Archives of Cardiovascular Diseases Supplements最新文献

{"title":"Characterization of impaired left ventricular mitral filling in HCM: A 4D-flow CMR study","authors":"H. Sakhi ,&nbsp;G. Soulat ,&nbsp;D. Craiem ,&nbsp;U. Gencer ,&nbsp;V. Stipechi ,&nbsp;T. Puscas ,&nbsp;A. Hagege ,&nbsp;E. Mousseaux","doi":"10.1016/j.acvdsp.2023.04.017","DOIUrl":"10.1016/j.acvdsp.2023.04.017","url":null,"abstract":"<div><h3>Introduction</h3><p>Diastolic dysfunction<span><span> is common and contributes to many clinical manifestations in hypertrophic cardiomyopathy (HCM). 4-dimensionnal (4D) flow </span>cardiac magnetic resonance (CMR) sequence can assess left ventricular mitral filling. The purpose of this study was to determine if the peak early filling rate normalized to the filling volume (PEFR/FV), estimated from 4D-flow sequence can accurately assess impaired left ventricular mitral filling and predict clinical outcomes.</span></p></div><div><h3>Method</h3><p><span>This monocentric study included 44 HCM patients from a prospective HCM register and 44 healthy volunteers, who all underwent CMR with 4D-Flow sequence. Median follow-up time of HCM cohort patients was 2.3 years (interquartile range: 1.7 to 3.3 years). The predefined primary endpoint was a composite criteria that included syncope, onset of atrial fibrillation, admission for congestive heart failure with administration of </span>diuretics, decision to perform septal reduction therapy due to persistent symptomatic obstruction, stroke, ventricular tachycardia or fibrillation and cardiac death.</p></div><div><h3>Results</h3><p>PEFR/FV was significantly lower in HCM cohort compared to healthy volunteers (<em>P</em> <!-->&lt;<!--> <!-->0.001). PFR/FV significantly correlated with BNP (<em>r</em> <!-->=<!--> <!-->−0.31, <em>P</em> <!-->&lt;<!--> <!-->0.001) and with E/E’ ratio (<em>r</em> <!-->=<!--> <!-->−0.56, p<!--> <!-->&lt;<!--> <span>0.001). PEFR/FV according to NYHA status in HCM cohort was statistically different (</span><em>P</em> <!-->=<!--> <!-->0.001). Primary endpoint occurred in 14 patients (32%). In univariate and bivariate adjusted cox-model analysis PEFR/FV<!--> <!-->&lt;<!--> <!-->2.61 s -1 was significantly associated with primary endpoint with Hazard Ratio ranging from [HR<!--> <!-->=<!--> <!-->9.46 (95% CI 2.61–45.17, <em>P</em> <!-->&lt;<!--> <!-->0.001) to 15.21 (95%CI 3.51–80.22, <em>P</em> <!-->&lt;<!--> <!-->0.001)] according to succesive bivariate models.</p></div><div><h3>Conclusion</h3><p>4D-Flow can accurately assess left ventricular mitral filling with a good predictive value of clinical outcomes in HCM patients. Relation of PEFR/FV calculated with 4D flow in HCM.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 251"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47121491","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":"A novel new 3D volume echo derived method for regurgitation fraction quantification in isolated aortic regurgitation","authors":"V. Baland,&nbsp;N. Pace,&nbsp;C. Selton Suty,&nbsp;A. Fraix,&nbsp;O. Huttin,&nbsp;D. Mandry,&nbsp;L. Filippetti","doi":"10.1016/j.acvdsp.2023.04.023","DOIUrl":"10.1016/j.acvdsp.2023.04.023","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Accurate quantification of chronic aortic regurgitation<span> (AR) using 2D-TTE is sometimes challenging. Cardiac magnetic resonance imaging (CMR) is increasingly used to refine this assessment by estimating measurement of regurgitation fraction (RF), but remains not widely available. 3D </span></span>echocardiography<span> (3D-ETT) allows a non-invasive approach of right ventricular (RV) and left ventricular (LV) volumes with a good correlation with CMR measurements. The 3D-TTE volume method is based on the comparison of RV and LV stroke volumes, which is then used to calculate the RF of the aortic valve in isolated AR.The primary objective of this study was to investigate the ability of 3D-TTE to assess the severity of chronic AR based on the criterion of regurgitation fraction (RF) obtained by the volume method in comparison to PC-CMR.</span></p></div><div><h3>Method</h3><p><span>We enrolled 42 patients with isolated AR who underwent ASE algorithm-guided 2D echocardiography (2D-TTE), 3D echocardiography and CMR. Regurgitation fraction (RF) was calculated by 3D-TTE using the formula [(LV Stroke Volume–RV Stroke Volume)/LV Stroke Volume]</span> <!-->×<!--> <!