Archives of Cardiovascular Diseases Supplements最新文献

{"title":"Independent predictors of mortality in peripartum cardiomyopathy: Casablanca university hospital","authors":"H.A. Zahidi,&nbsp;K. Badaoui,&nbsp;Y. Ettagmouti,&nbsp;R. Habbal","doi":"10.1016/j.acvdsp.2023.04.040","DOIUrl":"10.1016/j.acvdsp.2023.04.040","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Peripartum cardiomyopathy<span> (PPCM) is a rare, unrecognized and a life-threatening pregnancy-associated disease. It is established as left ventricular dysfunction occurring in the last month of pregnancy or the first 5</span></span> <span>months postpartum in the absence of known aetiology or preexisting heart disease. More than half of affected women recover systolic function<span>, although a minority requires mechanical support or cardiac transplantation (or both). We have conducted a five-year retrospective study to determine independent predictors of mortality in meadows cardiomyopathy.</span></span></p></div><div><h3>Method</h3><p><span><span>We retrospectively reviewed all the patients admitted for suspected PPCM in obstetric </span>gynecology, </span>cardiology or intensive care department from January 2017 to December 2022.</p></div><div><h3>Results</h3><p>A total of 88 patients were included in this study, all the patients were followed for at least 12<!--> <!-->months after diagnosis. The mean age of our patients was 29<!--> <!-->±<!--> <!-->5<!--> <!-->years. The diagnosis was established antepartum in 24%, postpartum in 48% and 26% at the start of labor. The mean age of pregnancy at diagnosis was 34<!--> <!-->±<!--> <!-->6<!--> <span>weeks of amenorrhea. Mean parity was 2.2</span> <!-->±<!--> <!-->1.8 and mean gravidity was 2.4<!--> <!-->±<!--> <!-->1.6. Dyspnea and left heart failure symptoms were the most frequent signs of PPCM observed in our patients with respectively 92% and 41% for each. Mortality rate was 11.5% in our population, and were associated significantly with the absence of pregnancy follow-up (<em>P</em> <!-->&lt;<!--> <span>0.01), preeclampsia (</span><em>P</em> <!-->=<!--> <span>0.045), altered left ejection fraction LVEF</span> <!-->&lt;<!--> <!-->30% (<em>P</em> <!-->=<!--> <span>0.029) and severe mitral regurgitation (</span><em>P</em> <!-->=<!--> <!-->0.036).</p></div><div><h3>Conclusion</h3><p><span>PPCM is a rare and potentially life-threatening heart disease with a significant maternal morbidity<span> and mortality rate. Early diagnosis based on transthoracic echocardiography is essential and appropriate medical therapy should be started rapidly (</span></span><span>Table 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 262"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48682685","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":"Which factors are associated with low flow in rheumatic mitral stenosis patients?","authors":"M.Y. Kallala,&nbsp;N. Bouchehda,&nbsp;S. Lamine,&nbsp;S. Kraeim,&nbsp;M. Boussaada,&nbsp;M. Ben Massoued,&nbsp;M. Mahjoub,&nbsp;M. Hassine,&nbsp;H. Gamra","doi":"10.1016/j.acvdsp.2023.04.055","DOIUrl":"10.1016/j.acvdsp.2023.04.055","url":null,"abstract":"<div><h3>Introduction</h3><p>Stroke volume (SV) raised enthusiasm in the early investigations of rheumatic MS pathophysiology and was considered as a key component triggering dyspnea. Giving the discrepancies uncovered in later studies, its importance was later downgraded. The objective of this study was to assess correlations between LA reservoir function (LASr) and global left ventricular longitudinal strain (LVS) determined by 2D STE and stroke volume index (SVI).</p></div><div><h3>Method</h3><p><span>We performed TTE in a cohort of patients with rheumatic MS. Basic 2D and doppler parameters were recorded such as mean trans-mitral gradient (MTMG), mitral valve area (MVA) with 2D planimetry and PHT. Studied parameters represent mean of three consecutive cardiac cycles. LASr data was obtained on a dedicated 4C view with STE technique. LVS was generated based on the 3 basic apical views. Low-flow state was defined as a SVI</span> <!-->≤<!--> <!-->35<!--> <!-->mL/m².