616 results on '"Bernard, Iung"'
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2. Infective Endocarditis in Belgium: Prospective Data in Adults from the ESC EORP European Endocarditis Registry
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Bram Roosens, Bernard Cosyns, Patrizio Lancellotti, Cécile Laroche, Christine Selton-Suty, Agnès Pasquet, Johan De Sutter, Philippe Unger, Bernard Paelinck, Paul Vermeersch, Andreea Motoc, Xavier Galloo, Bernard Iung, Gilbert Habib, and on behalf of the EURO-ENDO Investigators Group
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Belgium ,cardiac surgery ,infective endocarditis ,registry ,valve disease ,Medicine - Abstract
(1) Background: infective endocarditis (IE) is a significant health concern associated with important morbidity and mortality. Only limited, often monocentric, retrospective data on IE in Belgium are available. This prospective study sought to assess the clinical characteristics and outcomes of Belgian IE patients in the ESC EORP European endocarditis (EURO-ENDO) registry; (2) Methods: 132 IE patients were identified based on the ESC 2015 criteria and included in six tertiary hospitals in Belgium; (3) Results: The average Belgian IE patient was male and 62.8 ± 14.9 years old. The native valve was most affected (56.8%), but prosthetic/repaired valves (34.1%) and intracardiac device-related (5.3%) IE are increasing. The most frequently identified microorganisms were S. aureus (37.2%), enterococci (15.5%), and S. viridans (15.5%). The most frequent complications were acute renal failure (36.2%) and embolic events (23.6%). Cardiac surgery was effectively performed when indicated in 71.7% of the cases. In-hospital mortality occurred in 15.7% of patients. Predictors of mortality in the multivariate analysis were S. aureus (HR = 2.99 [1.07–8.33], p = 0.036) and unperformed cardiac surgery when indicated (HR = 19.54 [1.91–200.17], p = 0.012). (4) Conclusion: This prospective EURO-ENDO ancillary analysis provides valuable contemporary insights into the profile, treatment, and clinical outcomes of IE patients in Belgium.
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- 2024
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3. Cerebrovascular complications and outcomes of critically ill adult patients with infective endocarditis
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Thomas Rambaud, Etienne de Montmollin, Pierre Jaquet, Augustin Gaudemer, Eric Mariotte, Sonia Abid, Marylou Para, Claire Cimadevilla, Bernard Iung, Xavier Duval, Michel Wolff, Lila Bouadma, Jean-François Timsit, and Romain Sonneville
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Endocarditis ,Stroke ,Thoracic surgery ,Neuro-critical care ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Neurological complications are associated with poor outcome in patients with infective endocarditis (IE). Although guidelines recommend systematic brain imaging in the evaluation of IE patients, the association between early brain imaging findings and outcomes has never been evaluated in critically ill patients. We aimed to assess the association of CT-defined neurological complications with functional outcomes of critically ill IE patients. Methods This retrospective cohort study included consecutive patients with severe, left-sided IE hospitalized in the medical ICU of a tertiary care hospital. Patients with no baseline brain CT were excluded. Baseline CT-scans were classified in five mutually exclusive categories (normal, moderate-to-severe ischemic stroke, minor ischemic stroke, intracranial hemorrhage, other abnormal CT). The primary endpoint was 1-year favorable outcome, defined by a modified Rankin Scale score of 0–3. Results Between 06/01/2011 and 07/31/2018, 156 patients were included. Among them, 87/156 (56%) had a CT-defined neurological complication, including moderate-to-severe ischemic stroke (n = 33/156, 21%), intracranial hemorrhage (n = 24/156, 15%), minor ischemic stroke (n = 29/156, 19%), other (n = 3/156, 2%). At one year, 69 (45%) patients had a favorable outcome. Factors negatively associated with favorable outcome in multivariable analysis were moderate-to-severe ischemic stroke (OR 0.37, 95%CI 0.14 − 0.95) and age (OR 0.94, 95%CI 0.91–0.97). By contrast, the score on the Glasgow Coma Scale was positively associated with favorable outcome (per 1-point increment, OR 1.23, 95%CI 1.08–1.42). Sensitivity analyses conducted in operated patients revealed similar findings. Compared to normal CT, only moderate-to-severe ischemic stroke was associated with more frequent post-operative neurological complications (n = 8/23 (35%) vs n = 1/46 (2%), p
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- 2022
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4. Impact of Antibiotic Prophylaxis on Surgical Site Infections in Cardiac Surgery
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Christian de Tymowski, Tarek Sahnoun, Sophie Provenchere, Marylou Para, Nicolas Derre, Pierre Mutuon, Xavier Duval, Nathalie Grall, Bernard Iung, Solen Kernéis, Jean-Christophe Lucet, and Philippe Montravers
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antibiotic prophylaxis ,vancomycin ,gentamicin ,cephalosporins ,surgical site infection ,cardiac surgery ,Therapeutics. Pharmacology ,RM1-950 - Abstract
(1) Background: Cephalosporins (CA) are the first-line antibiotic prophylaxis recommended to prevent surgical site infection (SSI) after cardiac surgery. The combination of vancomycin/gentamicin (VGA) might represent a good alternative, but few studies have evaluated its efficacy in SSI prevention. (2) Methods: A single-centre retrospective study was conducted over a 13-year period in all consecutive adult patients undergoing elective cardiac surgery. Patients were stratified according to the type of antibiotic prophylaxis. CA served as the first-line prophylaxis, and VGA was used as the second-line prophylaxis. The primary endpoint was SSI occurrence at 90 days, which was defined as the need for reoperation due to SSI. (3) Results: In total, 14,960 adult patients treated consecutively from 2006 to 2019 were included in this study, of whom 1774 (12%) received VGA and 540 (3.7%) developed SSI. VGA patients had higher severity with increased 90-day mortality. Nevertheless, the frequency of SSI was similar between CA and VGA patients. However, the microbiological aetiologies were different, with more Gram-negative bacteria noted in the VGA group. (4) Conclusions: VGA seems to be as effective as CA in preventing SSI.
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- 2023
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5. Using surgical risk scores in nonsurgically treated infective endocarditis patients
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Giuseppe Gatti, Sidney Chocron, Jean-François Obadia, Xavier Duval, Bernard Iung, François Alla, Catherine Chirouze, Thanh Lecompte, Bruno Hoen, François Delahaye, Pierre Tattevin, Vincent Le Moing, and Andrea Perrotti
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Infective endocarditis ,Mortality/Survival ,Quality of care improvement ,Risk factors ,Valvular heart disease ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: The accuracy of surgical scores in predicting in-hospital mortality for nonsurgically treated patients with infective endocarditis (IE) has not yet been explored. Methods: Patients with definite IE who did not undergo valve surgery were selected from the database of seven French administrative areas (Association pour l'Étude et la Prévention de l'Endocardite Infectieuse [AEPEI] Registry, 2008). The patients were scored using (a) six systems specifically devised to predict in-hospital mortality after surgery for IE, (b) three commonly used risk scores for heart surgery, and (c) a risk score for predicting six-month mortality in IE after either surgery or medical therapy. Calibration (Hosmer–Lemeshow test) and discriminatory power (receiver operating characteristic [ROC] analysis) were assessed for each score. Areas under ROC curves were compared one-to-one (Hanley-McNeil method). Results: A total of 192 patients (mean age, 65.2±15.2 years) were considered for analysis. There were 38 (19.8%) in-hospital deaths. Age >70 years (p=0.001), Staphylococcus aureus as causal agent (p=0.05), and severe sepsis (p=0.027) were independent predictors of in-hospital mortality. Despite many differences in the number and type of variables, all but two of the investigated scores showed good calibration (p>0.66). However, discriminatory power was satisfactory (area under ROC curve >0.70) only for three of the scores specific for IE and two of the scores used to predict mortality after cardiac surgery. Conclusions: Among the 10 surgical scores evaluated in this study, five could be adopted to predict in-hospital mortality even for IE patients receiving medical treatment only.
