Annales de cardiologie et d'angeiologie最新文献

英文中文

Safety of exercise training for cardiac patients : results of a French multicenter COCARE study (COmplications in CArdiac REhabilitation) 运动训练对心脏病患者的安全性：一项法国多中心COCARE研究结果（心脏康复并发症）

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2025-09-22 DOI: 10.1016/j.ancard.2025.101940

Bruno Pavy , Marie-Christine Iliou , Mohamed Ghannem , Dany Marcadet , Warner Mampuya

Background

Cardiac rehabilitation is widely recognized as beneficial for patients with coronary artery disease, post-cardiac surgery, and heart failure, although it is underutilized. However, the benefit-risk balance must be updated to reflect the evolving characteristics of treated populations.

Objective

To evaluate the safety of supervised exercise training in a large sample of French cardiac rehabilitation patients, and to assess the utility of the modified Risk of Activity Related Events (RARE) score in identifying low-risk individuals.

Methods

This multicenter observational study included 6,793 patients from 32 centers surveyed between 2023 and 2025. Each center collected data over four consecutive months, including patient characteristics and events that interrupted programs, required transfer to acute care, or resulted in rehabilitation cessation. The modified RARE score was applied to identify a low-risk subgroup. Events were considered activity-related if they occurred during or within one hour of a training session.

Results

A total of 964 events (14.2%) were reported, of which 154 (2.3%) were activity-related. Two cardiac arrests occurred—one fatal—representing 0.98 cardiac arrests and 0.49 deaths per 100,000 patient-hours of training. A modified RARE score < 4 defined a low-risk group with an area under the ROC curve of 0.67 and an excellent negative predictive value (0.99). However, specificity was limited (0.32), reflecting the low incidence of events even in high-risk patients.

Conclusion

The COCARE study confirms the low risk of supervised exercise in phase II cardiac rehabilitation. The modified RARE score may be useful in identifying patients who could safely benefit from alternative, less monitored formats such as telerehabilitation.

背景：心脏康复被广泛认为对冠状动脉疾病、心脏手术后和心力衰竭患者有益，尽管它尚未得到充分利用。然而，必须更新利益-风险平衡，以反映治疗人群不断变化的特征。目的评估法国心脏康复患者大样本中监督运动训练的安全性，并评估改进的活动相关事件风险（RARE）评分在识别低风险个体中的效用。该多中心观察性研究纳入了来自32个中心的6793例患者，调查时间为2023年至2025年。每个中心收集了连续四个月的数据，包括患者的特征和中断项目的事件，需要转到急性护理，或导致康复停止。采用改良的RARE评分来确定低风险亚组。如果事件发生在训练期间或一小时内，则被认为与活动有关。结果共报告964例（14.2%），其中运动相关154例（2.3%）。发生了两次心脏骤停，其中一次是致命的，这意味着每10万患者小时的训练中有0.98次心脏骤停和0.49次死亡。修改后的RARE评分<； 4定义为低风险组，ROC曲线下面积为0.67，极好的阴性预测值（0.99）。然而，特异性有限（0.32），反映了即使在高危患者中事件的发生率也很低。结论COCARE研究证实了监督运动在二期心脏康复中的低风险。修改后的RARE评分可能有助于确定哪些患者可以安全地受益于其他较少监测的形式，如远程康复。

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引用次数: 0

Vers un modèle national de télésurveillance en insuffisance cardiaque : proposition d'un cadre organisationnel à partir d'un consensus infirmier ville-hôpital 建立全国心脏衰竭监测模式：基于医患共识的组织框架建议

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2025-09-20 DOI: 10.1016/j.ancard.2025.101929

Christine Lecerf , Gauthier Lefranc , Nathalie Vionnet , Valérie Ple , Emilie Saunier , Céline Picard , Céline Chauveau , Nawel Aouni

Remote monitoring of heart failure is now being deployed throughout France. It allows for effective remote monitoring and aims to improve patients' quality of life. Given the heterogeneity of practices, a committee of nurses has proposed a structured and reproducible organizational framework based on four pillars: Engage, Personalize, Support, and Coordinate.

This model encourages the standardization of practices, improves patient adherence, and ensures quality follow-up. Remote monitoring must remain temporary, educational, and patient-centered. Indicators must be used to assess its effectiveness.

