Archives of Cardiovascular Diseases最新文献

{"title":"Can LGE granularity inform revascularization strategies in ischemic cardiomyopathy?","authors":"A. Unger ,&nbsp;S. Toupin ,&nbsp;S. Duhamel ,&nbsp;P. Garot ,&nbsp;F. Sanguineti ,&nbsp;T. Hovasse ,&nbsp;M. Akodad ,&nbsp;T. Goncalves ,&nbsp;E. Gall ,&nbsp;A. Léquipar ,&nbsp;J. Hudelo ,&nbsp;J.-G. Dillinger ,&nbsp;P. Henry ,&nbsp;A. Bondue ,&nbsp;V. Bousson ,&nbsp;J. Garot ,&nbsp;T. Pezel","doi":"10.1016/j.acvd.2025.10.076","DOIUrl":"10.1016/j.acvd.2025.10.076","url":null,"abstract":"<div><h3>Introduction</h3><div>The role of cardiovascular magnetic resonance (CMR) in guiding coronary revascularisation based on myocardial viability remains debated, particularly after the REVIVED trial. Our group has recently introduced the concept of “late gadolinium enhancement (LGE) granularity”, incorporating LGE extent and location to refine myocardial characterization.</div></div><div><h3>Objective</h3><div>To assess whether CMR-guided coronary revascularisation, based on the LGE granularity, predicts mortality in patients with ischaemic cardiomyopathy (ICM), reduced left ventricular ejection fraction (LVEF<!--> <!-->&lt;<!--> <!-->50%), and viable myocardium (ischaemic-LGE transmurality<!--> <!-->&lt;<!--> <!-->50%).</div></div><div><h3>Method</h3><div>We conducted a retrospective analysis of a multicentre study including consecutive ICM patients referred for CMR-based viability assessment between 2008 and 2022. Eligibility criteria included left ventricular ejection fraction (LVEF)<!--> <!-->&lt;<!--> <!-->50%, viable myocardium, and at least one of the following:<!--> <!-->≥<!--> <!-->70% stenosis in<!--> <!-->≥<!--> <!-->1 epicardial coronary artery, prior myocardial infarction, or previous coronary revascularization. LGE parameters and revascularization within 90 days of CMR were collected. The primary endpoint was all-cause mortality. Cox proportional hazards regression analysis was performed to assess the predictive value of LGE parameters and revascularization status for all-cause mortality.</div></div><div><h3>Results</h3><div>Among 1698 patients (mean age 64<!--> <!-->±<!--> <!-->12 years; 74% male), 1502 (88%) underwent revascularisation within 90 days. LGE extent was low (1–2 segments) in 729 (43%), moderate (3–5 segments) in 922 (54%), and high (≥6 segments) in 47 (3%). Antero-septal LGE was present in 318 patients (19%). Over a median follow-up of 8.9 years (IQR 6.7–11.5 years), 79 patients (4.7%) died. In univariate analysis, revascularisation was associated with lower mortality (HR: 0.28, 95% CI: 0.17–0.45, <em>P</em> <!-->&lt;<!--> <!-->0.001). Subgroup analyses revealed that revascularisation particularly improved survival in patients with moderate LGE extent (3–5 segments, <em>P</em> <!-->=<!--> <!-->0.002) and antero-septal LGE (<em>P</em> <!-->&lt;<!--> <!-->0.001, <span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>Using the LGE granularity concept, we showed that in ICM patients with viable myocardium, revascularisation was associated with improved survival, particularly in those with moderate ischaemic LGE extent and an antero-septal distribution.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S43-S44"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904086","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":"Spontaneous coronary artery dissection vs atherosclerostic acute coronary syndrome: A propensity-matched study of long-term prognosis","authors":"A. Granier ,&nbsp;A. Trimaille ,&nbsp;A. Carmona ,&nbsp;A. Elidrissi ,&nbsp;M.C. Vu ,&nbsp;K. Roulot ,&nbsp;M. Kibler ,&nbsp;L. Jesel ,&nbsp;P. Ohlmann ,&nbsp;O. Morel","doi":"10.1016/j.acvd.2025.10.011","DOIUrl":"10.1016/j.acvd.2025.10.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Spontaneous coronary artery dissection (SCAD) is an underdiagnosed cause of type 2 myocardial infarction, primarily affecting middle-age women with few cardiovascular risk factors. Although recent research has increased, SCAD management remains uncertain. Current guidelines generally advocate for conservative treatment due to high complication rates with percutaneous coronary intervention (PCI) but these recommendations are largely based on expert consensus and there remains a critical gap in long-term outcome data.