-->100. Correlation and concordance between 3D-TTE-RF and PC-CMR-RF were analyzed. Reproducibility of 3D-TTE-RF measurement was evaluated.</p></div><div><h3>Results</h3><p>Seven (17%) had mild AR, 27 (64%) moderate AR, and 8 (19%) severe AR in PC-CMR. Mean RF was 32.7<!--> <!-->±<!--> <!-->13.9% by 3D-TTE and 30,7<!--> <!-->±<!--> <!-->14,9% by PC-CMR-RF (<em>P</em> <!-->&lt;<!--> <!-->0,05). 3D-TTE-RF and PC-CMR-RF had a good correlation (<em>r</em> <!-->=<!--> <!-->0.90, <em>P</em> <!-->&lt;<!--> <!-->0,05). We found a good intra-operator (<em>r</em>:0.95, <em>P</em> <!-->&lt;<!--> <!-->0.05) and inter-operator (<em>r</em>:0.87, <em>P</em> <!-->&lt;<!--> <!-->0.05) reproductibility. The final gradation of AR was concordant between 3D TTE and PC-CMR in 88% of the cases.</p></div><div><h3>Conclusion</h3><p>The assessment of isolated aortic regurgitation fraction in 3D-TTE by the volumetric method is a feasible and reproducible method in daily clinical practice, with a good correlation to PC-CMR. Estimation of the aortic regurgitation fraction in (<span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Pages 254-255"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46918812","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":"Exercise-induced pulmonary congestion assessed by lung ultra sound in patients with preserved left ventricular ejection fraction referred for exercise echocardiography to rule out myocardial ischemia","authors":"C. Granger,&nbsp;L. Legrand,&nbsp;Y. Allali,&nbsp;P. Guedeney,&nbsp;R. Isnard,&nbsp;F. Pousset,&nbsp;J.P. Collet,&nbsp;G. Montalescot,&nbsp;N. Hammoudi","doi":"10.1016/j.acvdsp.2023.04.013","DOIUrl":"10.1016/j.acvdsp.2023.04.013","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Lung ultrasound (LUS) can detect pulmonary congestion<span> assessed by B-lines in heart failure patients undergoing stress test. Exercise B-lines could help diagnose heart failure with preserved left ventricular ejection fraction (LVEF) at an early stage. This study aimed to assess exercise-induced pulmonary congestion </span></span>in patients<span> with preserved LVEF referred for exercise echocardiography to rule out </span></span>myocardial ischemia.</p></div><div><h3>Method</h3><p><span>Data of stress echocardiography combined with LUS at rest and immediately after exercise in patients with LVEF ≥ 50% referred for investigation of inducible myocardial ischemia in a tertiary center of </span>cardiology were retrospectively analyzed. B-lines were assessed by scanning 2 chest sites. Exercise-induced pulmonary congestion was defined as an increase of B-lines ≥ 2 between baseline and exercise.</p></div><div><h3>Results</h3><p>A total of 1114 patients were included. Mean age was 63 years, 54% of patients had hypertension and 27% had diabetes. Exercise-induced pulmonary congestion was identified in 131 (12%) patients. Age, left atrial volume index (LAVi), resting and 20<!--> <!-->W septal E/e’<!--> <!-->&gt;<!--> <span>15 and peak tricuspid regurgitation velocity (TRV) were associated with increased exercise-induced B-lines. At multivariable analysis, LAVi (OR</span> <!-->=<!--> <!-->1.03; 95% confidence interval (CI): 1.01–1.06; <em>P</em> <!-->=<!--> <!-->0.003) and peak TRV (OR<!--> <!-->=<!--> <!-->3.8; 95%CI: 1.4–10.1; <em>P</em> <!-->=<!--> <!-->0.009) were independent predictors of exercise-induced pulmonary congestion.</p></div><div><h3>Conclusion</h3><p>Exercise-induced pulmonary congestion could be diagnosed in patients with preserved LVEF referred to rule out inducible myocardial ischemia. Exercise B-lines are linked with left ventricular diastolic dysfunction indices.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 249"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49035731","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":"Effectiveness of a radiation protective device of interventional echocardiographers during structural heart disease interventions","authors":"F. Magniez (Interne) ,&nbsp;N. Piriou (Praticien Hospitalier) ,&nbsp;P. Jaafar (Praticien Hospitalier) ,&nbsp;P.Y. Tuergon ,&nbsp;C. Cueff (Praticien Hospitalier) ,&nbsp;M. Bertrand (Praticien Hospitalier) ,&nbsp;J.M. Langlard (Praticien Hospitalier) ,&nbsp;L. Legloan (Praticien Hospitalier) ,&nbsp;L. Ammour (Radiophysicien) ,&nbsp;P. Guerin","doi":"10.1016/j.acvdsp.2023.04.009","DOIUrl":"10.1016/j.acvdsp.2023.04.009","url":null,"abstract":"<div><h3>Introduction</h3><p>Interventional