Pub Date : 2025-04-01Epub Date: 2025-03-08DOI: 10.1016/j.ancard.2025.101863
Thibaut Renotte , Théophile Tamakloe , Jean-Louis Mariage , Xavier Michel , Baudry Gubin , Philippe Oriot , Emmanuelle Paternotte
Left ventricular thrombus (LVT) is a serious complication of both ischemic and non-ischemic cardiomyopathies, with a high risk of morbidity and mortality due to systemic embolism. We present the case of a 73-year-old man with a history of myocardial infarction who subsequently developed an apical thrombus. Seven years after the initial event, this thrombus caused a splenic infarction complicated by an abscessed hematoma. This case underlines the critical role of advanced medical imaging in the diagnosis of LVT and highlights the emerging therapeutic potential of direct oral anticoagulants. It also highlights the challenges of diagnosing and managing LVT and the importance of reviewing the latest evidence to refine and optimize therapeutic strategies.
{"title":"Approche diagnostique et prise en charge d'un thrombus intraventriculaire gauche compliqué par une embolie inattendue : un cas clinique","authors":"Thibaut Renotte , Théophile Tamakloe , Jean-Louis Mariage , Xavier Michel , Baudry Gubin , Philippe Oriot , Emmanuelle Paternotte","doi":"10.1016/j.ancard.2025.101863","DOIUrl":"10.1016/j.ancard.2025.101863","url":null,"abstract":"<div><div>Left ventricular thrombus (LVT) is a serious complication of both ischemic and non-ischemic cardiomyopathies, with a high risk of morbidity and mortality due to systemic embolism. We present the case of a 73-year-old man with a history of myocardial infarction who subsequently developed an apical thrombus. Seven years after the initial event, this thrombus caused a splenic infarction complicated by an abscessed hematoma. This case underlines the critical role of advanced medical imaging in the diagnosis of LVT and highlights the emerging therapeutic potential of direct oral anticoagulants. It also highlights the challenges of diagnosing and managing LVT and the importance of reviewing the latest evidence to refine and optimize therapeutic strategies.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 2","pages":"Article 101863"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579814","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 : 2025-04-01Epub Date: 2025-03-15DOI: 10.1016/j.ancard.2025.101878
Koudougou Jonas Kologo , A. Tall-Thiam , G.R.C. Millogo , K.J. Nabi , S. Traore , Y. Kambire , Z.M. Some , M.R. Kationo , N.V. Yameogo , A.K. Samadoulogou , P. Zabsonre
Objective
To study the correlation between glycaemic control and blood pressure control, in order to determine the factors associated with blood pressure control in diabetic patients.
Methodology
This was a descriptive cross-sectional study with an analytical aim over a period of 7 months. Patients were recruited on an outpatient basis, and all underwent ABPM, measurement of glycated haemoglobin and creatinine levels, and assessment of compliance with treatment.
Results
Our criteria enabled us to select 116 patients. Women predominated (69%). The mean age of the patients was 62 ± 7 years, with a peak between 60 and 70 years. The mean duration of hypertension was 12 years and that of diabetes 6 years. The most frequently associated cardiovascular risk factor was physical inactivity (71.5%), followed by age. 57.8% of patients had uncontrolled blood pressure at the practice, with systolic hypertension predominating (58.2%). MAPA found that 61.6% of patients were controlled, giving a white-coat hypertension rate of 47.8%. Glycaemic control was observed in 42.2% of cases, and 87% of patients had good renal function. Compliance with treatment was good in 53.4% of cases, and dual therapy was the most commonly used treatment modality (44.8%), followed by triple therapy. The factors associated with poor blood pressure control were glycaemic imbalance, lack of compliance and monotherapy. Combination therapy was associated with good blood pressure control.
Conclusion
The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. ABPM is the best method of assessing blood pressure control. Optimising blood pressure control in hypertensive diabetics requires optimising glycaemic control.
