Archives of Cardiovascular Diseases Supplements最新文献

{"title":"Value of echocardiography in estimating functional status and event-risk in patients with hypertrophic cardiomyopathy","authors":"M. Lacout","doi":"10.1016/j.acvdsp.2023.04.037","DOIUrl":"10.1016/j.acvdsp.2023.04.037","url":null,"abstract":"<div><h3>Introduction</h3><p>The prognosis in patients<span> with hypertrophic cardiomyopathy (HCM) remains complicated to estimate. Exercise testing is recommended. We sought to assess whether the echocardiographic evaluation could help in best understanding the clinical consequences and the event-risk of patients referred for HCM.</span></p></div><div><h3>Method</h3><p>In total, 302 HCM-patients (57.4<!--> <!-->±<!--> <!-->16.8<!--> <span><span>years old) were analysed. All patients underwent transthoracic rest and stress echocardiography for the evaluation of size and function including strain measurements. A </span>cardiopulmonary exercise test (CPET) was performed by all the patients at the time of echocardiography. The patients were followed for 3.4</span> <span>years for the occurrence of a composite endpoint including heart failure requiring hospitalization, syncope, ventricular tachycardia (VT) sustained or not, atrial heart rate episode registered by pacemaker or implanted defibrillator<span>, symptomatic supraventricular tachycardia, asymptomatic supraventricular tachycardia detected by Holter, defibrillator implantation, myomectomy/septal alcoholising, or HCM related death.</span></span></p></div><div><h3>Results</h3><p>Mean VO² peak for all patients was 21.57<!--> <!-->±<!--> <!-->7.6<!--> <!-->mL/kg/min. The best predictors of peak VO² were increased exercise mean E/Ea (9.17 [6.30–12.9]), decreased resting TAPSE (22.5<!--> <!-->±<!--> <!-->4.99<!--> <!-->mm) and decreased exercise LV GLS (−17.6<!--> <!-->±<!--> <!-->3.97%). Among the 302 patients, 132 (43.8%) met the composite endpoint. Among clinical, CPET and echocardiographic parameters recorded, PLAS was the best predictor of event with linear association.</p></div><div><h3>Conclusion</h3><p>The decrease in PLAS was strongly associated with the risk of event. It takes over CPET results. On top of this prognostic value, echocardiographic evaluation was demonstrated extremely relevant for our daily evaluation of HCM-patients.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 261"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45965443","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}

{"title":"Prognostic contribution of left ventricular myocardial work assessment in mitral valve prolapse","authors":"J. Thierry,&nbsp;D. Stevant,&nbsp;N. Piriou,&nbsp;P.Y. Turgeon,&nbsp;K. Warin-Fresse,&nbsp;J.M. Serfaty,&nbsp;D. Grimault,&nbsp;T. Le Tourneau","doi":"10.1016/j.acvdsp.2023.04.004","DOIUrl":"10.1016/j.acvdsp.2023.04.004","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Mitral Valve Prolapse (MVP) is the leading cause of primary </span>mitral regurgitation<span> (MR). Due to volume overload-induced changes in severe MR, assessment of left ventricular systolic function, an important marker to refer patients to surgery, is difficult. The aim of our study was to assess cardiac mechanics based on the non-invasive evaluation of myocardial work, by analysing the left ventricular pressure-strain loop, taking into account loading conditions.</span></p></div><div><h3>Method</h3><p><span>In total, 321 patients (63% male) with MVP (with or without severe MR), who underwent a comprehensive echocardiography<span><span> and cardiac magnetic resonance (CMR) between 2010 and 2021, were included. Myocardial work parameters were assessed using a dedicated software. The primary endpoint associated cardiovascular death, sustained </span>ventricular arrhythmia, heart failure, </span></span>new onset atrial fibrillation<span>, or arterial embolism.