Annales de cardiologie et d'angeiologie最新文献_第4页

Coronarographie et angioplastie coronaire ambulatoire avant et après la pandémie de COVID-19 : expérience du centre hospitalier de Versailles [COVID-19大流行前后的门诊冠状动脉造影术和经皮冠状动脉介入治疗：凡尔赛医院中心的经验]。

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2024-10-01 DOI: 10.1016/j.ancard.2024.101809

Taha Ettachfini , Géraldine Gibault-Genty , Elodie Blicq , Guillaume Godeau , Cheick-Hamala Fofana , Grégoire Lefèvre , Badreddine Ajlani , Bernard Livarek

Background

Same day discharge (SDD) diagnostic coronary angiography and percutaneous coronary interventions (PCIs) are increasingly performed, and indications extend to more complex procedures and more fragile patients. We report the evolution of SDD interventional cardiology activity in our centre since 2016, particularly before and after the COVID-19 pandemic. Secondarily, we analysed the feasibility and safety of SDD PCI.

Materials and methods

We analysed the number and percentage of SDD coronary angiograms and PCIs (elective or ad hoc), during 4 periods of 11 months each, from September 2016 to July 2024. Periods 1 and 2 took place before COVID-19, periods 3 and 4 after. We also compared the rate of complications and conversion to hospitalisation between periods 1-2 and 4.

Results

A total of 9587 procedures were analysed, including 1558 SDD procedures. The total number of SDD interventional cardiology procedures increased progressively over the 4 periods, from 146 SDD procedures (7.5%) in 2016–2017 to 620 (27.2%) in 2023–2024. This increase included both diagnostic coronary angiograms (respectively: 10.9%; 12.2%; 33.6% then 28.9%) and PCIs (respectively: 0.9%; 5.6%; 16.1% then 24.4%). In the immediate post-COVID-19 period, a significant increase, uncorrelated with the natural progression, was observed for SDD diagnostic coronary angiography and ad-hoc PCI. There were no deaths or serious complications, the rate of minor complications (1.1%) and conversion to conventional hospitalisation (4.5%) were low.

Conclusion

Provided a careful patient selection and rigorous organisation, SDD coronary angiography and PCI can safely be performed. The increase in the SDD interventional procedures, favoured by organisational (COVID-19) or economic constraints, need to be amplified.

背景：当日出院（SDD）诊断性冠状动脉造影术和经皮冠状动脉介入治疗（PCI）的实施越来越多，适应症也扩展到更复杂的手术和更脆弱的患者。我们报告了本中心自 2016 年以来 SDD 介入心脏病学活动的演变情况，尤其是 COVID-19 大流行前后的情况。其次，我们分析了 SDD PCI 的可行性和安全性：我们分析了从 2016 年 9 月到 2024 年 7 月的 4 个时期内 SDD 冠状动脉造影和 PCI（选择性或临时性）的数量和百分比，每个时期为 11 个月。第 1 和第 2 阶段发生在 COVID-19 之前，第 3 和第 4 阶段发生在 COVID-19 之后。我们还比较了第1-2期和第4期的并发症发生率和转住院率：共分析了 9587 例手术，其中包括 1558 例 SDD 手术。SDD 介入心脏病学手术总数在 4 个时期内逐渐增加，从 2016-2017 年的 146 例 SDD 手术（7.5%）增加到 2023-2024 年的 620 例（27.2%）。这一增长包括诊断性冠状动脉造影（分别为：10.9%；12.2%；33.6%，随后为 28.9%）和 PCI（分别为：0.9%；5.6%；16.1%，随后为 24.4%）。COVID-19之后的一段时间内，SDD诊断性冠状动脉造影和临时PCI的比例显著增加，与自然进展无关。没有出现死亡或严重并发症，轻微并发症（1.1%）和转为常规住院治疗（4.5%）的比例也很低：结论：只要精心挑选患者并严格组织，SDD冠状动脉造影和PCI是可以安全进行的。受组织（COVID-19）或经济限制因素的影响，SDD介入手术的数量还需进一步增加。