echocardiographers (IE) have a crucial role in growing structural heart interventional procedures. Previous studies showed a 5 times higher exposure of IE than that of the invasive cardiologist. No dedicated and adapted radiation protection device currently exists for IE. It is from this observation that the interventional cardiology team of the Nantes University Hospital, together with the company “LemerPax”, have designed a radiation protection cabin (EchoSafe) dedicated to the protection of the IE in the operative room. The objective of this study is to evaluate the radioprotective performances of this cabin in real life.</p></div><div><h3>Method</h3><p>We included during 6 months all procedures that required transesophageal echocardiography. These procedures were divided into two groups (the first on which the usual protection device were used, i.e. a leaded glass door – the second on which the “Echosafe” device was used). We matched the procedures to obtain a total amount of irradiation estimated by the DAP (dose area product) close between the two groups. Irradiation measurements of the IE were performed with 10 TLD (thermoluminescent detectors) distributed over the whole body.</p></div><div><h3>Results</h3><p>We included a total of 64 procedures: 24 procedures in the control group, and 40 in the “echosafe” group. The cumulative DAP for each group was 75,206.9 Cgy/cm² in the control group, and 70,042 mGy.cm²<span> in the echosafe group. Patient characteristics<span> were identical between the two groups. The results show that in the “echosafe” group, irradiation was below the dose limit for the left lens, shoulders, thorax, and neck, a 49% reduction in irradiation of the right lens, 76% of the right wrist, 12% of the left wrist, 49% of the pubis, and 36% of the right ankle.</span></span></p></div><div><h3>Conclusion</h3><p><span>The “echosafe” device offers a clear reduction in the irradiation of the IE during structural heart intervention. Irradiation measurment of the sonographer (</span><span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Pages 246-247"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48255772","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":"AI-based fully automated left atrioventricular coupling index as a prognostic marker in patients undergoing stress-CMR","authors":"T. Pezel ,&nbsp;P. Garot ,&nbsp;S. Toupin ,&nbsp;F. Sanguineti ,&nbsp;T. Hovasse ,&nbsp;T. Unterseeh ,&nbsp;S. Champagne ,&nbsp;T. Chitiboi ,&nbsp;B. Ambale Venkatesh ,&nbsp;J.A.C. Lima ,&nbsp;J. Garot","doi":"10.1016/j.acvdsp.2023.04.025","DOIUrl":"https://doi.org/10.1016/j.acvdsp.2023.04.025","url":null,"abstract":"<div><h3>Introduction</h3><p>The left atrioventricular coupling index (LACI) is a strong and independent predictor of heart failure (HF) in individuals without clinical cardiovascular disease. To determine in patients undergoing stress CMR whether fully automated artificial intelligence-based LACI can provide incremental prognostic value to predict HF.</p></div><div><h3>Method</h3><p><span>Between 2016 and 2018, we conducted a study including all consecutive patients with abnormal vasodilator<span> stress CMR [inducible ischemia or late </span></span>gadolinium<span><span> enhancement (LGE)]. Control subjects with normal CMR were selected using propensity score-matching. LACI was defined as the ratio of LA to LV end-diastolic volumes. The primary outcome included hospitalization for acute HF or cardiovascular death using </span>Cox regression.</span></p></div><div><h3>Results</h3><p>In 2662 patients [65<!--> <!-->±<!--> <!-->12 years, 68% men, 1:1 matched patients (1331 with normal and 1331 with abnormal CMR)], LACI was positively associated with the primary outcome [median follow-up 5.2 (4.8–5.5) years] before and after adjustment for risk factors in the overall propensity-matched population [adjusted hazard ratio (HR), 5.94 (95%CI, 3.74–9.45) per 0.1% increment], patients with abnormal [adjusted HR, 6.38 (95%CI, 3.77–10.8) per 0.1% increment], and normal CMR [adjusted HR, 6.15 (95%CI, 2.97–12.7) per 0.1% increment; all <em>P</em> <!-->&lt;<!--> <!-->0.001]. After adjustment, a higher LACI of ≥<!--> <!-->25% showed the greatest improvement in model discrimination and reclassification over and above traditional risk factors and stress CMR findings (C-statistic improvement: 0.15; NRI<!