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MINOCA révélant une anomalie de naissance de l’artère coronaire droite et un phéochromocytome : à propos d’un cas avec revue de la littérature [MINOCA显示右冠状动脉异常起源和嗜铬细胞瘤1例报告并文献复习]。
IF 0.3 Q4 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-22 DOI: 10.1016/j.ancard.2025.101986
A. Owona , C. Ebeni , B.Y. Mengue , L.A. Gakdang , M.J. Hamika , A.P. Menanga
Pheochromocytoma is a rare secretory neuroendocrine tumor of the adrenal medulla, which usually presents with Ménard's triad or high blood pressure. Its diagnosis is based on elevated adrenaline and noradrenaline levels. Cross-sectional imaging, such as computed tomography or magnetic resonance imaging highlights the tumor and management consists of excision of this tumor. Cardiovascular complications of pheochromocytoma are multiple, such as rhythm disturbances, hypotension, shock, acute coronary syndromes, transient ischemic attacks and cerebrovascular accidents. Thus, in the face of acute coronary syndromes manifested by (1) typical chest pain associated with (2) an electrocardiogram in favor of persistent ST segment elevation (STEMI) or non-persistent ST segment elevation (NSTEMI), (3) an elevation of cardiac necrosis markers and (4) a coronary angiography revealing normal coronary arteries or without significant stenosis, a myocardial infarction with angiographically non obstructed coronary arteries (MINOCA) is confirmed. Certain etiologies of MINOCA such as cardiomyopathies induced by Takotsubo, myocarditis and catecholamines are currently clearly identified, have been able to explain the link between Minoca and pheochromocytoma [1]. Although a few cases of MINOCA revealing a pheochromocytoma have been reported, anomalous origin of coronary artery remains an exceptional cause of MINOCA. We report a case of myocardial infarction with angiographically normal coronary arteries revealing both an anomalous origin of right coronary artery and a pheochromocytoma, which, to our knowledge, appears to be the first described in the literature.
嗜铬细胞瘤是一种罕见的肾上腺髓质分泌性神经内分泌肿瘤,通常表现为梅氏三联征或高血压。其诊断是基于肾上腺素和去甲肾上腺素水平升高。横断成像,如计算机断层扫描或磁共振成像突出肿瘤,治疗包括切除肿瘤。嗜铬细胞瘤的心血管并发症是多种多样的,如心律失常、低血压、休克、急性冠状动脉综合征、短暂性脑缺血发作和脑血管意外。因此,当急性冠状动脉综合征表现为(1)典型胸痛伴(2)心电图显示持续性ST段抬高(STEMI)或非持续性ST段抬高(NSTEMI),(3)心肌坏死标志物升高,(4)冠状动脉造影显示冠状动脉正常或无明显狭窄时,可确认为冠状动脉造影未阻塞的心肌梗死(MINOCA)。MINOCA的某些病因,如Takotsubo引起的心肌病、心肌炎和儿茶酚胺,目前已被清楚地确定,已经能够解释MINOCA与嗜铬细胞瘤[1]之间的联系。虽然有少数MINOCA显示嗜铬细胞瘤的病例报道,但冠状动脉异常起源仍然是MINOCA的特殊原因。我们报告一例冠状动脉造影正常的心肌梗死,显示右冠状动脉异常起源和嗜铬细胞瘤,据我们所知,这似乎是文献中第一次描述。
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引用次数: 0
Un signe de Frank (Diagonal Earlobe Crease) chez Georges Clemenceau (1929) 《弗兰克的标志》(对角线Earlobe Crease),乔治·克莱蒙梭著(1929)
IF 0.3 Q4 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-17 DOI: 10.1016/j.ancard.2025.101985