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引用次数: 0

Les patients hospitalisés en réanimation pour un syndrome coronarien aigu de 2012 à 2021 : une étude rétrospective monocentrique 2012 年至 2021 年因急性冠状动脉综合征在重症监护室住院的患者：一项单中心回顾性研究

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2024-09-26 DOI: 10.1016/j.ancard.2024.101799

A. Yesiloz , S. Sanchez , H. Mesrar , J. Chrusciel , M. Dacunka , F. Raoul , G. Simon , D. Metz , L. Chapoutot

Introduction

Acute Coronary Syndrome (ACS) are one of the main causes of mortality in France. Patients presenting with ACS are typically hospitalized in a specialized cardiology ward. The main objective of this study was to describe, characterize and evaluate the outcome of patients hospitalized for ACS in a generalist intensive care unit (rather than a cardiac care unit).

Methods

This was a retrospective study. Our population consisted of ACS patients admitted to an intensive care unit in a hospital center (Centre Hospitalier de Troyes) between 2012 and 2021. All patients admitted for ACS to the intensive care unit and who underwent coronary angiography were included.

Results

In 10 years, 104 patients, or 3.8% of ACS patients who underwent coronary angiography were admitted to intensive care. The majority were admitted after recovered cardiac arrest (72%) and were in cardiogenic shock (68%), accounting for a high in-hospital mortality (45.2%). In-hospital mortality was 45.2%. In multivariate analysis, the GRACE score was associated with in-hospital mortality (OR for each additional point = 1.024, 95% confidence interval 1.006–1.045, p = 0.01). Among the survivors, 88% had good neurological function when leaving the hospital.

Discussion

Mortality of ACS patients in intensive care was close to 50%. However, the neurological prognosis of the surviving patients was good. This population is rarely mentioned in the literature, and deserves to be evaluated by multicenter, prospective registries, with a view to improving management and prognosis.

导言急性冠状动脉综合征（ACS）是法国人死亡的主要原因之一。急性冠状动脉综合征患者通常在心脏病专科病房住院治疗。本研究的主要目的是描述、描述和评估在普通重症监护病房（而非心脏监护病房）住院的急性冠状动脉综合征患者的预后。研究对象包括2012年至2021年间在一家医院中心（特鲁瓦中心医院）重症监护室住院的ACS患者。结果 10年间，有104名患者（占接受冠状动脉造影术的ACS患者的3.8%）入住重症监护室。大多数患者是在心脏骤停（72%）和心源性休克（68%）后入院的，因此院内死亡率较高（45.2%）。院内死亡率为 45.2%。在多变量分析中，GRACE评分与院内死亡率相关（每增加一分的OR=1.024，95%置信区间为1.006-1.045，P=0.01）。讨论重症监护中的 ACS 患者死亡率接近 50%。然而，存活患者的神经系统预后良好。这一人群在文献中很少提及，值得通过多中心、前瞻性登记进行评估，以改善管理和预后。

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引用次数: 0

L'angioplastie du Tronc commun gauche en ambulatoire : Comment s'y prendre ? 左侧总干门诊血管成形术：如何进行？

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2024-09-23 DOI: 10.1016/j.ancard.2024.101797

Nicolas Amabile , Philippe Garot

The steady development of same-day discharge (SDD) PCIs in recent years means that, by 2024, we will be able to tackle increasingly complex lesions, including those of the left main artery. This strategy is supported by the literature, but requires an appropriate patient selection (based on medical and social criteria) and precise assessment of the anatomical complexity of the lesion and the foreseeable risks of the PCI. Strict adherence to pre-established service protocols for patient preparation and follow-up, as well as the establishment of clinical and paraclinical criteria for discharge to a conventional hospital unit, are essential to the success of an SDD PCI program.

