Archives of Cardiovascular Diseases最新文献

{"title":"Redo versus first transcatheter aortic valve implantation: A propensity score-matched analysis","authors":"Pierre Deharo ,&nbsp;Ferdinando Sabatino ,&nbsp;Christophe Saint Etienne ,&nbsp;Jeremy Boyer ,&nbsp;Anne Bernard ,&nbsp;Thierry Bourguignon ,&nbsp;Carl Semaan ,&nbsp;Jean Michel Clerc ,&nbsp;Thomas Cuisset ,&nbsp;Laurent Fauchier","doi":"10.1016/j.acvd.2025.11.002","DOIUrl":"10.1016/j.acvd.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Redo transcatheter aortic valve implantation (TAVI) is increasingly used to treat bioprosthetic valve dysfunction in patients who have undergone TAVI. As TAVI indications continue to expand to include younger patients, it is essential to systematically document redo TAVI procedures to better understand their long-term efficacy and safety. This study aimed to compare outcomes between redo TAVI and first TAVI procedures using a propensity score-matched analysis.</div></div><div><h3>Aims</h3><div>To compare the long-term clinical outcomes, including death, stroke and procedural adverse events, between redo TAVI and first TAVI procedures using a propensity score-matched analysis.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted using the TriNetX database, identifying adults (≥<!--> <!-->18<!--> <!-->years) with severe aortic stenosis who underwent TAVI (2012–2024). Redo TAVI required an interval of ≥<!--> <!-->12<!--> <!-->months. Propensity score matching was performed using all baseline characteristics listed in Table 1, with outcomes assessed over 36<!--> <!-->months.</div></div><div><h3>Results</h3><div>After matching, 446 patients were included in each cohort. No statistically significant difference was observed in the annual rates of all-cause death (11.3% vs 8.7%; hazard ratio 1.20, 95% confidence interval 0.86–1.68), ischaemic stroke (hazard ratio 2.07, 95% confidence interval 0.99–4.35) or major bleeding (hazard ratio 1.41, 95% confidence interval 0.99–2.02) between the redo TAVI and first TAVI groups. Pacemaker implantation (hazard ratio 0.25, 95% confidence interval 0.12–0.51), new-onset atrial fibrillation (hazard ratio 0.44, 95% confidence interval 0.24–0.79) and hospitalization for heart failure (hazard ratio 0.64, 95% confidence interval 0.41–0.99) were significantly lower in the redo TAVI group.</div></div><div><h3>Conclusions</h3><div>No statistically significant difference was observed in all-cause death, ischaemic stroke or major bleeding between the redo TAVI and first TAVI groups. Conversely, redo TAVI was associated with significantly lower rates of permanent pacemaker implantation and heart failure rehospitalization. These findings support the integration of redo TAVI as an essential component within a comprehensive lifetime treatment strategy for managing bioprosthetic aortic valve dysfunction.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages 25-31"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"My thoughts about last frontiers: Asymptomatic severe and moderate aortic stenosis","authors":"David Messika-Zeitoun ,&nbsp;Julien Dreyfus ,&nbsp;Ian G. Burwash","doi":"10.1016/j.acvd.2025.11.001","DOIUrl":"10.1016/j.acvd.2025.11.001","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages 8-11"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The STRAT clinical risk score to predict early ischaemic stroke post-TAVI: The FRANCE-TAVI registry","authors":"Matthieu Besutti ,&nbsp;Romain Chopard ,&nbsp;Fiona Ecarnot ,&nbsp;Manon Leclère ,&nbsp;Hélène Eltchaninoff ,&nbsp;Bernard Iung ,&nbsp;Martine Gilard ,&nbsp;Philippe Commeau ,&nbsp;Mariama Akodad ,&nbsp;Hakim Benamer ,&nbsp;Sylvain Beurtheret ,&nbsp;Thomas Cuisset ,&nbsp;Hervé Le Breton ,&nbsp;Eric Van Belle ,&nbsp;Jean-Philippe Verhoye ,&nbsp;Guillaume Cayla ,&nbsp;François Schiele ,&nbsp;Maxime Desmarets ,&nbsp;Nicolas Meneveau ,&nbsp;RHU STOP-AS, France-TAVI Investigators","doi":"10.1016/j.acvd.2025.12.003","DOIUrl":"10.1016/j.acvd.2025.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Practitioners recommending transcatheter aortic valve implantation (TAVI) currently lack reliable tools to predict periprocedural risk of ischaemic stroke.