P. Charlier, L. Lentignac, S. Lhortolary
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引用次数: 0
Impact on slow-flow/no-reflow of intravascular ultrasound-guided primary percutaneous coronary intervention in ST-elevation myocardial infarction 超声引导下st段抬高型心肌梗死初级经皮冠状动脉介入治疗对慢血流/无血流的影响
IF 0.3 Q4 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-22 DOI: 10.1016/j.ancard.2025.101982
Etienne Grenier, Sarah Balichard, Gaël Bouchou, Benjamain Haber, Pauline Brun, Alexis Cerisier, Karim Benali, Antoine Da Costa
<div><h3>Background</h3><div>Intravascular imaging (IVI) using intravascular ultrasound (IVUS) or optical coherence tomography is now strongly recommended to guide percutaneous coronary intervention (PCI), as studies have shown reduced rates of stent thrombosis and target lesion failure. Benefits seem to be greater in acute coronary syndrome, especially when optimal PCI criteria are met. Despite these positive results and the fact that IVUS was introduced almost 30 years ago, IVI is far from having become a routine tool in everyday clinical practice in Europe and the United States. In ST-elevation myocardial infarction (STEMI), the acute risk of slow-flow/no-reflow associated with post-stenting optimization and loss of time in emergency situations are cited as reasons, in addition to cost concerns and lack of availability.</div></div><div><h3>Methods</h3><div>In this case control study, 96 STEMI patients were assigned 1:2 to either IVUS-guided primary PCI (PPCI) (32 patients) or angiography-guided PPCI (64 patients). In the IVUS group, once a thrombolysis in myocardial infarction (TIMI) 3 flow was restored with minimalist immediate mechanical intervention, IVUS was performed before stenting for sizing, followed by direct stenting and angiography-guided optimization if necessary, with IVUS performed again after stenting until the result was considered optimal. In the control group, TIMI 3 flow restoration, predilatation, stenting, and postdilatation were left to the physician’s discretion based on angiographic assessment. Primary endpoint was the occurrence of slow-flow/no-reflow as assessed by TIMI flow score. Secondary endpoints were procedure time, contrast volume, X-ray exposure, distal embolization, in-hospital complications, and 1-month complications.</div></div><div><h3>Results</h3><div>Primary endpoint (slow-flow/no-reflow) occurred in 11/32 (34.4%) patients in the IVUS group and in 22/64 (34.4%) patients in the control group (p=1.00) and was similar in patients with optimal IVUS-guided PCI criteria (5/19 [26.3%]) and in the suboptimal PCI group (4/11 [36.4%]; p=0.687). Regarding the secondary endpoints, there was no difference in X-ray time (median of 760 s in the control group <em>vs.</em> 787 s in the IVUS group; p=0.529), procedure time (median of 32 min <em>vs</em>. 