近年来，当天出院（SDD）PCI 的稳步发展意味着，到 2024 年，我们将能够处理越来越复杂的病变，包括左主干动脉的病变。这一策略得到了文献的支持，但需要对患者进行适当的选择（基于医疗和社会标准），并对病变的解剖复杂性和 PCI 的可预见风险进行精确评估。严格遵守预先制定的患者准备和随访服务协议，以及制定出院到常规医院病房的临床和辅助临床标准，是 SDD PCI 项目取得成功的关键。

引用次数: 0

Performance du score de probabilité à 4 niveaux 4PEPS pour le diagnostic de l'embolie pulmonaire dans une population d'Afrique subsaharienne : données du Registre des Embolies Pulmonaires du Centre Hospitalier Universitaire de Bogodogo, Burkina Faso 撒哈拉以南非洲人群肺栓塞诊断4级概率评分4PEPS的性能：布基纳法索博戈多戈大学医院肺栓塞登记处的数据

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2024-09-23 DOI: 10.1016/j.ancard.2024.101798

Taryètba André Arthur Seghda , Temoua Dan Naibé , Yirtièrou Eric Dabiré , Martin Wendlassida Nacanabo , Sandrine Damoué Seghda , Djième Claudine Dah , Abouga Loya Mireille , Nobila Valentin Yaméogo , Georges R.C Millogo , Anna Tall Thiam , Laurence Flork , André K Samadoulougou , Patrice Zabsonré

Objective

To evaluate the performance of the 4PEPS score in the diagnosis of pulmonary embolism at the University Hospital of Bogodogo from January 1, 2021 to July 31, 2023.

Methodology

This was a cross-sectional descriptive and analytical diagnostic study, running from January 1, 2021 to July 31, 2023. It took place in the infectious and tropical diseases departments, including a pneumology unit and a cardiology unit, of the Bogodogo University Hospital. Patients of both sexes with suspected pulmonary embolism who had undergone CT scan were included. The 4PEPS score was calculated and dichotomized into probable and improbable. It thus constituted the diagnostic test. CT scan was the gold standard. The accuracy of the diagnostic test was judged by the area under the ROC curve. An area under the curve between 0.70 and 1 would mean that the score was moderately informative to perfect.

Results

Our study included 472 patients with suspected pulmonary embolism out of a total population of 1228 patients. Hospital prevalence was 21.7%. The mean age of patients was 54.3 years. Females accounted for 52.1% of cases, with a sex ratio of 0.93. The prevalence of pulmonary embolism in the different probability levels of the 4PEPS score was 13.3% for the very low level, 11.7% for the low level, 84.6% for the intermediate level and 93.3% for the high level. Sensitivity and specificity were 92.1% and 86.82% respectively. The positive and negative predictive values were 90.1% and 89.4% respectively. The area under the ROC curve was 0.91.

Conclusion

In our study, the 4PEPS score showed good negative and positive predictive values. The use of this score will enable practitioners faced with diagnostic difficulties to make therapeutic decisions, reducing inappropriate prescriptions for thoracic angioscan.

目的评估 2021 年 1 月 1 日至 2023 年 7 月 31 日期间博戈多戈大学医院在诊断肺栓塞时使用 4PEPS 评分的效果。方法这是一项横断面描述性和分析性诊断研究，研究时间为 2021 年 1 月 1 日至 2023 年 7 月 31 日。研究在博戈多戈大学医院的传染病和热带病科进行，其中包括肺病科和心脏病科。研究对象包括接受过 CT 扫描的疑似肺栓塞男女患者。计算出 4PEPS 评分，并将其分为可能和不可能两种。这就是诊断测试。CT 扫描是金标准。诊断测试的准确性由 ROC 曲线下的面积来判断。曲线下的面积在 0.70 和 1 之间，表示该评分具有中等至完美的信息量。医院发病率为 21.7%。患者的平均年龄为 54.3 岁。女性占 52.1%，性别比为 0.93。在 4PEPS 评分的不同概率级别中，肺栓塞的发病率分别为：极低级别 13.3%，低级别 11.7%，中级级别 84.6%，高级别的 93.3%。敏感性和特异性分别为 92.1%和 86.82%。阳性预测值为 90.1%，阴性预测值为 89.4%。结论在我们的研究中，4PEPS 评分显示出良好的阴性和阳性预测值。使用该评分可使面临诊断困难的从业人员做出治疗决定，减少胸腔血管扫描的不适当处方。