</div></div><div><h3>Aims</h3><div>We aimed to develop and internally validate a clinical risk score to accurately stratify this risk.</div></div><div><h3>Methods</h3><div>Using data from the nationwide, multicentre FRANCE-TAVI registry, we developed a clinical predictive risk score for 30-day ischaemic stroke post-TAVI using multivariable logistic regression analysis. The model was internally validated through cross-validation techniques.</div></div><div><h3>Results</h3><div>Among 62,747 patients, 1712 (2.7%) experienced ischaemic stroke within 30 days. Nine clinical predictors were identified: female sex, age &gt;<!--> <!-->85 years, weight &lt;<!--> <!-->60<!--> <!-->kg, symptomatic status, history of stroke or transient ischaemic attack, multiple (i.e. &gt;<!--> <!-->1) episodes of acute heart failure, severe mobility reduction, diabetes and creatinine clearance &lt;<!--> <!-->60<!--> <!-->mL/min. The resulting scoring model demonstrated good accuracy (Brier score 0.18), moderate discrimination (C-index 0.63) and excellent calibration as assessed by calibration plots, calibration-in-the-large and calibration slope. The score categorized patients into low – (90.2% of the population), intermediate – (8.0%) and high-risk (1.8%) groups. Observed stroke rates increased progressively across these groups, from 2.25% in the low-risk group to 6.51% in the intermediate-risk group and 10.10% in the high-risk group.</div></div><div><h3>Conclusions</h3><div>This newly developed STRAT score is a clinical, practical and effective tool for predicting early ischaemic stroke in patients undergoing TAVI. It was derived and internally validated in the FRANCE-TAVI registry and may help tailor preventive strategies. Further studies are necessary to externally validate this score and evaluate its impact on clinical decision-making.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages 15-24"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of a diuretic optimization protocol in non-selected acute worsening HF — the ProDUCT-HF study: A stepped-wedge cluster-randomized trial","authors":"C. Riocreux ,&nbsp;G. Clerfond ,&nbsp;B. Pereira ,&nbsp;P. Rossignol ,&nbsp;G. Vanzetto ,&nbsp;H. Barake ,&nbsp;B. Harbaoui ,&nbsp;P.-Y. Courand ,&nbsp;L. Flork ,&nbsp;S. Madi ,&nbsp;O. De Tauriac ,&nbsp;Y. Nahli ,&nbsp;M. Chacornac ,&nbsp;C. Mourgues ,&nbsp;K. Francis ,&nbsp;N. Combaret ,&nbsp;G. Souteyrand ,&nbsp;P. Motreff ,&nbsp;G. Massoullie ,&nbsp;R. Eschalier","doi":"10.1016/j.acvd.2025.10.061","DOIUrl":"10.1016/j.acvd.2025.10.061","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute worsening heart failure (AWHF) is a major medical issue in the history of chronic HF. Use of intra-venous diuretics is the keystone of this management, but sparse data are available in non-selected HF population. In this setting, the use and impacts of diuretics, need to be better evaluated to improve their efficacy and safety in the latter population.</div></div><div><h3>Objective</h3><div>To show benefit of a diuretic protocol combining furosemide and thiazid in AWHF.</div></div><div><h3>Method</h3><div>The Protocol of Diuretic's Use in Congestive Therapy for Heart Failure (ProDUCT-HF) study is a French multicenter, prospective, stepped-wedge cluster-randomized trial (CW-CRT) comparing pre-protocolized diuretics use based on CARRESS-HF's study protocol to routine practice diuretics use in AWHF. The primary endpoint was change-from-admission at day 4 in a bivariable endpoint: serum creatinine and bodyweight. Delta ePVS, approach of volemia, are analysed at day 4 comparing to admission. All analysis were led as modified intention-to-treat.</div></div><div><h3>Results</h3><div>Between May 2019 and December 2022, 271 patients were randomized in two group. At 96<!--> <!-->hours, the median change in the weight was more important in the protocol group (−4.9<!--> <!-->kg [−7.8; −2.9] vs. (−3.6<!--> <!-->kg [−5.6; −2.0]) in the SoC group, (OR −1.1 [−2.1 to −0.2], <em>P</em> <!