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- 2020
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6. Cancer and Infective Endocarditis: Characteristics and Prognostic Impact
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Bernard Cosyns, Bram Roosens, Patrizio Lancellotti, Cécile Laroche, Raluca Dulgheru, Valentina Scheggi, Isidre Vilacosta, Agnès Pasquet, Cornelia Piper, Graciela Reyes, Essam Mahfouz, Zhanna Kobalava, Lionel Piroth, Jarosław D. Kasprzak, Antonella Moreo, Jean-François Faucher, Julien Ternacle, Marwa Meshaal, Aldo P. Maggioni, Bernard Iung, and Gilbert Habib
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cancer ,cardiac surgery ,infective endocarditis ,registry ,valve disease ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: The interplay between cancer and IE has become of increasing interest. This study sought to assess the prevalence, baseline characteristics, management, and outcomes of IE cancer patients in the ESC EORP EURO-ENDO registry.Methods: Three thousand and eighty-five patients with IE were identified based on the ESC 2015 criteria. Three hundred and fifty-nine (11.6%) IE cancer patients were compared to 2,726 (88.4%) cancer-free IE patients.Results: In cancer patients, IE was mostly community-acquired (74.8%). The most frequently identified microorganisms were S. aureus (25.4%) and Enterococci (23.8%). The most frequent complications were acute renal failure (25.9%), embolic events (21.7%) and congestive heart failure (18.1%). Theoretical indication for cardiac surgery was not significantly different between groups (65.5 vs. 69.8%, P = 0.091), but was effectively less performed when indicated in IE patients with cancer (65.5 vs. 75.0%, P = 0.002). Compared to cancer-free IE patients, in-hospital and 1-year mortality occurred in 23.4 vs. 16.1%, P = 0.006, and 18.0 vs. 10.2%; P < 0.001, respectively. In IE cancer patients, predictors of mortality by multivariate analysis were creatinine > 2 mg/dL, congestive heart failure and unperformed cardiac surgery (when indicated).Conclusions: Cancer in IE patients is common and associated with a worse outcome. This large, observational cohort provides new insights concerning the contemporary profile, management, and clinical outcomes of IE cancer patients across a wide range of countries.
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- 2021
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7. Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry
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Pierre Deharo, Lionel Leroux, Alexis Theron, Jérome Ferrara, Antoine Vaillier, Nicolas Jaussaud, Alizée Porto, Pierre Morera, Vlad Gariboldi, Bernard Iung, Thierry Lefevre, Philippe Commeau, Margaux Gouysse, Florence du Chayla, Nicolas Glatt, Guillaume Cayla, Herve Le Breton, Hakim Benamer, Sylvain Beurtheret, Jean Philippe Verhoye, Helene Eltchaninoff, Martine Gilard, Jean Philippe Collet, Nicolas Dumonteil, Frederic Collart, Thomas Modine, and Thomas Cuisset
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TAVI ,mismatch ,paravalvular leak ,Medicine - Abstract
Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based on the large France-TAVI registry, we planned to report the incidence of both complications following TAVI, evaluate their respective risk factors, and study their respective impacts on long-term clinical outcomes, including mortality. Results: We identified 47,494 patients in the database who underwent a TAVI in France between 1 January 2010 and 31 December 2019. Within this population, 17,742 patients had information regarding PPM status (5138 with moderate-to-severe PPM, 29.0%) and 20,878 had information regarding PVL (4056 with PVL ≥ 2, 19.4%). After adjustment, the risk factors for PVL ≥ 2 were a lower body mass index (BMI), a high baseline mean aortic gradient, a higher body surface area, a lower ejection fraction, a smaller diameter of TAVI, and a self-expandable TAVI device, while for moderate-to-severe PPM we identified a younger age, a lower BMI, a larger body surface area, a low aortic annulus area, a low ejection fraction, and a smaller diameter TAVI device (OR 0.85; 95% CI, 0.83–0.86) as predictors. At 6.5 years, PVL ≥ 2 was an independent predictor of mortality and was associated with higher mortality risk. PPM was not associated with increased risk of mortality. Conclusions: Our analysis from the France-TAVI registry showed that both moderate-to-severe PPM and PVL ≥ 2 continue to be frequently observed after the TAVI procedure. Different risk factors, mostly related to the patient’s anatomy and TAVI device selection, for both complications have been identified. Only PVL ≥ 2 was associated with higher mortality during follow-up.
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- 2022
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8. Endocardite sur valve aortique insérée par voie transcutanée (TAVI)
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Xavier Duval and Bernard Iung
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- 2023
9. Indoxyl-sulfate activation of the AhR- NF-κB pathway promotes interleukin-6 secretion and the subsequent osteogenic differentiation of human valvular interstitial cells from the aortic valve
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Alexandre Candellier, Nervana Issa, Maria Grissi, Théo Brouette, Carine Avondo, Cathy Gomila, Gérémy Blot, Brigitte Gubler, Gilles Touati, Youssef Bennis, Thierry Caus, Michel Brazier, Gabriel Choukroun, Christophe Tribouilloy, Saïd Kamel, Cédric Boudot, Lucie Hénaut, Hélène Eltchaninoff, Jérémy Bellien, Benjamin Bertrand, Farzin Beygui, Delphine Béziau-Gasnier, Ebba Brakenhielm, Giuseppina Caligiuri, Karine Chevreul, Frédérique Debroucker, Eric Durand, Christophe Fraschini, Martine Gilard, Bernard Iung, Said Kamel, Jamila Laschet, Alain Manrique, Emmanuel Messas, David Messika-Zeitoun, Florence Pinet, Vincent Richard, Eric Saloux, Martin Thoenes, and Claire Vézier
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Cardiology and Cardiovascular Medicine ,Molecular Biology - Published
- 2023
10. Determinants of adherence to oral hygiene prophylaxis guidelines in patients with previous infective endocarditis
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Bettia Celestin, Emila Ilic Habensus, Sarah Tubiana, Marie Préau, Sarah Millot, François-Xavier Lescure, Caroline Kerneis, Marylou Para, Xavier Duval, and Bernard Iung
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
11. Vasoplegic Syndrome after Cardiac Surgery for Infective Endocarditis
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Pascal Lim, Margaux Le Maistre, Lucas Benoudiba Campanini, Quentin De Roux, Nicolas Mongardon, Valentin Landon, Hassina Bouguerra, David Aouate, Paul-Louis Woerther, Fihman Vincent, Adrien Galy, Vania Tacher, Sébastien Galien, Pierre-Vladimir Ennezat, Antonio Fiore, Thierry Folliguet, Raphaelle Huguet, Armand Mekontso-Dessap, Bernard Iung, and Raphael Lepeule
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endocarditis ,vasoplegic syndrome ,shock ,outcome ,Medicine - Abstract
Purpose: Post-operative vasoplegic syndrome is a dreaded complication in infective endocarditis (IE). Methods and Results: This retrospective study included 166 consecutive patients referred to cardiac surgery for non-shocked IE. Post-operative vasoplegic syndrome was defined as a persistent hypotension (mean blood pressure < 65 mmHg) refractory to fluid loading and cardiac output restoration. Cardiac surgery was performed 7 (5–12) days after the beginning of antibiotic treatment, 4 (1–9) days after negative blood culture and in 72.3% patients with adapted anti-biotherapy. Timing of cardiac surgery was based on ESC guidelines and operating room availability. Most patients required valve replacement (80%) and cardiopulmonary bypass (CPB) duration was 106 (95–184) min. Multivalvular surgery was performed in 43 patients, 32 had tricuspid valve surgery. Post-operative vasoplegic syndrome was reported in 53/166 patients (31.9%, 95% confidence interval of 24.8–39.0%) of the whole population; only 15.1% (n = 8) of vasoplegic patients had a post-operative documented infection (6 positive blood cultures) and no difference was reported between vasoplegic and non-vasoplegic patients for valve culture and the timing of cardiac surgery. Of the 23 (13.8%) in hospital-deaths, 87.0% (n = 20) occurred in the vasoplegic group and the main causes of death were multiorgan failure (n = 17) and neurological complications (n = 3). Variables independently associated with vasoplegic syndrome were CPB duration (1.82 (1.16–2.88) per tertile) and NTproBNP level (2.11 (1.35–3.30) per tertile). Conclusions: Post-operative vasoplegic syndrome is frequent and is the main cause of death after IE cardiac surgery. Our data suggested that the mechanism of vasoplegic syndrome was more related to inflammatory cardiovascular injury rather than the consequence of ongoing bacteremia.
