Pub Date : 2025-09-23DOI: 10.1016/j.ancard.2025.101951
Amina Maamri , Sabrina Denden , Meriem Mediouni , Amine Bejar , Thibault Guitteny , Mourad Bouayed , Sara Hezili , Nada Tababi , Sihem Mbarki , Taha Hassani , Hakim Gourari , Frederic Ghawche , Vincent Lefebvre
<div><h3>Introduction</h3><div>La recherche d’une source cardiaque potentielle est une étape fondamentale dans l’évaluation urgente d’un accident vasculaire cérébral ischémique (AVCI), dont la principale cause est la fibrillation atriale (FA). Des études récentes ont prouvé la supériorité de l’évaluation de la fonction atrial gauche par la méthode de Speckle-Tracking versus les dimensions de l’oreillette gauche (OG) comme prédicteur de FA paroxystique. L’altération du strain réservoir (SR) de l’OG est associée à l’incidence des AVCI.</div></div><div><h3>Méthodes</h3><div>Etude rétrospective, observationnelle chez des patients hospitalisés dans le service de neurologie, de janvier 2022 à avril 2023 pour accident vasculaire cérébral ischémique constitué ou transitoire, sans fibrillation atriale connue ni traitement anticoagulant préalable. Les objectifs de l’étude étaient la recherche 1) d’une association entre le SR et l’origine embolique de l’AVCI, avec identification des facteurs associés aux AVCI ; 2) d’une association entre le SR et la survenue de fibrillation atriale, avec identification des facteurs associés à l’altération du SR.</div></div><div><h3>Résultats</h3><div>L’étude a inclus 79 patients (56% d’hommes, âge médian 72 ans), 39% des AVCI étaient cryptogéniques (dont 26% sont transitoires), 23 % cardio-embolique et 14% emboliques d’origines indéterminées (ESUS). Parmi les causes cardio-embolique (18 patients), 33% étaient secondaires à une fibrillation atriale, 39 à un foramen ovale perméable (FOP). Le SR médian était de 27%, le SR était < 39% dans 86% des cas, que l’oreillette gauche soit dilatée ou non. Avec un seuil de 20% et une valeur de P à 0,01, le SR était associé à l’origine embolique de l’AVCI (groupe FOP exclu). Le SR < 20% était associé à la survenue de FA dans le suivi (P= 0,04).</div></div><div><h3>Conclusion</h3><div>Notre étude suggère qu’un strain réservoir de l’oreillette gauche < 20% à la phase aigue d’un AVCI/AIT, chez des patients sans antécédent de fibrillation atriale ni traitement anticoagulant, pourrait être associé à l’origine embolique de l’AVCI et à la survenue de fibrillation atriale dans le suivi.</div></div><div><h3>Background</h3><div>The search for a potential cardiac source is a fundamental step in the urgent evaluation of an ischaemic stroke (IS) or Transient ischemic attack (TIA). The most common cardioembolic cause of IS is atrial fibrillation (AF). Analysis of the left atrial function is superior to left atrial (LA) dimensions measurements as predictor of paroxysmal AF, especially with the study of deformation anomalies using 2D Speckle-Tracking. Alteration of the reservoir strain (RS) of the LA is associated with the incidence of IS.</div></div><div><h3>Methods</h3><div>Retrospective observational study in patients hospitalised in the neurology departement from January 2022 to April 2023, for IS or TIA, with no history of AF nor anticoagulation treatment. The objectives of the study were t
