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1. Cardiovascular magnetic resonance in autoimmune rheumatic diseases: a clinical consensus document by the European Association of Cardiovascular Imaging

Author: S Mavrogeni, A Pepe, R Nijveldt, N Ntusi, L M Sierra-Galan, K Bratis, J Wei, M Mukherjee, G Markousis-Mavrogenis, L Gargani, L E Sade, N Ajmone-Marsan, P Seferovic, E Donal, M Nurmohamed, M Matucci Cerinic, P Sfikakis, G Kitas, J Schwitter, J A C Lima, Dana Dawson, Marc Dweck, Kristina H Haugaa, Niall Keenan, James Moon, Ivan Stankovic, Erwan Donal, Bernard Cosyns, Clinical sciences, Cardio-vascular diseases, Cardiology, Rheumatology, ACS - Atherosclerosis & ischemic syndromes, AII - Inflammatory diseases, National and Kapodistrian University of Athens (NKUA), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Consensus, Magnetic Resonance Spectroscopy, MESH: Respiratory Distress Syndrome, [SDV]Life Sciences [q-bio], Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], MESH: Magnetic Resonance Imaging, MESH: Rheumatic Diseases, Autoimmune Diseases, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, coronary artery disease, echocardiography, inflammatory myocardial disease, inflammatory vascular disease, myocardial fibrosis, pulmonary hypertension, valvular heart disease, vessel fibrosis, MESH: Autoimmune Diseases, Rheumatic Diseases, Myocardial fibrosis, Humans, Radiology, Nuclear Medicine and imaging, MESH: Consensus, Respiratory Distress Syndrome, MESH: Humans, MESH: Magnetic Resonance Spectroscopy, MESH: Cardiovascular Diseases, General Medicine, Magnetic Resonance Imaging, Valvular heart disease, Cardiovascular Diseases, Cardiology and Cardiovascular Medicine
Abstract: Autoimmune rheumatic diseases (ARDs) involve multiple organs including the heart and vasculature. Despite novel treatments, patients with ARDs still experience a reduced life expectancy, partly caused by the higher prevalence of cardiovascular disease (CVD). This includes CV inflammation, rhythm disturbances, perfusion abnormalities (ischaemia/infarction), dysregulation of vasoreactivity, myocardial fibrosis, coagulation abnormalities, pulmonary hypertension, valvular disease, and side-effects of immunomodulatory therapy. Currently, the evaluation of CV involvement in patients with ARDs is based on the assessment of cardiac symptoms, coupled with electrocardiography, blood testing, and echocardiography. However, CVD may not become overt until late in the course of the disease, thus potentially limiting the therapeutic window for intervention. More recently, cardiovascular magnetic resonance (CMR) has allowed for the early identification of pathophysiologic structural/functional alterations that take place before the onset of clinically overt CVD. CMR allows for detailed evaluation of biventricular function together with tissue characterization of vessels/myocardium in the same examination, yielding a reliable assessment of disease activity that might not be mirrored by blood biomarkers and other imaging modalities. Therefore, CMR provides diagnostic information that enables timely clinical decision-making and facilitates the tailoring of treatment to individual patients. Here we review the role of CMR in the early and accurate diagnosis of CVD in patients with ARDs compared with other non-invasive imaging modalities. Furthermore, we present a consensus-based decision algorithm for when a CMR study could be considered in patients with ARDs, together with a standardized study protocol. Lastly, we discuss the clinical implications of findings from a CMR examination.
Published: 2022

2. Incidence, Clinical Characteristics, and Impact of Absent Echocardiographic Signs in Patients with Infective Endocarditis after Transcatheter Aortic Valve Implantation

Author: Norman Mangner, Vassili Panagides, David del Val, Mohamed Abdel-Wahab, Lisa Crusius, Eric Durand, Nikolaj Ihlemann, Marina Urena, Costanza Pellegrini, Francesco Giannini, Tomasz Gasior, Wojtek Wojakowski, Martin Landt, Vincent Auffret, Jan-Malte Sinning, Asim N Cheema, Luis Nombela-Franco, Chekrallah Chamandi, Francisco Campelo-Parada, Erika Munoz-Garcia, Howard C Herrmann, Luca Testa, Won-Keun Kim, Helene Eltchaninoff, Lars Søndergaard, Dominique Himbert, Oliver Husser, Azeem Latib, Hervé Le Breton, Clement Servoz, Philippe Gervais, Mélanie Côté, Holger Thiele, David Holzhey, Axel Linke, Josep Rodés-Cabau, Technische Universität Dresden = Dresden University of Technology (TU Dresden), Université Laval [Québec] (ULaval), Leipzig University, 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), Rigshospitalet [Copenhagen], Copenhagen University Hospital, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Ospedale San Raffaele, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), University Hospital Bonn, St. Michael's Hospital, 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 Toulouse (CHU Toulouse), Hospital Universitario Virgen de la Victoria [Malaga, Espagne], IRCCS Ospedale San Raffaele [Milan, Italy], and None
Subjects: Microbiology (medical), TAVI, Infectious Diseases, infective endocarditis, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, imaging, Duke criteria, TEE
Abstract: Background Echocardiography is the primary imaging modality for diagnosis of infective endocarditis (IE) in prosthetic valve endocarditis (PVE) including IE after transcatheter aortic valve implantation (TAVI). This study aimed to evaluate the characteristics and clinical outcomes of patients with absent compared with evident echocardiographic signs of TAVI-IE. Methods Patients with definite TAVI-IE derived from the Infectious Endocarditis after TAVI International Registry were investigated comparing those with absent and evident echocardiographic signs of IE defined as vegetation, abscess, pseudo-aneurysm, intracardiac fistula, or valvular perforation or aneurysm. Results Among 578 patients, 87 (15.1%) and 491 (84.9%) had absent (IE-neg) and evident (IE-pos) echocardiographic signs of IE, respectively. IE-neg were more often treated via a transfemoral access with a self-expanding device and had higher rates of peri-interventional complications (eg, stroke, major vascular complications) during the TAVI procedure (P < .05 for all). IE-neg had higher rates of IE caused by Staphylococcus aureus (33.7% vs 23.2%; P = .038) and enterococci (37.2% vs 23.8%; P = .009) but lower rates of coagulase-negative staphylococci (4.7% vs 20.0%, P = .001). IE-neg was associated with the same dismal prognosis for in-hospital mortality in a multivariate binary regression analysis (odds ratio: 1.51; 95% confidence interval [CI]: .55–4.12) as well as a for 1-year mortality in Cox regression analysis (hazard ratio: 1.10; 95% CI: .67–1.80). Conclusions Even with negative echocardiographic imaging, patients who have undergone TAVI and presenting with positive blood cultures and symptoms of infection are a high-risk patient group having a reasonable suspicion of IE and the need for an early treatment initiation.
Published: 2022

3. Evaluation of Left Atrial Size and Function: Relevance for Clinical Practice

Author: Marta Sitges, Liza Thomas, Bogdan A. Popescu, Erwan Donal, Monica Rosca, Gianni Pedrizzetti, Denisa Muraru, Luigi P. Badano, Michael Y. Henein, Westmead Hospital [Sydney], University of New South Wales [Sydney] (UNSW), Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Trieste, Umeå University, CHU Pontchaillou [Rennes], Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], 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), Thomas, L., Muraru, D., Popescu, B. A., Sitges, M., Rosca, M., Pedrizzetti, G., Henein, M. Y., Donal, E., Badano, L. P., Thomas, L, Muraru, D, Popescu, B, Sitges, M, Rosca, M, Pedrizzetti, G, Henein, M, Donal, E, Badano, L, Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Università degli studi di Trieste = University of Trieste, and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, Longitudinal strain, media_common.quotation_subject, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, Three-dimensional echocardiography, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Two-dimensional echocardiography, 0302 clinical medicine, Tissue Doppler echocardiography, Left atrial, Internal medicine, Humans, Medicine, Atrial Appendage, Radiology, Nuclear Medicine and imaging, Relevance (information retrieval), Heart Atria, Left atrium, Maximal volume, Minimal volumes, Noninvasive LA pressure, Phasic function, Speckle-tracking echocardiography, Function (engineering), media_common, Functional evaluation, business.industry, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Prognosis, Minimal volume, 3. Good health, Clinical Practice, Echocardiography, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Atrial Function, Left, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Left atrial (LA) structural and functional evaluation have recently emerged as powerful biomarkers for adverse events in a variety of cardiovascular conditions. Moreover, noninvasive evaluation of LA pressure has gained importance in the characterization of the hemodynamic profile of patients. This review describes the methodology, benefits and pitfalls of measuring LA size and function by echocardiography and provides a brief overview of the prognostic utility of newer echocardiographic metrics of LA geometry and function (i.e., three-dimensional volumes, longitudinal strain, and phasic function parameters). © 2020 American Society of Echocardiography
Published: 2020

4. Rational and design of the ROTAS study: a randomized study for the optimal treatment of symptomatic patients with low-gradient severe aortic valve stenosis and preserved left ventricular ejection fraction

Author: Thierry Le Tourneau, Emmanuel Oger, Elena Galli, Catherine Sportouch, Augustin Coisne, Mathieu Lederlin, Anne Bernard, Erwan Donal, Florent Le Ven, Patrizio Lancellotti, Loïc Bière, Christophe Tribouilloy, Gilbert Habib, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Clinique du Millénaire - Oc Santé [Montpellier], Oc Santé [Montpellier], 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), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Timone [CHU - APHM] (TIMONE), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie [Liège], CHU de Liège-Domaine Universitaire du Sart Tilman, Service de Cardiologie [Amiens], CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), PHRC-N 2017, National grant from « direction generale de la sante » -ministère de la santé, France, Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génomique Fonctionnelle - Montpellier GenomiX (IGF MGX), Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), 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), Soins Intensifs et Urgences Cardiologiques, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université d'Angers (UA), and Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)
Subjects: medicine.medical_specialty, Population, 030204 cardiovascular system & hematology, Doppler echocardiography, Severity of Illness Index, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Aortic valve replacement, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Cardiac magnetic resonance imaging, Internal medicine, medicine, Humans, Randomized study, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, education, ComputingMilieux_MISCELLANEOUS, Heart Valve Prosthesis Implantation, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, education.field_of_study, Ejection fraction, medicine.diagnostic_test, business.industry, Aortic stenosis, Low gradient, Stroke Volume, Aortic Valve Stenosis, General Medicine, Stroke volume, Prognosis, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, Stenosis, Treatment Outcome, Aortic Valve, Aortic valve stenosis, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract: Aims Fifteen to thirty percentage of patients with severe aortic stenosis (AS) have preserved left ventricular ejection fraction (LVEF) and a discordant AS pattern at Doppler echocardiography, which is characterized by a small ( Methods and results The ROTAS trial will be a multicentre randomized non-blinded study involving 16 reference centres. AS severity will be confirmed by a multimodality approach (rest and stress echocardiography, calcium scoring, and cardiac magnetic resonance imaging for optimally characterize the population), which could provide important inputs to improve the pathophysiological understanding of this complex disease. Well-characterized patients will be randomized according to the management strategy. The primary endpoint will be the occurrence of all-cause mortality or cardiac related-hospitalizations during 2-year FU. One hundred and eighty subjects per group will be included. Conclusion The management of patients with LS severe AS and preserved LVEF is largely debated. ROTAS trial will allow a comprehensive evaluation of this particular pattern of AS and will establish which is the most appropriate management of these patients.
Published: 2020

5. Mitral Valve Infective Endocarditis after Trans-Catheter Aortic Valve Implantation

Author: Vassili Panagides, David del Val, Mohamed Abdel-Wahab, Norman Mangner, Eric Durand, Nikolaj Ihlemann, Marina Urena, Costanza Pellegrini, Francesco Giannini, Piotr Scislo, Zenon Huczek, Martin Landt, Vincent Auffret, Jan Malte Sinning, Asim N. Cheema, Luis Nombela-Franco, Chekrallah Chamandi, Francisco Campelo-Parada, Erika Munoz-Garcia, Howard C Herrmann, Luca Testa, Won-Keun Kim, Juan Carlos Castillo, Alberto Alperi, Didier Tchetche, Antonio L. Bartorelli, Samir Kapadia, Stefan Stortecky, Ignacio Amat-Santos, Harindra C. Wijeysundera, John Lisko, Enrique Gutiérrez-Ibanes, Vicenç Serra, Luisa Salido, Abdullah Alkhodair, Ugolino Livi, Tarun Chakravarty, Stamatios Lerakis, Victoria Vilalta, Ander Regueiro, Rafael Romaguera, Utz Kappert, Marco Barbanti, Jean-Bernard Masson, Frédéric Maes, Claudia Fiorina, Antonio Miceli, Susheel Kodali, Henrique B. Ribeiro, Jose Armando Mangione, Fabio Sandoli de Brito, Guglielmo Mario Actis Dato, Francesco Rosato, Maria-Cristina Ferreira, Valter Correia de Lima, Alexandre Siciliano Colafranceschi, Alexandre Abizaid, Marcos Antonio Marino, Vinicius Esteves, Julio Andrea, Roger R. Godinho, Fernando Alfonso, Helene Eltchaninoff, Lars Søndergaard, Dominique Himbert, Oliver Husser, Azeem Latib, Hervé Le Breton, Clement Servoz, Isaac Pascual, Saif Siddiqui, Paolo Olivares, Rosana Hernandez-Antolin, John G. Webb, Sandro Sponga, Raj Makkar, Annapoorna S. Kini, Marouane Boukhris, Philippe Gervais, Axel Linke, Lisa Crusius, David Holzhey, Josep Rodés-Cabau, Université Laval [Québec] (ULaval), Universität Leipzig [Leipzig], Technische Universität Dresden = Dresden University of Technology (TU Dresden), 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), Rigshospitalet [Copenhagen], Copenhagen University Hospital, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Deutsches Herzzentrum München (DHM), Ospedale San Raffaele, Medical University of Warsaw - Poland, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], 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), 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), Hôpital Rangueil, CHU Toulouse [Toulouse], UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Département cardiovasculaire, Universität Leipzig, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: MESH: Endocarditis, Catheters, MESH: Humans, Endocarditis, MESH: Heart Valve Prosthesis, Aortic Valve Insufficiency, Aortic Valve Stenosis, MESH: Aortic Valve Insufficiency, MESH: Mitral Valve, Transcatheter Aortic Valve Replacement, Treatment Outcome, Risk Factors, MESH: Risk Factors, Aortic Valve, Heart Valve Prosthesis, Humans, Mitral Valve, [SDV.IB]Life Sciences [q-bio]/Bioengineering, MESH: Transcatheter Aortic Valve Replacement, MESH: Catheters, Cardiology and Cardiovascular Medicine, 610 Medicine & health, MESH: Aortic Valve, MESH: Aortic Valve Stenosis, MESH: Treatment Outcome
Abstract: Scarce data exist on mitral valve (MV) infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). This multicenter study included a total of 579 patients with a diagnosis of definite IE after TAVI from the IE after TAVI International Registry and aimed to evaluate the incidence, characteristics, management, and outcomes of MV-IE after TAVI. A total of 86 patients (14.9%) had MV-IE. These patients were compared with 284 patients (49.1%) with involvement of the transcatheter heart valve (THV) only. Two factors were found to be associated with MV-IE: the use of self-expanding valves (adjusted odds ratio 2.49, 95% confidence interval [CI] 1.23 to 5.07, p = 0.012), and the presence of an aortic regurgitation >= 2 at discharge (adjusted odds ratio 3.33; 95% CI 1.43 to 7.73, p < 0.01). There were no differences in IE timing and causative microorganisms between groups, but surgical management was significantly lower in patients with MV-IE (6.0%, vs 21.6% in patients with THV-IE, p = 0.001). All-cause mortality rates at 2-year follow-up were high and similar between patients with MV-IE (51.4%, 95% CI 39.8 to 64.1) and patients with THV-IE (51.5%, 95% CI 45.4 to 58.0) (log-rank p = 0.295). The factors independently associated with increased mortality risk in patients with MV-IE were the occurrence of heart failure (adjusted p < 0.001) and septic shock (adjusted p < 0.01) during the index hospitalization. One of 6 IE episodes after TAVI is localized on the MV. The implantation of a self-expanding THV and the presence of an aortic regurgitation >= 2 at discharge were associated with MV-IE. Patients with MV-IE were rarely operated on and had a poor prognosis at 2-year follow-up. (C) 2022 Elsevier Inc. All rights reserved.
Published: 2022

6. Factors Predicting Statin Initiation During Childhood in Familial Hypercholesterolemia: Importance of Genetic Diagnosis

Author: Peretti, N., Vimont, Alexandre, Mas, E., Ferrières, J., Tounian, P., Lemale, J., Boccara, F., Di Filippo, M., Charriere, S., Moulin, P., Poinsot, P., Cottin, Y., Ducluzeau, P. H., Dourmap, C., Cariou, B., Farnier, M., Paillard, F., Pradignac, A., Yelnik, C., Gallo, A., Bruckert, E., Beliard, S., 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), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Groupement Hospitalier Lyon-Est (GHE), Institut de Recherche en Santé Digestive (IRSD ), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), 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], Groupe de recherche clionique Complications Cardiovasculaires et Métaboliques chez les patients vivant avec le Virus de l’immunodéficience humaine (VIH) (GRC 22 - C²MV), Hôpital Louis Pradel [CHU - HCL], Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Pontchaillou [Rennes], 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)-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), Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Hôpital de Hautepierre [Strasbourg], Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE), 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), Service de médecine interne [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), 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), the New French Atherosclerosis Society and the French national project CHOPIN (CHOlesterol Personalized Innovation), French Registry of Familial Hypercholesterolemia (REFERCHOL) investigators, ANR-16-RHUS-0007,CHOPIN,CHOPIN(2016), CarMeN, laboratoire, CHOPIN - - CHOPIN2016 - ANR-16-RHUS-0007 - RHUS - VALID, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-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 Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Complications Cardiovasculaires et Métaboliques chez les patients vivant avec le Virus de l’immunodéficience humaine (GRC22 C²MV), Service de Cardiologie [CHU Saint-Antoine], CHU Saint-Antoine [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 Saint-Antoine [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)-Service d'Endocrinologie, diabétologie et endocrinologie de la reproduction [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Service de Maladies infectieuses et tropicales [CHU Tenon], CHU Tenon [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 Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université - Faculté de Médecine (SU FM), and Sorbonne Université (SU)-Service de cardiologie [CHU Tenon]
Subjects: cardiovascular risk, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, children, familial hypercholesterolemia, risk factor, treatment, Pediatrics, Perinatology and Child Health, statin, atherosclerotic cardiovascular disease, genetic, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Ldl
Abstract: International audience; OBJECTIVE: To identify childhood and parental factors associated with initiation of statin therapy in children with heterozygous familial hypercholesterolemia (HeFH), including underlying genetic diagnosis or parental premature atherosclerotic cardiovascular disease (ASCVD). STUDY DESIGN: This multicenter cohort study included 245 HeFH child-parent pairs from the REFERCHOL national register (2014-2020). Demographic and clinical characteristics at the last visit were collected. Vascular disease in parents was defined as a history of ASCVD, and/or a coronary artery calcium score \textgreater100, and/or stenosis of \textgreater50% in at least carotid artery. Statistical analyses included descriptive analysis, logistic regression for univariate and multivariate effects of statins, and a sensitivity analysis combining the characteristics of children and parents. RESULTS: Among the 245 children in the study cohort, 135 (58%), with a mean age of 14 ± 3 years, were treated with a statin. In multivariable analysis, the predictive childhood factors associated with statin treatment were genetic diagnosis (OR, 2.5; 95% CI, 1.3 to 4.9; P = .01), older age (OR, 4.4; 95% CI, 1.8-10.6; P = .01), more than 2 visits (OR, 2.36; 95% CI, 1.18-4.73; P = .015), and longer duration of follow-up (OR, 1.3; 95% CI, 1.1-1.6; P \textless .001). The predictive parental factor associated with childhood treatment was the presence of vascular disease (OR, 2.4; 95% CI, 1.0-5.7; P = .04). CONCLUSIONS: HeFH confirmed by DNA testing during childhood and a history of vascular disease in parents were independently associated with statin treatment in children with HeFH. Genetic diagnosis may be useful for cardiovascular prevention in children.
Published: 2023