心力衰竭的远程监测目前正在法国各地部署。它允许有效的远程监控，旨在提高患者的生活质量。鉴于实践的异质性，一个护士委员会提出了一个基于四个支柱的结构化和可复制的组织框架：参与、个性化、支持和协调。这种模式鼓励实践的标准化，提高患者的依从性，并确保高质量的随访。远程监测必须保持临时性、教育性和以患者为中心。必须使用指标来评估其有效性。

引用次数: 0

Experiment of Read’Hy : A hybrid, mix of home and centre, cardiac rehabilitation program Read 'Hy实验：一个家庭和中心的混合心脏康复计划

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2025-09-20 DOI: 10.1016/j.ancard.2025.101937

Sonia Corone , Romain Carpentier David , Christelle Pierre , Céline Chouhan , Titi Farrokhi , Aude Brucker , Romain Dorange , Pascal Guillo , Antoine Faure , Annie Fouard

Introduction

Despite the strong recommendations and obvious benefits, cardiac rehabilitation remains underutilised or is often discontinued in real‐world practice. To improve patient care, a hybrid (mix of home and centre) program (Read'Hy) has been developed, combining exercise training sessions and therapeutic education, with weekly face-to-face follow-up.

Methods

After a check-up and minimum five days initiation in the centre, patients returned home, equipped with a heart rate monitor and a mobile application. A personalised 10-week program was drawn up. Asynchronous home exercise was recorded and analysed daily by the rehabilitation technician. Each week, the patient came back to the centre for a supervised training session and interviews allowing to adjust the program.

Results

Out of 353 patients (mean age 55±11 years), 89% completed the program with 91% attendance and 35 physical activity sessions performed. Peak VO₂ increased by 20% (21.8 to 26.1 ml/min/kg, p<0.0001), as did VO₂ at point of intersection (16.6 to 19.9 ml/min/kg, p<0.0001) and maximum workload (140 to 168 Watts, p<0.0001). Only one rhythmic event was reported. Quality of life improved (VAS +14%, p<0.0001), and weekly physical activity quantified by IPAQ-SF increased by 53% (p<0.0001). After one year, IPAQ-SF remained 43.6% higher than the initial level (p<0.0001).

Conclusion

This hybrid program, both safe and effective, promotes the sustainable integration of physical activity into daily life.

尽管有强烈的建议和明显的益处，心脏康复仍然没有得到充分利用，或者在现实世界的实践中经常停止。为了改善病人的护理，一个混合（家庭和中心的混合）项目（Read'Hy）已经开发出来，结合运动训练课程和治疗教育，每周面对面的随访。方法患者在中心接受检查和至少5天的开始治疗后，带着心率监测仪和移动应用程序返回家中。他们制定了一个为期10周的个性化计划。每天由康复技师记录和分析非同步家庭运动。每周，患者回到中心接受有监督的培训课程和面试，以便调整计划。结果在353例患者（平均年龄55±11岁）中，89%的患者完成了该计划，91%的患者参加了该计划，并进行了35次体育锻炼。峰值VO2增加了20%(21.8至26.1 ml/min/kg, p<0.0001)，交叉点的VO2（16.6至19.9 ml/min/kg, p<0.0001）和最大工作负荷（140至168瓦，p<0.0001）也是如此。只有一个有节奏的项目被报道。生活质量得到改善（VAS +14%, p<0.0001）， IPAQ-SF量化的每周体力活动增加53% （p<0.0001）。一年后，IPAQ-SF仍比初始水平高43.6% （p<0.0001）。结论：该混合方案安全有效，促进了体育活动与日常生活的可持续结合。

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引用次数: 0

Implantation de stimulateurs cardiaques sans sonde : plaidoyer pour un élargissement des conditions d’implantation dans les centres sans chirurgie cardiaque 无导管心脏起搏器的植入：呼吁扩大无心脏手术中心的植入条件

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2025-09-20 DOI: 10.1016/j.ancard.2025.101941

Walid Amara , Anas El Mahi , Ahmed Salhi , Pierre Socié , Cyrus Moini , Jérôme Taieb

Leadless pacemakers’ implantations in France are limited to centers with onsite cardiac surgery. However, these implantations are now possible in centers without onsite surgery in most European countries. Indeed, the rates of tamponade and cardiac perforation are very low. This article argues for the implantation conditions to be extended to centers with thoracic or vascular surgery (and not cardiac), as is the case for atrial fibrillation ablations, because these centers already have immediate surgical back-up, allowing the treatment of cardiac tamponade or perforation.