34 min; p=0.278), contrast volume (165 ml <em>vs</em>. 150 ml; p=0.319), and radiation dose (dose area product 5353 cGy.cm² <em>vs</em>. 4745 cGy.cm²; p=0.633). Similar results were obtained for per-procedure complications, especially for distal embolization (5/64 [7.8%] in the control group <em>vs.</em> 2/32 [6.3%] in the IVUS group; p=1.000). Slow-flow/no-reflow increased the risk of ventricular arrhythmia during the procedure (9% <em>vs</em>. 0%; p=0.038), and was associated with higher troponin (6612 ng/L <em>vs</em>. 3972 ng/L; p=0.025) and C-reactive protein (33 ng/L <em>vs</em>. 15.4 ng/L; p=0.032) levels, lower left ventricular ejection fraction (median of 45% <em>
背景:血管内成像(IVI)使用血管内超声(IVUS)或光学相干断层扫描现在被强烈推荐用于指导经皮冠状动脉介入治疗(PCI),因为研究表明支架血栓形成和靶病变失败的发生率降低。急性冠脉综合征的获益似乎更大,特别是当满足最佳PCI标准时。尽管有这些积极的结果,而且IVUS在近30年前就被引入了,但IVI还远远没有成为欧洲和美国日常临床实践中的常规工具。在st段抬高型心肌梗死(STEMI)中,除了成本问题和缺乏可用性外,还有与支架植入后优化和紧急情况下时间损失相关的慢流/无回流急性风险被认为是原因。方法:在本病例对照研究中,96例STEMI患者被1:2分配到ivus引导的原发性PCI (PPCI)(32例)或血管造影引导的PPCI(64例)。在IVUS组中,一旦心肌梗死溶栓(TIMI) 3血流在极短的立即机械干预下恢复,则在支架置入前进行IVUS以确定尺寸,然后进行直接支架置入,必要时进行血管造影引导优化,支架置入后再次进行IVUS,直到认为结果最佳为止。在对照组中,timi3血流恢复、预扩张、支架植入和扩张后由医生根据血管造影评估判断。主要终点是通过TIMI血流评分评估的慢流/无血流的发生。次要终点为手术时间、造影剂体积、x线暴露、远端栓塞、院内并发症和1个月并发症。结果:IVUS组11/32例(34.4%)患者和对照组22/64例(34.4%)患者出现了主要终点(慢流/无回流)(p=1.00), IVUS引导下最佳PCI标准患者(5/19[26.3%])和次优PCI组(4/11 [36.4%],p=0.687)相似。次要终点方面,x线时间(对照组中位数为760 s, IVUS组中位数为787 s, p=0.529)、手术时间(中位数为32 min, vs. 34 min, p=0.278)、造影剂体积(165 ml vs. 150 ml, p=0.319)、辐射剂量(剂量面积积5353 cGy)无差异。cm²vs. 4745 cGy.cm²;p = 0.633)。手术并发症的结果相似,尤其是远端栓塞(对照组5/64 [7.8%]vs IVUS组2/32 [6.3%];p=1.000)。慢流/无回流增加了术中室性心律失常的风险(9%对0%,p=0.038),并与较高的肌钙蛋白(6612 ng/L对3972 ng/L, p=0.025)和c反应蛋白(33 ng/L对15.4 ng/L, p=0.032)水平、较低的左心室射血分数(中位数为45%对50%,p=0.006)以及指数住院期间和1个月时更多的并发症相关,主要表现为心力衰竭(21%对4.8%,p=0.029);9.7% vs. 0%, 1个月时p=0.040)。慢血流/无血流患者在1个月时的主要不良心血管事件也更频繁(9.68% vs. 0%; p=0.040)。结论:在STEMI中,ivus引导下的PPCI似乎是安全的,在直接支架置入的情况下不会增加慢流/无回流的发生率,并且在经验丰富的中心进行时不会增加手术时间、造影剂体积和并发症。
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引用次数: 0
Profil et prise en charge des patients hospitalisés pour syndrome coronaire aigu sans sus-décalage de ST à Dakar [达喀尔住院非st段抬高急性冠状动脉综合征的概况和处理]。
IF 0.3 Q4 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-18 DOI: 10.1016/j.ancard.2025.101983
Papa Guirane Ndiaye , Aliou Alassane Ngaide , Abdoulgabar Souleiman , Pape MD Fall , Joseph S. Mingou , Cheikh MBM Diop , Mohamed Gazal , Aymard Abadassi , Cheikh T Ndao , Cherif Mboup , Momar Dioum , Bouna Diack , Mouhamadou B. Ndiaye , Maboury Diao , Abdoul Kane
Non-ST-segment elevation acute coronary syndrome (NSTE-ACS) is the most common form of acute coronary syndrome. Its diagnosis and management have always been subjects of controversy, complicating its treatment, particularly in our setting. This study aimed to evaluate the overall management of patients admitted to the hospital for NSTE-ACS.
