Archives of Cardiovascular Diseases最新文献

{"title":"Management of DES coronary restenosis in a real-life setting in North African centers","authors":"F. Boukerche ,&nbsp;M. Kerrouche","doi":"10.1016/j.acvd.2024.10.078","DOIUrl":"10.1016/j.acvd.2024.10.078","url":null,"abstract":"<div><h3>Introduction</h3><div>One of the main causes of failure of angioplasty with stent implantation is in-stent restenosis (ISR). Even though its incidence has considerably decreased in recent years, it remains the Achilles’ heel of the interventional approach in patients with coronary disease.</div></div><div><h3>Objective</h3><div>We aimed to determine the predisposing factors of the different types of restenosis and evaluate the comparative efficacy and safety of the 2 most frequently used treatments of stent restenosis: drug-eluting balloon (DEB) and placement of a new drug-eluting stent (redo-DES).</div></div><div><h3>Method</h3><div>A prospective longitudinal analytical bicentric study, including all consenting patients presenting on coronary angiography in-stent restenosis, whether in the context of the exploration of stable angina or acute coronary syndrome. The different characteristics, mechanisms (analysis of initial PCI procedure, stent enhancement, and IVUS) management, and prognosis were noted. An angiographic control was systematically carried out between 6 and 12 months in patients treated with a Redo-DES or DEB (<span><span>Fig. 1</span></span>).</div></div><div><h3>Results</h3><div>A total of 73 patients were evaluated: the mean age was 61.3<!--> <!-->±<!--> <!-->10.2 years and 80.8% were male. The more frequent risk factor was diabetes with 67.1% (47 patients), and the main clinical presentation was CCS in 56.2% (41patients). The mean delay of in-stent restenosis occurrence was 20 months (4–48 months). The related artery includes the LAD in 61.6% and the two main characteristics of the initial lesion were calcified in 68.5% and the longest (&gt;<!--> <!-->24 mm) in 53.4% of patients. Stent under expansion was the most found mechanism in 54.8%. More than a half of the patients were treated with Redo-stenting and 34.2% with a DEB. The angiographic control was good with only two significant redo-restenosis in patients treated with a DEB and three in patients treated with a DES.</div></div><div><h3>Conclusion</h3><div>Diabetes mellitus, calcified and long lesions are the most important factors related to in-stent restenosis. Stent under expansion was the most found mechanism. Redo-stenting and DEB are safe and efficient treatments.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S16-S17"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150179","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":"What about markers inflammation on cardiac amyloidosis?","authors":"A. Zaroui ,&nbsp;G. Neculae ,&nbsp;B. Mélanie ,&nbsp;M. Kharoubi ,&nbsp;S. Oghina ,&nbsp;G.S. Chadha ,&nbsp;S. Bourgoin-Voillard ,&nbsp;J.-P. Bastard ,&nbsp;S. Fellahi ,&nbsp;T. Damy","doi":"10.1016/j.acvd.2024.10.051","DOIUrl":"10.1016/j.acvd.2024.10.051","url":null,"abstract":"<div><h3>Introduction</h3><div>Prognosis in cardiac amyloidosis has always been associated with amyloid infiltration, but there is increasing evidence of the role of inflammation and systemic immune response caused by the toxicity of free light chains and amyloid fibrils. However, there is very little knowledge about the systemic inflammation markers, their differential value, and prognostic significance in amyloidosis subtypes.</div></div><div><h3>Objective</h3><div>Differential value of inflammation markers and prognostic significance in amyloidosis subtypes.</div></div><div><h3>Method</h3><div>Prognostic markers well-known in AA amyloidosis, such as IL-6, calprotectin, and amyloide serique A (SAA), were measured at diagnosis and compared among AL, ATTR amyloidoses, and other cardiopathies.</div></div><div><h3>Results</h3><div>Pilot study of 147 patients (25 AL, 80 ATTR, and 42 others) with respective median ages of 76 years, 83 years, and 70 years, the median left ventricular function was 51.5% (±5), 52% (±4), and 48% (±6), with a median follow-up of 563 [20–590] days. Results showed a high incidence of inflammation with dissociation of markers in AL and ATTR-CA, For AL, the markers were higher,for ATTR-CA, there was some inflammatory substrate, less marked than in AL but more significant than in other cardiopathies. A certain population of ATTR-CA had a higher inflammatory profile (calprotectin and SAA). For other cardiopathies, the profile was rather homogeneous: the IL-6 was at 25.4<!