7. Cohort profile: the ESC EURObservational Research Programme Atrial Fibrillation III (AF III) Registry

Author: Maury, Philippe, Thambo, Jean Benoit, Maltret, Alice, Combes, Nicolas, Hascoet, Sébastien, Derval, Nicolas, Ladouceur, Magalie, Acar, Philippe, Amedro, Pascal, Anselm, Frederic, Bajolle, Fanny, Basquin, Adeline, Belli, Emre, Bordachar, Pierre, Duthoit, Guillaume, Di Filippo, Sylvie, Fauchier, Laurent, Gandjbakhch, Estelle, Gras, Daniel, Gronier, Celine, Karsenty, Clement, Klug, Didier, Koutbi, Linda, Lacotte, Jérôme, Laurent, Gabriel, Laux, Daniela, Mansourati, Jacques, Marijon, Eloi, Ovaert, Caroline, Sacher, Frederic, Sadoul, Nicolas, Warin-Fresse, Karine, Taieb, Jérôme, Waldmann, Victor, Defaye, Pascal, Chauvin, Michel, Anselme, Frederic, Piot, Olivier, Boveda, Serge, Cassagnes, Lucie, Dacher, Jean-Nicolas, Bartoli, Axel, Boyer, Louis, Cochet, Hubert, Deharo, Jean-Claude, Dubourg, Benjamin, Pontana, François, Jacquier, Alexis, Potpara, Tatjana, Lip, Gregory, Dagres, Nikolaos, Crijns, Harry, Boriani, Giuseppe, Kirchhof, Paulus, Arbelo, Elena, Savelieva, Irina, Lenarczyk, Radoslaw, Maggioni, Aldo, Gale, Chris, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Cardiologie (9), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Pessac, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Clinique Pasteur [Toulouse], Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Department of Cardiology, Georges Pompidou European Hospital and Necker-Enfants Malades Hospital, AP-HP, Adult Congenital Heart Disease Unit, Centre de Référence des Malformations Cardiaques Congénitales Complexes (M3C), 75015 Paris, France, Inserm U970, PARCC, 75015 Paris, France., Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), M3C-Necker Enfants Malades, Université Paris Descartes, Sorbonne Paris Cité, Paris, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Pôle des Cardiopathies Congénitales, Marie Lannelongue Hospital, 92350 Le Plessis-Robinson, Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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), 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], Service de Cardiologie Pédiatrique, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Cabinet de Cardiologie Foetale Pediatrique et Congenitale Adulte et Groupement d'Exploration Radiologique et Cardiovasculaire, Clinique de l'Orangerie, 67000 Strasbourg, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Université Paris Cité (UPCité), Centre Hospitalier d'Aix en Provence [Aix-en-Provence] (CHIAP ), Centre Hospitalier Universitaire [Grenoble] (CHU), Les Hôpitaux Universitaires de Strasbourg (HUS), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre cardiologique du Nord (CCN), CHU Clermont-Ferrand, Service de Radiologie [CHU Rouen], Normandie Université (NU)-Normandie Université (NU), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Service d’Imagerie Médicale et Radiologie Interventionnelle [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), CHU Bordeaux [Bordeaux], 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), University of Belgrade [Belgrade], University of Liverpool, Aalborg University [Denmark] (AAU), Universität Leipzig, Department of Physiology [Maastricht], Maastricht University [Maastricht], Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia (UNIMORE), University of Birmingham [Birmingham], Lomonosov Moscow State University (MSU), EURObservational Research Programme, European Society of Cardiology, and Maria Cecilia Hospital [Cotignola]
Subjects: medicine.medical_specialty, Registry, EORP, Cardiology, SOCIETY, MEMBER COUNTRIES, atrial fibrillation, non-interventional, observational, prospective, registry, GUIDELINES, ADHERENT ANTITHROMBOTIC TREATMENT, [SHS]Humanities and Social Sciences, ANTICOAGULATION, medicine, MANAGEMENT, Humans, Registries, HIGH-RISK PATIENTS, Stroke, Observational, Fibrillation, business.industry, STROKE PREVENTION, Health Policy, Anticoagulants, Non-interventional, Atrial fibrillation, Guideline, IMPROVED OUTCOMES, medicine.disease, Optimal management, Prospective, EURO HEART SURVEY, Stroke prevention, Emergency medicine, Cohort, Quality of Life, Observational study, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Aims The European Society of Cardiology (ESC) EURObservational Research Programme (EORP)-Atrial Fibrillation (AF) III Registry aims to identify contemporary patterns in AF management in clinical practice, assess their compliance with the 2016 ESC AF Guidelines, identify major gaps in guideline implementation, characterize the clinical practice settings associated with good vs. poor guideline implementation and assess and compare the 1-year outcome of guideline-adherent vs. guideline non-adherent management strategies. Methods and results Consecutive adult AF patients (n = 8306) were enrolled between 1 July 2018 and 15 July 2019, and individual patient data were prospectively collected across 192 centres and 31 participating countries during the 3-month enrolment period per centre. The Registry collected baseline and 1-year follow-up data in the eight main domains: patient demographic/enrolment setting, AF diagnosis/characterization, diagnostic assessment, stroke prevention treatments, arrhythmia-directed therapies, integrated AF management, major outcomes (death, non-fatal stroke or systemic embolic event, and non-fatal bleeding event), and the quality of life questionnaire. Conclusion The EORP-AF III Registry is an international, prospective registry of care and outcomes of patients treated for AF, which will provide insights into the contemporary patterns in AF management, ESC AF Guidelines implementation in routine practice and barriers to optimal management of this highly prevalent arrhythmia.
Published: 2021

8. Development and Validation of a New Risk Prediction Score for Life-Threatening Ventricular Tachyarrhythmias in Laminopathies

Author: Mélanie Fradin, Nicolas Sadoul, Xavier Waintraub, Didier Klug, Albert Hagège, Pascal Sabouraud, Arnaud Isapof, Julien Durigneux, Olivier Lascols, Pascal Laforêt, Armelle Magot, Ivana Dabaj, Eloi Marijon, Camille Vatier, Pascal Cintas, Emmanuelle Salort, Bénédicte Gaborit, Antoine Muchir, Xavier Ferrer, Pascale Richard, Corinne Metay, Stéphane Boulé, Sarah Leonard-Louis, Philippe Mabo, V. Tiffreau, Caroline Stalens, Jitendra K. Vohra, Stéphane Schaeffer, Khadija Chikhaoui, Eric Bieth, Sandra Mercier, Pierre Ambrosi, Aleksandra Nadaj-Pakleza, Michèle Mayer, Katja Zeppenfeld, Gisèle Bonne, Véronique Manel, Jean-Marc Davy, Guilhem Sole, Ghassan Moubarak, Nicolas Lamblin, Klaus Dieterich, Christophe Meune, Abdallah Fayssoil, Arnaud Lazarus, Philippe Maury, Karim Wahbi, Philippe Petiot, Isabelle Jéru, Annick Toutain, Corinne Vigouroux, Ana Ferreiro, Maud Michaud, H.M. Bécane, Bruno Eymard, Thomas D. Gossios, Marie-Christine Vantyghem, Saurabh Kumar, Estelle Gandjbakhch, Yann Péréon, T. Thompson, Marie-Christine Minot-Myhié, Anthony Behin, Frédéric Sacher, Philippe Charron, Nicolas Combes, Julien Praline, Dominique Babuty, Emmanuelle Lagrue, Usha B. Tedrow, Jean-Marc Sellal, Florence Petit, Perry M. Elliott, Frédéric Anselme, Philippe Chevalier, Frederic Taithe, Christine Barnerias, Vincent Laugel, Andoni Echaniz-Laguna, Raphaël P. Martins, Alexander F.A. Androulakis, Rabah Ben Yaou, Franck Boccara, Ulrike Walther-Louvier, Tanya Stojkovic, Françoise Bouhour, Annachiara De Sandre-Giovannoli, Susana Quijano-Roy, Françoise Chapon, Jean-Noël Trochu, Céline Tard, Anne Rollin, Jean-Marie Cuisset, Denis Duboc, Raphaël Porcher, Catherine Sarret, Jonathan M. Kalman, Florence Demurger, Damien Bonnet, Christine Francannet, Neal K. Lakdawala, Romain Eschalier, Fabien Labombarda, Kostantinos Savvatis, Raul Juntas Morales, Isabelle Desguerre, Nicolas Lévy, Anne-Claire Brehin, Service de Cardiologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de recherche en Myologie – U974 SU-INSERM, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), 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), CHU Rouen, Normandie Université (NU), St Bartholomew's Hospital (London), Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Association française contre les myopathies (AFM-Téléthon), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Service de Cardiologie B, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), 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), Hôpital Ambroise Paré [AP-HP], William Harvey Research Institute, Barts and the London Medical School, Biostatistique et épidemiologie clinique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Myologie, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Filière Neuromusculaire (FILNEMUS), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Université de Caen Normandie (UNICAEN), Laboratoire d'Informatique Scientifique et Industrielle (LISI), Université de Poitiers-Ecole Nationale Supérieure de Mécanique et d'Aérotechnique [Poitiers] (ISAE-ENSMA), Hôpital Raymond Poincaré [AP-HP], CHU Lille, Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 (EGID), 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 National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Aix Marseille Université (AMU), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de génétique médicale [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinique Pasteur [Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), The Royal Melbourne Hospital, Leiden University Medical Center (LUMC), Universiteit Leiden, Service de neurologie pédiatrique [CHU Necker], Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Saint-Antoine [AP-HP], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Necker - Enfants Malades [AP-HP], Hôpital Privé Le Bois Ramsay Santé [Lille], Service de génétique [Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Hôpital Côte de Nacre [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Mobilités : Vieillissement, Pathologie, Santé (COMETE), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Roger Salengro [Lille], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de ressources biologiques Tissus ADN Cellules [Hôpital de la Timone - APHM] (CRB TAC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Cytogénétique et de Biologie Cellulaire, Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire [Grenoble] (CHU), [GIN] Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Les Hôpitaux Universitaires de Strasbourg (HUS), CHU Clermont-Ferrand, Unité de Biologie Fonctionnelle et Adaptative (BFA (UMR_8251 / U1133)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de neurologie [Bordeaux], Service de Génétique Médicale [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Service de cardiologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-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)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Trousseau [APHP], Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE), 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), CHU Strasbourg, Clinique Ambroise Paré [Centres Médico-Chirurgicaux Ambroise Pré, Pierre Cherest, Hartmann], Hôpital Cochin [AP-HP], Hospices Civils de Lyon (HCL), Service de génétique médicale - Unité de génétique clinique [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Lorraine (UL), Service de neurologie [Angers], Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Centre Hospitalier Universitaire de Reims (CHU Reims), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Service de Neurologie [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de Neurologie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], Institut Cochin (IC UM3 (UMR 8104 / U1016)), Laboratoire d'étude de la motricité humaine - EA 3608 (LEMH), Université de Lille, Droit et Santé, Service de génétique [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Physiopathologie et thérapie du muscle strié, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR14-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Montréal (UdeM), Laboratoire Génie des procédés papetiers (LGP2 ), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), The Heart Hospital [London], University College of London [London] (UCL), This study was funded by grants from the AFM-Téléthon (French Alliance against Myopathies), which was not involved in the design and conduct of the study, collection, management, analysis, and interpretation of the data, preparation, review, or approval of the manuscript, and decision to submit the manuscript for publication. Some of this work was undertaken at University College London (United Kingdom) and St. Bartholomew’s Hospital (London, United Kingdom), which received a portion of funding from the United Kingdom Department of Health’s National Institute for Health Research Biomedical Research Centres funding scheme., Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Centre de recherche en myologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP], CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], 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), Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Pitié-Salpêtrière [APHP], Université Pierre et Marie Curie - Paris 6 (UPMC)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Unit of Neuromuscular Morphology [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [APHP]-Institut de Myologie, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre de référence des maladies rares neuromusculaires Aquitaine-Grand Sud Ouest, CHU Bordeaux [Bordeaux], Laboratoire d'Informatique Scientifique et Industrielle (LISI / ENSMA), LISI-ENSMA, Service de Biochimie-Génétique [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Thérapie des maladies du muscle strié, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Cardiologie A, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Endocrinologie et Métabolisme, Unité de Cardiologie et Soins Intensifs, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse], CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), Service de Génétique [Purpan], CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Centre de Référence M3C Malformations Cardiaques Congénitales Complexes, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité-CHU Necker - Enfants Malades [AP-HP], Hôpital neurologique, Centre Hospitalier Universitaire de Lille (CHU de Lille), Service Neurologie Pédiatrique, Service de Neuropédiatrie, INSERM U836, équipe 4, Muscles et pathologies, Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Département de Neurologie, Hôpital Civil de Strasbourg, Groupe Myologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de génétique médicale, CHU - HÔTEL-DIEU Clermont-Ferrand, CLAD Ouest, Centre Hospitalier Universitaire [Rennes], Centre recherche en CardioVasculaire et Nutrition (C2VN), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Neuropédiatrie [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Trousseau [APHP], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie et cerveau, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement (Inserm U1167 - RID-AGE - Institut Pasteur), Clinique Ambroise Paré, CHU Cochin [AP-HP], Epilepsie, sommeil et explorations fonctionnelles neuropédiatriques, Hospices Civils de Lyon (HCL)-Hopital Neurologique-Hôpital Femme Mère Enfant, Department of Medicine, Columbia University [New York]-College of Physicians and Surgeons, Service de neurologie, Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer (JPArc - U837 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université Lille 2 - Faculté de Médecine, Hôpital de Rangueil, Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), laboratoire d'étude de la motricité humaine (LEMH EA3608), Université de Montréal - UdeM (CANADA), Laboratoire Génie des procédés papetiers (LGP2), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche en Myologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Sorbonne Université (SU)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité-CHU Necker - Enfants Malades [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille, Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut de Myologie, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), European Genomic Institute for Diabetes - FR 3508 (EGID), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Hôpital Purpan [Toulouse], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Association française contre les myopathies (AFM-Téléthon)-Université Pierre et Marie Curie - Paris 6 (UPMC), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut de Myologie, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, Tachycardia, medicine.medical_specialty, implantable, Accurate estimation, Ventricular Tachyarrhythmias, Validation Studies as Topic, 030204 cardiovascular system & hematology, tachycardia, Sudden death, LMNA, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, death, Physiology (medical), Internal medicine, defibrillators, medicine, Humans, In patient, 030212 general & internal medicine, sudden, [SDV.GEN]Life Sciences [q-bio]/Genetics, Prediction score, business.industry, Defibrillators, Implantable, ventricular, Tachycardia, Ventricular, Cardiology, Female, medicine.symptom, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business
Abstract: Background: An accurate estimation of the risk of life-threatening (LT) ventricular tachyarrhythmia (VTA) in patients with LMNA mutations is crucial to select candidates for implantable cardioverter-defibrillator implantation. Methods: We included 839 adult patients with LMNA mutations, including 660 from a French nationwide registry in the development sample, and 179 from other countries, referred to 5 tertiary centers for cardiomyopathies, in the validation sample. LTVTA was defined as (1) sudden cardiac death or (2) implantable cardioverter defibrillator–treated or hemodynamically unstable VTA. The prognostic model was derived using the Fine-Gray regression model. The net reclassification was compared with current clinical practice guidelines. The results are presented as means (SD) or medians [interquartile range]. Results: We included 444 patients, 40.6 (14.1) years of age, in the derivation sample and 145 patients, 38.2 (15.0) years, in the validation sample, of whom 86 (19.3%) and 34 (23.4%) experienced LTVTA over 3.6 [1.0–7.2] and 5.1 [2.0–9.3] years of follow-up, respectively. Predictors of LTVTA in the derivation sample were: male sex, nonmissense LMNA mutation, first degree and higher atrioventricular block, nonsustained ventricular tachycardia, and left ventricular ejection fraction (https://lmna-risk-vta.fr). In the derivation sample, C-index (95% CI) of the model was 0.776 (0.711–0.842), and the calibration slope 0.827. In the external validation sample, the C-index was 0.800 (0.642–0.959), and the calibration slope was 1.082 (95% CI, 0.643–1.522). A 5-year estimated risk threshold ≥7% predicted 96.2% of LTVTA and net reclassified 28.8% of patients with LTVTA in comparison with the guidelines-based approach. Conclusions: In comparison with the current standard of care, this risk prediction model for LTVTA in laminopathies significantly facilitated the choice of candidates for implantable cardioverter defibrillators. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03058185.
Published: 2019

9. Current indications for the intra-aortic balloon pump: The CP-GARO registry

Author: Denis Angoulvant, Hervé Le Breton, Régis Delaunay, Marc Bedossa, Dominique Boulmier, Grégoire Rangé, Benoit Helleu, Vincent Letocart, Vincent Auffret, Philippe Commeau, Rémi Sabatier, Fabrice Prunier, Martine Gilard, Emmanuelle Filippi, Guillaume Leurent, Stephan Chassaing, 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Centre hospitalier universitaire de Nantes (CHU Nantes), Clinique Saint Gatien, Cellules Dendritiques, Immunomodulation et Greffes, Université de Tours (UT), Polyclinique Les Fleurs, Service de cardiologie [Chartres], Les hôpitaux de Chartres [Chartres], Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université d'Angers (UA), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre hospitalier de Vannes, Centre hospitalier Saint-Brieuc, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC)
Subjects: Male, Registry, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Shock, Cardiogenic, Hemodynamics, 030204 cardiovascular system & hematology, Balloon, Revascularization, law.invention, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Randomized controlled trial, Risk Factors, law, medicine, Humans, Hospital Mortality, Prospective Studies, Registries, 030212 general & internal medicine, Cardiogenic shock, Aged, Intra-aortic balloon pump, Intra-Aortic Balloon Pumping, business.industry, Mortality rate, Assistance circulatoire, Recovery of Function, General Medicine, Middle Aged, medicine.disease, 3. Good health, Surgery, Treatment Outcome, Registre, Etiology, Circulatory assistance, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Contre-pulsion par ballonnet intra-aortique, Choc cardiogénique
Abstract: Summary Background Intra-aortic balloon pumps (IABPs) have been used routinely since the 1970s. Recently, large randomized trials failed to show that IABP therapy has meaningful benefit, and international recommendations downgraded its place, particularly in cardiogenic shock. Aims The aim of this registry was to describe the contemporary use of IABP therapy, in light of these new data. Methods This prospective multicentre registry included 172 patients implanted with an IABP in 19 French cardiac centres in 2015. Baseline characteristics, aetiologies leading to IABP use, and IABP-related and disease-related complications were assessed. In-hospital and 1-year mortality rates were studied. Results A total of 172 patients were included (mean age 65.5 ± 12.0 years; 118 men [68.6%]). The reasons for IABP implantation were mainly haemodynamic (n = 107; 62.2%), followed by bridge to revascularization (n = 34; 19.8%) and four other “rare” aetiologies (n = 29 patients; 16.8%). In-hospital and 1-year mortality rates were 40.7% and 45.8%, respectively. Fourteen patients (8.1%) experienced ischaemic or haemorrhagic complications, which were directly related to the IABP in seven patients (4.1%). Conclusions Despite current international guidelines regarding the place of IABPs in ischaemic cardiogenic shock without mechanical complications, this aetiology remains the leading cause for its utilization in the contemporary era.
Published: 2018

10. Redefining the Classifications of Response to Cardiac Resynchronization Therapy: Results From the REVERSE Study

Author: Gold, Michael R, Rickard, John, Daubert, Jean-Claude, Zimmerman, Patrick, Linde, Cecilia, Medical University of South Carolina [Charleston] (MUSC), Cleveland Clinic, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], 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), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Medtronics, Karolinska University Hospital [Stockholm], Karolinska Institute, The REVERSE trial was supported by Medtronic, Inc., Minneapolis, Minnesota. Drs. Gold, Linde, and Daubert have served as consultants to and received research grants from Medtronic. Dr. Gold has served as a consultant and receives research grants from Boston Scientific. Dr. Rickard has received a research grant from Abbott, and has been a consultant for Medtronic. Dr. Daubert has received research grants, speaker honoraria, and consulting fees from Medtronic and St. Jude Medical. Dr. Zimmerman has been an employee of Medtronic. Dr. Linde has received honoraria payments from Medtronic, Abbott, and Impulse Dynamics, and has been supported by grants from the Swedish Heart Lung Foundation and Stockholm City Council., Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: [SDV.IB] Life Sciences [q-bio]/Bioengineering, Ventricular Dysfunction, Left, Treatment Outcome, response, Ventricular Remodeling, Humans, cardiac resynchronization therapy, heart failure, [SDV.IB]Life Sciences [q-bio]/Bioengineering, mortality, remodeling
Abstract: International audience; OBJECTIVES: This study sought to assess the impact of a more detailed classification of response on survival. BACKGROUND: Cardiac resynchronization therapy (CRT) improves functional status and outcomes in selected populations with heart failure (HF). However, approximately 30% of patients do not improve with CRT by various metrics, and they are traditionally classified as nonresponders. METHODS: REVERSE (Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction) was a randomized trial of CRT among patients with mild HF. Patients were classified as Improved, Stabilized, or Worsened using prespecified criteria based on the clinical composite score (CCS) and change in left ventricular end-systolic volume index (LVESVi). All-cause mortality across CRT ON subgroups at 5 years was compared. RESULTS: Of the 406 subjects surviving 1 year, 5-year survival differed between CCS subgroups (p = 0.03), with increased mortality in the Worsened response group. Of the 353 subjects with adequate echocardiograms, survival differed significantly between response groups (p
Published: 2021