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- 2022
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12. Unmet needs in valvular heart disease
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David Messika-Zeitoun, Helmut Baumgartner, Ian G Burwash, Alec Vahanian, Jeroen Bax, Philippe Pibarot, Vince Chan, Martin Leon, Maurice Enriquez-Sarano, Thierry Mesana, and Bernard Iung
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Cardiology and Cardiovascular Medicine - Abstract
Valvular heart disease (VHD) is the next epidemic in the cardiovascular field, affecting millions of people worldwide and having a major impact on health care systems. With aging of the population, the incidence and prevalence of VHD will continue to increase. However, VHD has not received the attention it deserves from both the public and policymakers. Despite important advances in the pathophysiology, natural history, management, and treatment of VHD including the development of transcatheter therapies, VHD remains underdiagnosed, identified late, and often undertreated with inequality in access to care and treatment options, and there is no medication that can prevent disease progression. The present review article discusses these gaps in the management of VHD and potential actions to undertake to improve the outcome of patients with VHD.
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- 2023
13. Infective endocarditis after transcatheter pulmonary valve implantation in patients with congenital heart disease: Distinctive features
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Julie Lourtet-Hascoët, Estibaliz Valdeolmillos, Ali Houeijeh, Eric Bonnet, Clément Karsenty, Shiv-Raj Sharma, Aleksander Kempny, Bernard Iung, Michael A. Gatzoulis, Alain Fraisse, and Sébastien Hascoët
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
14. Predictive value of the TRI-SCORE for in-hospital mortality after redo isolated tricuspid valve surgery
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Julien Dreyfus, Yohann Bohbot, Augustin Coisne, Yoan Lavie-Badie, Michele Flagiello, Baptiste Bazire, Florian Eggenspieler, Florence Viau, Elisabeth Riant, Yannick Mbaki, Damien Eyharts, Thomas Sénage, Thomas Modine, Martin Nicol, Fabien Doguet, Thierry Le Tourneau, Christophe Tribouilloy, Erwan Donal, Jacques Tomasi, Gilbert Habib, Christine Selton-Suty, Costin Radu, Pascal Lim, Richard Raffoul, Bernard Iung, Jean-Francois Obadia, Etienne Audureau, David Messika-Zeitoun, Centre cardiologique du Nord (CCN), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, CHU Lille, Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 (RNMCD), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre hospitalier universitaire de Nantes (CHU Nantes), Pole Cardio-vasculaire et pulmonaire [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Lariboisière-Fernand-Widal [APHP], CHU Rouen, Normandie Université (NU), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-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), CHU Pontchaillou [Rennes], Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Département de Cardiologie [Hôpital de la Timone - APHM], and Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)
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tricuspid valve insufficiency ,Cardiology and Cardiovascular Medicine ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
ObjectivesThe TRI-SCORE reliably predicts in-hospital mortality after isolated tricuspid valve surgery (ITVS) on native valve but has not been tested in the setting of redo interventions. We aimed to evaluate the predictive value of the TRI-SCORE for in-hospital mortality in patients with redo ITVS and to compare its accuracy with conventional surgical risk scores.MethodsUsing a mandatory administrative database, we identified all consecutive adult patients who underwent a redo ITVS at 12 French tertiary centres between 2007 and 2017. Baseline characteristics and outcomes were collected from chart review and surgical scores were calculated.ResultsWe identified 70 patients who underwent a redo ITVS (54±15 years, 63% female). Prior intervention was a tricuspid valve repair in 51% and a replacement in 49%, and was combined with another surgery in 41%. A tricuspid valve replacement was performed in all patients for the redo surgery. Overall, in-hospital mortality and major postoperative complication rates were 10% and 34%, respectively. The TRI-SCORE was the only surgical risk score associated with in-hospital mortality (p=0.005). The area under the receiver operating characteristic curve for the TRI-SCORE was 0.83, much higher than for the logistic EuroSCORE (0.58) or EuroSCORE II (0.61). The TRI-SCORE was also associated with major postoperative complication rates and survival free of readmissions for heart failure.ConclusionRedo ITVS was rarely performed and was associated with an overall high in-hospital mortality and morbidity, but hiding important individual disparities. The TRI-SCORE accurately predicted in-hospital mortality after redo ITVS and may guide clinical decision-making process (www.tri-score.com).
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- 2023
15. Endocarditis caused by Thalassospira sp.
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Laurène Deconinck, Rémi Gschwind, Marie Petitjean, Signara Gueye, Véronique Leflon-Guibout, Naouale Maataoui, Emilie Rondinaud, Augustin Suard, Katell Gallais, Rainui Richaud, Adeline Fuchs, Bernard Iung, Soleiman Alkhoder, Sophie Ismaël, Julia Herrou, Héloïse Prié, Laurence Armand-Lefèvre, Camille d’Humières, and Etienne Ruppé
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Infective endocarditis ,Next-Generation Sequencing ,Nanopore sequencing ,Thalassospira ,Infectious and parasitic diseases ,RC109-216 - Abstract
We report a case of an infective endocarditis caused by a Thalassospira sp. in a 53-year-old man with pre-existing valvular lesions and living in French Polynesia as a fisherman. The strain was identified with DNA-sequecing methods while it was not by mass spectrometry.
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- 2021
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16. Myocardial Work Predicts Outcome in Asymptomatic Severe Aortic Stenosis
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Marko Banovic, Niya Mileva, Ana Moya, Pasquale Paolisso, Monika Beles, Nikola Boskovic, Miodrag Jovanovic, Ivana Nedeljkovic, Anja Radunovic, Marija Radjenovic, Mina Raznatovic, Milica Bojanic, Andrea Manojlovic, Martin Kotrc, Radka Kockova, Guy Van Camp, Marc Vanderheyden, Svetozar Putnik, Bernard Iung, Jozef Bartunek, and Martin Penicka
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Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine - Published
- 2023
17. Data on prognostic factors associated with 3-month and 1-year mortality from infective endocarditis
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Magali Collonnaz, Marie-Line Erpelding, François Alla, François Goehringer, François Delahaye, Bernard Iung, Vincent Le Moing, Bruno Hoen, Christine Selton-Suty, and Nelly Agrinier
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Infective endocarditis ,Referral bias ,Tertiary hospitals ,Prognostic factors ,Survival ,Selection bias ,Computer applications to medicine. Medical informatics ,R858-859.7 ,Science (General) ,Q1-390 - Abstract
This article describes supplementary tables and figures associated with the research paper entitled “Impact of referral bias on prognostic studies outcomes: insights from a population-based cohort study on infective endocarditis”. The aforementioned paper is a secondary analysis of data from the EI 2008 cohort on infective endocarditis and aimed at characterising referral bias. A total of 497 patients diagnosed with definite infective endocarditis between January 1st and December 31st 2008 were included in EI 2008. Data were collected from hospital medical records by trained clinical research assistants. Patients were divided into three groups: admitted to a tertiary hospital (group T), admitted to a non-tertiary hospital and referred secondarily to a tertiary hospital (group NTT) or admitted to a non-tertiary hospital and not referred (group NT). The pooled (NTT+T) group mimicked studies recruiting patients in tertiary hospitals only. Two different starting points were considered for follow up: date of first hospital admission and date of first admission to a tertiary hospital if any (hereinafter referred to as “referral time”). Referral bias is a type of selection bias which can occur due to recruitment of patients in tertiary hospitals only (excluding those who are admitted to non-tertiary hospitals and not referred to tertiary hospitals). This bias may impact the description of patients’ characteristics, survival estimates as well as prognostic factors identification. The six tables presented in this paper illustrate how patients’ selection (population-based sample [pooled (NT+NTT+T) group] versus recruitment in tertiary hospitals only [pooled (NTT+T) group]) might impact Hazards Ratios values for prognostic factors. Crude and adjusted Cox regression analyses were first performed to identify prognostic factors associated with 3-month and 1-year mortality in the whole sample using inclusion as the starting point. Analyses were then performed in the pooled (NTT+T) group first using inclusion as the starting point and finally using referral time as the starting point. Figures 1 to 3 illustrate how HR increase with time for covariates that were considered as time-varying covariates (covariate*time interaction).