--> <!-->±<!--> <!-->37 pg/ml, the Calprotectin at 10.3<!--> <!-->±<!--> <!-->21<!--> <!-->mg/L, and the SAA at 14.8<!--> <!-->±<!--> <!-->37<!--> <!-->mg/L compared to 8.5<!--> <!-->±<!--> <!-->9.9 pg/ml, 3.3<!--> <!-->±<!--> <!-->5.6<!--> <!-->mg/L, and 10.5<!--> <!-->±<!--> <!-->9.2<!--> <!-->mg/L, respectively, for ATTR and others cardopathies. Patients with elevated IL-6 levels were the most severe (higher Troponin, NT-proBNP, and lower LVEF). Calprotectin was well correlated with NT-proBNP and LVEF (<em>R</em> <!-->=<!--> <!-->0.76 and 0.77, <em>P</em> <!-->=<!--> <!-->0.04 and 0.001, respectively). IL-6 was the only marker with iprognostic value with a Hazard ratio of mortality at 2 years at 1.67 [1.11–12.45] in AL and ATTR amyloidoses (independent of troponin, LVEF, and NT-proBNP), and a value above 22 pg/ml increased mortality at 2 years by 20% in ATTR and early mortality by 33% in AL (3 months).</div></div><div><h3>Conclusion</h3><div>Inflammation is part of the pathophysiology of amyloidosis and increases morbidity and mortality, especially in AL amyloidosis. Treating amyloidosis would likely involve addressing this aspect in addition to others.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S48-S49"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150462","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":"Is unstable angina a benign disease? A prospective multicenter contemporary study","authors":"R. Jouen ,&nbsp;P.-A. Meunier ,&nbsp;L. Moulis ,&nbsp;P. Robert ,&nbsp;B. Lattuca ,&nbsp;G. Cayla ,&nbsp;M. Steinecker ,&nbsp;J.-C. Macia ,&nbsp;F. Leclercq","doi":"10.1016/j.acvd.2024.10.083","DOIUrl":"10.1016/j.acvd.2024.10.083","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The use of high sensitivity cardiac troponin (hs-cTn) for the diagnostic strategy of acute coronary syndromes (ACS) resulted in decrease of unstable angina (UA) to the benefit of NSTEMI. However, prognostic of UA remains controversial with no precise guidelines.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate clinical characteristics and prognostic of a contemporary patients with UA.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;The study included all patients admitted in 2 French university centres with the diagnostic of UA defined with clinical ischemic symptoms and T hs-cTn concentrations&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;99 percentile (undetectable:&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;5 ng/l or non-elevated:&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;14 ng/l) or&lt;!--&gt; &lt;!--&gt;≥&lt;!--&gt; &lt;!--&gt;99 percentile but mildly elevated (14–50 ng/l) without significant rise (&lt;&lt;!--&gt; &lt;!--&gt;20%) between 2 dosages. Only patients with significant coronary stenosis were included. The primary end-point included major events at 1-year follow-up (total mortality, new ACS, hospitalization for cardiac causes).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 1682 patients admitted for ACS during the study period (December 2021–February 2023), 210 were diagnosed to have UA (12.5%). Mean age of patients with UA was 66&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;12 years, with predominantly males (68.1%). The patients with UA had undetectable (&lt;em&gt;n&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;4), non-elevated (&lt;em&gt;n&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;80) or moderately elevated T hs-cTn with no kinetics (&lt;em&gt;n&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;126). At least 2 cardiovascular risk factors were observed in 60.9% patients and a history of coronary artery disease (CAD) was found in 46.6% patients. Coronary angiography showed multitroncular disease in 56,7% patients and a mean SYNTAX 1 score of 8.27&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;5.06. Percutaneous coronary angioplasty was performed in 88.6% patients while 7.14% required bypass surgery. Only one adverse event occurred during the hospital phase related to documented stroke. Regarding the primary outcome, 55 patients had an adverse event (26.2% [20.2–32.1]) mainly related to new ACS (&lt;span&gt;&lt;span&gt;Table 1&lt;/span&gt;&lt;/span&gt;). The level of troponin was not associated with the primary outcome in univariate analysis nor was the SYNTAX I score. In multivariate logistic regression analysis, ≥&lt;!