{"title":"Profil tensionnel et équilibre glycémique du sujet diabétique type 2 et hypertendu au Centre Hospitalier Universitaire Yalgado Ouédraogo : à propos de 116 Cas","authors":"Koudougou Jonas Kologo , A. Tall-Thiam , G.R.C. Millogo , K.J. Nabi , S. Traore , Y. Kambire , Z.M. Some , M.R. Kationo , N.V. Yameogo , A.K. Samadoulogou , P. Zabsonre","doi":"10.1016/j.ancard.2025.101878","DOIUrl":"10.1016/j.ancard.2025.101878","url":null,"abstract":"<div><h3>Objective</h3><div>To study the correlation between glycaemic control and blood pressure control, in order to determine the factors associated with blood pressure control in diabetic patients.</div></div><div><h3>Methodology</h3><div>This was a descriptive cross-sectional study with an analytical aim over a period of 7 months. Patients were recruited on an outpatient basis, and all underwent ABPM, measurement of glycated haemoglobin and creatinine levels, and assessment of compliance with treatment.</div></div><div><h3>Results</h3><div>Our criteria enabled us to select 116 patients. Women predominated (69%). The mean age of the patients was 62 ± 7 years, with a peak between 60 and 70 years. The mean duration of hypertension was 12 years and that of diabetes 6 years. The most frequently associated cardiovascular risk factor was physical inactivity (71.5%), followed by age. 57.8% of patients had uncontrolled blood pressure at the practice, with systolic hypertension predominating (58.2%). MAPA found that 61.6% of patients were controlled, giving a white-coat hypertension rate of 47.8%. Glycaemic control was observed in 42.2% of cases, and 87% of patients had good renal function. Compliance with treatment was good in 53.4% of cases, and dual therapy was the most commonly used treatment modality (44.8%), followed by triple therapy. The factors associated with poor blood pressure control were glycaemic imbalance, lack of compliance and monotherapy. Combination therapy was associated with good blood pressure control.</div></div><div><h3>Conclusion</h3><div>The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. ABPM is the best method of assessing blood pressure control. Optimising blood pressure control in hypertensive diabetics requires optimising glycaemic control.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 2","pages":"Article 101878"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628512","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}
Pericarditis is often an asymptomatic complication of rheumatoid arthritis. It rarely progresses towards tamponade or chronicity. There is little data on the therapeutic management of this serious complication. Recently, some rare data evaluating the place of biotherapy in rheumatoid pericarditis have been published. We report the observation of a patient with immunopositive rheumatoid arthritis escaping several lines of treatment who developed tamponade which recurred after surgical drainage. Only combotherapy with rituximab and anakinra allowed the induction of rheumatological remission and the disappearance of pericarditis.
{"title":"Combothérapie par rituximab et anakinra dans le traitement d'une péricardite chronique compliquant une polyarthrite rhumatoïde","authors":"Nabil Belfeki , Nouha Ghriss , Houssem Hamrouni , Sonia Kammoun , Mazen Alloujami , Cyrus Moini","doi":"10.1016/j.ancard.2025.101865","DOIUrl":"10.1016/j.ancard.2025.101865","url":null,"abstract":"<div><div>Pericarditis is often an asymptomatic complication of rheumatoid arthritis. It rarely progresses towards tamponade or chronicity. There is little data on the therapeutic management of this serious complication. Recently, some rare data evaluating the place of biotherapy in rheumatoid pericarditis have been published. We report the observation of a patient with immunopositive rheumatoid arthritis escaping several lines of treatment who developed tamponade which recurred after surgical drainage. Only combotherapy with rituximab and anakinra allowed the induction of rheumatological remission and the disappearance of pericarditis<strong>.</strong></div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 2","pages":"Article 101865"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579815","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 : 2025-04-01Epub Date: 2025-03-08DOI: 10.1016/j.ancard.2025.101864
Y. Lyazidi
Arterial affection in Behçet's disease is serious and can be aneurysmal or thrombotic.