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引用次数: 0

Évaluation préliminaire de l'intérêt d'une cellule d'optimisation thérapeutique sur la titration des traitements de l'insuffisance cardiaque à fraction d’éjection ventriculaire gauche réduite et la qualité de vie des patients 初步评估治疗优化单元对左心室射血分数降低型心力衰竭滴定治疗和患者生活质量的益处

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2024-09-23 DOI: 10.1016/j.ancard.2024.101802

Hanane Aissaoui, Stéphane Pichard, Violaine Gaulupeau, Elodie Gautron, Thibault Wajchert, Franck Assayag, Floriane Gilles, Paul Duvillier, Jean-Louis Georges, Géraldine Gibault-Genty

Introduction

A multidisciplinary therapeutic optimization unit (COT) was created in January 2023 at Versailles Hospital, aimed at therapeutic optimisation of patients with chronic heart failure with reduced left ventricular ejection fraction. The objective of the study was to assess the impact of the first year of COT activity on the sequential implementation and titration of heart failure treatments, the clinical evolution, and improvement of patients’ quality of life.

Methods

This prospective study included consecutive patients treated by the COT after hospitalisation for acute heart failure, from January to December 2023. Clinical, biological, titration, and tolerance data were analysed. Quality of life was assessed at baseline and at the end of the follow-up by COT, using standardized SF-12 and EQ-5D questionnaires.

Results

We included 90 patients (men 73%, mean age 67 years). The mean left ventricular ejection fraction was 34 ± 10 %. At final visit (median number of visits 4 ; median follow-up duration 156 days), 76.7% of patients achieved optimisation with respect to maximum individually tolerated doses, but only 13.3% with respect to theoretical maximum doses for the four therapeutic classes. At 1-year follow up, total mortality was 4.4% (4/90), and 9 patients (10%) were rehospitalised unplanned for acute heart failure. COT monitoring was associated with significant improvement in NYHA class, left ventricular ejection fraction, and SF-12 and EQ-5D-5L quality of life scores.

Conclusion

Although titration of heart failure treatments remained suboptimal, significant improvement was observed for NYHA class, left ventricular ejection fraction, and patient quality of life parameters.

简介：2023年1月，凡尔赛医院成立了一个多学科治疗优化小组（COT），旨在对左心室射血分数降低的慢性心力衰竭患者进行治疗优化。这项前瞻性研究纳入了2023年1月至12月期间因急性心力衰竭住院后接受COT治疗的连续患者。研究分析了临床、生物、滴定和耐受性数据。结果我们纳入了90名患者（男性占73%，平均年龄67岁）。平均左心室射血分数为 34 ± 10%。在最后一次随访时（随访次数中位数为 4 次；随访时间中位数为 156 天），76.7% 的患者达到了个人可耐受的最大剂量，但只有 13.3% 的患者达到了四类疗法的理论最大剂量。在为期一年的随访中，总死亡率为 4.4%（4/90），9 名患者（10%）因急性心力衰竭意外再次住院。COT监测与NYHA分级、左心室射血分数以及SF-12和EQ-5D-5L生活质量评分的显著改善相关。