Patients and Methods: A multicentre, prospective, descriptive, and analytical study was carried out over 12 months, including all patients admitted for NSTE-ACS in three cardiology departments in Dakar.
Results: Among 2,329 patients seen, 131 were admitted for NSTE-ACS, representing 5.63% of hospitalized patients and 26.3% of all ACS cases. The average âge was 61 years. Most patients were women, with a sex ratio of 1.3. The distribution was as follows: NSTE-ACS with positive troponin (86.7%) and NSTE-ACS with negative troponin (13.3%). The main risk factors included sedentary lifestyle (75.6%), hypertension (64.9%), and diabetes (36.7%). Chest pain was the most common symptom (81.7%). Physical examination was mostly normal (75%). Cardiac ultrasound detected kinetic disorders and left ventricular dysfunction in 45% and 38.6% of patients, respectively. According to the GRACE score, 46.6% of patients were at high risk of ischemia. Coronary angiography was performed in 64.8% of patients, with 82.4% showing coronary artery disease and 46.7% having triple-vessel disease. Coronary angioplasty was carried out in 19.9% of cases. There were eight deaths, resulting in an in-hospital mortality rate of 6.1%.
Conclusion: This study highlights that the diagnosis and treatment of NSTE-ACS remain major challenges in Dakar, with limited access to troponin testing, coronary angiography, and angioplasty.
非st段抬高急性冠状动脉综合征(NSTE-ACS)是最常见的急性冠状动脉综合征。它的诊断和管理一直是争议的主题,使其治疗复杂化,特别是在我们的环境中。本研究旨在评估NSTE-ACS住院患者的整体管理。患者和方法:一项为期12个月的多中心、前瞻性、描述性和分析性研究,包括达喀尔三个心内科收治的所有NSTE-ACS患者。结果:在2329例患者中,131例因NSTE-ACS入院,占住院患者的5.63%,占所有ACS病例的26.3%。平均年龄为61岁。患者以女性为主,性别比为1.3。肌钙蛋白阳性的NSTE-ACS占86.7%,肌钙蛋白阴性的NSTE-ACS占13.3%。主要危险因素包括久坐生活方式(75.6%)、高血压(64.9%)和糖尿病(36.7%)。胸痛是最常见的症状(81.7%)。体格检查基本正常(75%)。心脏超声分别检测到45%和38.6%的患者存在运动障碍和左心室功能障碍。根据GRACE评分,46.6%的患者处于缺血高危状态。64.8%的患者行冠状动脉造影,82.4%的患者有冠状动脉病变,46.7%的患者有三支血管病变。19.9%的病例行冠状动脉成形术。有8人死亡,导致住院死亡率为6.1%。结论:本研究强调,由于肌钙蛋白检测、冠状动脉造影和血管成形术的限制,NSTE-ACS的诊断和治疗仍然是达喀尔的主要挑战。
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引用次数: 0
Editorial board / Ours rédaction 编委会/我们的组织
IF 0.3 Q4 Medicine Pub Date : 2026-02-01 Epub Date: 2026-01-27 DOI: 10.1016/S0003-3928(26)00003-X
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引用次数: 0
Atelier sur les objets connectés et maintien de l’activité physique à domicile : étude descriptive préliminaire chez des patients cardiaques 连接对象与在家保持体育活动研讨会:心脏病患者的初步描述性研究
IF 0.3 Q4 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-17 DOI: 10.1016/j.ancard.2025.101987
Julie Capart , Florent Krim , Aurélien Dassonneville , Éric passavant , Pierre-Henri Bréchat , Tarik Alaoui , Mohamed Ghannem , Pierre-Marie Leprêtre
There is a link between physical activity level and survival of cardiac patient. Less than 50 % of patients would remain physically active two months after a phase II cardiac rehabilitation.
