Author: "Nicolas Piriou" / Topic: humans - Searchworks@Jio Institute Digital Library Search Results

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1. Association of early electrical changes with cardiovascular outcomes in immune checkpoint inhibitor myocarditis

Author: John R. Power, Joachim Alexandre, Arrush Choudhary, Benay Ozbay, Salim S. Hayek, Aarti Asnani, Yuichi Tamura, Mandar Aras, Jennifer Cautela, Franck Thuny, Lauren Gilstrap, Dimitri Arangalage, Steven Ewer, Shi Huang, Anita Deswal, Nicolas L. Palaskas, Daniel Finke, Lorenz H. Lehmann, Stephane Ederhy, Javid Moslehi, Joe-Elie Salem, Charlotte Fenioux, Baptiste Abbar, Yves Allenbach, Shanthini M. Crusz, Arjun K. Ghosh, Tyler Moran, Tyler Mehegan, Lawrence Piro, Wei-Ting Chang, Johnny Chahine, Danette Flint, Ben Stringer, Valérie Gounant, Martin Nicol, Barouyr Baroudjian, Marie-Claire Zimmer, Elvire Mervoyer, Darryl Leong, Ryota Morimoto, Nicolas Piriou, Cecilia Monge, Amy Copeland, Kambiz Ghafourian, Avirup Guha, Sergey Brodsky, Osnat Itzhaki Ben Zadok, Manhal Habib, Grace Dy, Ellen Warner, Michal Laufer-Perl, Lily Koo Lin, Ana Narezkina, Alan Baik, Carrie Lenneman, Pankit Vachhani, Tariq U. Azam, Daniel Perry, Pennelope Blakely, Kazuko Tajiri, Matthew Martini, Joseph Nowatzke, Olusola Ayodeji Orimoloye, Andrew Hughes, Lauren A. Baldassarre, and Milan Patel
Subjects: Male, Myocarditis, Heart Block, Humans, Arrhythmias, Cardiac, Female, General Medicine, Cardiology and Cardiovascular Medicine, Immune Checkpoint Inhibitors, Aged, Retrospective Studies
Abstract: Immune-checkpoint inhibitor-associated myocarditis (ICI-myocarditis) often presents with arrhythmias, but the prognostic value of early electrocardiogram findings is unclear. Although ICI-myocarditis and acute cellular rejection (ACR) following cardiac transplantation use similar treatment strategies, differences in arrhythmia burden are unknown.To evaluate the association of electrocardiogram findings in ICI-myocarditis with myocarditis-related mortality and life-threatening arrhythmia.A total of 125 cases of ICI-myocarditis were identified retrospectively across 49 hospitals worldwide; 50 cases of grade 2R or 3R ACR were included as comparators. Two cardiologists blinded to clinical data interpreted electrocardiograms. Associations between electrocardiogram features, myocarditis-related mortality and the composite of myocarditis-related mortality and life-threatening arrhythmias were examined. Adjusted hazard ratios (aHRs) were calculated.The cohort had 78 (62.4%) men; median (interquartile range) age was 67 (58-76) years. At 30 days, myocarditis-related mortality was 20/124 (16.1%), and 28/124 (22.6%) met the composite endpoint. Patients who developed complete heart block (aHR by subdistribution hazards model [aHR(sh)] 3.29, 95% confidence interval [CI] 1.24-8.68; P=0.02) or life-threatening cardiac arrhythmias (aHR(sh) 6.82, 95% CI: 2.87-16.21; P0.001) had a higher risk of myocarditis-related mortality. Pathological Q waves (aHR(sh) 3.40, 95% CI: 1.38-8.33; P=0.008), low QRS voltage (aHR(sh) 6.05, 95% CI: 2.10-17.39; P0.001) and Sokolow-Lyon index (aHR(sh)/mV 0.54, 95% CI: 0.30-0.97; P=0.04) on admission electrocardiogram were also associated with increased risk of myocarditis-related mortality. These associations were mirrored in the composite outcome analysis. Compared with ACR, ICI-myocarditis had a higher incidence of life-threatening cardiac arrhythmias (15/125 [12.0%] vs 1/50 [2%]; P=0.04) and third-degree heart block (19/125 [15.2%] vs 0/50 [0%]; P=0.004).Electrocardiograms in ICI-myocarditis with ventricular tachycardias, heart block, low-voltage and pathological Q waves were associated with myocarditis-related mortality and life-threating arrhythmia. Arrhythmia burden in ICI-myocarditis exceeds that of ACR after heart transplant.
Published: 2022
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2. Coronary artery disease and revascularization associated with immune checkpoint blocker myocarditis: Report from an international registry

Author: Joseph Nowatzke, Paul Guedeney, Nicholas Palaskas, Lorenz Lehmann, Stephane Ederhy, Han Zhu, Jennifer Cautela, Sanjeev Francis, Pierre-Yves Courand, Anita Deswal, Steven M. Ewer, Mandar Aras, Dimitri Arangalage, Kambiz Ghafourian, Charlotte Fenioux, Daniel Finke, Giovanni Peretto, Vlad Zaha, Osnat Itzhaki Ben Zadok, Kazuko Tajiri, Nausheen Akhter, Joshua Levenson, Lauren Baldassarre, John Power, Shi Huang, Jean-Philippe Collet, Javid Moslehi, Joe-Elie Salem, Nazanin Aghel, Joachim Alexandre, Kazutaka Aonuma, Aarti H. Asnani, Juliane Behling, Mehmet Bilen, Wendy Bottinor, Eve Cariou, Johnny Chahine, Weiting Chan, Aman Chauhan, Max Cohen, Shanthini Crusz, Suran Fernando, Roberta Florido, Mauro Frigeri, Satoshi Fukushima, Elizabeth Gaughan, Benjamin P. Geisler, Lauren Gilstrap, Christian Grohe, Avirup Guha, Manhal Habib, Eva Haegler-Laube, Andrew Haydon, Salim Hayek, Andrew Hughes, Rysk Imai, Yumi Katsume, Hideki Kimura, Lily Koo Lin, Carrie Lenneman, Daryl Leong, Vicky Makker, Nicolas Martinez-Calle, Melissa Moey, Masahiro Mohri, Ryota Morimoto, Yoshinobu Moritoki, Anna Narezkina, Martin Nicol, Ajay Nooka, Olusola Orimoloye, Milan Patel, Michal Perl, Nicolas Piriou, Jayant K. Raikhelkar, Yasmin Raza, Anjali Rao, Sunil Reddy, Nobuhiko Seki, Karl Stangl, Andrew Stewart, Bryan Stringer, Balaji K. Tamarappoo, Yuichi Tamura, Frank Thuny, Sean Tierney, Romain Tresorier, Waqas Ullah, Jean-Jacques Von Hunolstein, Ellen Warner, Allison Weppler, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Universität Heidelberg [Heidelberg] = Heidelberg University, German Center for Cardiovascular Research (DZHK), Berlin Institute of Health (BIH), CHU Saint-Antoine [AP-HP], Groupe de REcherche en Cardio Oncologie (GRC 27 - GRECO), Sorbonne Université (SU), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Imagerie Ultrasonore, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), The University of Texas Medical School at Houston, University of Wisconsin-Madison, University of California [San Francisco] (UC San Francisco), University of California (UC), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University of Heidelberg, Medical Faculty, Division of Endocrinology, Metabolism, and Diabetes, University of Utah, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Universität Heidelberg [Heidelberg], Service de Cardiologie [CHU Saint-Antoine], Groupe de REcherche en Cardio Oncologie [CHU Saint-Antoine] (GRC 27 GRECO), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Service de Pharmacologie médicale [CHU Pitié-Salpêtrière]
Subjects: Cancer Research, Coronary Artery Disease, Prognosis, Coronary revascularization, Myocarditis, Oncology, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Immune-related adverse events, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, Registries, Immune checkpoint blockers, Acute coronary syndrome, [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph], Immune Checkpoint Inhibitors, Retrospective Studies
Abstract: International audience; Purpose: Immune checkpoint blocker (ICB) associated myocarditis (ICB-myocar-ditis) may present similarly and/or overlap with other cardiac pathology including acute cor-onary syndrome presenting a challenge for prompt clinical diagnosis.Methods: An international registry was used to retrospectively identify cases of ICB-myocarditis. Presence of coronary artery disease (CAD) was defined as coronary artery steno-sis >70% in patients undergoing coronary angiogram.Results: Among 261 patients with clinically suspected ICB-myocarditis who underwent a coro-nary angiography, CAD was present in 59/261 patients (22.6%). Coronary revascularization was performed during the index hospitalisation in 19/59 (32.2%) patients. Patients undergoing coro-nary revascularization less frequently received steroids administration within 24 h of admission compared to the other groups (p = 0.029). Myocarditis-related 90-day mortality was 9/17 (52.7%) in the revascularised cohort, compared to 5/31 (16.1%) in those not revascularized and 25/156 (16.0%) in those without CAD (p = 0.001). Immune-related adverse event-related 90-day mortality was 9/17 (52.7%) in the revascularized cohort, compared to 6/31 (19.4%) in those not revascularized and 31/156 (19.9%) in no CAD groups (p = 0.007). All-cause 90-day mortality was 11/17 (64.7%) in the revascularized cohort, compared to 13/31 (41.9%) in no revas-cularization and 60/158 (38.0%) in no CAD groups (p = 0.10). After adjustment of age and sex, coronary revascularization remained associated with ICB-myocarditis-related death at 90 days (hazard ratio [HR] = 4.03, 95% confidence interval [CI] 1.84-8.84, p < 0.001) and was margin-ally associated with all-cause death (HR = 1.88, 95% CI, 0.98-3.61, p = 0.057).Conclusion: CAD may exist concomitantly with ICB-myocarditis and may portend a poorer outcome when revascularization is performed. This is potentially mediated through delayed diag-nosis and treatment or more severe presentation of ICB-myocarditis.
Published: 2022
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3. 18F-Fluorodeoxyglucose Positron Emission Tomography for the Detection of Myocardial Inflammation in Arrhythmogenic Left Ventricular Cardiomyopathy