</span></p></div><div><h3>Results</h3><p><span>Of the 321 patients 186 (58%) had a GWW (global wasted work) &lt; 120 mmHg% and 135 (42%) a GWW ≥ 120 mmHg%. GWW &lt; 120 mmHg% was associated with echographic and CMR parameters of abnormal filling, volume overload and more severe regurgitation. During a mean follow-up of 4.5</span> <!-->±<!--> <span>2.8 years, censored at the time of mitral valve surgery, 36 cardiovascular events were recorded in the GWW</span> <!-->&lt;<!--> <!-->120 mmHg% group versus 14 in the GWW ≥ 120 mmHg% group (19% vs. 10%; <em>P</em> <!-->=<!--> <!-->0.028). Heart failure (15 vs. 6%; <em>P</em> <!-->=<!--> <!-->0.011) and mitral valve intervention (69 vs. 59%; <em>P</em> <!-->=<!--> <span>0.045) rates were higher in the GWW &lt; 120 mmHg% group. Five-year cardiovascular event-free survival was decreased in patients with GWW</span> <!-->&lt;<!--> <!-->120 mmHg% (46.6<!--> <!-->±<!--> <!-->7.7% vs. 59.1<!--> <!-->±<!--> <!-->12.4%; <em>P</em> <!-->=<!--> <!-->0.023). In multivariable analysis, MR severity, the presence of late enhancement on CMR, and GWW<!--> <!-->&lt;<!--> <!-->120 mmHg% (HR 1.76; 95% CI 0.93–3.34; <em>P</em> <!-->=<!--> <!-->0.085) were associated with impaired event-free survival.</p></div><div><h3>Conclusion</h3><p>Myocardial work-up provides additional diagnostic and prognostic information to echocardiography and cardiac MRI in MV.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 244"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47351570","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}

{"title":"Impact of sex on severity assessment and cardiac remodeling in primary mitral regurgitation due to valve prolapse","authors":"A. Altes ,&nbsp;F. Levy ,&nbsp;V. Hanet ,&nbsp;D. De Azevedo ,&nbsp;P. Krug ,&nbsp;L. Iacuzio ,&nbsp;M. Toledano ,&nbsp;V. Silvestri ,&nbsp;D. Vancraeynest ,&nbsp;A. Pasquet ,&nbsp;A. Vincentelli ,&nbsp;A. Eker ,&nbsp;S. Marechaux ,&nbsp;B. Gerber","doi":"10.1016/j.acvdsp.2023.04.002","DOIUrl":"10.1016/j.acvdsp.2023.04.002","url":null,"abstract":"<div><h3>Introduction</h3><p>The current recommended cut-off values for primary mitral regurgitation (MR) quantification (Effective Regurgitant Orifice Area [EROA], regurgitant volume [RegVol]) and left ventricular (LV) remodeling in MR (end-systolic diameter [ESD]) are not sex-specific.</p></div><div><h3>Method</h3><p>We retrospectively evaluated 470 patients (27% women, median age 63 years) with chronic significant primary MR due to prolapse who underwent echocardiography<span> (Echo) and cardiac magnetic resonance imaging (CMR) in 3 tertiary centers between 2005 and 2022.</span></p></div><div><h3>Results</h3><p><span>Women were older than men, had higher NYHA class, larger left atrial volume, higher pulmonary pressure, and more symptoms-triggered MV intervention (all </span><em>P</em> <!-->&lt;<!--> <!-->0.035). However, both MR EROA, Echo-RegVol and CMR-RegVol were lower in women than in men (all <em>P</em> <!-->&lt;<!--> <span>0.003), while CMR regurgitant fraction (RegFrac) values were similar (</span><em>P</em> <!-->=<!--> <!-->0.890). Abnormally increased CMR- (&gt; upper limit bound of UK Biobank reference values) indexed LV end-diastolic (indLVEDV), end-systolic volume (indLVESV) were observed in 55%, 29% of patients, respectively, without sex difference (<em>P</em> <!-->=<!--> <!-->1, <em>P</em> <!-->=<!--> <!-->0.9). The optimal cut-off values of MR EROA, Echo-RegVol and CMR-RegVol associated with enlarged indLVEDV were lower in women (40 mm², 60<!--> <!-->mL, 50<!--> <!-->mL) than in men (45 mm²,77<!--> <!-->mL, 62<!--> <!-->mL). LVESD ≥ 40<!