</p></div><div><h3>Results</h3><p>One hundred and ninety-five patients were included between February 2018 and October 2021. We divided our cohort into two groups: group I with SVI<!--> <!-->≤<!--> <!-->35<!--> <!-->mL/m² and group II with SVI<!--> <!-->&gt;<!--> <!-->35<!--> <!-->mL/m². There was not a significant difference in terms of age (49.8<!--> <!-->±<!--> <!-->12 vs. 51.6<!--> <!-->±<!--> <!-->10<!--> <!-->yrs, <em>P</em> <!-->=<!--> <!-->0.3), sex (70.7 vs. 72.2% were female, <em>P</em> <!-->=<!--> <!-->0.8) and history of atrial fibrillation (67.4 vs. 55.7%, <em>P</em> <!-->=<!--> <!-->0.09). 2D MVA was significantly lower in group I (1.22<!--> <!-->±<!--> <!-->0.4 vs. 1.43<!--> <!-->±<!--> <!-->0.5<!--> <!-->cm², <em>P</em> <!-->=<!--> <!-->0.003). Surprisingly, MVA determined with PHT did not significantly differ (1.43<!--> <!-->±<!--> <!-->0.6 vs. 1.39<!--> <!-->±<!--> <!-->0.4<!--> <!-->cm², <em>P</em> <!-->=<!--> <!-->0.5). The incidence of severe dyspnea was (44.3 vs. 44.4%, <em>P</em> <!-->=<!--> <!-->0.9). TRVmax levels (3.23<!--> <!-->±<!--> <!-->0.6 vs. 3.07<!--> <!-->±<!--> <!-->0.6<!--> <!-->m/s, <em>P</em> <!-->=<!--> <!-->0.14) were comparable. Group I had significantly higher MTMG (12.1<!--> <!-->±<!--> <!-->7 vs. 9.8<!--> <!-->±<!--> <!-->4<!--> <!-->mmHg, <em>P</em> <!-->=<!--> <!-->0.01). LVS and LVEF were significantly lower in low-flow patients: (−15<!--> <!-->±<!--> <!-->4 vs. −18<!--> <!-->±<!--> <!-->2%, <em>P</em> <!-->&lt;<!--> <!-->0.001) and (61.1<!--> <!-->±<!--> <!-->8% vs. 64.2<!--> <!-->±<!--> <!-->5%, <em>P</em> <!-->=<!--> <!-->0.04) respectively. LASr was higher in normal flow patients but did not reach the statistical significance. (9.5<!--> <!-->±<!--> <!-->7 vs. 11.5<!--> <!-->±<!--> <!-->6%, <em>P</em> <!-->=<!--> <!-->0.062).</p></div><div><h3>Conclusion</h3><p>MVA, LVS and LVEF were significant associates of low-flow state in MS patients. LA reservoir function was not significantly","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 269"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42286384","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":"Machine-learning score using stress CMR and CCTA for prediction of cardiovascular events in patients with obstructive CAD","authors":"T. Pezel ,&nbsp;P. Garot ,&nbsp;S. Toupin ,&nbsp;K. Hamzi ,&nbsp;T. Hovasse ,&nbsp;T. Lefevre ,&nbsp;T. Unterseeh ,&nbsp;F. Sanguineti ,&nbsp;T. Goncalves ,&nbsp;J.G. Dillinger ,&nbsp;V. Bousson ,&nbsp;P. Henry ,&nbsp;J. Garot","doi":"10.1016/j.acvdsp.2023.04.027","DOIUrl":"10.1016/j.acvdsp.2023.04.027","url":null,"abstract":"<div><h3>Introduction</h3><p><span>In patients<span> with suspected or known CAD, traditional prognostic risk assessment is based upon a limited selection of clinical and imaging findings. Machine learning (ML) methods can take into account a greater number and complexity of variables. To investigate the accuracy of ML-score using simultaneously stress CMR, coronary </span></span>CT angiography (CCTA), and clinical data to predict the occurrence of CV events in patients with suspected or known CAD.</p></div><div><h3>Method</h3><p>Between 2008 and 2020, consecutive symptomatic patients without known CAD referred for CCTA were screened in ICPS (Massy). Patients with obstructive CAD (at least one ≥<!--> <!-->50% stenosis on CCTA) were further referred for stress CMR and followed for the occurrence of major adverse cardiovascular events (MACE), defined as CV death or nonfatal myocardial infarction. Twenty-three clinical, 11 stress CMR and 11 CCTA parameters were evaluated. ML involved automated feature selection and model building by random survival forest. The external validation cohort was Lariboisiere Hospital (<em>N</em> <!-->=<!--> <!-->274 patients).</p></div><div><h3>Results</h3><p>Of 2038 consecutive patients (47% men; mean age 69<!--> <!-->±<!--> <span>12 years), 281 (13.8%) patients experienced a MACE after a median follow-up of 6.7 years (interquartile range: 5.9–9.1). Our ML score exhibited a higher area-under-the-curve compared with stress CMR data alone, CCTA data alone, and traditional Cox model for prediction of 10-year MACE (ML: 0.88 vs. CMR data alone: 0.79, CCTA data alone: 0.72; traditional Cox model: 0.81, all </span><em>P</em> <!