Author: Roxane Tessier, Lara Marteau, Marc Vivien, Béatrice Guyomarch, Aurélie Thollet, Imen Fellah, Bastien Jamet, Jean Charles Sébille, Thomas Eugene, Jean Michel Serfaty, Vincent Probst, Jean Noël Trochu, Claire Toquet, Karine Warin-Fresse, and Nicolas Piriou
Subjects: Inflammation, Myocarditis, Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Humans, Radiology, Nuclear Medicine and imaging, Radiopharmaceuticals, Cardiomyopathies, Cardiology and Cardiovascular Medicine
Published: 2022
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4. Apolipoprotein 1 amyloidosis cardiomyopathy and the grey zone of non-invasive diagnostic algorithms: Red flags to reach the diagnosis

Author: Amandine Pallardy, Nicolas Piriou, Louise Plard, and Jean-Noël Trochu
Subjects: Adult, Male, Pathology, medicine.medical_specialty, Apolipoprotein B, Cardiomyopathy, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Retrospective Studies, Apolipoprotein A-I, biology, business.industry, Amyloidosis, Non invasive, Diagnostic algorithms, Middle Aged, medicine.disease, Grey zone, Mutation, biology.protein, Female, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business, Algorithms, Red flags
Published: 2021
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5. Prevalence, Characteristics, and Outcomes of COVID-19-Associated Acute Myocarditis

Author: Enrico Ammirati, Laura Lupi, Matteo Palazzini, Nicholas S. Hendren, Justin L. Grodin, Carlo V. Cannistraci, Matthieu Schmidt, Guillaume Hekimian, Giovanni Peretto, Thomas Bochaton, Ahmad Hayek, Nicolas Piriou, Sergio Leonardi, Stefania Guida, Annalisa Turco, Simone Sala, Aitor Uribarri, Caroline M. Van de Heyning, Massimo Mapelli, Jeness Campodonico, Patrizia Pedrotti, Maria Isabel Barrionuevo Sánchez, Albert Ariza Sole, Marco Marini, Maria Vittoria Matassini, Mickael Vourc’h, Antonio Cannatà, Daniel I. Bromage, Daniele Briguglia, Jorge Salamanca, Pablo Diez-Villanueva, Jukka Lehtonen, Florent Huang, Stéphanie Russel, Francesco Soriano, Fabrizio Turrini, Manlio Cipriani, Manuela Bramerio, Mattia Di Pasquale, Aurelia Grosu, Michele Senni, Davide Farina, Piergiuseppe Agostoni, Stefania Rizzo, Monica De Gaspari, Francesca Marzo, Jason M. Duran, Eric D. Adler, Cristina Giannattasio, Cristina Basso, Theresa McDonagh, Mathieu Kerneis, Alain Combes, Paolo G. Camici, James A. de Lemos, Marco Metra, Ammirati, E, Lupi, L, Palazzini, M, Hendren, N, Grodin, J, Cannistraci, C, Schmidt, M, Hekimian, G, Peretto, G, Bochaton, T, Hayek, A, Piriou, N, Leonardi, S, Guida, S, Turco, A, Sala, S, Uribarri, A, Van De Heyning, C, Mapelli, M, Campodonico, J, Pedrotti, P, Barrionuevo Sanchez, M, Ariza Sole, A, Marini, M, Matassini, M, Vourc'H, M, Cannata, A, Bromage, D, Briguglia, D, Salamanca, J, Diez-Villanueva, P, Lehtonen, J, Huang, F, Russel, S, Soriano, F, Turrini, F, Cipriani, M, Bramerio, M, Di Pasquale, M, Grosu, A, Senni, M, Farina, D, Agostoni, P, Rizzo, S, De Gaspari, M, Marzo, F, Duran, J, Adler, E, Giannattasio, C, Basso, C, Mcdonagh, T, Kerneis, M, Combes, A, Camici, P, De Lemos, J, Metra, M, CarMeN, laboratoire, Niguarda Hospital [Milan, Italy], University of Brescia, University of Texas Southwestern Medical Center [Dallas], Tsinghua University [Beijing] (THU), Center for Systems Biology Dresden [Dresden, Germany] (CSBD), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Universita Vita Salute San Raffaele = Vita-Salute San Raffaele University [Milan, Italie] (UniSR), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Université de Lyon, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Università degli Studi di Pavia = University of Pavia (UNIPV), Fondazione IRCCS Policlinico San Matteo [Pavia], Hospital Clinico Universitario de Valladolid [Castilla y León, Spain] (HCUV), Instituto de Salud Carlos III [Madrid] (ISC), University of Antwerp (UA), Università degli Studi di Milano = University of Milan (UNIMI), IRCCS Istituto Nazionale dei Tumori [Milano], Bellvitge University Hospital [Barcelona, Spain], Presidio Ospedaliero 'G. Salesi' AN = Ancona Hospital Salesi [Ancona, Italy] (POGSA-AHS), Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Centre hospitalier universitaire de Nantes (CHU Nantes), Thérapeutiques cliniques et expérimentales des infections (EA 3826) (EA 3826), Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), King‘s College London, King's College Hospital (KCH), Mater Domini Humanitas Hospital [Castellanza, Italy] (MD2H), Hospital Universitario de La Princesa, Helsinki University Hospital [Finland] (HUS), Hôpital Foch [Suresnes], Ospedale Civile di Baggiovara [Modena, Italy] (OCB), Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Azienda Ospedale Università di Padova = Hospital-University of Padua (AOUP), Ospedale 'Infermi' di Rimini [Rimini, Italy] (OIR), University of California [San Diego] (UC San Diego), University of California (UC), and Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB)
Subjects: Adult, Male, outcome, SARS-CoV-2, cardiac, [SDV]Life Sciences [q-bio], Left, COVID-2019, MRI, myocarditis, Female, Humans, Prevalence, Retrospective Studies, Stroke Volume, Ventricular Function, Left, COVID-19, Myocarditis, [SDV] Life Sciences [q-bio], myocarditi, Physiology (medical), Ventricular Function, Human medicine, Cardiology and Cardiovascular Medicine
Abstract: Background: Acute myocarditis (AM) is thought to be a rare cardiovascular complication of COVID-19, although minimal data are available beyond case reports. We aim to report the prevalence, baseline characteristics, in-hospital management, and outcomes for patients with COVID-19–associated AM on the basis of a retrospective cohort from 23 hospitals in the United States and Europe. Methods: A total of 112 patients with suspected AM from 56 963 hospitalized patients with COVID-19 were evaluated between February 1, 2020, and April 30, 2021. Inclusion criteria were hospitalization for COVID-19 and a diagnosis of AM on the basis of endomyocardial biopsy or increased troponin level plus typical signs of AM on cardiac magnetic resonance imaging. We identified 97 patients with possible AM, and among them, 54 patients with definite/probable AM supported by endomyocardial biopsy in 17 (31.5%) patients or magnetic resonance imaging in 50 (92.6%). We analyzed patient characteristics, treatments, and outcomes among all COVID-19–associated AM. Results: AM prevalence among hospitalized patients with COVID-19 was 2.4 per 1000 hospitalizations considering definite/probable and 4.1 per 1000 considering also possible AM. The median age of definite/probable cases was 38 years, and 38.9% were female. On admission, chest pain and dyspnea were the most frequent symptoms (55.5% and 53.7%, respectively). Thirty-one cases (57.4%) occurred in the absence of COVID-19–associated pneumonia. Twenty-one (38.9%) had a fulminant presentation requiring inotropic support or temporary mechanical circulatory support. The composite of in-hospital mortality or temporary mechanical circulatory support occurred in 20.4%. At 120 days, estimated mortality was 6.6%, 15.1% in patients with associated pneumonia versus 0% in patients without pneumonia ( P =0.044). During hospitalization, left ventricular ejection fraction, assessed by echocardiography, improved from a median of 40% on admission to 55% at discharge (n=47; P Conclusions: AM occurrence is estimated between 2.4 and 4.1 out of 1000 patients hospitalized for COVID-19. The majority of AM occurs in the absence of pneumonia and is often complicated by hemodynamic instability. AM is a rare complication in patients hospitalized for COVID-19, with an outcome that differs on the basis of the presence of concomitant pneumonia.
Published: 2022
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6. Cardiac sarcoidosis: A multimodal approach to reach the diagnosis

