Archives of Cardiovascular Diseases最新文献

{"title":"Epidemiological and echocardiographic profile of rheumatic valvular heart disease in a Moroccan population: Insights from a 408-patient retrospective cohort","authors":"A. Mounssif,&nbsp;Z. Moulay Rchid,&nbsp;A. Arous","doi":"10.1016/j.acvd.2025.10.036","DOIUrl":"10.1016/j.acvd.2025.10.036","url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatic heart disease (RHD) remains a leading cause of valvular pathology in low- and middle-income countries. Characterizing its epidemiological and echocardiographic profile is essential to improve screening strategies and guide interventions.</div></div><div><h3>Objective</h3><div>This study aimed to describe the demographic and echocardiographic characteristics of patients with rheumatic valvular disease in a Moroccan tertiary care setting.</div></div><div><h3>Method</h3><div>We conducted a retrospective analysis of 408 patients admitted to Casablanca University Hospital for rheumatic valvular heart disease between 2019 and 2025. Data included demographic information, clinical presentation, and transthoracic echocardiography findings.</div></div><div><h3>Results</h3><div>Among the 408 patients, the mean age was 56.4 years, and 78% were female (<em>n</em> <!-->=<!--> <!-->318). The mitral valve was the most frequently involved, with a predominance of moderate to severe mitral stenosis. Many patients also presented with mixed valvular lesions. Left ventricular ejection fraction was generally preserved. Surprisingly, no documented atrial fibrillation was reported at admission, despite significant left atrial remodeling in several cases (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>This study highlights the ongoing burden of rheumatic valvular disease in Moroccan patients, particularly among women. Despite relatively young age, patients frequently present with advanced mitral valve disease. These findings support the urgent need for earlier detection, community awareness, and systematic screening in high-risk populations.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S22-S23"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904253","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 Classification System for Cardiac Allograft Rejection is positively associated with the pathology severity of rejection","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.2025.10.053","DOIUrl":"10.1016/j.acvd.2025.10.053","url":null,"abstract":"<div><h3>Introduction</h3><div>Targeted molecular profiling combined with reproducible formalin-fixed paraffin-embedded (FFPE) EMB-based technology has the potential to support cardiac rejection diagnosis.</div></div><div><h3>Objective</h3><div>We aimed to develop and validate targeted gene expression diagnostic models of cardiac rejection and show their association with ISHLT pathological grades.</div></div><div><h3>Method</h3><div>We built a multicenter cohort of 591 FFPE-EMBs collected from four international centers between 2011 and 2021. Biopsies were graded according to the ISHLT working formulations, including 188 AMR cases, 289 ACR cases, and 114 non-rejection cases, randomly split in a derivation (<em>n</em> <!-->=<!--> <!-->475) and a validation cohort (<em>n</em> <!-->=<!--> <!-->116). Tissue gene expression was analyzed on FFPE-EMB using the Banff Human Organ Transplant gene set. Molecular classifiers for AMR and ACR were built using a supervised model. Association between molecular scores and pathology severity of rejection were analyzed in both derivation and validation set.</div></div><div><h3>Results</h3><div>The derivation included a total of 151 AMR (pAMR1H+: <em>n</em> <!-->=<!--> <!-->46, pAMR1I+: <em>n</em> <!-->=<!--> <!-->36, pAMR2-3: <em>n</em> <!-->=<!--> <!-->69), 232 ACR (ACR 1R: <em>n</em> <!-->=<!--> <!-->143, ACR 2-3R: <em>n</em> <!-->=<!--> <!-->89) and 92 non-rejection cases. The validation set included a total of 37 AMR (pAMR1H+: <em>n</em> <!-->=<!--> <!-->12, pAMR1I+: <em>n</em> <!-->=<!--> <!-->15, pAMR2-3: <em>n</em> <!-->=<!--> <!-->10), 57 ACR (ACR 1R: <em>n</em> <!-->=<!--> <!-->31, ACR 2-3R: <em>n</em> <!-->=<!--> <!-->26) and 22 non-rejection cases. Median AMR scores in AMR, ACR and non-rejection cases were 0.655 (IQR<!--> <!-->=<!--> <!-->0.316), 0.217 (IQR<!--> <!-->=<!--> <!-->0.254) and 0.140 (IQR<!--> <!-->=<!