在法国，无铅心脏起搏器的植入仅限于有现场心脏手术的中心。然而，在大多数欧洲国家，这些植入物现在可以在中心进行，而无需现场手术。事实上，心包填塞和心脏穿孔的发生率非常低。本文主张将植入条件扩展到胸外科或血管手术中心（而不是心脏），就像心房纤颤消融的情况一样，因为这些中心已经有立即的手术支持，可以治疗心脏填塞或穿孔。

引用次数: 0

Évaluation du strain de l’oreillette gauche en échocardiographie : intérêt physiopathologique, diagnostique et pronostic 超声心动图左心绞痛评估：生理病理意义、诊断和预后

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2025-09-20 DOI: 10.1016/j.ancard.2025.101934

Patrick Meimoun, Karina Rahmouni, Ines Idir, Vanessa Kacy, Houssam Louhani, Jérome Clerc

Several studies have evaluated left atrial function, mainly using two-dimensional longitudinal myocardial strain with the speckle tracking technique. The study of left atrial strain (LAS) allows the analysis of the different phases of left atrial function (reservoir, conduit, pump) and its correlations with left ventricular systolic and diastolic function, and exercise capacity. Furthermore, LAS has diagnostic value in estimating left ventricular diastolic dysfunction and filling pressure. It helps differentiate the etiologies of left ventricular hypertrophy and has prognostic value in various diseases, including heart failure, valvular diseases, coronary artery disease, atrial fibrillation, and various causes of left ventricular hypertrophy. In this review, we will focus on these topics and discuss the growing interest in three-dimensional LAS.

一些研究评估了左心房功能，主要是利用二维纵向心肌应变与斑点跟踪技术。左心房应变（LAS）的研究可以分析左心房功能（贮、管、泵）的不同阶段及其与左心室收缩、舒张功能和运动能力的相关性。此外，LAS在估计左室舒张功能障碍和充盈压力方面具有诊断价值。它有助于区分左心室肥厚的病因，并对各种疾病有预后价值，包括心力衰竭、瓣膜疾病、冠状动脉疾病、心房颤动和各种原因的左心室肥厚。在这篇综述中，我们将重点讨论这些主题，并讨论对三维LAS日益增长的兴趣。

引用次数: 0

Fibrose endomyocardique biventriculaire mimant une endocardite infectieuse 模拟感染性心内膜炎的双心室肌内纤维化

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2025-09-20 DOI: 10.1016/j.ancard.2025.101931

Falah Aboukhoudir , Karim Moussa , Sami Rahmani , Safia Chebrek , Sofiene Rekik , Alexandra Dernys

Endomyocardial fibrosis is a rare form of restrictive cardiomyopathy consequent to endocardial damage mediated by hypereosinophilia. It is characterized by fibrous deposits in the ventricular endocardium to a lesser extent, in the myocardium. We report the case of a 75-year-old man having chronic myeloid leukemia in blastic phase, in whom we diagnosed an endomyocardial fibrosis mimicking infective endocarditis. We describe diagnostic modalities and clinical evolution.

心内膜纤维化是一种罕见的限制性心肌病，由嗜酸性粒细胞增多介导的心内膜损伤引起。它的特点是纤维沉积在心室心内膜，在心肌中较少。我们报告的情况下，75岁的男子慢性髓性白血病在母细胞期，我们在其中诊断为心肌内膜纤维化模拟感染性心内膜炎。我们描述了诊断方式和临床演变。

引用次数: 0

Profil clinique, échocardiographique, prise en charge et pronostic des thrombi intraventriculaire gauches : étude rétrospective analytique 左室内血栓形成的临床概况、超声心动图、治疗和预后：回顾性研究

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2025-09-20 DOI: 10.1016/j.ancard.2025.101938

Taryètba Andre Arthur Seghda , Abou Coulibaly , Martin Wendlassida Nacanabo , Djeme Claudine Dah , Mireille Abouga Loya , Laurence Flork , Anna Tall Thiam , Nobila Valentin Yaméogo , André K Samadoulougou , Patrice Zabsonre

Introduction/objective

To analyze the clinical and echocardiographic features, as well as the prognosis of patients hospitalized for left ventricular thrombi.