Author: Patrick Bruneval and Nicolas Piriou
Subjects: medicine.medical_specialty, Angiotensins, Sarcoidosis, business.industry, Biopsy, MEDLINE, Stroke Volume, Multimodal therapy, Cardiac sarcoidosis, Ventricular Function, Left, Endomyocardial biopsy, medicine, Humans, Radiology, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business, Cardiac imaging
Published: 2021
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7. Hypermetabolism of the spleen or bone marrow is an additional albeit indirect sign of infective endocarditis at FDG-PET

Author: B. Hoen, Amandine Pallardy, François Goehringer, Besma Mahida, Aurélie Bourdon, François Rouzet, Caroline Boursier, Zohra Lamiral, Nicolas Piriou, Olivier Morel, Véronique Roch, Elodie Chevalier, Pierre-Yves Marie, Xavier Duval, Christine Selton-Suty, Nancyclotep- Experimental Imaging Platform = Plate-forme d'imagerie moléculaire, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Centre d'investigation Clinique [CHU Bichat] - Épidémiologie clinique (CIC 1425), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Services de Maladies Infectieuses et Tropicales [CHU Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Nuclear Medicine Department [Hôpital Bichat - Claude Bernard], Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Service de Médecine Nucléaire [Nancy], Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de médecine nucléaire [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Médecine Nucléaire [Nantes], Hôpital Laennec, Service de Médecine nucléaire, biophysique, isotopes [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), and Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
Subjects: Male, medicine.medical_specialty, Spleen, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, Gastroenterology, Malignant disease, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Bone Marrow, Fluorodeoxyglucose F18, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, FDG-PET, Aged, Aged, 80 and over, business.industry, valvular heart disease, Endocarditis, Bacterial, Odds ratio, Middle Aged, medicine.disease, 3. Good health, PET, medicine.anatomical_structure, Positron-Emission Tomography, Infective endocarditis, Cohort, Hypermetabolism, Female, Bone marrow, Radiopharmaceuticals, Infection, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Purpose: This study aimed at determining the diagnostic implications of indirect signs of infection at FDG-PET-i.e., hypermetabolisms of the spleen and/or bone marrow (HSBM)-when documented in patients with known or suspected infective endocarditis (IE).Methods: HSBM were defined by higher mean standardized uptake values comparatively to that of the liver on FDG-PET images from patients with a high likelihood of IE and prospectively included in a multicenter study.Results: Among the 129 included patients, IE was ultimately deemed as definite in 88 cases. HSBM was a predictor of definite IE (P = 0.014; odds ratio (OR) 3.2), independently of the criterion of an abnormal cardiac FDG uptake (P = 0.0007; OR 9.68), and a definite IE was documented in 97% (29/30) of patients showing both HSBM and abnormal cardiac uptake, 78% (7/9) of patients with only abnormal cardiac uptake, 67% (42/63) of patients with only HSBM, and 37% (10/27) of patients with neither one.Conclusion: In this cohort with a high likelihood of IE, HSBM is an additional albeit indirect sign of IE, independently of the criterion of an abnormal cardiac uptake, and could reinforce the suspicion of IE in the absence of any other infectious, inflammatory, or malignant disease.
Published: 2020
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8. Percutaneous repair or medical treatment for secondary mitral regurgitation: outcomes at 2 years

Author: Lionel Leroux, Nicolas Piriou, Frédéric Rouleau, Xavier Armoiry, David Messika-Zeitoun, Gilles Rioufol, Sophie Thivolet, Nathan Mewton, Guillaume Bonnet, Bertrand Cormier, Thierry Lefèvre, Florent Boutitie, Guillaume Leurent, Martine Gilard, Delphine Maucort-Boulch, Jean-François Obadia, Gilbert Habib, Mitra-Fr Investigators, Christophe Piot, Didier Carrié, Patrick Ohlmann, Dominique Himbert, Bernard Iung, Patrice Guerin, Mohammed Nejjari, Alec Vahanian, Jean-Noël Trochu, Géraldine Samson, Hélène Thibault, Eric Brochet, Erwan Donal, and Christophe Saint Etienne
Subjects: Male, Cardiac Catheterization, medicine.medical_specialty, Time Factors, Percutaneous, 030204 cardiovascular system & hematology, Effective Regurgitant Orifice Area, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Aged, Retrospective Studies, Heart Failure, Heart Valve Prosthesis Implantation, Mitral regurgitation, Ejection fraction, business.industry, Hazard ratio, Mitral Valve Insufficiency, Stroke Volume, Middle Aged, medicine.disease, Confidence interval, 3. Good health, Surgery, Treatment Outcome, Heart failure, Mitral Valve, Female, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal, Percutaneous Mitral Valve Repair, Follow-Up Studies
Abstract: Aims The MITRA-FR trial showed that among symptomatic patients with severe secondary mitral regurgitation, percutaneous repair did not reduce the risk of death or hospitalization for heart failure at 12 months compared with guideline-directed medical treatment alone. We report the 24-month outcome from this trial. Methods and results At 37 centres, we randomly assigned 304 symptomatic heart failure patients with severe secondary mitral regurgitation (effective regurgitant orifice area >20 mm2 or regurgitant volume >30 mL), and left ventricular ejection fraction between 15% and 40% to undergo percutaneous valve repair plus medical treatment (intervention group, n = 152) or medical treatment alone (control group, n = 152). The primary efficacy outcome was the composite of all-cause death and unplanned hospitalization for heart failure at 12 months. At 24 months, all-cause death and unplanned hospitalization for heart failure occurred in 63.8% of patients (97/152) in the intervention group and 67.1% (102/152) in the control group [hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.77-1.34]. All-cause mortality occurred in 34.9% of patients (53/152) in the intervention group and 34.2% (52/152) in the control group (HR 1.02, 95% CI 0.70-1.50). Unplanned hospitalization for heart failure occurred in 55.9% of patients (85/152) in the intervention group and 61.8% (94/152) in the control group (HR 0.97, 95% CI 0.72-1.30). Conclusions In patients with severe secondary mitral regurgitation, percutaneous repair added to medical treatment did not significantly reduce the risk of death or hospitalization for heart failure at 2 years compared with medical treatment alone.
Published: 2019
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9. Impact of systematic whole-body 18F-fluorodeoxyglucose PET/CT on the management of patients suspected of infective endocarditis: the prospective multicenter TEPvENDO study

Author: Xavier, Duval, Vincent, Le Moing, Sarah, Tubiana, Marina, Esposito-Farèse, Emila, Ilic-Habensus, Florence, Leclercq, Aurélie, Bourdon, François, Goehringer, Christine, Selton-Suty, Elodie, Chevalier, David, Boutoille, Nicolas, Piriou, Thierry, Le Tourneau, Catherine, Chirouze, Marie-France, Seronde, Olivier, Morel, Lionel, Piroth, Jean-Christophe, Eicher, Olivier, Humbert, Matthieu, Revest, Elise, Thébault, Anne, Devillers, François, Delahaye, André, Boibieux, Bastien, Grégoire, Bruno, Hoen, Cédric, Laouenan, Bernard, Iung, François, Rouzet, Ophélie, Rogier, CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( EA 3920) (PCVP / CARDIO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Centre d'Investigation Clinique 1432 (Dijon) - Module Plurithématique : Périnatalité Cancérologie Handicap et Ophtalmologie (CIC-P803), Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction Générale de l'Organisation des Soins (DGOS)-Université de Bourgogne (UB), Centre de génétique - Centre de référence des maladies rares, anomalies du développement et syndromes malformatifs (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Dijon, CHU Pontchaillou [Rennes], ARN régulateurs bactériens et médecine (BRM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Eugène Marquis (CRLCC), Hospices Civils de Lyon (HCL), Service de Maladies Infectieuses et Tropicales [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), 13549-P130938, French Ministry of Health, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Laboratoire Chrono-environnement (UMR 6249) (LCE), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( UR 3920) (PCVP / CARDIO), Université de Bourgogne (UB)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: Microbiology (medical), medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, 18F-FDG-PET/CT, 030204 cardiovascular system & hematology, Tertiary care, Duke criteria, Fluorodeoxyglucose PET, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Fluorodeoxyglucose F18, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Positron Emission Tomography Computed Tomography, diagnostic impact, medicine, Humans, 030212 general & internal medicine, Prospective Studies, patient management, Prosthetic valve, Endocarditis, business.industry, infective endocarditis, medicine.disease, Diagnostic classification, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Infectious Diseases, [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, Native valve, Infective endocarditis, Heart Valve Prosthesis, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Radiology, Radiopharmaceuticals, Whole body, business
Abstract: BackgroundDiagnostic and patients’ management modifications induced by whole-body 18F-FDG-PET/CT had not been evaluated so far in prosthetic valve (PV) or native valve (NV) infective endocarditis (IE)-suspected patients.MethodsIn sum, 140 consecutive patients in 8 tertiary care hospitals underwent 18F-FDG-PET/CT. ESC-2015-modified Duke criteria and patients’ management plan were established jointly by 2 experts before 18F-FDG-PET/CT. The same experts reestablished Duke classification and patients’ management plan immediately after qualitative interpretation of 18F-FDG-PET/CT. A 6-month final Duke classification was established.ResultsAmong the 70 PV and 70 NV patients, 34 and 46 were classified as definite IE before 18F-FDG-PET/CT. Abnormal perivalvular 18F-FDG uptake was recorded in 67.2% PV and 24.3% NV patients respectively (P < .001) and extracardiac uptake in 44.3% PV and 51.4% NV patients. IE classification was modified in 24.3% and 5.7% patients (P = .005) (net reclassification index 20% and 4.3%). Patients’ managements were modified in 21.4% PV and 31.4% NV patients (P = .25). It was mainly due to perivalvular uptake in PV patients and to extra-cardiac uptake in NV patients and consisted in surgery plan modifications in 7 patients, antibiotic plan modifications in 22 patients and both in 5 patients. Altogether, 18F-FDG-PET/CT modified classification and/or care in 40% of the patients (95% confidence interval: 32–48), which was most likely to occur in those with a noncontributing echocardiography (P < .001) or IE classified as possible at baseline (P = .04), while there was no difference between NV and PV.ConclusionsSystematic 18F-FDG-PET/CT did significantly and appropriately impact diagnostic classification and/or IE management in PV and NV-IE suspected patients.Clinical Trials RegistrationNCT02287792.
Published: 2021
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10. Replacement Myocardial Fibrosis in Patients With Mitral Valve Prolapse: Relation to Mitral Regurgitation, Ventricular Remodeling, and Arrhythmia