--> <!-->mm showed in women and men high specificity [Sp] (91%, 79%) but poor sensitivity [Se] (40% 50%) to predict enlarged indLVESV, while the optimal threshold was slightly lower in women (35<!--> <!-->mm, Se<!--> <!-->=<!--> <!-->65%, Sp<!--> <!-->=<!--> <!-->71%) than in men (37<!--> <!-->mm, Se<!--> <!-->=<!--> <!-->65%, Sp<!--> <!-->=<!--> <!-->68%).</p></div><div><h3>Conclusion</h3><p>Despite clear hallmarks of more advanced valve disease, women with primary MR have lower mitral RegVol and lower ventricular volumes than men. Then, cut-off values of mitral RegVol, EROA and LV dimensions for predicting abnormal LV dilatation are lower in women than in men. Hence, guideline-based criteria for grading MR and timing of intervention could be sex-specific (<span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 243"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49005846","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}

{"title":"Aortic valve calcification of surgical bioprostheses and its impact on clinical outcome","authors":"G. Guimbretiere,&nbsp;T. Senage,&nbsp;A.S. Boureau,&nbsp;N. Piriou,&nbsp;K. Warin-Fresse,&nbsp;J.M. Serfaty,&nbsp;J.C. Roussel,&nbsp;T. Le Tourneau","doi":"10.1016/j.acvdsp.2023.04.005","DOIUrl":"10.1016/j.acvdsp.2023.04.005","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Aortic valve calcification (AVC) of surgical valve bioprostheses (BP) has been poorly explored. We aimed to evaluate </span><em>in vivo</em> and <span><em>ex vivo</em></span> BP AVC and its prognosis value.</p></div><div><h3>Method</h3><p>Between 2011 and 2019, AVC was assessed in 361 patients with surgical BP on <em>in vivo</em><span> computed tomography (CT) scanner (6.4</span> <!-->±<!--> <!-->4.3 years after surgery). Follow-up was obtained in all patients. <em>Ex vivo</em> CT-scans were performed in 37 explanted BP.</p></div><div><h3>Results</h3><p>After exclusion of 19 (5.2%) CT-scans, mean <em>in vivo</em> AVC was 307<!--> <!-->±<!--> <!-->500 AU in the remaining 342 BP (77<!--> <!-->±<!--> <!-->9 years, 64% male). Of these, 183 (53.5%) had a structural valve degeneration (SVD) with an AVC of 562<!--> <!-->±<!--> <!-->570 AU compared with 13<!--> <!-->±<!--> <!-->43 AU (<em>P</em> <!-->&lt;<!--> <!-->0.0001) for non-SVD BP. Early calcification was observed in around 10% of BP (12/124) examined before the 3rd postoperative year. In explanted BP <em>in vivo</em> AVC correlated strongly with <em>ex vivo</em> AVC (<em>r</em> <!-->=<!--> <!-->0.88, <em>P</em> <!-->&lt;<!--> <!-->0.0001). An <em>in vivo</em> AVC<!--> <!-->&gt;<!--> <!-->100 AU (<em>n</em> <!-->=<!--> <!-->147, 43%) had an excellent specificity (96%) for diagnosing stage 2–3 SVD. Patients with AVC<!--> <!-->&gt;<!--> <!-->100 AU had worse survival compared with those with an AVC<!--> <!-->&lt;<!--> <!-->100 (<em>n</em> <!-->=<!--> <!-->195, 57%). In multivariable analyses, AVC value was a predictor of overall mortality (HR<!--> <!-->=<!--> <!-->1.16 [1.04–1.29]; <em>P</em> <!-->=<!--> <span>0.009), cardiovascular mortality (HR</span> <!-->=<!--> <!-->1.21 [1.03–1.41]; <em>P</em> <!-->=<!--> <!-->0.021) and cardiovascular events (HR<!--> <!-->=<!--> <!-->1.19 [1.08–1.31]; <em>P</em> <!-->=<!--> <!-->0.001). After further adjustment for SVD diagnosis, AVC remained a predictor of overall mortality (HR<!--> <!-->=<!--> <!-->1.24 [1.07–1.44]; <em>P</em> <!-->=<!--> <!-->0.005), and cardiovascular events (HR<!--> <!-->=<!--> <!-->1.16 [1.02–1.32]; <em>P</em> <!-->=<!--> <!-->0.029).</p></div><div><h3>Conclusion</h3><p>CT-scan AVC of surgical BP is a reliable tool for assessing leaflets calcification. Whereas calcification can develop early after surgery, an AVC &gt; 100 AU is tightly associated with SVD, and is a strong predictor of overall mortality and cardiovascular events, even after adjustment for SVD diagnosis. Hence, AVC scoring is a complementary tool to echocardiography that should be used in the follow-up of patients with surgical aortic BP.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Pages 244-245"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43584878","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}