-->&lt;<!--> <!-->0.001). The ML score assessed in the derivation cohort (AUC: 0.88, F1-score 0.80) exhibited also a good area-under-the-curve in the external cohort for prediction of 10-year MACE (AUC: 0.86, F1-score 0.80).</p></div><div><h3>Conclusion</h3><p>The ML score including clinical, stress CMR and CCTA data exhibited a higher prognostic value to predict 10-year MACE compared with all traditional clinical data, CMR data or CCTA data alone (<span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 257"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44429010","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":"Heterogeneity of echocardiographic variables in systemic lupus erythematosus among clinical subgroups according to non-cardiac organ involvement","authors":"C. Bourg ,&nbsp;E. Le Tallec ,&nbsp;L. Curtis ,&nbsp;G. Bouzille ,&nbsp;E. Oger ,&nbsp;A. Lescoat ,&nbsp;E. Donal","doi":"10.1016/j.acvdsp.2023.04.050","DOIUrl":"10.1016/j.acvdsp.2023.04.050","url":null,"abstract":"<div><h3>Introduction</h3><p>Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease. Cardiac involvement is rare but plays an important prognostic role. The degree of cardiac involvement according to SLE subsets defined by non-cardiac manifestations is unknown. The objective of this study was to identify differences in TTE parameters associated with different SLE subgroups.</p></div><div><h3>Method</h3><p>One hundred and eighty-one patients fulfilling the ACR/EULAR 2019 classification criteria for SLE and had a TTE were included in this cross-sectional study. We defined four subsets of SLE based on the predominant clinical manifestations. A multivariate multinomial regression analysis was performed to determine whether TTE parameters differ between the subsets.</p></div><div><h3>Results</h3><p>The first subset (<em>n</em> <!-->=<!--> <span>37) of patients showed features of mixed connective tissue disease (MCTD); the second subset (</span><em>n</em> <!-->=<!--> <!-->76) had primarily cutaneous involvement; the third subset (<em>n</em> <!-->=<!--> <!-->18) exhibited serositis and the last subset (<em>n</em> <!-->=<!--> <!-->50) had severe disease with significant organ involvement, including renal involvement. Forty TTE parameters were assessed in each patient. Using a multivariate multinomial regression analysis, 3 parameters differed between groups: early diastolic tricuspid annular velocity (RV-E′, <em>P</em> <!-->&lt;<!--> <!-->0.0001), RV-S′ (RV-pulse DTI systolic peak wave, <em>P</em> <!-->=<!--> <!-->0.0031), and RV end-diastole diameter (<em>P</em> <!-->=<!--> <span>0.0419). The degree of RV dysfunction was lowest in patients with primarily cutaneous involvement.</span></p></div><div><h3>Conclusion</h3><p>Four distinct clinical subsets based on clinical manifestations differed in terms of TTE parameters of right heart function and diastolic dysfunction. This could help to tailor the cardiac follow-up required by the different clinical subsets of SLE.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 267"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42584150","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":"LV and LA mechanics in pediatric HCM: A CMR study of phenotype-genotype correlation","authors":"E. Panaioli ,&nbsp;V. Dangouloff-Ros ,&nbsp;N. Boddaert ,&nbsp;D. Bonnet ,&nbsp;D. Khraiche","doi":"10.1016/j.acvdsp.2023.04.016","DOIUrl":"10.1016/j.acvdsp.2023.04.016","url":null,"abstract":"<div><h3>Introduction</h3><p><span>The relationship between the genotype variation and phenotype expression in paediatric<span><span> hypertrophic cardiomyopathy (HCM) has not been fully elucidated. In HCM, fibrosis and hypertrophy contribute to left ventricular (LV) mechanics with a decreased global longitudinal and radial strains (GLS, GRS). The epicardial thickening leads to preserved global circumferential strain (GCS) and LV twist. Feature tracking – </span>cardiac magnetic resonance (FT-CMR) has enhanced the non-invasive assessment of myocardial deformation in HCM. The aim of our study was to assess differences of LV and LA mechanics features on CMR between patients harbouring multiple pathogenic or likely pathogenic variants (MGv, </span></span><em>n</em> <!