&nbsp;Romain Dorange ,&nbsp;Pascal Guillo ,&nbsp;Antoine Faure ,&nbsp;Annie Fouard","doi":"10.1016/j.ancard.2025.101937","DOIUrl":"10.1016/j.ancard.2025.101937","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the strong recommendations and obvious benefits, cardiac rehabilitation remains underutilised or is often discontinued in real‐world practice. To improve patient care, a hybrid (mix of home and centre) program (Read'Hy) has been developed, combining exercise training sessions and therapeutic education, with weekly face-to-face follow-up.</div></div><div><h3>Methods</h3><div>After a check-up and minimum five days initiation in the centre, patients returned home, equipped with a heart rate monitor and a mobile application. A personalised 10-week program was drawn up. Asynchronous home exercise was recorded and analysed daily by the rehabilitation technician. Each week, the patient came back to the centre for a supervised training session and interviews allowing to adjust the program.</div></div><div><h3>Results</h3><div>Out of 353 patients (mean age 55±11 years), 89% completed the program with 91% attendance and 35 physical activity sessions performed. Peak VO₂ increased by 20% (21.8 to 26.1 ml/min/kg, <em>p</em>&lt;0.0001), as did VO₂ at point of intersection (16.6 to 19.9 ml/min/kg, <em>p</em>&lt;0.0001) and maximum workload (140 to 168 Watts, <em>p</em>&lt;0.0001). Only one rhythmic event was reported. Quality of life improved (VAS +14%, <em>p</em>&lt;0.0001), and weekly physical activity quantified by IPAQ-SF increased by 53% (<em>p</em>&lt;0.0001). After one year, IPAQ-SF remained 43.6% higher than the initial level (<em>p</em>&lt;0.0001).</div></div><div><h3>Conclusion</h3><div>This hybrid program, both safe and effective, promotes the sustainable integration of physical activity into daily life.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101937"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095993","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":"Vers un modèle national de télésurveillance en insuffisance cardiaque : proposition d'un cadre organisationnel à partir d'un consensus infirmier ville-hôpital","authors":"Christine Lecerf ,&nbsp;Gauthier Lefranc ,&nbsp;Nathalie Vionnet ,&nbsp;Valérie Ple ,&nbsp;Emilie Saunier ,&nbsp;Céline Picard ,&nbsp;Céline Chauveau ,&nbsp;Nawel Aouni","doi":"10.1016/j.ancard.2025.101929","DOIUrl":"10.1016/j.ancard.2025.101929","url":null,"abstract":"<div><div>Remote monitoring of heart failure is now being deployed throughout France. It allows for effective remote monitoring and aims to improve patients' quality of life. Given the heterogeneity of practices, a committee of nurses has proposed a structured and reproducible organizational framework based on four pillars: Engage, Personalize, Support, and Coordinate.</div><div>This model encourages the standardization of practices, improves patient adherence, and ensures quality follow-up. Remote monitoring must remain temporary, educational, and patient-centered. Indicators must be used to assess its effectiveness.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101929"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095954","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":"Sommaire","authors":"","doi":"10.1016/S0003-3928(25)00113-1","DOIUrl":"10.1016/S0003-3928(25)00113-1","url":null,"abstract":"","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101974"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358303","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":"Optimization of Post-ACS Management in France: National Consensus Outcomes from the EuroPath II Initiative","authors":"Marc Villaceque ,&nbsp;Cyrille Bergerot ,&nbsp;François Schiele ,&nbsp;Pierre Sabouret ,&nbsp;Chaimae Ighidi ,&nbsp;Franck Boccara ,&nbsp;Jean Ferrières ,&nbsp;Meyer Elbaz ,&nbsp;Adrien Lemaitre","doi":"10.1016/j.ancard.2025.101969","DOIUrl":"10.1016/j.ancard.2025.101969","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The in-hospital management of acute coronary syndrome (ACS) is clearly established; however, post discharge, ACS patients face significant challenges including securing timely follow-up appointments, managing complex medication regimens, and maintaining long-term adherence to lifestyle changes while lacking adequate psychological support. A national Delphi consensus process was conducted to assess post-ACS management practices in France. This involved administration of a structured questionnaire to a panel of experts, aiming to evaluate current clinical practices and establish a unified approach.