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- 2020
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18. Dismal Outcomes and High Societal Burden of Mitral Valve Regurgitation in France in the Recent Era: A Nationwide Perspective
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David Messika‐Zeitoun, Pascal Candolfi, Alec Vahanian, Vincent Chan, Ian G. Burwash, Jean‐François Philippon, Jean‐Manuel Toussaint, Patrick Verta, Ted E. Feldman, Bernard Iung, David Glineur, Thierry Mesana, and Maurice Enriquez‐Sarano
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mitral valve regurgitation ,outcomes ,management ,cost ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Although US recent data suggest that mitral regurgitation (MR) is severely undertreated and carries a poor outcome, population‐based views on outcome and management are limited. We aimed to define the current treatment standards, clinical outcomes, and costs related to MR at the nationwide level. Methods and Results In total, 107 412 patients with MR were admitted in France in 2014 to 2015. Within 1 year, 8% were operated and 92% were conservatively managed and constituted our study population (68% primary MR and 32% secondary MR). The mean age was 77±15 years; most patients presented with comorbidities. In‐hospital and 1‐year mortality rates were 4.1% and 14.3%, respectively. Readmissions were common (63% at least once and 37% readmitted ≥2 times). Rates of 1‐year mortality or all‐cause readmission and 1‐year mortality or heart failure readmission were 67% and 34%, respectively, and increased with age, Charlson index, heart failure at admission, and secondary MR etiology; however, the event rate remained notably high in the primary MR subset (64% and 28%, respectively). The mean costs of hospital admissions and of readmissions were 5345±6432 and 10 080±10 847 euros, respectively. Conclusions At the nationwide level, MR was a common reason for admission and affected an elderly population with frequent comorbidities. Less than 10% of patients underwent a valve intervention. All subsets of patients who were conservatively managed incurred high mortality and readmissions rates, and MR represented a major societal burden with an extrapolated annual cost of 350 to 550 million euros (390–615 million US dollars). New strategies to improve the management and outcomes of patients with both primary and secondary MR are critical and warranted.
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- 2020
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19. Advances in risk stratification of asymptomatic mitral regurgitation. The quest for optimal timing of surgery continues
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Bernard Iung and Gaspard Suc
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Cardiology and Cardiovascular Medicine - Published
- 2023
20. One-Year Outcome After Cardiac Surgery for Patients With Cancer: An Observational Monocentric Retrospective Study
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Hadrien Portefaix, Sophie Provenchère, Bernard Iung, Dan Longrois, Grégory Papin, Philippe Montravers, and Elie Kantor
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medicine.medical_specialty ,law.invention ,Postoperative Complications ,Risk Factors ,law ,Neoplasms ,Internal medicine ,Cardiopulmonary bypass ,medicine ,Humans ,Prospective Studies ,Cardiac Surgical Procedures ,Retrospective Studies ,Cardiopulmonary Bypass ,Proportional hazards model ,business.industry ,Mortality rate ,Cancer ,Retrospective cohort study ,medicine.disease ,Cardiac surgery ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Observational study ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Cardiac surgery increasingly is being performed in patients with a history of or with active cancer. The aim of this study was to analyze the association between a history of cancer and 1-year mortality after cardiac surgery with cardiopulmonary bypass (CPB).An observational monocentric study, with data collected from a prospective institutional database was conducted.A single academic center.All consecutive patients undergoing cardiac surgery with CPB between 2005 and 2017.None.A history of cancer was preoperatively identified. Mortality rates were estimated by the Kaplan-Meier method. The 1-year mortality risk of patients with and without cancer was compared using a multivariate Cox model.During the study period, 12,143 patients underwent cardiac surgery with CPB, including 4,681 (39%) isolated coronary artery bypass surgeries. Their median EuroSCORE II was 3.1, interquartile range 1.5-to-6.4. Nine hundred thirty patients (8%) had a diagnosis of cancer, out of whom 469 (50%) were diagnosed ≤5 years before the index surgery; 103 (11%) patients had hemopathy, and 825 (89%) had solid cancers. The estimated unadjusted 1-year mortality was significantly higher among patients with cancer, 11% (95% confidence interval [CI] 10-14) versus 8% (95%CI 7-9) p0.01. After adjustment, a diagnosis of cancer was not associated with the risk of 1-year mortality (adjusted hazard ratio = 1.17 [95%CI 0.96-1.43]; p = 0.13).In a large cohort of patients undergoing cardiac surgery with CPB, cancer was not independently associated with 1-year mortality. An isolated cancer history should not lead to denial of cardiac surgery. The impact of cancer on complications and long-term survival after cardiac surgery requires further research.
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- 2022
21. High Post-Procedural Transvalvular Gradient or Delayed Mean Gradient Increase after Transcatheter Aortic Valve Implantation: Incidence, Prognosis and Associated Variables. The FRANCE-2 Registry
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Romain Didier, Clément Benic, Bahaa Nasr, Florent Le Ven, Sinda Hannachi, Hélène Eltchaninoff, Edward Koifman, Patrick Donzeau-Gouge, Jean Fajadet, Pascal Leprince, Alain Leguerrier, Michel Lièvre, Alain Prat, Emmanuel Teiger, Thierry Lefevre, Thomas Cuisset, Herve Le Breton, Vincent Auffret, Bernard Iung, and Martine Gilard
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mean gradient ,structural valve degeneration ,TAVI ,post-procedural mean gradient ,Medicine - Abstract
Mean Gradient (MG) elevation can be detected immediately after transcatheter aortic valve implantation (TAVI) or secondarily during follow-up. Comparisons and interactions between these two parameters and their impact on outcomes have not previously been investigated. This study aimed to identify incidence, influence on prognosis, and parameters associated with immediate high post-procedural mean transvalvular gradient (PPMG) and delayed mean gradient increase (6 to 12 months after TAVI, DMGI) in the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry. The registry includes all consecutive symptomatic patients with severe aortic stenosis who have undergone TAVI. Three groups were analyzed: (1) PPMG < 20 mmHg without DMGI > 10 mmHg (control); (2) PPMG < 20 mmHg with DMGI > 10 mmHg (Group 1); and (3) PPMG ≥ 20 mmHg (Group 2). From January 2010 to January 2012, 4201 consecutive patients were prospectively enrolled in the registry. Controls comprised 2078 patients. In Group 1(n = 131 patients), DMGI exceeded 10 mmHg in 5.6%, and was not associated with greater 4-years mortality than in controls (32.6% vs. 40.1%, p = 0.27). In Group 2 (n = 144 patients), PPMG was at least 20 mmHg in 6.1% and was associated with higher 4-year mortality (48.7% versus 40.1%, p = 0.005). A total of two-thirds of the patients with PPMG ≥ 20 mmHg had MG < 20 mmHg at 1 year, with mortality similar to the controls (39.2% vs. 40.1%, p = 0.73). Patients with PPMG > 20 mmHg 1 year post-TAVI had higher 4-years mortality than the general population of the registry, unlike patients with MG normalization.