Author: Laura Filippetti, J.M. Serfaty, Nicolas Piriou, Pierre-Yves Marie, Jean-Noël Trochu, Gabriella Hossu, Karine Warin-Fresse, Thomas Senage, Antoine Jobbe-Duval, Clément Venner, Claire Toquet, Marine Beaumont, Marie Marrec, Solena Le Scouarnec, Thierry Le Tourneau, Romain Capoulade, Christine Selton-Suty, Caroline Cueff, Aurélie Thollet, Jean-Marc Sellal, Jean-Christian Roussel, Anne-Laure Constant Dit Beaufils, Jean-Jacques Schott, Jean-Baptiste Gourraud, Damien Mandry, Olivier Huttin, Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Nantes (UN), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'Investigation Clinique - Innovation Technologique [Nancy] (CIC-IT), Centre d'investigation clinique [Nancy] (CIC), and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: Male, medicine.medical_specialty, Arterial embolism, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Fibrosis, Physiology (medical), Internal medicine, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Mitral valve prolapse, Humans, In patient, 030212 general & internal medicine, cardiovascular diseases, Ventricular remodeling, Mitral regurgitation, Mitral Valve Prolapse, Ventricular Remodeling, business.industry, Myocardium, Mitral Valve Insufficiency, Arrhythmias, Cardiac, Middle Aged, medicine.disease, 3. Good health, Echocardiography, Heart failure, Cardiology, cardiovascular system, Myocardial fibrosis, Female, Cardiology and Cardiovascular Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background: Mitral valve prolapse (MVP) is a frequent disease that can be complicated by mitral regurgitation (MR), heart failure, arterial embolism, rhythm disorders, and death. Left ventricular (LV) replacement myocardial fibrosis, a marker of maladaptive remodeling, has been described in patients with MVP, but the implications of this finding remain scarcely explored. We aimed at assessing the prevalence, pathophysiological and prognostic significance of LV replacement myocardial fibrosis through late gadolinium enhancement (LGE) by cardiac magnetic resonance in patients with MVP. Methods: Four hundred patients (53±15 years of age, 55% male) with MVP (trace to severe MR by echocardiography) from 2 centers, who underwent a comprehensive echocardiography and LGE cardiac magnetic resonance, were included. Correlates of replacement myocardial fibrosis (LGE+), influence of MR degree, and ventricular arrhythmia were assessed. The primary outcome was a composite of cardiovascular events (cardiac death, heart failure, new-onset atrial fibrillation, arterial embolism, and life-threatening ventricular arrhythmia). Results: Replacement myocardial fibrosis (LGE+) was observed in 110 patients (28%; 91 with myocardial wall including 71 with basal inferolateral wall, 29 with papillary muscle). LGE+ prevalence was 13% in trace-mild MR, 28% in moderate MR, and 37% in severe MR, and was associated with specific features of mitral valve apparatus, more dilated LV and more frequent ventricular arrhythmias (45% versus 26%, P P =0.009) and moderate-severe MR (odds ratio, 2.28 [95% CI, 1.21–4.31], P =0.011). LGE+ was associated with worse 4-year cardiovascular event–free survival (49.6±11.7 in LGE+ versus 73.3±6.5% in LGE–, P P =0.002) were associated with poor outcome. Conclusions: LV replacement myocardial fibrosis is frequent in patients with MVP; is associated with mitral valve apparatus alteration, more dilated LV, MR grade, and ventricular arrhythmia; and is independently associated with cardiovascular events. These findings suggest an MVP-related myocardial disease. Last, cardiac magnetic resonance provides additional information to echocardiography in MVP.
Published: 2021
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11. The role of antibody responses against glycans in bioprosthetic heart valve calcification and deterioration

Author: Thomas Senage, Anu Paul, Thierry Le Tourneau, Imen Fellah-Hebia, Marta Vadori, Salam Bashir, Manuel Galiñanes, Tomaso Bottio, Gino Gerosa, Arturo Evangelista, Luigi P. Badano, Alberto Nassi, Cristina Costa, Galli Cesare, Rizwan A. Manji, Caroline Cueff de Monchy, Nicolas Piriou, Romain Capoulade, Jean-Michel Serfaty, Guillaume Guimbretière, Etienne Dantan, Alejandro Ruiz-Majoral, Guénola Coste du Fou, Shani Leviatan Ben-Arye, Liana Govani, Sharon Yehuda, Shirley Bachar Abramovitch, Ron Amon, Eliran Moshe Reuven, Yafit Atiya-Nasagi, Hai Yu, Laura Iop, Kelly Casós, Sebastián G. Kuguel, Arnau Blasco-Lucas, Eduard Permanyer, Fabrizio Sbraga, Roger Llatjós, Gabriel Moreno-Gonzalez, Melchor Sánchez-Martínez, Michael E. Breimer, Jan Holgersson, Susann Teneberg, Marta Pascual-Gilabert, Alfons Nonell-Canals, Yasuhiro Takeuchi, Xi Chen, Rafael Mañez, Jean-Christian Roussel, Jean-Paul Soulillou, Emanuele Cozzi, Vered Padler-Karavani, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR des Sciences Pharmaceutiques et Biologiques (Nantes Université - UFR Pharmacie), Tel Aviv University (TAU), Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), Università degli Studi di Padova = University of Padua (Unipd), Universitat Autònoma de Barcelona (UAB), Vall d'Hebron University Hospital [Barcelona], Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Llobregat Hospital [Barcelona], Fondazione Avantea [Cremona, Italy], St. Boniface Hospital Albrechtsen Research Centre [Winnipeg], Israel Institute for Biological Research (IIBR), University of California [Davis] (UC Davis), University of California (UC), Institut d'Investigació Biomèdica de Bellvitge [Barcelone] (IDIBELL), Quironsalud Teknon Heart Institute [Barcelona, Spain] (QTHI), Mind the Byte [Barcelona, Spain], Molomics [Barcelona, Spain], Sahlgrenska Academy at University of Gothenburg [Göteborg], Institut Universitari de Ciència i Tecnologia [Barcelona, Spain] ((Inkemia Group) IUCT), DevsHealth [Barcelona, Spain] (DH), University College of London [London] (UCL), Bellvitge University Hospital [Barcelona, Spain], Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology (U1064 Inserm - CR2TI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Dantan, Etienne, Senage, T, Paul, A, Le Tourneau, T, Fellah-Hebia, I, Vadori, M, Bashir, S, Galinanes, M, Bottio, T, Gerosa, G, Evangelista, A, Badano, L, Nassi, A, Costa, C, Cesare, G, Manji, R, Cueff de Monchy, C, Piriou, N, Capoulade, R, Serfaty, J, Guimbretiere, G, Dantan, E, Ruiz-Majoral, A, Coste du Fou, G, Leviatan Ben-Arye, S, Govani, L, Yehuda, S, Bachar Abramovitch, S, Amon, R, Reuven, E, Atiya-Nasagi, Y, Yu, H, Iop, L, Casos, K, Kuguel, S, Blasco-Lucas, A, Permanyer, E, Sbraga, F, Llatjos, R, Moreno-Gonzalez, G, Sanchez-Martinez, M, Breimer, M, Holgersson, J, Teneberg, S, Pascual-Gilabert, M, Nonell-Canals, A, Takeuchi, Y, Chen, X, Manez, R, Roussel, J, Soulillou, J, Cozzi, E, Padler-Karavani, V, Institut Català de la Salut, [Senage T] Institut du Thorax, Institut National de la Santé et de la Recherche Médicale UMR1087, University Hospital, Nantes, France. Institut National de la Santé et de la Recherche Médicale UMR 1246-SPHERE, Nantes University, Tours University, Nantes, France. [Paul A] Department of Cell Research and Immunology, Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel. Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA. [Le Tourneau T, Fellah-Hebia I] Institut du Thorax, Institut National de la Santé et de la Recherche Médicale UMR1087, University Hospital, Nantes, France. [Vadori M] Consortium for Research in Organ Transplantation, Ospedale Giustinianeo, Padova, Italy. [Bashir S] Department of Cell Research and Immunology, Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel. [Galiñanes M] Servei de Cirurgia Cardíaca, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Evangelista A] Servei de Cardiologia, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Casós K] Servei de Cirurgia Cardíaca, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Infectious Diseases and Transplantation Division, Institut d’Investigació Biomèdica de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain. Grup de Recerca en Malalties Cardiovasculars, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Blasco-Lucas A] Servei de Cirurgia Cardíaca, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Cardiac Surgery Department, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain. [Permanyer E] Servei de Cirurgia Cardíaca, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Department of Cardiac Surgery, Quironsalud Teknon Heart Institute, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
Subjects: [SDV]Life Sciences [q-bio], Immunology, enfermedades cardiovasculares::enfermedades cardíacas [ENFERMEDADES], Cardiovascular, Medical and Health Sciences, General Biochemistry, Genetics and Molecular Biology, Mice, Polysaccharides, Animals, Humans, Prospective Studies, Polysaccharide, Bioprosthesi, Bioprosthesis, 5.3 Medical devices, Animal, Calcinosis, Galactose, Otros calificadores::Otros calificadores::/cirugía [Otros calificadores], MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, General Medicine, Aortic Valve Stenosis, Aortic Valve Stenosi, Other subheadings::Other subheadings::/surgery [Other subheadings], Vàlvula aòrtica - Cirurgia, [SDV] Life Sciences [q-bio], Cardiovascular Diseases::Heart Diseases [DISEASES], Prospective Studie, Heart Disease, Aortic Valve, Immunoglobulin G, Antibody Formation, Calcinosi, Development of treatments and therapeutic interventions, Immunoglobulines, Human
Abstract: Outcomes research; Risk factors Investigación de resultados; Factores de riesgo Recerca dels resultats; Factors de risc Bioprosthetic heart valves (BHVs) are commonly used to replace severely diseased heart valves but their susceptibility to structural valve degeneration (SVD) limits their use in young patients. We hypothesized that antibodies against immunogenic glycans present on BHVs, particularly antibodies against the xenoantigens galactose-α1,3-galactose (αGal) and N-glycolylneuraminic acid (Neu5Gc), could mediate their deterioration through calcification. We established a large longitudinal prospective international cohort of patients (n = 1668, 34 ± 43 months of follow-up (0.1–182); 4,998 blood samples) to investigate the hemodynamics and immune responses associated with BHVs up to 15 years after aortic valve replacement. Early signs of SVD appeared in
Published: 2021
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12. [Inflammatory cardiomyopathies: Diagnosis, correlations with imaging, interest of myocardial biopsy and place of molecular biology]