--> <!-->=<!--> <!-->0.705; IDI<!--> <!-->=<!--> <!-->0.398, all <em>P</em> <!-->&lt;<!--> <!-->0.001; LR-test <em>P</em> <!-->&lt;<!--> <!-->0.001).</p></div><div><h3>Conclusion</h3><p>LACI is independently associated with hospitalization for HF and cardiovascular death in patients undergoing stress CMR, with an incremental prognostic value over traditional risk factors including inducible ischemia and LGE (<span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 256"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49725854","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":"Post-processing methodology for the multimodal study of the left atrium during atrial fibrillation","authors":"T. Raoult","doi":"10.1016/j.acvdsp.2023.04.043","DOIUrl":"10.1016/j.acvdsp.2023.04.043","url":null,"abstract":"<div><h3>Introduction</h3><p>In the context of a prospective study for the multimodal characterization of the left atrium<span><span> in patients undergoing </span>atrial fibrillation ablation, we developed a systematic pipeline to allow the co-registration and analysis of three different imaging modalities: LGE-CMR, 3D catheter-based invasive voltage maps and FDG uptake measured by PET.</span></p></div><div><h3>Method</h3><p>The software SLICER3D was choosed as the primary building block. As a free, open source software, it allows for the quick building and deployment of custom solutions thanks to its python wrapper. Several software solutions were developped in python using both the SLICER3D innate capabilities and the Vizualisation toolkit library (VTK) powerful post-processing power.</p></div><div><h3>Results</h3><p>Building on a previous work from Hohmann S. we developed a program allowing the importation in SLICER3D of CARTOv7 (biosense) voltage maps. Using built-in tools, 3D meshes were created from LGE-CMR and PET studies. Unto those 3D meshes, a custom program calculated a maximum intensity projection of the atrial wall along normal vectors, allowing for the creation of LGE and SUV 3D maps. Lastly, iterative point cloud registration permitted the fusion of all 3 mappings. Point-by-point test of association between low voltage, low FDG uptake and high-LGE was used.</p></div><div><h3>Conclusion</h3><p><span>We were able to fusion and do a point-by-point analysis of three different imaging studies of the left atrium in atria fibrillation: voltage maps, LGE-CMR, and PET. Software solutions developed for this post-processing pipeline are generic and could be adapted for other multimodalities studies. A prospective study using this methodology and involving patients in AF undergoing ablation is underway and will be presented at the ESC congress 2023 (</span><span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Pages 263-264"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49459177","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":"Diagnostic value of the International Society of Cardio-Oncology (IC-OS) definition for suspected immune checkpoint inhibitor-associated myocarditis","authors":"F. Deharo,&nbsp;J. Cautela,&nbsp;F. Thuny,&nbsp;M. Gaubert,&nbsp;F. Paganelli,&nbsp;N. Resseguier,&nbsp;F. Cadour,&nbsp;J. Alexandre,&nbsp;C. Dolladille","doi":"10.1016/j.acvdsp.2023.04.021","DOIUrl":"10.1016/j.acvdsp.2023.04.021","url":null,"abstract":"<div><h3>Introduction</h3><p>The diagnosis of immune checkpoint inhibitor-associated myocarditis (ICI-M) is challenging. Recently, the International Society of Cardio-Oncology (IC-OS) proposed an empirical definition of ICI-M; however, this definition has never been validated. We aimed to assess the diagnostic value at admission of the IC-OS definition in a cohort of patients with suspected ICI-M and to determine whether the addition of other criteria to this definition would improve its performance.</p></div><div><h3>Method</h3><p>Between May 2017 and November 2021, all patients with suspected ICI-M were consecutively included in a multicenter cohort. The final diagnosis was the one recorded in the patient's electronic medical record, established within one month of hospital discharge by the expert cardio-oncology team that managed the patient.