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The outcomes of the national consensus on post-ACS management were developed with the collective clinical expertise and real-world experience of a panel of French cardiologists. A two-day national face-to-face expert board was convened to identify challenges in post-ACS management and collaboratively develop solutions aimed at harmonizing clinical practices across France. Building upon the insights gathered during this board, a structured national survey was subsequently distributed to assess and further standardize these practices nationwide.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A comprehensive post-ACS checklist proposes a structured pathway integrating hospital discharge protocols, scheduled follow-up appointments, secondary prevention treatments, rehabilitation planning, and a standardized discharge document for transmitting comprehensive patient information to ensure safe discharge from hospital. The European Society of Cardiology (ESC) guidelines for post-ACS care pathway management include in-hospital empowerment consultation by cardiologists and specialized nurses, scheduled appointments (4–6 weeks and 1-year with a cardiologist), intermediate follow-ups through calls or visits, cardiac rehabilitation planning, and coordinated communication among healthcare providers (utilizing digital tools and trained networks) to maintain consistent prevention messaging and enhance patient adherence. To warrant 100% review of post-ACS patients within 6 weeks post discharge, coordinated discharge planning, mandatory training for healthcare correspondents, streamlined appointment scheduling, patient education, and media engagement to facilitate effective follow-up care are necessary. The first post-ACS consultation encompasses a comprehensive approach, including disease history review, risk factor assessment, determination of the extent of coronary disease via angiography, clinical and laboratory evaluations, treatment optimization, lifestyle counseling, patient education on warning signs, psychosocial support, cardiac rehabilitation options, and follow-up planning, aimed at reducing recurrence risk and ensuring optimal patient care. The ESC guidelines-based personalized approach for medication management between 1 and 12 months includes antiplatelet treatment (intensity modulated by selecting a p","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101969"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358195","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":"Efficacy and Safety of SGLT2 Inhibitors in Heart Failure: Observational Evidence in Geriatric Patients AGING-HF","authors":"A. Hacil MD ,&nbsp;Y. Antakly-Hanon MD ,&nbsp;A. Lacour MD ,&nbsp;J.P. David MD, PhD ,&nbsp;T. Khalifa MD ,&nbsp;M. Piccoli MD ,&nbsp;A. clemencin MD ,&nbsp;P. Assayag MD, PhD ,&nbsp;J.S. Vidal MD, PhD ,&nbsp;O. Hanon MD, PhD","doi":"10.1016/j.ancard.2025.101961","DOIUrl":"10.1016/j.ancard.2025.101961","url":null,"abstract":"<div><h3>Contexte</h3><div>Les inhibiteurs du cotransporteur sodium-glucose de type 2 (iSGLT2) ont montré des effets bénéfiques dans la prise en charge de l'insuffisance cardiaque (IC), mais les données concernant leur utilisation chez les populations gériatriques à forte comorbidité restent limitées. Cette étude observationnelle avait pour but d’évaluer l’efficacité et la tolérance des iSGLT2 en conditions réelles chez des patients âgés atteints d’IC.</div></div><div><h3>Méthodes</h3><div>Cette étude prospective multicentrique a inclus 496 patients hospitalisés pour insuffisance cardiaque aiguë (ICA) dans trois unités gériatriques. L'âge moyen était de 90 ans, avec un score moyen de comorbidité de Charlson de 8,2. Les participants ont été répartis en deux groupes: le groupe iSGLT2 (n=260), recevant de l’empagliflozine ou de la dapagliflozine en complément du traitement standard de l’IC, et le groupe contrôle (n=236), recevant uniquement le traitement standard. Les critères de jugement principaux étaient la mortalité toutes causes confondues, les réhospitalisations pour IC, et les événements indésirables sur un an.