Author: Raphaël, Bourgade, Nicolas, Piriou, Céline, Bressollette-Bodin, Delphine, Loussouarn, and Claire, Toquet
Subjects: Myocarditis, Biopsy, Myocardium, Humans, Cardiomyopathies, Molecular Biology
Abstract: Inflammatory cardiomyopathies, also known as "myocarditis" are inflammatory pathologies affecting the myocardium and characterized by vast etiological and clinical heterogeneity. They can be asymptomatic, particularly in viral forms, or be responsible for sudden death, particularly in subjects under 35 years olds. Due to insufficient sensitivity and specificity of imaging and biology, the gold standard is histopathological and is performed on an endomyocardial biopsy or on explanted heart samples in a transplant context. Their classification has considerably evolved and is now based on the identification of a predominant cell pattern such as lymphocytic, neutrophilic or eosinophilic polynuclear, giant cell or granulomatous myocarditis. These different patterns will guide the etiological diagnosis, prognosis and the therapies to be implemented. Due to the importance of viral etiologies, this morphological analysis must be complemented by a virological analysis based on PCR with viral load quantification. In addition, some authors have been able to demonstrate the occurrence of myocarditis in patients with arrhythmogenic cardiomyopathy of genetic origin. The aim of this chapter is to review the current state of knowledge on inflammatory cardiomyopathies and their management.
Published: 2020

13. Impact of Mitral Regurgitation Severity and Left Ventricular Remodeling on Outcome After MitraClip Implantation: Results From the Mitra-FR Trial

Author: David, Messika-Zeitoun, Bernard, Iung, Xavier, Armoiry, Jean-Noël, Trochu, Erwan, Donal, Gilbert, Habib, Eric, Brochet, Hélène, Thibault, Nicolas, Piriou, Bertrand, Cormier, Christophe, Tribouilloy, Patrice, Guerin, Thierry, Lefèvre, Delphine, Maucort-Boulch, Alec, Vahanian, Florent, Boutitie, and Jean-Francois, Obadia
Subjects: Heart Valve Prosthesis Implantation, Treatment Outcome, Ventricular Remodeling, Predictive Value of Tests, Humans, Mitral Valve Insufficiency
Abstract: This study aimed to identify a subset of patients based on echocardiographic parameters who might have benefited from transcatheter correction using the MitraClip system in the MITRA-FR (Percutaneous Repair with the MitraClip Device for Severe Functional/Secondary Mitral Regurgitation) trial.It has been suggested that differences in the degree of mitral regurgitation (MR) and left ventricular (LV) remodeling may explain the conflicting results between the MITRA-FR and the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) trials.In a post hoc analysis, we evaluated the interaction between the intervention and subsets of patients defined based on MR severity (effective regurgitant orifice [ERO], regurgitant volume [RVOL] and regurgitant fraction [RF]), LV remodeling (end-diastolic and end-systolic diameters and volumes) and combination of these parameters with respect to the composite of death from any cause or unplanned hospitalization for heart failure at 24 months.We observed a neutral impact of the intervention in subsets with the highest MR degree (ERO ≥30 mmIn the MITRA-FR trial, we could not identify a subset of patients defined based on the degree of the regurgitation, LV remodeling or on their combination, including those deemed as having disproportionate MR, that might have benefited from transcatheter correction using the MitraClip system. (Multicentre Study of Percutaneous Mitral Valve Repair MitraClip Device in Patients With Severe Secondary Mitral Regurgitation [MITRA-FR]; NCT01920698).
Published: 2020

14. Familial screening in case of acute myocarditis reveals inherited arrhythmogenic left ventricular cardiomyopathies

Author: Nicolas Piriou, Karine Warin-Fresse, Claire Toquet, Emilie Conan, Jean Michel Serfaty, Lara Marteau, Laurianne Le Gloan, F. Kyndt, Vincent Probst, Damien Guijarro, Jean-Noël Trochu, Aurélie Thollet, and Thierry Le Tourneau
Subjects: medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Myocarditis, Heart Ventricles, Arrhythmogenic cardiomyopathy, Cardiomyopathy, Desmoglein-2, Contrast Media, Gadolinium, 030204 cardiovascular system & hematology, Sudden death, Right ventricular cardiomyopathy, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Original Research Articles, medicine, Genetics, Humans, 030212 general & internal medicine, Original Research Article, Genetic testing, medicine.diagnostic_test, biology, business.industry, Desmoplakin, Dilated cardiomyopathy, medicine.disease, Desmoplakins, lcsh:RC666-701, Cardiology, biology.protein, Cardiology and Cardiovascular Medicine, business, Cardiomyopathies
Abstract: Aims Several data suggest that acute myocarditis could be related to genetic variants involved in familial cardiomyopathies, particularly arrhythmogenic cardiomyopathy, but the management of patients with acute myocarditis and their families regarding their risk for having an associated inherited cardiomyopathy is unclear. Methods and results Families with at least one individual with a documented episode of acute myocarditis and at least one individual with a cardiomyopathy or a history of sudden death were included in the study. Comprehensive pedigree, including genetic testing, and history of these families were analysed. Six families were included. Genetic analysis revealed a variant in desmosomal proteins genes in all the probands [five in desmoplakin (DSP) gene and one in desmoglein 2 gene]. In the five families identified with a DSP variant, genetic testing was triggered by the association of an acute myocarditis with a single case of apparently isolated dilated cardiomyopathy or sudden death. Familial screening identified 28 DSP variant carriers; 39% had an arrhythmogenic left ventricular (LV) cardiomyopathy phenotype. Familial histories of sudden death were frequent, and a remarkable phenotype of isolated LV late gadolinium enhancement on contrast‐enhanced cardiac magnetic resonance without any other structural abnormality was found in 38% of asymptomatic mutation carriers. None of the DSP variant carriers had imaging characteristics of right ventricle involvement meeting current Task Force criteria for arrhythmogenic right ventricular cardiomyopathy. Conclusions Comprehensive familial screening including genetic testing in case of acute myocarditis associated with a family history of cardiomyopathy or sudden death revealed unknown or misdiagnosed arrhythmogenic variant carriers with left‐dominant phenotypes that frequently evade arrhythmogenic right ventricular cardiomyopathy Task Force criteria. In view of our results, acute myocarditis should be considered as an additional criterion for arrhythmogenic cardiomyopathy, and genetic testing should be advised in patients who experience acute myocarditis and have a family history of cardiomyopathy or sudden death.
Published: 2019

15. The MITRA-HR study: design and rationale of a randomised study of MITRACLIP(R) transcatheter mitral valve repair in patients with severe primary mitral regurgitation eligible for high-risk surgery