</p></div><div><h3>Results</h3><p>Of the 68 patients included, 45 patients presented with ICI-M. The sensitivity, specificity, and positive and negative likelihood ratios of the IC-OS definition were 93% (95% CI: 82%–99%), 70% (95% CI: 47%–87%), 3.1 (95% CI: 1.7–5.7), and 0.1 (95% CI: 0–0.3), respectively. A delay in the onset of the first events &lt; 3 months after the introduction of ICIs was the only variable that was both significantly associated with the final diagnosis of ICI-M and did not already meet the criteria of the IC-OS definition (72% vs. 52%, <em>P</em> <!-->=<!--> <!-->0.03). By including this variable as a new minor criterion and increasing the number of minor criteria for defining ICI-M to 3, the specificity increased from 70% to 83% (<em>P</em> <!-->=<!--> <!-->0.08), and the sensitivity remained unchanged (93%).</p></div><div><h3>Conclusion</h3><p>The IC-OS definition for the diagnosis of ICI-M showed excellent sensitivity and moderate specificity. The latter could be increased by a modified definition including the time of the onset of the first events &lt; 3 months after the introduction of ICIs (<span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Pages 253-254"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46706200","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":"Prognostic value of right ventricular dysfunction in patients with acute pulmonary embolism and normal blood pressure","authors":"M. Hassine,&nbsp;S. Lamine,&nbsp;M.Y. Kallala,&nbsp;S. Kraeim,&nbsp;N. Bouchehda,&nbsp;M.M. Boussaada,&nbsp;M. Ben Messoud,&nbsp;M. Mahjoub,&nbsp;H. Gamra","doi":"10.1016/j.acvdsp.2023.04.053","DOIUrl":"10.1016/j.acvdsp.2023.04.053","url":null,"abstract":"<div><h3>Introduction</h3><p>The role of echocardiographic right ventricular (RV) dysfunction in predicting clinical outcome in clinically stable patients with pulmonary embolism (PE) is undefined. In this study, we assessed the prevalence and clinical outcome of normotensive patients with RV dysfunction among a broad spectrum of PE patients.</p></div><div><h3>Method</h3><p>This retrospective clinical outcome study included cohort of 186 consecutive patients (age: 62<!--> <!-->±<!--> <!-->15<!--> <!-->years) with documented PE. Acute RV dysfunction was diagnosed in the presence of one or more of the following criteria: a quotient of RV septal-lateral diameter/LV septal-lateral diameter<!--> <!-->&gt;<!--> <span>0.9 in the 4 chamber view in TTE or CT, RV hypokinesis (TAPSE</span> <!-->&lt;<!--> <!-->15<!--> <!-->mm), Doppler evidence of pulmonary hypertension (PASP<!--> <!-->&gt;<!--> <!-->40<!--> <!-->mmHg) and/or paradox septal systolic motion.</p></div><div><h3>Results</h3><p><span>Eighty-eight patients were judged to have RV dysfunction (47.3%). There was no difference in age, gender, prevalence of deep venous thrombosis (DVT), cancer or other risk factors in these two groups. In hospital mortality (21.6% vs. 5.4%; </span><em>P</em> <!-->=<!--> <span>0.001), cardiogenic shock (</span><em>P</em> <!-->=<!--> <span>0.001), and thrombolytic therapy use (</span><em>P</em> <!-->=<!--> <span>0.004) were significantly higher for RV dysfunction patients than for the other group. The multivariate logistic regression models revealed significant associations between RV dysfunction and in-hospital mortality (OR: 3.815, 95% CI: 1.012–10.47, </span><em>P</em> <!-->=<!--> <!-->0.001)</p></div><div><h3>Conclusion</h3><p><span>A significant proportion (47%) of normotensive patients with acute PE presents with RV dysfunction; these patients with latent </span>hemodynamic impairment have more PE-related shock and in-hospital mortality and may require aggressive therapeutic strategies.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 268"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46761604","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":"Characterization of left atrial appendage geometry and function using three-dimensional transesophageal echocardiography in patients in atrial fibrillation","authors":"L. Soulat-Dufour ,&nbsp;T. Simon ,&nbsp;S. Lang ,&nbsp;S. Ederhy ,&nbsp;S. Adavane-Scheuble ,&nbsp;M. Chauvet-Droit ,&nbsp;E. Capderou ,&nbsp;C. Arnaud ,&nbsp;P. Issaurat ,&nbsp;F. Boccara ,&nbsp;A. Cohen","doi":"10.1016/j.acvdsp.2023.04.046","DOIUrl":"10.1016/j.acvdsp.2023.04.046","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Few data are available on left atrial appendage (LAA) remodeling using three-dimensional (3D) transoesophageal echocardiography (TEE) </span>in patients in atrial fibrillation (AF). The aim of this study was to evaluate LAA thrombogenic milieu, LAA velocities, spontaneous echocardiographic contrast/thrombus, 3D LAA geometry and volume in AF.