-->=<!--> <!-->16) or single genetic variations (SGv, <em>n</em> <!-->=<!--> <!-->35).</p></div><div><h3>Method</h3><p>Our retrospective CMR study included 51 patients (1.7–18.8 years ago). CMR data were: LV and LA's morphological values, late gadolinium enhancement (LGE) of LA and LV walls, LV feature tracking (FT) derived strain and LV twist (LVT). LV twist was calculated as the difference between basal and apical rotation. The LA feature FT derived strain and function's parameters were computed.</p></div><div><h3>Results</h3><p>In MGv group, the indexed LV mass 108.8–53.0 vs. 74.3 ± 22.2 in SGv (<em>P</em> <!-->=<!--> <!-->0.03). LGE was present in 51% patients of the whole cohort, with LGE in 64% of MGv group. LV FT derived strain values were not statistically significant different between groups (MGv vs. SGv: GLS −15.8 ± 5.3 vs. −18.7 ± 4.8, GCS −27.8 ± 8 vs. −31.1 ± 8.6, GRS 44.7 ± 24.6 vs. 62.3 ± 32). LVT was reduced in MGv group (0.04 ± 7.6) vs. (7.4 ± 7.4) in SGv (<em>P</em> <!-->=<!--> <span>0.003). LA contractile function did not differ between the groups.</span></p></div><div><h3>Conclusion</h3><p><span>Patients with multiple genetic variants have a greater LV mass and altered LV mechanics with reduced LV twist. This study gives insights in phenotype-genotype correlation in paediatric HCM and warrants larger longitudinal studies to assess its clinical significance (</span><span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Pages 250-251"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47665072","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":"Machine learning model including left ventricular strain analysis for sudden cardiac death prediction in hypertrophic cardiomyopathy","authors":"A. Al Wazzan ,&nbsp;M. Taconne ,&nbsp;V. Le Rolle ,&nbsp;M. Inngjerdingen Forsaa ,&nbsp;K. Hermann Haugaa ,&nbsp;E. Galli ,&nbsp;A. Hernandez ,&nbsp;T. Edvarsen ,&nbsp;E. Donal","doi":"10.1016/j.acvdsp.2023.04.026","DOIUrl":"10.1016/j.acvdsp.2023.04.026","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>The excess mortality in HCM patients is mainly attributed to the occurrence of </span>SCD<span>. The prediction of ventricular arrhythmias remains challenging and could be improved. This study evaluated the added predictive value of a machine learning-based model combining clinical and conventional imaging parameters with information from left ventricular strain analysis to predict sudden cardiac death (SCD) </span></span>in patients with hypertrophic cardiomyopathy (HCM).</p></div><div><h3>Method</h3><p><span>A total of 434 HCM patients (65% men, mean age 56 years) were retrospectively included from two referral centers (Oslo University Hospital, Rennes University Hospital) and followed longitudinally (mean duration 6 years). Mechanical and temporal parameters were automatically extracted from the left ventricle<span><span> longitudinal strain (LV-LS) segmental curves of each patient and included in a Ridge Regression model alongside conventional clinical and imaging data. The composite endpoint included sustained ventricular tachycardia, appropriate </span>implantable cardioverter defibrillator therapy, aborted cardiac arrest, or sudden cardiac death (</span></span><span>Fig. 1</span>).</p></div><div><h3>Results</h3><p>Thirty-four patients (7.8%) met the endpoint with an incidence of ventricular arrhythmias of 0.9%/years. From a subset of 18 most discriminating parameters, including 7 derived from LV-LS, and after <em>n</em> <!-->=<!--> <!-->200 rounds of cross-validation, the final model showed superior predictive performance compared to conventional models with a mean area under the curve (AUC) of 0.83<!--> <!-->±<!--> <!-->0.8.