Author: Patrice Guerin, Nicolas Piriou, Jean Noël Trochu, Sabine Pattier, Béatrice Guyomarch, Ousama Al Habash, Alec Vahanian, Bernard Iung, Thomas Senage, Jean-Christian Roussel, Thierry Le Tourneau, Jean-François Obadia, Erwan Donal, Institut du thorax, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), AGROCAMPUS OUEST, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche en Electrotechnique et Electronique de Nantes Atlantique EA4642 (IREENA), Institut Universitaire de Technologie Saint-Nazaire (IUT Saint-Nazaire), Université de Nantes (UN)-Université de Nantes (UN)-Ecole Polytechnique de l'Université de Nantes (EPUN), Université de Nantes (UN)-Institut Universitaire de Technologie - La Roche-sur-Yon (IUT La Roche-sur-Yon), Université de Nantes (UN)-Université de Nantes (UN), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche en Energie Electrique de Nantes Atlantique EA4642 (IREENA), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), and Ecole Polytechnique de l'Université de Nantes (Polytech Nantes)
Subjects: medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Mitral valve, medicine, Clinical endpoint, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Contraindication, Heart Valve Prosthesis Implantation, Mitral valve repair, Mitral regurgitation, business.industry, MitraClip, Mitral Valve Insufficiency, 3. Good health, Surgery, medicine.anatomical_structure, Treatment Outcome, Mitral Valve, Cardiology and Cardiovascular Medicine, business, Percutaneous Mitral Valve Repair
Abstract: International audience; AIMS: Percutaneous mitral valve repair has become an alternative to conventional surgery in patients suffering primary mitral regurgitation (MR) with a contraindication to surgery and could benefit patients at high surgical risk. The aim of the MITRA-HR study is to raise the level of evidence supporting the use of the MitraClip(R) device in primary MR patients with a pre-defined high risk for surgery. METHODS AND RESULTS: MITRA-HR is a prospective, multicentre, randomised study designed to compare mitral valve repair using MitraClip(R) with conventional surgery in patients with severe primary mitral regurgitation at high risk for surgery. The surgical risk is defined by age, Society of Thoracic Surgeons (STS) risk estimate score, frailty, major organ system dysfunction, and procedure-specific impediments. The study will enrol 330 patients randomised between conventional surgery and MitraClip(R) with a 1:1 ratio. The composite primary endpoint includes all-cause mortality, unplanned rehospitalisation for cardiovascular reasons, and mitral valve reintervention at 12 months. The main secondary safety endpoint is a major adverse event composite assessment evaluated 30 days after the procedure. CONCLUSIONS: The randomised MITRA-HR study is designed to provide additional supportive evidence of non-inferiority in efficacy and superiority in safety for percutaneous mitral valve repair using MitraClip(R) compared to conventional surgery in high surgical risk patients.
Published: 2019
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16. Role of multimodality imaging in the diagnosis and management of cardiomyopathies

Author: Gilles Barone-Rochette, Patricia Reant, Stéphane Ederhy, Nicolas Mansencal, Nicolas Piriou, Thrombose, atherothrombose et pharmacologie appliquée, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Radiopharmaceutiques biocliniques (LRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), CCSD, Accord Elsevier, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Ambroise Paré [AP-HP], Épidémiologie et recherches translationnelles sur les maladies rénales et cardiovasculaires (EPREC) (U1018 (Équipe 5)), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, CHU Bordeaux [Bordeaux], Université de Bordeaux (UB), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Centre hospitalier universitaire de Nantes (CHU Nantes), and CHU Grenoble
Subjects: medicine.medical_specialty, Cardiomyopathy, Transthoracic echocardiography, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Computed tomography scan, Imaging data, Multimodal Imaging, Multimodality imaging, Multimodality, 03 medical and health sciences, 0302 clinical medicine, Cardiac magnetic resonance imaging, Predictive Value of Tests, Risk Factors, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Cardiac imaging, Modalities, medicine.diagnostic_test, Myocardial tissue, business.industry, Reproducibility of Results, General Medicine, Cardiac nuclear imaging, medicine.disease, Prognosis, 3. Good health, [SDV] Life Sciences [q-bio], Positron emission tomography, Cardiology and Cardiovascular Medicine, business, Cardiomyopathies
Abstract: International audience; Multimodality imaging plays an important role in the initial evaluation, diagnosis and management of patients suspected of having a cardiomyopathy. Beyond functional and anatomical information, multimodality imaging provides important variables that facilitate risk stratification and prognosis evaluation. Whatever the underlying suspected cardiomyopathy, echocardiography is the most common initial imaging test used to establish the presence of cardiomyopathy, by depicting structural and functional abnormalities. However, echocardiographic findings are non-specific, and therefore have a limited role in identifying the underlying aetiology. Cardiac magnetic resonance imaging allows characterization of myocardial tissue, which can be of great help in identifying the aetiology of the cardiomyopathy. When a specific aetiology is suspected, particularly inflammation, 18F-fluorodeoxyglucose positron emission tomography is recommended. The clinician should be capable of selecting the appropriate imaging techniques for each clinical scenario. Each technique has strengths and weaknesses, which should be known. In order to improve diagnostic performance, and as proposed by the European Association for Cardiovascular Imaging, cardiovascular imaging groups must be composed of experts from all modalities. The future of multimodality imaging in the diagnosis and management of cardiomyopathies will also involve evolution of its use in care, teaching and research. Training goals for future cardiac imaging experts must be defined; academic and industry partnerships should enable the connection to be made between imaging data and clinical data on the one hand and outcomes on the other hand, using big-data analysis and artificial intelligence.
Published: 2019
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17. Intramyocardial transplantation of mesenchymal stromal cells for chronic myocardial ischemia and impaired left ventricular function: Results of the MESAMI 1 pilot trial

Author: Daniel Cussac, Gilles Lande, Nicolas Piriou, Joffrey Pozzo, Matthieu Berry, J.B. Ruidavet, Angelo Parini, Philippe Bourin, T. Le Tourneau, M. Lebrin, A. Huynh, S. Kramer, Olivier Lairez, Fabian Gross, Luc Sensebé, Alain Manrique, Damien Guijarro, Jean-Noël Trochu, Patricia Lemarchand, Jerome Roncalli, Michel Galinier, Guillaume Lamirault, Meyer Elbaz, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de thérapie cellulaire, Etablissement Français du Sang, Laboratoire de chimie organique et organométallique (LCOO), Université Sciences et Technologies - Bordeaux 1-Centre National de la Recherche Scientifique (CNRS), Equipe 7 Inserm U1048, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), STROMALab, Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Etablissement Français du Sang-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Biothérapie, CHU Toulouse [Toulouse], CIC - Nantes, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine nucléaire [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Laboratoire national des champs magnétiques intenses - Grenoble (LNCMI-G ), Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Institut du thorax, Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement Français du Sang-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), Semiconductor Photonics Research Group, Trinity College Dublin-Science Foundation Ireland-Enterprise Ireland-Higher Education Authority, Biosense Webster, Inc., Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement Français du Sang-Centre National de la Recherche Scientifique (CNRS), Lemarchand, Patricia, Unité de recherche de l'institut du thorax (ITX-lab), Université Sciences et Technologies - Bordeaux 1 (UB)-Centre National de la Recherche Scientifique (CNRS), Module Biothérapies, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut National des Sciences Appliquées (INSA)-Université Fédérale Toulouse Midi-Pyrénées-Institut National des Sciences Appliquées (INSA)-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Laboratoire national des champs magnétiques intenses - Grenoble (LNCMI), Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), and Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Joseph Fourier - Grenoble 1 (UJF)-Université Grenoble Alpes (UGA)
Subjects: 0301 basic medicine, Cardiac function curve, Male, medicine.medical_specialty, Single Photon Emission Computed Tomography Computed Tomography, medicine.medical_treatment, Myocardial Ischemia, Pilot Projects, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, 030204 cardiovascular system & hematology, Revascularization, Mesenchymal Stem Cell Transplantation, Transplantation, Autologous, 03 medical and health sciences, Ventricular Dysfunction, Left, 0302 clinical medicine, Internal medicine, Medicine, Humans, Prospective Studies, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, ComputingMilieux_MISCELLANEOUS, Cells, Cultured, Ejection fraction, Ischemic cardiomyopathy, business.industry, Myocardium, Mesenchymal stem cell, Middle Aged, 3. Good health, Clinical trial, Transplantation, 030104 developmental biology, Treatment Outcome, Cardiology, Feasibility Studies, Female, Cardiology and Cardiovascular Medicine, business, Perfusion, Follow-Up Studies
Abstract: Background: The MESAMI 1 trial was a bicentric pilot study designed to test the feasibility and safety of intramyocardially injected autologous bone marrow-derived mesenchymal stromal cells (MSCs) for the treatment of ischemic cardiomyopathy. Methods and Results: The study included 10 patients with chronic myocardial ischemia, left ventricular (LV) ejection fractions (EFs) of ≤35%, and reversible perfusion defects who were on stable optimal medical therapy and were not candidates for revascularization. MSCs (mean: 61.5×106 cells per patient) were injected into 10-16 viable sites at the border of the LV scar via a NOGA-guided catheter. Both primary endpoints, feasibility (successful harvest, expansion, and injection of autologous MSCs) and safety (absence of severe adverse events [SAEs]) were met in all 10 patients at the 1-month follow-up time point, and none of the SAEs reported during the full 2-year follow-up period were attributable to the study intervention. The results of secondary efficacy endpoint analyses identified significant improvements from baseline to Month 12 in LVEF (29.4±2.0% versus 35.7±2.5%; p=0.003), LV end-systolic volume (167.8±18.8 mL versus 156.1±28.6 mL; p=0.04), 6- minute walk test and NYHA functional class. Conclusions: Our results suggest that autologous MSCs can be safely administered to the hearts of patients with severe, chronic, reversible myocardial ischemia and impaired cardiac function and may be associated with improvements in cardiac performance, LV remodeling, and patient functional status. A randomized, double blind, multicenter, placebo-controlled clinical trial (MESAMI 2) will evaluate the efficacy of this treatment approach in a larger patient population. Clinical Trial Registration: Unique identifier: NCT01076920
Published: 2016
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18. Drug-induced aortic valve stenosis: An under recognized entity