--> <!-->0.209), respectively. Median ACR scores in ACR, AMR and non-rejection cases were 0.678 (IQR<!--> <!-->=<!--> <!-->0.347), 0.263 (IQR<!--> <!-->=<!--> <!-->0.364) and 0.302 (IQR<!--> <!-->=<!--> <!-->270), respectively. AMR and ACR molecular scores were strongly associated with the pathology assessment of severity of rejection according to AMR and ACR international working formulations, respectively (derivation set: ACR: <em>P</em> for trend<!--> <!-->=<!--> <!-->1.017E-46, AMR: <em>P</em> for trend<!--> <!-->=<!--> <!-->2.911E-52; validation set: ACR: <em>P</em> for trend<!--> <!-->=<!--> <!-->1.827E-13, AMR: <em>P</em> for trend<!--> <!-->=<!--> <!-->5.174E-10, <span><span>Fig. 1</span></span>). Molecular AMR score was not associated with ACR severity; neither was the ACR molecular score with AMR severity.</div></div><div><h3>Conclusion</h3><div>Tissue-based molecular diagnostic system developed closely aligned with histological grading of cardiac allograft rejection, enhancing diagnostic precision, and offering a reliable companion tool for routine practice.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S29-S30"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903918","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":"Effect of Mavacamten on left ventricular diastolic function and left atrial function in obstructive HCM","authors":"N. Cohen ,&nbsp;C. Lucas ,&nbsp;C. Idini ,&nbsp;E. Conte ,&nbsp;M. Philip ,&nbsp;G. Stolpe ,&nbsp;H. Martel ,&nbsp;S. Quaranta ,&nbsp;G. Habib","doi":"10.1016/j.acvd.2025.10.067","DOIUrl":"10.1016/j.acvd.2025.10.067","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Obstructive hypertrophic cardiomyopathy (HCM) is characterized by dynamic left ventricular outflow tract (LVOT) obstruction, leading to disabling symptoms. Mavacamten, a selective cardiac myosin inhibitor, has demonstrated efficacy in reducing obstruction. However, its impact on diastolic function and left atrial remodeling remains poorly characterized.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Primary objective: to evaluate the effect of Mavacamten on diastolic function and left atrial remodeling in patients with obstructive HCM.&lt;/div&gt;&lt;div&gt;Secondary objectives: to assess its impact on echocardiographic parameters, clinical outcomes (NYHA class, symptoms), and biomarkers (NT-proBNP).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;This single-center prospective study included 55 symptomatic HCM patients (mean 67.5 [11.99] years, 22 men [40%]). Parameters assessed before and after titration included diastolic function markers: left atrial end-systolic volume (LA VTS), E/E’ ratio, E/A ratio, PALS 2D, PACS 2D, as well as obstruction gradients (rest, Valsalva), LVEF, left ventricular 2D strain, myocardial wall thickness, and clinical and biological parameters.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The mean titration duration was 5.11 months, with a median dose of 5&lt;!--&gt; &lt;!--&gt;mg/day.&lt;/div&gt;&lt;div&gt;After titration, we observed a significant reduction in NYHA class from 2.53 to 1.44 (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.0001) and a decrease in NT-proBNP levels from 2276.8 to 395.3&lt;!--&gt; &lt;!--&gt;pg/mL (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.0001).&lt;/div&gt;&lt;div&gt;The LVOT gradient significantly decreased at rest from 65.7&lt;!--&gt; &lt;!--&gt;mmHg to 11.9&lt;!--&gt; &lt;!--&gt;mmHg, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.0001) and after Valsalva (102.2&lt;!--&gt; &lt;!--&gt;mmHg&lt;!--&gt; &lt;!--&gt;→&lt;!--&gt; &lt;!--&gt;19.3&lt;!--&gt; &lt;!--&gt;mmHg, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.0001) (&lt;span&gt;&lt;span&gt;Fig. 1&lt;/span&gt;&lt;/span&gt;).&lt;/div&gt;&lt;div&gt;Mavacamten significantly improved several diastolic function parameters. LA VTS decreased from 53.1 to 43.3&lt;!--&gt; &lt;!--&gt;mL/m&lt;sup&gt;2&lt;/sup&gt; (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.0001). The E/E’ ratio improved from 14.5 to 10.6 (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001).&lt;/div&gt;&lt;div&gt;However, the E/A ratio remained unchanged and left atrial strain parameters worsened under therapy, with a decrease in PALS 2D from 20.6% to 17.5% (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.01) and PACS 2D from 10.8% to 8.0% (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.01). LVEF decreased (69%&lt;!