{"title":"Ours SFC","authors":"","doi":"10.1016/S1878-6480(23)00213-6","DOIUrl":"https://doi.org/10.1016/S1878-6480(23)00213-6","url":null,"abstract":"","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page iii"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49726514","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}

{"title":"Associated factors and clinical implications of dynamic changes in late gadolinium enhancement after acute myocarditis","authors":"Y. Bohbot ,&nbsp;F. Sanguineti ,&nbsp;C. Renard ,&nbsp;T. Hovasse ,&nbsp;I. Limouzineau ,&nbsp;T. Unterseeh ,&nbsp;C. Di Lena ,&nbsp;W. Boukefoussa ,&nbsp;C. Tawa ,&nbsp;S. Duhamel ,&nbsp;P. Garot ,&nbsp;C. Tribouilloy ,&nbsp;J. Garot","doi":"10.1016/j.acvdsp.2023.04.011","DOIUrl":"https://doi.org/10.1016/j.acvdsp.2023.04.011","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Although follow-up cardiac magnetic resonance (CMR) is often performed after acute </span>myocarditis<span> (AM), the prognostic implications of dynamic changes in late gadolinium enhancement (LGE) are unknown. We aimed to determine the prognostic implications of dynamic LGE changes after acute AM.</span></p></div><div><h3>Method</h3><p>In a two-centre study, 204 consecutive hemodynamically stable patients (mean age 35<!--> <!-->±<!--> <span>16 years, 78.9% males) with a CMR-based diagnosis of AM were included and underwent repeat CMR 3–12 months after diagnosis. Quantitative LGE was expressed as percent of left ventricular (LV) myocardium<span>. The primary endpoint was the occurrence of major adverse cardiac events (MACE) at median 7.3 [IQR: 5.7–8.7] years.</span></span></p></div><div><h3>Results</h3><p><span>Compared to index CMR, there was an increase in LV ejection fraction (EF) (59% vs. 55%, </span><em>P</em> <!-->&lt;<!--> <!-->0.001) and a decrease in LGE extent (7.6% vs. 12.0%, <em>P</em> <!-->&lt;<!--> <!-->0.001) at follow-up (mean 5.7<!--> <!-->±<!--> <!-->2.6 months after index CMR). LGE persisted in 175 patients at follow-up (85.8%). LGE decreased by ≥ 50% from baseline in 94 patients (46%), by &lt; 50% in 86 (42%) and increased in 24 (12%). Female gender (OR [95%CI]<!--> <!-->=<!--> <!-->3.27 [1.17–9.12], <em>P</em> <!-->=<!--> <!-->0.023), low baseline LVEF (OR [95%CI]<!--> <!-->=<!--> <!-->0.93 [0.88–0.98] per %, <em>P</em> <!-->=<!--> <!-->0.010) and LGE involving both septal and lateral walls (OR [95%CI]<!--> <!-->=<!--> <!-->4.64 [1.77–12.17], <em>P</em> <!-->=<!--> <span>0.002) were independently associated with increased LGE. By multivariate Cox analysis, only baseline LVEF (HR [95%CI]</span> <!-->=<!--> <!-->0.94 [0.89–0.99] per %, <em>P</em> <!-->=<!--> <!-->0.031), a &lt; 50% LGE decrease (HR [95%CI]<!--> <!-->=<!--> <!-->3.78 [1.04–10.70], <em>P</em> <!-->=<!--> <!-->0.044) and an increase in LGE (HR [95%CI]<!--> <!-->=<!--> <!-->8.35 [2.05–24.00], <em>P</em> <!-->=<!--> <!-->0.003) were significantly associated with MACE.</p></div><div><h3>Conclusion</h3><p><span>After AM, LGE persists at 6 months in the vast majority of patients but tends to decrease. A &lt; 50% decrease or an increase in LGE are associated with MACE, indicating that follow-up CMR is relevant for risk stratification (</span><span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 248"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49737860","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}