11. Arsenic trioxide inhibits the functions of lung fibroblasts derived from patients with idiopathic pulmonary fibrosis

Author: Joannes, Audrey, Morzadec, Claudie, Duclos, Maëla, Gutierrez, Francisco Llamas, Chiforeanu, Dan Cristian, Le Naoures, Cécile, de Latour, Bertrand, Rouzé, Simon, Wollin, Lutz, Jouneau, Stéphane, Vernhet, Laurent, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), CHU Pontchaillou [Rennes], Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Boehringer Ingelheim Pharma GmbH & Co. KG, This work was supported by The Institut National de la Santé et de la Recherche Médicale (INSERM), the Université de Rennes-1(Univ Rennes-1) and Boehringer Ingelheim Pharma GmbH., and Chard-Hutchinson, Xavier
Subjects: Pharmacology, Metalloid, Interstitial lung diseases, NF-E2-Related Factor 2, [SDV]Life Sciences [q-bio], Proliferation, Becaplermin, respiratory system, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, Fibroblasts, Toxicology, Idiopathic Pulmonary Fibrosis, respiratory tract diseases, [SDV] Life Sciences [q-bio], [SDV.TOX] Life Sciences [q-bio]/Toxicology, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, Transforming Growth Factor beta1, Arsenic Trioxide, Differentiation, [SDV.TOX]Life Sciences [q-bio]/Toxicology, Primary human lung fibroblasts, Humans, Lung, Migration
Abstract: International audience; Idiopathic pulmonary fibrosis (IPF) is a chronic and fatal interstitial lung disease. Currently, no treatment can block or reverse the development of lung fibrosis in patients suffering from IPF. Recent studies indicate that arsenic trioxide (ATO), a safe, effective anti-cancer pro-oxidant drug, prevents the differentiation of normal human lung fibroblasts (NHLFs) in vitro and reduces experimental pulmonary fibrosis in vivo. In this context, we investigated the anti-fibrotic effects of ATO on the main fibrosis functions of human lung fibroblasts (HLFs) isolated from patients with IPF. IPF and non-IPF (control) HLFs were incubated with 0.01-1 μM ATO and stimulated with pro-fibrotic factors (PDGF-BB or TGF-β1). We measured their rates of proliferation, migration and differentiation and the cell stress response triggered by ATO. ATO did not affect cell viability but strongly inhibited the proliferation and migration of PDGF-BB-stimulated IPF and control HLFs. ATO also prevented myofibroblastic differentiation, as assessed by the expression of α-smooth muscle actin (α-SMA) and collagen-1, and the phosphorylation of SMAD2/3 in TGF-β1-stimulated HLFs. These antifibrotic effects were associated with increased expression of the transcription factor NRF2 and its target genes NQO1 and HMOX1. Genetic silencing of NRF2 inhibited the ATO-induced cell stress response but did not prevent the ATO-dependent inhibition of α-SMA expression in TGF-β1-stimulated HLFs. The results demonstrate that ATO, at concentrations similar to exposure in blood plasma of ATO-treated cancer patients, counteracted pro-fibrotic activities of HLFs from IPF patients. We propose to consider ATO for clinical exploration to define the therapeutic potential in patients with IPF.
Published: 2022

12. Successful linkage of French large-scale national registry populations to national reimbursement data: Improved data completeness and minimized loss to follow-up

Author: Laura Liepchitz, Bernard Glatt, Guillaume Cayla, Mehdi Gabbas, Hervé Le Breton, Martine Gilard, Margaux Gouysse, Philippe Tuppin, Bernard Iung, Romain Didier, Philippe Commeau, Marjorie Boussac, Nicolas Glatt, Hélène Eltchaninoff, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Clinityx, Anesthésie et réanimation en chirurgie cardiaque [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Caisse Nationale de l'Assurance Maladie [Paris] (CNAM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and CCSD, Accord Elsevier
Subjects: Time Factors, SNIIRAM, Databases, Factual, Pilot Projects, 030204 cardiovascular system & hematology, SNDS, 0302 clinical medicine, Documentation, Data Mining, Electronic Health Records, Medicine, 030212 general & internal medicine, Claims database, Registries, Case report form, Reimbursement, MESH: Electronic Health Records, education.field_of_study, Data Collection, General Medicine, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Data Accuracy, 3. Good health, Insurance, Health, Reimbursement, MESH: Administrative Claims, Healthcare, France, Medical Record Linkage, Medical emergency, Cardiology and Cardiovascular Medicine, Completeness (statistics), Algorithms, MESH: Medical Record Linkage, Registry, Population, MESH: Algorithms, TAVI, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, education, business.industry, MESH: Data Mining, Patient data, PMSI, medicine.disease, MESH: Pilot Projects, MESH: Insurance, Health, Reimbursement, National registry, business, Administrative Claims, Healthcare
Abstract: Summary Background Registries, a cornerstone of contemporary medicine, frequently suffer from incomplete documentation and losses to follow-up. By linking data to a single-payer national claims database, national registries may be enriched and the quality enhanced. Aims To explore the value of data from the French Systeme National des Donnees de Sante (SNDS) as a resource to enhance the quality of registries when combined with data from electronic case report forms, and to assess the power to minimize data gaps and losses to follow-up. Methods A probabilistic algorithm was developed to link and match records in the SNDS with patient data from the electronic case report forms of two registries on transcatheter aortic valve implantation: FRANCE-2 and FRANCE-TAVI. The algorithm created patient profiles from transcatheter aortic valve implantation procedures in the SNDS, matching them as closely as possible to the profiles in the registry databases. The objective was to achieve 90% linkage of the populations. The linked database was analysed for completeness and loss to follow-up. For validation, mortality curves for the linked registry cohorts were compared with those for the original populations. Results A total of 34,397 unique registries entries were identified, and 89.9% of patients in the SNDS could be linked. Rates of losses to follow-up over 2 years were 1.0% in the linked FRANCE-TAVI population compared with 40.3% based on electronic case report form documentation. For FRANCE-2, 3-year rates of losses to follow-up were 1.7% and 6.1%, respectively. Mortality curves for populations based on SNDS and electronic case report form data were practically superimposable. Conclusions Linking data from a single-payer national claims database to national registries using a probabilistic approach is feasible and can close data gaps and practically abolish losses to follow-up in the registry population.
Published: 2020

13. Position paper concerning the competence, performance and environment required for the practice of ablation in children and in congenital heart disease

Author: Jérôme Lacotte, Fanny Bajolle, Karine Warin-Fresse, Nicolas Combes, Olivier Piot, Magalie Ladouceur, Jérôme Taieb, Guillaume Duthoit, Philippe Acar, Frederic Anselm, Jacques Mansourati, Jean Benoit Thambo, Daniel Gras, Clément Karsenty, Sylvie Di Filippo, Estelle Gandjbakhch, Serge Boveda, Pascal Defaye, Frederic Sacher, Pierre Bordachar, Pascal Amedro, Céline Gronier, Eloi Marijon, Emre Belli, Gabriel Laurent, Linda Koutbi, Alice Maltret, Adeline Basquin, Victor Waldmann, Nicolas Derval, Didier Klug, Daniela Laux, Sébastien Hascoët, Philippe Maury, Caroline Ovaert, Nicolas Sadoul, Laurent Fauchier, Clinical sciences, Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Centre de Référence Maladies Cardiaques Héréditaires, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Clinique Pasteur [Toulouse], Hôpital Marie-Lannelongue, IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], 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), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), CHU Rouen, Normandie Université (NU), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Nouvelles Cliniques Nantaises - NCN [Nantes], Clinique De L' Orangerie - ELSAN [Strasbourg] (CDOS), CHU Lille, Hôpital de la Timone [CHU - APHM] (TIMONE), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Privé Jacques Cartier [Massy], Institut Cardiovasculaire Paris Sud [Massy] (ICPS), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier d'Aix en Provence [Aix-en-Provence] (CHIAP ), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Grenoble, Centre cardiologique du Nord (CCN), CHU Toulouse [Toulouse], CHU Pessac, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Congenital Heart Disease Service, Marie Lannelongue Hospital, 92350 Le Plessis-Robinson, France., Department of Cardiology, Georges Pompidou European Hospital and Necker-Enfants Malades Hospital, AP-HP, Adult Congenital Heart Disease Unit, Centre de Référence des Malformations Cardiaques Congénitales Complexes (M3C), 75015 Paris, France, Inserm U970, PARCC, 75015 Paris, France., Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Paediatric Cardiology Department, AP-HP, Necker-Enfants malades, M3C National Reference Centre, Paris Descartes University, Sorbonne Paris Cite, Paris, France, Pôle des Cardiopathies Congénitales, Marie Lannelongue Hospital, 92350 Le Plessis-Robinson, Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Cardiologie [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Service de Cardiologie Pédiatrique, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Cardiopathies et mort subite [ERL 3147], Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes (UN), Cabinet de Cardiologie Foetale Pediatrique et Congenitale Adulte et Groupement d'Exploration Radiologique et Cardiovasculaire, Clinique de l'Orangerie, 67000 Strasbourg, Service de Cardiologie A, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Département de Cardiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Institut Cardiovasculaire Paris Sud, Jacques Cartier Private Hospital, 91300 Massy, Service de Cardiologie [CHU de Dijon], Centre chirurgical Marie Lannelongue, Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service de Cardiologie [CHRU Nancy], Centre Hospitalier du Pays d'Aix, Department of Cardiology, Brest University Hospital, 29200 Brest, 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), Cardiac Stimulation and Rhythmology, Clinique Pasteur et Groupe Rythmologie Stimulation Cardiaque/SFC, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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), 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], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Chirurgical Marie Lannelongue (CCML), 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), CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)
Subjects: Heart disease, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Cryosurgery, 0302 clinical medicine, Cardiologists, heart rate, risk factors, 030212 general & internal medicine, Child, ComputingMilieux_MISCELLANEOUS, education.field_of_study, Cardiac electrophysiology, Paediatric cardiology, Age Factors, Arrhythmias, Cardiac/diagnosis, Cardiology Service, Hospital/standards, survivors, General Medicine, 3. Good health, Cardiac Surgical Procedures/adverse effects, Catheter, Treatment Outcome, Catheter Ablation, Electrophysiologic Techniques, Cardiac/standards, young adult, Cardiology Service, Hospital, Clinical Competence, Electrophysiologic Techniques, Cardiac, Cardiology and Cardiovascular Medicine, Heart Defects, Congenital, Adult, medicine.medical_specialty, Consensus, Adolescent, Child, preschool, Population, Catheter Ablation/adverse effects, Catheter ablation, Ablation procedures, Clinical Competence/standards, Competence (law), 03 medical and health sciences, Cardiologists/standards, Intensive care, medicine, Humans, cardiovascular diseases, Cardiac Surgical Procedures, education, Intensive care medicine, Congenital heart disease, Cryosurgery/adverse effects, Heart Defects, Congenital/diagnostic imaging, business.industry, Infant, Newborn, Infant, Arrhythmias, Cardiac, medicine.disease, Position paper, business
Abstract: International audience; The population of patients with congenital heart disease (CHD) is continuously increasing, and a significant proportion of these patients will experience arrhythmias because of the underlying congenital heart defect itself or as a consequence of interventional or surgical treatment. Arrhythmias are a leading cause of mortality, morbidity and impaired quality of life in adults with CHD. Arrhythmias may also occur in children with or without CHD. In light of the unique issues, challenges and considerations involved in managing arrhythmias in this growing, ageing and heterogeneous patient population and in children, it appears both timely and essential to critically appraise and synthesize optimal treatment strategies. The introduction of catheter ablation techniques has greatly improved the treatment of cardiac arrhythmias. However, catheter ablation in adults or children with CHD and in children without CHD is more technically demanding, potentially causing various complications, and thus requires a high level of expertise to maximize success rates and minimize complication rates. As French recommendations regarding required technical competence and equipment are lacking in this situation, the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the Affiliate Group of Paediatric and Adult Congenital Cardiology have decided to produce a common position paper compiled from expert opinions from cardiac electrophysiology and paediatric cardiology. The paper details the features of an interventional cardiac electrophysiology centre that are required for ablation procedures in adults with CHD and in children, the importance of being able to diagnose, monitor and manage complications associated with ablations in these patients and the supplemental hospital-based resources required, such as anaesthesia, surgical back-up, intensive care, haemodynamic assistance and imaging. Lastly, the need for quality evaluations and French registries of ablations in these populations is discussed. The purpose of this consensus statement is therefore to define optimal conditions for the delivery of invasive care regarding ablation of arrhythmias in adults with CHD and in children, and to provide expert and - when possible - evidence-based recommendations on best practice for catheter-based ablation procedures in these specific populations.
Published: 2020

14. Outcomes of Left Ventricular Assist Device Implantation in Patients With Uncommon Etiology Cardiomyopathy

Author: Romain Eschalier, Marie Bielefeld, Nicolas D'Ostrevy, Philippe Rouvière, Aude Boignard, Vincent Galand, Olivier Chavanon, François Picard, Céline Chabanne, Fabien Garnier, Frédéric Anselme, Jérôme Jouan, Katrien Blanchart, Erwan Flecher, Camille Dambrin, Hugues Blangy, Fabrice Vanhuyse, Gerard Babatasi, Edeline Pelcé, Walid Ghodhbane, Tam Hoang Minh, Céline Goéminne, Thierry Bourguignon, Raphaël P. Martins, Matteo Pozzi, Pierre-Yvesl Litzler, Frederic Sacher, Philippe Gaudard, E. Varlet, Constance Verdonk, Nicolas Lellouche, Thomas Senage, Magali Michel, Vlad Gariboldi, Bernard Lelong, Thibaud Genet, Michel Kindo, Christophe Leclercq, David Hamon, Jean-François Obadia, Clément Delmas, André Vincentelli, 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 chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Strasbourg, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Centre hospitalier universitaire de Nantes (CHU Nantes), CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire [Grenoble] (CHU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), 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), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Carnegie Mellon University [Pittsburgh] (CMU), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), 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 National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Henri Mondor [Créteil], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, chirurgie cardio-vasculaire, 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 Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Fédération Française de Cardiologie, Rennes University Hospital, 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), Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, CHU Henri Mondor, Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre de recherches (CRT), Société Lafarge, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), Nouvel Hôpital Civil, Strasbourg, France., Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Hospital Bichat Paris, Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-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-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), Centre Hospitalier Régional Universitaire de Caen (CHRU Caen), Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de cardiologie et maladies vasculaires, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, 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), and MORNET, Dominique
Subjects: Adult, Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Myocarditis, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Cardiomyopathy, Myocardial Ischemia, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Idiopathic dilated cardiomyopathy, medicine, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, business.industry, Mortality rate, valvular heart disease, Hypertrophic cardiomyopathy, Cardiomyopathy, Hypertrophic, Middle Aged, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Treatment Outcome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Ventricular assist device, Etiology, Cardiology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; The impact of uncommon etiology cardiomyopathies on Left-ventricular assist device (LVAD)-recipient outcomes is not very well known. This study aimed to characterize patients with uncommon cardiomyopathy etiologies and examine the outcomes between uncommon and ischemic/idiopathic dilated cardiomyopathy. This observational study was conducted in 19 centers between 2006 and 2016. Baseline characteristics and outcomes of patients with uncommon etiology were compared to patients with idiopathic dilated/ischemic cardiomyopathies. Among 652 LVAD-recipients included, a total of 590 (90.5%) patients were classified as ischemic/idiopathic and 62 (9.5%) patients were classified in the "uncommon etiologies" group. Main uncommon etiologies were: hypertrophic (n = 12(19%)); cancer therapeutics-related cardiac dysfunction (CTRCD) (n = 12(19%)); myocarditis (n = 11(18%)); valvulopathy (n = 9(15%)) and others (n = 18(29%)). Patients with uncommon etiologies were significantly younger with more female and presented less co-morbidities. Additionally, patients with uncommon cardiomyopathies were less implanted as destination therapy compared with ischemic/idiopathic group (29% vs 38.8%). During a follow-up period of 9.1 months, both groups experienced similar survival. However, subgroup of hypertrophic/valvular cardiomyopathies and CTRCD had significantly higher mortality compared to the ischemic/idiopathic or myocarditis/others cardiomyopathies. Conversely, patients with myocarditis/others etiologies experienced a better survival. Indeed, the 12-months survival in the myocarditis/others; ischemic/idiopathic and hypertrophic/CTRCD/valvulopathy group were 77%; 65%, and 46% respectively. In conclusion, LVAD-recipients with hypertrophic cardiomyopathy, valvular heart disease and CTRCD experienced the higher mortality rate.
Published: 2020

15. Correlation between non-invasive myocardial work indices and main parameters of systolic and diastolic function

Author: Arnaud Ancion, Ciro Santoro, Roberto M. Lang, Krasimira Hristova, Dragos Vinereanu, Patrizio Lancellotti, Marie Moonen, Maurizio Galderisi, George Kacharava, José Luis Zamorano, Daniele Barone, Andreas Hagendorff, Julien Magne, Christophe Martinez, Bernard Cosyns, Nico Van de Veire, Monica Baroni, Tolga Ozyigit, Toshimitsu Tsugu, Nuno Cardim, Raluca Elena Dulgheru, Ralph Stephan von Bardeleben, Gonzalo de la Morena, Concetta Zito, Scipione Carerj, Luigi P. Badano, Elena Galli, Martin Penicka, George Athanassopoulos, Bogdan A. Popescu, Erwan Donal, Jose David Rodrigo Carbonero, Adriana Postolache, Federica Ilardi, Monica Rosca, Teresa López, Andreea Calin, Marianna Cicenia, Tadafumi Sugimoto, Roberta Manganaro, Stella Marchetta, Clinical sciences, Cardio-vascular diseases, Cardiology, Manganaro, Roberta, Marchetta, Stella, Dulgheru, Raluca, Sugimoto, Tadafumi, Tsugu, Toshimitsu, Ilardi, Federica, Cicenia, Marianna, Ancion, Arnaud, Postolache, Adriana, Martinez, Christophe, Kacharava, George, Athanassopoulos, George D, Barone, Daniele, Baroni, Monica, Cardim, Nuno, Hagendorff, Andrea, Hristova, Krasimira, Lopez, Teresa, de la Morena, Gonzalo, Popescu, Bogdan A, Penicka, Martin, Ozyigit, Tolga, Rodrigo Carbonero, Jose David, van de Veire, Nico, Von Bardeleben, Ralph Stephan, Vinereanu, Drago, Zamorano, Jose Lui, Rosca, Monica, Calin, Andreea, Moonen, Marie, Magne, Julien, Cosyns, Bernard, Galli, Elena, Donal, Erwan, Carerj, Scipione, Zito, Concetta, Santoro, Ciro, Galderisi, Maurizio, Badano, Luigi P, Lang, Roberto M, Lancellotti, Patrizio, Centre Hospitalier Universitaire de Liège (CHU-Liège), Service de cardiologie [Liège], CHU de Liège-Domaine Universitaire du Sart Tilman, Universität Leipzig [Leipzig], Hospital Univeristario Virgen de la Arrixaca, Johannes Gutenberg - Universität Mainz (JGU), University and Emergency Hospital, Universidad de Alcalá - University of Alcalá (UAH), Service de cardiologie [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Academisch Ziekenhuis Vrije Universiteit Brussel, 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), University of Messina, Università degli studi di Napoli Federico II, GE Healthcare and Philips Healthcare, Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de cardiologie et maladies vasculaires [CHU de Rennes], Manganaro, R, Marchetta, S, Dulgheru, R, Sugimoto, T, Tsugu, T, Ilardi, F, Cicenia, M, Ancion, A, Postolache, A, Martinez, C, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Hagendorff, A, Hristova, K, Lopez, T, de la Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, van de Veire, N, Von Bardeleben, R, Vinereanu, D, Zamorano, J, Rosca, M, Calin, A, Moonen, M, Magne, J, Cosyns, B, Galli, E, Donal, E, Carerj, S, Zito, C, Santoro, C, Galderisi, M, Badano, L, Lang, R, and Lancellotti, P
Subjects: Adult, Male, medicine.medical_specialty, Systole, adult echocardiography, Diastole, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, myocardial strain, myocardial work, speckle tracking echocardiography, Ventricular Function, Left, Correlation, Ventricular Dysfunction, Left, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Ejection fraction, business.industry, Work (physics), Stroke Volume, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, General Medicine, Middle Aged, medicine.anatomical_structure, Blood pressure, Echocardiography, Ventricle, Cardiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cardiology and Cardiovascular Medicine, business
Abstract: Aims The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE). Methods and results A total of 226 (85 men, mean age: 45 ± 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained. On multivariable analysis, GWI was significantly correlated with GLS (standardized beta-coefficient = −0.23, P Conclusion The non-invasive MW indices show a good correlation with traditional 2DE parameters of myocardial systolic function and myocardial strain.
Published: 2020

16. Left-ventricular non-compaction–comparison between different techniques of quantification of trabeculations: Should the diagnostic thresholds be modified?