寻找潜在的心脏源是缺血性中风（缺血性中风）紧急评估的基本步骤，缺血性中风的主要原因是房颤（房颤）。最近的研究证明，与左耳尺寸（OG）相比，用斑点跟踪法评估左心房功能作为发作性FA的预测器具有优势。OG菌株库（SR）的改变与CVA的发病率有关。方法对2022年1月至2023年4月在神经内科住院的患者进行回顾性观察性研究，研究对象为没有已知房颤或事先抗凝治疗的形成性或暂时性缺血性中风患者。本研究的目的是寻找1)SR与ICAD的象征起源之间的联系，并确定与ICAD相关的因素；2)之间有一个协会的SR和治疗房颤的发生与鉴别SR.RésultatsL’étude风化的相关因素,包括了79名患者(56%的男性,平均年龄72岁),有39%的AVCI cryptogéniques(其中26%),23% cardio-embolique过渡性和不明来源的emboliques (ESUS 14%)。在心脏栓塞病因（18例）中，33%为房颤继发，39为卵巢通孔（FOP）继发。中位SR为27%，86%的病例中SR为39%，无论左耳廓是否扩张。阈值为20%，P值为0.01，SR与CVID的栓塞起源有关（不包括FOP组）。20%的LR与随访中FA的发生有关（P= 0.04）。结论：我们的研究表明，在没有房颤史或抗凝治疗的患者中，急性ICD / ITD中20%的左耳膜紧张储层可能与房颤的栓塞起源和随访中房颤的发生有关。寻找潜在的心脏源是缺血性中风（IS）或暂时性缺血性发作（TIA）紧急评估的基本步骤。心肌梗死最常见的原因是心房纤颤（AF）。左心室功能的分析优于左心室（LA）尺寸测量作为发作性AF的预测，特别是在使用2D斑点跟踪研究畸形异常时。洛杉矶水库菌株（RS）的改变与IS的发病率有关。方法：对2022年1月至2023年4月在神经内科住院的无AF或抗凝治疗史的IS或TIA患者的回顾性观察研究。这项研究的目的是调查1)RS与IS的栓塞起源（心脏栓塞和ESUS）之间的联系，确定与IS相关的因素；2) RS与房颤发生之间的关联，识别与RS缺陷相关的因素20%。该研究包括79例患者（56%为男性，中位年龄72岁），39%的缺血性中风是隐源性的（其中26%是暂时性的），23%是心脏栓塞性的，14%是来源不明的栓塞性的。在心脏栓塞的原因（18例）中，33%为房颤继发，39%为卵巢专利孔（PFO）继发。无论左中庭是否扩张，86%的病例中，中位RS为27%，中位RS为39%。阈值为20%，P值为0.01，RS与脑卒中的栓塞起源有关（不包括全氟辛烷磺酸组）。随访期间，20%的RS与房颤的发生相关（P= 0.04）。ConclusionOur study suggests that a的水库体格of the left atrium < 20%的急性阶段during the of an ischemic她/ transient ischemic遭袭,病人in without a history of atrial房颤抗凝剂治疗,黄金may be associated with an embolic origin of the上了她的ischemic and the of atrial发生房颤during后续活动。
{"title":"Le Strain réservoir de l’oreillette gauche dans l’accident vasculaire cérébral ischémique The left atrial reservoir strain in ischemic stroke","authors":"Amina Maamri , Sabrina Denden , Meriem Mediouni , Amine Bejar , Thibault Guitteny , Mourad Bouayed , Sara Hezili , Nada Tababi , Sihem Mbarki , Taha Hassani , Hakim Gourari , Frederic Ghawche , Vincent Lefebvre","doi":"10.1016/j.ancard.2025.101951","DOIUrl":"10.1016/j.ancard.2025.101951","url":null,"abstract":"<div><h3>Introduction</h3><div>La recherche d’une source cardiaque potentielle est une étape fondamentale dans l’évaluation urgente d’un accident vasculaire cérébral ischémique (AVCI), dont la principale cause est la fibrillation atriale (FA). Des études récentes ont prouvé la supériorité de l’évaluation de la fonction atrial gauche par la méthode de Speckle-Tracking versus les dimensions de l’oreillette gauche (OG) comme prédicteur de FA paroxystique. L’altération du strain réservoir (SR) de l’OG est associée à l’incidence des AVCI.</div></div><div><h3>Méthodes</h3><div>Etude rétrospective, observationnelle chez des patients hospitalisés dans le service de neurologie, de janvier 2022 à avril 2023 pour accident vasculaire cérébral ischémique constitué ou transitoire, sans fibrillation atriale connue ni traitement anticoagulant préalable. Les objectifs de l’étude étaient la recherche 1) d’une association entre le SR et l’origine embolique de l’AVCI, avec identification des facteurs associés aux AVCI ; 2) d’une association entre le SR et la survenue de fibrillation atriale, avec identification des facteurs associés à l’altération du SR.</div></div><div><h3>Résultats</h3><div>L’étude a inclus 79 patients (56% d’hommes, âge médian 72 ans), 39% des AVCI étaient cryptogéniques (dont 26% sont transitoires), 23 % cardio-embolique et 14% emboliques d’origines indéterminées (ESUS). Parmi les causes cardio-embolique (18 patients), 33% étaient secondaires à une fibrillation atriale, 39 à un foramen ovale perméable (FOP). Le SR médian était de 27%, le SR était < 39% dans 86% des cas, que l’oreillette gauche soit dilatée ou non. Avec un seuil de 20% et une valeur de P à 0,01, le SR était associé à l’origine embolique de l’AVCI (groupe FOP exclu). Le SR < 20% était associé à la survenue de FA dans le suivi (P= 0,04).