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- 2021
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22. A worldwide perspective on the temporal burden and impact of calcific aortic valve disease
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Bernard Iung
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Health Policy ,Cardiology and Cardiovascular Medicine - Published
- 2023
23. Emergent transcatheter mitral valve implantation: Early and mid-term outcomes
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Clémence Delhomme, Marina Urena, Caroline Chong-Nguyen, Eric Brochet, Grégory Ducrocq, Bernard Iung, and Dominique Himbert
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
24. Transcatheter Aortic Valve Replacement in Patients with Reduced Ejection Fraction and Nonsevere Aortic Stenosis
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Sebastian Ludwig, Niklas Schofer, Mohamed Abdel-Wahab, Marina Urena, Guillaume Jean, Matthias Renker, Christian W. Hamm, Holger Thiele, Bernard Iung, Joris F. Ooms, Maya Wiessman, Nils S.B. Mogensen, Benjamin Longère, Nils Perrin, Walid Ben Ali, Augustin Coisne, Jordi S. Dahl, Nicolas M. Van Mieghem, Ran Kornowski, Won-Keun Kim, Marie-Annick Clavel, and Cardiology
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Cardiology and Cardiovascular Medicine - Abstract
Background: The potential benefit of transcatheter aortic valve replacement (TAVR) in patients with nonsevere aortic stenosis (AS) and heart failure is controversial. This study aimed to assess outcomes of patients with nonsevere low-gradient AS (LGAS) and reduced left ventricular ejection fraction undergoing TAVR or medical management. Methods: Patients undergoing TAVR for LGAS and reduced left ventricular ejection fraction ( Results: A total of 706 LGAS patients undergoing TAVR (TS-LGAS, N=527; PS-LGAS, N=179) and 470 Medical-Mod patients were included. After adjustment, both TAVR groups showed superior survival compared with Medical-Mod patients (all P P =0.96). After propensity score-matching among patients with nonsevere AS, PS-LGAS TAVR patients showed superior 2-year overall (65.4%) and cardiovascular survival (80.4%) compared with Medical-Mod patients (48.8% and 58.5%, both P ≤0.004). In a multivariable analysis including all patients with nonsevere AS, TAVR was an independent predictor of survival (hazard ratio, 0.39 [95% CI, 0.27–0.55]; P Conclusions: Among patients with nonsevere AS and reduced left ventricular ejection fraction, TAVR represents a major predictor of superior survival. These results reinforce the need for randomized-controlled trials comparing TAVR versus medical management in heart failure patients with nonsevere AS. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04914481.
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- 2023
25. Carcinoid heart disease in patients with midgut neuroendocrine tumours
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Clémence Delhomme, Thomas Walter, Dimitri Arangalage, Gaspard Suc, Olivia Hentic, Agnès Cachier, Soleiman Alkhoder, Laurent François, Catherine Lombard‐Bohas, Bernard Iung, Philippe Ruszniewski, and Louis de Mestier
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Cellular and Molecular Neuroscience ,Endocrinology ,Endocrine and Autonomic Systems ,Endocrinology, Diabetes and Metabolism - Published
- 2023
26. Cost-Effectiveness Analysis of SAPIEN 3 Transcatheter Aortic Valve Implantation Procedure Compared With Surgery in Patients With Severe Aortic Stenosis at Low Risk of Surgical Mortality in France
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Gérard de Pouvourville, Christian Spaulding, Nicolas Dumonteil, Pierre Mutuon, Thierry Lefèvre, Christophe Roussel, Hélène Eltchaninoff, Bernard Iung, Pascal Candolfi, Michelle Green, Martine Gilard, and Judith Shore
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Clinical Trials as Topic ,medicine.medical_specialty ,education.field_of_study ,Transcatheter aortic ,business.industry ,Cost-Benefit Analysis ,Health Policy ,Population ,Public Health, Environmental and Occupational Health ,Surgical mortality ,Aortic Valve Stenosis ,Cost-effectiveness analysis ,medicine.disease ,Surgery ,Transcatheter Aortic Valve Replacement ,Stenosis ,Quality of life ,Aortic valve replacement ,Quality of Life ,medicine ,Humans ,Adverse effect ,education ,business - Abstract
Objectives The clinical and cost-saving benefits of transcatheter aortic valve implantation (TAVI) over surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis who are at high or intermediate risk of surgical mortality are supported by a growing evidence base. The PARTNER 3 trial (Placement of AoRTic TraNscathetER Valve Trial) demonstrated clinical benefits with SAPIEN 3 TAVI compared with SAVR in selected patients at low risk of surgical mortality. This study uses PARTNER 3 outcomes in combination with a French national hospital claim database to inform a cost-utility model and examine the cost implications of TAVI over SAVR in a low-risk population. Methods A 2-stage cost-utility analysis was developed to estimate changes in both direct healthcare costs and health-related quality of life using TAVI with SAPIEN 3 compared with SAVR. Early adverse events associated with TAVI were captured using the PARTNER 3 data set. These data fed into a Markov model that captured longer-term outcomes of patients, after TAVI or SAVR intervention. Results TAVI with SAPIEN 3 offers meaningful benefits over SAVR in providing both cost saving (€12 742 per patient) and generating greater quality-adjusted life-years (0.89 per patient). These results are robust with TAVI with SAPIEN 3 remaining dominant across several scenarios and deterministic and probabilistic sensitivity analyses. Conclusions This model demonstrated that TAVI with SAPIEN 3 was dominant compared with SAVR in the treatment of patients with severe symptomatic aortic stenosis who are at low risk of surgical mortality. These findings should help policy makers in developing informed approaches to intervention selection for this patient population.
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- 2022
27. Temporal Trends on Percutaneous Mitral Commissurotomy: 30 Years of Experience
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Cyrielle Desnos, Bernard Iung, Dominique Himbert, Grégory Ducrocq, Marina Urena, Bertrand Cormier, Eric Brochet, Phalla Ou, Alec Vahanian, and Claire Bouleti
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mitral stenosis ,percutaneous procedure ,temporal trends ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Percutaneous mitral commissurotomy (PMC) was the first available transcatheter technique for treatment of mitral valve diseases. Experience has led to extending the indications to patients with less favorable characteristics. We aimed to analyze (1) the temporal trends in characteristic and outcomes of patients undergoing PMC in a single center over 30 years and (2) the predictive factors of poor immediate results of PMC. Methods and Results From 1987 to 2016, 1 full year for each decade was analyzed: 1987, 1996, 2006, and 2016. Poor immediate results of PMC were defined as a mitral valve area 2. Mitral anatomy was assessed using the Cormier classification and the fluoroscopic extent of calcification. Six hundred three patients were included: 111, 202, 205, and 85, respectively. Mean age increased >10 years over time (P40% during the past decade (P3 out of 4 patients in recent years.