{"title":"Feasibility, efficacy and safety of PFO closure under local anesthesia with transoesophageal echocardiography microprobe: A single-center study of 383 patients","authors":"S. Lagrange,&nbsp;B. Mouhat,&nbsp;M. Besutti,&nbsp;O. Zbitou,&nbsp;R. Chopard,&nbsp;N. Meneveau","doi":"10.1016/j.acvdsp.2023.04.029","DOIUrl":"10.1016/j.acvdsp.2023.04.029","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Percutaneous patent foramen ovale (PFO) closure is usually performed under </span>general anesthesia<span><span> (GA) with guidance by transesophageal echocardiograpy (TEE). Microrobe makes this procedure possible under local anesthesia (LA). Our study aimed to assess the feasibility, efficacy and safety of PFO closure under LA with </span>microprobe guidance.</span></p></div><div><h3>Method</h3><p><span>The aim was to evaluate the rate of PFO closure failure in patients who underwent a procedure under LA with a TEE microprobe (micro-LA group) vs. under GA with a conventional probe (conventional-GA group). The primary endpoint was the persistence of inter-atrial shunt (&gt;</span> <!-->10 microbubbles) 6 months after procedure, screened by contrast transthoracic ultrasound. The secondary objectives were: identification of risk markers for the persistence of inter-atrial shunt at 6 months, post-procedure complication rates and major cardiovascular events rate.</p></div><div><h3>Results</h3><p>Three hundred and eighty three patients were included: 303 (79%) in the conventional-GA group, 79 (21%) in the micro-AL group. The median follow-up was 28.0 (14.0–49.0) months. The average age was 49.9<!--> <!-->±<!--> <!-->12.6 years, 61.9% of men. There was no failure of PFO closure under AL. Six months after PFO closure, there was no difference in persistence of inter-atrial shunt between the conventional-GA group and the micro-AL group (29.3% vs. 25.5%, <em>P</em> <!-->=<!--> <span>0.583). There was no difference in the occurrence of complications related to the procedure between the 2 groups. In multivariate analysis, the presence of interatrial septal aneurysm [OR 1.88 (95% CI 1.07–3.31), </span><em>P</em> <!-->=<!--> <!-->0.029], ROPE score<!--> <!-->&gt;<!--> <!-->6 [OR 1.22 (1.04–1.43), <em>P</em> <!-->=<!--> <!-->0.015] and the occurrence of stroke following the procedure [OR 4.48 (1.12–17.87), <em>P</em> <!-->=<!--> <!-->0.034] were independently associated with the presence of a residual inter-atrial shunt at 6 months.</p></div><div><h3>Conclusion</h3><p>Our study identified that PFO closure under LA with TEE microprobe is feasible and safe. There was no difference in efficacy of 6-month FOP closure, regardless of conventional-GA or micro-AL method.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 258"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43931709","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}

{"title":"Microvascular dysfunction assessed by dynamic cardiac SPECT in subjects with cardiac transthyretin amyloidosis","authors":"M. Bailly ,&nbsp;A. Bisson ,&nbsp;M. Courtehoux ,&nbsp;N. Chane-Sone ,&nbsp;A. Bernard","doi":"10.1016/j.acvdsp.2023.04.042","DOIUrl":"10.1016/j.acvdsp.2023.04.042","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Few studies found that coronary microvascular dysfunction<span> was highly prevalent in subjects with cardiac transthyretin amyloidosis (ATTR), even in the absence of </span></span>epicardial coronary artery<span> disease (CAD). The aim of this preliminary report is to confirm the coronary microvascular dysfunction using dynamic cardiac SPECT.