--&gt; &lt;!--&gt;3 cardiovascular risk factors (OR 1.93 [1.01–3.69], &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.0194), history of CAD (OR 3.09 [1.63–5.87], &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.0005), previous antiplatelet therapy (OR 2.54 [1.11–5.84], &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.0279) and tritroncular disease (OR 2.66 [1.24–5.69], &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.0118) were significantly associated with major events at follow-up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Incidence of UA is low (12.5% of all ACS) but with a 1-year incidence of major cardiac events high (26.2%), mainly related to new acute coronary event. UA is therefore not a benign disease and secondary prevention","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S19"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149752","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":"Impact of a post-myocardial infarction sexuality education session on erectile dysfunction, anxiety and depression","authors":"E. Allouche ,&nbsp;R. Laajimi ,&nbsp;A. Chetoui ,&nbsp;H. Ben Jemaa ,&nbsp;F. Boudiche ,&nbsp;M.S. Aissa ,&nbsp;W. Ouechtati Ben Attia ,&nbsp;H. Ben Ahmed ,&nbsp;L. Bezdah","doi":"10.1016/j.acvd.2024.10.065","DOIUrl":"10.1016/j.acvd.2024.10.065","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with coronary artery disease (CAD) experience a decline in their quality of life due to the onset of depression, anxiety, and erectile dysfunction (ED) following an acute event.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the impact of a post-myocardial infarction (MI) sexuality education session on ED, anxiety, and depression.</div></div><div><h3>Method</h3><div>The study was a prospective randomized trial, involving stable coronary men in the Cardiology Department of Charles Nicolle Hospital. It included one 100 patients randomly assigned to either an intervention group or a control group. During the initial interview, the patients’ erectile dysfunction (ED) was evaluated using the IIEF-5 score, and anxiety disorders were assessed using the DASS-21 score. The intervention group received an individual post-myocardial infarction (MI) sexuality education session. After three months, both groups were reassessed using the same scores.</div></div><div><h3>Results</h3><div>During the first interview there was no difference between the intervention group and the control group with high rates of ED (94% <em>vs.</em> 90%), depression (74% <em>vs.</em> 78%) and anxiety (96% <em>vs.</em> 90%). The intervention group exhibited significantly lower rates of ED (42% <em>vs.</em> 70%, <em>p</em> <!-->=<!--> <!-->0.005), depression (32% <em>vs.</em> 62%, <em>p</em> <!-->=<!--> <!-->0.003), and anxiety (50% <em>vs.</em> 76%, <em>p</em> <!-->=<!--> <!-->0.007) compared to the control group during the second interview. There was a significant decrease in the rates of ED (42% <em>vs.</em> 94%, <em>p</em> <!-->&lt;<!--> <!-->0.001), depression (32% <em>vs.</em> 74%, <em>p</em> <!-->=<!--> <!-->0.001), and anxiety (50% <em>vs.</em> 96%, <em>p</em> <!-->&lt;<!--> <!-->0.001) among patients in the intervention group during the second interview, compared to the first. In contrast, there was no significant difference in the prevalence of ED, depression, and anxiety between the first and second interviews for patients in the control group. Patients in the Intervention Group experienced a significant improvement in ED and anxiety (<em>p</em> <!-->&lt;<!--> <!-->0.001) and OR (95% CI) to 4,53 [1,95–10,51].</div></div><div><h3>Conclusion</h3><div>Therefore, it is imperative to incorporate sexuality education into therapeutic education and cardiac rehabilitation programs for post-MI coronary heart disease patients. This will undoubtedly have a positive impact on sexual function and anxiety disorders.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S10"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150173","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 differences in management of LDL-cholesterol in patients with chronic coronary syndrome","authors":"J. Mesnier ,&nbsp;L. Giovachini ,&nbsp;G. Ducrocq ,&nbsp;R. Ferrari ,&nbsp;I. Ford ,&nbsp;J.