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- 2019
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28. Godina 2022. u kardiovaskularnoj medicini: 10 najboljih radova o bolestima srčanih zalistaka
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Helmut Baumgartner, Bernard Iung, and David Messika-Zeitoun
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valvular heart disease ,клапни сърдечни заболявания valvular heart disease ,Cardiology and Cardiovascular Medicine - Abstract
Сърдечно-съдовата медицина през 2022 г: 10-те най-добри статии за клапни сърдечни заболявания The year in cardiovascular medicine 2022: the top 10 papers in valvular heart disease
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- 2023
29. The year in cardiovascular medicine 2021: valvular heart disease
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Helmut Baumgartner, Bernard Iung, David Messika-Zeitoun, and Catherine M. Otto
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Heart Valve Prosthesis ,Heart Valve Diseases ,Humans ,Cardiovascular Agents ,Cardiology and Cardiovascular Medicine - Published
- 2022
30. 2015 ESC GUIDELINES FOR THE MANAGEMENT OF INFECTIVE ENDOCARDITIS
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Gilbert Habib, Patrizio Lancellotti, Manuel J. Antunes, Maria Grazia Bongiorni, Jean-Paul Casalta, Francesco Del Zotti, Raluca Dulgheru, Gebrine El Khoury, Paola Anna Erba, Bernard Iung, Jose M. Miro, Barbara J. Mulder, Edyta Plonska-Gosciniak, Susanna Price, Jolien Roos-Hesselink, Ulrika Snygg-Martin, Franck Thuny, Pilar Tornos Mas, Isidre Vilacosta, Jose Luis Zamorano, and A. A. Demin
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endocarditis ,cardiac imaging ,valve disease ,echocardiography ,prognosis ,guidelines ,infection ,nuclear imaging ,cardiac surgery ,cardiac device ,prosthetic heart valves ,congenital heart disease ,pregnancy ,prophylaxis ,prevention ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM)
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- 2016
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31. GUIDELINES FOR PRE-OPERATIVE CARDIAC RISK ASSESSMENT AND PERIOPERATIVE CARDIAC MANAGEMENT IN NON-CARDIAC SURGERY
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Don Poldermans, Jeroen J. Bax, Eric Boersma, Stefan De Hert, Erik Eeckhout, Gerry Fowkes, Bulent Gorenek, Michael G. Hennerici, Bernard Iung, Malte Kelm, Keld Per Kjeldsen, Steen Dalby Kristensen, Jose Lopez-Sendon, Paolo Pelosi, François Philippe, Luc Pierard, Piotr Ponikowski, Jean-Paul Schmid, Olav F.M. Sellevold, Rosa Sicari, Greet Van den Berghe, Frank Vermassen, and M. O. Evseev
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Therapeutics. Pharmacology ,RM1-950 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery.
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- 2016
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32. Author response for 'Carcinoid heart disease in patients with midgut neuroendocrine tumours'
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null Clémence Delhomme, null Thomas Walter, null Dimitri Arangalage, null Gaspard Suc, null Olivia Hentic, null Agnès Cachier, null Soleiman Alkhoder, null Laurent François, null Catherine Lombard‐Bohas, null Bernard Iung, null Philippe Ruszniewski, and null Louis de Mestier
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- 2022
33. TAVI in asymptomatic patients with severe aortic stenosis: pros and cons
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Philippe Généreux and Bernard Iung
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Transcatheter Aortic Valve Replacement ,Humans ,Aortic Valve Stenosis ,Cardiology and Cardiovascular Medicine - Published
- 2022
34. Data standards for transcatheter aortic valve implantation: the European Unified Registries for Heart Care Evaluation and Randomised Trials (EuroHeart)
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Suleman Aktaa, Gorav Batra, Stefan K James, Daniel J Blackman, Peter F Ludman, Mamas A Mamas, Mohamed Abdel-Wahab, Gianni D Angelini, Martin Czerny, Victoria Delgado, Giuseppe De Luca, Eustachio Agricola, Dan Foldager, Christian W Hamm, Bernard Iung, Norman Mangner, Julinda Mehilli, Gavin J Murphy, Darren Mylotte, Radoslaw Parma, Anna Sonia Petronio, Bodgan A Popescu, Lars Sondergaard, Rui C Teles, Manel Sabaté, Christian J Terkelsen, Luca Testa, Jianhua Wu, Aldo P Maggioni, Lars Wallentin, Barbara Casadei, Chris P Gale, and NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
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TAVI ,Registry ,Health Policy ,Data standards ,Variables ,EuroHeart ,Quality of care ,Aortic valve ,Cardiology and Cardiovascular Medicine ,Data definitions - Abstract
Aims Standardized data definitions are necessary for the quantification of quality of care and patient outcomes in observational studies and randomised controlled trials (RCTs). The European Unified Registries for Heart Care Evaluation and Randomised Trials (EuroHeart) project of the European Society of Cardiology (ESC) aims to create pan-European data standards for cardiovascular diseases and interventions, including transcatheter aortic valve implantation (TAVI). Methods and results We followed the EuroHeart methodology for cardiovascular data standard development. A Working Group of 29 members representing 12 countries was established and included a patient representative, as well as experts in the management of valvular heart disease from the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the European Association of Cardiovascular Imaging (EACVI) and the Working Group on Cardiovascular Surgery. We conducted a systematic review of the literature and used a modified Delphi method to reach consensus on a final set of variables. For each variable, the Working Group provided a definition, permissible values, and categorized the variable as mandatory (Level 1) or additional (Level 2) based on its clinical importance and feasibility. In total, 93 Level 1 and 113 Level 2 variables were selected, with the level 1 variables providing the dataset for registration of patients undergoing TAVI on the EuroHeart IT platform. Conclusion This document provides details of the EuroHeart data standards for TAVI processes of care and in-hospital outcomes. In the context of EuroHeart, this will facilitate quality improvement, observational research, registry-based RCTs and post-marketing surveillance of devices, and pharmacotherapies. One-sentence summary The EuroHeart data standards for transcatheter aortic valve implantation (TAVI) are a set of internationally agreed data variables and definitions that once implemented will facilitate improvement of quality of care and outcomes for patients receiving TAVI.
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- 2022
35. Added value of heart valve clinics in the management of asymptomatic aortic stenosis
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Bernard Iung and Marko Banovic
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Cardiology and Cardiovascular Medicine - Published
- 2023
36. JESFC 2023: The return to the great celebration of the French-speaking cardiology community
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Victor Aboyans, Anne Bernard, Bernard Iung, Ariel Cohen, and Christophe Leclercq
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Cardiology and Cardiovascular Medicine - Published
- 2023
37. JESFC 2023 : Le grand retour de la célébration de la cardiologie française et francophone
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Victor Aboyans, Anne Bernard, Bernard Iung, Ariel Cohen, and Christophe Leclercq
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Cardiology and Cardiovascular Medicine - Published
- 2023
38. TAVR Patients Requiring Anticoagulation
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Jean Philippe Verhoye, Thibaut Manigold, Alain Cribier, Nicolas Dumonteil, Patrick Ohlmann, Dominique Himbert, Hervé Le Breton, Frederic Collet, Philippe Guyon, Nicolas Meneveau, Xavier Favereau, Didier Carrié, Stéphane Delépine, Thomas Cuisset, Francois Bourlon, Emmanuel Teiger, Farzin Beygui, Olivier Bar, Bernard Albat, Bernard Bertrand, Martine Gilard, Géraud Souteyrand, Bernard Iung, France-TAVI, Arnaud Sudre, Remi Houel, Vincent Auffret, Philippe Commeau, Romain Didier, Louis Labrousse, Antoine Gommeaux, Guillaume Cayla, Thierry Lefèvre, Jean-Philippe Collet, Hélène Eltchaninoff, Didier Blanchard, Sylvain Beurtheret, Jean-Philippe Claudel, Vincent Doisy, Thibault Lhermusier, Gilles Rioufol, Stop-As, and Said Ghostine
- Subjects
medicine.medical_specialty ,business.industry ,medicine.drug_class ,medicine.medical_treatment ,Anticoagulant ,Hazard ratio ,030204 cardiovascular system & hematology ,Vitamin K antagonist ,Confidence interval ,3. Good health ,03 medical and health sciences ,0302 clinical medicine ,Valve replacement ,Internal medicine ,Propensity score matching ,Oral anticoagulant ,Medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,Major bleeding - Abstract
Objectives Using French transcatheter aortic valve replacement (TAVR) registries linked with the nationwide administrative databases, the study compared the rates of long-term mortality, bleeding, and ischemic events after TAVR in patients requiring oral anticoagulation with direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs). Background The choice of optimal drug for anticoagulation after TAVR remains debated. Methods Data from the France-TAVI and FRANCE-2 registries were linked to the French national health single-payer claims database, from 2010 to 2017. Propensity score matching was used to reduce treatment-selection bias. Two primary endpoints were death from any cause (efficacy) and major bleeding (safety). Results A total of 24,581 patients who underwent TAVR were included and 8,962 (36.4%) were treated with OAC. Among anticoagulated patients, 2,180 (24.3%) were on DOACs. After propensity matching, at 3 years, mortality (hazard ratio [HR]: 1.37; 95% confidence interval [CI]: 1.12-1.67; P Conclusions In these large multicenter French TAVR registries with an exhaustive clinical follow-up, the long-term mortality and major bleeding were lower with DOACs than VKAs at discharge. The present study supports preferential use of DOACs rather than VKAs in patients requiring oral anticoagulation therapy after TAVR.