The literature on the characteristics of arterial aneurysms in Behçet's disease remains scarce.
This is a case report of a 19-year-old young male who was operated on for a false aneurysm of the left carotid bulb Aneurysm whose etiological investigation revealed Behçet's disease immediately complicated by the arterial localization.
The false aneurysm was excised and the carotid bulb was repaired with polytetrafluoroethylene prosthesis
{"title":"Les faux anévrismes carotidiens au cours de la maladie de Behçet : nouveau cas inaugural de la maladie","authors":"Y. Lyazidi","doi":"10.1016/j.ancard.2025.101864","DOIUrl":"10.1016/j.ancard.2025.101864","url":null,"abstract":"<div><div>Arterial affection in Behçet's disease is serious and can be aneurysmal or thrombotic.</div><div>The literature on the characteristics of arterial aneurysms in Behçet's disease remains scarce.</div><div>This is a case report of a 19-year-old young male who was operated on for a false aneurysm of the left carotid bulb Aneurysm whose etiological investigation revealed Behçet's disease immediately complicated by the arterial localization.</div><div>The false aneurysm was excised and the carotid bulb was repaired with polytetrafluoroethylene prosthesis</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 2","pages":"Article 101864"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579813","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 : 2025-04-01Epub Date: 2025-03-26DOI: 10.1016/S0003-3928(25)00022-8
{"title":"Sommaire","authors":"","doi":"10.1016/S0003-3928(25)00022-8","DOIUrl":"10.1016/S0003-3928(25)00022-8","url":null,"abstract":"","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 2","pages":"Article 101883"},"PeriodicalIF":0.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2025-01-09DOI: 10.1016/j.ancard.2024.101853
Hennebicq Sophie , Joly Emmanuel , Haberman David , Unger Philippe , De Cannière Didier , Leone Attilio
Case Report
We report the case of a 63-year-old patient who underwent aortic valve replacement with a biological valve for a bicuspid aortic stenosis, and LIMA-IVA single-bypass surgery. Two weeks later, he presented with Enterococcus faecillis bacteremia, attributed to left pyelonephritis and successfully treated with Amoxicillin. Two months after his surgery, he had a new bacteremia due to Enterococcus faecalis and we discovered a pseudo-aneurysm of the mitro-aortic trigone. Our patient is treated medically at first, before benefiting from the "Hemi-Commando" procedure.
Discussion
The mitro-aortic trigone is a fibrous area, located between the left half of the noncoronary cusp and the left coronary cusp of the aortic valve and the anterior leaflet of the mitral valve [1]. This area, important in the maintenance of mitral and aortic functions, [ii] is poorly vascularized and therefore very susceptible to infections and trauma [2]. Erosion of the aortic ring leads to the formation of a subvalvular abcess, secondarily detergated en then leads to the destruction of the trigone.
Conclusions
Pseudoaneurysm is a rare complication of aortic valve surgery and endocarditis. Given the risk of rupture, early surgery is recommended.