</div></div><div><h3>Conclusion</h3><div>Notre étude suggère qu’un strain réservoir de l’oreillette gauche < 20% à la phase aigue d’un AVCI/AIT, chez des patients sans antécédent de fibrillation atriale ni traitement anticoagulant, pourrait être associé à l’origine embolique de l’AVCI et à la survenue de fibrillation atriale dans le suivi.</div></div><div><h3>Background</h3><div>The search for a potential cardiac source is a fundamental step in the urgent evaluation of an ischaemic stroke (IS) or Transient ischemic attack (TIA). The most common cardioembolic cause of IS is atrial fibrillation (AF). Analysis of the left atrial function is superior to left atrial (LA) dimensions measurements as predictor of paroxysmal AF, especially with the study of deformation anomalies using 2D Speckle-Tracking. Alteration of the reservoir strain (RS) of the LA is associated with the incidence of IS.</div></div><div><h3>Methods</h3><div>Retrospective observational study in patients hospitalised in the neurology departement from January 2022 to April 2023, for IS or TIA, with no history of AF nor anticoagulation treatment. The objectives of the study were t","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101951"},"PeriodicalIF":0.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118248","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}
Pub Date : 2025-09-22DOI: 10.1016/j.ancard.2025.101933
Marlène Esteban , Olivier Maurou , Marc Harboun , Sophie Nisse Durgeat , Rémi Esser
Introduction
Heart failure (HF) is a major cause of morbidity and mortality in older adults, with a rising prevalence after the age of 70. Conventional hospitalization, commonly required in this frail population, exposes patients to numerous iatrogenic complications. Alternative care models, such as diuretic-based day hospital (DH) management, may help mitigate these risks.
Objectives
To describe the geriatric profile of patients treated for acute heart failure (AHF) in a diuretic day hospital within a cardiogeriatrics unit, and to report the organization of the associated care pathway.
Methods
This was a retrospective, observational, monocentric study conducted in the cardiogeriatrics department of Hôpital La Porte Verte (Versailles, France). Patients aged ≥65 years who were treated in a diuretic day hospital for acute heart failure between January and June 2025 were included. Geriatric, cardiologic, and organizational data were collected from medical records. A purely descriptive analysis was performed.
Results
Forty patients were included, with a mean age of 88 ± 6.8 years. Most lived at home (95%) and had preserved autonomy (mean ADL score: 5.4). The average Charlson Comorbidity Index was 8.9 ± 2.3; 50% were at risk of malnutrition and 92.5% had chronic kidney disease. From a cardiologic standpoint, 57.5% had preserved LVEF and 67.5% had atrial fibrillation. The mean delay between referral and the first day hospital session was 1.6 days, with an average of 3.1 sessions per patient. The rate of subsequent full hospitalization was 12.5%. Main complications included electrolyte disorders (5%), non-catheter-related infections (7.5%), and acute kidney injury (7.5%). Following day hospital management, 22.5% of patients were enrolled in a geriatric frailty day hospital program, 32.5% in an intravenous iron day hospital, and 22.5% in a remote monitoring program.
Conclusion
This diuretic day hospital model, integrated into a structured geriatric care pathway, appears feasible, safe, and relevant for managing very elderly patients with acute heart failure. It may represent an effective alternative to conventional hospitalization.