-C. Tardif ,&nbsp;M. Tendera ,&nbsp;K. Fox ,&nbsp;P.G. Steg","doi":"10.1016/j.acvd.2024.10.056","DOIUrl":"10.1016/j.acvd.2024.10.056","url":null,"abstract":"<div><h3>Introduction</h3><div>Effective management of low-density lipoprotein cholesterol (LDL-C) is crucial for preventing recurrent cardiovascular (CV) events in patients with chronic coronary syndrome (CCS). Sex may impact the LDL-C management.</div></div><div><h3>Objective</h3><div>We examined sex-specific LDL-C management in CCS patients, assessing target achievement rates and their implications for CV outcomes.</div></div><div><h3>Method</h3><div>In the international CLARIFY registry, we included 22,134 CCS patients with baseline LDL-C measurements. LDL-C levels were monitored annually over the 5-year follow-up period. Target LDL-C was set at 100 mg/dL, in line with prevailing recommendations at that time. Sex-specific differences in LDL-C were adjusted forage, geographical region and indication for lipid lowering drugs (stroke, MI, PAD). The primary endpoint was the incidence of MACE, defined as CV death or MI during the 5-year follow-up, evaluated using multivariable analysis adjusted for known predictors of recurrent CV events in CCS patients.</div></div><div><h3>Results</h3><div>Of 22,134 patients, 21.6% were women. Upon inclusion (6.5<!--> <!-->±<!--> <!-->6.3 years after CCS diagnosis), women were more likely than men to have LDL-C levels above the recommended threshold (45.6% vs. 37.4%; aOR 1.47, 95%CI 1.38–1.58, <em>P</em> <!-->&lt;<!--> <!-->0.001, <span><span>Fig. 1</span></span>) and less likely to receive statin treatment (82.7% vs. 85.4%, <em>P</em> <!-->&lt;<!--> <!-->0.001). The discrepancies endured over the 5-year observation period, with women consistently showing lower likelihood of achieving LDL-C targets at 1, 2, 3, 4, and5 years post-inclusion (<em>P</em> <!-->&lt;<!--> <!-->0.001 for all time points). Overall, women were less likely than men to have all available LDL-C concentrations within the target range (37.8% vs. 44.6%; aOR 0.70, 95% CI 0.64–0.76, <em>P</em> <!-->&lt;<!--> <!-->0.001) and more likely to never reach the target LDL-C goal during follow-up (22.6% vs. 17.5%; aOR 1.43, 95% CI 1.32–1.55, <em>P</em> <!-->&lt;<!--> <!-->0.001). Failing to achieve at least one LDL-C concentration below100 mg/dL was associated with an increased risk of subsequent MACE (adjusted HR 1.57, 95%CI 1.38–1.77, <em>P</em> <!-->&lt;<!--> <!-->0.001), with similar associations observed in both men (aHR 1.66, 95% CI 1.44–1.91, <em>P</em> <!-->&lt;<!--> <!-->0.001) and women (aHR 1.31, 95% CI 1.01–1.70, <em>P</em> <!-->=<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>In patients with CCS, women consistently showed lower likelihood of reaching LDL-C targets throughout follow-up compared to men. Women were more likely to have no LDL-C concentration within recommended range during follow-up, which is particularly concerning given its association with an increased risk of CV events.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S5"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150426","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":"Toward a multidisciplinary approach: The increasing involvement of nurses in heart failure management","authors":"F. Zorès ,&nbsp;T. Damy ,&nbsp;A. Duchenne ,&nbsp;E. Huet ,&nbsp;C. Lecerf ,&nbsp;B. Lequeux ,&nbsp;E. Martin ,&nbsp;M. Moulin ,&nbsp;F. Mouquet ,&nbsp;B. Pedrono ,&nbsp;J. Redureau ,&nbsp;M. Salvat ,&nbsp;V. Thoré ,&nbsp;M. Villaceque ,&nbsp;E. Berthelot","doi":"10.1016/j.acvd.2024.10.044","DOIUrl":"10.1016/j.acvd.2024.10.044","url":null,"abstract":"<div><h3>Introduction</h3><div>The increasing prevalence of heart failure (HF), alongside the scarcity of medical time, necessitates the development of new practices and the promotion of task-sharing and skill-sharing. Over the past few years, new professions have emerged to facilitate the care of patients with HF: specialized nurses in heart failure management (ISPIC), advanced practice nurses (IPA), and telemonitoring nurses (ITS).</div></div><div><h3>Objective</h3><div>In spring 2023, the GICC (Groupe Insuffisance Cardiaque et Cardiomyopathies) distributed a questionnaire via email and social networks to better understand these new professions.