Author: Valeria Donghi, Patricia Reant, Alexis Jacquier, N. Resseguier, Marie Viala, Farouk Tradi, Karine Nguyen, Marco Guazzi, Christine Selton-Suty, Gilbert Habib, Guillaume Gaubert, Olivier Huttin, Andreina Carbone, Erwan Donal, Jean-Christophe Eicher, Nicolas Michel, Medicina Interna, IRCCS Policlinico San Donato, University of Milano, Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service de neuroradiologie diagnostique et interventionnelle, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de génétique médicale [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-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], Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de cardiologie, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), CCSD, Accord Elsevier, Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
Subjects: Male, Cardiac magnetic resonance, Cardiomyopathy, Imagerie cardiaque, 030204 cardiovascular system & hematology, Imaging, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Prospective Studies, Registries, 030212 general & internal medicine, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Isolated Noncompaction of the Ventricular Myocardium, Current threshold, Dilated cardiomyopathy, General Medicine, Middle Aged, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Echocardiography, Predictive value of tests, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, cardiovascular system, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Female, France, Cardiology and Cardiovascular Medicine, [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, IRM, Adult, Cardiomyopathy, Dilated, Heart Ventricles, Échocardiographie, Magnetic Resonance Imaging, Cine, Diagnosis, Differential, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, medicine, Humans, In patient, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Cardiomyopathie, business.industry, Reproducibility of Results, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, body regions, Non-compaction, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Nuclear medicine, business
Abstract: International audience; Background: Diagnosis of left ventricular non-compaction (LVNC) is challenging, and different imaging techniques propose different criteria.Aim: To compare the value of two-dimensional transthoracic echocardiography (2D-TTE) and cardiac magnetic resonance (CMR) criteria in diagnosing LVNC, and to test a new trabecular quantification method obtained by 2D-TTE, exploring its relationship with CMR non-compacted mass quantification.Methods: From a multicentre French study, we selected 48 patients with LVNC and 20 with dilated cardiomyopathy (DCM) who underwent 2D-TTE and CMR. Current 2D-TTE (Jenni et al.) and CMR criteria (Petersen et al., Jacquier et al.), were tested. A new 2D-TTE method of trabecular quantification (percentage of trabecular area) was also proposed, and compared with current criteria.Results: The best cut-off values for the diagnosis of LVNC were a non-compacted/compacted ratio≥2.3 (Petersen et al.), a trabeculated left ventricular mass≥20% (Jacquier et al.) and a non-compacted/compacted ratio≥1.8 (Jenni et al.). Lowering the threshold for the criterion of Jenni et al. from>2 to ≥1.8 improved its sensitivity from 69% to 98%. The 2D-TTE percentage of trabecular area was 25.9±8% in the LVNC group vs. 9.9±4.4% in the DCM group (P2 to ≥1.8 is necessary to improve LVNC diagnosis in patients with left ventricular dysfunction. A new 2D-TTE trabecular quantification method improves TTE diagnosis of LVNC.
Published: 2020

17. Number of electrocardiogram leads in the diagnosis of spontaneous Brugada syndrome

Author: Aurélie Thollet, J. Briand, Romain Tixier, Béatrice Guyomarch, Frederic Sacher, Jean-Baptiste Gourraud, Jacques Mansourati, F. Kyndt, Philippe Mabo, Xavier Le Guillou, P. Berthome, Marine Arnaud, Dominique Babuty, Nathalie Behar, Laurence Jesel, Vincent Probst, O. Geoffroy, Jean-Marc Dupuis, Paul Bru, Centre National de la Recherche Scientifique (CNRS), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de cardiologie [CHU La Réunion], Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Université d'Angers (UA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP)
Subjects: Adult, Male, medicine.medical_specialty, Time Factors, Early Repolarization Pattern, Fragmented qrs, [SDV]Life Sciences [q-bio], Electric Countershock, Action Potentials, 030204 cardiovascular system & hematology, Sudden cardiac death, NAV1.5 Voltage-Gated Sodium Channel, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, Heart Rate, Predictive Value of Tests, Risk Factors, Internal medicine, medicine, Humans, In patient, cardiovascular diseases, 030212 general & internal medicine, Derivation, Prospective Studies, Registries, Overdiagnosis, Brugada syndrome, Aged, Brugada Syndrome, business.industry, Reproducibility of Results, General Medicine, Middle Aged, medicine.disease, Prognosis, 3. Good health, Defibrillators, Implantable, Death, Sudden, Cardiac, Shock (circulatory), Mutation, cardiovascular system, Cardiology, Female, France, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Summary Background The recently recommended single lead-based criterion for the diagnosis of Brugada syndrome may lead to overdiagnosis of this disorder and overestimation of the risk of sudden cardiac death. Aim To investigate the value of a single-lead diagnosis in patients with Brugada syndrome and a spontaneous type 1 electrocardiogram. Methods Consecutive patients with Brugada syndrome were included in a multicentre prospective registry; only those with a spontaneous type 1 electrocardiogram were enrolled. Clinical and electrocardiogram data were reviewed by two physicians blinded to the patients’ clinical and genetic status. Results Among 1613 patients, 505 (31%) were enrolled (79% male; mean age 46 ± 15 years). A spontaneous type 1 electrocardiogram pattern was found in one lead in 250 patients (group 1), in two leads in 227 patients (group 2) and in three leads in 27 patients (group 3). Groups were similar except for individuals in group 3, who presented more frequently a fragmented QRS complex, an early repolarization pattern and a prolonged Tpeak–Tend interval. After a mean follow-up of 6.4 ± 4.7 years, ventricular arrhythmia, sudden cardiac death or implantable cardiac defibrillator shock occurred in 46 (9%) patients, without differences between groups. Conclusion The prognosis of Brugada syndrome with a spontaneous type 1 electrocardiogram pattern does not appear to be affected by the number of leads required for the diagnosis.
Published: 2020

18. Suicide Attempts Among LVAD Recipients: Real-Life Data From the ASSIST-ICD Study

Author: Charton, Marion, Flécher, Erwan, Leclercq, Christophe, Delmas, Clément, Dambrin, Camille, Goeminne, Céline, Vincentelli, André, Michel, Magali, Lehelias, Laurence, Verdonk, Constance, Para, Marylou, Pozzi, Matteo, Obadia, Jean-François, Boignard, Aude, Chavanon, Olivier, Barandon, Laurent, Nubret, Karine, Kindo, Michel, Minh, Tam Hoang, Gaudard, Philippe, Rouvière, Philippe, Pelcé, Edeline, Gariboldi, Vlad, Litzler, Pierre-Yves, Anselme, Frédéric, Babatasi, Gerard, Belin, Annette, Garnier, Fabien, Bielefeld, Marie, Hamon, David, Lellouche, Nicolas, Bourguignon, Thierry, Genet, Thibaud, Eschalier, Romain, d'Ostrevy, Nicolas, Bories, Marie-Cécile, Jouan, Jérôme, Vanhuyse, Fabrice, Blangy, Hugues, Doucerain, Julie, Martins, Raphael, Galand, Vincent, Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], 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), Service de cardiologie [Toulouse], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre hospitalier universitaire de Nantes (CHU Nantes), Hospital Bichat Paris, Hospital,Bichat- Paris, Carnegie Mellon University [Pittsburgh] (CMU), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), 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), Laboratoire HP2 (ESPRI), Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Michallon, Grenoble, France., Adaptation cardiovasculaire à l'ischemie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), Nouvel Hôpital Civil, Strasbourg, France., Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital de la Timone [CHU - APHM] (TIMONE), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de cardiologie [CHU Rouen], CHU Rouen, Centre Hospitalier Régional Universitaire de Caen (CHRU Caen), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de cardiologie et maladies vasculaires, CHU Henri Mondor, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), chirurgie cardio-vasculaire, Centre Hospitalier Universitaire de Clermont-Ferrand, Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], AP-HP - Hôpital Bichat - Claude Bernard [Paris], CHU Strasbourg, Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Henri Mondor [Créteil], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN), Université de Rouen Normandie (UNIROUEN), and MORNET, Dominique
Subjects: Male, Risk, [SDV]Life Sciences [q-bio], MEDLINE, Suicide, Attempted, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), Sadness, Suicide attempt, Medicine, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Heart Failure, business.industry, Depression, Incidence, Length of Stay, Middle Aged, 16. Peace & justice, medicine.disease, Real life data, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Suicide, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, Medical emergency, France, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: International audience
Published: 2020

19. High Risk of Sustained Ventricular Arrhythmia Recurrence After Acute Myocarditis

Author: Laurent, Rosier, Amir, Zouaghi, Valentin, Barré, Raphaël, Martins, Vincent, Probst, Eloi, Marijon, Nicolas, Sadoul, Samuel, Chauveau, Antoine, Da Costa, Marc, Badoz, Michael, Peyrol, Jérémie, Barraud, Grégoire, Massoullie, Romain, Eschalier, Madeline, Espinosa, François, Lesaffre, Rodrigue, Garcia, Bruno, Degand, Antoine, Noël, Jacques, Mansourati, Fabrice, Extramiana, Vincent, Algalarrondo, Hervé, Devilliers, Yves, Cottin, Estelle, Gandjbakhch, Charles, Guenancia, Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], 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), 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), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Nord [CHU - APHM], CHU Clermont-Ferrand, SIGMA Clermont (SIGMA Clermont), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), 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), 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], Service de médecine interne et maladies systémiques (SOC 2) [CHU de Dijon], Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de Cardiologie [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Gestionnaire, Hal Sorbonne Université, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: [SDV] Life Sciences [q-bio], implantable cardioverter defibrillator, [SDV]Life Sciences [q-bio], lcsh:R, cardiovascular system, lcsh:Medicine, cardiovascular diseases, ventricular tachycardia, myocarditis, ventricular fibrillation, Article
Abstract: Acute myocarditis is associated with cardiac arrhythmia in 25% of cases, a third of these arrhythmias are ventricular tachycardia (VT) or ventricular fibrillation (VF). The implantation of a cardiac defibrillator (ICD) following sustained ventricular arrhythmia remains controversial in these patients. We sought to assess the risk of major arrhythmic ventricular events (MAEs) over time in patients implanted with an ICD following sustained VT/VF in the acute phase of myocarditis compared to those implanted for VT/VF occurring on myocarditis sequelae. Our retrospective observational study included patients implanted with an ICD following VT/VF during acute myocarditis or VT/VF on myocarditis sequelae, from 2007 to 2017, in 15 French university hospitals. Over a median follow-up period of 3 years, MAE occurred in 11 (39%) patients of the acute myocarditis group and 24 (60%) patients of the myocarditis sequelae group. Kaplan&ndash, Meier MAE rate estimates at one and three years of follow-up were 19% and 45% in the acute group, and 43% and 64% in the sequelae group. Patients who experienced sustained ventricular arrhythmias during acute myocarditis had a very high risk of VT/VF recurrence during follow-up. These results show that the risk of MAE recurrence remains high after resolution of the acute episode.
Published: 2020

20. Analysis of weather exposure 7 days before occurrence of ST-segment elevation myocardial infarction

Author: Martine Gilard, Bahaa Nasr, Antoine Noel, Pierre Philippe Nicol, Michel Aidonidis, Florent Le Ven, Edward Koifman, Vincent Auffret, Jacques Mansourati, Mehdi Ouchiha, Chaker Oueslati, Yannick Jobic, Romain Didier, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de chirurgie thoracique et cardio vasculaire [Brest] (CCTV - Brest), and Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)
Subjects: Male, medicine.medical_specialty, Time Factors, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Interquartile range, Internal medicine, Humans, Medicine, ST segment, Registries, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Weather, Aged, Retrospective Studies, Univariate analysis, business.industry, Incidence, Incidence (epidemiology), Temperature, Humidity, Retrospective cohort study, General Medicine, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Atmospheric Pressure, Cardiology, ST Elevation Myocardial Infarction, Female, France, Cardiology and Cardiovascular Medicine, business
Abstract: Summary Background Several studies have highlighted the relationship between weather patterns and the occurrence of ST-elevation myocardial infarction (STEMI). Aim To evaluate the statistical association between the occurrence of STEMI and meteorological variables over the preceding 7 days. Methods This was a retrospective study, using prespecified data from the ORBI (Breton Regional Observatory on Myocardial Infarction) registry, which includes all consecutive patients hospitalized for STEMI in the geographical area of Brest, France. Over a 7-year period, we compared the number of STEMIs per week with the mean values of meteorological variables over the preceding 7 days. Results Overall, 7517 patients with STEMI were recorded in the ORBI registry between January 2009 and January 2016. After exclusion of patients not living in the geographical area of interest, 742 patients were included. The weekly incidence of STEMI ranged from 0 to 7 (median 2, interquartile range 1–3). In the univariate analysis, air temperature (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.005–1.01 per 1 °C decrease; P = 0.03) and atmospheric pressure (OR 1.03, 95% CI 1.01–1.06 per 1 hPa increase; P = 0.008) were associated with the weekly incidence of STEMI. In the multivariable analysis, air temperature (OR 1.06, 95% CI 1.01–1.10 per 1 °C decrease; P = 0.01), atmospheric pressure (OR 1.05, 95% CI 1.02–1.08 per 1 hPa increase; P 80% (OR 1.09, 95% CI 1.02–1.15 per 1 hour increase; P = 0.007) in the previous 7 days were associated with the occurrence of STEMI. Conclusions In this specific geographical area, occurrence of STEMI was statistically associated with a decrease in air temperature, an increase in atmospheric pressure and an increase in humidity over the preceding 7-day period.
Published: 2020

21. Blood pressure measurements on a bare arm, over a sleeve or below a rolled-up sleeve: a systematic review and meta-analysis

Author: David Seguret, Olivier Steichen, C. Dourmap, Danaé Gamelon, Service de Médecine Interne = Hôpital de jour de médecine [CHU Tenon], CHU Tenon [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), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Sorbonne Paris Nord, Gestionnaire, Hal Sorbonne Université, Service de Médecine Interne [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Physiology, business.industry, [SDV]Life Sciences [q-bio], Blood Pressure, Blood Pressure Determination, 030204 cardiovascular system & hematology, Confidence interval, Clothing, [SDV] Life Sciences [q-bio], 03 medical and health sciences, Cross-Sectional Studies, 0302 clinical medicine, Blood pressure, Meta-analysis, Arm, Internal Medicine, Humans, Medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Nuclear medicine
Abstract: International audience; Objective: Several guidelines call for blood pressure (BP) measurement on a bare arm, which is not always easy. This systematic review aims to synthesize existing evidence concerning the effect of a sleeve on BP measurement.Methods: Pubmed and Embase were searched for cross-sectional studies comparing BP values measured on a bare arm, over a sleeve or below a rolled-up sleeve. A meta-analysis was conducted on available data.Results: Thirteen articles were selected from 720 references. All studies reported office BP values, 12 compared measurements on a bare arm and on a sleeve, and four also performed measurements below a rolled-up sleeve, with heterogeneous sleeve types and thicknesses. Most studies had a high risk of bias. Three studies showed a small overestimation of BP measured over a sleeve, but the remaining 10 studies did not find statistically significant differences between measurements. Meta-analysis showed a nonsignificant 0.59 mmHg [95% confidence interval (CI) -0.11 to +1.30; P = 0.10] overestimation of SBP measured over a sleeve when the thinnest sleeve was considered for studies that investigated various thicknesses, a nonsignificant 1.10 mmHg (95% CI -0.21 to +2.40; P = 0.10) overestimation of SBP when the thickest sleeve was considered, and a nonsignificant 2.76 mmHg (95% CI -0.96 to +6.47; P = 0.15) overestimation of SBP measured below a rolled-up sleeve.Conclusion: Measuring BP over a thick sleeve in the office may result in a small overestimation of recorded values but measuring over a thin sleeve does not appear to have a significant impact and, in any case, should be preferred to rolling it up.
Published: 2020

22. Assistance circulatoire mécanique de courte durée dans le choc cardiogénique en unité de soins intensifs de cardiologie : avis et mise au point du groupe USIC de la SFC endossé par le GACI

Author: Laurent Bonello, Guillaume Schurtz, Guillaume Leurent, Nadia Aissaoui, Eric Bonnefoy, Patrick Henry, Clément Delmas, Vascular research center of Marseille (VRCM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 (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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), 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)-Université Claude Bernard Lyon 1 (UCBL), 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)-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), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Centre recherche en CardioVasculaire et Nutrition (C2VN), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Récepteurs nucléaires, maladies cardiovasculaires et diabète (EGID), Université de Lille, Droit et Santé-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de cardiologie et maladies vasculaires [CHU de Rennes], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Inotrope, Unité de soins intensifs, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Insuffisance cardiaque aiguë, Hemodynamics, 030204 cardiovascular system & hematology, law.invention, 0302 clinical medicine, Risk Factors, law, Ventricular Function, Assisted Circulation, 030212 general & internal medicine, Mortality rate, Cardiogenic shock, General Medicine, Syndrome coronaire aigu, Intensive care unit, 3. Good health, Intensive Care Units, Treatment Outcome, Cardiology, Acute coronary syndrome, Cardiology and Cardiovascular Medicine, Algorithms, medicine.medical_specialty, Consensus, Clinical Decision-Making, Shock, Cardiogenic, Decision Support Techniques, Time-to-Treatment, 03 medical and health sciences, Mechanical circulatory support, Intensive care, Internal medicine, medicine, Extracorporeal membrane oxygenation, Humans, business.industry, Patient Selection, Acute heart failure, Recovery of Function, medicine.disease, Support hémodynamique mécanique, Heart Transplantation, business, Choc cardiogénique
Abstract: International audience; Cardiogenic shock (CS) is a major challenge in contemporary cardiology. Despite a better understanding of the pathophysiology of CS, its management has only improved slightly. The prevalence of CS has remained stable over the past decade, but its outcome has seen few improvements, with the 1-month mortality rate still in the range of 40-60%. Inotropes and vasopressors are the first-line therapies for CS, but they are associated with significant hazards, and have well-known deleterious effects. Furthermore, a significant number of patients develop refractory CS with haemodynamic instability, causing critical organ hypoperfusion and/or pulmonary congestion, despite increasing doses of catecholamines. A major change has resulted from the recent advent and availability of potent mechanical circulatory support (MCS) devices. These devices, which ensure sustained blood flow, provide a great and long-awaited opportunity to improve the prognosis of CS. Several efficient MCS devices are now available, including left ventricle-to-aorta circulatory support devices and full pulmonary and circulatory support with venoarterial extracorporeal membrane oxygenation. However, evidence to support their indications, the timing of implantation and the selection of patients and devices is scarce. Because these devices are gaining momentum and are becoming readily available, the "Unité de Soins Intensifs de Cardiologie" group of the French Society of Cardiology aims to propose practical algorithms for the use of these devices, to help intensive care unit and cardiac care unit physicians in this complex area, where evidence is limited.; Le choc cardiogénique (CC) reste un enjeu majeur de la cardiologie contemporaine. Malgré une meilleure compréhension de sa physiopathologie, sa prise en charge n’a que peu évoluée. Au cours de la dernière décennie, sa prévalence est restée stable mais son pronostic ne s’est que peu amélioré avec une mortalité à un mois comprise entre 40 % et 60 %. Les inotropes et les vasopresseurs forment la première ligne de traitement dans le CC mais ils ont une efficacité variable et des effets délétères bien connus. De plus un nombre significatif de patients développent un CC réfractaire avec une hémodynamique instable et une hypoperfusion d’organe et/ou une congestion malgré des doses croissantes de catécholamines. La mise à disposition récente de systèmes efficaces de support hémodynamique mécanique représente un changement majeur. Ces dispositifs, qui assurent un support au flux sanguin, représentent une grande opportunité, attendue depuis longtemps, d’améliorer le pronostic du CC. Il y a aujourd’hui plusieurs systèmes de support hémodynamique mécaniques disponibles allant de dispositifs de support circulatoire du ventricule gauche vers l’aorte à un support cardio-pulmonaire complet avec les systèmes de circulation extracorporelle incluant une membrane d’oxygénation. Cependant les données concernant leurs indications, leur délai d’implantation, la sélection des patients ou du dispositif sont peu nombreuses. Du fait de la grande disponibilité de ces dispositifs et de l’équipement rapide des centres, le groupe « unité de soins intensifs cardiologiques » de la société française de cardiologie a voulu proposer un algorithme pratique d’utilisation pour aider les médecins de soins intensifs dans ce domaine où les données scientifiques sont rares. Previous article in issue
Published: 2018

23. Influence of gender on delays and early mortality in ST-segment elevation myocardial infarction: Insight from the first French Metaregistry, 2005–2012 patient-level pooled analysis