</span></p></div><div><h3>Method</h3><p><span>Adult patients with confirmed ATTR cardiomyopathy were included before Tafamidis<span> treatment in a multicentric, prospective, observational cohort study (AMYTRE study, </span></span><span>NCT05103943</span><svg><path></path></svg>). Dynamic cardiac SPECT data were acquired on CZT-based pinhole cardiac cameras in listmode using a stress (249<!--> <!-->±<!--> <!-->13<!--> <!-->MBq)/rest (506<!--> <!-->±<!--> <!-->17<!--> <span>MBq) one-day 99mTc-tetrofosmin protocol. Kinetic analysis was done with Corridor4DMTM software using a 1-tissue-compartment model and converted to myocardial blood flow using a previously determined extraction fraction correction. Myocardial flow reserve (MFR) was defined as the ratio between stress and rest myocardial blood flow.</span></p></div><div><h3>Results</h3><p>Thirteen (9 male, 4 female) patients were prospectively included. Mean age was 77<!--> <!-->±<!--> <!-->18; mean BMI was 28<!--> <!-->±<!--> <span>8.1. ATTR was diagnosed on 99mTc-HDP bone scintigraphy (8 grade 2 and 5 grade 3). LVEF was preserved, mean 57</span> <!-->±<!--> <span>7.5%. Twelve patients had normal perfusion imaging<span>, without ischemia; 1 patient had moderate infero-basal ischemia (5–10% extent). MFR was significantly reduced both globally (1.5</span></span> <!-->±<!--> <!-->0.35) and in all territories (1.5<!--> <!-->±<!--> <!-->0.34 for left anterior descending, 1.6<!--> <!-->±<!--> <!-->0.39 for left circumflex, and 1.6<!--> <!-->±<!--> <!-->0.45 for right coronary).</p></div><div><h3>Conclusion</h3><p>In this preliminary report, MFR is significantly reduced in all territories in patients with ATTR cardiomyopathy, undergoing cardiac dynamic SPECT. This confirms potential coronary microvascular dysfunction.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 263"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47298045","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}

{"title":"Echocardiographic findings in systemic lupus erythematosus","authors":"M. Drissa (Professor),&nbsp;A. Ayadi (Intern),&nbsp;H. Drissa (Professor)","doi":"10.1016/j.acvdsp.2023.04.041","DOIUrl":"10.1016/j.acvdsp.2023.04.041","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by inflammation of multiple organs. The heart may be seriously involved. Aim of study: to investigate the cardiac involvement </span>in patients diagnosed with SLE assessed from an echocardiographic view.</p></div><div><h3>Method</h3><p>We retrospectively reviewed the records of 75 patients with diagnosis of SLE based on the American College of Rheumatology<span> criteria and who were referred to our echocardiography laboratory between 2010 to 2022. All echocardiographic exams were carried by transthoracic way.</span></p></div><div><h3>Results</h3><p>Patients were female in 92% of cases. Mean age was 27.8<!--> <!-->years (16–70<!--> <span><span>years). Echocardiography showed 17 cases (22%) of minim or moderate pericardial effusion, tamponadein 2 cases. Valvularabnormalities were observed in 19 cases (25%), this included thickening of valves in all cases associated to 6 cases of significant </span>mitral regurgitation (&gt;</span> <span><span><span>grade 1) and 2 cases of Libman sacks mitral valve </span>endocarditis. However, aortic involvement was noted only in 3 cases resulting in thickening and mild regurgitation. </span>Myocardium<span> was involved in 5 cases (6%) including dilated left ventricular in 3 cases and hypertrophy in 2 cases. High arterial pulmonary hypertension was reported in 4 cases (5%) with mean systolic pulmonary arterial pressure was 59</span></span> <!-->mmHg (38–120<!--> <!-->mmHg).</p></div><div><h3>Conclusion</h3><p>Patients with SLE have an increased risk of cardiac involvement. In agreement with previous reports, our study shows that pericardial effusion is the most frequent cardiac complication of lupus and Valvular involvement in SLE is relatively frequent but the degree of valvular dysfunction is not important. Echocardiography should be used as a screening tool in these patients, including annual echocardiographic screening of asymptomatic individuals with systemic autoimmunity.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Pages 262-263"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44216692","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}