Objective. To descriptively assess the physical activity behavior of cardiac patients exposed to connected devices during rehabilitation, at 2- and 4-month post-discharge.
Method. 18 cardiac patients (52.3 ± 11.0 years) attended a therapeutic workshop on linked objects and social networks during four weeks of supervised cardiac rehabilitation. Then, they freely reported their adapted physical activity information on social networks during two periods of 8 weeks, intercepted by 2 weeks, at home.
Results. Three patients (16.7 %) dropped out during the second 8-week period. 15 patients practiced more different physical activities during the second period compared to the first period (1.2 ± 0.4 vs. 1.8 ± 0.9, p=0.007) with no significant effect on weekly duration (90.9 ± 40.8 vs. 91.8 ± 55.9 min, p=0.290) or frequency of adapted physical activities (2.6 ± 1.8 vs. 2.6 ± 1.1, p=0.183). Walking sessions (2.3 ± 0.9 vs. 2.0 ± 1.0, p=0.033) and distance (8.7 ± 3.7 vs. 7.8 ± 3.9 km, p = 0.002) decreased between both periods, the number of bicycling sessions increased (0.0 ± 0.0 vs. 9.0 ± 3.0).
Conclusion. Education on connected health devices, combined with remote professional support, appears to help maintain physical activity in post-discharge cardiac patients. These preliminary findings highlight the need for further studies to assess the intervention’s impact on cardiovascular rehabilitation.
心脏病患者的生存与身体活动水平有一定的关系。不到50%的患者在二期心脏康复后两个月仍能保持体力活动。目的:描述性地评估在康复期间暴露于连接设备的心脏病患者在出院后2个月和4个月的身体活动行为。18例心脏病患者(52.3±11.0岁)在为期四周的心脏康复监督下参加了一个关于连接对象和社会网络的治疗讲习班。然后,他们在两个8周的时间里自由地在社交网络上报告他们适应的体育活动信息,在家里每隔两周进行拦截。3名患者(16.7%)在第二个8周期间退出。15例患者在第二阶段比第一阶段进行了更多不同的体育活动(1.2±0.4比1.8±0.9,p=0.007),但对每周持续时间(90.9±40.8比91.8±55.9分钟,p=0.290)或适应体育活动的频率(2.6±1.8比2.6±1.1,p=0.183)没有显著影响。步行次数(2.3±0.9 vs. 2.0±1.0,p=0.033)和距离(8.7±3.7 vs. 7.8±3.9 km, p= 0.002)减少,骑自行车次数(0.0±0.0 vs. 9.0±3.0)增加。有关联网医疗设备的教育,加上远程专业支持,似乎有助于出院后心脏病患者保持身体活动。这些初步发现强调需要进一步研究来评估干预对心血管康复的影响。
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引用次数: 0
Sommaire 摘要
IF 0.3 Q4 Medicine Pub Date : 2026-02-01 Epub Date: 2026-01-27 DOI: 10.1016/S0003-3928(26)00005-3
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引用次数: 0
Supervised Exercise-Based Cardiac Rehabilitation Program for Lower-Limb Peripheral Arterial Disease : Effect on Walking Capacity, Hemodynamic Parameters, Anxiety, Depression, and Quality of Life in Cameroon [喀麦隆强迫性下肢动脉疾病心血管康复监督锻炼计划:对改善步行、血液动力学参数、焦虑、抑郁和生活质量的影响]。
IF 0.3 Q4 Medicine Pub Date : 2026-02-01 Epub Date: 2025-12-17 DOI: 10.1016/j.ancard.2025.101984
Valérie Ndobo , Augustine Telouwe Ndava , Hermann Tsague , Amalia Owona , Nafissatou Nsangou , Carole Ngo Yon , Zéphanie Kobe , Marcus Fokou , Sépolin Lowe , Alain Patrick Menanga , Liliane Mfeukeu Kuate