</div></div><div><h3>Résultats</h3><div>L’utilisation des iSGLT2 était associée à une réduction du risque de mortalité toutes causes confondues (HR 0,67 [IC 95%: 0,46–0,98], p = 0,031), de réhospitalisation pour IC (HR 0,64 [IC 95%: 0,42–0,97], p = 0,037), et du critère combiné (HR 0,60 [IC 95%: 0,44–0,82], p = 0,001) à un an, après ajustement multivarié. Aucune interaction significative n’a été observée entre la fraction d'éjection du ventricule gauche et l'utilisation des iSGLT2 (p pour interaction = 0,12). Bien que les infections urinaires et génitales aient été rapportées plus fréquemment dans le groupe iSGLT2, le taux d’arrêt du traitement est resté faible (2,7%).</div></div><div><h3>Conclusion</h3><div>Chez cette population très âgée et à forte comorbidité, le traitement par iSGLT2 était associé à une réduction significative de la mortalité et des réhospitalisations pour IC, avec une bonne tolérance et un profil de sécurité acceptable.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101961"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358198","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 du strain de l’oreillette gauche en échocardiographie : intérêt physiopathologique, diagnostique et pronostic","authors":"Patrick Meimoun,&nbsp;Karina Rahmouni,&nbsp;Ines Idir,&nbsp;Vanessa Kacy,&nbsp;Houssam Louhani,&nbsp;Jérome Clerc","doi":"10.1016/j.ancard.2025.101934","DOIUrl":"10.1016/j.ancard.2025.101934","url":null,"abstract":"<div><div>Several studies have evaluated left atrial function, mainly using two-dimensional longitudinal myocardial strain with the speckle tracking technique. The study of left atrial strain (LAS) allows the analysis of the different phases of left atrial function (reservoir, conduit, pump) and its correlations with left ventricular systolic and diastolic function, and exercise capacity. Furthermore, LAS has diagnostic value in estimating left ventricular diastolic dysfunction and filling pressure. It helps differentiate the etiologies of left ventricular hypertrophy and has prognostic value in various diseases, including heart failure, valvular diseases, coronary artery disease, atrial fibrillation, and various causes of left ventricular hypertrophy. In this review, we will focus on these topics and discuss the growing interest in three-dimensional LAS.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101934"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095998","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":"Implantation de stimulateurs cardiaques sans sonde : plaidoyer pour un élargissement des conditions d’implantation dans les centres sans chirurgie cardiaque","authors":"Walid Amara ,&nbsp;Anas El Mahi ,&nbsp;Ahmed Salhi ,&nbsp;Pierre Socié ,&nbsp;Cyrus Moini ,&nbsp;Jérôme Taieb","doi":"10.1016/j.ancard.2025.101941","DOIUrl":"10.1016/j.ancard.2025.101941","url":null,"abstract":"<div><div>Leadless pacemakers’ implantations in France are limited to centers with onsite cardiac surgery. However, these implantations are now possible in centers without onsite surgery in most European countries. Indeed, the rates of tamponade and cardiac perforation are very low. This article argues for the implantation conditions to be extended to centers with thoracic or vascular surgery (and not cardiac), as is the case for atrial fibrillation ablations, because these centers already have immediate surgical back-up, allowing the treatment of cardiac tamponade or perforation.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101941"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095996","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":"DOME-HF : évaluation rétrospective sur six mois de la prise en charge diurétique ambulatoire chez des patients âgés atteints d’insuffisance cardiaque","authors":"Marlène Esteban ,&nbsp;Olivier Maurou ,&nbsp;Marc Harboun ,&nbsp;Sophie Nisse Durgeat ,&nbsp;Rémi Esser","doi":"10.1016/j.ancard.2025.101933","DOIUrl":"10.1016/j.ancard.2025.101933","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) is a major cause of morbidity and mortality in older adults, with a rising prevalence after the age of 70. Conventional hospitalization, commonly required in this frail population, exposes patients to numerous iatrogenic complications. Alternative care models, such as diuretic-based day hospital (DH) management, may help mitigate these risks.