{"title":"Pseudo-anévrisme du trigone mitro-aortique : cas clinique et revue de littérature","authors":"Hennebicq Sophie , Joly Emmanuel , Haberman David , Unger Philippe , De Cannière Didier , Leone Attilio","doi":"10.1016/j.ancard.2024.101853","DOIUrl":"10.1016/j.ancard.2024.101853","url":null,"abstract":"<div><h3>Case Report</h3><div>We report the case of a 63-year-old patient who underwent aortic valve replacement with a biological valve for a bicuspid aortic stenosis, and LIMA-IVA single-bypass surgery. Two weeks later, he presented with <em>Enterococcus faecillis bacteremia</em>, attributed to left pyelonephritis and successfully treated with Amoxicillin. Two months after his surgery, he had a new bacteremia due to <em>Enterococcus faecalis</em> and we discovered a pseudo-aneurysm of the mitro-aortic trigone. Our patient is treated medically at first, before benefiting from the \"Hemi-Commando\" procedure.</div></div><div><h3>Discussion</h3><div>The mitro-aortic trigone is a fibrous area, located between the left half of the noncoronary cusp and the left coronary cusp of the aortic valve and the anterior leaflet of the mitral valve [<span><span>1</span></span>]. This area, important in the maintenance of mitral and aortic functions, [ii] is poorly vascularized and therefore very susceptible to infections and trauma [<span><span>2</span></span>]. Erosion of the aortic ring leads to the formation of a subvalvular abcess, secondarily detergated en then leads to the destruction of the trigone.</div></div><div><h3>Conclusions</h3><div>Pseudoaneurysm is a rare complication of aortic valve surgery and endocarditis. Given the risk of rupture, early surgery is recommended.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101853"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963562","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 : 2025-02-01Epub Date: 2025-01-10DOI: 10.1016/j.ancard.2024.101859
A. Soufiani , Z. Agoumy , M. Tribak , S. El Mhadi , Z. Fassi Fehri , H. Chraibi , L. Bakamel , O. Soussi , H. El Assili , K. Berrag , J. Raoui , FZ Hattab , Z. Idrissi , S. Essebany , H. Leghlimi , F. Lachhab , N. Fellat , R. Fellat , A. Bensouda , A. Chaib , S. Moughil
Background
Surgical management of patients with severe aortic regurgitation (AR) in the setting of significantly impaired left ventricle (LV) function generally carries very high operative risk. The aim of this study is to assess the short and long-term outcomes of aortic valve replacement (AVR) in a selected young Moroccan population.
Materiel and methods
This is a retrospective study between January 2008 and June 2022 including all patients who underwent AVR for massive isolated AR with an LV ejection fraction EF ≤35%.
Results
In this center, a total of 3820 patients were operated for valvular disease, from which 110 had important AR. Overall, 42 patients of 110 patients had an LV ejection fraction≤35%, and benefited from AVR. Rheumatic cause was predominant (50%). Preoperative characteristics find an average age of 46.3 ±14.4 years with male prevalence. Only two deaths are noted in the immediate postoperative period. At the 15 years follow-up, the survival was 86.8%. Clinical improvement was present in the majority of patients. The mean LVEF post-AVR has increased by an average of 16% with proof of reverse remodeling.
Conclusions
In this series, patients benefited largely from AVR with good postoperative outcomes. The global operative mortality was acceptable (4.7%). The long-term survival (86.8%) was better than that described in the western series. Therefore, our results should encourage a surgical approach for those patients.
{"title":"Promising long-term surgical outcomes of aortic valve replacement in patients with important isolated aortic regurgitation and severe left ventricular dysfunction","authors":"A. Soufiani , Z. Agoumy , M. Tribak , S. El Mhadi , Z. Fassi Fehri , H. Chraibi , L. Bakamel , O. Soussi , H. El Assili , K. Berrag , J. Raoui , FZ Hattab , Z. Idrissi , S. Essebany , H. Leghlimi , F. Lachhab , N. Fellat , R. Fellat , A. Bensouda , A. Chaib , S. Moughil","doi":"10.1016/j.ancard.2024.101859","DOIUrl":"10.1016/j.ancard.2024.101859","url":null,"abstract":"<div><h3>Background</h3><div>Surgical management of patients with severe aortic regurgitation (AR) in the setting of significantly impaired left ventricle (LV) function generally carries very high operative risk. The aim of this study is to assess the short and long-term outcomes of aortic valve replacement (AVR) in a selected young Moroccan population.</div></div><div><h3>Materiel and methods</h3><div>This is a retrospective study between January 2008 and June 2022 including all patients who underwent AVR for massive isolated AR with an LV ejection fraction EF ≤35%.</div></div><div><h3>Results</h3><div>In this center, a total of 3820 patients were operated for valvular disease, from which 110 had important AR. Overall, 42 patients of 110 patients had an LV ejection fraction≤35%, and benefited from AVR. Rheumatic cause was predominant (50%). Preoperative characteristics find an average age of 46.3 ±14.4 years with male prevalence. Only two deaths are noted in the immediate postoperative period. At the 15 years follow-up, the survival was 86.8%. Clinical improvement was present in the majority of patients. The mean LVEF post-AVR has increased by an average of 16% with proof of reverse remodeling.</div></div><div><h3>Conclusions</h3><div>In this series, patients benefited largely from AVR with good postoperative outcomes. The global operative mortality was acceptable (4.7%). The long-term survival (86.8%) was better than that described in the western series. Therefore, our results should encourage a surgical approach for those patients.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101859"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969445","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}
The aim of the study was to assess the level of treatment optimization after follow-up at discharge.