Author: Bernard Assoun, Marie-Christine Copin, B. Blanchard-Lemoine, Carlo Banfi, Jean-Pierre Gueffet, Xavier Halna du Fretay, Sylvie Lantuejoul, Emmanuel Bogino, Sylvestre Maréchaux, Jean-Fortuné Ikoli, Caroline Augier, Raymond Roudaut, Louis Guillou, Yannick Jobic, M.-C. Malergue, Pierre Nazeyrollas, Pierre Morera, Pierre-Vladimir Ennezat, Patrick Bruneval, Dominique Grisoli, Odile Patra, Nicolas Piriou, Olivier Fabre, Christophe Tribouilloy, Olivier Chavanon, Hélène Petit-Eisenmann, J.P. Remadi, Lorraine Greffe, Daniel Czitrom, Eric Brochet, Jean Noel Trochu, Camille Dambrin, André Vincentelli, Département de cardiologie et hypertension, CHU Grenoble, Immunopathologie humaine, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mutualiste de Montsouris (IMM), Institut du thorax, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centre Hospitalier Universitaire de Reims (CHU Reims), Département Cardiologie, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de cardiologie, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Nouvel Hôpital Civil de Strasbourg, CHU Strasbourg, Université de Strasbourg (UNISTRA), Service Chirurgie Cardio-Vasculaire [CHU Toulouse] (CCV), Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Langages, Littératures, Sociétés, Études Transfrontalières et Internationales (LLSETI), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Oncology - Pathology - Anatomy, Institute of Pathology-University of Bern, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Département d'anatomie et cythologie pathologique, CHU Grenoble-Hôpital Michallon, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupement Hospitalier de l'Institut Catholique de Lille, Faculté Libre de Médecine de Lille (FLM), Institut Catholique de Lille (ICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL)-Institut Catholique de Lille (ICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL)-UC Lille, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), and Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Fenfluramine/adverse effects/analogs & derivatives, Aortic Valve Stenosis/chemically induced/diagnostic imaging/pathology, Regurgitation (circulation), 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Bicuspid aortic valve, Aortic valve replacement, Internal medicine, Fenfluramine, medicine, Humans, 030212 general & internal medicine, Aortic valve regurgitation, Methysergide/adverse effects, Aged, Retrospective Studies, Aged, 80 and over, ddc:617, business.industry, Methysergide, valvular heart disease, Mitral valve replacement, Aortic Valve Stenosis, Middle Aged, medicine.disease, Surgery, Stenosis, Aged 80 and over, Aortic valve stenosis, Cardiology, cardiovascular system, Female, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Background: We have been intrigued by the observation that aortic stenosis (AS) may be associated with characteristic features of mitral drug-induced valvular heart disease (DI-VHD) in patients exposed to valvulopathic drugs, thus suggesting that beyond restrictive heart valve regurgitation, valvulopathic drugs may be involved in the pathogenesis of AS. Methods: Herein are reported echocardiographic features, and pathological findings encountered in a series of patients suffering from both AS (mean gradient > 15 mm Hg) and mitral DI-VHD after valvulopathic drugs exposure. History of rheumatic fever, chest radiation therapy, systemic disease or bicuspid aortic valve disease were exclusion criteria. Results: Twenty-five (19 females, mean age 62 years) patients having both AS and typical features of mitral DI-VHD were identified. Mean transaortic pressure gradient was 32+/-13 mm Hg. Aortic regurgitation was >= mild in 24 (96%) but trivial in one. Known history of aortic valve regurgitation following drug initiation prior the development of AS was previously diagnosed in 17 patients (68%). Six patients underwent aortic valve replacement and 3 both aortic and mitral valve replacement. In the 9 patients with pathology analysis, aortic valvular endocardium was markedly thickened by dense non-inflammatory fibrosis, a characteristic feature of DI-VHD. Conclusion: The association between AS and typical mitral DI-VHD after valvulopathic drug exposure may not be fortuitous. Aortic regurgitation was usually associated to AS and preceded AS in most cases but may be lacking. Pathology demonstrated the potential role of valvulopathic drugs in the development of AS. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
Published: 2016
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19. Speckle tracking analysis allows sensitive detection of stress cardiomyopathy in severe aneurysmal subarachnoid hemorrhage patients

Author: Yvonnick Blanloeil, Philippe Seguin, L. Brisard, Raphaël Cinotti, Romain Bourcier, Karim Asehnoune, Jean-Noël Trochu, Maxime Lamer, Fanny Feuillet, Nicolas Piriou, Yannick Mallédant, Bertrand Rozec, Adrien Delater, Karim Lakhal, Hubert Desal, Thierry Le Tourneau, Yoann Launey, Hôtel-Dieu de Nantes, Foie, métabolismes et cancer, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Service d’Anesthésie-Réanimation, Hôpital Guillaume et René Laennec-Centre hospitalier universitaire de Nantes (CHU Nantes), Biostatistique, Recherche Clinique et Mesures Subjectives en Santé, Université de Nantes (UN), Thérapeutiques cliniques et expérimentales des infections (EA 3826) (EA 3826), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Service d'Anesthésie-Réanimation [CHU Limoges], CHU Limoges, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX)
Subjects: Male, medicine.medical_specialty, Percentile, Subarachnoid hemorrhage, [SDV]Life Sciences [q-bio], Cardiomyopathy, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Aneurysm, Takotsubo Cardiomyopathy, Internal medicine, Anesthesiology, medicine, Humans, Prospective Studies, cardiovascular diseases, Prospective cohort study, Takotsubo, Aged, Speckle tracking, Ejection fraction, business.industry, 2D strain, Middle Aged, medicine.disease, 3. Good health, Echocardiography, Stress cardiomyopathy, Cardiology, Female, Complication, business, 030217 neurology & neurosurgery
Abstract: International audience; PURPOSE: Stress cardiomyopathy is a common life-threatening complication after aneurysmal subarachnoid hemorrhage (SAH). We hypothesized that left ventricular (LV) longitudinal strain alterations assessed with speckle tracking could identify early systolic function impairment. METHODS: This was an observational single-center prospective pilot controlled study conducted in a neuro-intensive care unit. Forty-six patients with severe SAH with a World Federation of Neurological Surgeons grade (WFNS) ≥III were included. Transthoracic echocardiography (TTE) was performed on day 1, day 3, and day 7 after the patient's admission. A cardiologist blinded to the patient's management analyzed the LV global longitudinal strain (GLS). The control group comprised normal subjects matched according to gender and age. RESULTS: On day 1 median (25th-75th percentile) GLS was clearly impaired in SAH patients compared to controls [-16.7 (-18.7/-13.7) % versus -20 (-22/-19) %, p \textless 0.0001], whereas LVEF was preserved [65 (59-70) %]. GLS was severely impaired in patients with a WFNS score of V versus III-IV [-15.6 (-16.9/-12.3) % versus -17.8 (-20.6/-15.8) %, p = 0.008]. Seventeen (37 %) patients had a severe GLS alteration (\textgreater-16 %). In these patients, GLS improved from day 1 [-12.4 (-14.8/-10.9) %] to last evaluation [-16.2 (-19/-14.6) %, p = 0.0007] in agreement with the natural evolution of stress cardiomyopathy. CONCLUSIONS: On the basis of LV GLS assessment, we demonstrated for the first time that myocardial alteration compatible with a stress cardiomyopathy is detectable in up to 37 % of patients with severe SAH while LVEF is preserved. GLS could be used for sensitive detection of stress cardiomyopathy. This is critical because cardiac impairment remains a major cause of morbidity and mortality after SAH
Published: 2016
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20. Left Ventricular Function Assessment Using 2 Different Cadmium-Zinc-Telluride Cameras Compared with a γ-Camera with Cardiofocal Collimators: Dynamic Cardiac Phantom Study and Clinical Validation