Materials and Methods

This retrospective cross-sectional study was conducted in the Cardiology Department of the Bogodogo University Hospital Center. The study period, which extended from January 1, 2017, to October 31, 2023, aimed to achieve both descriptive and analytical objectives. The study population consisted of all hospitalized patients diagnosed with left ventricular thrombi, regardless of the underlying cardiac pathology. Data collection focused on clinical characteristics, echocardiographic parameters, and in-hospital mortality outcomes.

Results

Sixty-five patients were included. Underlying heart conditions were mostly cardiomyopathies: Ischemic, idiopathic, and peripartum. Thrombi were considered high embolic risk in 49.2% of cases. In-hospital mortality was 23%. The mobility or floating nature of the thrombi did not influence mortality. Factors associated with in-hospital death were dyspnea of at least stage 3 and cardiogenic shock.

Conclusion

Left ventricular thrombi are common to ischemic, idiopathic, and peripartum cardiomyopathy. They don’t increase in-hospital but do increase morbidity.

前言/目的分析左室血栓住院患者的临床、超声心动图特点及预后。材料和方法本回顾性横断面研究在波哥大大学医院中心心脏科进行。研究期间从2017年1月1日延长至2023年10月31日，旨在实现描述性和分析性目标。研究人群包括所有诊断为左心室血栓的住院患者，无论其潜在的心脏病理如何。数据收集的重点是临床特征、超声心动图参数和住院死亡率结果。结果共纳入65例患者。潜在的心脏疾病主要是心肌病：缺血性、特发性和围产期。49.2%的病例认为血栓是高栓塞风险。住院死亡率为23%。血栓的流动性或漂浮性不影响死亡率。与院内死亡相关的因素是3期以上呼吸困难和心源性休克。结论左室血栓在缺血性、特发性和围生期心肌病中常见。它们不会增加住院人数，但会增加发病率。

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引用次数: 0

Tachycardie de Gallavardin syncopale détectée sur un moniteur implantable chez une patiente âgée : prise en charge ablative 一名老年患者在植入监视器上发现的加拉瓦丁心动过速：消融治疗

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2025-09-20 DOI: 10.1016/j.ancard.2025.101930

P.-Y. Tarlet, F. Elmkies, P. Lachambre, T. Zerah, J. Clerc, P. Meimoun

We report the case of a 75-year-old female patient who was evaluated for an exertional syncope, revealing an infundibular ventricular tachycardia. The diagnosis was made possible by the implantation of a loop recorder, which detected frequent episodes of non-sustained ventricular tachycardia. Radiofrequency ablation guided by a three-dimensional mapping system led to the complete suppression of the arrhythmias. This case highlights the value of implantable monitoring tools in the etiological diagnosis of syncope, the importance of obtaining a 12-lead ECG during the arrhythmia to determine its origin, and the role of three-dimensional mapping systems in the diagnosis and treatment of idiopathic ventricular arrhythmias.

我们报告的情况下，一个75岁的女性患者谁是评估一个运动性晕厥，揭示了室性心动过速。通过植入循环记录仪，可以检测到非持续性室性心动过速的频繁发作，从而使诊断成为可能。三维定位系统引导下的射频消融可完全抑制心律失常。本病例强调了植入式监测工具在晕厥病因诊断中的价值，在心律失常期间获得12导联心电图以确定其起源的重要性，以及三维制图系统在特发性室性心律失常诊断和治疗中的作用。

引用次数: 0

Profil étiologique et pronostic de l’insuffisance cardiaque du sujet jeune dans un pays à ressources limitées 资源有限国家年轻人心力衰竭的病因和预后

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2025-09-20 DOI: 10.1016/j.ancard.2025.101935

Anna Thiam , Jules Ramdé , Georges RC Millogo , Larissa J. Kagambega , Jonas K. Kologo , Laurence Benon , Elisé Kabore , Valentin N. Yameogo , André K. Samadoulougou , Patrice Zabsonre

Objectives

To study the etiological factors and prognosis of heart failure in subjects aged 15 to 45 in the cardiology department of the Yalgado Ouédraogo University Hospital Center.