</div></div><div><h3>Objective</h3><div>To compare clinical profiles, management strategies, and outcomes of SCAD patients with those of patients with atherosclerotic acute coronary syndrome (ACS).</div></div><div><h3>Method</h3><div>This retrospective, observational and single-center study included all patients hospitalized for SCAD at Strasbourg University Hospital between March 13, 2009, and July 20, 2022. Clinical, biological, angiographic, and prognostic data were compared to patients admitted for atherosclerotic ACS. Propopensity score matching (1:3) was performed based on age, sex, and follow-up duration.</div></div><div><h3>Results</h3><div>We included 42 SCAD and 891 patients. SCAD patients were younger, predominantly female, and had fewer traditional cardiovascular risk factors. Unlike the ACS group, in which all patients underwent revascularization, over half of the SCAD patients (54.8%) were managed conservatively. Among those treated with PCI, SCAD patients required significantly longer stent lengths. After propensity score matching, no significant differences were observed in all-cause or cardiovascular mortality between groups. Recurrent myocardial infarction was more frequent in the atherosclerotic cohort (16 vs 0 <em>P</em> <!-->=<!--> <!-->0.012). No stent thrombosis occured in the SCAD group; only one case of in-stent restenosis was reported. The median follow-up duration was 1507 days, allowing for robust long-term outcome assessment.</div></div><div><h3>Conclusion</h3><div>SCAD mainly affects younger women with few traditional cardiovascular risk factors. Although concerns persist regarding PCI in this population, our findings suggest that when revascularization is required, outcomes are comparable to those in patients with atherosclerotic ACS. Furthermore, complications such as stent thrombosis and restenosis were more common in the atherosclerotic group. These findings supports the individualized management in SCAD and challenge the blanket recommendation for conservative treatment in all cases.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S10-S11"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904132","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":"Surgical revascularization in acute coronary syndromes: Seven-years single center experience","authors":"M. Laali ,&nbsp;C. D’Alessandro ,&nbsp;S. Manzo-Silberman ,&nbsp;R. Choussat ,&nbsp;D. Pichoy ,&nbsp;C. Juvin ,&nbsp;G. Lebreton ,&nbsp;P. Leprince","doi":"10.1016/j.acvd.2025.10.019","DOIUrl":"10.1016/j.acvd.2025.10.019","url":null,"abstract":"<div><h3>Introduction</h3><div>In Acute Coronary Syndromes (ACS) urgent Coronary Artery Bypass Grafting (CABG) is infrequently performed. Percutaneous Coronary Interventions (PCI) are the preferred option because they are more expeditious, while CABG is usually reserved for cases where PCI is not feasible or unsuccessful.</div></div><div><h3>Objective</h3><div>We reviewed our seven-year experience in patients undergoing CABG for ACS according to perioperative characteristics and urgency status.</div></div><div><h3>Method</h3><div>A single center retrospective analysis included 2076 patients undergoing CABG between 2018 and 2024. Patients were divided into three groups according to their EuroSCORE II Urgency Status: Elective (<em>n</em> <!-->=<!--> <!-->1322), Urgent (<em>n</em> <!-->=<!--> <!-->663), Emergency (<em>n</em> <!-->=<!--> <!-->88).</div><div>Patients’ data and outcomes were extracted from the French Society of Thoracic and Cardiovascular Surgery database (EPICARD). Primary end-point was the occurrence of Major Adverse Cardiac Events (MACE), including coronary graft malfunction, perioperative myocardial infarction, cardiac arrest, the need for extra-corporeal membrane oxygenation (ECMO) or Intra-Aortic Balloon Pump (IABP) and in-hospital mortality.