{"title":"Echocardiographic assessment of right ventricular function and right ventriculoarterial coupling in tricuspid regurgitation","authors":"L. Trousselle ,&nbsp;F. Eggenspieler ,&nbsp;L. Faroux ,&nbsp;P. Nazeyrollas ,&nbsp;O. Huttin ,&nbsp;N. Pace ,&nbsp;L. Filippetti ,&nbsp;A. Fraix ,&nbsp;B. Carquin ,&nbsp;C. Selton-Suty ,&nbsp;D. Metz","doi":"10.1016/j.acvdsp.2023.04.032","DOIUrl":"10.1016/j.acvdsp.2023.04.032","url":null,"abstract":"<div><h3>Introduction</h3><p>Echographic evaluation of the cardiopulmonary unit may be difficult in the presence of TR. Purpose: To assess the variation of simple and combined echographic parameters analysing the cardiopulmonary unit according to the severity of TR.</p></div><div><h3>Method</h3><p>Echographic images were reviewed in 179 patients to assess TR grade according to Hahn's 5 grades classification. Classical morphological (RV end diastolic length and area), function [TAPSE, RVFAC, S’,RVFWS (RV free wall longitudinal strain)] and load [PASP,TRTVI (TR Time-velocity integral)] parameters analysing RV were assessed. Combined parameters of function and load (TAPSE/PASP, TR TVI<!--> <!-->×<!--> <!-->RVFWS), morphology and load (load adaptation index<!--> <!-->=<!--> <!-->TRTVIxRVED length/area) and morphology, load, and function [myomechanical index (MMI<!--> <!-->=<!--> <!-->RV-RA mean pressure gradient<!--> <!-->×<!--> <!-->RVFWS/indexed RAED area<!--> <!-->×<!--> <!-->10–2) and morphology-load-function index (MLF<!--> <!-->=<!--> <!-->RVED length/area xTRTVIx RVFWS)] were calculated. We used ROC curves to analyze the diagnostic value of echocardiographic parameters to predict potential high (&gt;<!--> <!-->3) or low (&lt;<!--> <!-->6) surgical risk of mortality according to TRISCORE.</p></div><div><h3>Results</h3><p>Simple parameters were significatively different among groups with a nonlinear progression between the 5 levels of TR. Combined parameters were also significatively different. Among them, MMI and MLF had a linear progression (MMI: grade 1: 0.20<!--> <!-->±<!--> <!-->0.09; grade 2: 0.15<!--> <!-->±<!--> <!-->0.08; grade 3: 0.10<!--> <!-->±<!--> <!-->0.05, grade 4: 0.09<!--> <!-->±<!--> <!-->0.08; grade 5: 0.05<!--> <!-->±<!--> <!-->0.04 <em>P</em> <em>=</em> <!-->0.000; MLF: grade 1: 7.56<!--> <!-->±<!--> <!-->2.06; grade 2: 6.57<!--> <!-->±<!--> <!-->2.14; grade 3: 4.85<!--> <!-->±<!--> <!-->2.29, grade 4: 4.79<!--> <!-->±<!--> <!-->3.17; grade 5: 3.06<!--> <!-->±<!--> <!-->1.82 <em>P</em> <em>=</em> <!-->0.000) and had the best predictive value for TRISCORE (MMI: AUC<!--> <!-->=<!--> <!-->0.889 <em>P</em> <em>=</em> <!-->0.000 for low risk, 0.855 <em>P</em> <em>=</em> <!-->0.000 for high risk; MLF: AUC<!--> <!-->=<!--> <!-->0.873 <em>P</em> <em>=</em> <!-->0.000 and 0.822 <em>P</em> <em>=</em> <!-->0.000).</p></div><div><h3>Conclusion</h3><p>Combined parameters are relevant to evaluate cardiopulmonary unit in a population presenting with TR, especially when combining morphology, function and load (<span>Fig. 1</span>).</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":"15 3","pages":"Page 259"},"PeriodicalIF":18.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45527314","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}