{"title":"Évaluation préliminaire de l'intérêt d'une cellule d'optimisation thérapeutique sur la titration des traitements de l'insuffisance cardiaque à fraction d’éjection ventriculaire gauche réduite et la qualité de vie des patients","authors":"Hanane Aissaoui, Stéphane Pichard, Violaine Gaulupeau, Elodie Gautron, Thibault Wajchert, Franck Assayag, Floriane Gilles, Paul Duvillier, Jean-Louis Georges, Géraldine Gibault-Genty","doi":"10.1016/j.ancard.2024.101802","DOIUrl":"10.1016/j.ancard.2024.101802","url":null,"abstract":"<div><h3>Introduction</h3><div>A multidisciplinary therapeutic optimization unit (COT) was created in January 2023 at Versailles Hospital, aimed at therapeutic optimisation of patients with chronic heart failure with reduced left ventricular ejection fraction. The objective of the study was to assess the impact of the first year of COT activity on the sequential implementation and titration of heart failure treatments, the clinical evolution, and improvement of patients’ quality of life.</div></div><div><h3>Methods</h3><div>This prospective study included consecutive patients treated by the COT after hospitalisation for acute heart failure, from January to December 2023. Clinical, biological, titration, and tolerance data were analysed. Quality of life was assessed at baseline and at the end of the follow-up by COT, using standardized SF-12 and EQ-5D questionnaires.</div></div><div><h3>Results</h3><div>We included 90 patients (men 73%, mean age 67 years). The mean left ventricular ejection fraction was 34 ± 10 %. At final visit (median number of visits 4 ; median follow-up duration 156 days), 76.7% of patients achieved optimisation with respect to maximum individually tolerated doses, but only 13.3% with respect to theoretical maximum doses for the four therapeutic classes. At 1-year follow up, total mortality was 4.4% (4/90), and 9 patients (10%) were rehospitalised unplanned for acute heart failure. COT monitoring was associated with significant improvement in NYHA class, left ventricular ejection fraction, and SF-12 and EQ-5D-5L quality of life scores.</div></div><div><h3>Conclusion</h3><div>Although titration of heart failure treatments remained suboptimal, significant improvement was observed for NYHA class, left ventricular ejection fraction, and patient quality of life parameters.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"73 5","pages":"Article 101802"},"PeriodicalIF":0.3,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endocardite de Libman-Sachs et accident vasculaire cérébral ischémique : à propos d'un cas 利伯曼-萨克斯心内膜炎与缺血性中风：病例报告

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2024-09-23 DOI: 10.1016/j.ancard.2024.101801

M.C. Hoara , B. Simorre , M.R. Belabed , P. Berdague , F. Georger

Libman-Sacks endocarditis is a rare cardiac manifestation of anti-phospholipid syndromes, in which non-infectious thrombotic vegetations are found on the heart valves. Most patients are asymptomatic whereas the risk of thromboembolism is considerable. Diagnostic work-up is based on questioning and clinical examination data looking for extracardiac signs, biological data and also on imaging, and, above all, echocardiography.

We report the case of a 47-year-old female patient with no known history who is admitted to hospital with paresthesia of the right hemi-body associated with dysarthria. Cerebral CT scan confirms a paraventricular ischemic stroke. The etiological work-up for stroke is negative except the transesophageal echocardiogram which reveals mitral valve vegetations. Further investigations lead to the diagnosis of Libman-Sacks endocarditis. Treatment with Coumadin is started, with a target INR of between 2 and 3, as recommended. The clinical course was favourable, with stable lesions on transoesophageal echocardiography carried out later.

利伯曼-萨克斯（Libman-Sacks）心内膜炎是抗磷脂综合征的一种罕见心脏表现，在这种疾病中，心脏瓣膜上会出现非感染性血栓植被。大多数患者没有症状，但血栓栓塞的风险却相当大。我们报告了一例 47 岁女性患者的病例，该患者无任何病史，因右半身麻痹并伴有构音障碍而入院。脑 CT 扫描证实为脑室旁缺血性中风。除了经食道超声心动图发现二尖瓣植被外，中风的病因检查结果均为阴性。进一步检查后诊断为利伯曼-萨克斯心内膜炎。根据建议，开始使用 Coumadin 治疗，目标 INR 值为 2 至 3。临床疗效良好，随后进行的经食道超声心动图检查显示病变稳定。

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引用次数: 0

TAVIGER : Intérêt d’une expertise coordonnée gériatrique et cardiologique dans le bilan d’éligibilité des patients âgés à un remplacement valvulaire aortique par voie percutanée TAVIGER：在评估老年患者是否符合经皮主动脉瓣置换术的条件时，协调老年病学和心脏病学专业知识的益处。

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2024-09-23 DOI: 10.1016/j.ancard.2024.101800

A. Manier , C. Seunes , D. Broucqsault , M. Verhaeghe , H. Behal , V. Petit , G. Hannebicque

Background

Transcatheter aortic valve implantation (TAVI) is the gold standard treatment for aortic stenosis in the elderly. Pre-identification of patients likely to benefit from this procedure remains crucial. A standardised geriatric assessment is used to identify the major geriatric syndromes likely to influence postoperative outcomes.