-->=<!--> <!-->0.020). The median change of serum creatinine at 96<!--> <!-->hours was greater in the protocol group (+13<!--> <!-->μmol/L [−2; 37] vs. (+8<!--> <!-->μmol/L [−6; 20]), (OR 12.7 [4.1 to 21.3], <em>P</em> <!-->=<!--> <!-->0.004) (<span><span>Fig. 1</span></span>). Decongestion (evaluated by Delta ePVS) was improved in the protocol group (−0.81 [−3.03; 1.08] vs. (0.00 [−1.51; 1.97]), (OR −1.1 [−1.8 to −0.4], <em>P</em> <!-->=<!--> <!-->0.004). The median duration of intravenous furosemide treatment and one-month endpoints (all cause death, GFR, NTproBNP) were similar in both groups.</div></div><div><h3>Conclusion</h3><div>The ProDUCT-HF diuretics protocol is relevant to obtain a good decongestion with a good safety profile in non-selected AWHF population (<span><span>NCT03892148</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S33-S34"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Diagnostic Classification of Heart Allograft Rejection: A calibrated and validated system","authors":"G. Coutance ,&nbsp;A. Giarraputo ,&nbsp;J. Patel ,&nbsp;M. Fedrigo ,&nbsp;S. Varnous ,&nbsp;J.-P. Duong ,&nbsp;J. Dagobert ,&nbsp;P. Rouvier ,&nbsp;P. Leprince ,&nbsp;P. Achouh ,&nbsp;X. Jouven ,&nbsp;P. Bruneval ,&nbsp;A. Angelini ,&nbsp;J. Kobashigawa ,&nbsp;A. Loupy","doi":"10.1016/j.acvd.2025.10.062","DOIUrl":"10.1016/j.acvd.2025.10.062","url":null,"abstract":"<div><h3>Introduction</h3><div>Endomyocardial biopsies (EMB) gene expression profiling is a promising companion tool for rejection diagnosis. We developped a fully automatised molecular analysis sytem for the diagnosis of cardiac allograft rejection.</div></div><div><h3>Objective</h3><div>We aimed to properly assess the clinical validity of this tool by assessing precisely its statistical performance.</div></div><div><h3>Method</h3><div>We performed a multicenter, retrospective study (<span><span>NCT06436027</span><svg><path></path></svg></span>), collecting 591 FFPE-EMBs between 2011 and 2021 representative of the landscape of rejection (antibody-mediated rejection-AMR, <em>n</em> <!-->=<!--> <!-->188; acute cellular rejection-ACR, <em>n</em> <!-->=<!--> <!-->289; non-rejection, <em>n</em> <!-->=<!--> <!-->114). Tissue gene expression was analyzed using the consensus Banff Human Organ Transplant gene panel. Molecular classifiers for AMR and ACR were built using a supervised model, assessing thoroughly the performance. Models’ calibration was optimized, and discrepancies were analyzed in training and validation set.</div></div><div><h3>Results</h3><div>In the validation cohort (<em>n</em> <!-->=<!--> <!-->116), the molecular classifiers demonstrated strong diagnostic performance: AMR detection achieved an accuracy of 81.89% (ROC-AUC<!--> <!-->=<!--> <!-->0.831, Brier score<!--> <!-->=<!--> <!-->0.143, F1 score<!--> <!-->=<!--> <!-->0.70), while ACR detection achieved 77.58% accuracy (ROC-AUC<!--> <!-->=<!--> <!-->0.812, Brier score<!--> <!-->=<!--> <!-->0.176, F1 score<!--> <!-->=<!--> <!-->0.76). Models’ stabilization was reached around 400 samples, confirming sufficient statistical power for reliable predictions. Calibration curves resulted adequate for AMR and ACR models sets, reflecting the reliability of the probabilistic predictions (<span><span>Fig. 1</span></span>).</div><div>In the derivation cohort, the predicted probabilities closely followed the ideal trend for both rejection-specifics models, indicating minimal bias. In the validation cohort, the mean absolute error was 0.031 for the AMR model and 0.014 for the ACR model respectively, suggesting excellent calibration. Minor deviations from the ideal line were observed at sub-clinical probability levels. Overall, the calibration curves support the reliability of the models for predicting rejection events in both cohorts.</div></div><div><h3>Conclusion</h3><div>The molecular diagnostic system demonstrated a good reliability in identifying rejection events. This system can complement standard pathology, reduce diagnostic uncertainty, and serve as a practical companion tool in the clinical management of heart transplant patients.