--&gt; &lt;!--&gt;→&lt;!--&gt; &lt;!--&gt;66%, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). Left ventricular 2D strain remained unchanged after treatment (−14.56% to −14.89%, &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;NS).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Mavacamten significantly improves diastolic function in HCM patients, as evidenced by the decrease in LA volume and improvement in the E/E’ ratio. However, the observed reduction in PALS and PACS suggests persistent left atrial stiffness. These findings support the role of Mavacamten in the management of obstructive HCM, but further studies are needed t","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S37-S38"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903974","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":"Reducing heart failure hospitalizations through a context-adaptive day-hospital model: A mixed-methods evaluation of USETIC in Réunion Island","authors":"M. Taranzano ,&nbsp;I. Cabrera Rubio ,&nbsp;J. Corré ,&nbsp;D. Fanfan ,&nbsp;S. Molinari ,&nbsp;M. Churet ,&nbsp;J. Marot ,&nbsp;C. Lallemand ,&nbsp;T. Si Moussi ,&nbsp;R. Rossanaly Vasram ,&nbsp;R. Perrin ,&nbsp;S. Vally ,&nbsp;F. Auclair ,&nbsp;C. Ferdynus ,&nbsp;C. Marimoutou ,&nbsp;V. Aboyans ,&nbsp;L.-M. Desroche","doi":"10.1016/j.acvd.2025.10.083","DOIUrl":"10.1016/j.acvd.2025.10.083","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) remains a leading cause of morbidity worldwide, especially in underserved territories. USETIC is a day-hospital model developed in Réunion Island to provide structured, multidisciplinary, and culturally adapted HF care. This study evaluated its clinical impact and explored implementation mechanisms through a mixed-methods approach.</div></div><div><h3>Objective</h3><div>To assess the effectiveness of USETIC on HF outcomes and to understand the contextual factors driving its implementation success.</div></div><div><h3>Method</h3><div>We conducted a retrospective cohort study of 424 patients enrolled in USETIC (mean age 57.5<!--> <!-->±<!--> <!-->13.9 years, 64.6% male). Hospitalization rates and therapeutic adherence were assessed at 1 and 2 years. In parallel, semi-structured interviews (<em>n</em> <!-->=<!--> <!-->13) with professionals involved in USETIC were analyzed using Braun &amp; Clarke's thematic approach to identify implementation facilitators and barriers.</div></div><div><h3>Results</h3><div>Hospitalizations significantly decreased from 61% in the year before USETIC to 24% at year <!--> <!-->+<!--> <!-->1, and remained lowat 9% by year <!--> <!-->+<!--> <!-->2. The mean length of stay also declinedfrom 5.0 days (year -1) to 1.7 days (year <!--> <!-->+<!--> <!-->1), and 0.6 days(year <!--> <!-->+<!--> <!-->2). LVEF improved from 32.1% to 39.2% over follow-up. Therapeutic optimization was substantial: 65% of patients received ARNi, and 73% of those reached target dose. Qualitative analysis identified five major implementation themes: (1) Multidisciplinary coordination fostered therapeutic alignment; (2) Patient empowerment enhanced engagement and adherence; (3) Cultural adaptation addressed language and local beliefs; (4) Institutional barriers included workforce limitations and fragmented communication; (5) Leadership and adaptability supported sustained implementation. <span><span>Fig. 1</span></span> summarizes hospitalization trends and thematic findings from the qualitative analysis.</div></div><div><h3>Conclusion</h3><div>The USETIC model led to a sustained reduction in HF hospitalizations through both evidence-based care and strong contextual integration. The mixed-methods approach demonstrates how tailored implementation strategies—culturally and organizationally—can optimize care delivery in high-risk, underserved populations. These insights provide a practical framework for replication in other regions.