Background

Lower-limb peripheral arterial disease (PAD) is underdiagnosed despite its high prevalence among patients with cardiovascular risk factors. Given the well-documented benefits of physical activity on physical and mental capacities, we aimed to assess the effects of a supervised exercise-based cardiac rehabilitation program for PAD on walking performance, hemodynamic parameters, anxiety, depression, and quality of life.

Methods

We conducted a prospective quasi-experimental before–after study at Yaoundé General Hospital from November 2024 to June 2025 among adult patients, with or without prior revascularization (bypass, stent, or angioplasty), at Leriche and Fontaine stages II/III, recruited consecutively in clinic. The intervention comprised 20 sessions over 7 weeks combining therapeutic education, walking-centered endurance training (45–60 min) and muscle strengthening (15–30 min), with psychological support. Maximal walking distance, pain-free walking distance, hemodynamic parameters, anxiety/depression, and quality of life were assessed pre- and post-intervention.

Results

We included 13 patients (mean age 57 ± 10 years), predominantly male. Hypertension was present in 67% and diabetes in 31%. After 7 weeks, walking performance improved markedly: pain-free walking time increased from 3.70 ± 1.57 to 6.30 ± 1.95 min (p = 0.006) and pain-free distance from 220.30 ± 76.21 to 350.10 ± 89.39 m (p = 0.002); maximal walking time from 8.00 ± 4.08 to 14.00 ± 5.06 min (p = 0.003) and maximal distance from 446.38 ± 258.75 to 754.50 ± 331.09 m (p = 0.002). Hemodynamically, systolic blood pressure decreased significantly in both arms (≈154–153 to ≈134 mmHg) and diastolic blood pressure decreased in the right arm (p = 0.039); BMI also declined (28.63 to 27.01 kg/m²; p < 0.001). Anxiety scores decreased from 8.46 ± 2.63 to 5.38 ± 1.45 (p < 0.001), while the reduction in depression scores (7.31 ± 2.78 to 4.69 ± 2.06) did not reach significance (p = 0.16). Finally, optimal quality of life was achieved in 100% of patients (p < 0.001).

Conclusion

The rehabilitation program improved walking capacity, systolic blood pressure, weight/BMI, and anxiety, with overall better quality of life. However, evidence remains limited (pre–post without control, single center, small sample, short follow-up), underscoring the need for multicenter randomized controlled trials.
背景:下肢外周动脉疾病(PAD)在具有心血管危险因素的患者中发病率很高,但仍未得到充分诊断。考虑到体力活动对身心能力的益处,我们旨在评估PAD患者在监督下的基于运动的心脏康复计划对行走性能、血流动力学参数、焦虑、抑郁和生活质量的影响。方法:我们于2024年11月至2025年6月在雅温得总医院进行了一项前瞻性准实验前后研究,在Leriche和Fontaine II/III期连续招募有或未有过血管重建术(搭桥、支架或血管成形术)的成年患者。干预包括20个疗程,为期7周,结合治疗性教育,以步行为中心的耐力训练(45-60分钟)和肌肉强化(15-30分钟),以及心理支持。干预前后分别评估最大步行距离、无痛步行距离、血流动力学参数、焦虑/抑郁和生活质量。结果:我们纳入13例患者(平均年龄57±10岁),以男性为主。67%的人患有高血压,31%的人患有糖尿病。7周后,患者步行能力明显改善:无痛步行时间从3.70±1.57 min增加到6.30±1.95 min (p = 0.006),无痛步行距离从220.30±76.21 m增加到350.10±89.39 m (p = 0.002);最大步行时间从8.00±4.08到14.00±5.06 min (p = 0.003),最大步行距离从446.38±258.75到754.50±331.09 m (p = 0.002)。血流动力学方面,两臂收缩压明显下降(≈154-153 ~≈134 mmHg),右臂舒张压下降(p = 0.039);BMI也有所下降(28.63 ~ 27.01 kg/m²,p < 0.001)。焦虑评分由8.46±2.63分降至5.38±1.45分(p < 0.001),抑郁评分由7.31±2.78分降至4.69±2.06分,差异无统计学意义(p = 0.16)。最终,100%的患者获得了最佳的生活质量(p < 0.001)。结论:康复方案改善了行走能力、收缩压、体重/BMI和焦虑,总体生活质量更好。然而,证据仍然有限(前后无对照,单中心,小样本,短随访),强调需要进行多中心随机对照试验。
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引用次数: 0
Effect of neighborhood socioeconomic status on smoking behavior in the CARVAR 92 cohort study [社区的社会经济地位对吸烟的影响,CARVAR 92队列研究]。
IF 0.3 Q4 Medicine Pub Date : 2025-12-01 Epub Date: 2025-10-27 DOI: 10.1016/j.ancard.2025.101956
Hélène Hergault , Diane Mansencal , Alain Beauchet , Loïc Josseran , Thomas Lévesque , Pierre Boisson de Chazournes , Orianne Weizman , Abdallah Fayssoil , Marion Pépin , Christophe Rodon , Olivier Dubourg , Nicolas Mansencal , Marie Hauguel-Moreau