Methodology

It was a retrospective cohort study from March 1, 2020, to February 28, 2022, involving 130 patients.

Results

The average age of our patients was 30 ±7,88 years, with a female predominance of 57,7 %. Sedentary lifestyle was the most found cardiovascular risk factor in 49,2 % of cases, followed by hypertension in 25,2%. Congestive heart failure was the most frequent clinical presentation in our total sample (79%). Rheumatic valvulopathies were the most common aetiology in 27,6 % followed by peripartum cardiomyopathy in 23,8 %. On the electrocardiogram, arrhythmias were found in 27,5 % of patients; they were dominated by atrial arrhythmias (33,3% of arrhythmias). The left ventricular ejection fraction was reduced in 53,85% of cases. One-year Mortality was 9,2 %. In a post-hospital survey, 65 patients were not coming back. Among the monitored patients, 11 were deceased. The factors linked to the deaths were the existence of comorbidities and rehospitalizations.

Conclusion

Aetiologies are always dominated by valvulopathies. However, the peripartum cardiomyopathy is often found in our context. The prognosis can be improved by more appropriate management, like cardiac surgery for valvulopathies and prevention for peripartum cardiomyopathy.

目的探讨亚尔加多大学附属医院中心心内科15 ~ 45岁患者心力衰竭的病因及预后。方法回顾性队列研究，时间为2020年3月1日至2022年2月28日，共纳入130例患者。结果本组患者平均年龄30±7.88岁，女性占57.7%。久坐不动的生活方式是最常见的心血管危险因素，占49.2%，其次是高血压，占25.2%。在我们的总样本中，充血性心力衰竭是最常见的临床表现（79%）。风湿性心瓣膜病是最常见的病因，占27.6%，其次是围产期心肌病，占23.8%。在心电图上，心律失常发生率为27.5%；其中以房性心律失常为主（33.3%）。在53.85%的病例中左心室射血分数降低。一年死亡率为9.2%。在一次出院后的调查中，65名患者没有再回来。在受监测的患者中，有11人死亡。与死亡相关的因素是合并症的存在和再住院。结论病因以瓣膜病为主。然而，围产期心肌病却经常出现在我们的语境中。通过适当的治疗，如心脏手术治疗瓣膜病和预防围产期心肌病，可改善预后。

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引用次数: 0

Thrombus enclavé dans le foramen ovale perméable : à propos d’un cas révélé par une embolie pulmonaire au CHU de Libreville 可渗透的椭圆形孔内的血栓：关于利伯维尔医院肺栓塞的一个病例

IF 0.3 Q4 Medicine

Annales de cardiologie et d'angeiologie

Pub Date : 2025-09-20 DOI: 10.1016/j.ancard.2025.101936

Christelle P Akagha Konde , Mahutondji Christian Allognon , Elsa Ayo Bivigou , Francis Ndoume Obiang , Jean Léonard Mbini Junior , Arthur Matsanga , Ervais Richard Obame

The patent foramen ovale is common in the general population. It is often encountered during paradoxical embolisms. During a pulmonary embolism, its presence is a poor prognosis. The discovery of an enclosed thrombus in this area is rare. We report a case of an enclaved thrombus in the patent foramen ovale discovered during a transthoracic echocardiography indicated in the presence of a suspected pulmonary embolism in a pregnant woman. This patient presented with hemodynamic instability, the evolution of which was favorable after thrombolysis with tenecteplase. In the absence of consensus on the management of thrombi trapped in the patent foramen ovale, the track of a better prognosis according to the class of thrombolytics used should be studied.

卵圆孔未闭在普通人群中很常见。这是经常遇到的矛盾栓塞。在肺栓塞时，它的存在预后很差。在此区域发现封闭血栓是罕见的。我们报告一例包膜血栓在未闭的卵圆孔发现在经胸超声心动图表明在一个怀疑肺栓塞的孕妇。该患者表现为血流动力学不稳定，在用替尼替普酶溶栓后，血流动力学的发展是有利的。在对卵圆孔未闭内血栓的处理缺乏共识的情况下，应根据所使用的溶栓药物的种类来研究更好的预后。

引用次数: 0

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