Objective

To identify factors associated with lack of TAVI management and to compare one-year survival in TAVI vs. non-TAVI patients.

Methods

Retrospective study, between 2016 and 2020, at the Arras hospital. Patients aged 70 years and older with symptomatic severe aortic stenosis who had undergone geriatric assessment were included.

Results

One hundred and ninety-two (192) patients, mean age 82.3 years. The 1-year mortality rate was 18% in the TAVI group and 44% in the non-TAVI group (p < 0.001).

Parameters associated with no TAVI were Euroscore (ESL) 1 (19.6 ± 10.9 vs. 23.2 ± 13.5, p = 0.020), malnutrition (14% vs. 35%, p = 0.004), walking speed < 0.8 m/s (39% vs. 75%, p = 0.001), Activities of Daily Life (ADL) score (5.4 ± 1 vs. 4.2 ± 1. 6, p < 0. 001) and Instrumental Activities of Daily Life (IADL) score (2.6 ± 1.2 vs. 1.8 ± 1.4, p = 0.002), Mini Geriatric Depression Scale (mini GDS) ≥ 1 (16% vs. 38%, p = 0.045), Mini Mental State Examination (MMSE) score (25.1 ± 3.5 vs. 21.6 ± 4.3 < 0.001).

Conclusions

Geriatric syndromes are important determinants of TAVI candidacy. Cardiological surgical risk scores are not effective in discriminating between patients. Coordinated assessment may optimise selection. Therefore, geriatric assessment should be systematically performed as part of the pre-TAVI evaluation.

背景导管主动脉瓣植入术（TAVI）是治疗老年人主动脉瓣狭窄的金标准疗法。预先识别可能从该手术中获益的患者仍然至关重要。方法2016年至2020年间在阿拉斯医院进行的回顾性研究。结果 192（192）名患者，平均年龄 82.3 岁。TAVI 组 1 年死亡率为 18%，非 TAVI 组 1 年死亡率为 44%（P = 0.001）。2 ± 13.5，p = 0.020）、营养不良（14% vs. 35%，p = 0.004）、行走速度 < 0.8 m/s（39% vs. 75%，p = 0.001）、日常生活活动（ADL）评分（5.4 ± 1 vs. 4.2 ± 1.6, p < 0. 001）和器质性日常生活活动（IADL）评分（2.6 ± 1.2 vs. 1.8 ± 1.4, p = 0.002），迷你老年抑郁量表（mini GDS）≥ 1（16% vs. 38%，p = 0.025）。结论老年综合征是 TAVI 候选资格的重要决定因素。心脏病手术风险评分不能有效区分患者。协调评估可优化选择。因此，作为 TAVI 术前评估的一部分，应系统地进行老年病学评估。

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引用次数: 0

Myocardite aiguë secondaire à une maladie de Basedow : à propos d'un cas 继发于巴塞杜氏病的急性心肌炎：病例报告

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2024-09-21 DOI: 10.1016/j.ancard.2024.101808

Laura Eouzan-Dahan , Alexandre Neyret , Thibaut Wajchert , Virginie Desforges-Bullet , Géraldine Gibault-Genty , Jean-Louis Georges

The relationships between the thyroid and the heart are close and complex. In rare cases, hyperthyroidism induced by Graves' disease can be complicated by an acute myocarditis, which may be life-threatening. We report the case of a 41-year-old woman with Graves' disease not controlled by antithyroid drugs, hospitalized for odynophagia, palpitations due to atrial fibrillation, diffuse ST elevation on ECG and an increase in cardiac troponin. Coronary angiography was normal, cardiac MRI confirmed acute myocarditis. The evolution was favorable after a phase marked by supraventricular and ventricular rhythm disorders. The diagnostic and therapeutic challenge of this association are discussed, with a review of the literature.