Background

Tobacco is one of the strongest modifiable cardiovascular risk factors, contributing significantly to cardiovascular morbidity and mortality. We aimed to assess the impact of neighborhood deprivation on smoking status and smoking intensity.

Methods

Between 2010 and 2018, we studied smoking status and intensity in 7821 participants residing in Paris west suburb included in the CARVAR 92 prospective cohort. Moderate or high-intensity smoking was defined as consuming more than 10 cigarettes a day Three neighborhood clusters of decreasing socioeconomic status (SES) were obtained after a hierarchical clustering analysis applied to eighteen measures of SES. We used multivariate logistic models to estimate the association between neighborhood SES (NSES) clusters and smoking status and intensity.

Results

Of the 7821 participants (mean age: 55.1 ± 9.7 years, 56.8% women), 16.4% were smokers (N=1284): 18.8% of males (N=635) and 14.6% of females (N=649, p < 0.0001). The overall proportions of smokers were similar in the three groups: 16.2%, 15.6% and 18.2% in high, medium, and low NSES, respectively (p for trend=0.171). We observed a higher proportion of males among smokers in each NSES: 17.6%, 20.1% and 20.2% (p for trend=0.03) in high, medium and low NSES, respectively, versus 15.2%, 12.3%, and 15.9% (p for trend=0.801) among women. Lowest SES neighborhood was independently associated with moderate or high-intensity smoking in the whole population (OR=1.66; 95% CI 1.27-2.04, p = 0.02), in men (OR 1.59, 95% CI 1.06-2.40), and in women (OR 1.79, 95% CI 1.17-2.72).

Conclusion

In conclusion, the intensity of smoking is greatly influenced by neighborhood SES. We found an association between lowest SES neighborhoods and moderate or high-intensity smoking, regardless of sex, with a slightly more pronounced effect among women.
背景:烟草是最强的可改变的心血管危险因素之一,对心血管发病率和死亡率有显著影响。我们的目的是评估邻里剥夺对吸烟状况和吸烟强度的影响。方法:2010年至2018年间,我们研究了CARVAR 92前瞻性队列中居住在巴黎西郊的7821名参与者的吸烟状况和强度。中等或高强度吸烟被定义为每天消费超过10支香烟,在对18项社会经济地位(SES)测量进行分层聚类分析后,得到了三个社会经济地位(SES)下降的邻里聚类。我们使用多元逻辑模型来估计社区SES (NSES)集群与吸烟状况和强度之间的关系。结果:在7821名参与者中(平均年龄:55.1±9.7岁,56.8%为女性),16.4%为吸烟者(N=1284),其中男性占18.8% (N=635),女性占14.6% (N=649, p < 0.0001)。三组吸烟者的总体比例相似:高、中、低NSES分别为16.2%、15.6%和18.2%(趋势p =0.171)。我们观察到,在每个NSES中,男性吸烟者的比例更高:在高、中、低NSES中,分别为17.6%、20.1%和20.2% (p为趋势=0.03),而在女性中,分别为15.2%、12.3%和15.9% (p为趋势=0.801)。社会经济地位最低的社区与整个人群中中度或高强度吸烟独立相关(or =1.66; 95% CI 1.27-2.04, p = 0.02),男性(or 1.59, 95% CI 1.06-2.40),女性(or 1.79, 95% CI 1.17-2.72)。结论:综上所述,吸烟强度受社区经济地位的影响较大。我们发现,社会经济地位最低的社区与中等或高强度吸烟之间存在关联,无论性别如何,对女性的影响略显明显。
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引用次数: 0
Contribution de la téléexpertise échocardiographique à la prise en charge des cardiopathies congénitales : expérience du Burkina Faso 超声心动图远程专业知识对先天性心脏病管理的贡献:布基纳法索的经验
IF 0.3 Q4 Medicine Pub Date : 2025-12-01 Epub Date: 2025-07-06 DOI: 10.1016/j.ancard.2025.101902
Relwendé Aristide Yameogo , Lydie Kologo , Adama Sawadogo , Yibar Kambire , Hippolyte N Some , Lassina Konate , Safiatou Tiemtore , Lynda Compaore , Patrice Zabsonre , Nicolas Meda , Cheick Oumar Bagayoko