</div></div><div><h3>Objectives</h3><div>To describe the geriatric profile of patients treated for acute heart failure (AHF) in a diuretic day hospital within a cardiogeriatrics unit, and to report the organization of the associated care pathway.</div></div><div><h3>Methods</h3><div>This was a retrospective, observational, monocentric study conducted in the cardiogeriatrics department of Hôpital La Porte Verte (Versailles, France). Patients aged ≥65 years who were treated in a diuretic day hospital for acute heart failure between January and June 2025 were included. Geriatric, cardiologic, and organizational data were collected from medical records. A purely descriptive analysis was performed.</div></div><div><h3>Results</h3><div>Forty patients were included, with a mean age of 88 ± 6.8 years. Most lived at home (95%) and had preserved autonomy (mean ADL score: 5.4). The average Charlson Comorbidity Index was 8.9 ± 2.3; 50% were at risk of malnutrition and 92.5% had chronic kidney disease. From a cardiologic standpoint, 57.5% had preserved LVEF and 67.5% had atrial fibrillation. The mean delay between referral and the first day hospital session was 1.6 days, with an average of 3.1 sessions per patient. The rate of subsequent full hospitalization was 12.5%. Main complications included electrolyte disorders (5%), non-catheter-related infections (7.5%), and acute kidney injury (7.5%). Following day hospital management, 22.5% of patients were enrolled in a geriatric frailty day hospital program, 32.5% in an intravenous iron day hospital, and 22.5% in a remote monitoring program.</div></div><div><h3>Conclusion</h3><div>This diuretic day hospital model, integrated into a structured geriatric care pathway, appears feasible, safe, and relevant for managing very elderly patients with acute heart failure. It may represent an effective alternative to conventional hospitalization.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101933"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118254","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":"Une CVDA pas comme les autres","authors":"S. DUDAY,&nbsp;T. WAJCHERT","doi":"10.1016/j.ancard.2025.101967","DOIUrl":"10.1016/j.ancard.2025.101967","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Un homme de 46 ans qui a pour seul antécédent une spondylarthrite ankylosante avec sacro-iliite consulte en cardiologie pour une dyspnée d’effort depuis 4 mois. Ce tableau révèle après échographie cardiaque et angioscanner thoracique une dilatation et une dysfonction du ventricule droit (VD) sans embolie pulmonaire. L’ECG met en évidence une onde epsilon et un aspect de bloc de branche droit incomplet (BBD) avec ondes T négatives de V1 à V4. La télémétrie montre des épisodes de tachycardies ventriculaires non soutenus. La coronarographie est normale. Le cathétérisme droit ne montre pas d’hypertension pulmonaire et l’angiographie du VD montre un aspect en pile d’assiettes. L’IRM cardiaque montre des zones dyskinétiques et anévrismales du VD avec des plages de rehaussements tardifs ventriculaires gauche et droite ainsi qu’un thrombus intra-VD. On note également la présence d’une dysfonction systolique du ventricule gauche (FEVG à 35%).&lt;/div&gt;&lt;div&gt;Alors que le diagnostic de cardiomyopathie arythmogène du ventricule droit (CVDA) est en train d’être posé devant 3 critères majeurs et 2 mineurs de la Task-Force&lt;span&gt;&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt;, on note cependant plusieurs atypies dans le dossier. Premièrement, les troubles du rythme ventriculaire s’associent à des troubles de conductions (BAV 1 et BAV2 Mobitz 2 à la télémétrie). Deuxièmement, en IRM la paroi du VD n’est pas amincie et il existe un important œdème septal. Enfin, il n’existe pas d’antécédents familiaux de cardiomyopathies.