</p></div><div><h3>Conclusion</h3><p><span>A machine learning model including automatically extracted left ventricular strain-derived parameters was superior in the prediction of sustained ventricular arrhythmias and SCD in patients with HCM compared to existing models. Machine learning model including LV-LS analysis could improve SCD risk stratification in HCM patients (</span><span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 257"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49142638","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":"Aortic valve replacement for aortic stenosis in patients under 65-years-old","authors":"R. Coelho,&nbsp;T. Bourguignon,&nbsp;A. Bernard","doi":"10.1016/j.acvdsp.2023.04.006","DOIUrl":"10.1016/j.acvdsp.2023.04.006","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Aortic valve stenosis is the most common valve disease in the world, with particularly poor prognosis if left untreated. Its management in young patients is based on surgical </span>aortic valve<span> replacement (bioprosthesis or mechanical prosthesis, and Ross or Ozaki technique), and rarely percutaneous (TAVR). In this population, the choice of the technique used is of primary importance in terms of hemodynamic<span> performance and durability. The objective of this work is to compare 5 different techniques used in the management of aortic stenosis </span></span></span>in patients under 65 years old at CHRU of Tours.</p></div><div><h3>Method</h3><p>We conducted a retrospective, single-center, observational study at the CHRU of Tours. Five cohorts (mechanical prosthesis, INSPIRIS bioprosthesis, Ross, Ozaki and TAVR) were compared in terms of pre-, per- and postoperative, clinical and hemodynamic parameters.</p></div><div><h3>Results</h3><p><span>We included 163 patients under 65-years-old with aortic stenosis operated at the CHRU of Tours between January 2015 and October 2021. Hemodynamically, after stratification on the prosthetic caliber, the best results were found with the Ozaki and Ross techniques, followed by TAVR, the INSPIRIS bioprosthesis and finally the mechanical prosthesis. A severe prosthesis-patient mismatch rate of 10% was found in all patients, with no significant difference between the different techniques (</span><em>P</em> <!-->=<!--> <!-->0.1827). Clinically, there was no significant difference between the groups in terms of mortality or re-intervention related to the aortic valve after a mean follow-up of 19.2 months (<em>P</em> <!-->=<!--> <span>0.6545). However, pacemaker implantation was significantly higher in the TAVR group (</span><em>P</em> <!-->=<!--> <!-->0.0178).</p></div><div><h3>Conclusion</h3><p>Each surgical and percutaneous technique has its specific advantages and complications. The excellent short-term hemodynamic parameters of the Ross and Ozaki techniques seem to encourage the use of these techniques in the management of aortic stenosis in young patients. More powerful studies with a longer follow-up time would allow to confirm these preliminary results.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 245"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48199146","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":"Abnormal left atrial compliance is associated with history of life-threatening arrhythmia in corrected tetralogy of Fallot","authors":"M. Vautier","doi":"10.1016/j.acvdsp.2023.04.049","DOIUrl":"https://doi.org/10.1016/j.acvdsp.2023.04.049","url":null,"abstract":"<div><h3>Introduction</h3><p>This study examined the left atrial (LA) function and compliance using two-dimensional (2D) strain analysis in adult patients with corrected tetralogy of Fallot<span> (c-ToF), as well as relationships between LA function and patient characteristics, especially history of life-threatening arrhythmia (h-LTA).</span></p></div><div><h3>Method</h3><p>Fifty-one patients (34 males, age: 39<!--> <!-->±<!--> <!-->15<!--> <!-->years; h-LTA: <em>n</em> <!-->=<!--> <span>13) with c-ToF were included in this retrospective monocenter study. Besides a 2D standard echocardiography<span> examination, 2D strain imaging was performed to assess left ventricular (LV) and LA functions including peak-positive LA strain (LAS – reservoir function) and LA compliance [defined as the ratio LAS/(E/Ea)].