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S34-S35"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical and ECG based score to predict incident atrial fibrillation in cardiac amyloidosis: The Amy-Lyon AF score","authors":"T. Bollon ,&nbsp;A. Jobbé-Duval ,&nbsp;L. Sebbag ,&nbsp;N. Mewton ,&nbsp;H. Thibault ,&nbsp;M. Serraille ,&nbsp;B. Harbaoui ,&nbsp;P. Lantelme ,&nbsp;P.-Y. Courand","doi":"10.1016/j.acvd.2025.10.068","DOIUrl":"10.1016/j.acvd.2025.10.068","url":null,"abstract":"<div><h3>Introduction</h3><div>Atrial Fibrillation (AF) is the most frequent arrythmia in patients with cardiac amyloidosis (CA) and is poorly tolerated. There is currently no tool to assess the risk of AF occurrence in CA.</div></div><div><h3>Objective</h3><div>The aim of the present study was to a clinical and ECG basesd score to predict incident atrial fibrillation in CA.</div></div><div><h3>Method</h3><div>We enrolled patients with light chain (AL) or transthyretin (ATTR) CA and no history of AF at diagnosis between January 2015 and September 2023 at 3 university hospitals. Clinical, biochemical and electrocardiographic parameters were retrospectively collected and their predictive value for AF was determined.</div></div><div><h3>Results</h3><div>The study included 169 patients [56.2% wild-type (wt) ATTR, 35.5% AL, 8.3% variant (v) ATTR]. Over a median follow-up of 21 months, 55 patients (33%) presented a first episode of AF. Five independent predictors for AF were identified in a multivariate logistic regression model: obesity, hypertension, CA subtype, <em>P</em> wave duration<!--> <!-->≥<!--> <!-->120<!--> <!-->ms, 1st degree AV block. The Amy-Lyon AF score (range 0-55), based on these variables, predicts the risk of AF occurrence (AUC 0.767 [0.677–0.858], <em>P</em> <!-->&lt;<!--> <!-->0.001). At two years of follow-up, the incidence of AF was 91.5% in the subgroup of patients with a score<!--> <!-->≥<!--> <!-->40 (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>Our study identifies 5 simple key predictors for risk stratification of AF occurrence in patients with CA. It could be helpfull to define AF screening strategy and anticoagulation therapy.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S38"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ischemic stroke risk after acute coronary syndrome","authors":"F. Menzou ,&nbsp;M. Fissah ,&nbsp;N. Laraba","doi":"10.1016/j.acvd.2025.10.015","DOIUrl":"10.1016/j.acvd.2025.10.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute coronary syndrome is a clinical manifestation of an atherothrombotic vascular disease that can affect several vascular beds, the risk of ischemic stroke after an acute coronary syndrome remains significant; it may be of multifactorial origin. There is, however, limited evidence on the duration of this risk and its direct link to cardiac ischemic injury.</div></div><div><h3>Objective</h3><div>To determine the clinical and cardiovascular imaging factors predictive of the ischemic stroke risk of patients hospitalized for an ACS.</div></div><div><h3>Method</h3><div>It is a single-center prospective study with a follow-up of patients with ACS for one year; the clinical and cardiovascular imaging factors are evaluated and integrated into a prognostic index of the risk of ischemic stroke.</div></div><div><h3>Results</h3><div>403 patients are included and screened; there is a clear male predominance with a sex-ratio of 2.4 and an average age of 63.5<!--> <!-->±<!--> <!-->12.5 years. The prevalence of ischemic stroke at one year is 5.46%, after binary regression logistic the ischemic stroke risk score has four variables: left ventricular ejection fraction (RR<!--> <!-->=<!--> <!-->0.221; 95%CI<!--> <!-->=<!--> <!-->0.05–0.967, <em>P</em> <!-->&lt;<!--> <!-->0.01), left ventricular sphericity index (RR<!--> <!-->=<!--> <!-->5.648; 95%CI<!--> <!-->=<!--> <!-->2.668–8.797, <em>P</em> <!-->&lt;<!--> <!-->0.01), left atrium volume indexed (RR<!--> <!-->=<!--> <!-->1.757; 95%CI<!--> <!-->=<!--> <!-->1.1–4.8, <em>P</em> <!-->=<!--> <!