Author: Frederic Valette, Alban Bailliez, Charles Merlin, Nicolas Piriou, Alain Manrique, Denis Agostini, Damien Legallois, Tanguy Blaire, and Olivier Lairez
Subjects: Male, Pathology, medicine.medical_specialty, Transducers, 030204 cardiovascular system & hematology, Sensitivity and Specificity, Imaging phantom, 030218 nuclear medicine & medical imaging, Coronary artery disease, 03 medical and health sciences, Cardiac phantom, chemistry.chemical_compound, Myocardial perfusion imaging, Ventricular Dysfunction, Left, 0302 clinical medicine, medicine, Cadmium Compounds, Humans, Radiology, Nuclear Medicine and imaging, Gamma Cameras, Tomography, Emission-Computed, Single-Photon, Ejection fraction, medicine.diagnostic_test, business.industry, Phantoms, Imaging, Reproducibility of Results, Stroke Volume, Equipment Design, Middle Aged, medicine.disease, Anger Camera, Cadmium zinc telluride, Equipment Failure Analysis, chemistry, Zinc Compounds, Female, Tellurium, Nuclear medicine, business, Volume (compression)
Abstract: This study compared two SPECT cameras with cadmium-zinc-telluride (CZT) detectors to a conventional Anger camera with cardiofocal collimators for the assessment of left ventricular (LV) function in a phantom and patients.A gated dynamic cardiac phantom was used. Eighteen acquisitions were processed on each CZT camera and the conventional camera. The total number of counts within a myocardial volume of interest varied from 0.25 kcts to 1.5 Mcts. Ejection fraction was set to 33%, 45%, or 60%. Volume, LV ejection fraction (LVEF), regional wall thickening, and motion (17-segment model) were assessed. One hundred twenty patients with a low pretest likelihood of coronary artery disease and normal findings on stress perfusion SPECT were retrospectively analyzed to provide the reference limits for end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction, and regional function for each camera model.In the phantom study, for each ejection fraction value, volume was higher for the CZT cameras than for the conventional camera, resulting in a decreased but more accurate LVEF (all P0.001). In clinical data, body-surface-indexed EDV and ESV (mL/m(2)) were higher for one of the CZT cameras (Discovery NM 530c) than for the other (D-SPECT) or the conventional camera (respectively, 40.5 ± 9.2, 37 ± 7.9, and 35.8 ± 6.8 for EDV [P0.001] and 12.5 ± 5.3, 9.4 ± 4.2, and 8.3 ± 4.4 for ESV [P0.001]), resulting in a significantly decreased LVEF: 70.3% ± 9.1% vs. 75.2% ± 8.1% vs. 77.8% ± 9.3%, respectively (P0.001).The new CZT cameras yielded global LV function results different from those yielded by the conventional camera. LV volume was higher for the Discovery NM 530c than for the D-SPECT or the conventional camera, leading to decreased LVEF in healthy subjects. These differences should be considered in clinical practice and warrant the collection of a specific reference database.
Published: 2015

21. Congenital anomalous origin of a single coronary artery and high-level sporting competition

Author: Anne L. Laprerie, Pierre Menu, C. Dubois, Marc Dauty, Jean Noel Trochu, and Nicolas Piriou
Subjects: Male, medicine.medical_specialty, business.industry, Coronary Vessel Anomalies, Physical Therapy, Sports Therapy and Rehabilitation, Competition (economics), Young Adult, Death, Sudden, Cardiac, Internal medicine, Right coronary artery, medicine.artery, Single coronary artery, cardiovascular system, medicine, Cardiology, Humans, Orthopedics and Sports Medicine, Clinical case, Surgical treatment, business, human activities, Sports
Abstract: Using a single clinical case of a professional soccer player presenting an anomalous origin of the right coronary artery, cardiac screening and surgical treatment are described taking into account the recommendations of cardiac and sports societies.
Published: 2012

22. Utility of cardiac FDG-PET imaging coupled to magnetic resonance for the management of an acute myocarditis with non-informative endomyocardial biopsy

Author: Nicolas Piriou, Jean Noel Trochu, Amandine Pallardy, Jean Michel Serfaty, and Jérome Sassier
Subjects: Adult, medicine.medical_specialty, Acute coronary syndrome, Biopsy, Diagnosis, Differential, Adrenal Cortex Hormones, Fluorodeoxyglucose F18, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Ejection fraction, medicine.diagnostic_test, biology, business.industry, Magnetic resonance imaging, General Medicine, medicine.disease, Magnetic Resonance Imaging, Troponin, Myocarditis, medicine.anatomical_structure, Acute myocarditis, Ventricle, Positron emission tomography, Positron-Emission Tomography, Acute Disease, cardiovascular system, Cardiology, biology.protein, Female, Radiology, Radiopharmaceuticals, Cardiology and Cardiovascular Medicine, business
Abstract: A cardiac magnetic resonance (CMR) imaging was performed 7 days after the admission of a 41-year-old woman referred for an acute coronary syndrome and normal coronary angiography, high-sensitive Tc troponin increase, and impaired left ventricle ejection fraction (LVEF). T2-weighted sequences showed increased sub-epicardial signal in anterior and inferior walls in favour of a myocardial …
Published: 2015
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23. Valvular heart disease associated with benfluorex

Author: Jean-Noël Trochu, Nicolas Piriou, and Jean-Pierre Gueffet
Subjects: medicine.medical_specialty, Cardiac output, Hypertension, Pulmonary, Heart Valve Diseases, Adverse drug reaction, Pulmonary hypertension, Amphétamines, chemistry.chemical_compound, Furosemide, Benfluorex, Fibrose valvulaire, Internal medicine, Effets secondaires médicamenteux, Appetite Depressants, Fenfluramine, medicine, Humans, Pulmonary wedge pressure, Diuretics, Hypolipidemic Agents, Tricuspid valve, business.industry, valvular heart disease, Amphetamines, General Medicine, Middle Aged, medicine.disease, Pulmonary embolism, Echocardiography, Doppler, Color, Valvular fibrosis, medicine.anatomical_structure, Treatment Outcome, chemistry, cardiovascular system, Cardiology, Hypertension valvulaire, Female, Elevated right atrial pressure, business, Cardiology and Cardiovascular Medicine
Abstract: MOTS CLES Benfluorex ; Fibrose valvulaire ; Amphetamines ; A 57-year-old woman was referred for dyspnoea during mild exercise, especially during the past year. Electrocardiogram and chest X-ray demonstrated no significant anomaly. Ntpro brain natriuretic peptide was moderately elevated to 319 ng/L (range: 0—290 ng/L). Echocardiographic examination showed normal left ventricle function and anatomy, mild regurgitations of the aortic and mitral valves and a severe regurgitation of the tricuspid valve (Figs. 1 and 2), with an estimated systolic pulmonary pressure of 60mmHg. Themechanism of the valvular regurgitations corresponded to valvular fibrosis and subsequently restriction motion. Right heart catheterization confirmed pulmonary arterial hypertension with normal pulmonary wedge pressure and cardiac output. Thoracic tomodensitometry ruled out pulmonary embolism. There was also no clinical or biological evidence for a carcinoid syndrome. The patient had no previous medical history, but she had taken benfluorex (150mg tid) for the past 8 years because of excessive weight (159 cm, 82 kg) and hypertriglyceridaemia. In addition to withdrawal of the drug, and because of elevated right atrial pressure, we
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23 results on '"Nicolas Piriou"'

1. Association of early electrical changes with cardiovascular outcomes in immune checkpoint inhibitor myocarditis

2. Coronary artery disease and revascularization associated with immune checkpoint blocker myocarditis: Report from an international registry

3. 18F-Fluorodeoxyglucose Positron Emission Tomography for the Detection of Myocardial Inflammation in Arrhythmogenic Left Ventricular Cardiomyopathy

4. Apolipoprotein 1 amyloidosis cardiomyopathy and the grey zone of non-invasive diagnostic algorithms: Red flags to reach the diagnosis

5. Prevalence, Characteristics, and Outcomes of COVID-19-Associated Acute Myocarditis

6. Cardiac sarcoidosis: A multimodal approach to reach the diagnosis

7. Hypermetabolism of the spleen or bone marrow is an additional albeit indirect sign of infective endocarditis at FDG-PET

8. Percutaneous repair or medical treatment for secondary mitral regurgitation: outcomes at 2 years

9. Impact of systematic whole-body 18F-fluorodeoxyglucose PET/CT on the management of patients suspected of infective endocarditis: the prospective multicenter TEPvENDO study

10. Replacement Myocardial Fibrosis in Patients With Mitral Valve Prolapse: Relation to Mitral Regurgitation, Ventricular Remodeling, and Arrhythmia

11. The role of antibody responses against glycans in bioprosthetic heart valve calcification and deterioration

12. [Inflammatory cardiomyopathies: Diagnosis, correlations with imaging, interest of myocardial biopsy and place of molecular biology]

13. Impact of Mitral Regurgitation Severity and Left Ventricular Remodeling on Outcome After MitraClip Implantation: Results From the Mitra-FR Trial

14. Familial screening in case of acute myocarditis reveals inherited arrhythmogenic left ventricular cardiomyopathies

15. The MITRA-HR study: design and rationale of a randomised study of MITRACLIP(R) transcatheter mitral valve repair in patients with severe primary mitral regurgitation eligible for high-risk surgery

16. Role of multimodality imaging in the diagnosis and management of cardiomyopathies

17. Intramyocardial transplantation of mesenchymal stromal cells for chronic myocardial ischemia and impaired left ventricular function: Results of the MESAMI 1 pilot trial

18. Drug-induced aortic valve stenosis: An under recognized entity

19. Speckle tracking analysis allows sensitive detection of stress cardiomyopathy in severe aneurysmal subarachnoid hemorrhage patients

20. Left Ventricular Function Assessment Using 2 Different Cadmium-Zinc-Telluride Cameras Compared with a γ-Camera with Cardiofocal Collimators: Dynamic Cardiac Phantom Study and Clinical Validation

21. Congenital anomalous origin of a single coronary artery and high-level sporting competition

22. Utility of cardiac FDG-PET imaging coupled to magnetic resonance for the management of an acute myocarditis with non-informative endomyocardial biopsy

23. Valvular heart disease associated with benfluorex

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