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S47-S48"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904058","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":"Recognizing Frailty in heart Failure: Implications for clinical practice and patient prognosis","authors":"H. El Garni ,&nbsp;M. Ztati ,&nbsp;M. El Hattaoui","doi":"10.1016/j.acvd.2025.10.084","DOIUrl":"10.1016/j.acvd.2025.10.084","url":null,"abstract":"<div><h3>Introduction</h3><div>Frailty is a common and serious concern in heart failure, which increases the risk of complications and unfavorable results. Its management is not standardized and necessitates a customized, patient-centered strategy that takes into account each person's particular vulnerabilities.</div></div><div><h3>Objective</h3><div>Our study's objectives were to first characterize frailty in heart failure patients in a resource-constrained Moroccan setting before suggesting a customized management approach that took into account the requirements and circumstances of this susceptible group.</div></div><div><h3>Method</h3><div>The study involved a follow-up period of at least 18 months, and we used a simplified Frailty Index with 20 criteria to measure frailty in heart failure patients. The index includes clinical, physical, nutritional, and biological factors that are easily measurable in a setting with limited resources. Each criterion is scored from 0 to 1, with a total score ranging from 0 to 20. A score above 10 indicates severe frailty, between 5 and 10 indicates pre-frailty, and below 5 indicates a non-frail state.</div></div><div><h3>Results</h3><div>Out of a total of 642 patients followed for 18 months, the evaluation of frailty using our simplified Frailty Index with 20 criteria revealed that 35% of patients were severely frail, 42% were in pre-frailty, and 23% were non-frail. Frail patients were generally older, had a higher prevalence of comorbidities, and exhibited significant functional decline, with a marked reduction in walking ability and muscle strength. The mortality rate for frail patients was 15% compared to 7% for non-frail patients, and their hospitalization rate was higher (55% vs 30%). The predictive factors for frailty identified were unintentional weight loss, decreased muscle strength, and poor nutrition. Among frail patients, those who received nutritional support and physical therapy showed a significant improvement in their frailty score. Fdditionally, hospitalizations were decreased and quality of life was improved for frail patients receiving optimal pharmaceutical treatment.</div></div><div><h3>Conclusion</h3><div>Our study emphasizes how crucial it is to evaluate frailty in heart failure patients, especially in environments with limited resources. Better comorbidity control, fewer hospitalizations, and an improved quality of life were among the benefits of the geriatrics department's involvement and individualized care. A multidisciplinary approach and early frailty detection are essential for maximizing care in this susceptible group.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S48"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904059","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":"10-year outcomes of patients with non-ST-segment elevation myocardial infarction according to coronary arteries atherosclerosis extent on coronary angiography","authors":"F. Boukerche","doi":"10.1016/j.acvd.2025.10.002","DOIUrl":"10.1016/j.acvd.2025.10.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Current risk assessment of patients with NSTE-ACS may fail to identify some patients with severe coronary artery disease (CAD).</div></div><div><h3>Objective</h3><div>We aimed to identify predictors of high risk coronary artery disease in patients with NSTEMI undergoing early angiography and evaluating its long-term impact on prognosis.</div></div><div><h3>Method</h3><div>We examined prospectively 292 consecutive patients admitted for first time NSTEMI during 2015, to whom CAG was performed. Patients were classified by CAG into: 0-vessel disease (0VD), 1-vessel disease (1VD), 2VD, and 3VD with stenosis<!--> <!-->≥<!--> <!-->50%. Follow-up period: 10 years.</div></div><div><h3>Results</h3><div>10-year mortality for NSTEMI patients with 0VD was 7.7%, 1VD 15.2%, 2VD 28.0%, and 3VD 41.7% (<span><span>Fig. 1</span></span>).</div><div>ST segment modification (OR 3,5, 95%CI 1.6–7.5, <em>P</em> <!-->=<!--> <!-->0.001) and kinetic disorder at echocardiography (OR 3.0, 95%CI 1.6–5.9, <em>P</em> <!-->=<!--> <!-->0.001) were the strongest predictors of three-vessels disease (<span><span>Table 1</span></span>). Patients with three vessels disease were prone to have more cardiovascular events during 10-year follow-up (65.0% vs. 31.5%, <em>P</em> <!