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- 2021
39. 2022 ESC Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
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Sigrun, Halvorsen, Julinda, Mehilli, Salvatore, Cassese, Trygve S, Hall, Magdy, Abdelhamid, Emanuele, Barbato, Stefan, De Hert, Ingrid, de Laval, Tobias, Geisler, Lynne, Hinterbuchner, Borja, Ibanez, Radosław, Lenarczyk, Ulrich R, Mansmann, Paul, McGreavy, Christian, Mueller, Claudio, Muneretto, Alexander, Niessner, Tatjana S, Potpara, Arsen, Ristić, L Elif, Sade, Henrik, Schirmer, Stefanie, Schüpke, Henrik, Sillesen, Helge, Skulstad, Lucia, Torracca, Oktay, Tutarel, Peter, Van Der Meer, Wojtek, Wojakowski, Kai, Zacharowski, Juhani, Knuuti, Steen Dalby, Kristensen, Victor, Aboyans, Ingo, Ahrens, Sotiris, Antoniou, Riccardo, Asteggiano, Dan, Atar, Andreas, Baumbach, Helmut, Baumgartner, Michael, Böhm, Michael A, Borger, Hector, Bueno, Jelena, Čelutkienė, Alaide, Chieffo, Maya, Cikes, Harald, Darius, Victoria, Delgado, Philip J, Devereaux, David, Duncker, Volkmar, Falk, Laurent, Fauchier, Gilbert, Habib, David, Hasdai, Kurt, Huber, Bernard, Iung, Tiny, Jaarsma, Aleksandra, Konradi, Konstantinos C, Koskinas, Dipak, Kotecha, Ulf, Landmesser, Basil S, Lewis, Ales, Linhart, Maja Lisa, Løchen, Michael, Maeng, Stéphane, Manzo-Silberman, Richard, Mindham, Lis, Neubeck, Jens Cosedis, Nielsen, Steffen E, Petersen, Eva, Prescott, Amina, Rakisheva, Antti, Saraste, Dirk, Sibbing, Jolanta, Siller-Matula, Marta, Sitges, Ivan, Stankovic, Rob F, Storey, Jurrien, Ten Berg, Matthias, Thielmann, and Rhian M, Touyz
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Anti-thrombotic therapy ,Biomarkers ,Guidelines ,Non-cardiac surgery ,Peri-operative beta-blockers ,Peri-operative cardiac management ,Peri-operative myocardial injury/infarction ,Peri-operative treatment of arrhythmias ,Post-operative cardiac surveillance ,Pre-operative cardiac risk assessment ,Pre-operative cardiac testing ,Pre-operative coronary artery revascularization ,Pre-operative treatment of valvular disease ,Humans ,Risk Assessment ,Intraoperative Complications ,Postoperative Complications ,Cardiology and Cardiovascular Medicine - Abstract
Sí
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- 2022
40. Response by Banovic et al to Letter Regarding Article, 'Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis: The AVATAR Trial'
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Marko Banovic, Svetozar Putnik, Bernard Iung, and Jozef Bartunek
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Physiology (medical) ,Aortic Valve ,Heart Valve Prosthesis ,Humans ,Aortic Valve Stenosis ,Cardiology and Cardiovascular Medicine ,Conservative Treatment - Published
- 2022
41. New insights into transcatheter edge-to-edge repair: filling a gap for undertreatment of primary mitral regurgitation in the elderly?
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Bernard Iung and Marina Urena
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Heart Valve Prosthesis Implantation ,Humans ,Mitral Valve ,Mitral Valve Insufficiency ,Cardiology and Cardiovascular Medicine ,Aged - Published
- 2022
42. Impact of Mitral Regurgitation Severity and Left Ventricular Remodeling on Outcome After MitraClip Implantation
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Delphine Maucort-Boulch, Jean-Noël Trochu, Gilbert Habib, Erwan Donal, Eric Brochet, Thierry Lefèvre, Florent Boutitie, Hélène Thibault, Bernard Iung, Jean-François Obadia, Bertrand Cormier, Xavier Armoiry, Nicolas Piriou, Alec Vahanian, Patrice Guerin, Christophe Tribouilloy, and David Messika-Zeitoun
- Subjects
Mitral regurgitation ,medicine.medical_specialty ,business.industry ,MitraClip ,Diastole ,Regurgitation (circulation) ,030204 cardiovascular system & hematology ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Heart failure ,Regurgitant fraction ,Cardiology ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Ventricular remodeling ,Percutaneous Mitral Valve Repair - Abstract
Objectives 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. Background 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. Methods 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. Results We observed a neutral impact of the intervention in subsets with the highest MR degree (ERO ≥30 mm2, RVOL ≥45 ml or RF ≥50%) as in patients with milder MR degree. The same was seen in subsets with the milder LV remodeling using either diastolic or systolic diameters or volumes. When parameters of MR severity and LV remodeling were combined, there was still no benefit of the intervention including in the subset of patients with an ERO/end-diastolic volume ratio ≥ 0.15 despite similar ERO and LV end-diastolic volume compared with COAPT patients. Conclusions In 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
- 2021
43. Predictors and clinical impact of thrombosis after transcatheter mitral valve implantation using balloon-expandable bioprostheses
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Marina Urena, John Kikoïne, Dominique Himbert, Alec Vahanian, Eric Brochet, Quentin Fischer, Caroline Nguyen, Jose Luis Carrasco, Gregory Ducrocq, and Bernard Iung
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Computed tomography ,medicine.disease ,Thrombosis ,Surgery ,medicine.anatomical_structure ,Balloon expandable stent ,Shock (circulatory) ,Mitral valve ,medicine ,In patient ,Heart valve ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Subclinical infection - Abstract
AIMS The aim of this study was to report the predictors and clinical impact of transcatheter heart valve (THV) thrombosis in patients undergoing transcatheter mitral valve implantation (TMVI). METHODS AND RESULTS We included 130 patients who consecutively underwent TMVI. Transoesophageal echocardiography (TOE) and/or computed tomography (CT) were performed in 91.7% of patients at discharge, in 73.3% at three months and in 72% beyond three months. THV thrombosis was defined as the presence of at least one thickened leaflet with restricted motion confirmed by TOE or contrast CT and classified as immediate, early, or late according to the timing of diagnosis. THV thrombosis was observed in 16 (12.3%) patients: immediate in 43.7%, early in 37.5% and late in 18.8%. Most of these thromboses were subclinical (93.7%) and non-obstructive (87.5%). No thromboembolic event occurred. After optimisation of antithrombotic treatment, THV thromboses resolved in all but one patient. Predictors were shock for immediate (p
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- 2021
44. Simple Scoring System to Predict In‐Hospital Mortality After Surgery for Infective Endocarditis
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Giuseppe Gatti, Andrea Perrotti, Jean‐François Obadia, Xavier Duval, Bernard Iung, François Alla, Catherine Chirouze, Christine Selton‐Suty, Bruno Hoen, Gianfranco Sinagra, François Delahaye, Pierre Tattevin, Vincent Le Moing, Aniello Pappalardo, and Sidney Chocron
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cardiac valvular surgery ,critical care ,infective endocarditis ,mortality ,predictors ,pulmonary hypertension ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundAspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in‐hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. Methods and ResultsOutcomes of 361 consecutive patients (mean age, 59.1±15.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in‐hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty‐six (15.5%) patients died postsurgery. BMI >27 kg/m2 (odds ratio [OR], 1.79; P=0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P=0.032), and critical state (OR, 2.37; P=0.017) were independent predictors of in‐hospital death. A scoring system was devised to predict in‐hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734–0.822). The score performed better than 5 of 6 scoring systems for in‐hospital death after cardiac surgery that were considered. ConclusionsA simple scoring system based on risk factors for in‐hospital death was specifically created to predict mortality risk postsurgery in patients with IE.