心衰（HF）是老年人发病和死亡的主要原因，70岁以后患病率上升。传统的住院治疗，通常需要在这个虚弱的人群，使患者暴露于许多医源性并发症。替代护理模式，如以利尿剂为基础的日间医院（DH）管理，可能有助于减轻这些风险。目的描述急性心力衰竭（AHF）患者在一家利尿日间医院的老年内科治疗的老年特征，并报告相关护理途径的组织。方法：这是一项回顾性、观察性、单中心研究，在Hôpital La Porte Verte （Versailles, France）心脏科进行。纳入2025年1月至6月期间在利尿日间医院治疗急性心力衰竭的年龄≥65岁的患者。从医疗记录中收集老年、心脏病和组织数据。进行了纯描述性分析。结果入选患者40例，平均年龄88±6.8岁。大多数人（95%）住在家里，并保持了自主性（平均ADL评分：5.4）。平均Charlson合并症指数为8.9±2.3；50%的人有营养不良的危险，92.5%的人患有慢性肾病。从心脏病学的角度来看，57.5%的患者保留了LVEF， 67.5%的患者有心房颤动。从转诊到第一天住院之间的平均延迟为1.6天，平均每位患者为3.1次。随后完全住院率为12.5%。主要并发症包括电解质紊乱（5%）、非导管相关感染（7.5%）和急性肾损伤（7.5%）。在日间医院管理之后，22.5%的患者入组了老年虚弱日间医院项目，32.5%入组了静脉注射铁日间医院项目，22.5%入组了远程监测项目。结论：将这种利尿剂日间医院模式整合到一个结构化的老年护理路径中，似乎是可行的、安全的，并且与管理高龄急性心力衰竭患者相关。它可能是传统住院治疗的一种有效替代方法。
{"title":"DOME-HF : évaluation rétrospective sur six mois de la prise en charge diurétique ambulatoire chez des patients âgés atteints d’insuffisance cardiaque","authors":"Marlène Esteban , Olivier Maurou , Marc Harboun , Sophie Nisse Durgeat , Rémi Esser","doi":"10.1016/j.ancard.2025.101933","DOIUrl":"10.1016/j.ancard.2025.101933","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) is a major cause of morbidity and mortality in older adults, with a rising prevalence after the age of 70. Conventional hospitalization, commonly required in this frail population, exposes patients to numerous iatrogenic complications. Alternative care models, such as diuretic-based day hospital (DH) management, may help mitigate these risks.</div></div><div><h3>Objectives</h3><div>To describe the geriatric profile of patients treated for acute heart failure (AHF) in a diuretic day hospital within a cardiogeriatrics unit, and to report the organization of the associated care pathway.</div></div><div><h3>Methods</h3><div>This was a retrospective, observational, monocentric study conducted in the cardiogeriatrics department of Hôpital La Porte Verte (Versailles, France). Patients aged ≥65 years who were treated in a diuretic day hospital for acute heart failure between January and June 2025 were included. Geriatric, cardiologic, and organizational data were collected from medical records. A purely descriptive analysis was performed.</div></div><div><h3>Results</h3><div>Forty patients were included, with a mean age of 88 ± 6.8 years. Most lived at home (95%) and had preserved autonomy (mean ADL score: 5.4). The average Charlson Comorbidity Index was 8.9 ± 2.3; 50% were at risk of malnutrition and 92.5% had chronic kidney disease. From a cardiologic standpoint, 57.5% had preserved LVEF and 67.5% had atrial fibrillation. The mean delay between referral and the first day hospital session was 1.6 days, with an average of 3.1 sessions per patient. The rate of subsequent full hospitalization was 12.5%. Main complications included electrolyte disorders (5%), non-catheter-related infections (7.5%), and acute kidney injury (7.5%). Following day hospital management, 22.5% of patients were enrolled in a geriatric frailty day hospital program, 32.5% in an intravenous iron day hospital, and 22.5% in a remote monitoring program.</div></div><div><h3>Conclusion</h3><div>This diuretic day hospital model, integrated into a structured geriatric care pathway, appears feasible, safe, and relevant for managing very elderly patients with acute heart failure. It may represent an effective alternative to conventional hospitalization.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101933"},"PeriodicalIF":0.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118254","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}
Pub Date : 2025-09-22DOI: 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.
{"title":"Safety of exercise training for cardiac patients : results of a French multicenter COCARE study (COmplications in CArdiac REhabilitation)","authors":"Bruno Pavy , Marie-Christine Iliou , Mohamed Ghannem , Dany Marcadet , Warner Mampuya","doi":"10.1016/j.ancard.2025.101940","DOIUrl":"10.1016/j.ancard.2025.101940","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101940"},"PeriodicalIF":0.3,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118255","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}
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.
{"title":"Vers un modèle national de télésurveillance en insuffisance cardiaque : proposition d'un cadre organisationnel à partir d'un consensus infirmier ville-hôpital","authors":"Christine Lecerf , Gauthier Lefranc , Nathalie Vionnet , Valérie Ple , Emilie Saunier , Céline Picard , Céline Chauveau , Nawel Aouni","doi":"10.1016/j.ancard.2025.101929","DOIUrl":"10.1016/j.ancard.2025.101929","url":null,"abstract":"<div><div>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.</div><div>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.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101929"},"PeriodicalIF":0.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095954","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}
Pub Date : 2025-09-20DOI: 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.