Methods
We conducted a retrospective study carried out from January 1st, 2016 to December 31st, 2018 in Abidjan Heart Institute with patients hospitalized for heart failure and reviewed in consultation.
Results
The study involved 350 patients with an average age of 53.53 ± 16.38 years (54% were males). The prescription of diuretics (92%) after optimization was at the mean and with maximum doses of 29.1% and 7.7%. ACEIs/ARBs (77.1%) had optimal and mean doses for ACEIs of 14.3% and 29.7%. With beta-blockers (72.6%) there was an improvement in doses at 35.4% for the average doses and 3.1%. for the maximum dose. Spironolactone (44.3%) kept the same average dose at 5.7% The median time of optimization was 287.05 days with a median of 140 days. Only 13.4% of patients were receiving optimal treatment at optimal doses. By logistic regression, the presence of LVEF ≤ 0,40 or LVEF= 0.41–0.49 or global heart failure (P < 0.001) favored drug optimization (OR = 24.68[7.15–82.22], P < 0.001); (OR = 11.39[3.25–39.86], P < 0.001) on the other hand, a high serum creatinine level was an obstacle for treatment optimization (OR = 0.92[0.88–0.96], P < 0.001).
Conclusion
The optimization of the treatment of heart failure is insufficient with too long delays in our context. The optimization time was so long. It could be improved by setting up a clinic to optimize the treatment of heart failure.
前言：本研究的目的是评估出院后随访的治疗优化水平。方法：我们对2016年1月1日至2018年12月31日在阿比让心脏研究所因心力衰竭住院的患者进行回顾性研究，并进行会诊。结果：共纳入350例患者，平均年龄53.53±16.38岁，其中男性占54%。优化后的利尿剂处方（92%）平均、最大剂量分别为29.1%和7.7%。acei / arb（77.1%）的最佳和平均acei剂量分别为14.3%和29.7%。使用-受体阻滞剂（72.6%）时，平均剂量的改善率为35.4%,3.1%。最大剂量。螺内酯（44.3%）平均用量为5.7%，优化时间中位数为287.05 d，中位数为140 d。只有13.4%的患者接受了最佳剂量的最佳治疗。通过logistic回归分析，LVEF≤0,40或LVEF= 0.41-0.49或整体心力衰竭（P < 0.001）有利于药物优化（or = 24.68[7.15-82.22], P < 0.001）；（OR = 11.39[3.25-39.86], P < 0.001）另一方面，血清肌酐水平高是优化治疗的障碍（OR = 0.92[0.88-0.96], P < 0.001）。结论：我国对心力衰竭治疗的优化不足，延误时间过长。优化时间太长了。可以通过建立一个诊所来优化心力衰竭的治疗来改善这种情况。
{"title":"Optimisation du traitement de l'insuffisance cardiaque à l'institut de cardiologie d'Abidjan","authors":"Marie Nina Koffi , Anicet Kassi Adoubi , Fatouma Sall , Loa Ambroise Gnaba , Florent Diby , Serge Armel Dakoi , Esaïe Soya","doi":"10.1016/j.ancard.2024.101854","DOIUrl":"10.1016/j.ancard.2024.101854","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of the study was to assess the level of treatment optimization after follow-up at discharge.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study carried out from January 1st, 2016 to December 31st, 2018 in Abidjan Heart Institute with patients hospitalized for heart failure and reviewed in consultation.</div></div><div><h3>Results</h3><div>The study involved 350 patients with an average age of 53.53 ± 16.38 years (54% were males). The prescription of diuretics (92%) after optimization was at the mean and with maximum doses of 29.1% and 7.7%. ACEIs/ARBs (77.1%) had optimal and mean doses for ACEIs of 14.3% and 29.7%. With beta-blockers (72.6%) there was an improvement in doses at 35.4% for the average doses and 3.1%. for the maximum dose. Spironolactone (44.3%) kept the same average dose at 5.7% The median time of optimization was 287.05 days with a median of 140 days. Only 13.4% of patients were receiving optimal treatment at optimal doses. By logistic regression, the presence of LVEF ≤ 0,40 or LVEF= 0.41–0.49 or global heart failure (<em>P</em> < 0.001) favored drug optimization (OR = 24.68[7.15–82.22], <em>P</em> < 0.001); (OR = 11.39[3.25–39.86], <em>P</em> < 0.001) on the other hand, a high serum creatinine level was an obstacle for treatment optimization (OR = 0.92[0.88–0.96], <em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>The optimization of the treatment of heart failure is insufficient with too long delays in our context. The optimization time was so long. It could be improved by setting up a clinic to optimize the treatment of heart failure.