</div></div><div><h3>Method</h3><div>196 usable questionnaires were collected, of which 106 (54%) had exhaustive responses. The majority of respondents were IPAs (59 (47%)), 45 (36%) were ISPICs, and 21 (17%) were ITSs. The average age was 44 years, similar across the three groups. Respondents had a median of 11 years of experience with CV pathologies, but IPAs had significantly less time working with cardiac patients than the other two groups.</div></div><div><h3>Results</h3><div>57% of IPAs, 81% of ISPICs, and 80% of ITSs have exclusive activity in cardiology (<em>P</em> <!-->=<!--> <!-->0.021). Outside of cardiology, the most frequently invested specialties are diabetology, geriatrics, and vascular medicine. 48% of the nurses exclusively work with HF patients.</div><div>Professional practice is mainly in public hospital structures (66%), with non-university hospital centers leading. Private practice is more common among IPAs than other professions (29% of IPAs vs. 5% for ISPICs and 0% for ITSs; <em>P</em> <!-->&lt;<!--> <!-->0.005).</div><div>Consultations for uptitration of medical therapy are conducted by 72% of IPAs and 55% of ISPICs. 94% of IPAs and 48% of ISPICs conduct clinical and biological follow-up consultations. A majority of nurses already perform or are in the process of implementing tools to coordinate patient care pathways. 70% of ISPICs participate in therapeutic patient education workshops, compared to only 37% of IPAs and 44% of ITSs (<em>P</em> <!-->=<!--> <!-->0.049). 100% of ITSs conduct telemonitoring, compared to only 46% of IPAs and 80% of ISPICs (<em>P</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>This initial study highlights the already effective involvement of specialized nurses in the care of HF patients, despite disparities in training and practice mode. It also highlights differences in roles with patients for each of these professions. Studies with larger populations will further refine this preliminary work.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S45"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150509","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 Healthcare Amyloidosis European Registry (HEAR): Study design and methods","authors":"P. Réant ,&nbsp;M. Kharoubi ,&nbsp;F. Delelis ,&nbsp;J. Jeanneteau ,&nbsp;C. Dagrenat ,&nbsp;F. Bauer ,&nbsp;J.C. Eicher ,&nbsp;A. Bisson ,&nbsp;A. Jobbé-Duval ,&nbsp;J. Inamo ,&nbsp;F. Roubille ,&nbsp;J.-P. Gueffet ,&nbsp;M.-F. Seronde ,&nbsp;N. Piriou ,&nbsp;A. Zaroui ,&nbsp;O. Lairez ,&nbsp;T. Damy","doi":"10.1016/j.acvd.2024.10.009","DOIUrl":"10.1016/j.acvd.2024.10.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac amyloidosis (CA) is a rare disease that can lead to poor quality of life, conduction disorders, arrhythmia, heart failure, and even death. Fortunately, specific treatments that can modify the natural history of the disease and the disease outcomes are now available. However, data on the prevailing patient management procedures and long-term outcomes of CA are scarce. In order to gather more information on the diagnosis and management of CA, we created the Healthcare Amyloidosis European Registry (HEAR).</div></div><div><h3>Objective</h3><div>The registry's primary objective is to describe the demographic, clinical, biological and imaging characteristics of patients with CA. The secondary objectives are to (i) describe the different types of CA and their progression, (ii) describe the prevailing disease management procedures and any changes in these procedures, (iii) evaluate tools and quality of life questionnaires, (iv) describe the prognosis for patients with CA; (v) describe the management of CA by cardiologists, and (vi) assess hospital admissions and treatments and any changes in these factors. The HEAR will give us an opportunity to share good practice and to evaluate and optimize the quality of care for patients with CA.</div></div><div><h3>Method</h3><div>The HEAR is non-intervention, longitudinal, multicentre registry initiated in France, but which has been designed with a view to extension to other European countries. It includes prospective, retroprospective and retrospective cohorts of patients referred for suspected CA or with a confirmed diagnosis of CA.