{"title":"Experiment of Read’Hy : A hybrid, mix of home and centre, cardiac rehabilitation program","authors":"Sonia Corone , Romain Carpentier David , Christelle Pierre , Céline Chouhan , Titi Farrokhi , Aude Brucker , Romain Dorange , Pascal Guillo , Antoine Faure , Annie Fouard","doi":"10.1016/j.ancard.2025.101937","DOIUrl":"10.1016/j.ancard.2025.101937","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Out of 353 patients (mean age 55±11 years), 89% completed the program with 91% attendance and 35 physical activity sessions performed. Peak VO<sub>2</sub> increased by 20% (21.8 to 26.1 ml/min/kg, <em>p</em><0.0001), as did VO<sub>2</sub> at point of intersection (16.6 to 19.9 ml/min/kg, <em>p</em><0.0001) and maximum workload (140 to 168 Watts, <em>p</em><0.0001). Only one rhythmic event was reported. Quality of life improved (VAS +14%, <em>p</em><0.0001), and weekly physical activity quantified by IPAQ-SF increased by 53% (<em>p</em><0.0001). After one year, IPAQ-SF remained 43.6% higher than the initial level (<em>p</em><0.0001).</div></div><div><h3>Conclusion</h3><div>This hybrid program, both safe and effective, promotes the sustainable integration of physical activity into daily life.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101937"},"PeriodicalIF":0.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095993","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}
Pub Date : 2025-09-20DOI: 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.
{"title":"Implantation de stimulateurs cardiaques sans sonde : plaidoyer pour un élargissement des conditions d’implantation dans les centres sans chirurgie cardiaque","authors":"Walid Amara , Anas El Mahi , Ahmed Salhi , Pierre Socié , Cyrus Moini , Jérôme Taieb","doi":"10.1016/j.ancard.2025.101941","DOIUrl":"10.1016/j.ancard.2025.101941","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101941"},"PeriodicalIF":0.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095996","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}
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.
{"title":"Évaluation du strain de l’oreillette gauche en échocardiographie : intérêt physiopathologique, diagnostique et pronostic","authors":"Patrick Meimoun, Karina Rahmouni, Ines Idir, Vanessa Kacy, Houssam Louhani, Jérome Clerc","doi":"10.1016/j.ancard.2025.101934","DOIUrl":"10.1016/j.ancard.2025.101934","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101934"},"PeriodicalIF":0.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095998","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}
Pub Date : 2025-09-20DOI: 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.
{"title":"Fibrose endomyocardique biventriculaire mimant une endocardite infectieuse","authors":"Falah Aboukhoudir , Karim Moussa , Sami Rahmani , Safia Chebrek , Sofiene Rekik , Alexandra Dernys","doi":"10.1016/j.ancard.2025.101931","DOIUrl":"10.1016/j.ancard.2025.101931","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101931"},"PeriodicalIF":0.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096000","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}
Pub Date : 2025-09-20DOI: 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.
{"title":"Profil clinique, échocardiographique, prise en charge et pronostic des thrombi intraventriculaire gauches : étude rétrospective analytique","authors":"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","doi":"10.1016/j.ancard.2025.101938","DOIUrl":"10.1016/j.ancard.2025.101938","url":null,"abstract":"<div><h3>Introduction/objective</h3><div>To analyze the clinical and echocardiographic features, as well as the prognosis of patients hospitalized for left ventricular thrombi.</div></div><div><h3>Materials and Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>Left ventricular thrombi are common to ischemic, idiopathic, and peripartum cardiomyopathy. They don’t increase in-hospital but do increase morbidity.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101938"},"PeriodicalIF":0.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095994","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}
Pub Date : 2025-09-20DOI: 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.
{"title":"Tachycardie de Gallavardin syncopale détectée sur un moniteur implantable chez une patiente âgée : prise en charge ablative","authors":"P.-Y. Tarlet, F. Elmkies, P. Lachambre, T. Zerah, J. Clerc, P. Meimoun","doi":"10.1016/j.ancard.2025.101930","DOIUrl":"10.1016/j.ancard.2025.101930","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 5","pages":"Article 101930"},"PeriodicalIF":0.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095999","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}
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