-->&lt;<!--> <!-->10⁻³). Three vessels disease was the strongest predictor of 10-year mortality and MACCE occurrence.</div></div><div><h3>Conclusion</h3><div>Multivessel disease is predicted by clinical, electrical and echocardigraphic parameters. These patients fared worse compared to those with low risk anatomy.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S5"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904070","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 relationship between cardiac structure, function, and clinical outcomes, and the impact of Vutrisiran from the HELIOS-B trial","authors":"K. Jering ,&nbsp;M. Fontana ,&nbsp;H. Skali ,&nbsp;B. Bulwer ,&nbsp;O. Lairez ,&nbsp;S. Longhi ,&nbsp;O. Azevedo ,&nbsp;S. Bender ,&nbsp;P. Jay ,&nbsp;J. Vest ,&nbsp;S. Solomon","doi":"10.1016/j.acvd.2025.10.089","DOIUrl":"10.1016/j.acvd.2025.10.089","url":null,"abstract":"<div><h3>Introduction</h3><div>Transthyretin cardiomyopathy (ATTR-CM) is associated with high morbidity and mortality. Vutrisiran, an RNA interference therapeutic, rapidly knocks down circulating levels of TTR, thus suppressing the amyloid deposition that drives disease progression. In HELIOS-B, vutrisiran decreased risks of cardiovascular (CV) events and all-cause mortality (ACM) for patients with ATTR-CM. Vutrisiran also positively impacted echocardiographic measures of left ventricular (LV) structure and function compared to placebo. Effects on systolic and diastolic function were observed as early as month 12 of treatment.</div></div><div><h3>Objective</h3><div>To evaluate the impact of vutrisiran on echocardiographic measures of cardiac structure and function, and their prognostic value, in patients with ATTR-CM.</div></div><div><h3>Method</h3><div>HELIOS-B is a phase 3, randomized, double-blind, placebo-controlled, multicenter study. HELIOS-B randomized 655 patients with wild-type ATTR (wtATTR) or hereditary ATTR-CM to vutrisiran (25<!--> <!-->mg) or placebo Q3<!--> <!-->M. The primary endpoint was a composite of ACM and recurrent CV events (CV hospitalizations and urgent heart failure visits) assessed separately in the overall population and in the monotherapy population (defined as patients not on tafamidis at baseline). Patients underwent echocardiograms at baseline, months 12, 18, 24, and 30. The association of select echocardiographic parameters on outcomes, and the impact of vutrisiran on echocardiographic parameters was assessed.</div></div><div><h3>Results</h3><div>At baseline (median age 77 years, 93% male, 88% wtATTR) mean LV ejection fraction was 56<!--> <!-->±<!--> <!-->13%, absolute peak longitudinal strain 14<!--> <!-->±<!--> <!-->3%, and mean LV wall thickness 1.8<!--> <!-->±<!--> <!-->0.3<!--> <!-->cm. Prespecified analyses evaluating the prognostic significance of echocardiographic parameters and the impact of vutrisiran will be presented.</div></div><div><h3>Conclusion</h3><div>Improvements in cardiac structure and function support the benefits of vutrisiran in reducing the risk of CV events and ACM compared to placebo for patients with ATTR-CM.</div><div>These results will likely demonstrate the prognostic significance of echocardiographic parameters of cardiac structure and function on later clinical outcomes of CV events and ACM, as well as the impact of vutrisiran treatment to improve cardiac structure and function.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S50-S51"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904115","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":"From ACS to stable angina: How do Sirolimus and Paclitaxel DCBs perform in daily practice?","authors":"M.M. Baouni,&nbsp;A. Makhloufi,&nbsp;A. Allouache,&nbsp;N. Dahimene,&nbsp;F. Chaouat,&nbsp;S. Bachtarzi,&nbsp;D. Djermane,&nbsp;Z. Benoui,&nbsp;Y. Aoudia","doi":"10.1016/j.acvd.2025.10.027","DOIUrl":"10.1016/j.acvd.2025.10.027","url":null,"abstract":"<div><h3>Introduction</h3><div>Drug-coated balloons (DCB) are increasingly used as a therapeutic strategy for coronary artery disease, especially in small vessel lesions or situations where stent implantation is not desirable. However, real-world comparative data between paclitaxel- and sirolimus-coated DCBs, especially in acute coronary syndrome (ACS) versus stable coronary syndrome (SCS), remain scarce.