</p></div><div><h3>Method</h3><p>We prospectively evaluated patients 206 hospitalized for AF with two-dimensional (2D) transthoracic and 3D TEE of the LAA within 24<!--> <!-->hours of admission. 3D parameters were off-line analysed using Tomtec software (4D Cardio-View, Generic Volume, Philips) (<span>Fig. 1</span><span>). Patients were divided into two groups according to the type of AF at admission: paroxysmal AF<span> (62 patients) or persistent AF (144 patients).</span></span></p></div><div><h3>Results</h3><p><span>Patients with persistent AF had higher BMI, more prevalent hypertension and diabetes, as well as history of AF, heart failure, renal failure. They had also higher CHA2DS2-VASc. Patients with persistent AF at admission had lower LVEF, higher left atrial volume, higher E and E/e′ and pulmonary arterial systolic pressure. Patients with persistent AF had more severe LAA spontaneous echo contrast/sludge, lower LAA emptying and filling flow velocity, and higher 3D LAA measurements (ostium area, length, volume) (</span><span>Table 1</span>).</p></div><div><h3>Conclusion</h3><p><span>3D evaluation of the LAA may reflect atrial remodeling in AF and seems to be associated with the burden of AF. Follow-up data are needed to determine the impact of such abnormalities in the </span>risk stratification of such patients.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 265"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43513572","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":"Left atrioventricular coupling index assessed using cardiac CT as a prognostic marker of cardiovascular death","authors":"T. Pezel ,&nbsp;J.G. Dillinger ,&nbsp;S. Toupin ,&nbsp;R. Mirailles ,&nbsp;D. Logeart ,&nbsp;A. Cohen-Solal ,&nbsp;T. Gonçalves ,&nbsp;J. Lima ,&nbsp;V. Bousson ,&nbsp;P. Henry","doi":"10.1016/j.acvdsp.2023.04.044","DOIUrl":"10.1016/j.acvdsp.2023.04.044","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Although the left atrioventricular coupling index (LACI) measured by Cardiac MRI is a strong predictor of CV events, the availability to CMR remains limited in clinical routine. Therefore, it would be useful to validate LACI assessment using other imaging methods such as </span>computed tomography (CT). To investigate the prognostic value of the LACI assessed by </span>cardiac CT, to predict the occurrence of CV death in consecutive patients without known CVD referred for CCTA.</p></div><div><h3>Method</h3><p>Between 2010 and 2020, we conducted a single-center study with all consecutive patients without known CVD referred for CCTA. LACI was defined as the ratio of LA to LV end-diastolic volumes. The primary outcome was cardiovascular death. Cox regressions were used to evaluate the association of LACI with the primary outcome after adjustment for traditional risk factors and CCTA findings.</p></div><div><h3>Results</h3><p>In 1444 patients (70<!--> <!-->±<!--> <!-->12<!--> <!-->years, 43% men), 92 (6.4%) patients experienced all-cause death, including 67 (4.3%) patients with cardiovascular death after a median (IQR) follow-up of 6.8 (5.9–9.1) years. After adjustment for risk factors and CCTA findings, LACI was positively associated with the occurrence of cardiovascular death (adjusted hazard ratio [HR]: 1.07 [95% CI: 1.05–1.09] per 1% increment, <em>P</em> <!-->&lt;<!--> <!-->0.001), and all-cause death (adjusted HR, 1.05 [95% CI: 1.03–1.07] per 1% increment, <em>P</em> <!-->&lt;<!--> <!-->0.001). After adjustment, a LACI<!--> <!-->≥<!--> <!-->25% showed the best improvement in model discrimination and reclassification above traditional risk factors and CCTA findings (C-statistic improvement: 0.27; NRI<!--> <!-->=<!--> <!-->0.826; IDI<!--> <!-->=<!--> <!-->0.209, all <em>P</em> <!-->&lt;<!--> <!-->0.001; LR-test <em>P</em> <!-->&lt;<!--> <!-->0.001).</p></div><div><h3>Conclusion</h3><p><span>LACI measured by CCTA is independently associated with cardiovascular death and all-cause death in patients without known CVD referred for CCTA, with an incremental prognostic value over traditional risk factors and CCTA findings. Incremental prognostic value of LACI using CT (</span><span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 264"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46956622","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}