</div></div><div><h3>Results</h3><div>Since July 2021, 34 hospitals across France have joined the HEAR project. We expect to include 6500 patients in the HEAR between January 2021 and December 2027. At baseline, we use an electronic case report form to collect data on demographics, clinical, biological and imaging variables, the management of CA by cardiologists, specific treatments, quality of life, and diagnostic data. Lastly, we intend to collect in-hospital data on outcomes (deaths, cause of death, and hospital readmissions) annually.</div></div><div><h3>Conclusion</h3><div>The HEAR is the first nationally representative, internationally extendable registry dedicated to suspected and confirmed cases of CA. It will provide crucial information on the prevailing aetiologies, prevalences, and CA management practices.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S26"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143151301","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":"Diagnostic value of Left Atrial Strain and NT-ProBNP in the Diagnosis of HFpEF","authors":"G. Ben Hassen,&nbsp;S. Antit,&nbsp;M.K. Bahri,&nbsp;R. Fekih,&nbsp;S. Romdhane,&nbsp;I. Mtiri,&nbsp;E. Boussabeh,&nbsp;L. Zakhama","doi":"10.1016/j.acvd.2024.10.033","DOIUrl":"10.1016/j.acvd.2024.10.033","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure with preserved ejection fraction (HFpEF) poses diagnostic challenges due to its heterogeneous presentation.</div></div><div><h3>Objective</h3><div>This prospective study aimed to assess the utility of left atrial (LA) strain measured by echocardiography and NT-ProBNP levels in diagnosing HFpEF.</div></div><div><h3>Method</h3><div>We enrolled 110 consecutive participants who underwent comprehensive echocardiography, including assessment of left atrial strain using speckle tracking. NT-ProBNP levels were measured concurrently. A continuous diagnostic score for HFpEF was calculated based on the European Society of Cardiology's HFA-PEFF diagnostic algorithm.</div></div><div><h3>Results</h3><div>Mean age was 61.8<!--> <!-->±<!--> <!-->11.5 years; 57.3% female. Hypertension and Diabetes were the most common cardiovascular risk factor (90% and 60% respectively). In the study population, 44 patients (40%) had a confirmed diagnosis of HFpEF according to the HFA-PEFF score, after evaluation at rest and on exertion. The median PALS was 26%<!--> <!-->±<!--> <!-->7.6. Exploration objected a median N-terminal pro-BNP (NT-pro-BNP) of 95<!--> <!-->pg/mL [52–247]. A Value of NT Pro-BNP<!--> <!-->&gt;<!--> <!-->125<!--> <!-->pn/mL was found in 42% patients. LA strain reservoir was significatively correlated with NT Pro-BNP (<em>P</em> <!-->=<!--> <!-->0.049, <em>r</em> <!-->=<!--> <!-->−0.14).</div></div><div><h3>Conclusion</h3><div>Assessment of LA strain using speckle tracking echocardiography, alongside NT-ProBNP levels, shows promise in diagnosing HFpEF. These non-invasive measures offer valuable insights into cardiac dysfunction and may aid in early detection and management of HFpEF.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S39"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149747","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":"Outcomes of initial intravenous diuretic dose in Acute heart failure","authors":"H. Bendoudouch ,&nbsp;B. El Boussaadani ,&nbsp;L. Hara ,&nbsp;A. Ech-Chenbouli ,&nbsp;Z. Raissouni","doi":"10.1016/j.acvd.2024.10.046","DOIUrl":"10.1016/j.acvd.2024.10.046","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute heart failure is a frequent motive for emergency admissions. Intravenous loop diuretics remain the cornerstone of its management, yet its optimal initial dose remains controversial</div></div><div><h3>Objective</h3><div>Comparison of initial furosemide dose between ER practicians and both guidelines &amp; cardiology specialists, analysis of clinical improvement in the 3 categories, analysis of lack of clinical improvement in the 3 categories in relation with creatinine serum levels</div></div><div><h3>Method</h3><div>The present study included 300 patients from the Emergency Room. Anthropometric &amp; clinical elements were noted, as well as heart risk factors &amp; anterior therapeutics. Patients were divided into two groups depending on their oral diuretic intake. They were further classified into three IV bolus categories: Optimal, More &amp; Less, following guidelines. Clinical elements including diuresis and congestion physical signs were noted after 24<!--> <!-->h.