Author: Yves Cottin, Francis Couturaud, Vincent Auffret, Sandrine Charpentier, Carlos El Khoury, Tabassome Simon, Stéphane Manzo-Silberman, Martine Gilard, Francois Schiele, Loic Belle, Stéphanie Marlière, Marianne Zeller, Nicolas Danchin, Hervé Le Breton, Biomarqueurs CArdioNeuroVASCulaires (BioCANVAS), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), 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 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Centre hospitalier Lucien Hussel, Service de Cardiologie (hôpital d'Annecy), Centre hospitalier de la région d'Annecy, Département de cardiologie [CHU de Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Laboratoire de Physiopathologie et Pharmacologie Cardio-Métaboliques (U866, Lipides et nutrition, équipe 5) (LPPCM), Lipides - Nutrition - Cancer (U866) (LNC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bourgogne (UB)-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bourgogne (UB)-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), 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), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), 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), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de cardiologie [CHRU de Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Université de Toulouse (UT)-Université de Toulouse (UT)-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), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( UR 3920) (PCVP / CARDIO), Unité mixte de recherche 942 - BIOCANVAS - Biomarqueurs cardiovasculaires ( UMR 942 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de cardiologie (APHP-Hôpital Lariboisière), Hôpital Lariboisière-APHP, Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital de la Cavale Blanche, Département de Médecine Interne et Pneumologie [Brest] ( DMIP - Brest ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps [Toulouse], Université Paul Sabatier - Toulouse 3 ( UPS ) -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 ), Service de cardiologie et maladies vasculaires [CHU de Rennes], Département de cardiologie (CHU de Grenoble), Centre Hospitalier Universitaire [Grenoble] ( CHU ), Laboratoire de Physiopathologie et Pharmacologie Cardio-Métaboliques (U866, Lipides et nutrition, équipe 5) ( LPPCM ), Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ) -Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Laboratoire de Recherche Vasculaire Translationnelle ( LVTS ), Université Paris 13 ( UP13 ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Marqueurs pronostiques et facteurs de régulations des pathologies cardiaques et vasculaires - UFC ( PCVP / CARDIO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Optimisation des régulations physiologiques ( ORPHY (EA 4324) ), Université de Brest ( UBO ) -Institut Brestois du Numérique et des Mathématiques ( IBNM ), and Université de Brest ( UBO ) -Université de Brest ( UBO )
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, 030204 cardiovascular system & hematology, Coronary Angiography, Clinical research, STEMI, Electrocardiography, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Gender issues, medicine, Humans, ST segment, Registries, 030212 general & internal medicine, Myocardial infarction, Sex Distribution, Survival rate, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Percutaneous coronary intervention, Retrospective cohort study, Emergency department, Middle Aged, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Prognosis, medicine.disease, 3. Good health, Survival Rate, Emergency medicine, ST Elevation Myocardial Infarction, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract: International audience; Background - Women show greater mortality after acute myocardial infarction. We decided to investigate whether gender affects delays and impacts in-hospital mortality in a large population.Methods and results - We performed a patient-level analysis of 7 French MI registries from different regions from January 2005 to December 2012. All patients with acute STEMI were included within 12 h from symptom onset and a first medical contact with a mobile intensive care unit an emergency department of a hospital with percutaneous coronary intervention facility. Primary study outcomes were STEMI, patient and system, delays. Secondary outcome was in-hospital mortality. 16,733 patients were included with 4021 females (24%). Women were significantly older (mean age 70.6 vs 60.6), with higher diabetes (19.6% vs 15.4%) and hypertension rates (58.7% vs 38.8%). Patient delay was longer in women with adjusted mean difference of 14.4 min (p Conclusions - This overview of 16,733 real-life consecutive STEMI patients in prospective registries over an extensive period strongly indicates gender-related discrepancies, highlighting clinically relevant delays in seeking medical attention. However, higher in-hospital mortality was not totally explained by clinical characteristics or delays. Dedicated studies of specific mechanisms underlying this female disadvantage are mandatory to reduce this gender gap.
Published: 2018

24. Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: the ORBI risk score

Author: Isabelle Coudert, Marianne Zeller, Romain Didier, Frédéric Chagué, Jean-Claude Beer, Jean-Christophe Cornily, Emanuelle Filippi, Rishi Puri, Amer Zabalawi, Vincent Auffret, Hervé Le Breton, Orbi, Guillaume Leurent, Damien Brunet, Jean-Philippe Hacot, Maud Maza, Yves Cottin, Marielle Le Guellec, Marc Bedossa, Philippe Brunel, Emilie Bot, B. Boulanger, Mourad Mejri, Gilles Rouault, Luc Lorgis, Aurélie Loirat, Martine Gilard, Dominique Boulmier, Philippes Druelles, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], 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), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), CHU de Saint-Brieuc, CHU Dijon, Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Daiichi-Sankyo, University Hospital of Dijon, Association de Cardiologie de Bourgogne, Agence Regionale de Sante (ARS) de Bourgogne-Franche Comte, French Ministry of Research, Institut National de la Sante et de la Recherche Medicale (INSERM), Conseil Regional de Bourgogne-Franche Comte, and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Shock, Cardiogenic, 030204 cardiovascular system & hematology, Risk Assessment, Peripheral Arterial Disease, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Humans, Registries, 030212 general & internal medicine, Myocardial infarction, 10. No inequality, Cardiogenic shock, Stroke, Aged, Killip class, Aged, 80 and over, Framingham Risk Score, Predictors, business.industry, Age Factors, Percutaneous coronary intervention, Thrombolysis, Middle Aged, Prognosis, medicine.disease, Heart Arrest, 3. Good health, ST-segment elevation myocardial infarction, Logistic Models, Hypertension, Cohort, Cardiology, ST Elevation Myocardial Infarction, Risk score, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, France, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Aims To derive and validate a readily useable risk score to identify patients at high-risk of in-hospital ST-segment elevation myocardial infarction (STEMI)-related cardiogenic shock (CS). Methods and results In all, 6838 patients without CS on admission and treated by primary percutaneous coronary intervention (pPCI), included in the Observatoire Regional Breton sur l'Infarctus (ORBI), served as a derivation cohort, and 2208 patients included in the obseRvatoire des Infarctus de Cote-d'Or (RICO) constituted the external validation cohort. Stepwise multivariable logistic regression was used to build the score. Eleven variables were independently associated with the development of in-hospital CS age >70 years, prior stroke/transient ischaemic attack, cardiac arrest upon admission, anterior STEMI, first medical contact-to-pPCI delay >90 min, Killip class, heart rate >90/min, a combination of systolic blood pressure 10 mmol/L, culprit lesion of the left main coronary artery, and post-pPCI thrombolysis in myocardial infarction flow grade = 13). Observed in-hospital CS rates were 1.3%, 6.6%, 11.7%, and 31.8%, across the four risk categories, respectively. Validation in the RICO cohort demonstrated in-hospital CS rates of 3.1% (score 0-7), 10.6% (score 8-10), 18.1% (score 11-12), and 34.1% (score >= 13). The score demonstrated high discrimination (c-statistic of 0.84 in the derivation cohort, 0.80 in the validation cohort) and adequate calibration in both cohorts. Conclusion The ORBI risk score provides a readily useable and efficient tool to identify patients at high-risk of developing CS during hospitalization following STEMI,which may aid in further risk-stratification and thus potentially facilitate pre-emptive clinical decision making.
Published: 2018

25. Estimation of myocardial work from pressure–strain loops analysis: an experimental evaluation

Author: Philippe Mabo, Cyrille Casset, Elena Galli, Eigil Samset, Virginie Le Rolle, Alfredo Hernandez, Arnaud Hubert, Erwan Donal, Christophe Leclercq, 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 ), Service de cardiologie et maladies vasculaires, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], 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 ), 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], University of Oslo (UiO), Abbott, 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), ANR-16-CE19-0008-01, Agence Nationale de la Recherche, General Electric Healthcare, ANR-16-CE19-0008,MAESTRo,Approche à base de modèles pour l'analyse du strain obtenu en échocardiographie 3D(2016), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent, and Approche à base de modèles pour l'analyse du strain obtenu en échocardiographie 3D - - MAESTRo2016 - ANR-16-CE19-0008 - AAPG2016 - VALID
Subjects: Pacemaker, Artificial, medicine.medical_specialty, Mean squared error, Correlation coefficient, invasive haemodynamic, Hemodynamics, [ SPI.SIGNAL ] Engineering Sciences [physics]/Signal and Image processing, 030204 cardiovascular system & hematology, PSL, Risk Assessment, Severity of Illness Index, Sampling Studies, Ventricular Dysfunction, Left, 03 medical and health sciences, strain, 0302 clinical medicine, Predictive Value of Tests, medicine.artery, Internal medicine, Image Interpretation, Computer-Assisted, Ventricular Pressure, medicine, Humans, Radiology, Nuclear Medicine and imaging, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, 030212 general & internal medicine, Brachial artery, [SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, business.industry, Work (physics), Cardiac Pacing, Artificial, General Medicine, Middle Aged, Myocardial Contraction, myocardial work, Blood pressure, Echocardiography, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Pressure strain, Cardiology and Cardiovascular Medicine, business, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing
Abstract: International audience; Purpose - The area of left ventricular (LV) pressure-strain loop (PSL) is used as an index of regional myocardial work. The purpose of the present work is to compare the main segmental PSL markers and the derived global work indices, when they are calculated using an estimated pressure signal or an observed pressure signal.Methods and results - In nine patients implanted with a bi-ventricular pace-maker (CRT), LV pressure was invasively measured in five conditions: CRT-off, LV-pacing, right ventricular-pacing and two different CRT-pacing. For each condition, systolic blood pressure was measured by brachial artery cuff-pressure and transthoracic echocardiography loops were recorded simultaneously. The error and relative root mean square error (rRMSE) between measured and estimated pressure were calculated for each patient and each configuration. Correlation coefficient (R2) and Bland-Altman (BA) analysis were performed for PSL area and work indices. A total of 43 different haemodynamic conditions were compared (774 segmental PSL). The global rRMSE between estimated and measured LV-pressure was 12.3 mmHg. The estimated and measured segmental LV-PSL were strongly correlated, with an R2 of 0.98. BA analysis shows that the mean bias for the estimation of segmental LV-PSL area is 86.0 mmHg.%. A significant bias effect with linearly increasing error with pressure values is observed. R2 ≥ 0.88 and a mean bias in BA analysis ≤41.4 mmHg.% was observed for the estimation of global myocardial work indices.Conclusion - The non-invasive estimation for LV pressure-strain loop area and the global myocardial work indices obtained from LV-PSL strongly correlates with invasive measurements.
Published: 2018

26. Value of Myocardial Work Estimation in the Prediction of Response to Cardiac Resynchronization Therapy

Author: Eigil Samset, Alfredo Hernandez, Erwan Donal, Arnaud Hubert, Anne Bernard, Maxime Fournet, Christophe Leclercq, Otto A. Smiseth, Philippe Mabo, Elena Galli, 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), 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), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Cardiac resynchronization therapy, Value (computer science), Speckle tracking echocardiography, 030204 cardiovascular system & hematology, Ventricular Function, Left, Cardiac Resynchronization Therapy, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Myocardial work, End-systolic volume, Aged, Heart Failure, Receiver operating characteristic, Left bundle branch block, business.industry, Speckle-tracking echocardiography, Area under the curve, Stroke Volume, Middle Aged, medicine.disease, Treatment Outcome, ROC Curve, Echocardiography, Heart failure, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Background - Cardiac resynchronization therapy (CRT) in heart failure is plagued by too many nonresponders. The aim of the present study is to evaluate whether the estimation of myocardial performance by pressure-strain loops (PSLs) is useful for the selection of CRT candidates.Methods - Ninety-seven patients undergoing CRT were included in the study. Bidimensional and speckle-tracking echocardiography were performed before CRT and at the 6-month follow-up (FU). Conventional dyssynchrony parameters were evaluated. Left ventricular (LV) constructive work (CW) and wasted work (WW) were estimated by PSLs. Positive response to CRT (CRT+) was defined as ≥15% reduction in LV end-systolic volume at FU and was observed in 63 (65%) patients.Results - The addition of CW > 1,057 mm Hg% (area under the curve, 0.72, P 384 mm Hg% (area under the curve, 0.67, P = .005) to a baseline model including clinical, echocardiographic, and conventional dyssynchrony parameters significantly increased the model power (χ, 25.11 vs 47.5, P 1,057 mm Hg% (OR = 9.49; P = .002), and WW > 384 mm Hg% (OR = 16.24, P 1,057 mm Hg% and WW > 384 mm Hg% showed a good specificity (100%) and positive predictive value (100%) but a low sensitivity (22%), negative predictive value (41%), and accuracy (49%) for the identification of CRT+.Conclusions - The estimation of CW and WW by PSLs is a novel tool for the assessment of CRT patients. Although these parameters cannot be used by their own to select CRT candidates, they can provide further insights into the comprehension of dyssynchrony mechanisms and contribute to improving the identification of CRT responders.
Published: 2018

27. Effectiveness of a patient education programme in heart failure with preserved ejection fraction: Results from the ODIN cohort study using propensity score matching

Author: Emilie Drouet, Christophe Leclercq, Justine Druelle, Matthieu Schockmel, Yves Juillière, Geneviève Mulak, Hervé Laborde-Castérot, François Dany, Nelly Agrinier, Nathalie Thilly, Patrick Jourdain, François Alla, CIC 1433 Epidémiologie clinique, Institut National de la Santé et de la Recherche Médicale (INSERM), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier René Dubos [Pontoise], Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], ICARLIM Network, Société française de cardiologie, CHU Saint-Antoine [APHP], CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Odin, Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), 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)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and 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, Health Knowledge, Attitudes, Practice, Time Factors, Health Behavior, Comorbidity, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Ventricular Function, Left, 0302 clinical medicine, Risk Factors, Cause of Death, Odds Ratio, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, Ejection fraction, Smoking, Hazard ratio, Cohort, Age Factors, Patient education, General Medicine, Middle Aged, Markov Chains, 3. Good health, Europe, Treatment Outcome, Score de propension, Female, Cardiology and Cardiovascular Medicine, Monte Carlo Method, Cohort study, medicine.medical_specialty, Alcohol Drinking, Éducation thérapeutique du patient, Diastolic, Mortalité, 03 medical and health sciences, Sex Factors, Patient Education as Topic, Internal medicine, medicine, Humans, Mortality, Propensity Score, Aged, Proportional Hazards Models, Heart Failure, Proportional hazards model, business.industry, Stroke Volume, Cohorte, Confidence interval, Insuffisance cardiaque, Self Care, Logistic Models, Propensity score matching, Physical therapy, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Heart failure with preserved ejection fraction, business
Abstract: Summary Background Patient education programmes (PEP) are recommended for patients with heart failure but have not been specifically assessed in heart failure with preserved ejection fraction (HFpEF). Aim To assess the effectiveness of a structured PEP in reducing all-cause mortality in patients with HFpEF. Methods Patients with HFpEF were selected from the ODIN cohort, designed to assess PEP effectiveness in patients with HF whatever their ejection fraction, included from 2007 to 2010, and followed up until 2013. Baseline sociodemographic, clinical, biological and therapeutic characteristics were collected. At inclusion, patients were invited to participate in the PEP, which consisted of educational diagnosis, education sessions and final evaluation. Education focused on HF pathophysiology and medication, symptoms of worsening HF, dietary recommendations and management of exercise. Propensity score matching and Cox models were performed. Results Of 849 patients with HFpEF, 572 (67.4%) participated in the PEP and 277 (32.6%) did not. Patients who participated in the PEP were younger (67.0 ± 13.1 vs 76.1 ± 13.2 years; standardized difference [StDiff] = −54.6%), less often women (39.7% vs 48.4%; StDiff = −17.6%) and presented more often with hypercholesterolaemia (55.2% vs 35.2%; StDiff 41.2%), smoking (35.1% vs 28.7%; StDiff 13.8%), alcohol abuse (14.1% vs 8.9%; StDiff 16.5%) and ischaemic HF (38.7% vs 29.2%; StDiff 20.0%) than those who did not; they also presented with better clinical cardiovascular variables. After propensity score matching, baseline characteristics were balanced, except hypertension (postmatch StDiff 19.1%). The PEP was associated with lower all-cause mortality (pooled hazard ratio 0.70, 95% confidence interval 0.49–0.99; P = 0.042). This association remained significant after adjustment for hypertension (adjusted pooled hazard ratio 0.68, 95% confidence interval 0.48–0.97; P = 0.036). Conclusions In this investigation, a structured PEP was associated with lower all-cause mortality. Patient education might be considered an effective treatment in patients with HFpEF.
Published: 2018

28. Rationale and design of the EACVI AFib Echo Europe Registry for assessing relationships of echocardiographic parameters with clinical thrombo-embolic and bleeding risk profile in non-valvular atrial fibrillation

Author: Bogdan A. Popescu, Bernard Cosyns, Gilbert Habib, Erwan Donal, Leyla Elif Sade, Andreas Hagendorff, Maurizio Galderisi, Matteo Cameli, Thor Edvardsen, Eustachio Agricola, Julien Magne, Alexandar N Neskovic, Nuno Cardim, Patrizio Lancellotti, Ehud Schwammenthal, Francesco Lo Iudice, José Luis Zamorano, Clinical sciences, Cardio-vascular diseases, Cardiology, Università degli studi di Napoli Federico II, 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 ), Service de cardiologie et maladies vasculaires [CHU de Rennes], CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Academisch Ziekenhuis Vrije Universiteit Brussel, Universität Leipzig [Leipzig], Universidad de Alcalá = University of Alcalá ( UAH ), Groupe Interdisciplinaire de Génoprotéomique Appliquée ( GIGA-Research ), Université de Liège-Faculté de médecine vétérinaire, Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Microbes évolution phylogénie et infections ( MEPHI ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Centre National de la Recherche Scientifique ( CNRS ), Oslo University Hospital, 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Universidad de Alcalá - University of Alcalá (UAH), Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-Research), Université de Liège, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Oslo University Hospital [Oslo], University of Naples Federico II = Università degli studi di Napoli Federico II, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Universität Leipzig, Galderisi, Maurizio, Donal, Erwan, Magne, Julien, Lo Iudice, Francesco, Agricola, Eustachio, Sade, Leyla Elif, Cameli, Matteo, Schwammenthal, Ehud, Cardim, Nuno, Cosyns, Bernard, Hagendorff, Andrea, Neskovic, Alexandar N., Zamorano, Josè Lui, Lancellotti, Patrizio, Habib, Gilbert, Edvardsen, Thor, Popescu, Bogdan A., Neskovic, Alexandar N, and Popescu, Bogdan A
Subjects: Registrie, Male, Radiology, Nuclear Medicine and Imaging, Management of atrial fibrillation, Predictive Value of Test, 030204 cardiovascular system & hematology, Doppler echocardiography, left atrium, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, non-valvular atrial fibrillation, Atrial Fibrillation, echocardiography, Medicine, Prospective Studies, Registries, 030212 general & internal medicine, Prospective cohort study, Societies, Medical, thromboembolic events, Framingham Risk Score, medicine.diagnostic_test, Atrial fibrillation, General Medicine, 3. Good health, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Echocardiography, Radiology Nuclear Medicine and imaging, Practice Guidelines as Topic, Cardiology, Female, Cardiology and Cardiovascular Medicine, Risk assessment, Human, medicine.medical_specialty, thromboembolic event, Diastole, Hemorrhage, Risk Assessment, Sensitivity and Specificity, 03 medical and health sciences, Predictive Value of Tests, Thromboembolism, Internal medicine, Humans, Radiology, Nuclear Medicine and imaging, Cross-Sectional Studie, business.industry, bleeding, medicine.disease, Prospective Studie, Cross-Sectional Studies, CHA2DS2–VASc score, business
Abstract: International audience; The European Society of Cardiology (ESC) guidelines for management of atrial fibrillation (AF) recommend the use of CHA(2)DS(2)VASc risk score for assessment of thromboembolic (TE) risk, whereas the stratification of bleeding risk should be obtained by HAS-Bleed to balance the most appropriate anticoagulation (OAC) therapy. However, men with CHA(2)DS(2)VASc score=1 and women with CHA(2)DS(2)VASc=2, who are at intermediate TE risk, represent a grey zone where guidelines do not provide a definite OAC indication. Accordingly, implementation of risk stratification with echocardiography could be extremely useful. Both prospective and cross-sectional studies on transthoracic echocardiography (TTE) prediction of TE events and studies utilizing transoesophageal echocardiographic parameters as surrogate markers of TE events makes sustainable the hypothesis that echocardiography could improve TE prediction in non-valvular AF. Moreover, considering the close association of AF and stroke, all echo-Doppler parameters that have shown to predict AF onset and recurrence could be useful also to predict TE events in this clinical setting. Accordingly, EACVI AFib Echo Europe Registry has been designed as an observational, cross-sectional study, with the aim of evaluating: (i) left atrial (LA) size and function together with left ventricular geometry, systolic and diastolic functions in paroxysmal, persistent, and permanent AF; (ii) relationships of structural/ functional parameters with clinical TE and bleeding risk profile. By the AFib Echo Europe Registry, we expect to collect data on echocardiographic phenotype of patients with AF. The large data set accumulated will be useful to test the level of agreement of different echocardiographic measurements with the available risk scores.
Published: 2017