-->0.03) and carotid plaque score (RR<!--> <!-->=<!--> <!-->3.187; 95% CI<!--> <!-->=<!--> <!-->1.627–6.243, <em>P</em> <!-->&lt;<!--> <!-->0.01), with a very good ability to discriminate better than CHA2DS2-VASC score (AUC 0.893 versus 0.776).</div></div><div><h3>Conclusion</h3><div>Ischemic stroke after an acute coronary syndrome is a serious complication involving the functional and vital prognosis of patients, the integration of risk markers in a prognostic risk prediction score makes it possible to orient and guide therapeutic management.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S12-S13"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex disparities in coronary angiography findings of out-of-hospital cardiac arrest complicating myocardial infarction","authors":"M. Singh ,&nbsp;F. Picard ,&nbsp;O. Varenne ,&nbsp;V. Pham","doi":"10.1016/j.acvd.2025.10.003","DOIUrl":"10.1016/j.acvd.2025.10.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Out-of-hospital cardiac arrest (OHCA) frequently results from myocardial infarction (MI) and is associated with high mortality. Sex-based disparities in care and outcomes have been well documented, yet data remain scarce on sex differences in coronary angiographic findings among OHCA survivors with confirmed MI.</div></div><div><h3>Objective</h3><div>To investigate sex-specific differences in invasive coronary angiography (ICA) and percutaneous coronary intervention (PCI) characteristics in OHCA survivors presenting with MI.</div></div><div><h3>Method</h3><div>This retrospective, single-center study included consecutive patients admitted at Cochin Hospital (Paris, France) for OHCA between 2007 and 2024 and underwent emergent ICA and PCI due to acute coronary syndrome. Propensity score matching (1:1) was used to account for baseline differences including rhythm, resuscitation timings, and hemodynamic status.</div></div><div><h3>Results</h3><div>Among 486 patients (mean age 60.6<!--> <!-->±<!--> <!-->12.2 years), 105 (21.6%) were women. Women were less likely to present with shockable rhythm (73.3% vs 85.3%, <em>P</em> <!-->=<!--> <!-->0.004) and arrest in public (52.1% vs 66.7%, <em>P</em> <!-->=<!--> <!-->0.01). In-hospital mortality was higher in women (51.4% vs 39.6%, <em>P</em> <!-->=<!--> <!-->0.03). After matching (<em>n</em> <!-->=<!--> <!-->210), coronary artery disease extent was similar, but right coronary artery was more often the culprit in women (35.2% vs 16.2%, <em>P</em> <!-->=<!--> <!-->0.002), with less left circumflex involvement (10.5% vs 22.9%, <em>P</em> <!-->=<!--> <!-->0.02). Thromboaspiration was more frequent in women (33.3% vs 21.0%, <em>P</em> <!-->=<!--> <!-->0.04). No sex differences were observed in procedural success or complications.</div></div><div><h3>Conclusion</h3><div>In OHCA survivors with MI, women exhibit distinct culprit lesion patterns and higher in-hospital mortality despite similar angiographic and procedural profiles. These findings suggest early prehospital factors may contribute significantly to outcome disparities.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S6"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of left atrial enlargement for atrial fibrillation in mitral stenosis: A retrospective cohort study of 138 patients","authors":"A. Mounssif,&nbsp;Z. Moulay Rchid","doi":"10.1016/j.acvd.2025.10.049","DOIUrl":"10.1016/j.acvd.2025.10.049","url":null,"abstract":"<div><h3>Introduction</h3><div>Left atrial (LA) enlargement is a key marker of chronic pressure overload and a predictor of atrial fibrillation (AF) in valvular heart disease, particularly in rheumatic mitral stenosis. The ratio of left atrial size to left ventricular end-diastolic diameter (LA/LV ratio) has been proposed as a simple echocardiographic marker for left heart remodeling and arrhythmic risk.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the association between the LA/LV ratio and the occurrence of atrial fibrillation in a population with predominant valvular disease.