</div></div>","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101854"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969429","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}
<div><h3>Introduction</h3><div>The use of medicinal plants in Algeria is an ancestral practice that remains relevant today. The population relies on plants to treat various diseases and everyday ailments, which can be dangerous, especially when taking medication [<span><span>1</span></span>,<span><span>2</span></span>]. The interaction between plants and medication can lead to a modification of the plasma concentrations of the latter, which can impact its therapeutic effectiveness and be responsible for toxicity or therapeutic failure [<span><span>1</span></span>,<span><span>2</span></span>]. The interaction can also be pharmacodynamic, resulting in the potentiation of the effect or its antagonism. The risk is even higher when the medication has a narrow therapeutic range or presents high inter- or intra-individual variability, such as with vitamin K antagonist anticoagulants.</div></div><div><h3>Clinical Case</h3><div>We report the case of patient B.Z., aged 77, who is suffering from complete atrial fibrillation (ACFA). The patient has been under antivitamin K (AVK) treatment with acenocoumarol for 8 years and has been followed at the central laboratory of Didouche Mourad Hospital since August 2019.</div><div>The patient has been stable with an INR within the therapeutic target range of <strong>2-3</strong> for 4 years. She is compliant and adheres to the dietary regimen. The dosage of acenocoumarol is alternated between <strong>1/2 tablet</strong> and <strong>1/4 tablet</strong>. On September 6, 2023, during a routine check-up, the patient's INR was <strong>6.42</strong>, and the PT was <strong>17.9%</strong>. The recommendation was to stop AVK and perform a control the following day. The interview revealed that the patient had started taking an infusion of oregano (<em>Origanum vulgare</em>), and occasionally verbena, at a rate of one <strong>200 ml cup</strong> per day for a week. On September 7, 2023, the INR decreased to <strong>3.80</strong> and the PT to <strong>26.9%</strong>, so the recommendation was to resume AVK at a dosage of <strong>1/4 tablet</strong> to <strong>1/2 tablet</strong>, with discontinuation of the herbal tea intake and an INR check after 72 hours. On the fourth day after resuming the anticoagulant, the INR was <strong>2.5</strong>. Despite being informed of the risk of interaction, the patient resumed taking the freshly picked oregano herbal tea from her garden. Given the patient's determination to continue her infusion, the recommendation was made to limit her intake, to prepare much more diluted infusions, and to reduce the dose of acenocoumarol to <strong>1/4 tablet</strong>; this allowed the stabilization of the patient's INR. The last check-up was performed on April 7, 2024, with an INR value of <strong>2.3</strong>.</div></div><div><h3>Results</h3><div>Oregano, a plant from the <em>Lamiaceae</em> family, is used in herbal tea to treat a wide range of diseases, including joint pain, respiratory conditions, and di