29. Right ventricular exercise contractile reserve and outcomes after early surgery for primary mitral regurgitation

Author: Elena Galli, Hervé Corbineau, Emilie Vitel, Erwan Donal, Maxime Fournet, Guillame Bouzille, Christian Bosseau, Christophe Leclercq, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], 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), Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], institutional grant (CORECT), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, medicine.medical_specialty, Ventricular Dysfunction, Right, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030204 cardiovascular system & hematology, Asymptomatic, New york heart association, 03 medical and health sciences, Basal (phylogenetics), Early surgery, Postoperative Complications, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Early Medical Intervention, valve disease surgery, Internal medicine, medicine, Humans, echocardiography, In patient, 030212 general & internal medicine, Aged, Mitral regurgitation, Receiver operating characteristic, business.industry, Mitral Valve Insufficiency, Middle Aged, Prognosis, Myocardial Contraction, Survival Analysis, Fractional area change, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, mitral regurgitation, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Echocardiography, Stress
Abstract: ObjectiveTo assess if the lack of development of right ventricular (RV) contractile reserve during exercise echocardiography (ex-echo) might be a predictor of postoperative major adverse cardiovascular events (MACEs) in patients with primary mitral regurgitation (pMR) undergoing early surgery.MethodsComprehensive resting and ex-echo were performed in 142 asymptomatic patients (58±21 years, 68% men, New York Heart Association functional class ≤2) with isolated severe pMR and preserved left ventricular (LV) function (LV ejection >60%, LV end-systolic diameter ResultsAfter median follow-up of 30 months (IQR 16–60 months), MACEs occurred in 48 (34%) patients. Using Bayesian model averaging, among all the characteristics including the type of surgery, exercise TAPSE (ex-TAPSE) emerged as the most likely predictor of prognosis (HR 0.91, 95% CI 0.86 to 0.96). Other probable predictors were exercise fractional area change (HR 0.02, 95% CI 0.00 to 0.80), male gender (HR 0.40, 95% CI 0.21 to 0.75) and RV basal diameter (HR 1.06, 95% CI 0.98 to 1.14). In the receiver operating characteristic curve analysis, an ex-TAPSE value of ConclusionLack of development of exercise-induced RV contractile reserve is a prognostic predictor in patients with severe pMR undergoing early mitral valve surgery.
Published: 2017

30. A joint procedural position statement on imaging in cardiac sarcoidosis

Author: Slart, R. H. J. A., Glaudemans, A. W. J. M., Lancellotti, P., Hyafil, F., Blankstein, R., Schwartz, R. G., Jaber, W. A., Russell, R., Gimelli, A., Rouzet, F., Hacker, M., Gheysens, O., Plein, S., Miller, E. J., Dorbala, S., Donal, E., Sciagra, R., Bucerius, J., Verberne, H. J., Lindner, O., Ubleis, C., Agostini, D., Signore, A., Edvardsen, T., Neglia, D., Beanlands, R. S., Di Carli, M., Chareonthaitawee, P., Dilsizian, V., Soman, P., Habib, G., Delgado, V., Cardim, N., Cosyns, B., Flachskampf, F., Gerber, B., Haugaa, K., Lombardi, M., Masci, P. G., Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, Radiology and Nuclear Medicine, Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-Research), Université de Liège, 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), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent, INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), RS: CARIM - R3.11 - Imaging, MUMC+: DA BV Medisch Specialisten Nucleaire Geneesk (9), Beeldvorming, Biomedical Photonic Imaging, Clinical sciences, Cardio-vascular diseases, Cardiology, 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), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Vascular Ageing Programme (VAP), Translational Immunology Groningen (TRIGR), Cardiovascular Centre (CVC), and Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE)
Subjects: Male, positron emission tomography, diagnosis, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Biopsy, diagnostic, Speckle tracking echocardiography, 030204 cardiovascular system & hematology, Myocardial Perfusion Imaging/standards, medical, Multimodal Imaging, cardiac sarcoidosis, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, X ray computed, cardiac imaging techniques, cardiology, cardiomyopathies, europe, female, humans, magnetic resonance imaging, male, multimodal imaging, myocardial perfusion imaging, nuclear medicine, positron emission tomography computed tomography, radionuclide imaging, sarcoidosis, societies, medical, united states, practice guidelines as topic, Positron Emission Tomography Computed Tomography, MAGNETIC-RESONANCE, Image Processing, Computer-Assisted, Medicine, echocardiography, F-18-FDG PET, Positron Emission Tomography Computed Tomography/standards, ComputingMilieux_MISCELLANEOUS, Societies, Medical, medicine.diagnostic_test, HYPERTROPHIC CARDIOMYOPATHY, LATE GADOLINIUM ENHANCEMENT, Hypertrophic cardiomyopathy, Myocardial Perfusion Imaging, CORTICOSTEROID-THERAPY, imaging, Sarcoidosis/diagnostic imaging, General Medicine, F 18 fdg pet, Prognosis, Magnetic Resonance Imaging, 3. Good health, Europe, Positron emission tomography, Practice Guidelines as Topic, Cardiology, Nuclear Medicine/standards, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, Radiology, Sarcoidosis, STRAIN ECHOCARDIOGRAPHY, Cardiology and Cardiovascular Medicine, Cardiomyopathies, Cardiology/standards, Position statement, Diagnostic Imaging, medicine.medical_specialty, SPECKLE-TRACKING ECHOCARDIOGRAPHY, Systemic sarcoidosis, SYSTEMIC SARCOIDOSIS, Cardiac sarcoidosis, fluorodeoxyglucose, Imaging Sarcoidosis Myocardium, Myocardial perfusion imaging, 03 medical and health sciences, Cardiomyopathies/diagnostic imaging, Radionuclide Imaging/standards, societies, POSITRON-EMISSION-TOMOGRAPHY, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Fluorodeoxyglucose F18, Internal medicine, Medical imaging, cardiac MRI, Late gadolinium enhancement, Humans, Radiology, Nuclear Medicine and imaging, Radionuclide Imaging, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Multimodal Imaging/standards, business.industry, Magnetic Resonance Imaging/standards, Reproducibility of Results, LOW-CARBOHYDRATE-DIET, Magnetic resonance imaging, medicine.disease, n/a OA procedure, United States, Cardiac Imaging Techniques/standards, Cardiac Imaging Techniques, MYOCARDIAL FDG UPTAKE, inflammation, Positron-Emission Tomography, Position paper, Nuclear Medicine, business, Nuclear medicine, Tomography, X-Ray Computed
Abstract: International audience; This joint position paper illustrates the role and the correct use of echocardiography, radionuclide imaging with 18F-fluorodeoxyglucose positron emission tomography, radionuclide myocardial perfusion imaging and cardiovascular magnetic resonance imaging for the evaluation and management of patients with known or suspected cardiac sarcoidosis. This position paper will aid in standardizing imaging for cardiac sarcoidosis and may facilitate clinical trials and pooling of multi-centre data on cardiac sarcoidosis. Proposed flow charts for the work up and management of cardiac sarcoidosis are included.
Published: 2017

31. Cardiogenic shock management: Still a challenge and a need for large-registry data

Author: Eric Bonnefoy, Nicolas Lamblin, Guillaume Leurent, François Roubille, Clément Delmas, Jonchère, Laurent, Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE), 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), Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie (Hôpital Louis Pradel), Hospices Civils de Lyon (HCL), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Subjects: Registry, medicine.medical_specialty, business.industry, Cardiogenic shock, cardiogenic shock, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Clinical trial, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Études cliniques, Registre, medicine, Registry data, 030212 general & internal medicine, Medical emergency, Cardiology and Cardiovascular Medicine, Intensive care medicine, business, ComputingMilieux_MISCELLANEOUS, Choc cardiogénique
Abstract: International audience
Published: 2017

32. Pilot study using 3D–longitudinal strain computation in a multi-parametric approach for best selecting responders to cardiac resynchronization therapy

Author: Maxime, Fournet, Anne, Bernard, Sylvestre, Marechaux, Elena, Galli, Raphael, Martins, Philippe, Mabo, J Claude, Daubert, Christophe, Leclercq, Alfredo, Hernandez, Erwan, Donal, 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), CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupement Hospitalier de l'Institut Catholique de Lille, Faculté Libre de Médecine-UC Lille, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], ‘fondation de l’Avenir’ (Fondation de France). Grant ET2–654., Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), and Université catholique de Lille (UCL)-Université catholique de Lille (UCL)-UC Lille
Subjects: Male, Cardiac resynchronization therapy, lcsh:Diseases of the circulatory (Cardiovascular) system, Patient Selection, Research, Reproducibility of Results, Pilot Projects, Stroke Volume, Heart failure, Middle Aged, Three-dimensional echocardiography, Ventricular Dysfunction, Left, Dyssynchrony, Echocardiography, Predictive Value of Tests, lcsh:RC666-701, Image Interpretation, Computer-Assisted, Humans, Female, Vascular Resistance, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiac Resynchronization Therapy Devices, Algorithms, Aged
Abstract: International audience; BACKGROUND: Almost all attempts to improve patient selection for cardiac resynchronization therapy (CRT) using echo-derived indices have failed so far. We sought to assess: the performance of homemade software for the automatic quantification of integral 3D regional longitudinal strain curves exploring left ventricular (LV) mechanics and the potential value of this tool to predict CRT response. METHODS: Forty-eight heart failure patients in sinus rhythm, referred for CRT-implantation (mean age: 65 years; LV-ejection fraction: 26%; QRS-duration: 160 milliseconds) were prospectively explored. Thirty-four patients (71%) had positive responses, defined as an LV end-systolic volume decrease ≥15% at 6-months. 3D-longitudinal strain curves were exported for analysis using custom-made algorithms. The integrals of the longitudinal strain signals (I L,peak) were automatically measured and calculated for all 17 LV-segments. RESULTS: The standard deviation of longitudinal strain peak (SDI L,peak ) for all 17 LV-segments was greater in CRT responders than non-responders (1.18% s(-1) [0.96; 1.35] versus 0.83% s(-1) [0.55; 0.99], p = 0.007). The optimal cut-off value of SDI L,peak to predict response was 1.037%.s(-1). In the 18-patients without septal flash, SDI L,peak was significantly higher in the CRT-responders. CONCLUSIONS: This new automatic software for analyzing 3D longitudinal strain curves is avoiding previous limitations of imaging techniques for assessing dyssynchrony and then its value will have to be tested in a large group of patients.
Published: 2017

33. Bioprosthetic Valve Thrombosis

Author: Vincent Auffret, Rishi Puri, Josep Rodés-Cabau, Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Université Laval [Québec] (ULaval), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], 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), Edwards Lifesciences, Medtronic, Heart Leaflet Technologies, Federation Francaise de Cardiologie, Abbott, Biosensors, Terumo, Boston Scientific, and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, Prospective data, 030204 cardiovascular system & hematology, Computed tomographic, Bioprosthetic valve, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Internal medicine, medicine, Animals, Humans, Clinical significance, 030212 general & internal medicine, Heart valve, thrombolytic therapy, Subclinical infection, Bioprosthesis, Heart Valve Prosthesis Implantation, business.industry, Optimal treatment, Thrombosis, 4-dimensional computed tomography, thromboembolism, medicine.disease, 3. Good health, medicine.anatomical_structure, heart valve prosthesis, Cardiology, transcatheter aortic valve replacement, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Radiology, Cardiology and Cardiovascular Medicine, business, surgical aortic valve replacement
Abstract: International audience; Bioprosthetic valve (BPV) thrombosis is considered a relatively rare clinical entity. Yet a more recent analysis involving a more systematic echocardiographic follow-up, the advent of transcatheter heart valve (THV) technologies coupled with the highly sensitive nature of 4-dimensional computed tomographic imaging for detecting subclinical thrombi upon both surgically implanted and THVs, has generated enormous interest in this field, casting new light on both its true incidence and clinical relevance. Debate continues among clinicians as to both the clinical relevance of subclinical BPV thrombosis and the value of empirical oral anticoagulation following BPV implantation. Furthermore, currently no systematic, prospective data exist regarding the optimal treatment approach in THV recipients. The authors provide an overview of the clinical and subclinical spectrum of BPV thrombosis of surgical and THVs, outline its diagnostic challenges, summarize its pathophysiological basis, and discuss various therapeutic options that are emerging, particularly within the rapidly expanding field of THV implantation. (C) 2017 by the American College of Cardiology Foundation.
Published: 2017

34. Rational and design of EuroCRT: an international observational study on multi-modality imaging and cardiac resynchronization therapy

Author: Bogdan A. Popescu, Ivan Stankovic, Gerhard Hindricks, Chiara Bucciarelli-Ducci, E. Sade, Julien Magne, Maurizio Galderisi, Victoria Delgado, Eustachio Agricola, Thor Edvardsen, Sven Plein, Denisa Muraru, Bernard Cosyns, Ehud Schwammenthal, Christophe Leclercq, Patrizio Lancellotti, Marta Sitges, Erwan Donal, Alfredo Hernandez, Gilbert Habib, Clinical sciences, Cardio-vascular diseases, Donal, E, Delgado, V, Magne, J, Bucciarelli Ducci, C, Leclercq, C, Cosyns, B, Sitges, M, Edvardsen, T, Sade, E, Stankovic, I, Agricola, E, Galderisi, M, Lancellotti, P, Hernandez, A, Plein, S, Muraru, D, Schwammenthal, E, Hindricks, G, Popescu, B, Habib, G, 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 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [CHU Limoges], CHU Limoges, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Cardiology Department, Thorax Clinic Institute, Hospital Cliınic, Institut d'Investigacions Biomèdiques [Barcelona], Universitat de Barcelona (UB), Oslo University Hospital [Oslo], Università degli studi di Napoli Federico II, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-Research), Université de Liège, Universita degli Studi di Padova, National Institutes of Health, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), University of Naples Federico II = Università degli studi di Napoli Federico II, Università degli Studi di Padova = University of Padua (Unipd), Donal, Erwan, Delgado, Victoria, Magne, Julien, Bucciarelli-Ducci, Chiara, Leclercq, Christophe, Cosyns, Bernard, Sitges, Marta, Edvardsen, Thor, Sade, Elif, Stankovic, Ivan, Agricola, Eustachio, Galderisi, Maurizio, Lancellotti, Patrizio, Hernandez, Alfredo, Plein, Sven, Muraru, Denisa, Schwammenthal, Ehud, Hindricks, Gerhard, Popescu, Bogdan A., and Habib, Gilbert
Subjects: Male, Radiology, Nuclear Medicine and Imaging, Internationality, [SDV]Life Sciences [q-bio], medicine.medical_treatment, cardiac resynchronization therapy, Predictive Value of Test, Magnetic Resonance Imaging, Cine/methods, Speckle tracking echocardiography, cardiac magnetic resonance, echocardiography, observational study, strain, 030204 cardiovascular system & hematology, Multimodal Imaging, Cohort Studies, Ventricular Dysfunction, Left, 0302 clinical medicine, Ventricular Remodeling/physiology, Myocardial scarring, Prospective Studies, 030212 general & internal medicine, Cardiac imaging, Heart Failure/mortality, Ejection fraction, Ventricular Remodeling, medicine.diagnostic_test, Cardiac Imaging Techniques/methods, General Medicine, Middle Aged, Prognosis, 3. Good health, Europe, Survival Rate, Treatment Outcome, cardiovascular system, Cardiology, Female, Radiology, medicine.symptom, Ventricular Dysfunction, Left/diagnostic imaging, Cardiology and Cardiovascular Medicine, Multimodal Imaging/methods, Human, medicine.medical_specialty, Prognosi, Cardiac resynchronization therapy, Magnetic Resonance Imaging, Cine, Echocardiography/methods, Risk Assessment, Statistics, Nonparametric, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, Confidence Intervals, Journal Article, medicine, Medical imaging, Cardiac Resynchronization Therapy/methods, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Aged, Heart Failure, Cardiac Imaging Technique, business.industry, Magnetic resonance imaging, Original Articles, medicine.disease, Prospective Studie, Cardiac Imaging Techniques, Heart failure, Cohort Studie, business, Confidence Interval
Abstract: International audience; Aims: Assessment of left ventricular (LV) volumes and ejection fraction (LVEF) with cardiac imaging is important in the selection of patients for cardiac resynchronization therapy (CRT). Several observational studies have explored the role of imaging-derived LV dyssynchrony parameters to predict the response to CRT, but have yielded inconsistent results, precluding the inclusion of imaging-derived LV dyssynchrony parameters in current guidelines for selection of patients for CRT. Methods: The EuroCRT is a large European multicentre prospective observational study led by the European Association of Cardiovascular Imaging. We aim to explore if combing the value of cardiac magnetic resonance (CMR) and echocardiography could be beneficial for selecting heart failure patients for CRT in terms of improvement in long-term survival, clinical symptoms, LV function, and volumes. Speckle tracking echocardiography will be used to assess LV dyssynchrony and wasted cardiac work whereas myocardial scar will be assessed with late gadolinium contrast enhanced CMR. All data will be measured in core laboratories. The study will be conducted in European centres with known expertise in both CRT and multimodality cardiac imaging.
Published: 2017

35. Heart rate complexity analysis in Brugada syndrome during physical stress testing

Author: N. Behar, Alfredo Hernandez, Mireia Calvo, Daniel Romero, Philippe Mabo, Pedro Gomis, V Le Rolle, 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), Universitat Politècnica de Catalunya [Barcelona] (UPC), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent, and Universitat Politècnica de Catalunya. Departament d'Enginyeria de Sistemes, Automàtica i Informàtica Industrial
Subjects: Male, Physiology, Stress testing, risk stratification, 02 engineering and technology, Disease, 030204 cardiovascular system & hematology, 0302 clinical medicine, Heart Rate, Heart rate variability, ComputingMilieux_MISCELLANEOUS, Brugada Syndrome, Brugada syndrome, Heart, Signal Processing, Computer-Assisted, Middle Aged, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Cardiologia -- Informàtica, Cardiology, stress test, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Adult, Informàtica::Aplicacions de la informàtica::Bioinformàtica [Àrees temàtiques de la UPC], medicine.medical_specialty, Bioinformatics, 0206 medical engineering, Biomedical Engineering, Biophysics, Asymptomatic, Young Adult, 03 medical and health sciences, Bioinformàtica, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), Internal medicine, medicine, Humans, Exertion, Rest (music), [SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, business.industry, heart rate dynamics, autonomic nervous system, medicine.disease, 020601 biomedical engineering, Autonomic nervous system, Asymptomatic Diseases, Exercise Test, business
Abstract: Symptoms such as ventricular arrhythmias in Brugada syndrome (BS) typically occur at rest, especially during sleep, suggesting that the autonomic nervous system (ANS) function may be relevant in the arrhythmogenesis of the disease. The aim of this work was to assess the ANS response captured by a non-linear heart rate variability (HRV) measure in 69 patients diagnosed with BS, who underwent a standardized physical stress test. Heart rate complexity (HRC) was evaluated by the power-law scaling analysis (Beta slope) during rest, exercise, recovery and rest post-recovery, in order to discriminate between symptomatic and asymptomatic BS patients. Symptomatic patients showed a significant reduction in HRC in comparison to asymptomatic subjects, after exertion (p=0.015); during the whole recovery period (p=0.023), and, in particular within the passive recovery phase (p=0.025), as well as during rest post-recovery (p=0.022). Based on these results, symptoms could be associated with a lower ANS complexity during the stress test stages where parasympathetic activity is predominant. Therefore, the proposed HRV indicators could be of help in the risk stratification of asymptomatic patients.
Published: 2017

36. Changes in natriuretic peptides after acute hospital presentation for heart failure with preserved ejection fraction: A feasible surrogate trial endpoint? A report from the prospective Karen study

Author: Camilla Hage, Erwan Donal, Gianluigi Savarese, Cecilia Linde, Jean-Claude Daubert, Hans Persson, Emmanuel Oger, Lars H. Lund, Department of Cardiology, Karolinska Institutet [Stockholm]-Karolinska University Hospital [Stockholm], 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), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes], Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-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), and Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Research Report, heart failure with preserved ejection fraction, medicine.medical_specialty, Acute decompensated heart failure, Acute decompensated heart failure with preserved ejection fraction, Heart failure, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Natriuretic Peptide, Brain, medicine, Humans, Prospective Studies, Natriuretic peptides, 030212 general & internal medicine, Aged, Aged, 80 and over, Ejection fraction, Surrogate endpoint, business.industry, Proportional hazards model, Hazard ratio, Acute heart failure, Stroke Volume, Odds ratio, medicine.disease, Peptide Fragments, 3. Good health, Hospitalization, Acute Disease, Cardiology, Feasibility Studies, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, Heart failure with preserved ejection fraction, business, Biomarkers, Follow-Up Studies
Abstract: International audience; BACKGROUND: In acute decompensated heart failure (ADHF) with preserved ejection fraction (HFpEF) there are no surrogate endpoints for early phase trials. The aim of the current study was to evaluate whether a reduction in natriuretic peptides (NP) between acute hospital presentation to stable follow-up is associated with improved mortality and morbidity. METHODS: Patients presenting acutely to the hospital for ADHF with HFpEF enrolled in the Karolinska Rennes (KaRen) study and reporting N-terminal pro-B-type NP or B-type NP assessment at baseline hospital presentation and at 4-8weeks follow-up were prospectively studied. Logistic regression analyses were performed to detect the predictors of baseline and changes in NPs. Cox regression models were performed to assess the impact of NP reductions on mortality and the composite of mortality and HF hospitalization. RESULTS: Of 361 patients (median follow-up 585days), 267 (74%) reported an improvement in NPs, while 94 (26%) reported worsening. At baseline, the independent predictors of lower NPs were higher glomerular filtration rate (Odds Ratio [OR] per unit: 1.013; 95% Confidence Interval [CI]: 1.005-1.021) and younger age (OR per year: 0.972; CI: 0.947-0.998). Improvement in NPs at follow-up was predicted by higher heart rate at baseline (OR per bpm: 1.014; CI: 1.003-1.025). After adjustments, the hazard ratio for all-cause death was 0.730 (CI: 0.456-1.169) and for the composite outcome 0.814 (CI: 0.582-1.139) for patients who improved vs. worsened in NP levels. CONCLUSIONS: In patients presenting acutely to the hospital with HFPEF, an improvement in NP levels did not independently and significantly predict improved mortality and/or morbidity. NPs as surrogate endpoints in acute HFpEF require further study.
Published: 2017