</div></div><div><h3>Results</h3><div>Preoperative characteristics, operative data and postoperative outcomes are resumed in <span><span>Fig. 1</span></span>a. Even if MACE occurrence was concordant with urgency status (2.9% in elective, 7.4% in urgent, 18% in emergency patients, <em>P</em> <!-->&lt;<!--> <!-->0.001), urgency status alone was not significantly associated with adverse events at multivariate analysis (Urgent vs Elective OR 1.59 [0.948; 2.66], <em>P</em> <!-->=<!--> <!-->0.076; Emergency vs Elective OR 0.974 [0.339; 2.53], <em>P</em> <!-->=<!--> <!-->0.96). Forestplot of independent predictive risk factors for MACE occurrence at multivariate analysis is shown in <span><span>Fig. 1</span></span>b: previous PCI (OR 1.79 [1.11; 2.85], <em>P</em> <!-->=<!--> <!-->0.015), Left Main Disease (LMD) (OR 1.83 [1.15; 2.95], <em>P</em> <!-->=<!--> <!-->0.012), critical preoperative status (OR 4.12 [1.40; 11.7], <em>P</em> <!-->&lt;<!--> <!-->0.01), EuroSCORE II, (OR 1.16 [1.08; 1.24], <em>P</em> <!-->&lt;<!--> <!-->0.001) and number of grafts (OR 0.766 [0.604; 0.969], <em>P</em> <!-->=<!--> <!-->0.027).</div></div><div><h3>Conclusion</h3><div>In our recent experience, surgical revascularization for ACS can be performed in the emergency setting with satisfactory outcomes. The occurrence of MACE appears to depend more on the clinical presentation and risk profile of the patient than on the urgency status alone. On-pump total arterial revascularization can be performed safely and complete revascularization may protect against adverse events.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S14-S15"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904164","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-based differences in phenotypic expression and prognosis of hereditary transthyretin cardiac amyloidosis associated with the Val122Ile mutation","authors":"A. Monfort ,&nbsp;T. Damy ,&nbsp;M. Kharoubi ,&nbsp;P. Réant ,&nbsp;P. Charron ,&nbsp;F. Roubille ,&nbsp;J.C. Eicher ,&nbsp;A. Hagège ,&nbsp;B. Funalot ,&nbsp;O. Lairez ,&nbsp;J. Inamo ,&nbsp;A. Zaroui","doi":"10.1016/j.acvd.2025.10.088","DOIUrl":"10.1016/j.acvd.2025.10.088","url":null,"abstract":"<div><h3>Introduction</h3><div>Transthyretin cardiac amyloidosis (ATTR-CA) is an under-recognized cause of heart failure with preserved ejection fraction (HFpEF), resulting from either the wild-type (ATTRwt) or hereditary form (ATTRv). In France, the valine-to-isoleucine substitution (Val122Ile) is the most common inherited variant.</div></div><div><h3>Objective</h3><div>Difference on gender differences in phenotype, prognosis, and the impact of tafamidis treatment in patients with Val122Ile-associated ATTR-CA remain limited.</div></div><div><h3>Method</h3><div>From the 5151 ATTR patients of the Healthcare European Amyloidosis Registry (HEAR,) 830 (16.1%) patients were ATTRv of whom and 513(9.9%) were patients with symptomatic ATTRv Val122Ile, the rest were ATTRv asymptomatic carriers (167 (3.2%)) and other type of ATTRv mutation. Gender differences in clinical presentation, echocardiographic parameters at diagnosis, and prognosis were assessed.</div></div><div><h3>Results</h3><div>150 (29.2%) were women and they were significantly older at diagnosis than men (83 [77–87] years vs. 77 [72–82] years; <em>P</em> <!-->&lt;<!--> <!-->0.001). Neuropathy symptoms, including carpal tunnel syndrome, were more frequent in women. Women also had lower septal wall thickness than men, even after adjusting for body mass index. Regarding left ventricular function, women exhibited higher LVEF and longitudinal strain (GLS) compared than men (LVEF: 54 [44–62] vs. 48 [38–56]; GLS: -10.6 [8.7–13.1 9.7] vs. −7.5–12.4]; <em>P</em> <!-->=<!--> <!-->0.001 and <em>P</em> <!-->=<!--> <!-->0.003, respectively). While NT-proBNP and troponinT HS levels were similar between genders, bilirubin levels were lower in women than men. The 48-month mortality rate did not differ significantly between women and men (74% vs. 63%; <em>P</em> <!-->=<!--> <!