Introduction

Medical imaging is a major focus of information and communication technologies (ICTs) as it generates the largest volume of digital data. L’utilisation de la télémédecine est une opportunité qui permettra d’améliorer la prise en charge des patients. The objective of our study was to assess the contribution of echocardiographic tele-expertise in the management of heart diseases in Burkina Faso.

Methods

This was a prospective cohort study conducted from February 16, 2021, to April 6, 2023, in the thoracic and cardiovascular surgery department of the Tengandogo University Hospital. Patients included were those who had undergone echocardiographic tele-expertise and cardiac surgery in Burkina Faso. We compared the concordance between the diagnoses of the requesting cardiologist and the consulting cardiologist on one hand, and between the consulting physician and intraoperative diagnoses on the other hand. Diagnostic concordance rates were used for comparisons.

Results

A total of 384 patients benefited from tele-expertise, and 123 underwent surgery in Burkina Faso. Of these, 111 patients were included in the study. The cohort exhibited a female predominance (59.5%), with a mean age of 9.3 years. Congenital heart diseases accounted for 82.9% of cases, dominated by patent ductus arteriosus (40.2%). Acquired heart diseases represented 17.1%, mainly mitral stenosis (52.6%). The diagnostic concordance rate was 94.5% between the requesting and consulting cardiologists and 100% between the consulting cardiologist and intraoperative findings. The mortality rate was 3.6%.

Conclusion

Echocardiographic tele-expertise is a reliable and safe practice for both patient management and continuous training of cardiologists. Deploying this practice in regional hospital with cardiologists can improve healthcare delivery.
医学成像是信息和通信技术(ict)的一个主要焦点,因为它产生的数字数据量最大。利用这些数据为患者提供了一个机会,让他们能够更好地了解这些数据。我们研究的目的是评估超声心动图远程专业知识在布基纳法索心脏病管理中的贡献。方法:该前瞻性队列研究于2021年2月16日至2023年4月6日在Tengandogo大学医院胸外科和心血管外科进行。包括那些在布基纳法索接受过超声心动图远程专家和心脏手术的患者。我们比较了求诊医师与会诊医师诊断的一致性,以及会诊医师与术中诊断的一致性。诊断符合率用于比较。结果布基纳法索共有384例患者受益于远程专业知识,123例患者接受了手术。其中,111名患者被纳入研究。该队列以女性为主(59.5%),平均年龄9.3岁。先天性心脏病占82.9%,以动脉导管未闭为主(40.2%)。获得性心脏病占17.1%,以二尖瓣狭窄为主(52.6%)。求诊与会诊心脏科医生的诊断符合率为94.5%,会诊心脏科医生的诊断符合率为100%。死亡率为3.6%。结论超声心动图远程诊断是一种可靠、安全的方法,可用于患者管理和心脏科医师的持续培训。在有心脏病专家的地区医院部署这种做法可以改善医疗保健服务。
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Annales de cardiologie et d'angeiologie
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