37. The prognostic significance of atrial fibrillation in heart failure with preserved ejection function: insights from KaRen, a prospective and multicenter study

Author: Christian, Bosseau, Erwan, Donal, Lars H, Lund, Emmanuel, Oger, Camilla, Hage, Geneviève, Mulak, Jean-Claude, Daubert, Cecilia, Linde, Hans, Emtell, 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), Department of Cardiology, Karolinska Institutet [Stockholm]-Karolinska University Hospital [Stockholm], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pharmacologie [Rennes], Société française de cardiologie, Société Française de Cardiologie, Medtronic Bakken Research Center, 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 Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, medicine.medical_specialty, Heart Ventricles, Population, Heart failure, Comorbidity, 030204 cardiovascular system & hematology, Electrocardiography, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, atrial fibrillation, Sinus rhythm, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, education, Aged, Aged, 80 and over, Sweden, education.field_of_study, business.industry, Stroke Volume, Atrial fibrillation, Middle Aged, Preserved ejection fraction, Vascular surgery, Prognosis, medicine.disease, Survival Analysis, 3. Good health, Cardiac surgery, Echocardiography, Multivariate Analysis, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, Cardiology and Cardiovascular Medicine, business, Heart failure with preserved ejection fraction
Abstract: International audience; The prognostic value of atrial fibrillation (AF) in heart failure with preserved ejection fraction (HFPEF) remains controversial. We sought to study the prognostic value of AF in a prospective cohort and to characterize the HFPEF patients with AF. KaRen was a prospective, multicenter, international, observational study intended to characterize HFPEF; 538 patients presenting with an acute decompensated cardiac failure and a left ventricular EF > 45% were included. EKG and echocardiogram performed 4-8 week following the index hospitalization were analyzed in core centers. Clinical and echocardiographic characteristics of patients in sinus rhythm vs. with documented AF at enrolment (decompensated HF), upon their 4-8-week visit (in presumed stable clinical condition) and according to patients' cardiac history, were compared. The primary study endpoint was death from any cause or first hospitalization for decompensated heart failure (HF). A total of 413 patients (32% in AF) were analyzed, with a mean follow-up period of 28 months. The patients were primarily elderly individuals (mean age: 76.2 years), with a slight female predominance and a high prevalence of non-cardiovascular comorbidities. The baseline echocardiographic characteristics and the natriuretic peptide levels were indicative of a more severe heart condition among the patients with AF. However, the patients with AF exhibited a similar survival-free interval compared with the patients in sinus rhythm. In this elderly HFPEF population with a high prevalence of non-cardiovascular comorbidities, the presence of AF was not associated with a worse prognosis despite impaired clinical and echocardiographic features.ClinicalTrials.gov: NCT00774709.
Published: 2016

38. [Expert consensus statement on blood pressure measurement from the French Society of Hypertension, an affiliate of the French Society of Cardiology]

Author: Denolle, Thierry, Asmar, Roland, Boivin, Jean-Marc, Girerd, Xavier, Le Jeune, Sylvain, Vaisse, Bernard, Antakly-Hanon, Yara, Artifoni, Mathieu, Atallah, André, Bachelet, Christophe, Barber-Chamoux, Nicolas, Bejan-Angoulvant, Theodora, Blacher, Jacques, Boulestreau, Romain, Chantrel, François, Dimitrov, Yves, Doll, Gérard, Dugelay, Giselle, Duly-Bouhanick, Béatrice, Gosse, Philippe, Guerrot, Dominique, Jarraya, Faiçal, Lamirault, Guillaume, Lequeux, Benoît, Lopez-Sublet, Marilucy, Mercier, Alain, Millet, Laurène, Mounier-Vehier, Claire, Mourad, Jean-Jacques, Nasr, Edgar, Ormezzano, Olivier, Perez, Laurence, Persu, Alexandre, Ribstein, Jean, Silhol, François, Sosner, Philippe, Steyer, Elisabeth, Temmar, Mohamed, Van De Borne, Philippe, Vidal-Petiot, Emmanuelle, Service de cardiologie et maladies vasculaires [CHU de Rennes], CHU Pontchaillou [Rennes], Département de médecine générale [Univ. Lorraine], Université de Lorraine (UL), Service d'endocrinologie-métabolisme [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Hôpital de la Timone [CHU - APHM] (TIMONE), Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de cardiologie, Centre Hospitalier de la Basse Terre, CIC 501, Centre d’Investigation Clinique (CIC), Service de Pharmacologie Clinique, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Université de Bordeaux (UB), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Hôpital Saint-André, Service de Néphrologie [Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), 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), Service de cardiologie [CHU de Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Institut français de l'Education (IFÉ), École normale supérieure - Lyon (ENS Lyon), Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital avicenne, Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Avicenne, Clinique Cardiologie et Hypertension Artérielle, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) (MOVE), Université de Poitiers, Cabinet médical, Centre d'Investigations Préventives et Cliniques (CIPC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-hôpital Jean-Verdier, Department of Cardiology, Erasme University Hospital, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Société française d’hypertension artérielle (SFHTA), Service d’Endocrinologie, Métabolisme et Prévention des Risques Cardio-Vasculaires [CHU Pitié-Salpêtrière], 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Clermont-Ferrand, Université de Tours (UT), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Centre hospitalier de Haguenau, CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Sfax - University of Sfax, 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), Hôpital Avicenne [AP-HP], Cliniques Universitaires Saint-Luc [Bruxelles], Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Université de Tours, 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, Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Consensus, Time Factors, Hypertension, Humans, Blood Pressure Determination, France, Blood Pressure Monitoring, Ambulatory, Societies, Medical, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Since 2016, the French Society of Hypertension has warned about the decline in the management of high blood pressure in France: stagnation, or even decreased number of people who know their blood pressure level, take a treatment and are controlled. These results are lower than those observed in many other countries. Blood pressure is measured with an old method in the doctor's office. Accepted, simple and cost-effective, this method is currently unavoidable for reasons of feasibility and social habit. It has been used in observational and intervention studies that are the basis of the medical reasoning for screening, treatment and drug control of hypertension. In practice, it is too often poorly applied and unpredictable. It is now necessary to measure blood pressure in mmHg using a validated oscillometric automatic device coupled to a specific upper arm cuff adapted to the arm circumferences for the diagnosis and monitoring of high blood pressure in the doctor's office and at home. The auscultatoric measurement is only recommended if any doubt about the reliability of the electronic measurement. Blood pressure measurement is basically performed on both arms to detect asymmetry and then on the arm with the highest blood pressure. It is performed in sitting or lying position after a few minutes of rest without speaking and without having smoked and then in standing position to diagnose orthostatic hypotension, especially in elderly, diabetic and multi-medicated subjects. The blood pressure measurement during the consultation must be repeated and include at least 3 consecutive measurements at one minute intervals. The average of the last 2 measurements determines the blood pressure level. It is recommended to perform BP measurements outside the medical environment for the diagnosis and monitoring of hypertension; Home BP measurement is preferred to ambulatory blood pressure measurement for practical reasons unless otherwise specified. The home blood pressure measurement should include three measurements in the morning at breakfast and three measurements in the evening before bedtime at one minute intervals for at least three days. Prior training must be provided. In treated hypertensive patients, a masked hypertension should be considered as an uncontrolled hypertension and antihypertensive therapy adapted accordingly. The measurement of central BP pressure (aorta) should be limited to clinical research.
Published: 2019

39. [Expert consensus statement on blood pressure measurement from the French Society of Hypertension, an affiliate of the French Society of Cardiology]

Author: Thierry Denolle, Roland Asmar, Jean-Marc Boivin, Xavier Girerd, Sylvain Le Jeune, Bernard Vaisse, Yara Antakly-Hanon, Mathieu Artifoni, André Atallah, Christophe Bachelet, Nicolas Barber-Chamoux, Theodora Bejan-Angoulvant, Jacques Blacher, Romain Boulestreau, François Chantrel, Yves Dimitrov, Gérard Doll, Giselle Dugelay, Béatrice Duly-Bouhanick, Philippe Gosse, Dominique Guerrot, Faiçal Jarraya, Guillaume Lamirault, Benoit Lequeux, Marilucy Lopez-Sublet, Alain Mercier, Laurène Millet, Claire Mounier-Véhier, Jean-Jacques Mourad, Edgar Nasr, Olivier Ormezzano, Laurence Perez, Alexandre Persu, Jean Ribstein, François Silhol, Philippe Sosner, Elisabeth Steyer, Mohamed Temmar, Philippe Van De Borne, Emmanuelle Vidal-Petiot, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Société française d’hypertension artérielle (SFHTA), Département de médecine générale [Univ. Lorraine], Université de Lorraine (UL), Service d'Endocrinologie, Métabolisme et Prévention des Maladies Cardio-vasculaires [CHU Pitié-Salpêtrière], 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Service de médecine interne [Nantes], Université de Nantes (UN)-Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Clermont-Ferrand, Université de Tours (UT), Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Centre hospitalier de Haguenau, Hôpital Saint-André, Service de Néphrologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), 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), Université de Sfax - University of Sfax, 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 de cardiologie [CHU de Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Avicenne [AP-HP], Clinique Cardiologie et Hypertension Artérielle, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, 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), Cliniques Universitaires Saint-Luc [Bruxelles], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Laboratoire 'Mobilité, Vieillissement, Exercice' (MOVE) (MOVE), Université de Poitiers, Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], and Guerrot, Dominique
Subjects: medicine.medical_specialty, Evening, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, General Medicine, 030204 cardiovascular system & hematology, Sitting, 3. Good health, 03 medical and health sciences, Orthostatic vital signs, Masked Hypertension, 0302 clinical medicine, Blood pressure, Drug control, Ambulatory, Physical therapy, Medicine, Observational study, 030212 general & internal medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Since 2016, the French Society of Hypertension has warned about the decline in the management of high blood pressure in France: stagnation, or even decreased number of people who know their blood pressure level, take a treatment and are controlled. These results are lower than those observed in many other countries. Blood pressure is measured with an old method in the doctor's office. Accepted, simple and cost-effective, this method is currently unavoidable for reasons of feasibility and social habit. It has been used in observational and intervention studies that are the basis of the medical reasoning for screening, treatment and drug control of hypertension. In practice, it is too often poorly applied and unpredictable. It is now necessary to measure blood pressure in mmHg using a validated oscillometric automatic device coupled to a specific upper arm cuff adapted to the arm circumferences for the diagnosis and monitoring of high blood pressure in the doctor's office and at home. The auscultatoric measurement is only recommended if any doubt about the reliability of the electronic measurement. Blood pressure measurement is basically performed on both arms to detect asymmetry and then on the arm with the highest blood pressure. It is performed in sitting or lying position after a few minutes of rest without speaking and without having smoked and then in standing position to diagnose orthostatic hypotension, especially in elderly, diabetic and multi-medicated subjects. The blood pressure measurement during the consultation must be repeated and include at least 3 consecutive measurements at one minute intervals. The average of the last 2 measurements determines the blood pressure level. It is recommended to perform BP measurements outside the medical environment for the diagnosis and monitoring of hypertension; Home BP measurement is preferred to ambulatory blood pressure measurement for practical reasons unless otherwise specified. The home blood pressure measurement should include three measurements in the morning at breakfast and three measurements in the evening before bedtime at one minute intervals for at least three days. Prior training must be provided. In treated hypertensive patients, a masked hypertension should be considered as an uncontrolled hypertension and antihypertensive therapy adapted accordingly. The measurement of central BP pressure (aorta) should be limited to clinical research.
Published: 2019

40. A large thermal turbulent Taylor-Couette (THETACO) facility for investigation of turbulence induced by simultaneous action of rotation and radial temperature gradient

Author: Claude Houssin, Harminder Singh, Hugues Besnard, Innocent Mutabazi, Arnaud Prigent, Antoine Bonnesoeur, Olivier Crumeyrolle, Laboratoire Ondes et Milieux Complexes (LOMC), Centre National de la Recherche Scientifique (CNRS)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU), Postgraduate Program of Chemical Engineering, Universidade Federal de Sao Carlos, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de Physique Théorique (SPhT), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS), and Universidade Federal de São Carlos [São Carlos] (UFSCar)
Subjects: 010302 applied physics, [PHYS.PHYS.PHYS-FLU-DYN]Physics [physics]/Physics [physics]/Fluid Dynamics [physics.flu-dyn], Materials science, Turbulence, Reynolds number, Rayleigh number, Mechanics, 01 natural sciences, 7. Clean energy, 010305 fluids & plasmas, Physics::Fluid Dynamics, Temperature gradient, symbols.namesake, Particle image velocimetry, 0103 physical sciences, symbols, Annulus (firestop), Cylinder, Working fluid, Instrumentation
Abstract: A thermal turbulent Taylor-Couette facility has been designed to investigate turbulent flows generated by differential rotation and radial temperature gradient. It consists of a cylindrical annulus with a rotating inner cylinder and a fixed outer cylinder. The electric heating system is installed inside the inner cylinder, and the annulus is immersed in a large cylindrical container filled with cooling fluid. Temperature regulators independently control the temperature of the inner surface of the inner cylinder and that of the cooling fluid. The facility allows us to reach values of the Reynolds number (Re ∼ 5 × 105) and of the Rayleigh number (Ra ∼ 3 × 106) for water as the working fluid. The facility provides torque measurements, a full optical access at the side and from the bottom for velocity measurements using particle image velocimetry (2D, stereoscopic, and tomographic). Temperature measurements in the flow can be performed by thermochromic liquid crystals or laser induced fluorescence.
Published: 2019

41. Early Ventricular Arrhythmias After LVAD Implantation Is the Strongest Predictor of 30-Day Post-Operative Mortality

Author: Vincent Auffret, Walid Ghodbane, Stéphane Boulé, Annette Belin, Michel Kindo, Nicolas Jacob, Romain Eschalier, Gerard Babatasi, Mathieu Pernot, Philippe Rouvière, Fabien Garnier, Frédéric Anselme, Christophe Leclercq, Anne Rollin, Philippe Gaudard, Edeline Pelcé, David Hamon, Nicolas Lellouche, Thomas Senage, Jean-François Obadia, Nicolas D'Ostrevy, Arnaud Savouré, André Vincentelli, Olivier Chavanon, Marie-Cécile Bories, Vincent Galand, Vlad Gariboldi, Raphaël P. Martins, Matteo Pozzi, Erwan Flecher, Laurent Barandon, Pascal Defaye, Jean-Philippe Verhoye, Thierry Bourguignon, Camille Pichard, Hugues Blangy, Constance Verdonk, Thomas Cardi, Bertrand Pierre, Eloi Marijon, Fabrice Vanhuyse, Marie Bielefeld, Pierre Mondoly, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Univ Rennes, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Department of Cardiology and Cardiac Surgery, CHU Lille, Institut Coeur-Poumons, Lille, France, Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France, Department of Cardiovascular Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France, Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Department of Anesthesiology and Critical Care Medicine, Centre hospitalier universitaire de Nantes (CHU Nantes), Cardiac Stimulation and Rhythmology, CHU Grenoble, Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France, Hospital Bichat Paris, Department of Cardiology and Cardiac Surgery, Bichat-Hospital, Paris, France, Hôpital de la Timone [CHU - APHM] (TIMONE), Department of Cardiac Surgery, 'Louis Pradel' Cardiologic Hospital, Lyon, France, Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de chirurgie cardio-vasculaire et thoracique (CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Department of Cardiology and Cardiac Surgery, Tours University Hospital, Tours, France, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Clermont-Ferrand, 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), Cardiology Department, European Georges Pompidou Hospital, Paris, France, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Fédération Française de Cardiologie, 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), Department of Cardiology, Department of Cardiac Surgery, CHU de Toulouse, Toulouse, France, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-CHU Rouen
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Heart Ventricles, [SDV]Life Sciences [q-bio], Discharged alive, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Internal medicine, medicine, left ventricular assist device, Humans, Post operative mortality, Clinical significance, 030212 general & internal medicine, post-operative mortality, Aged, Retrospective Studies, ventricular arrhythmia, Heart Failure, Ejection fraction, business.industry, Incidence (epidemiology), Arrhythmias, Cardiac, Middle Aged, medicine.disease, 3. Good health, Heart failure, Ventricular assist device, Ventricular fibrillation, Cardiology, Female, Heart-Assist Devices, business
Abstract: International audience; Objectives - This study aimed to evaluate incidence, clinical significance, and predictors of early ventricular arrhythmias (VAs) in left ventricular assist device (LVAD) recipients. Background - LVAD implantation is increasingly used in patients with end-stage heart failure. Early VAs may occur during the 30-day post-operative period, but many questions remain unanswered regarding their incidence and clinical impact. Methods - This observational study was conducted in 19 centers between 2006 and 2016. Early VAs were defined as sustained ventricular tachycardia and/or ventricular fibrillation occurring
Published: 2019

42. EHRA White Paper: knowledge gaps in arrhythmia management-status 2019

Author: Goette, A., Auricchio, A., Boriani, G., Braunschweig, F., Terradellas, J.B., Burri, H., Camm, A.J., Crijns, H., Dagres, N., Deharo, J.C., Dobrev, D., Hatala, R., Hindricks, G., Hohnloser, S.H., Leclercq, C., Lewalter, T., Lip, G.Y.H., Merino, J.L., Mont, L., Prinzen, F., Proclemer, A., Purerfellner, H., Savelieva, I., Schilling, R., Steffel, J., Gelder, I.C. van, Zeppenfeld, K., Zupan, I., Heidbuchel, H., Boveda, S., Defaye, P., Brignole, M., Chun, J., Ramos, J.M.G., Fauchier, L., Svendsen, J.H., Traykov, V.B., Heinzel, F.R., ESC Sci Document Grp, Otto-von-Guericke-Universität Magdeburg, Center for Computational Medicine in Cardiology [Lugano], Università della Svizzera italiana = University of Italian Switzerland (USI), Università degli Studi di Modena e Reggio Emilia, University of Geneva [Switzerland], Hôpital de la Timone [CHU - APHM] (TIMONE), Goethe-University Frankfurt am Main, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Cardiology Department, Thorax Clinic Institute, Hospital Cliınic, Institut d'Investigacions Biomèdiques [Barcelona], Universitat de Barcelona (UB), Department of Physiology [Maastricht], Maastricht University [Maastricht], Universiteit Antwerpen [Antwerpen], RS: CARIM - R2.01 - Clinical atrial fibrillation, Cardiologie, MUMC+: MA Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, Fysiologie, RS: CARIM - R2 - Cardiac function and failure, RS: Carim - H06 Electro mechanics, Clinical sciences, Otto-von-Guericke-Universität Magdeburg = Otto-von-Guericke University [Magdeburg] (OVGU), Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia (UNIMORE), Université de Genève = University of Geneva (UNIGE), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Universiteit Antwerpen = University of Antwerpen [Antwerpen], Cardiovascular Centre (CVC), and ESC Sci Document Grp
Subjects: Biomedical Research, IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR, medicine.medical_treatment, Medizin, Management of atrial fibrillation, RHYTHM SOCIETY HRS, White Paper, Heart failure, 030204 cardiovascular system & hematology, Sudden death, 03 medical and health sciences, 0302 clinical medicine, White paper, Ventricular tachycardia ablation, AIAC ITALIAN ASSOCIATION, Physiology (medical), PERSISTENT ATRIAL-FIBRILLATION, Tachycardia, medicine, Humans, Organizational Objectives, 030212 general & internal medicine, PULMONARY VEIN ISOLATION, Societies, Medical, EXPERT CONSENSUS STATEMENT, European Heart Rhythm Association, CATHETER ABLATION, ddc:616, Medical education, CARDIAC-RESYNCHRONIZATION THERAPY, VENTRICULAR-TACHYCARDIA ABLATION, business.industry, Arrhythmia, Fibrillation, Cardiac arrhythmia, Arrhythmias, Cardiac, Subject (documents), Implantable cardioverter-defibrillator, ATRIOVENTRICULAR NODE ABLATION, 3. Good health, Heart Rhythm, Europe, Arrhythmias, Cardiac/therapy, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Human medicine, business, Cardiology and Cardiovascular Medicine
Abstract: Clinicians accept that there are many unknowns when we make diagnostic and therapeutic decisions. Acceptance of uncertainty is essential for the pursuit of the profession: bedside decisions must often be made on the basis of incomplete evidence. Over the years, physicians sometimes even do not realize anymore which the fundamental gaps in our knowledge are. As clinical scientists, however, we have to halt and consider what we do not know yet, and how we can move forward addressing those unknowns. The European Heart Rhythm Association (EHRA) believes that scanning the field of arrhythmia / cardiac electrophysiology to identify knowledge gaps which are not yet the subject of organized research, should be undertaken on a regular basis. Such a review (White Paper) should concentrate on research which is feasible, realistic, and clinically relevant, and should not deal with futuristic aspirations. It fits with the EHRA mission that these White Papers should be shared on a global basis in order to foster collaborative and needed research which will ultimately lead to better care for our patients. The present EHRA White Paper summarizes knowledge gaps in the management of atrial fibrillation, ventricular tachycardia/sudden death and heart failure.
Published: 2019

43. Is there still a role for the intra-aortic balloon pump in the management of cardiogenic shock following acute coronary syndrome?