</div></div><div><h3>Objective</h3><div>To compare the angiographic performance of paclitaxel- and sirolimus-coated DCBs based on clinical presentation and procedural strategy.</div></div><div><h3>Method</h3><div>This was a single-center retrospective study including 15 patients treated with DCBs between 2022 and 2024 for coronary lesions in the context of ACS or SCS. Clinical, angiographic, and procedural data were collected. The primary endpoint was acute lumen gain (ALG), expressed as a percentage. Analyses were stratified by DCB type, clinical context, gender, use of 1:1 pre-dilatation, and number of balloons used.</div></div><div><h3>Results</h3><div>In this monocentric retrospective study including 15 patients treated with drug-coated balloons (DCB) for coronary lesions, the average age was 59.8 years and 73% were male. Paclitaxel-based DCBs were used in 60% of cases, and sirolimus-based DCBs in 40%. The mean acute lumen gain (ALG) was 114.4%<!--> <!-->±<!--> <!-->112.6, with a final minimal lumen diameter of 1.73<!--> <!-->mm, a reference vessel diameter of 2.39<!--> <!-->mm, and a residual stenosis of 57.7%. Sirolimus DCBs showed higher ALG in acute coronary syndrome (ACS) settings (129.3%) compared to chronic coronary syndrome (CCS, 49.0%), while paclitaxel DCBs were more effective in CCS (130.3%). ALG was higher in patients who did not undergo 1:1 pre-dilatation (125.9% vs. 82.7%). Most treated vessels were marginal branches, distal LAD, and diagonal branches. Using a single balloon was the most common strategy (60%) with a corresponding ALG of 92.6% (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>Both paclitaxel- and sirolimus-coated DCBs demonstrated significant efficacy with high acute lumen gain. Sirolimus DCBs appeared more effective in ACS, while paclitaxel DCBs showed more consistent results in SCS. These findings support the value of DCBs within a “leave nothing behind” strategy, consistent with current ESC guidelines and major trials such as PEPCAD II and BASKET-SMALL 2.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S18"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904131","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":"Left main revascularisation: Study of two techniques; angioplasty and bypass surgery","authors":"O. Garci ,&nbsp;S. Boudiche ,&nbsp;M.S. Mourali","doi":"10.1016/j.acvd.2025.10.028","DOIUrl":"10.1016/j.acvd.2025.10.028","url":null,"abstract":"<div><h3>Introduction</h3><div>Several randomized clinical trials have shown that percutaneous coronary intervention in unprotected left main coronary artery is an efficient approach, paving the way for remarkable changes in recent guidelines.</div></div><div><h3>Objective</h3><div>To evaluate short and long-term clinical outcomes following percutaneous interventions and coronary artery bypass grafting in left main disease.</div></div><div><h3>Method</h3><div>From 2012 to 2018, consecutive patients with unprotected left main disease treated by percutaneous intervention or bypass grafting were included in this registry after excluding highly instable patients namely revascularization in the settings of ST elevation myocardial infarction or cardiogenic shock. A sub-study to get in line with landmark randomized trials design with propensity score analysis in order to adjust for baseline differences in overall cohort was performed to compare the two techniques in this real-world registry.</div></div><div><h3>Results</h3><div>During study period, 308 patients were included: 159 vs. 149 in percutaneous and surgical groups respectively (<span><span>Fig. 1</span></span>). During in-hospital stay, major adverse cerebrovascular and cardiac events occurred in 1.9% vs. 12.1%, <em>P</em> <!-->=<!--> <!-->0.001. Difference was driven by in-hospital deaths 1.3% vs. 10.1%, <em>P</em> <!-->=<!--> <!-->0.001. At median follow-up of 48 months, major adverse cardio and cerebrovascular events occurred in 28.9% vs. 36.2%, <em>P</em> <!-->=<!--> <!-->0.077. Components of major events were as follows: all-cause deaths 15.7% vs. 24.8%, <em>P</em> <!-->=<!--> <!-->0.027; cardiac deaths 10.7% vs. 17.4%, <em>P</em> <!-->=<!--> <!-->0.047; myocardial infarction 8.2% vs. 5.3%, <em>P</em> <!-->=<!--> <!-->0.496; Cerebrovascular accidents 1.3% vs. 3.3%, <em>P</em> <!-->=<!--> <!