{"title":"Origanum vulgare et risque hémorragique, à propos d'un cas","authors":"Imene Beghriche , Abdelaali Belhachem , Imene Hamidene , Allaoua Hicham Fendri","doi":"10.1016/j.ancard.2024.101856","DOIUrl":"10.1016/j.ancard.2024.101856","url":null,"abstract":"<div><h3>Introduction</h3><div>The use of medicinal plants in Algeria is an ancestral practice that remains relevant today. The population relies on plants to treat various diseases and everyday ailments, which can be dangerous, especially when taking medication [<span><span>1</span></span>,<span><span>2</span></span>]. The interaction between plants and medication can lead to a modification of the plasma concentrations of the latter, which can impact its therapeutic effectiveness and be responsible for toxicity or therapeutic failure [<span><span>1</span></span>,<span><span>2</span></span>]. The interaction can also be pharmacodynamic, resulting in the potentiation of the effect or its antagonism. The risk is even higher when the medication has a narrow therapeutic range or presents high inter- or intra-individual variability, such as with vitamin K antagonist anticoagulants.</div></div><div><h3>Clinical Case</h3><div>We report the case of patient B.Z., aged 77, who is suffering from complete atrial fibrillation (ACFA). The patient has been under antivitamin K (AVK) treatment with acenocoumarol for 8 years and has been followed at the central laboratory of Didouche Mourad Hospital since August 2019.</div><div>The patient has been stable with an INR within the therapeutic target range of <strong>2-3</strong> for 4 years. She is compliant and adheres to the dietary regimen. The dosage of acenocoumarol is alternated between <strong>1/2 tablet</strong> and <strong>1/4 tablet</strong>. On September 6, 2023, during a routine check-up, the patient's INR was <strong>6.42</strong>, and the PT was <strong>17.9%</strong>. The recommendation was to stop AVK and perform a control the following day. The interview revealed that the patient had started taking an infusion of oregano (<em>Origanum vulgare</em>), and occasionally verbena, at a rate of one <strong>200 ml cup</strong> per day for a week. On September 7, 2023, the INR decreased to <strong>3.80</strong> and the PT to <strong>26.9%</strong>, so the recommendation was to resume AVK at a dosage of <strong>1/4 tablet</strong> to <strong>1/2 tablet</strong>, with discontinuation of the herbal tea intake and an INR check after 72 hours. On the fourth day after resuming the anticoagulant, the INR was <strong>2.5</strong>. Despite being informed of the risk of interaction, the patient resumed taking the freshly picked oregano herbal tea from her garden. Given the patient's determination to continue her infusion, the recommendation was made to limit her intake, to prepare much more diluted infusions, and to reduce the dose of acenocoumarol to <strong>1/4 tablet</strong>; this allowed the stabilization of the patient's INR. The last check-up was performed on April 7, 2024, with an INR value of <strong>2.3</strong>.</div></div><div><h3>Results</h3><div>Oregano, a plant from the <em>Lamiaceae</em> family, is used in herbal tea to treat a wide range of diseases, including joint pain, respiratory conditions, and di","PeriodicalId":7899,"journal":{"name":"Annales de cardiologie et d'angeiologie","volume":"74 1","pages":"Article 101856"},"PeriodicalIF":0.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963560","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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