&lt;/div&gt;&lt;div&gt;L’ensemble de ces éléments peuvent alors faire suspecter une sarcoïdose cardiaque.&lt;/div&gt;&lt;div&gt;Le bilan extracardiaque de la sarcoïdose met uniquement en évidence des épaississements de septa interlobulaires, et un antécédent de sacro-iliite qui bien que décrite dans les sarcoïdoses, n’est pas typique&lt;span&gt;&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt;. En revanche le PET-TDM met en évidence un hypermétabolisme diffus du VD, du septum et de la paroi inférieure, sans autre hypermétabolisme associé. La biopsie endomyocardique confirme la présence de granulomes épithélioïdes gigantocellulaires sans nécrose caséeuse, et donc le diagnostic de sarcoïdose. Le patient a été par la suite implanté d’un défibrillateur implantable et traité par méthotrexate et corticothérapie.&lt;/div&gt;&lt;div&gt;La CVDA et la sarcoïdose cardiaque sont des pathologies pouvant être difficiles à distinguer car elles peuvent remplir toutes les deux les critères diagnostiques de la Task-Force. Toutefois comparée à la CVDA, la sarcoïdose cardiaque se révèle à un âge plus tardif (45 ans d’âge médian au diagnostic 29 ans), il n’existe pas d’histoire familiale, et est plus souvent associée à des troubles de conductions, à une dysfonction VG et à un rehaussement tardif en IRM dans le septum, comme chez notre patient&lt;span&gt;&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt;. De plus, notre patient ne présentait pas d’atteinte extracardiaque évocatrice de sarcoïdose, renforçant la difficulté du diagnostic.&lt;/div&gt;&lt;div&gt;S’il faut effe","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101967"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358301","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":"Safety of exercise training for cardiac patients : results of a French multicenter COCARE study (COmplications in CArdiac REhabilitation)","authors":"Bruno Pavy ,&nbsp;Marie-Christine Iliou ,&nbsp;Mohamed Ghannem ,&nbsp;Dany Marcadet ,&nbsp;Warner Mampuya","doi":"10.1016/j.ancard.2025.101940","DOIUrl":"10.1016/j.ancard.2025.101940","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac rehabilitation is widely recognized as beneficial for patients with coronary artery disease, post-cardiac surgery, and heart failure, although it is underutilized. However, the benefit-risk balance must be updated to reflect the evolving characteristics of treated populations.</div></div><div><h3>Objective</h3><div>To evaluate the safety of supervised exercise training in a large sample of French cardiac rehabilitation patients, and to assess the utility of the modified Risk of Activity Related Events (RARE) score in identifying low-risk individuals.</div></div><div><h3>Methods</h3><div>This multicenter observational study included 6,793 patients from 32 centers surveyed between 2023 and 2025. Each center collected data over four consecutive months, including patient characteristics and events that interrupted programs, required transfer to acute care, or resulted in rehabilitation cessation. The modified RARE score was applied to identify a low-risk subgroup. Events were considered activity-related if they occurred during or within one hour of a training session.</div></div><div><h3>Results</h3><div>A total of 964 events (14.2%) were reported, of which 154 (2.3%) were activity-related. Two cardiac arrests occurred—one fatal—representing 0.98 cardiac arrests and 0.49 deaths per 100,000 patient-hours of training. A modified RARE score &lt; 4 defined a low-risk group with an area under the ROC curve of 0.67 and an excellent negative predictive value (0.99). However, specificity was limited (0.32), reflecting the low incidence of events even in high-risk patients.</div></div><div><h3>Conclusion</h3><div>The COCARE study confirms the low risk of supervised exercise in phase II cardiac rehabilitation. The modified RARE score may be useful in identifying patients who could safely benefit from alternative, less monitored formats such as telerehabilitation.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101940"},"PeriodicalIF":0.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118255","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}