</div></div><div><h3>Results</h3><div>In our study, 36.3% of our patients are on diuretic regimen, whereas 63.7% never received diuretics. Globally, emergency practicians indicated initial doses similar to the cardiologist assessment 36.7% of the, whereas it was different 63.7% of the time, mostly higher doses (36%). After dividing patients by their anterior diuretic intake, we found that emergency practicians tend to give higher doses to diuretic free patients (47.4%), whereas they mostly don’t increase diuretic doses for patients who are already on diuretics (18.2%), with sometimes even lower boluses (36.4%). Patients in the Optimal category had 81.8% adequate mean diuresis after 24<!--> <!-->h, as well as 85% clinical congestion improvement. Patients in the Less category had 60% adequate diuresis, and only 40% clinical improvement, with some worsening cases (8%). Patients in the More category had 81.8% adequate diuresis, as well as 85% clinical improvement. Patients in the More category had 76,9% adequate mean diuresis after 24<!--> <!-->h, less than in the Optimal category, and only 80% clinical congestion improvement (<span><span>Fig. 1</span></span>). Through analysis by Logistic Regression, we found that the unimprovement of congestion in the Low category isn’t related to creatinine serum levels. We also found that patients who didn’t improve with Optimal category doses didn’t have higher creatinine serum levels.</div></div><div><h3>Conclusion</h3><div>Our study shows that guidelines-based initial diuretic doses are effective on congestion improvement after 24<!--> <!-->h, and consequently should be followed by all medical practicians.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S46"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150515","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":"ATTR Cardiomyopathy in early and late onset ATTRV30M","authors":"A. Perault ,&nbsp;A. Echaniz-Laguna ,&nbsp;A. Monfort ,&nbsp;R. Chequer ,&nbsp;J. Inamo ,&nbsp;F. Rouzet ,&nbsp;M. Slama ,&nbsp;V. Algalarrondo","doi":"10.1016/j.acvd.2024.10.016","DOIUrl":"10.1016/j.acvd.2024.10.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Hereditary transthyretin amyloidosis (ATTRv) arising from the <em>TTR</em> gene V30M variant (ATTRV30M) manifests in two distinct phenotypes: early-onset (before age 50 years) with polyneuropathy and late-onset (after age 50 years) with a mixed phenotype, encompassing neurological and cardiac manifestations (ATTR-CM). Comparative studies examining ATTR-CM in early and late ATTRV30M have typically involved patients post-diagnosis, with early-onset individuals being younger.</div></div><div><h3>Objective</h3><div>This study aimed to compare ATTR-CM in early and late ATTRV30M at similar ages.</div></div><div><h3>Method</h3><div>Medical records of 370 ATTRV30M patients were analysed (median follow-up: 3.6 years), data were analysed by 10-year age groups. Confirmed ATTR-CM was defined by a positive DPD scan (Perugini score<!--> <!-->≥<!--> <!-->2), OR positive biopsy with unexplained interventricular septum<!--> <!-->&gt;<!--> <!-->12<!--> <!-->mm, CMR suggestive of cardiac amyloidosis or Perugini 1). Suspected ATTRv-CM was defined in case of cardiac abnormalities that did not meet the confirmed ATTRv-CM criteria.</div></div><div><h3>Results</h3><div>Among V30M carriers, 138 had early-onset polyneuropathy, 113 late-onset polyneuropathy, and 119 were asymptomatic carriers. ATTR-CM was confirmed in 16.7% of early-onset, 75.2% of late-onset, and 3.9% of asymptomatic carriers. ATTR-CM frequency increased with age. In a given age group, ATTR-CM degree was identical in early and late-onset groups (<span><span>Fig. 1</span></span>). Conversely, asymptomatic carriers showed lower ATTR-CM frequency (<em>P</em> <!-->=<!--> <!-->0.001 in the 50–59<!--> <!-->yo age group, <em>P</em> <!-->&lt;<!--> <!-->0.001 in the 60–69<!--> <!-->yo age group). Late-onset patients had significantly higher life expectancy than early-onset patients (83<!--> <!-->yo vs. 62<!--> <!-->yo, respectively; <em>P</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>In a comparable age group, ATTR-CM extent is consistent in early and late-onset ATTRV30M. ATTR-CM penetrance rises with age, and both early and late-onset ATTRV30M exhibit a mixed phenotype. Neurological manifestations precede ATTR-CM onset.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S30"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150708","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}