甲状腺和心脏之间的关系既密切又复杂。在极少数情况下，由巴塞杜氏病诱发的甲状腺功能亢进可能并发急性心肌炎，从而危及生命。我们报告了一例41岁的女性患者，她患有巴塞杜氏病，抗甲状腺药物无法控制病情，因吞咽异物、心房颤动引起的心悸、心电图弥漫性ST段抬高和心肌肌钙蛋白升高而住院治疗。冠状动脉造影检查正常，心脏核磁共振成像证实为急性心肌炎。在经历了以室上性和室性节律紊乱为特征的阶段后，病情发展良好。本文结合文献综述，讨论了这种关联在诊断和治疗方面的挑战。

引用次数: 0

Coronarographie et angioplastie coronaire ambulatoire ; pourquoi, comment, pour quels patients ? 门诊冠状动脉造影术和血管成形术：为什么要做，如何做，针对哪些患者？

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2024-09-21 DOI: 10.1016/j.ancard.2024.101805

Marine Quillot , Raphaël Lasserre , Karim Moussa , Mathieu Pankert , Candice Venturelli , Stéphane Andrieu

There is great heterogeneity in lengths of stay in interventional cardiology but the number of outpatient procedures is increasing. The expected benefits of an outpatient procedure are numerous and non-inferiority of this strategy has been demonstrated. Proper selection of patients eligible for this treatment is essential to minimize the risks of unplanned hospitalization and early complications. It is based on clinical, medico-social and organizational criteria. Perfect management of the care pathway based on an organizational unit and a geographical unit is essential.

介入心脏病学的住院时间差异很大，但门诊手术的数量却在不断增加。门诊手术的预期好处很多，而且这种策略的非劣效性已得到证实。为了最大限度地降低意外住院和早期并发症的风险，正确选择符合接受这种治疗的患者至关重要。这需要根据临床、医疗社会和组织标准来确定。必须以组织单位和地理单位为基础，对护理路径进行完善的管理。

引用次数: 0

Le coroscanner peut-il être réalisé en dépistage à grande échelle en prévention des syndromes coronaires aigus et de l'insuffisance cardiaque ischémique ? Coroscan 可用于大规模筛查，以预防急性冠状动脉综合征和缺血性心力衰竭吗？

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2024-09-21 DOI: 10.1016/j.ancard.2024.101807

Adrien Pasteur-Rousseau , Karam Souibri , Fabien Vannier , Laurent Sebagh

Coronary CT-Scan permits non-invasive visualization of all stages of coronary artery atherosclerosis allowing early therapeutic interventions, lifestyle changes and accurate follow-up all of which result in an improved prognosis. We discuss the possibility of a systematic coronary CT-scan in the global population at certain ages such as fifty or sixty years-old (or both). May this strategy decrease the onset of myocardial infarction or ischemic chronic heart failure thus improving quality (and quantity) of life? May it also reduce the medical costs for the individual and the society? Is it technically possible to deploy such a strategy? What would be the obstacles for its set up and what solutions might be proposed?

冠状动脉 CT 扫描可对冠状动脉粥样硬化的各个阶段进行无创观察，以便及早采取治疗干预措施、改变生活方式和进行准确随访，从而改善预后。我们讨论了在特定年龄段，如 50 岁或 60 岁（或两者），对全球人口进行系统冠状动脉 CT 扫描的可能性。这一策略能否减少心肌梗死或缺血性慢性心力衰竭的发病率，从而提高生活质量（和数量）？它还能降低个人和社会的医疗费用吗？在技术上是否有可能实施这种战略？在实施过程中会遇到哪些障碍？

引用次数: 0