-->0.07). Among the 430 (83.8) patients receiving treatment, the therapeutic benefit was consistent across genders. Women had significantly better 48-month survival than men (81% vs. 69%; <em>P</em> <!-->=<!--> <!-->0.02). The adjusted 48-month mortality risk for women treated with Tafamidis was 0.452 [0.332–0.614] vs 0.767 [0.356–0.877] for men, <em>P</em> <!-->=<!--> <!-->0.02.</div></div><div><h3>Conclusion</h3><div>ATTR Val122Ile women are underrepresented in this hereditary disease, are diagnosed at an older age and exhibit a different extracardiac phenotype, better cardiac function, and improved prognosis with or without treatment compared to men.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S50"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904172","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 factors of cardiogenic shock in patients with Acute Coronary Syndrome (ACS)","authors":"Y. El Grini,&nbsp;H. Dahmani,&nbsp;A. Islam,&nbsp;L. Oukerraj,&nbsp;M. Cherti","doi":"10.1016/j.acvd.2025.10.042","DOIUrl":"10.1016/j.acvd.2025.10.042","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiogenic shock is a serious and potentially fatal complication in patients with acute coronary syndrome, often developing unpredictably. This study aims to identify independent predictive factors of cardiogenic shock in patients with ACS.</div></div><div><h3>Objective</h3><div>Early diagnosis and rapid, appropriate management in high-risk patients in order to improve prognosis.</div></div><div><h3>Method</h3><div>This is a retrospective, analytical, and comparative study conducted in a single center. It includes 156 patients hospitalized for ACS between January 2024 and December 2024 in the cardiology department B of IBN SINA University Hospital. Patients presenting with cardiogenic shock at admission were excluded. The population was divided into two groups: the ‘shock’ group, consisting of patients who developed cardiogenic shock during hospitalization, and the ‘non-shock’ group, without cardiogenic shock. The clinical characteristics and outcomes of the two groups were compared.</div></div><div><h3>Results</h3><div>Among the 156 patients included, 12 (7.8%) developed cardiogenic shock. The main predictive factors identified were:.<ul><li><span>•</span><span><div>the presence of acute heart failure at admission;</div></span></li><li><span>•</span><span><div>a GRACE score<!--> <!-->≥<!--> <!-->140;</div></span></li><li><span>•</span><span><div>a left ventricular ejection fraction<!--> <!-->&lt;<!--> <!-->50%;</div></span></li><li><span>•</span><span><div>eccentric left ventricular hypertrophy;</div></span></li><li><span>•</span><span><div>right ventricular dysfunction;</div></span></li><li><span>•</span><span><div>patients in the ‘shock’ group had a higher rate of complications and increased mortality.</div></span></li></ul></div></div><div><h3>Conclusion</h3><div>Cardiogenic shock occurring in the context of acute coronary syndrome is associated with a poor prognosis, marked by increased mortality. These findings highlight the importance of early diagnosis and rapid, appropriate management in high-risk patients in order to improve clinical outcomes.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S25"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904259","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":"Acknowledging our reviewers","authors":"","doi":"10.1016/j.acvd.2026.01.005","DOIUrl":"10.1016/j.acvd.2026.01.005","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page 1"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193179","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S1-S2"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146474619","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","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":"146474628","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S33"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146474629","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S42-S43"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146474646","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}