</div></div><div><h3>Method</h3><div>We conducted a retrospective, single-center cohort study including patients hospitalized for valvular heart disease at Casablanca University Hospital between 2019 and 2025. Echocardiographic measurements of the left atrium and left ventricular end-diastolic diameter were collected, and the LA/LV ratio was calculated. Patients were classified according to their rhythm status (sinus rhythm vs atrial fibrillation) on admission. Statistical analysis assessed the difference in LA/LV ratio between the two groups.</div></div><div><h3>Results</h3><div>A total of 138 patients were included, with a mean age of 48 years and a female predominance. Rheumatic mitral stenosis was the predominant valvular pathology. The mean LA/LV ratio was significantly higher in patients with atrial fibrillation compared to those in sinus rhythm (1.97<!--> <!-->±<!--> <!-->0.32 vs 1.65<!--> <!-->±<!--> <!-->0.28, respectively; <em>P</em> <!-->=<!--> <!-->0.006) (<span><span>Fig. 1</span></span>). The LA/LV ratio showed a good discriminatory ability for predicting atrial fibrillation, with an optimal cutoff value identified at 1.8.There was no significant difference in left ventricular ejection fraction between the two groups.</div></div><div><h3>Conclusion</h3><div>In patients with valvular heart disease, particularly rheumatic mitral stenosis, an increased LA/LV ratio is significantly associated with the presence of atrial fibrillation. This simple echocardiographic parameter could serve as a useful, accessible marker for atrial remodeling and arrhythmic risk stratification in routine clinical practice.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S27-S28"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with left ventricular reverse remodeling in heart failure with reduced ejection fraction: Findings from a prospective cohort study","authors":"R. Kipenge ,&nbsp;B. Mulongo ,&nbsp;H. Kabash ,&nbsp;P. Mutombo ,&nbsp;O. Ngungwa ,&nbsp;E. Yolola ,&nbsp;D. Malamba-Lez ,&nbsp;D. Ngoy Nkulu","doi":"10.1016/j.acvd.2025.10.092","DOIUrl":"10.1016/j.acvd.2025.10.092","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure with improved ejection fraction (HFimpEF) is a recently recognized phenotype, characterized by an improvement in left ventricular systolic function following an episode of heart failure with reduced ejection fraction (HFrEF).</div></div><div><h3>Objective</h3><div>To identify factors associated with improvement in elft ventricular ejection fraction among patients with HFrEF.</div></div><div><h3>Method</h3><div>We conducted a prospective study involving patients diagnosed with heart failure and a reduced LVEF (≤ 40%), who were followed for at least six months. Patients were categorized into two groups: those with improved LVEF (defined as an increase from ≤ 40% to<!--> <!-->&gt;<!--> <!-->40%, with a minimum absolute gain of 10%) and those without such improvement. Clinical, biological, echocardiographic, and therapeutic characteristics were compared to identify factors associated with LVEF improvement.</div></div><div><h3>Results</h3><div>A total of 123 patients with heart failure were included, of whom 70 had reduced LVEF. No gender differences were observed. Hypertension was present in 66% of patients, and 32% had a prior history of left ventricular dysfunction. Improvement in LVEF was observed in 27.1% of cases. In multivariate analysis, younger age (HR: 5.57; 95% CI: 1.79–17.3; <em>P</em> <!-->=<!--> <!-->0.001), optimal beta-blocker therapy (HR: 2.16; 95% CI: 1.39–5.32; <em>P</em> <!-->=<!--> <!-->0.0271), and higher baseline LVEF (HR: 1.57; 95% CI: 1.16–4.23; <em>P</em> <!-->=<!--> <!-->0.0381) were independently associated with LVEF improvement.</div></div><div><h3>Conclusion</h3><div>Improvement in LVEF among patients with HFrEF is influenced by specific clinical factors and optimized medical therapy. Identifying patients most likely to experience LVEF improvement and ensuring appropriate follow-up may help improve clinical outcomes in heart failure management.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S52"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}