Author: Laurent Bonello, Vincent Auffret, Marc Laine, Guillaume Leurent, Camille Pichard, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CCSD, Accord Elsevier, 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), Service de cardiologie et maladies vasculaires, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], and Centre recherche en CardioVasculaire et Nutrition (C2VN)
Subjects: Acute coronary syndrome, medicine.medical_specialty, Left ventricular unloading, medicine.medical_treatment, Shock, Cardiogenic, Hemodynamics, Infarctus du myocarde, 030204 cardiovascular system & hematology, Extracorporeal, 03 medical and health sciences, 0302 clinical medicine, Afterload, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, Acute Coronary Syndrome, Cardiogenic shock, Intra-aortic balloon pump, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Intra-Aortic Balloon Pumping, business.industry, Flux coronaire, Recovery of Function, General Medicine, medicine.disease, Coronary flow, Myocardial infarction, Treatment Outcome, Décharge ventriculaire gauche, Life support, Circulatory system, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Ballon de contre pulsion intra-aortique, Choc cardiogénique
Abstract: International audience; The intra-aortic balloon pump has been widely used in the management of cardiogenic shock. Reducing cardiac afterload and myocardial oxygen consumption, and improving coronary blood flow, this safe and simple mechanical circulatory support has been considered the cornerstone of cardiogenic shock management for decades. However, because it failed to provide any clinical benefit in recent randomized trials, the latest guidelines discourage its routine use in this clinical setting. Moreover, new percutaneous circulatory supports providing greater haemodynamic improvement have recently been developed. Thus, intra-aortic balloon pump use has declined considerably in this clinical setting. However, the device does retain a minor role in cardiogenic shock management - mainly in the setting of mechanical complication of acute coronary syndrome, and for left ventricular unloading in patients treated with extracorporeal life support.
Published: 2019

44. Incidence, predictors and clinical impact of electrical storm in patients with left ventricular assist devices: new insights from the ASSIST-ICD study

Author: Caroline Kerneis, Nicolas D'Ostrevy, Fabien Garnier, Frédéric Anselme, Edeline Pelcé, Magali Michel, Pierre Mondoly, Erwan Flecher, Pierre-Yves Litzler, Christophe Leclercq, Romain Eschallier, Fabrice Vanhuyse, Vincent Galand, Raphaël P. Martins, Matteo Pozzi, Jean-Baptiste Gourraud, Pascal Defaye, Nicolas Sadoul, Frederic Sacher, Marie Bielefeld, Nicolas Lellouche, Hamed Bourenane, Vincent Auffret, Pierre Bordachar, Stéphane Boulé, Michel Kindo, Valentin Loobuyck, Jérôme Jouan, Gerard Babatasi, Philippe Rouvière, Thierry Bourguignon, Olivier Chavanon, Philippe Gaudard, Annette Belin, David Hamon, Camille Dambrin, Walid Ghodhbane, Marie-Cécile Bories, Vlad Gariboldi, Thomas Cardi, Bertrand Pierre, Daniel Grinberg, CHU Pontchaillou [Rennes], Université de Rennes (UNIV-RENNES), 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Toulouse [Toulouse], Université de Bordeaux (UB), Université de Strasbourg (UNISTRA), CHU Strasbourg, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Grenoble, Hôpital Michallon, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Rouen, Normandie Université (NU), Service de cardiologie [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, 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 Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Fédération Française de Cardiologie, Université de Rennes (UR), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)
Subjects: Male, Radiofrequency ablation, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Left ventricular assist device, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Ventricular tachycardia, law.invention, Cohort Studies, Postoperative Complications, 0302 clinical medicine, law, Interquartile range, 030212 general & internal medicine, Incidence, Incidence (epidemiology), Age Factors, Middle Aged, Markov Chains, 3. Good health, Survival Rate, Cardiology, Female, ventricular tachycardia, Cardiology and Cardiovascular Medicine, electrical storm, Adult, medicine.medical_specialty, Risk Assessment, 03 medical and health sciences, Sex Factors, Predictive Value of Tests, Physiology (medical), Internal medicine, medicine, Humans, Survival rate, Aged, Proportional Hazards Models, Retrospective Studies, ventricular arrhythmia, Heart Failure, business.industry, medicine.disease, ventricular fibrillation, mortality, Ventricular assist device, Heart failure, Ventricular fibrillation, Tachycardia, Ventricular, Heart-Assist Devices, business
Abstract: International audience; Background - Ventricular arrhythmias (VAs) can occur after continuous flow left ventricular assist device (LVAD) implantation as a single arrhythmic event or as electrical storm (ES) with multiple repetitive VA episodes. Objective - We aimed at analyzing the incidence, predictors, and clinical impact of ES in LVAD recipients. Methods - Patients analyzed were those included in the multicenter ASSIST-ICD observational study. ES was consensually defined as occurrence of ≥3 separate episodes of sustained VAs within a 24-hour interval. Results - Of 652 patients with an LVAD, 61 (9%) presented ES during a median follow-up period of 9.1 (interquartile range [IQR] 2.5-22.1) months. The first ES occurred after 17 (IQR 4.0-56.2) days post LVAD implantation, most of them during the first month after the device implantation (63%). The incidence then tended to decrease during the initial years of follow-up and increased again after the third year post LVAD implantation. History of VAs before LVAD implantation and heart failure duration > 84 months were independent predictors of ES. The occurrence of ES was associated with an increased early mortality since 20 patients (33%) died within the first 2 weeks of ES. Twenty-two patients (36.1%) presented at least 1 recurrence of ES, occurring 43.0 (IQR 8.0-69.0) days after the initial ES. Patients experiencing ES had a significantly lower 1-year survival rate than did those free from ES (log-rank, P = .039). Conclusion - There is a significant incidence of ES in patients with an LVAD. The short-term mortality after ES is high, and one-third of patients will die within 15 days. Whether radiofrequency ablation of arrhythmias improves outcomes would require further studies.
Published: 2019

45. Automatic aortic root segmentation and anatomical landmarks detection for TAVI procedure planning

Author: Lucas Royer, Miguel Castro, Jacques Tomasi, Pascal Haigron, Vincent Auffret, Florent Lalys, Simon Esneault, Therenva SAS, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Therenva, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and Jonchère, Laurent
Subjects: Male, Aortic valve, medicine.medical_specialty, Aortic root, endovascular procedures, statistical-based methods, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, Transcatheter Aortic Valve Replacement, TAVI, Automation, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, Segmentation, Aorta, [SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Aged, 80 and over, active contour models, business.industry, Aortic Valve Stenosis, medicine.disease, Stenosis, medicine.anatomical_structure, Aortic Valve, Heart Valve Prosthesis, Cardiology, cardiovascular system, Female, Surgery, [SDV.IB]Life Sciences [q-bio]/Bioengineering, business, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing
Abstract: International audience; Purpose - Minimally invasive trans-catheter aortic valve implantation (TAVI) has emerged as a treatment of choice for high-risk patients with severe aortic stenosis. However, the planning of TAVI procedures would greatly benefit from automation to speed up, secure and guide the deployment of the prosthetic valve. We propose a hybrid approach allowing the computation of relevant anatomical measurements along with an enhanced visualization. Material and methods - After an initial step of centerline detection and aorta segmentation, model-based and statistical-based methods are used in combination with 3 D active contour models to exploit the complementary aspects of these methods and automatically detect aortic leaflets and coronary ostia locations. Important anatomical measurements are then derived from these landmarks. Results - A validation on 50 patients showed good precision with respect to expert sizing for the ascending aorta diameter calculation (2.2 ± 2.1 mm), the annulus diameter (1.31 ± 0.75 mm), and both the right and left coronary ostia detection (1.96 ± 0.87 mm and 1.80 ± 0.74 mm, respectively). The visualization is enhanced thanks to the aorta and aortic root segmentation, the latter showing good agreement with manual expert delineation (Jaccard index: 0.96 ± 0.03). Conclusion - This pipeline is promising and could greatly facilitate TAVI planning.
Published: 2019

46. Los fármacos antiarrítmicos no son la única opción en la tormenta eléctrica: el oxigenador extracorpóreo de membrana es una alternativa

Author: Martins, Raphaël P, Flecher, Erwan, Le Pennec-Prigent, Solène, Galand, Vincent, 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.IB]Life Sciences [q-bio]/Bioengineering, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2019

47. Stroke prevention in patients with atrial flutter: many questions still unanswered

Author: Maury, Philippe, Thambo, Jean Benoit, Maltret, Alice, Combes, Nicolas, Hascoet, Sébastien, Derval, Nicolas, Ladouceur, Magalie, Acar, Philippe, Amedro, Pascal, Anselm, Frederic, Bajolle, Fanny, Basquin, Adeline, Belli, Emre, Bordachar, Pierre, Duthoit, Guillaume, Di Filippo, Sylvie, Fauchier, Laurent, Gandjbakhch, Estelle, Gras, Daniel, Gronier, Celine, Karsenty, Clement, Klug, Didier, Koutbi, Linda, Lacotte, Jérôme, Laurent, Gabriel, Laux, Daniela, Mansourati, Jacques, Marijon, Eloi, Ovaert, Caroline, Sacher, Frederic, Sadoul, Nicolas, Taieb, Jérôme, Waldmann, Victor, Warin-Fresse, Karine, Defaye, Pascal, Piot, Olivier, Boveda, Serge, Chao, Tze-Fan, Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Pessac, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Clinique Pasteur [Toulouse], Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Department of Cardiology, Georges Pompidou European Hospital and Necker-Enfants Malades Hospital, AP-HP, Adult Congenital Heart Disease Unit, Centre de Référence des Malformations Cardiaques Congénitales Complexes (M3C), 75015 Paris, France, Inserm U970, PARCC, 75015 Paris, France., Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), M3C-Necker Enfants Malades, Université Paris Descartes, Sorbonne Paris Cité, Paris, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Pôle des Cardiopathies Congénitales, Marie Lannelongue Hospital, 92350 Le Plessis-Robinson, Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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), 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], Service de Cardiologie Pédiatrique, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Cabinet de Cardiologie Foetale Pediatrique et Congenitale Adulte et Groupement d'Exploration Radiologique et Cardiovasculaire, Clinique de l'Orangerie, 67000 Strasbourg, 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), and Université de Nantes (UN)-Université de Nantes (UN)
Subjects: medicine.medical_specialty, business.industry, MEDLINE, Atrial fibrillation, medicine.disease, [SHS]Humanities and Social Sciences, Physiology (medical), Internal medicine, Stroke prevention, medicine, Cardiology, In patient, Cardiology and Cardiovascular Medicine, business, Stroke, Atrial flutter, ComputingMilieux_MISCELLANEOUS, Cohort study
Abstract: International audience
Published: 2019

48. Risk factors and prognostic impact of left ventricular assist device–associated infections

Author: Marylou Para, Vincent Veniard, Louis Bernard, Vincent Auffret, Stéphane Boulé, Constance Verdonk, Laurent Barandon, Michel Kindo, Thierry Bourguignon, Pascal Defaye, Marie Bielefeld, David Hamon, Edeline Pelcé, Pierre Tattevin, Jérôme Jouan, Fabien Garnier, Philippe Gaudard, Pierre-Yves Litzler, Christophe Leclercq, Fabrice Vanhuyse, Nicolas Lellouche, Thomas Senage, Clément Delmas, Emilie Varlet, Thomas Cardi, Vlad Gariboldi, Daniel Grinberg, André Vincentelli, Arnaud Savouré, Erwan Flecher, Annette Belin, Nicolas Jacob, Gerard Babatasi, Philippe Rouvière, Romain Eschalier, Olivier Chavanon, Hugues Blangy, Camille Dambrin, Raphaël P. Martins, Matteo Pozzi, Nicolas D'Ostrevy, Vincent Galand, MORNET, Dominique, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Centre Hospitalier Universitaire de Lille (CHU de Lille), 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), Equipe 'Obésité et insuffisance cardiaque: approches moléculaires et cliniques ', 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)-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), Adaptation cardiovasculaire à l'ischemie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Bordeaux II, Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Grenoble] (CHU), Hôpital Michallon, Hospital Bichat Paris, Hospital,Bichat- Paris, Hôpital de la Timone [CHU - APHM] (TIMONE), Département de Chirurgie Cardiaque [Hôpital de la Timone - APHM], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, chirurgie cardio-vasculaire, 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), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French Federation of Cardiology, 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), Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN)
Subjects: Male, medicine.medical_specialty, Percutaneous, Prosthesis-Related Infections, medicine.medical_treatment, Heart Ventricles, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, Device Removal, Retrospective Studies, Heartmate ii, Pseudomonas aeruginosa, business.industry, Retrospective cohort study, Middle Aged, Prognosis, equipment and supplies, Cannula, 3. Good health, Icd implantation, Defibrillators, Implantable, [SDV] Life Sciences [q-bio], Staphylococcus aureus, Ventricular assist device, Catheter-Related Infections, Multivariate Analysis, Female, France, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Background - Left ventricular assist device (LVAD)-associated infections may be life-threatening and impact patients' outcome. We aimed to identify the characteristics, risk factors, and prognosis of LVAD-associated infections. Methods - Patients included in the ASSIST-ICD study (19 centers) were enrolled. The main outcome was the occurrence of LVAD-associated infection (driveline infection, pocket infection, or pump/cannula infection) during follow-up. Results - Of the 652 patients enrolled, 201 (30.1%) presented a total of 248 LVAD infections diagnosed 6.5 months after implantation, including 171 (26.2%), 51 (7.8%), and 26 (4.0%) percutaneous driveline infection, pocket infection, or pump/cannula infection, respectively. Patients with infections were aged 58.7 years, and most received HeartMate II (82.1%) or HeartWare (13.4%). Most patients (62%) had implantable cardioverter-defibrillators (ICDs) before LVAD, and 104 (16.0%) had ICD implantation, extraction, or replacement after the LVAD surgery. Main pathogens found among the 248 infections were Staphylococcus aureus (n = 113' 45.4%), Enterobacteriaceae (n = 61; 24.6%), Pseudomonas aeruginosa (n = 34; 13.7%), coagulase-negative staphylococci (n = 13; 5.2%), and Candida species (n = 13; 5.2%). In multivariable analysis, HeartMate II (subhazard ratio, 1.56; 95% CI, 1.03 to 2.36; P = .031) and ICD-related procedures post-LVAD (subhazard ratio, 1.43; 95% CI, 1.03-1.98; P = .031) were significantly associated with LVAD infections. Infections had no detrimental impact on survival. Conclusions - Left ventricular assist device-associated infections affect one-third of LVAD recipients, mostly related to skin pathogens and gram-negative bacilli, with increased risk with HeartMate II as compared with HeartWare, and in patients who required ICD-related procedures post-LVAD. This is a plea to better select patients needing ICD implantation/replacement after LVAD implantation.
Published: 2019

49. Long-Term Mortality and Early Valve Dysfunction According to Anticoagulation Use

Author: Stéphanie Rouanet, Olivier Barthelemy, Hélène Eltchaninoff, Jean Philippe Verhoye, Eric Van Belle, Martine Gilard, Géraud Souteyrand, Bernard Iung, Pavel Overtchouk, Gilles Montalescot, Pascal Leprince, Thierry Lefèvre, Jean-Philippe Collet, Eric Vicaut, Hervé Le Breton, Paul Guedeney, 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), StatEthic, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], CHU Pontchaillou [Rennes], Hôpital Privé Jacques Cartier [Massy], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Clermont-Ferrand, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [ICAN], Laboratoire Traitement du Signal et de l'Image [LTSI], Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 [RNMCD], Optimisation des régulations physiologiques [ORPHY (EA 4324)], CCSD, Accord Elsevier, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, 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), Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut Cardiovasculaire Paris Sud (ICPS), Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 (RNMCD), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de cardiologie et maladies vasculaires, Unité de Recherche Clinique Saint-Louis Lariboisère Fernand Widal, and Clinique Saint-Louis Lariboisère Fernand Widal
Subjects: medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], structural valve deterioration, anticoagulation therapy, TAVR, 030204 cardiovascular system & hematology, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aspirin, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Proportional hazards model, business.industry, Atrial fibrillation, Clopidogrel, medicine.disease, Confidence interval, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV] Life Sciences [q-bio], Cardiology, Long term mortality, Cardiology and Cardiovascular Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, medicine.drug
Abstract: International audience; Background: The optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) remains a matter of debate. Although dual antiplatelet therapy is recommended, single antiplatelet therapy or oral anticoagulation is frequently used according to the patient profile. Whether this approach may affect clinical outcome is unknown.Objectives: FRANCE TAVI (French Transcatheter Aortic Valve Implantation) is a prospective, multicenter, nationwide French registry. The study objectives were to identify independent correlates of long-term all-cause mortality and early bioprosthetic valve dysfunction (BVD), defined as increased prosthetic gradient ≥10 mm Hg or new gradient ≥20 mm Hg.Methods: To account for missing values, multiple imputations were performed. Stepwise multivariable Cox regression and logistic regression were used for all-cause mortality and bioprosthesis valve dysfunction was used, respectively. Sensitivity analysis retaining only patients with complete data were also performed.Results: Of 12,804 patients included in the registry between January 1, 2013, and December 31, 2015, a total of 11,469 (mean ± SE age: 82.8 ± 0.07 years; logistic European System for Cardiac Operative Risk Evaluation: 17.8 ± 0.1%; mean duration of follow-up: 495 ± 3.5 days) were alive at discharge with known antithrombotic treatment and were analyzed for mortality. A total of 2,555 patients had at least 2 echocardiographic evaluations and were eligible for BVD assessment. One-third of patients had a history of atrial fibrillation, and the same proportion had oral anticoagulation at discharge (n = 3,836). Neither aspirin nor clopidogrel was independently associated with mortality. Male sex (adjusted hazard ratio [aHR]: 1.63; 95% confidence interval [CI]: 1.44 to 1.84; p < 0.001), history of atrial fibrillation (aHR: 1.41; 95% CI: 1.23 to 1.62; p < 0.001), and chronic renal failure (aHR: 1.37; 95% CI: 1.23 to 1.53; p < 0.001) were the strongest independent correlates of mortality. Anticoagulation at discharge (adjusted odds ratio [aOR]: 0.54; 95% CI: 0.35 to 0.82; p = 0.005) and a nonfemoral approach (aOR: 0.53; 95% CI: 0.28 to 1.02; p = 0.049) were independently associated with lower rates of BVD, whereas chronic renal failure (aOR: 1.46; 95% CI: 1.03 to 2.08; p = 0.034) and prosthesis size ≤23 mm (aOR: 3.43; 95% CI: 2.41 to 4.89; p < 0.001) yielded higher risk of BVD.Conclusions: Sex, renal failure, and atrial fibrillation affected mortality the most at the 3-year follow-up. In contrast, anticoagulation (mostly given for atrial fibrillation) decreased the risk of BVD after TAVR.
Published: 2019

50. Semi-automated volume-strain loops: a new tool in TTE to assess diastolic dysfunction

Author: Arnaud Hubert, Alfredo Hernandez, V Le Rolle, Erwan Donal, Elena Galli, CHU Pontchaillou [Rennes], 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: [SDV.IB] Life Sciences [q-bio]/Bioengineering, medicine.medical_specialty, Ejection fraction, Longitudinal strain, business.industry, Amyloidosis, Complete Method, Ultrasound, Diastole, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Cardiac amyloidosis, Internal medicine, medicine, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Heart failure with preserved ejection fraction, ComputingMilieux_MISCELLANEOUS
Abstract: Aim This work aims to evaluate a novel semi-automatic tool for the assessment of volume-strain loops by transthoracic echocardiography (TTE). The proposed method was evaluated on a typical model of left ventricular (LV) diastolic dysfunction: the cardiac amyloidosis. Method Seventeen patients with proved cardiac amyloidosis and 18 patients with heart failure with preserved ejection fraction (HFpEF) were compared to 19 controls, from a local database. All TTE were performed using Vivid E9 or E95 ultrasound system (General Electrics Healthcare, Horten, Norway). The complete method includes several steps: 1) extraction of LV strain full traces from apical 4 and 2 cavities views, 2) estimation of LV volume from these two traces by spline interpolations, 3) resampling of LV strain curves, determined for the same cardiac beat, (in apical 4-, 2- and 3- cavities views) as a function of pre-defined percentage increments of LV-volume and 4) calculation of the LV volume-strain loop area. ( Fig. 1 , panel A) Results ( Table 1 ): LVEF was similar between all groups whereas global longitudinal strain was significantly lower in amyloidosis group than controls (−14.4 vs. −20.5%; P Fig. 1 , panel B, HFpEF in green). This area was better correlated with mean e’ (r = 0.650, P Conclusion LV volume-strain loop area appears a very promising new tool to assess semi-automatically diastolic function.
Published: 2019

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