-->0.21 and ischemia-driven target vessel revascularization 13.8% vs. 8.0%, <em>P</em> <!-->=<!--> <!-->0.106. 89 matched pairs were identified for propensity matching score after excluding patients with left ventricle ejection fraction<!--> <!-->≤<!--> <!-->30%, eGFR<!--> <!-->≤<!--> <!-->30<!--> <!-->mL/min and SYNTAX score<!--> <!-->≥<!--> <!-->33 and any bare metal stent use. At median follow-up of 42 months there was a significant difference in favor of percutaneous coronary interventions in terms of all-cause death (Hazard Ratio: 0.3, 95% CI [0.1–0.8]; <em>P</em> <!-->=<!--> <!-->0.004) and cardiac death (Hazard Ratio: 0.1, 95% CI [0.1–0.5]; <em>P</em> <!-->=<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>In-hospital mortality after bypass grafting for unprotected left main disease was the major difference when comparing this real-world registry with landmark randomized clinical trials supporting current guidelines.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S18-S19"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904136","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":"Early heart failure detection using a Heart Failure Symptom Questionnaire and NT-proBNP Fingerstick Testing: A multicenter study (DEP&#39;IC FR 2024)","authors":"E. Berthelot ,&nbsp;N. Mewton ,&nbsp;D. Logeart ,&nbsp;N. Mansencal ,&nbsp;A. Jagu ,&nbsp;L. Legrand ,&nbsp;C. Fauvel ,&nbsp;O. Lairez ,&nbsp;F. Roubille ,&nbsp;T. Damy","doi":"10.1016/j.acvd.2025.10.097","DOIUrl":"10.1016/j.acvd.2025.10.097","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) remains underdiagnosed in primary care, often due to the nonspecific nature of symptoms and limited access to diagnostic tools. The acronym “EPOF” (dyspnea, weight gain, oedema, fatigue) is used in France to raise awareness of HF-related symptoms, but its diagnostic value has not been formally assessed. We aimed to evaluate the association between EPOF symptoms and elevated NT-proBNP levels in a population without known HF participating in a national screening campaign.</div></div><div><h3>Objective</h3><div>In this study, we sought to determine whether EPOF symptoms are associated with elevated NT-proBNP levels in a population of adults with no known history of HF, who voluntarily participated in a national HF awareness and screening campaign. The primary objective was to assess the diagnostic value of individual and combined symptoms in identifying NT-proBNP<!--> <!-->&gt;<!--> <!-->125<!--> <!-->pg/mL, the commonly used threshold for suspecting HF in ambulatory settings.</div></div><div><h3>Method</h3><div>We conducted a prospective, multicenter screening study across 21 French hospitals and clinics. Adults at steady state with no prior history of HF underwent NT-proBNP testing via fingerstick and completed a symptom questionnaire. The primary outcome was the diagnostic performance of all four clinical “EPOF” signs to detect patients with elevated NT-proBNP defined as<!--> <!-->&gt;<!--> <!-->125<!--> <!-->pg/mL.</div></div><div><h3>Results</h3><div>Of 2481 participants, 419 (16.9%) had NT-proBNP<!--> <!-->&gt;<!--> <!-->125<!--> <!-->pg/mL. Age, previous cardiology consultation, and history of coronary artery disease were independently associated with elevated NT-proBNP. Among the four symptoms, dyspnea was the most sensitive (47.7%) while weight gain was the most specific (84.7%) to detect NTproBNP<!--> <!-->&gt;<!--> <!-->125<!--> <!-->pg/mL. The presence of<!--> <!-->≥<!--> <!-->1 symptom yielded a sensitivity of 63.2% and negative predictive value of 85.0%, but specificity remained low (42.4%) for the primary outcome. When all four symptoms were present, specificity increased to 96.1% but sensitivity dropped to 7.1% (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>In a nationwide screening population without known HF, NT-proBNP<!--> <!-->&gt;<!--> <!-->125<!--> <!-->pg/mL was present in 16.9%. EPOF symptoms were more frequent in individuals with elevated NT-proBNP, but their individual diagnostic performance was limited. Combining symptom-based screening with NT-proBNP testing may help guide earlier identification and referral of patients at risk of HF in primary care.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S54-S55"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904150","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}