</span></span></p></div><div><h3>Results</h3><p><span>Patients with h-LTA were older and exhibited a longer QRS duration. LV ejection fraction, LAS and LA compliance were significantly lower in the group of patients with h-LTA. Indexed LA and RA volumes, RV end-diastolic area and RV fractional area change were significantly higher in the h-LTA group. LA compliance was the best echocardiographic predictor for h-LTA (AUC: 0.839; </span><em>P</em> <!-->&lt;<!--> <!-->0.001). Moderate inverted correlations were found between LA compliance and age and either QRS duration. Among the echocardiographic parameters, LA compliance was moderately inversely correlated with RV end-diastolic area (<em>r</em> <!-->=<!--> <!-->−0.40, <em>P</em> <!-->=<!--> <!-->0.01).</p></div><div><h3>Conclusion</h3><p>We documented abnormal LAS and LA compliance values in adults after c-ToF. Further study is needed to determine how best to incorporate LA strain, particularly LA compliance into multi-parametric predictive models for LTA in c-ToF.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 267"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49726298","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":"Index","authors":"","doi":"10.1016/S1878-6480(23)00219-7","DOIUrl":"https://doi.org/10.1016/S1878-6480(23)00219-7","url":null,"abstract":"","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Pages I7-I9"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49738119","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":"Atrial strain in patients with pulmonary arterial hypertension associated with congenital heart disease","authors":"P. Moceri ,&nbsp;J. Kraemer","doi":"10.1016/j.acvdsp.2023.04.031","DOIUrl":"https://doi.org/10.1016/j.acvdsp.2023.04.031","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Pulmonary arterial hypertension (PAH) has a major impact on mortality and morbidity on congenital heart disease (CHD) patients. Atrial strain in PAH patients has been related to clinical severity and </span>adverse outcomes<span>. The aim of this study was therefore to assess the prognostic role and compare bi-atrial function in patients with CHD-PAH, PAH from other causes (nPAH) and healthy controls.</span></p></div><div><h3>Method</h3><p><span>We included in this prospective cohort study<span> 65 patients with CHD-PAH, 67 patients with nPAH and 65 healthy volunteers. Transthoracic echocardiography, clinical assessment, BNP measurement and 6MWT were performed at baseline. Classic echocardiographic measurements and </span></span>atrial function studying the 3 different phases strain were measured in both.</p></div><div><h3>Results</h3><p>Atrial strain parameters are decreased in patients with CHD-PAH as compared to healthy volunteers, especially the right atrial (RA) reservoir (RASR 29,67% vs. 44,15%, <em>P</em> <!-->&lt;<!--> <!-->0,0001) and conduit phase (RASCD −15,85 vs. −28,52, <em>P</em> <!-->&lt;<!--> <span>0,0001), but also left atrial (LA) reservoir and conduit phases. Active contractile phase seems preserved in both PAH group. Atrial function was comparable between CHD-PAH and nPAH patients. On multivariate analysis<span><span>, BNP, pericardial effusion, RA </span>ejection fraction, RASR and RASCD were independently associated with death or transplantation. RASR</span></span> <!-->≤<!--> <!-->30% or RASCD<!--> <!-->&gt;<!--> <!-->−8% strain identified patients with a more than 3-fold-increased risk of death or transplant.</p></div><div><h3>Conclusion</h3><p><span>Patients with CHD-PAH do not differ in atrial adaptation in comparison with npah. Impaired RASR and RASCD identify high risk PAH patients. RA conduit or reservoir function impairment represents a severity marker of PAH, including in patients with CHD-PAH suggesting the importance of RV diastolic dysfunction. This might be an early marker of poor prognosis (</span><span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 259"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49762588","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}