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- 2017
- Full Text
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45. Is the EuroSCORE II reliable to estimate operative mortality among octogenarians?
- Author
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Sophie Provenchère, Arnaud Chevalier, Walid Ghodbane, Claire Bouleti, Philippe Montravers, Dan Longrois, and Bernard Iung
- Subjects
Medicine ,Science - Abstract
Concerns have been raised about the predictive performance (PP) of the EuroSCORE I (ES I) to estimate operative mortality (OM) of patients aged ≥80. The EuroSCORE II (ES II) has been described to have better PP of OM but external validations are scarce. Furthermore, the PP of ES II has not been investigated among the octogenarians. The goal of the study was to compare the PP of ES II and ES I among the overall population and patients ≥ 80.The ES I and ES II were computed for 7161 consecutive patients who underwent major cardiac surgery in a 7-year period. Discrimination was assessed by using the c- index and calibration with the Hosmer-Lemeshow (HL) and calibration plot by comparing predicted and observed mortality.From the global cohort of 7161 patients, 832 (12%) were ≥80. The mean values of ES I and ES II were 7.4±9.4 and 5.2±9.1 respectively for the whole cohort, 6.3±8.6 and 4.7±8.5 for the patients
- Published
- 2017
- Full Text
- View/download PDF
46. Delayed hospitalisation for heart failure after transcatheter repair or medical treatment for secondary mitral regurgitation: a landmark analysis of the MITRA-FR trial
- Author
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Guillaume Leurent, Vincent Auffret, Erwan Donal, Hervé Corbineau, Daniel Grinberg, Guillaume Bonnet, Pierre-Yves Leroux, Patrice Guérin, Fabrice Wautot, Thierry Lefèvre, David Messika-Zeitoun, Bernard Iung, Xavier Armoiry, Jean-Noël Trochu, Florent Boutitie, Jean-François Obadia, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Hospices Civils de Lyon (HCL), Hôpital Louis Pradel [CHU - HCL], CHU Marseille, Médipôle Lyon-Villeurbanne, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Cardio-Thoracique de Monaco (CCTM), Hôpital Privé Jacques Cartier [Massy], University of Ottawa [Ottawa], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Matériaux, ingénierie et science [Villeurbanne] (MATEIS), 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)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), The MITRA-FR trial was financed by an academic grant from the French Ministry of Health., 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), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)-Université Sorbonne Paris Nord
- Subjects
Heart Failure ,Heart Valve Prosthesis Implantation ,Hospitalization ,Cardiac Catheterization ,Treatment Outcome ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Humans ,Mitral Valve Insufficiency ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Cardiology and Cardiovascular Medicine - Abstract
International audience; BACKGROUND: In the MITRA-FR trial, transcatheter mitral valve repair (TMVR) was not associated with a 2-year clinical benefit in patients with secondary mitral regurgitation (SMR). AIMS: This landmark analysis aimed at investigating a potential reduction of the hospitalisation rate for heart failure (HF) between 12 and 24 months after inclusion in the MITRA-FR trial in patients randomised to the intervention group (TMVR with the MitraClip device), as compared with patients randomised to the control group (guideline-directed medical therapy [GDMT]). METHODS: The MITRA-FR trial randomised 307 patients with SMR for TMVR on top of GDMT (TMVR group; n=152) or for GDMT alone (control group; n=155). We conducted a 12-month landmark analysis in surviving patients who were not hospitalised for HF within the first 12 months of follow-up. The primary endpoint was the 1-year cumulative number of HF hospitalisations. RESULTS: A total of 140 patients (TMVR group: 67; GDMT group: 73) were selected for this landmark analysis with similar characteristics at inclusion in the trial. The primary endpoint was 28 events per 100 patient-years in the TMVR group, as compared with 60 events per 100 patient-years in the GDMT group (hazard ratio [HR] 0.46, 95% confidence interval [CI]: 0.20-1.02; p=0.057). CONCLUSIONS: In this landmark analysis of the MITRA-FR trial, the cumulative rate of HF hospitalisation between 12 and 24 months among patients treated with TMVR on top of GDMT was approximately half as many as those of patients treated with GDMT alone, a difference which did not reach statistical significance in the setting of a low number of events.
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- 2022
47. Towards a new journal
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Ariel Cohen, Yves Cottin, and Bernard Iung
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2022
48. Current Indications for Transcatheter Mitral Valve Replacement Using Transcatheter Aortic Valves
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Marina Urena, Eric Brochet, Dominique Himbert, Bernard Iung, Gregory Ducrocq, and Alec Vahanian
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Aortic valve ,medicine.medical_specialty ,Transcatheter aortic ,business.industry ,medicine.medical_treatment ,Mitral valve replacement ,030204 cardiovascular system & hematology ,medicine.disease ,Valve in valve ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Physiology (medical) ,Internal medicine ,Mitral valve ,cardiovascular system ,Cardiology ,Medicine ,cardiovascular diseases ,030212 general & internal medicine ,Heart valve ,Cardiology and Cardiovascular Medicine ,business ,Mitral annulus calcification ,Calcification - Abstract
Use of transcatheter mitral valve replacement (TMVR) using transcatheter aortic valves in clinical practice is limited to patients with failing bioprostheses and rings or mitral valve disease associated with severe mitral annulus calcification. Whereas the use of valve-in-valve TMVR appears to be a reasonable alternative to surgery in patients at high surgical risk, much less evidence supports valve-in-ring and valve-in-mitral annulus calcification interventions. Data on the results of TMVR in these settings are derived from small case series or voluntary registries. This review summarizes the current evidence on TMVR using transcatheter aortic valves in clinical practice from the characteristics of the TMVR candidates, screening process, performance of the procedure, and description of current results and future perspectives. TMVR using dedicated devices in native noncalcified mitral valve diseases is beyond the scope of the article.
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- 2021
49. Major adverse cardiovascular events and anaesthetic management in pregnant women with cardiac disease: a retrospective, single-centre study
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Agnes Bourgeois-Moine, Philippe Montravers, Morgan Roué, Elie Kantor, and Bernard Iung
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Adult ,Anaesthetic management ,medicine.medical_specialty ,Heart Diseases ,business.industry ,Pregnancy Complications, Cardiovascular ,Disease ,Delivery, Obstetric ,Cohort Studies ,Single centre ,Anesthesiology and Pain Medicine ,Obstetric anaesthesia ,Pregnancy ,Emergency medicine ,Humans ,Medicine ,Anesthesia ,Female ,Pregnant Women ,business ,High risk pregnancy ,Anesthetics ,Retrospective Studies - Published
- 2021
50. Antibiotics for prevention of endocarditis: time to scale up? Not yet!
- Author
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Gilbert HABIB and Bernard Iung
- Subjects
Cardiology and Cardiovascular Medicine - Published
- 2022
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